Tech-Enabled Care for Chronic Conditions

Chronic diseases require continuous medical attention, often resulting in lasting impacts on patients and their families. Medical consultations are essential interactions between patients and healthcare professionals, focused on delivering treatment, offering health management guidance, and facilitating information exchange. The use of patient-operated Information and Communication Technologies (ICTs) is transforming care management. ICTs support medical professionals by enhancing the accuracy, completeness and frequency of patient information; and they empower patients to actively participate in their care and decision-making processes.

Chronic diseases encompass non-communicable diseases, including diabetes, cardiovascular diseases, and depression; and communicable diseases, such as AIDS and tuberculosis. The management of chronic diseases is characterised by long-term, ongoing medical attention and symptom management, with the potential for management to be lifelong (1). This condition has the potential to also impact patients’ parents, spouses, and informal caregivers (2, 3).

Patients with chronic diseases require self-management skills to cope with their condition in their daily lives. This may include following a medication routine and adhering to treatment plans, such as engaging in physical or occupational therapy, which can support the development of self-management skills. ICTs can support patients. Smartphone applications, commercial wearable devices or the Internet of Things (IoT) offer patients the opportunity to track, record and view their self-reported information (4).

Chronic diseases are often complex. Medical consultations based on missing, incomplete, or inaccurate information may result in a lower quality of care and a higher risk of medical errors (5). As a result, patients may not receive the necessary information and advice (6), which, along with inadequate follow-up, can contribute to depression and unhealthy lifestyle changes (7).

ICTs such as eHealth, mHealth and telemedicine can support interventions in chronic disease consultations. 

Key Themes in ICT-Based Health Interventions

Randine and colleagues conducted a literature review on ICT-based interventions in chronic care (8) identifying three key themes:

  • The purposes for which ICTs are used by patients, healthcare professionals, and others across the different stages of consultation (before, during, and after)
  • The types of information these technologies manage
  • How they address security and privacy concerns.

Why ICTs Are Used in Chronic Disease Management

ICTs empower patients to take an active role in consultations and support the long-term self-management of chronic conditions. They enable patients to track and manage their personal health data, such as symptoms, treatments, and lifestyle factors, while also improving disease understanding and addressing barriers like limited health literacy or insufficient follow-up.

For healthcare professionals, ICTs enhance the accuracy and completeness of patient information, reduce the risk of errors, and improve communication during consultations. It is also vital to note that they enable continuous monitoring and support across all stages of care (before, during, and after visits). This is essential for managing chronic conditions effectively.

Beyond the patient–clinician relationship, ICTs also promote family involvement in care through features that enable data sharing and participation in self-management activities. Evidence in the literature highlights this in two main ways: 

  1. Patients could invite family members to engage in the self-management of chronic heart failure (9); 
  2. Family members received notifications about a patient’s activities in the context of Parkinson’s disease (10).
 

Additionally, these technologies offer researchers valuable tools for developing and evaluating innovative health solutions and engagement strategies.

Overall, ICTs are reshaping the consultation process into a comprehensive model that integrates preparation, real-time interaction, and follow-up, promoting more informed, coordinated, and participatory chronic disease care.

Type of Information ICTs Manage

When used in chronic disease care, ICTs help manage a wide range of health-related data across nine key categories: identification, medical history, laboratory results, treatment, reminders, consultation media, physiological data, lifestyle parameters, and symptoms.

Physiological data, including blood pressure and oxygen saturation, was the most frequently managed category, Randine and colleagues have found. In nearly all the studies reviewed, devices like sensors and wearables were used to collect this information.

Information is gathered through two channels: manual input (mainly via smartphone apps, web portals and tablets) and automatic reporting (via wearables and sensors). Automatic data collection is generally preferred for reducing errors and easing the burden on patients and clinicians.

Comprehensive ICT-based interventions that span the entire consultation process (before, during, and after) were found to manage the broadest range of information and offer continuous support through tools like reminders and treatment updates.

 

How ICTs Address Security and Privacy Concerns

The information collected and processed from wearable sensors and IoT devices introduces security and privacy challenges (11-14). The sensitive nature of health information requires health systems to guarantee the secure storage, access to, and processing of personal identifiable information (15), potentially including it in medical consultations.

According to Randine and collaborators (8), security issues are more frequently addressed than privacy concerns in ICT-based health interventions, though often in a superficial way. Indeed, among 24 studies, most mentioned basic security measures (e.g. authentication, encryption), but only one referenced encrypted data storage.

Privacy was addressed in just eight studies, usually with vague references to regulations such as the General Data Protection Regulation (GDPR) in the European Union and European Economic Area, or the Health Insurance Portability and Accountability Act (HIPAA) in the US. These regulations have been introduced partly because smartphones and wearables are now collecting vast amounts of sensitive information. They provide organisations with guidance on how to store, access and process sensitive information, such as health data. Only two studies have described specific design strategies to protect patient data.

ICT-based interventions have the potential to transform chronic care by empowering patients and improving coordination throughout the consultation process. However, despite their growing use, particularly of wearables and sensors outside of clinical settings, there is still an urgent need for robust and transparent data protection. Legal constraints on data storage and hosting further emphasise the importance of integrating privacy safeguards and regulatory compliance into these technology designs.

Bibliography

  1. S. Bernell, S.W. Howard, Use your words carefully: what is a chronic disease? Front. Public Health 4 (2016) 159.
  2. C.M. Martin, Chronic disease and illness care: adding principles of family medicine to address ongoing health system redesign, Can. Fam. Physician 53 (2007) 2086–2091.
  3. M. Von Korff, J. Gruman, J. Schaefer, S.J. Curry, E.H. Wagner, Collaborative management of chronic illness, Am. Coll. Physicians (1997).
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  8. Randine, P., Sharma, A., Hartvigsen, G., Johansen, H. D., & Årsand, E. (2022). Information and communication technology-based interventions for chronic diseases consultation: Scoping review. International journal of medical informatics, 163, 104784.
  9. X. Guo, X. Gu, J. Jiang, H. Li, R. Duan, Y. Zhang, L. Sun, Z. Bao, J. Shen, F. Chen, A hospital-community-family–based telehealth program for patients with chronic heart failure: single-arm, prospective feasibility study, JMIR mHealth uHealth 7 (12) (2019) e13229.
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