The Role of eHealth in Supporting Care Coordination

  • Nick Goodwin
  • Albert Alonso
Part of the The Palgrave Macmillan IESE Business Collection book series (IESEBC)


All western industrialised nations face important new challenges in meeting the long-term health and social care needs of their populations. Over the past two decades, an important demographic and epidemiological transition has taken place. Age-related and long-term chronic illnesses have replaced communicable diseases as the biggest challenge that health systems must now address. More than half of the growing number of people aged over 65 in Europe are living with more than three chronic conditions, and about one-fifth have five or more concurrent health problems (Anderson and Horvath, 2004). This shift means that the economic burden of age-related chronic illness represents between 75–80 per cent of healthcare expenditure, a figure that is also expected to rise as society ages (Nolte and McKee, 2008). Current health and care systems, however, appear to be ill equipped to meet the challenge as they have developed systemic and institutional structures that focus on cure rather than care. As a result, and particularly in an era of economic uncertainty, most countries and regions have begun the search for new and more integrated care models — supported by technological innovation — that place the emphasis on preventing ill health, supporting self-care and delivering care closer to people’s homes.


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  1. Ali, M.K., Shah, S. and Tandon, N. (2011), “Review of electronic decision-support tools for diabetes care: a viable option for low-and middle-income countries?”, Journal of Diabetes Science and Technology 5(3): 553–570.CrossRefGoogle Scholar
  2. Anchala, R., Pinto, M.P., Shroufi, A., Chowdhury, R., Sanderson, J., Johnson, L., Blanco, P., Prabhakaran, D. and Franco, O.H. (2012), “The role of Decision Support System (DSS) in prevention of cardiovascular disease: a systematic review and meta-analysis”, PLoS.One 7(10): e47064.CrossRefGoogle Scholar
  3. Anderson, G. and Horvath, J. (2004), “The growing burden of chronic disease in America”, Public Health Reports 119(3): 263–270.CrossRefGoogle Scholar
  4. Berwick, D.M., Nolan, T.W. and Whittington, J. (2008), “The triple aim: care, health, and cost”, Health Affairs (Millwood.) 27(3): 759–769.CrossRefGoogle Scholar
  5. Billings, J., Dixon, J., Mijanovich, T. and Wennberg, D. (2006), “Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients”, British Medical journal 333(7563): 327.CrossRefGoogle Scholar
  6. Billings, J., Carretero, S., Kagialaris, G., Mastroyiannakis, T and Meriläinen-Porras, S. (2013), “The role of information technology in long term care for older people”, in Leichsenring, K., Billings, J. and Nies, H. (eds) Long-Term Care in Europe. Improving Policy and Practice. Palgrave Macmillan: Basingstoke.Google Scholar
  7. Bodenheimer, T (2008), “Coordinating care — a perilous journey through the health care system”. North England journal of Medicine 358(10): 1064–1071.CrossRefGoogle Scholar
  8. Carretero, S., Stewart, J., Centeno, C., Barbabella, F., Schmidt, A., Lamontagne-Godwin, F. and Lamura, G. (2012), Can Technology-Based Services support Long-term Care Challenges in Home Care? Joint Research Centre, JRC77709.Google Scholar
  9. Clark, M. and Goodwin, N. (2010), Sustaining Innovation in Telehealth and Telecare. The King’s Fund, London.Google Scholar
  10. Coleman, K., Austin, B.T., Brach, C. and Wagner, E.H. (2009), “Evidence on the Chronic Care Model in the new millennium”, Health Affairs (Millwood.) 28(1): 75–85.CrossRefGoogle Scholar
  11. COM, (2007), Commission of the European Communities, A Lead Market Initiative for Europe. Brussels, COM(2007) 860 final.Google Scholar
  12. COM, (2010), Commission of the European Communities, A Digital Agenda for Europe. Brussels, COM(2010) 245 final/2.Google Scholar
  13. Darkins, A., Ryan, P., Kobb, R., Foster, L., Edmonson, E., Wakefield, B. and Lancaster, A.E. (2008), “Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions”, Telemedicine journal and EHealth 14(10): 1118–1126.CrossRefGoogle Scholar
  14. Divall, P., Camosso-Stefinovic, J. and Baker, R. (2013), “The use of personal digital assistants in clinical decision making by health care professionals: a systematic review”, Health Informatics journal 19(1): 16–28.CrossRefGoogle Scholar
  15. Edgren, L. and Barnard, K. (2012), “Complex adaptive systems for management of integrated care”, Leadership in Health Services 25(1): 39–51.CrossRefGoogle Scholar
  16. European Commission (2013). European Innovation Partnership on Active and Healthy Ageing, 2013. 27 August 2013. (Electronic Citation)
  17. Georghiou, T., Steventon, A., Billings, J., Blunt, I., Lewis, G. and Bardsley M. (2011), Predictive Risk and Health Care: An Overview, London: Nuffield Trust.Google Scholar
  18. Goodwin, N. (2013), “Understanding integrated care: a complex process, a fundamental principle”, International journal of Integrated Care 13: e011.Google Scholar
  19. Goodwin, N., Curry, N., Naylor, C., Ross, S. and Duldig, W. (2010), Managing People with Long-Term Conditions, London: The Kings’ Fund.Google Scholar
  20. Goud, R., van Engen-Verheul, M., de Keizer, N.F., Bal, R., Hasman, A., Hellemans, I.M. and Peek, N. (2010), “The effect of computerized decision support on barriers to guideline implementation: a qualitative study in outpatient cardiac rehabilitation”, International Journal Medical Informatics 79(6): 430–437.CrossRefGoogle Scholar
  21. Graafmans, J. and Brouwers, T (1989), “Gerontechnology, the modelling of normal aging” in Human Factors and Ergonomics Society Annual Meeting. Human Factors and Ergonomics Society, pp. 187–190.Google Scholar
  22. Gunter, TD. and Terry, N.P. (2005), “The emergence of national electronic health record architectures in the United States and Australia: models, costs, and questions”, journal of Medical Internet Research 7(1): e3.CrossRefGoogle Scholar
  23. Ham, C. (2010), “The ten characteristics of the high-performing chronic care system”, Health Economics, Policy and Law S (1): 71–90.Google Scholar
  24. Hofmarcher, M., Oxley H. and Rusticelli, E. (2007), Improved Health System performance through better care coordination, OECD. Directorate for employment, labour and social affairs. Health Committee, 30.Google Scholar
  25. IFIC (2013), International Foundation for Integrated Care, 2013. International Foundation for Integrated Care. 27-8-2013. (Electronic Citation).
  26. Kubitschke, L., Cullen, K., M’ller, S., Delaney, S., Garies, K., Dolphin, C., Frenzel-Erkert, U., Wynne, R., Lull, F. and Rauhala, M. (2010), ICT & Ageing — European Study on Users, Markets and Technologies. Final Report. Available at 18_final_report.pdf.
  27. Lewis, G.H. (2010), “’ Impactibility models’: identifying the subgroup of high-risk patients most amenable to hospital-avoidance programs”, Milbank Quarterly 88(2): 240–255.CrossRefGoogle Scholar
  28. Lewis, G., Bardsley, M., Vaithianathan, R., Steventon, A., Georghiou, T., Billings, J. and Dixon, J. (2011), “Do ‘virtual wards’ reduce rates of unplanned hospital admissions, and at what cost? A research protocol using propensity matched controls”, International Journal of Integrated Care 11: e079.Google Scholar
  29. Mastroyiannakis, T. (2010), eHealth Unit Sotiria Hospital. Case report. Interlinks Project. (Grant 223037) OfSotiriaHospital. (Electronic Citation)
  30. McDonald, K.M., Sundaram, V., Bravata, D.M., Lewis, R., Lin, N., Kraft, S., McKinnon, M., Paguntalan, H. and Owens, D. K. (2007), Care Coordination (Volume 7 of Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies), Agency for Healthcare Research and Quality, Rockville, MD, Technical Review 9.Google Scholar
  31. Mitchell, N., Randell, R., Foster, R., Dowding, D., Lattimer, V., Thompson, C., Cullum, N. and Summers, R. (2009), “A national survey of computerized decision support systems available to nurses in England”, Journal of Nursing Management 17(7): 772–780.CrossRefGoogle Scholar
  32. Montenegro, H., Levcovitz, E., Holder, R., Ruales, J. and Suárez, J. (2011), Integrated Health Service Delivery Networks: Concepts, Policy Options and a Road Map for Implementation in the Americas. Washington, D.C.: Pan American Health Organization (PAHO), p. 4.Google Scholar
  33. Nancarrow, S.A., Booth, A., Ariss, S., Smith, T., Enderby P. and Roots, A. (2013), “Ten principles of good interdisciplinary team work”, Human Resources for Health 11(1): 19.CrossRefGoogle Scholar
  34. Nolte, E. and McKee, M. (2008), “Integration and chronic care: A review”, in Nolte, E. and McKee, M. (eds) Caring for People with Chronic Conditions. A Health System Perspective. Maidenhead: Open University Press, pp. 64–91.Google Scholar
  35. Ouwens, M., Wollersheim, H., Hermens, R., Hulscher, M. and Grol, R. (2005), “Integrated care programmes for chronically ill patients: a review of systematic reviews”, International Journal for Quality in Health Care 17(2): 141–146.CrossRefGoogle Scholar
  36. Pruitt, S., Annandale, S., Epping-Jordan, J., Fernández, J., Khan, M., Kisa, A., Kaplow, J., Nuño, R., Reddy S. and Wagner, E. (2002), Innovative Care for Chronic Conditions: Building Blocks for Actions: Global Report. Geneva, Switzerland: Noncommunicable Diseases and Mental Health, World Health Organization, c2002.Google Scholar
  37. Stans, S.E., Stevens, J.A. and Beurskens, A.J. (2013), “Interprofessional practice in primary care: development of a tailored process model”, Journal of Multidisciplinary Healthcare 6: 139–147.CrossRefGoogle Scholar
  38. Tepponen, M. and Hammar, T (2011), ICT solutions and new health technology facilitating integration in home care, AndNewHealthTechnologyFacilitatingIntegrationInHome%20care. Interlinks project (Grant 223037). (Electronic Citation)
  39. Valentijn, P.P., Schepman, S.M., Opheij, W. and Bruijnzeels, MA. (2013), “Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care”, International Journal of Integrated Care 13: e010.Google Scholar
  40. Vazquez, M.L., Vargas, I., Unger, J.P., Mogollon, A., Silva, M.R. and Paepe, P. (2009), “Integrated health care networks in Latin America: toward a conceptual framework for analysis”, Rev.Panam.Salud Publica 26(4): 360–367.CrossRefGoogle Scholar
  41. Wagner, E.H., Davis, C., Schaefer, J., Von, K.M. and Austin, B. (1999), “A survey of leading chronic disease management programs: are they consistent with the literature?” Managed Care Quarterly 7(3): 56–66.Google Scholar
  42. Wagner, E.H., Austin, B.T., Davis, C., Hindmarsh, M., Schaefer, J. and Bonomi, A. (2001), “Improving chronic illness care: translating evidence into action”, Health Affairs (Millwood) 20(6): 64–78.CrossRefGoogle Scholar
  43. Zwarenstein, M., Goldman, J. and Reeves, S. (2009), “Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes”, Cochrane Database of Systemic Reviews 3: CD000072.Google Scholar

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© Nick Goodwin and Albert Alonso 2014

Authors and Affiliations

  • Nick Goodwin
  • Albert Alonso

There are no affiliations available

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