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Special Issue "E-health in Primary Care: Trends and Advances in Applications, Usage and Implementation"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 6504

Special Issue Editors

Prof. Dr. Roland Friele
E-Mail Website
Guest Editor
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
Interests: health services research
Dr. Lilian van Tuyl
E-Mail Website
Guest Editor
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
Interests: quality and organization of care; e-health; implementation; primary care
Dr. Anita Suijkerbuijk
E-Mail Website
Guest Editor
National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands
Interests: e-health; prevention; health economics; evaluation of national programs
Dr. Jiska Aardoom
E-Mail Website
Guest Editor
Department of Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
Interests: eHealth; public health and prevention; chronic disease; mental health; self-management
Special Issues, Collections and Topics in MDPI journals
Dr. Anke Versluis
E-Mail Website
Guest Editor
Department of Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
Interests: mHealth; eHealth; mental health; behavioral change; self-management; chronic diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Primary care organizations, such as general practices, pharmacists and physiotherapists, are continuously challenged to provide affordable, accessible and high quality care. E-health, which is defined as ‘health services and information delivered or enhanced through the Internet and related technologies’, might help to accomplish this. Modern technology enables remote care and can promote patient self-management. There is a rapid growth of e-health applications, and a growing number of people and healthcare organizations are recognizing the added value of e-health. The COVID-19 pandemic and subsequent social distancing measures have further stimulated the use of technology to provide remote care.

This transition from traditional healthcare to more digital healthcare does not take place over night and requires in-depth insight into the experiences and perceptions of healthcare providers and healthcare consumers. In addition, a thorough understanding of how e-health can be optimally integrated in the care processes is a prerequisite for the sustainable implementation of e-health within healthcare organizations.

This special issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the use of e-health technology in primary care and the perspectives and experiences of health care professionals and health care consumers with e-health technology. Original research papers, reviews, and case reports are welcome to this issue. Papers dealing with experiences gained during the COVID-19 pandemic are also welcome. Other manuscript types accepted include methodological papers, position papers, brief reports, and commentaries.

We welcome manuscripts with different topics, including implementation,  epidemiology, intervention studies, patient safety, and cost-effectiveness studies.

Prof. Dr. Roland Friele
Dr. Lilian van Tuyl
Dr. Anita Suijkerbuijk
Dr. Jiska Aardoom
Dr. Anke Versluis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • General practice
  • primary care
  • paramedic care
  • prevention
  • perspectives
  • experiences
  • e-health
  • innovation
  • COVID-19
  • implementation

Published Papers (5 papers)

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Research

Article
Developing a Smartphone Application That Promotes Responsible Short-Acting Beta2-Agonist Use in People with Asthma: A Participatory Design
Int. J. Environ. Res. Public Health 2022, 19(14), 8496; https://doi.org/10.3390/ijerph19148496 - 12 Jul 2022
Viewed by 728
Abstract
Around 339 million people worldwide have asthma, and 50% have uncontrolled asthma. One trait of uncontrolled asthma, often seen in primary care, is short-acting β2-agonist (SABA) overuse, defined as using SABA more than twice a week. SABA overuse can cause adverse health effects. [...] Read more.
Around 339 million people worldwide have asthma, and 50% have uncontrolled asthma. One trait of uncontrolled asthma, often seen in primary care, is short-acting β2-agonist (SABA) overuse, defined as using SABA more than twice a week. SABA overuse can cause adverse health effects. An application could help patients gain more insight into their SABA use. Engaging stakeholders during the development is important to maximize the usability of and adherence to an application. This study describes the development process of an application that promotes responsible SABA use in people with asthma, using a participatory design. Different stakeholder groups were involved in two iterative development cycles. In the first cycle, four end-users evaluated the app’s prototype. During the second cycle, five end-users were interviewed about the usability of the new version. Resulting in an app that allows patients to register SABA use, asthma symptoms, and symptom triggers. A graph shows how these factors are related, and end-users can show the graph to their physician to facilitate communication. Medication use is compared to the medical guidelines or, when applicable, to the advice given by the users’ healthcare professionals. End-users found the app helpful. Research into the usability and effectiveness of the app in a bigger sample will follow. Full article
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Article
“Get Used to the Fact That Some of the Care Is Really Going to Take Place in a Different Way”: General Practitioners’ Experiences with E-Health during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(9), 5120; https://doi.org/10.3390/ijerph19095120 - 22 Apr 2022
Viewed by 964
Abstract
The first outbreak of the COVID-19 pandemic led to the introduction of the more extensive use of e-health in Dutch general practices. The objective of this study was to investigate the experiences of general practitioners (GPs) regarding this change. In addition, the necessary [...] Read more.
The first outbreak of the COVID-19 pandemic led to the introduction of the more extensive use of e-health in Dutch general practices. The objective of this study was to investigate the experiences of general practitioners (GPs) regarding this change. In addition, the necessary conditions for e-health technology to be of added value to general practices were explored. In April 2020, 30 GPs were recruited for in-depth interviews via a web survey which contained questions regarding the use of e-health during the first wave of the pandemic. While most GPs intend to keep using e-health applications more extensively than before the pandemic, the actual use of e-health depends on several factors, including the characteristics of the application’s users. The following conditions for successful and sustainable implementation of e-health were identified: (1) integration of e-health technology in the organization of GP care, (2) sufficient user-friendliness of applications as well as digital skills of professionals and patients, and (3) adequate technological and financial support of e-health services. GPs clearly recognize the benefits of using e-health, and most GPs intend to keep using e-health applications more extensively than before the pandemic. However, improvements are needed to allow widespread and sustainable adoption of e-health technology in general practices. Full article
Article
Use of E-Health in Dutch General Practice during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(23), 12479; https://doi.org/10.3390/ijerph182312479 - 26 Nov 2021
Cited by 1 | Viewed by 1259
Abstract
The COVID-19 pandemic has forced general practices to search for possibilities to provide healthcare remotely (e.g., e-health). In this study, the impact of the pandemic on the use of e-health in general practices in the Netherlands was investigated. In addition, the intention of [...] Read more.
The COVID-19 pandemic has forced general practices to search for possibilities to provide healthcare remotely (e.g., e-health). In this study, the impact of the pandemic on the use of e-health in general practices in the Netherlands was investigated. In addition, the intention of practices to continue using e-health more intensively and differences in the use of e-health between practice types were investigated. For this purpose, web surveys were sent to general practices in April and July 2020. Descriptive data analysis was performed and differences in the use of e-health between practice types were tested using one-way ANOVA. Response rates were 34% (n = 1433) in April and 17% (n = 719) in July. The pandemic invoked an increased use of several (new) e-health applications. A minority of practices indicated the intention to maintain this increased use. In addition, small differences in the use of e-health between the different practice types were found. This study showed that although there was an increased uptake of e-health in Dutch general practice during the COVID-19 pandemic, only a minority of practices intends to maintain this increased use in the future. This may point towards a temporary uptake of digital healthcare delivery rather than accelerated implementation of digital processes. Full article
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Article
Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder
Int. J. Environ. Res. Public Health 2021, 18(22), 12056; https://doi.org/10.3390/ijerph182212056 - 17 Nov 2021
Cited by 3 | Viewed by 1226
Abstract
Virtual assistants are programs that interact with users through text or voice messages simulating a human-based conversation. The development of healthcare virtual assistants that use messaging platforms is rapidly increasing. Still, there is a lack of validation of these assistants. In particular, this [...] Read more.
Virtual assistants are programs that interact with users through text or voice messages simulating a human-based conversation. The development of healthcare virtual assistants that use messaging platforms is rapidly increasing. Still, there is a lack of validation of these assistants. In particular, this work aimed to validate the effectiveness of a healthcare virtual assistant, integrated within messaging platforms, with the aim of improving medication adherence in patients with comorbid type 2 diabetes mellitus and depressive disorder. For this purpose, a nine-month pilot study was designed and subsequently conducted. The virtual assistant reminds patients about their medication and provides healthcare professionals with the ability to monitor their patients. We analyzed the medication possession ratio (MPR), measured the level of glycosylated hemoglobin (HbA1c), and obtained the patient health questionnaire (PHQ-9) score in the patients before and after the study. We also conducted interviews with all participants. A total of thirteen patients and five nurses used and evaluated the proposed virtual assistant using the messaging platform Signal. Results showed that on average, the medication adherence improved. In the final interview, 69% of the patients agreed with the idea of continuing to use the virtual assistant after the study. Full article
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Article
Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach
Int. J. Environ. Res. Public Health 2021, 18(10), 5280; https://doi.org/10.3390/ijerph18105280 - 16 May 2021
Viewed by 1391
Abstract
The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians [...] Read more.
The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried out through six semi-structured interviews and two focus groups in a sample of eleven PCPs and five HAPs. Interviews were carried out from September 2019 to February 2020. Data were analysed by creating the initial categories, recording the sessions, transcribing the information, by doing a comprehensive reading of the texts obtained, and analysing the contents. The results show that DETELPROG gives the PCP greater prominence as a patient’s health coordinator by improving their relationship and patient safety; it also improves the relationship between PCP and HAP, avoiding unnecessary face-to-face referrals and providing safety to the PCP when making decisions. The barriers for DETELPROG to be used by PCP were defensive medicine, patients’ skepticism in DETELPROG, healthcare burden, and inability to focus on the patient or interpret a sign, symptom, or diagnostic test. For HAP, the barriers were lack of confidence in the PCP and complexity of the patient. As a conclusion, DETELPROG referral model provides a lot of advantages and does not pose any new barrier to face-to-face referral or other non-face-to-face referral models, so it should be implemented in primary care. Full article
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