Previously submitted to: JMIR Formative Research (no longer under consideration since Dec 08, 2025)
Date Submitted: Mar 24, 2025
Open Peer Review Period: Mar 25, 2025 - May 20, 2025
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A digitally supported person-centered, integrated and proactive care system. What does it look like, and how do we get there? A qualitative study of healthcare system stakeholder perspectives.
ABSTRACT
Background:
In the face of the demographic change, patients, authorities, and professionals express a need to radically reorganize health services for patients with long-term and complex needs (CLNs) to maintain sustainability and quality of care. In line with policy recommendations, the Patients and Professionals in Partnership (3P)-project transition from reactive, single-disase, profession-centric care to digitally supported Person-centered, Integrated, and Proactive (Digi-PIP)-care. In this paper we collected insights from a wide stakeholder group associated with 3P, representing those who use, work for, or shape the Norwegian care system.
Objective:
To answer the following research questions: • What do stakeholders understand by the terms digitally supported, Person-centered, Integrated, and Proactive care? • How do we transform care towards Digi-PIP care?
Methods:
This research was a collaborative effort involving observations and co-creation in 4 Workshops, with 104 stakeholders representing patients, informal caregivers, professionals at all levels of care, healthcare decision-makers, e-health providers, and health service researchers from four innovation hubs in Norway and Denmark. Participants worked in groups, each creating three oral poster presentations of their discussions and insights. A condensed summary of the 45 filmed presentations was the basis for an inductive/deductive content analysis structured by the research questions.
Results:
A wide range of healthcare stakeholders recognize Person-centered, Integrated, and Proactive as intuitive, critical and synergistic features of high-quality and sustainable care. Stakeholders agreed on the essence of the three concepts: • Person-centered care (PCC) is guided by the patient’s answer to the What Matters To You? (WMTY?) question. • Integrated care recognizes the patient journey as a team product that requires a digital shared information flow. • Proactive care is key to sustainability. It builds on a prioritized shared care plan, which supports patient involvement and engagement for realistic self-care and “WMTY?”-goals. In addition, proactive care involves the active use of health data, sensors and algorithms to identify opportunities for prevention/ early treatment. Stakeholders suggested a wide range of innovations to transition to Digi-PIP care: • Education and training to support professionals in the delivery of person-centered care. • New organizational roles and logic to reduce care fragmentation. • A shared digitized information flow to enable all contributors to be aware of personal goals, shared care plans, and risk-reduction strategies.
Conclusions:
Stakeholders agreed on what Person-centered, Integrated, and Proactive care is and found these features useful in describing sustainable high-quality patient journeys. Transforming care requires multiple synergistic innovations in education, organization, and digital information systems. There is a need for further research into the regulatory and economic support of such innovation
Citation
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