Introduction
Expanding the possibilities of providing timely medical care is one of the main objectives of introducing eHealth technologies. The case study by Currie et al. (2015) offers a rationale for the benefits of this approach to community engagement and assesses potential barriers to implementation. According to the authors, eHealth technologies are an effective solution to address the health needs of older patients living in rural areas (Currie et al., 2015). Individual conditions, particularly the level of social contacts, are decisive in accepting this innovative program by the target audience (Currie et al., 2015). This paper aims to analyze intervention outcomes, assess the specific conditions and challenges of optimizing care procedures, and identify prospects for the future of eHealth technologies.
Challenges of Adopting the eHealth Program
The analysis of the case study shows that implementing the eHealth program was accompanied by challenges that were traditional for medical employees’ work in rural areas. Among a number of constraints on the effective organization of program principles, Currie et al. (2015) highlight the “complex health needs” of the target population (p. 2). As rural areas tend to be more populated by older adults, the workload for health professionals is increasing due to more frequent health problems in patients of this age.
Another difficulty to mention is the high cost of caring for dispersed populations living in rural areas. According to the researchers, lower population density is directly correlated with the time spent on interacting with as many patients as possible (Currie et al., 2015). As a result, unlike urban territories, rural areas require longer work to establish contact with the population. In addition, travel time to patients is increasing, and this factor is essential to consider because, despite the possibility of remote interaction with medical providers, older people still need occasional face-to-face appointments.
Financial barriers are among the challenges affecting the sustainability of the eHealth program. As Currie et al. (2015) argue, due to fiscal constraints and economic challenges, healthcare professionals are forced to look for new, less costly ways to engage with the public. Since funding for rural health facilities is often unstable and differs in level from that in cities, care delivery models have to be adapted to existing capacities. All of these difficulties relate to the general principles of program implementation and are more likely to have been anticipated when planning the intervention.
The distinctive perception of the value of the program in question among the target audience is a more specific issue. Currie et al. (2015) highlight the different views of older patients on the prospects for participation in the eHealth project and note the unwillingness of some of them to completely switch to remote interaction. This may be related to the fears of rural people about the sustainability of such a program and their traditional views on the principles of care. According to Ibeneme et al. (2020), a patient-centered approach is to be at the core of an eHealth strategy to justify itself and gain trust among the population. Otherwise, the level of health in the target areas may decline due to the unwillingness of patients to use the services of innovative technologies and, therefore, to cope with health problems on their own.
Another important factor that emerges from the intervention considered in the case study is program leadership. As Currie et al. (2015) state, the involved medical professionals should have not only professional knowledge but also the ability to use the technological methods of interaction with patients. Otherwise, the probability of program success is reduced due to the inability to establish a stable interaction mode. Patients should have stable access to work with digital equipment. According to Currie et al. (2015), “mobile Internet access (3G or 4G signal) is not available in many rural areas and download speeds on fixed Internet connections tend to be much slower in rural compared to urban areas” (p. 7). Ibeneme et al. (2020) also draw attention to the importance of effective leadership as a mechanism to control the intervention at all its stages. When analyzing the sustainability of eHealth projects in Nigeria, the authors note the importance of productive management, which ensures rational funding and eliminates communication gaps (Ibeneme et al., 2020). The more effective the leadership, the less risk there is to the sustainability of the program.
To ensure that the program is effectively integrated into the daily lives of targeted patients, the work of various stakeholders is crucial. Currie et al. (2015) emphasize the problem of the impossibility of organizing multi-specialist care in rural areas, where, unlike cities, there are no large medical centers with different departments. Baldwin-Medsker et al. (2020) also draw attention to this barrier and note that specialized care is often worse in rural areas, which, in turn, reflects negatively on patient outcomes. Therefore, the eHealth program under consideration should include the access of the population to the services of various specialists to prove its effectiveness.
Influence on eHealth Providers’ Functional Decision-Making
Given the aforementioned difficulties associated with the community targeted for outreach, eHealth providers can optimize their functional decision-making. Firstly, shared decision-making capabilities may improve as the proposed intervention program is designed to improve interprofessional collaboration and create an environment in which different stakeholders participate. Yu et al. (2021) draw attention to the value of innovation in improving patient decision-making, but from a provider perspective, this aspect can also be enhanced. By analyzing the outcomes of the intervention and taking into account the needs and interests of target patients, medical professionals can tailor the individual nuances of the program. For instance, this may include addressing the concerns of older patients about the complete replacement of traditional care with remote contact. As a result, medical specialists will take into account the concerns of the population in their decision-making strategies and promote sustainable interaction based on combining the innovative technology and direct meetings.
A more advanced level of care can be achieved if healthcare providers take into account the outcomes of the intervention in their decision-making strategies, particularly patient needs and preferences. According to Currie et al. (2015), a distinctive perception of the benefits of the eHealth program is observed among the rural population, and one of the key determinants is the level of social contacts. Providers should consider the lifestyles of target patients when planning appropriate treatment programs to either increase or, conversely, reduce the proportion of remote sessions. Moreover, as Yu et al. (2021) state, effective work planning, based on assessing intervention conditions, directly correlates with the quality of self-care. This means that if the practice is successful in building care through the eHealth program, providers will be able to establish a work in which patient self-care will be part of care programs. Such a result can be achieved through the effective education of the population, and this aspect can be included in functional decision-making.
An objective analysis of the intervention outcomes can help the providers engaged in reducing the time it takes to plan care programs. Functional decision-making involves precision, which can be accomplished through rational planning and scheduling activities. Laing and Mercer (2021) draw attention to the improved patient outcomes achieved due to decision-making accuracy and note that the simplicity and convenience of intervention programs are the consequences of productive planning. By being aware of the needs and requirements of the target population, providers can establish a care regimen where any patient requests are addressed without delay. In addition, as Currie et al. (2015) remark, the identified perceptions of older rural residents of the proposed eHealth program are critical aspects to consider when planning activities. Providers need comprehensive data to establish an interaction mode that allows them to quickly and efficiently respond to patient requests. The findings by Currie et al. (2015) will make it possible to adapt the traditional communication mode that previously had significant gaps caused by the aforementioned challenges. As a result, through optimized planning, functional decision-making can be enhanced, thereby increasing the likelihood of more effective patient-centered care.
Efficient resource allocation can be another valuable implication for providers’ functional decision-making based on the outcomes of the intervention in question. Currie et al. (2015) mention service delivery in rural areas as a challenging task, greatly complicated by financial constraints caused by the unequal distribution of funds to maintain local healthcare infrastructure. By obtaining comprehensive data from patients, providers can allocate available resources more efficiently to reduce unwanted costs and address only the immediate needs of the population. In their research, Laing and Mercer (2021) explore the benefits of implementing electronic medical records as simple optimization tools and argue that even such instruments improve cost efficiencies. When speaking of more advanced forms of digital innovation through telecommuting, one can point out that providers can reduce the costs of transportation and procedure care through stable communication with patients. With constant interaction, the need for an emergency response to any call is eliminated due to advanced self-care skills in patients. Thus, the intervention outcomes can help healthcare professionals create a caring environment in which not only patient outcomes are improved but related tasks are also addressed, including resource management and planning.
Technology and Its Impact on the Program’s Functionality
The eHealth technology under consideration does not imply one specific digital tool but rather combines a range of available technological solutions designed to simplify communication. The breadth of instruments used for patient-provider interaction is a favorable factor that increases the functionality of the program. Under the concept of technology, Currie et al. (2015) imply “a mobile (or cell) phone or a smart phone, a computer or an Internet-enabled television and the various applications that can be used on these devices” (p. 2). Despite the fact that older adults involved as a target audience tend to demonstrate lower technical innovation skills, the aforementioned devices are widely utilized by all people without exception. Internet access is also available in most localities, although, judging by the challenges previously discussed, interruptions in network access do occur. A wide range of gadgets used today gives older patients an opportunity to choose the most convenient devices with simple and understandable functionality. As Nielsen et al. (2020) note, the eHealth realm offers an extensive set of application options. Therefore, the wide technological functionality of the program under consideration is a relevant criterion that increases its effectiveness.
Given the results of the study, the eHealth technology can be considered an indispensable tool not only for rural older adults but also for those living in urban areas. According to Currie et al. (2015), even those patients who previously expressed doubts about the appropriateness of using modern devices to interact with medical providers accepted the idea of ​​introducing such a mode of communication. In other words, skepticism about the technology is irrational because real health improvements are observed. For all older patients, introducing such a program into daily life significantly expands the functionality of interventions in view of preventive measures. Currie et al. (2015) mention fall alarm applications as program components and analyze the relevance of these digital tools to the older population. The provision of such instruments is an important option for many patients who are at risk of falls. Therefore, promoting this technology among the target audience significantly reduces the risk of injury and, therefore, increases the value of the intervention. The functionality of the program is expanding, allowing it to be used both as advisory and preventive practices for targeted patients.
A special role of using the considered eHealth technology is addressing various aspects of patient well-being, including both physical and mental health issues. Currie et al. (2015) do not mention the impact of the program on patients’ emotional states, but based on their findings, one can see that older people who live alone tend to show greater confidence in the use of technology. This is due to the fact that limited social contacts and the lack of emotional support affect the morale of patients negatively, prompting them to seek communication through modern applications. In their study, Theis et al. (2019) note that older adults who use a variety of convenient technologies on a daily basis show reduced stress levels, which, in turn, has a positive effect on their mental health. Moreover, the authors note that the regular use of digital tools is a stress-coping mechanism in case of an unpleasant diagnosis (Theis et al., 2019). Such a range of the advantages of using technologies allows speaking about the wide functionality of the eHealth program under consideration and its important implications for public health.
Finally, one should mention additional options offered to the target population due to the technology. Currie et al. (2015) provide feedback from participants in the intervention project and note their positive views on the updated list of relaxation and therapeutic exercises they discovered. Convenient and free access to medical resources and interaction with providers enhances the functionality of the program, which, in addition to improving patient outcomes, reduces the burden on healthcare professionals. Attracting as many patients as possible can help create an effective inclusive environment in which education and the timely participation of specialists can minimize health risks. Cost reduction also allows available resources to be directed to the most urgent needs. Thus, the eHealth technology with a wide range of options improves the functionality of the program in question by simplifying self-care for target patients and, at the same time, facilitating healthcare employees’ activities.
Efficacy of the Communication Methods
Communication in the considered case study is effective, as evidenced by the work methodology. As one of the research steps, Currie et al. (2015) use semi-structured interviews in which they interact closely with the participants involved. The authors obtain objective data regarding the topic in question, particularly the relevance of utilizing the eHealth technology (Currie et al., 2015). The interviews are conducted directly, not remotely, which eliminates the potential bias in the interpretation of the results. Therefore, both the collection of data and the mechanism for processing them, based on statistical analysis, are valid and confirm the effectiveness of communication.
Another factor confirming the effectiveness of the interaction between the parties involved in this case study is the awareness of the target participants about all the principles and options of the eHealth program. Currie et al. (2015) communicate with older patients living in rural areas, and for this population group, the capabilities of modern technologies are often difficult to implement into everyday life. Lee et al. (2020) conduct a similar intervention and emphasize the relevance of interpersonal interaction, assessing its effectiveness in the context of the target audience’s knowledge of the goals and objectives of their program. The more participants understand the possibilities of a proposed change plan, the more likely they are to draw objective conclusions about its relevance to their daily needs. The members of the case study by Currie et al. (2015) obtain comprehensive data regarding program features, the functioning of digital devices, and their application to address specific health issues. This knowledge testifies to the success of communication and productive interaction between the study’s organizers and participants, which, in turn, allows achieving credible results, free from the subjective perception of the proposed conditions of participation.
As an argument proving the efficacy of communication used in the analyzed case study, one can mention the comprehensive data collected from the target participants, including their anxieties. Currie et al. (2015) present the views of the members of the research regarding their concerns about the existing health problems, particularly chronic pain, and take these facts into account to propose the best technologies. Although not all participants demonstrate satisfaction with digital methods of remote interaction with providers, personal views are an essential component of the intervention and help form an overall picture of the acceptance of the proposed eHealth technology. In the study by Widberg et al. (2020), the authors also cite the concerns of target participants in the palliative care unit regarding the usability of digital communication channels. However, as the researchers remark, this can be associated with patients’ poor health and deteriorated morale aggravated by protracted illnesses and associated problems (Widberg et al., 2020). Therefore, the task of medical providers is to make life easier for the older population, including through remote communication mechanisms, to create an inclusive environment for stable interaction and maintaining patient morale.
One of the critical factors to mention in the context of discussing communication in the case study is the criterion of acceptance by the target population with regard to the proposed eHealth program. Currie et al. (2015) argue that “acceptance of technology therefore relates to existing levels of personal and social contact, and appears to be greater where technological help is not perceived to be replacing inperson care” (p. 10). In other words, the individual aspects of older patients’ lives, including their social circle, determine how productive and necessary communication with providers is for them. The unwillingness to move to new principles of interaction with medical staff through remote communication affects the level of interaction negatively. This, however, is an individual deterrent and does not depend on the quality of interpersonal relationships promoted by the organizers of the intervention. According to Lee et al. (2020), healthcare providers should give clients all the necessary information regarding care approaches and any changes, including the introduction of technological innovations. Thus, in the case study in question, medical professionals have done their best to convey to the target patients the value of digital communication.
Conclusion
The reviewed case study offers a comprehensive assessment of the eHealth program based on introducing digital technologies to maintain stable communication between medical providers and older patients living in rural areas. Despite some challenges associated with economic and geographical aspects, the functionality of this intervention is high, which is ensured by close interaction with the target audience. The older population receives all the necessary data regarding participation in the program, and socialization is one of the main criteria determining the acceptance of the intervention by the study members. By following the program’s provisions, providers can improve their decision-making and address the needs of older patients comprehensively. The effectiveness of communication in the case study is high, which is achieved due to close interaction and explanation of the provisions and principles of the program to the participants involved.
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