Self-management support: online tools to the rescue

More people are living longer with chronic diseases. The EU-funded project USECARE AAL targets those older adults living with diabetes, heart or respiratory disease. Objective: to evaluate an electronic self-management support system.

What is eHealth?

A range of definitions exist related to information and communication technologies (ICT) respectively consumer-facing technologies. eHealth is one such umbrella term. It is considered an easy scalable and low cost approach that may reach many people. Furthermore, it has the potential to address individual challenges and consequences when living with chronic conditions.

eHealth provides healthcare solutions by using digital technologies such as mobile phones, computers, wireless digital devices etc. The goal is to optimize healthcare delivery by

  • providing a higher degree of patient self-control
  • fitting flexible solutions into everyday life
  • monitoring symptoms 24 hours everyday
  • supporting patient and informal caregiver engagement
  • having secure data storage
  • ensuring a rich data flow

The following video provides answers on the question «What is eHealth?»:

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© eHealth Industries Innovation Centre (2012)

More people live with chronic diseases 

The number of people living with a chronic disease is growing globally. Switzerland is no exception. Almost every 2nd person aged 50 years or older lives with at least one chronic disease.

According to the World Health Organization (WHO), cancer, cardiovascular- and respiratory diseases and diabetes mellitus are the four major chronic diseases. The distribution of such diseases is reflected in Switzerland.Here, cancer and cardiovascular diseases are cause more than half of all deaths, followed by respiratory diseases (COPD) and diabetes mellitus (see following figure on WHO country profile Switzerland, PDF, 111 kB).

Chronic diseases require daily monitoring and management of symptoms. This may have great practical and psychological impact on everyday life. For instance, people with diabetes have to control their blood sugar several times per day due to the risk of hypoglycemia. Such circumstances can affect quality of life and may limit everyday activities. Additionally, family members and friends experience psychological and physical consequences as they often are close support persons.

Find out more on chronic diseases or eHealth – Swiss National Health Report 2015 (in German, PDF, 3.1MB), aging with multimorbidity (review), impact on family caregivers (review) or eHealth effects on healthcare outcomes (Cochrane review).

Field-testing an eHealth tool in 3 countries

Consumer-facing devices could support people in their chronic disease self-management, if the technology is accepted. Here is the link to the Use Cases for Informal Care Ambient Assisted Living (USECARE AAL) project. It aims to field-test and evaluate the electronic self-management support system «SENior health ACAdemy» (SENACA) in relation to patient acceptance, process parameters and clinical outcomes.

SENACA is a web platform with several interacting components linked to tele-monitoring, peer-to-peer interacting and individual health plans, -logbook and evidence-based health information. The system enables wireless connectivity and the participants have 24 hours access to their biometric data via home computers and mobile devices (tablets, smart phones etc.). The different components of the system include disease specific information, nutrition, social interaction elements for motivational support and behavior change elements.

The USECARE AAL project will provide deeper understanding of patients’ and informal caregivers’ readiness and acceptability of electronic interventions in healthcare delivery. This will provide insights for further adjustments of SENACA (and eHealth in general) on an empirical and valid basis, which may help to better address the needs of people living with chronic diseases.

eHealth self-management support: the future?

What is your opinion on eHealth and self-management support in chronic illness?

What are your experiences, recommendations and comments to a project like USECARE AAL?

What is important to consider if eHealth tools are developed respectively used as healthcare solutions for people living with chronic diseases?

I am looking forward to your input and thoughts!

USECARE AAL – funding and collaborators
USECARE AAL is funded by the Active and Assisted Living Programme of the European Commission. The consortium consists of organizations from different European countries plus Isreal.

Israel: Aussuta Medical Center, Tel Aviv

Italy: Institute for Health and Consumer Protection IHCP, Ispra

Norway: University Hospital North Norway, Tromsoe; University of Oslo, Dept. of Health Management & Health Economics

Spain: Open University of Catalonia UOC, Barcelona
Soluciones Tecnologicas para la Salud y el Bienestar, TSB, Valentia

Switzerland: Institute of Nursing Science, University of Basel; Careum Research, Research Institute, Kalaidos University of Applied Science, Zurich; European Medical Network EMN, Kilchberg

Mette Iversen

As a trained midwife and health scientist, I am working on self-management of older adults living with chronic illness at Careum Research, with a particular focus on mixed methods research as part of my PhD program at the Institute of Nursing Science, University of Basel

3 thoughts on “Self-management support: online tools to the rescue

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  • 2016-04-21 at 09:31

    Thank you for the interesting blogpost. SENACA seems to be a program, which involves a variety of different dimensions related to chronic diseases management.

    In my opinion eHealth solutions seem to be the way forward, whether we like it or not. Mainly, I see that the potential of eHealth in terms of increasing effectiveness and patient involvement in own health. However I have some concerns.

    I see a potential risk of people not having sufficient personal contact to their general practitioner as a result of eHealth. This can lead to lack of individual care/treatment/supervision etc. How do you see this potential risk? And do you somehow account for this in the USECARE project?

    Best regards
    Maria K. Jensen

    • 2016-05-05 at 08:18

      Dear Maria,
      Thank you very much for your comment and view on the topic.
      I agree; eHealth can potentially be a huge step forward in order to improve and make health care more effective in involving patients in their own care.

      In terms of your concern for lacking personal/individual care, SENACA takes this into account in a variety of different ways. For example SENACA gathers individual basic health information before the patients start using the system. That means collection of baseline information on each person and from there further information and recommendations coming from SENACA will be tailored to individual needs etc. Furthermore, the system will provide individual feedback building on the daily performance in order to improve the self-management of the particular disease (e.g. diabetes, COPD or heart failure).

      On a more general level, eHealth solutions are not merely thought to replace the individual contact to the patient’s general practitioner, but is supposed to support the daily management and different tasks such a taking medication correctly, living healthy and facilitate peer-to-peer contact. In my view eHealth solutions has the potential to increase independency and quality of life for the patients as they (hopefully) do not have to see a health professional with the same frequency as before. However, I think it is important to stress that eHealth solutions are not supposed to replace the individual contact to a health professional, but can be seen as a supplementary tool/resource in order to support adults experiencing the consequences of living with a chronic disease.
      In my experience, there is a huge variation in the elements included in different eHealth solutions, as well as big variations in the level of interaction between the system, health professionals and the patient. This fact makes it difficult to judge/evaluate the level of personal and individualized care incorporated in eHealth solutions. Lastly, I think that the patients’ different life circumstances and personalities will influences whether they experience that the eHealth solution reach their individual needs and add a real value in their management of the disease.

      Thanks again for the comment and the fruitful discussion.
      Best regards, Mette


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