title: eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US.
abstract: Information technology (IT) in healthcare, also referred to as eHealth technologies, may offer a promising solution to the provision of better care and support for people who have multiple conditions and complex care needs, and their caregivers. eHealth technologies can include electronic medical records, telemonitoring systems and web-based portals, and mobile health (mHealth) technologies that enable information sharing between providers, patients, clients and their families. IT often acts as an enabler of improved care delivery, rather than being an intervention per se. But how are different countries seeking to leverage adoption of these technologies to support people who have chronic conditions and complex care needs? This article presents three case examples from Ontario (Canada), Scotland and Kaiser Permanente Colorado (United States) to identify how these jurisdictions are currently using technology to address multimorbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case and a final discussion addresses the future of eHealth for complex care needs. The case reports presented in this manuscript mark the foundational work of the Multi-National eHealth Research Partnership Supporting Complex Chronic Disease and Disability (the eCCDD Network); a CIHR-funded project intended to support the international development and uptake of eHealth tools for people with complex care needs.
authors.affiliation: Postdoctoral fellow in the Institute for Health Policy, Management and Evaluation in the Dalla Lana School of Public Health, University of Toronto, and in the Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenebaum Research Institute, Sinai Health System.
authors.forename: Carolyn Steele
authors.initials: CS
authors.lastname: Gray
authors.affiliation: The chair in Primary Care Research at the University of Glasgow.
authors.forename: Stewart
authors.initials: S
authors.lastname: Mercer
authors.affiliation: Physician manager for Clinical Reporting, physician investigator and practicing internist at Colorado Permanente Medical Group and Kaiser Permanente Institute for Health Research.
authors.forename: Ted
authors.initials: T
authors.lastname: Palen
authors.affiliation: Member of the Usher Institute of Population Health Sciences and Informatics, Centre for Population Health Sciences at the University of Edinburgh.
authors.forename: Brian
authors.initials: B
authors.lastname: McKinstry
authors.affiliation: Consultant physician in Geriatric Medicine and national clinic lead for Integrated Care in the Joint Improvement Team in Scotland.
authors.forename: Anne
authors.initials: A
authors.lastname: Hendry
mesh_terms: D002908:Chronic Disease / Q000628:therapy; D003120:Colorado; D015897:Comorbidity; D019468:Disease Management; D057286:Electronic Health Records / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D008491:Medical Informatics Applications; D018670:Monitoring, Ambulatory / Q000379:methods; D009864:Ontario; D012606:Scotland; D017216:Telemedicine / Q000331:legislation & jurisprudence / Q000458:organization & administration*