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What's the Name of the Game?: The Impact of eHealth on Productive Interactions in Chronic Care Management
Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden..
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, S-17177 Stockholm, Sweden.. (HAL)ORCID iD: 0000-0002-4771-8349
Karolinska Inst, Dept Mol Med & Surg, Endocrine & Diabet Unit, S-17176 Stockholm, Sweden..
Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, S-17177 Stockholm, Sweden.;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Pediat Emergency Dept, S-17176 Stockholm, Sweden..
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2021 (English)In: Sustainability, E-ISSN 2071-1050, Vol. 13, no 9, article id 5221Article in journal (Refereed) Published
Abstract [en]

Chronic care management is dependent on productive interactions between patients and healthcare professionals. Digital health technologies (eHealth) open up new possibilities for improving the quality of care, but there is a limited understanding of what productive interactions entail. This study explores characteristics of productive interactions to support self-care and healthcare in the context of eHealth use in diabetes care. We collected qualitative data based on interviews with nurses and responses to open-ended survey questions from patients, prior to and post using an eHealth service for self-monitoring and digital communication. We found that eHealth's influence on productive interactions was characterized by unconstrained access, health parameter surveillance, and data-driven feedback, with implications for self-care and healthcare. Our findings indicate that eHealth perforates the boundaries that define interactions under traditional, non-digital care. This was manifested in expressions of uncertainty and in blurred boundaries between self-care and healthcare. We conclude that the attainment of a sustainable eHealth ecosystem will require healthcare to acknowledge eHealth as a disruptive change that may require re-organization to optimally support the productive use of eHealth services for both patients and staff, which includes agreement on new routines, as well as social interaction rules.

Place, publisher, year, edition, pages
MDPI , 2021. Vol. 13, no 9, article id 5221
Keywords [en]
eHealth, mHealth, home telehealth, self-tracking, self-monitoring, remote monitoring, coproduction, qualitative research, chronic care model
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-54277DOI: 10.3390/su13095221ISI: 000650877100001Scopus ID: 2-s2.0-85105914540OAI: oai:DiVA.org:mdh-54277DiVA, id: diva2:1557788
Available from: 2021-05-27 Created: 2021-05-27 Last updated: 2022-02-10Bibliographically approved

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