JMIR Publications

ABSTRACT

Background:

Helsinki University Hospital has developed digital care pathways (DCPs) for the improvement of the quality of care and patient processes in the hospital. Multiple sclerosis (MS) DCP of the neurology outpatient clinic was designed to support especially newly diagnosed patients and to facilitate communication between caregivers and patients.

Objective:

This study aimed to investigate the impact of the DCP on MS care, with a focus on resource usage, patient satisfaction, and patient quality of life.

Methods:

This is a case-control study where all patients enrolled on the DCP with a diagnosis of relapsing-remitting MS within 3 years were invited to participate, and altogether 36 patients gave their consent to regular questionnaires at time points 0, 3, 6 and 12 months from starting the DCP. A historical control group of 36 patients matched by age, sex, time from diagnosis and disease subtype was identified from the medical records. Data was collected also from hospital medical records for the patients in the intervention and control groups and for all patients under follow-up in the neurology outpatient clinic of Helsinki University Hospital. Resource usage was measured in terms of the number of physical and remote appointments with doctors and nurses. Patient satisfaction was evaluated using the Net Promoter Score (NPS), and the Multiple Sclerosis Impact Scale (MSIS-29) was used to assess quality of life.

Results:

The DCP group had a lower median number of physical doctor appointments and a higher number of remote nurse appointments than the control group. Overall, the DCP resulted in a significant reduction in resource usage. The patient satisfaction scores of the DCP cohort were positive, with the NPS index increasing from 21 at the three-month mark to 63 at the one-year mark. Impact of MS on daily life, as measured by the MSIS-29, remained similar across the study period, suggesting no adverse effect of the DCP.

Conclusions:

The DCP for MS appears to be a resource-efficient, satisfactory, and high-quality care delivery model. Our results indicate that DCPs hold great promise for managing chronic conditions like MS. Future studies should explore strategies to increase long-term patient engagement with digital health services. Furthermore, the potential of DCPs in different healthcare settings and patient subgroups should be evaluated.