Impact of Patient-centered eHealth Applications on Patient Outcomes: A Review on the Mediating Influence of Human Factor Issues.
OBJECTIVE
To examine the evidence of the impact of patient- centered eHealth applications on patient care and to analyze if and how reported human factor issues mediated the outcomes.


METHODS
We searched PubMed (2014-2015) for studies evaluating the impact of patient-centered eHealth applications on patient care (behavior change, self-efficacy, and patient health-related outcomes). The Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model was used as a guidance framework to identify the reported human factors possibly impacting the effectiveness of an eHealth intervention.


RESULTS
Of the 348 potentially relevant papers, 10 papers were included for data analysis. None of the 10 papers reported a negative impact of the eHealth intervention. Seven papers involved a randomized controlled trial (RCT) study. Six of these RCTs reported a positive impact of the eHealth intervention on patient care. All 10 papers reported on human factor issues possibly mediating effects of patient-centered eHealth. Human factors involved patient characteristics, perceived social support, and (type of) interaction between patient and provider.


CONCLUSIONS
While the amount of patient-centered eHealth interventions increases, many questions remain as to whether and to what extent human factors mediate their use and impact. Future research should adopt a formal theory-driven approach towards human factors when investigating those factors' influence on the effectiveness of these interventions. Insights could then be used to better tailor the content and design of eHealth solutions according to patient user profiles, so as to enhance eHealth interventions impact on patient behavior, self-efficacy, and health-related outcomes.
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M.W.M. Jaspers, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam, Postbus 22660, 1100 DD, Amsterdam, Location J1B-114-2, The Netherlands, Tel: +31 20 5665 269, E-mail: m.w.jaspers@amc.uva.nl.
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D015438:Health Behavior; D006801:Humans; D018802:Patient-Centered Care; D020377:Self Efficacy; D012944:Social Support; D017216:Telemedicine; D016896:Treatment Outcome
behavior change; eHealth; health-related outcome; impact; patients; self-efficacy