Giver den digitale teknologi mulighed for, at vi udvikler sundhedsvæsenet i retning af en mere personlig og patientcentreret pleje og behandling?
DOI:
https://doi.org/10.7146/pl.v45i1.146547Nøgleord:
digitalisering, fremtidens sundhedsvæsen, patientcentreret pleje, brugerdreven innovation, digitale interaktionsformerResumé
I denne artikel anvendes de aktuelle anbefalinger fra Robusthedskommissionen til at undersøge, hvilke former for digitalisering der kan bidrage til at skabe et mere digitaliseret sundhedsvæsen med patient-centrerede løsninger. Et udvalg af nyere digitale sundhedsløsninger gennemgås i forhold til deresgrad af patient-centrering og innovative potentiale for at vurdere deres relevans for patienten som bruger. Via denne gennemgang identificeres tre centrale områder for digitalisering: kommunikation og informationsdeling, understøttelse af patientuddannelse og egenomsorg samt digitaliseret interaktion og intervention. Det diskuteres, hvilke fordele og ulemper digitalisering af sundhedsvæsenet kan medføre, både for brugerens tilgængelighed og samarbejde med sundhedsvæsenet, men også for accepten af digitaliseringen, herunder præferencer for dens udformning. Det konkluderes, at brugerperspektivet er centralt for de innovative udviklingsprocesser, hvis et digitaliseret sundhedsvæsen skal kunne tilbyde relevante personligt tilpassede sundhedsydelser til den enkelte patient.
Referencer
Akintomide, E., Shah, B., Sridharan, S., Visram, S., Sebire, N.J. & Peters, C. (2021). Clinical perception of effectiveness of virtual appointments and comparison with appointment outcomes at a specialist children’s hospital. Future healthcare journal, 8(3), e660-e665. https://doi.org/10.7861/fhj.2021-0044
Biddiss, E., Chan-Viquez, D., Cheung, S.T. & King, G. (2021). Engaging children with cerebral palsy in interactive computer play-based motor therapies: theoretical perspectives. Disability and Rehabilitation, 43(1), 133-147. https://doi.org/10.1080/09638288.2019.1613681
Brennan, D., Tindall, L., Theodoros, D., Brown, J., Campbell, M., Christiana, D., Smith, D., Cason, J. & Lee, A. (2010). A blueprint for telerehabilitation guidelines. International Journal of Telerehabilitation, 2(2), 31. https://doi.org/10.5195/ijt.2010.6063
Brouwers, R.W.M., van Exel, H.J., van Hal, J.M.C., Jorstad, H.T., de Kluiver, E.P., Kraaijenhagen, R.A., Kuijpers, M.J.C., van der Linde, M.R., Spee, R.F., Sunamura, M., Uszko-Lencer, N.H.M., Vromen, T., Wittekoek, M.E. & Kemps, H.M.C., on behalf of the Committee for Cardiovascular Prevention and Cardiac Rehabilitation of the Netherlands Society of Cardiology. (2020). Cardiac telerehabilitation as an alternativeto centre-based cardiac rehabilitation. Netherlands Heart Journal, 28, 443-451. https://doi.org/10.1007/s12471-020-01432-y
Clemensen, J., Rothmann, M.J., Smith, A.C., Caffery, L.J. & Danbjorg, D.B. (2017). Participatory design methods in telemedicine research. Journal of telemedicine and telecare, 23(9), 780-785. https://doi.org/10.1177/1357633X16686747
Craig, T.K., Rus-Calafell, M., Ward, T., Leff, J.P., Huckvale, M., Howarth, E., Emsley, R. & Garety, P.A. (2018). AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial. Lancet Psychiatry, 5(1), 31-40. https://doi.org/10.1016/S2215-0366(17)30427-3
Dalleck, L.C., Schmidt, L.K. & Lueker, R. (2011). Cardiac rehabilitation outcomes in a conventional versus telemedicine-based programme. Journal of Telemedicine and Telecare, 17(5), 217-221. https://doi.org/10.1258/jtt.2010.100407
Darcy, A., Daniels, J., Salinger, D., Wicks, P. & Robinson, A. (2021). Evidence of humanlevel bonds established with a digital conversational agent: Cross-sectional, retrospective observational study. JMIR Form Res, 5(5), e27868. https://doi.org/10.2196/27868
Deng, W., Hu, D., Xu, S., Liu, X., Zhao, J., Chen, Q., Liu, J., Zhang, Z., Jiang, W., Ma, L., Hong, X., Cheng, S., Liu, B. & Li, X. (2019). The efficacy of virtual reality exposure therapy for PTSD symptoms: A systematic review and meta-analysis. Journal of Affective Disorders, 257, 698-709. https//doi.org/10.1016/j.jad.2019.07.086
Dinesen, B., Dam Gade, J., Skov Schacksen, C., Spindler, H., Eie Albertsen, A., Dittmann, L., Jochumsen, M. & Svenstrup Møller, D. (2021). The Danish Future Patient Telerehabilitation Program for Patients With Atrial Fibrillation: Design and Pilot Study in Collaboration With Patients and Their Spouses. JMIR cardio, 5(2), e27321. https://doi.org/10.2196/27321
Dinesen, B., Dittmann, L., Gade, J.D., Jørgensen, C.K., Hollingdal, M., Leth, S., Melholt, C., Spindler, H. & Refsgaard, J. (2019). “Future Patient” Telerehabilitation for Patients With Heart Failure: Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 8(9), artikel e14517. https://doi.org/10.2196/14517
Dinesen, B., Hansen, H.K., Grønborg, G.B., Dyrvig, A.K., Leisted, S.D., Stenstrup, H., Schacksen, C.S. & Oestergaard, C. (2022a). Use of a Social Robot (LOVOT) for Persons With Dementia: Exploratory Study. JMIR Rehabilitation and Assistive Technologies, 9(3), e36505. https://doi.org/10.2196/36505
Dinesen, B., Huniche, L., Madsen, J.Ø. & Ugilt Østergaard, C. (2012). Brugerdreven innovation: at spotte behov for velfærdsteknologi hos mennesker med kronisk sygdom. Institut for Medicin og Sundhedsteknologi, Aalborg Universitet. http://www.telekat. dk/fileadmin/user_upload/Brugerdreven_innovation_at_spotte_behov_for_velfaedsteknologi_hos_mennesker_med_kronisk_sygdom.pdf
Dinesen, B., Spindler, H., Refsgaard, J. & Hollingdal, M. (2022b). Future Patient: Telerehabilitation of Patients With Heart Failure Empower Patients. Iproceedings, 8(1), artikel e41491. https://doi.org/10.2196/41491
Dithmer, M., Rasmussen, J.O., Grönvall, E., Spindler, H., Hansen, J., Nielsen, G., Sørensen, S.B. & Dinesen, B. (2016). “The Heart Game”: using gamification as part of a telerehabilitation program for heart patients. Games for health journal, 5(1), 27-33. https://doi.org/10.1089/g4h.2015.0001
Epstein, R.M. & Street, R.L., Jr (2011). The values and value of patient-centered care. Annals of family medicine, 9(2), 100-103. https://doi.org/10.1370/afm.1239
Flückiger, C., Del Re, A.C., Wampold, B.E. & Horvath, A.O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316. https://doi.org/10.1037/pst0000172
Garety, P., Edwards, C.J., Ward, T., Emsley, R., Huckvale, M., McCrone, P., Rus-Calafell, M., Fornells-Ambrojo, M., Gumley, A., Haddock, G., Bucci, S., McLeod, H., Hardy, A., Peters, E., Myin-Germeys, I. & Craig, T. (2021). Optimising AVATAR therapy for people who hear distressing voices: study protocol for the AVATAR2 multi-centre randomised controlled trial. Trials, 22(1), 1-17. https://doi.org/10.1186/s13063-021-05301-w
He, Y., Yang, L., Zhu, X., Wu, B., Zhang, S., Qian, C. & Tian, T. (2022). Mental health chatbot for young adults with depressive symptoms during the covid-19 pandemic: Single-blind, three-arm randomized controlled trial. J Med Internet Res, 24(11), e40719. https://doi.org/10.2196/40719
He, Y., Yang, L., Qian, C., Li, T., Su, Z., Zhang, Q. & Hou, X. (2023). Conversational agent interventions for mental health problems: systematic review and meta-analysis of randomized controlled trials. Journal of Medical Internet Research, 25, e43862. https://doi.org/10.2196/43862
Hougaard, E. (2019). Psykoterapi: Teori og forskning. Dansk Psykologisk Forlag.
Højgaard, H. (2016). Telemedicin medvirker til lige adgang til sundhedsydelser. Sygeplejersken, 2, 77-80.
Jensen, L.W.H., Dinesen, B., Kold, S. & Rahbek, O. (2022). Digital Communication Between Patients and Health Care Professionals Across Disciplines and Sectors After Hospital Discharge: Facilitators, Barriers, and Effects. Iproceedings, 8(1), [e41310]. https://doi.org/10.2196/41310
Kommission for robusthed i sundhedsvæsenet (2023). Robusthedskommissionens anbefalinger. Sundhedsministeriet. https://ism.dk/Media/638336462586551242/Robusthed-Samlet-Rapport-TILG.pdf
Kothgassner, O.D., Goreis, A., Kafka, J.X., Van Eickels, R.L., Plener, P.L. & Felnhofer, A. (2019). Virtual reality exposure therapy for posttraumatic stress disorder (PTSD): a meta-analysis. European journal of psychotraumatology, 10(1), 1654782. https://doi.org/10.1080/20008198.2019.1654782
Lund, S.R. (2023). Efter fire år: Danskerne får stadig ikke hjælp i junglen af sundhedsapps. Altinget https://www.altinget.dk/digital/artikel/efter-fire-aar-danskerne-faarstadig-ikke-hjaelp-i-junglen-af-sundhedsapps
Matsangidou, M., Otkhmezuri, B., Ang C.S., Avraamides, M., Riva G., Gaggioli, A., Iosif, D. & Karekla, M. (2022). “Now I can see me” designing a multi-user virtual reality remote psychotherapy for body weight and shape concerns. Human-Computer Interaction, 37(4), 314-340. https://doi.org/10.1080/07370024.2020.1788945
O’Donohue, W.T. & Draper, C. (2010). The case for evidence-based stepped care as part of a reformed delivery system. I W.T. O’Donohue & C. Draper (red.), Stepped care and e-health: Practical applications to behavioral disorders (s. 1-16). Springer New York. https://psycnet.apa.org/doi/10.1007/978-1-4419-6510-3_1
Oestergaard, C.U., Spindler, H. & Dinesen, B. (2022). Video and social rehabilitation of persons with mental illness helps to structure everyday life: a qualitative study. mHealth, 8(4). https://doi.org/10.21037/mhealth-21-14
Pettersson, B., Janols, R., Wiklund, M., Lundin-Olsson, L. & Sandlund, M. (2021). Older adults’ experiences of behavior change support in a digital fall prevention exercise program: Qualitative study framed by the self-determination theory. Journal of medical internet research, 23(7), e26235. https://doi.org/10.2196/26235
Pihl, A. (2022). Digitale sundhedsteknologier på recept. Ugeskrift for læger. https://ugeskriftet.dk/debat/digitale-sundhedsteknologier-pa-recept
Pinborg, K. (2019). Ny app giver danskere let adgang til egen læge. Dagens Medicin. https://dagensmedicin.dk/ny-app-giver-danskere-let-adgang-til-egen-laege/
Piotrowicz, E., Baranowski, R., Bilinska, M., Stepnowska, M., Piotrowska, M., Wójcik, A., Korewicki, J., Chojnowska, L., Lukasz, A.M., Klopotowski, M., Piotrowski, W. & Piotrowicz, R. (2010). A new model of home-based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life, and adherence. European journal of heart failure, 12(2), 164-171. https://doi.org/10.1093/eurjhf/hfp181
Prochaska, J.J., Vogel, E.A., Chieng, A., Kendra, M., Baiocchi, M., Pajarito, S. & Robinson, A. (2021). A therapeutic relational agent for reducing problematic substance use (woebot): Development and usability study. J Med Internet Res, 23(3), e24850. https://doi.org/10.2196/24850
Rehm, I.C., Foenander, E., Wallace, K., Abbott, J.A.M., Kyrios, M. & Thomas, N. (2016). What role can avatars play in e-mental health interventions? Exploring new models of client-therapist interaction. Frontiers in Psychiatry, 7, 186. https://doi.org/10.3389/fpsyt.2016.00186
Ryan, R.M., Patrick, H., Deci, E.L. & Williams, G.C. (2008). Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist, 10(1), 2-5. https://www.researchgate.net/publication/ 252435526_Facilitating_health_behavior_change_and_its_maintenance_Interventions_ based_on_Self-Determination_Theory
Shaver J. (2022). The State of Telehealth Before and After the COVID-19 Pandemic. Primary care, 49(4), 517-530. https://doi.org/10.1016/j.pop.2022.04.002
Sodemann, M. (2023). Ja, differentieret brug af sundhedsvæsenet er mere retfærdigt. Altinget. https://www.altinget.dk/sundhed/artikel/professor-i-sundhedssystemet-vinder-de-velstillede-patienter-til-enhver-tid-over-de-mindre-velstillede
Spindler, H., Hollingdal, M., Refsgaard, J. & Dinesen, B. (2021). Motivating patients in cardiac rehabilitation programs: a multicenter randomized controlled trial. International Journal of Telerehabilitation, 13(1). https://doi.org/10.5195/ijt.2021.6365
Sundhedsministeriet (2021). Personalised medicine for the benefit of patients. Sundhedsministeriet. https://sum.dk/Media/7/C/Personalised%20medicine%20for%20the%20benefit%20of%20patients%20publikation.pdf
Tidd, J. & Bessant, J. (2009). Managing Innovation. Integrating Tecnological, Market and Organizational Changes (4. udgave). John Wiley & Sons, Ltd.
YouGov (2021). International technology report 2021: Automation and AI. YouGov PLC. https://business.yougov.com/sectors/technology/international-technology-report-2021
Yohannes, A.M., Doherty, P., Bundy, C. & Yalfani, A. (2010). The long-term benefits of cardiac rehabilitation on depression, anxiety, physical activity and quality of life. Journal of Clinical Nursing, 19(19-20), 2806-2813. https://doi.org/10.1111/j.1365-2702.2010.03313.x
Downloads
Publiceret
Citation/Eksport
Nummer
Sektion
Licens
Ophavsret er tidsskriftets og forfatternes. Det er gældende praksis, at artikler publiceret i Psyke & Logos, som efterfølgende oversættes til andet sprog, af forfatteren frit kan publiceres i internationale tidsskrifter, dog således at det ved reference fremgår, at den oversatte artikel har et forlæg i en dansksproget version i Psyke & Logos. Artikler kan frit deles og linkes til på forsknings- og undervisningsnetværk (så som Blackboard). Link foretrækkes, fordi det giver oplysning om brug af tidsskriftets artikler.
