JMIR Publications

ABSTRACT

Background:

Case managers for persons with dementia coordinate patients’ assessments, follow-ups, support services, and provide family caregivers with educational information. Taiwan that uses a government-based information system for monitoring the provision of healthcare services. However, scheduling patient follow-ups, determining what services are needed, and providing educational information for family caregivers continues to be paper-based. This lack of a cohesive information system can lead to discontinuity of care, duplication of assessments, and inadequate educational information, which limits the ability of case managers to provide timely service.

Objective:

This multi-phase study aimed to develop an electronic information system for dementia-care case managers based on their perceived case management support needs and what they desired in an electronic healthcare app.

Methods:

A Dementia Case Management Information System (DCMIS) app for dementia-care case managers was developed in four phases. Case managers were recruited to participate (n=63) by purposive sampling from 28 facilities representing two types of community-based dementia care centers in Taiwan. Phase 1 collected and analyzed qualitative face-to-face or virtual interviews with 33 case managers, to understand the perceived needs of what should be included in the DCMIS. Phase 2 included the key categories identified in Phase 1 to formulate a framework for the DCMIS that would support dementia-care case managers. During Phase 3, a multidisciplinary team of information technology engineers and experts in dementia care designed and developed the DCMIS: hardware and software was selected, interfaces for case managers and family caregivers were developed, and content validity evaluated components of the system. Phase 4 involved a second group of case managers (n = 30) who pilot-tested the DCMIS and provided feedback via face-to-face interviews about their experience using the system.

Results:

Phase 1 findings indicated the framework of the DCMIS should be a system that included a unified database of resources for caregiving and support services, a health education module, a reminder notification for persons with dementia requiring follow-up, and a shared recordkeeping platform to facilitate teamwork and communication. The DCMIS was built on the LINE Messaging Platform, which is the most commonly used mobile app in Taiwan. We included an open-source database management system to securely enter and store user information and patient data. Case managers had easy access to educational materials on dementia as well as caregiving for persons living with dementia, which could be provided to family members. Feedback following pilot testing indicated the DCMIS app facilitated case managers’ ability more easily fulfill responsibilities. However, some case managers preferred a desktop computer to a mobile app and had concerns that the app would be difficult for caregivers to use.

Conclusions:

Pilot testing of the DCMIS app demonstrated the app could reduce the challenges faced by case managers and improve continuity of care. However, some gaps remain in the benefits of the system. These findings will serve as a reference for further development of an integrated electronic healthcare system in Taiwan. Clinical Trial: ClinicalTrials.gov (NCT05131789).