JMIR Publications

ABSTRACT

Background:

The (self)-management of heart failure is complex. Innovative solutions are required to support healthcare providers with decision-making and people with heart failure to sustain appropriate self-care behaviors. In recent years, more sophisticated technologies have emerged within healthcare practice. These technologies use data collection, intelligent data processing, and communication to enable new healthcare models, such as smart health ecosystems. Smart health ecosystems may assist diagnosis and treatment of conditions, support self-care, and monitor people to support primary and secondary disease prevention. Currently, there is little information about the characteristics of smart health ecosystems for people with heart failure.

Objective:

We aimed to identify and describe the characteristics of smart health ecosystems that support self-care for people with heart failure.

Methods:

We conducted a scoping review using the Joanna Briggs Institute (JBI) methodology. MEDLINE, Embase, CINAHL, PsycINFO, IEEE Xplore, and ACM Digital Library databases were searched from January 2008 to September 2021. The search strategy focused on studies that described smart health ecosystems to support self-care among people with heart failure. Two reviewers screened articles and extracted relevant data from the included full texts.

Results:

After removing duplicates, 1543 articles were screened, and 34 articles were identified, representing 13 interventions. To support self-care, interventions collected data from service users through sensors and questionnaires and used tailoring methods to provide personalized support. We identified 34 behavior change techniques (BCTs) in the interventions, which were facilitated by a combination of 8 features for service users; automated feedback, monitoring (integrated and manual input), presentation of data, education, reminders, communication with a healthcare provider and psychological support. Furthermore, features to support healthcare providers included the presentation of data, alarms, and alerts, communication with the service user, remote care plan modification, health record integration, and communication with other members of the care team.

Conclusions:

This scoping review identified that there are few reports of smart health ecosystems to support self-care among people with heart failure, and those that have been reported do not provide comprehensive support across all domains of self-care. This review outlines the technical and behavioral components of the identified interventions, information that can be used as a starting point for designing and testing future smart health ecosystem interventions.