Introduction of novel complex integrated care models supported by digital health interventions in European primary settings: a scoping review

Abstract

Introduction

There remains the need to develop comprehensive organisational care models supported by digital health interventions (DHIs) to manage chronic conditions in primary healthcare.

Objective

this review aimed to identify and map methods, interventions and outcomes investigated regarding the introduction of novel complex integrated care models supported by DHIs in the European primary care setting, as well as the level of integration achieved.

Methods

a scoping review to identify literature from 2013 to 2023 in the European context was conducted across PubMed, Scopus and Web of Science. DHIs description, care models and outcomes were reported using the PRISMA- ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.

Results

A total of 53 studies was included. The models introduced, along with a DHI, at least one innovation in their structure or in the modality of care delivery: either a new figure (44%), interprofessional collaboration (37%), new functions like person-centred care (59%) or population stratification (11%). As regarding the DHIs, 56% implemented monitoring/management platforms and apps for chronic conditions. The most frequent combination of care model-DHI was the introduction of an app/platform, supported by phone calls/texts and electronic health records, paired with the introduction of a new healthcare professional/person centred care/ multidisciplinary team. All the studies reaching statistically significant outcomes introduced, along with one or more DHIs, either a new figure or a multidisciplinary team as part of the organizational change to support the technology.

Conclusions

novel complex integrated care models are focusing on introducing multidisciplinary perspectives and personalization of care, in line with the complex needs of chronic patients. The predominant development of monitoring/management platforms for patients is a further confirmation of this trend. Future research efforts should focus on the investigation of the effectiveness of current complex integrated care models integrating DHIs.