The identified gap in quality related to the delivery of health care is technology barriers in care coordination for chronically ill patients. Care coordination is a complicated process since it involves a variety of specialists from different locations and at different times. It may be complicated to arrange high-quality coordination of care depending on several major aspects. These include the seriousness of the patient’s condition, the availability of specialists, accessibility to healthcare facilities, and the willingness of each of the stakeholder to collaborate with the aim of gaining the optimal result. Recent breakthroughs in technology allow planning and carrying out coordinated care with high efficiency due to ample opportunities offered by smartphone applications (Carayon et al., 2019; Liss et al., 2018). However, because of insufficient accessibility to such apps, as well as due to some patients’ low acceptability of this option, a gap in health care delivery quality has emerged.
Among the most unfavorable associations with technology use for care coordination, scholars identify insufficient notifications and poor access to information. More specifically, Carayon et al. (2019) have reported such problems as restricted usability and usefulness of technologies, inadequate information, using multiple health information technologies, and technical issues. Meanwhile, Liss et al. (2018) expand this list by such complications as smartphone battery drainage, false alerts, and excessive burden on the user. Therefore, the mentioned problems make up the gap in quality of health care delivery, which demands effective solutions.
History
Whereas the use of digital technology in health care has shown positive results, scholars note that the uptake of this approach is too low. For instance, Palacholla et al. (2019) have found that although technologies can enhance patient care, their adoption in clinical settings is introduced at a low pace. A scoping review by Palacholla et al. (2019) has allowed identifying the following barriers to physicians’ willingness to use technology: the lack of validation and integration with the clinical system, low usability, and poor technical support. Meanwhile, on the part of patients, scholars have found such barriers as the lack of validation of technology and hindrance of patient-provider relationship (Palacholla et al., 2019). Speaking of care coordination specifically, the most common obstacles include the interference of health apps with smartphones’ work and “false alarm” notifications (Liss et al., 2018, p. e112). Therefore, over the course of technology development, the basic aspects of the identified gap have remained unchanged. Both patients and physicians acknowledge the positive prospects of utilizing health applications, but there are some obstacles to their successful implementation and regular use.
Socioeconomic Background
Chronically ill patients belong to diverse socioeconomic backgrounds, so it is impossible to say that some particular aspect affects this population group. Generally, well-off individuals have more opportunities to utilize technology in health care since they can afford more modern and high-quality smartphones or other appliances on which health apps can be installed. Also, people with higher education can learn how to use the apps faster, and they feel more confident about utilizing these methods. As Moscelli et al. (2018) note, access to health care is directly related to one’s socioeconomic status, with richer people having better options. On the other hand, patients with lower income and education may face more difficulties in both purchasing and learning to use health applications.
Effect
Inevitably, the health care delivered to the population is negatively affected by the gap in access. The better opportunity to utilize technology patients have, the better their health outcomes will be. At the same time, the more options physicians have to coordinate chronically ill patients’ health via technology use, the higher health quality will be arranged. Therefore, it is crucial not to underestimate the influence of technology on health care. The effect produced by the gap has the potential to undermine the success of health care delivery. Moreover, patients living in remote places can considerably benefit from the use of technology, which makes it highly important to analyze the possible ways of eliminating the barriers and increasing people’s access to healthcare apps.
Implications
If the gap is not addressed timely and properly, negative implications can be experienced both by the population in question and healthcare facilities. First of all, without appropriate coordination of care, chronically ill patients are under the threat of having their symptoms complicated and health condition deteriorated. If an individual does not receive the necessary information, feedback, receipt, or any other crucial element of care, there is a risk of wasteful health spending and excessive readmission rates (Liss et al., 2018). Since the financial burden on hospitals and clinics is already too high, it is crucial to avoid the gaps in care delivery that can complicate the situation. Also, readmissions affect patients negatively, including both psychical health condition and psychological state. On the part of healthcare employees, the failure to address the gap poses a threat of burnout due to work overload. In the current environment of the world being overwhelmed with COVID-19 aftermath and healthcare workers’ shortenings, it is of utmost importance to do everything possible to eliminate the possibility of the identified gap’s further development.
References
Carayon, P., Hundt, A. S., & Hoonakker, P. (2019). Technology barriers and strategies in coordinating care for chronically ill patients.Applied Ergonomics, 78, 240-247.
Liss, D. T., Serrano, E., Wakeman, J., Nowicki, C., Buchanan, D. R., Cesan, A., & Brown, T. (2018). “The doctor needs to know”: Acceptability of smartphone location tracking for care coordination. JMIR mHealth and uHealth, 6(5), e112.
Moscelli, G., Siciliani, L., Gutacker, N., & Cookson, R. (2018). Socioeconomic inequality of access to healthcare: Does choice explain the gradient?Journal of Health Economics, 57, 290-314.
Palacholla, R. S., Fischer, N., Coleman, A., Agboola, S., Kirley, K., Felsted, J., Katz, C., Lloyd, S., & Jethwani, K. (2019). Provider- and patient-related barriers to and facilitators of digital health technology adoption for hypertension management: Scoping review. JMIR Cardio, 3(1), e11951.