Assessing a Patient-Centered E-Health Approach to Chronic Disease Self-Management

Assessing a Patient-Centered E-Health Approach to Chronic Disease Self-Management

Elizabeth Cummings (University of Tasmania and Smart Internet Technology Co-operative Research Centre, Australia), Stephen Chau (University of Tasmania and Verdant Health, Australia) and Paul Turner (University of Tasmania, Australia)
Copyright: © 2009 |Pages: 18
DOI: 10.4018/978-1-60566-016-5.ch013


This chapter explores how in developing patient-centred e-health systems it is possible to accommodate heterogeneous characteristics of end-users and their diverse health and care contexts. It concurs with conventional sociotechnical design paradigms that argue systems must be easy to use, fulfill a perceived need, and present a clear value proposition to ensure successful adoption and utilisation by patients. The chapter also highlights the need for awareness of a number of key challenges relating to emerging discourses on ‘empowering patients’ and ‘e-health’. The implications of these challenges for the development of a truly patient-centred e-health approach are explored in a detailed case study. This chapter contributes to research focused on supporting patients to become genuine co-participants in their own care, health and well-being. However, it also acknowledges that part of the challenge of achieving this goal requires a focus on assisting clinicians to learn to respond to this shift in the autonomy of decision- making
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This chapter examines a number of key challenges related to the emerging discourses on “empowering patients” and “e-health.” The implications of these challenges are explored in a detailed case study. The case study presented in the second part of this book chapter highlights the inherent challenges of moving towards a patient-centred model of healthcare. The case study focuses on a controlled trial that aims to assist people with chronic respiratory conditions, including chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF), to achieve increased levels of self-efficacy for self-management through interactions with case mentors (community health nurses), and the adoption and use of Web and mobile information systems.

This chapter promotes a patient-centred e-health approach. It is argued that benefits from such an approach can only be realised if systems are specifically designed and implemented on the basis of a detailed understanding of end-users, their needs and complex interactions with one another, the health system, and the wider environment. Without such a holistic approach, there is a concern that the existing inequities of access to quality healthcare faced by many patients will be further compounded by an emerging e-health divide. We must avoid widening this divide to allow the existing inequalities between information “haves” and “have-nots” to be compounded by presenting additional financial, technological, and skill barriers to chronically ill patients (many of the poorest, oldest, and most vulnerable members of our societies) as more health information and services come to be provided primarily online.

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