scholarly journals BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments (Preprint)

2020 ◽  
Author(s):  
Jordi Piera-Jiménez ◽  
Signe Daugbjerg ◽  
Panagiotis Stafylas ◽  
Ingo Meyer ◽  
Sonja Müller ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Integrated Care ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Social Care ◽  
Intervention Group ◽  
Domiciliary Care ◽  
Comparator Group ◽  
Health And Social Care ◽  
Information And Communication

BACKGROUND Information and communication technology may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of information and communication technology in the context of integrated care models is relatively scarce. OBJECTIVE The objective of our study was to provide evidence on the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site in Spain. METHODS A quasi-experimental study was used to assess the cost-effectiveness of information and communication technology–enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Participants were followed for 8 months. RESULTS The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14, 95% CI –4.51 to 4.78; <i>P</i>=.95) but decreased in the comparator group (mean change –3.23, 95% CI –5.34 to –1.11; <i>P</i>=.003). Instrumental Activities of Daily Living significantly decreased in both groups: mean changes of –0.23 (95% CI –0.44 to –0.02; <i>P</i>=.03) and –0.33 (95% CI –0.46 to –0.20; <i>P</i>&lt;.001) in the intervention and comparator groups, respectively. No differences were found in the Geriatric Depression Scale (intervention: mean change 0.28, 95% CI –0.44 to 1.01, <i>P</i>=.44; comparator: mean change –0.29, 95% CI –0.59 to 0.01, <i>P</i>=.06). The intervention showed cost-effectiveness (incremental cost-effectiveness ratio €6505.52, approximately US $7582). CONCLUSIONS The information and communication technology–enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely upon the commitment of the professional staff involved. CLINICALTRIAL ClinicalTrials.gov NCT03111004; http://clinicaltrials.gov/ct2/show/ NCT03111004

scholarly journals BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments

10.2196/20938 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e20938
Author(s):  
Jordi Piera-Jiménez ◽  
Signe Daugbjerg ◽  
Panagiotis Stafylas ◽  
Ingo Meyer ◽  
Sonja Müller ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Integrated Care ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Social Care ◽  
Intervention Group ◽  
Domiciliary Care ◽  
Comparator Group ◽  
Health And Social Care ◽  
Information And Communication

Background Information and communication technology may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of information and communication technology in the context of integrated care models is relatively scarce. Objective The objective of our study was to provide evidence on the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site in Spain. Methods A quasi-experimental study was used to assess the cost-effectiveness of information and communication technology–enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Participants were followed for 8 months. Results The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14, 95% CI –4.51 to 4.78; P=.95) but decreased in the comparator group (mean change –3.23, 95% CI –5.34 to –1.11; P=.003). Instrumental Activities of Daily Living significantly decreased in both groups: mean changes of –0.23 (95% CI –0.44 to –0.02; P=.03) and –0.33 (95% CI –0.46 to –0.20; P<.001) in the intervention and comparator groups, respectively. No differences were found in the Geriatric Depression Scale (intervention: mean change 0.28, 95% CI –0.44 to 1.01, P=.44; comparator: mean change –0.29, 95% CI –0.59 to 0.01, P=.06). The intervention showed cost-effectiveness (incremental cost-effectiveness ratio €6505.52, approximately US $7582). Conclusions The information and communication technology–enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely upon the commitment of the professional staff involved. Trial Registration ClinicalTrials.gov NCT03111004; http://clinicaltrials.gov/ct2/show/ NCT03111004

Future Development of Medical Informatics from the Viewpoint of Health Telematics

2009 ◽  
Vol 48 (01) ◽  
pp. 55-61 ◽  
Author(s):  
K. P. Pfeiffer
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Information And Communication Technology ◽  
Medical Informatics ◽  
Communication Technology ◽  
Social Care ◽  
Care Process ◽  
Health And Social Care ◽  
Care Systems ◽  
Information And Communication

Summary Objectives: The transformation process of the health care systems in most countries in direction of integrated care needs the support of information and communication technology. The central element of this development is the electronic health care record. But there are many other applications around this record and the functionality and usability of these systems has to be improved and extended. Methods: A system-analytic approach to integrated care is used to analyze the possibilities and the role of information and communication technology in current and future health and social care systems. Results: The key elements of the improvements in the next years are the integration of evidence-based knowledge in the care process, the improvement of the usability for patients and health care providers, the development of pro-active systems for decision support, the support of the mobility of patients and the activities of daily living, the integration of data form molecular biology, semantic interoperability and last but not least the processing and analysis of these data. In a series of tables requirements of the functionality of eHealth applications are summarized. Conclusion: Research in medical informatics has to focus on strategic concepts and how to transform the demands of a modern integrated health and social care system into user-friendly, secure and efficient ICT solutions and to support the citizen’s responsibility for her/his own healthcare. But there is also a high demand for research to improve the technology of ICT systems in health and social care.

scholarly journals The Role of Information and Communication Technology (ICT) for Older Adults’ Decision-Making Related to Health, and Health and Social Care Services in Daily Life—A Scoping Review

2021 ◽  
Vol 19 (1) ◽  
pp. 151
Author(s):  
Susanna Nordin ◽  
Jodi Sturge ◽  
Maria Ayoub ◽  
Allyson Jones ◽  
Kevin McKee ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Scoping Review ◽  
Social Care ◽  
Care Services ◽  
Health And Social Care ◽  
Information And Communication

Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults’ decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults’ decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults’ use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.

scholarly journals Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Intervention Effectiveness and Cost-Effectiveness Study

10.2196/22135 ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. e22135
Author(s):  
Jordi de Batlle ◽  
Mireia Massip ◽  
Eloisa Vargiu ◽  
Nuria Nadal ◽  
Araceli Fuentes ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Usual Care ◽  
Integrated Care ◽  
Mobile Health ◽  
Social Care ◽  
Short Form ◽  
Care Model ◽  
Chronic Patients ◽  
Patient Centered ◽  
Health And Social Care

Background Integrated care can generate health and social care efficiencies through the defragmentation of care and adoption of patient-centered preventive models. eHealth can be a key enabling technology for integrated care. Objective The aim of this study was to assess the effectiveness and cost-effectiveness of the implementation of a mobile health (mHealth)-enabled integrated care model for complex chronic patients. Methods As part of the CONNECARE Horizon 2020 project, a prospective, pragmatic, two-arm, parallel implementation trial was held in a rural region of Catalonia, Spain. During 3 months, elderly patients with chronic obstructive pulmonary disease or heart failure and their carers experienced the combined benefits of the CONNECARE organizational integrated care model and the eHealth platform supporting it, consisting of a patient self-management app, a set of integrated sensors, and a web-based platform connecting professionals from different settings, or usual care. We assessed changes in health status with the 12-Item Short-Form Survey (SF-12), unplanned visits and admissions during a 6-month follow up, and the incremental cost-effectiveness ratio (ICER). Results A total of 48 patients were included in the integrated care arm and 28 patients receiving usual care were included in the control arm (mean age 82 years, SD 7 years; mean Charlson index 7, SD 2). Integrated care patients showed a significant increase in the SF-12 physical domain with a mean change of +3.7 (SD 8.4) (P=.004) and total SF-12 score with a mean change of +5.8 (SD 12.8) (P=.003); however, the differences in differences between groups were not statistically significant. Integrated care patients had 57% less unplanned visits (P=.004) and 50% less hospital admissions related to their main chronic diseases (P=.32). The integrated care program generated savings in different cost scenarios and the ICER demonstrated the cost-effectiveness of the program. Conclusions The implementation of a patient-centered mHealth-enabled integrated care model empowering the patient, and connecting primary, hospital, and social care professionals reduced unplanned contacts with the health system and health costs, and was cost-effective. These findings support the notion of system-wide cross-organizational care pathways supported by mHealth as a successful way to implement integrated care.

scholarly journals OBJECT ORIENTED METRIC BASED ANALYSIS OF TEXT TRANSMISSION IN E-LEARNING THROUGH NATURAL LANGUAGE STEGANOGRAPHY

2020 ◽  
Vol 4 (11) ◽  
pp. 68-74
Author(s):  
Soumendu Banerjee ◽  
Kh Amirul Islam ◽  
Sunil Karforma ◽  
Akash Nag
Keyword(s):  
Cost Effectiveness ◽  
Natural Language ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Object Oriented ◽  
Learning System ◽  
Proposed Model ◽  
Text Steganography ◽  
Information And Communication ◽  
E Learning

E-learning is an application of information and communication technology in the field of learning. Through steganography the e-learning institution can provide security to other participants of e-learning like teacher and learner. Here we use text steganography with modified SNOW algorithm while passing secret texts from the administrator to the learner in an e-learning system. In this paper, we calculate the object oriented metric based analysis of CK and MOOD metrics of our proposed model, which ensures the advantages of code redundancy, code reusability, and cost effectiveness and so on.

scholarly journals Information and communication technology use in daily life among young adults with mild-to-moderate intellectual disability

2018 ◽  
Vol 24 (3) ◽  
pp. 289-308 ◽  
Author(s):  
Camilla Ramsten ◽  
Lene Martin ◽  
Munir Dag ◽  
Lena Marmstål Hammar
Keyword(s):  
Young Adults ◽  
Intellectual Disability ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Family Relationships ◽  
Technology Use ◽  
Social Care ◽  
Daily Life ◽  
Structured Interviews ◽  
Information And Communication

Background: Information and communication technology (ICT) increases participation in life activities, and young adults are frequent users. Young adults with intellectual disability (ID) do not use ICT as much as their peers, and little is known about how ICT is used by young adults with ID. This study describes the use of ICT from the perspective of young adults with mild to moderate ID in a municipal social care context. Method: Semi-structured interviews were used to collect information from 11 young adults with mild-to-moderate ID living in residential care and analysed using a content analysis. Results: ICT was used for family relationships, daily support, interactions based on interests and amusement, and as support for offline activities. Family members were important providers of support for ICT use. Conclusion: Young adults with mild-to-moderate ID use ICT in their daily life. The social care context needs to be further investigated due to its influence on the young adults’ access to ICT and need of support.

scholarly journals Web-Based Interventions Supporting Adolescents and Young People With Depressive Symptoms: Systematic Review and Meta-Analysis (Preprint)

2017 ◽  
Author(s):  
Maritta Välimäki ◽  
Katriina Anttila ◽  
Minna Anttila ◽  
Mari Lahti
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Meta Analysis ◽  
Intervention Group ◽  
Short Term ◽  
Web Based ◽  
Information And Communication ◽  
The Web

BACKGROUND Although previous studies on information and communication technology (ICT)–based intervention on mental health among adolescents with depressive symptoms have already been combined in a number of systematic reviews, coherent information is still missing about interventions used, participants’ engagement of these interventions, and how these interventions work. OBJECTIVE We conducted a systematic review and meta-analysis of trials to describe the effectiveness of Web-based interventions to support adolescents with depression or depressive symptoms, anxiety, and stress. We also explored the content of the interventions, as there has previously been a lack of coherent understanding of the detailed content of the Web-based interventions for these purposes. METHODS We included parallel randomized controlled trials targeted at adolescents, or young people in the age range of 10 and 24 years, with symptoms or diagnoses of depression and anxiety. The interventions were from original studies aimed to support mental health among adolescents, and they were delivered via Web-based information and communication technology. RESULTS Out of 2087 records identified, 27 papers (22 studies) met the inclusion criteria. On the basis of a narrative analysis of 22 studies, a variety of Web-based interventions were found; the most commonly used intervention was based on cognitive behavioral therapy. Meta-analysis was further conducted with 15 studies (4979 participants). At the end of the intervention, a statistically significant improvement was found in the intervention group (10 studies) regarding depressive symptoms (P=.02, median 1.68, 95% CI 3.11-0.25) and after 6 months (3 studies; P=.01, median 1.78, 95% CI 3.20-0.37). Anxiety symptoms (8 studies; P<.001, median 1.47, 95% CI 2.36-0.59) and moods and feelings (2 studies; P=.04, median 5.55, 95% CI 10.88-0.22) improved as well in the Web-based intervention group, but there was no difference in stress scores. However, adolescents in the intervention group left the study early more often, both in short-term studies (11 studies; P=.007, median 1.31, 95% CI 1.08-1.58) and mid-term studies (3 studies; P=.02, median 1.65, 95% CI 1.09-2.49). We did not find any studies that had assessed the costs of the Web-based interventions. CONCLUSIONS Despite widely reported promises that information technology use is beneficial to adolescents with depression, the results of our review show only short-term effects on adolescents’ mental well-being, whereas long-term effects remain questionable because of the limited number of studies reviewed. Information about the economic benefits of Web-based interventions is still lacking. The quality of the studies, especially biases related to attrition rates and selective reporting, still needs serious attention.

scholarly journals Modelling the Economic Impact of Reducing Loneliness in Community Dwelling Older People in England

2021 ◽  
Vol 18 (4) ◽  
pp. 1426
Author(s):  
David McDaid ◽  
A-La Park
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Older People ◽  
Social Care ◽  
Intervention Group ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Social Activities ◽  
Potential Cost ◽  
Health And Social Care

Loneliness has been associated with poor mental health and wellbeing. In England, a 2018 national strategy on loneliness was published, and public health guidelines recommend participation in social activities. In the absence of existing economic evidence, we modelled the potential cost effectiveness of a service that connects lonely older people to social activities against no-intervention. A 5-year Markov model was constructed from a health and social care perspective. Parameters were drawn from the literature, with the intervention structure based on an existing loneliness alleviation programme implemented in several settings across England. Univariate and probabilistic sensitivity analyses were undertaken. The total expected cost per participant in the intervention group is £7131 compared to £6783 in the usual care group with 0.45 loneliness free years (LFY) gained. The incremental cost per LFY gained is £768; in the probabilistic sensitivity analysis the intervention is cost saving in 3.5% of iterations. Potentially such interventions may be cost-effective but are unlikely to be cost-saving even allowing for sustained effects and cumulative adverse health and social care events averted. Empirical studies are needed to determine the cost-effectiveness of these interventions, ideally mapping changes in loneliness to the quality of life, in order to allow the key metric in health economic studies, cost per quality adjusted life year to be estimated.

scholarly journals Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Intervention Effectiveness and Cost-Effectiveness Study (Preprint)

2020 ◽  
Author(s):  
Jordi de Batlle ◽  
Mireia Massip ◽  
Eloisa Vargiu ◽  
Nuria Nadal ◽  
Araceli Fuentes ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Usual Care ◽  
Integrated Care ◽  
Mobile Health ◽  
Social Care ◽  
Short Form ◽  
Care Model ◽  
Chronic Patients ◽  
Patient Centered ◽  
Health And Social Care

BACKGROUND Integrated care can generate health and social care efficiencies through the defragmentation of care and adoption of patient-centered preventive models. eHealth can be a key enabling technology for integrated care. OBJECTIVE The aim of this study was to assess the effectiveness and cost-effectiveness of the implementation of a mobile health (mHealth)-enabled integrated care model for complex chronic patients. METHODS As part of the CONNECARE Horizon 2020 project, a prospective, pragmatic, two-arm, parallel implementation trial was held in a rural region of Catalonia, Spain. During 3 months, elderly patients with chronic obstructive pulmonary disease or heart failure and their carers experienced the combined benefits of the CONNECARE organizational integrated care model and the eHealth platform supporting it, consisting of a patient self-management app, a set of integrated sensors, and a web-based platform connecting professionals from different settings, or usual care. We assessed changes in health status with the 12-Item Short-Form Survey (SF-12), unplanned visits and admissions during a 6-month follow up, and the incremental cost-effectiveness ratio (ICER). RESULTS A total of 48 patients were included in the integrated care arm and 28 patients receiving usual care were included in the control arm (mean age 82 years, SD 7 years; mean Charlson index 7, SD 2). Integrated care patients showed a significant increase in the SF-12 physical domain with a mean change of +3.7 (SD 8.4) (<i>P</i>=.004) and total SF-12 score with a mean change of +5.8 (SD 12.8) (<i>P</i>=.003); however, the differences in differences between groups were not statistically significant. Integrated care patients had 57% less unplanned visits (<i>P</i>=.004) and 50% less hospital admissions related to their main chronic diseases (<i>P</i>=.32). The integrated care program generated savings in different cost scenarios and the ICER demonstrated the cost-effectiveness of the program. CONCLUSIONS The implementation of a patient-centered mHealth-enabled integrated care model empowering the patient, and connecting primary, hospital, and social care professionals reduced unplanned contacts with the health system and health costs, and was cost-effective. These findings support the notion of system-wide cross-organizational care pathways supported by mHealth as a successful way to implement integrated care.

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