gms | German Medical Science

Introduction: The number of patients suffering from chronic diseases is rising globally, fostered by both demographic change and advances in medicine and public health [1]. Chronically ill patients, especially with increasing multimorbidity, require long-term, continuous treatment and care [2]. Fulfilling these requirements within the existing organizational structures poses a great challenge due to the prevailing segmentation of healthcare systems into primary, specialist and in-patient care. These services are often offered by different providers. eHealth is increasingly used in integrated care in Europe, but mostly limited to electronic medical records [3]. With new advances in mobile technologies, comprehensive mobile internet coverage and wide availability of mobile devices, major determining factors for the use of mobile applications as a means to overcome the barriers of chronic care, are better than ever The potential for mHealth applications to improve treatment compliance is described in a reivew [4]. This research project aims to evaluate possibilities and risks of mobile applications in promoting integrated care for chronically ill.

Methods: We have performed a feasibility study for an mHealth system in a resource constrained setting and searched the literature for the role of mHealth in integrated care. As a next step, requirements of mHealth applications for integrated care for people with chronic conditions will be investigated and defined through expert interviews and focus groups with key user groups. We will recruit providers (primary care and specialist physicians as well as chronic disease nurses) for semi-structured expert interviews and patients suffering from chronic disease for focus groups. Additionally, end user baseline will be collected. Once a working prototype is developed based off these requirements, a randomized, not blinded intervention study will be conducted in Germany and in a developing country. A group of patients will use the mHealth application to support their treatment, while a comparison group will receive the current standard of care. The duration of the study is to be determined. Besides measurement of treatment outcomes and patient satisfaction, a SWOT-analysis will be conducted.

Results: The study to investigate the feasibility of an mHealth system to improve the quality of care for diabetes patients through remote monitoring in rural Cameroon showed technical and organizational feasibility of mHealth in resource-limited settings, but also challenges regarding financial feasibility [5]. We have reviewed the literature for integrated care approaches for low- and middle-income countries and have identified mHealth solutions as a possible facilitator for integrated care [6].

Discussion: Literature and the preliminary results show the feasibility and potential of mHealth applications for chronically ill, but evidence is lacking. The study will help generate evidence on the requirements for and effect of mHealth for integrated care as well as organizational feasibility.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.