Health Information Technology for Empowering Elderly Patients with Chronic Diseases

Patient empowerment (PE) is at the centre of the ongoing paradigm shift toward patient-centred healthcare. Novel health information technology (HIT) interventions frequently aim to improve PE and trigger changes in the healthcare. However, little is known about the actual efficacy of HIT to induce PE. The objective of this thesis is to study how HIT can improve PE. The thesis describes empirical research in C3-Cloud, an EU project developing broad HIT-based solutions for PE in multi-morbidity care; and in EMPARK, a homebased HIT monitoring system for PE in Parkinson disease. Theoretical research covers the systematic evaluation of shortcomings hindering HITs to induce PE, and the development of ICT4PEM, a framework for HIT development targeting PE. Empirical research was based on user-centric design for ICT artefact development and evaluation. Design science research was guiding the ICT4PEM development, including utility demonstration by applying it for the project-wide evaluation of the C3-Cloud and EMPARK regarding their design, interventions, evaluation and expected effects on PE. The thesis demonstrates empirical examples on how HIT contributes to PE by enabling multidisciplinary, patient-centric individual care plan elaboration, patient monitoring, patient-targeted and clinician feedback, and clinical decision support (CDS), including a clinical guideline based intelligent CDS for multi-morbidity. ICT4PEM is the first framework, which provides a patient-centric, HIT-friendly conceptual foundation for PE, and assists HIT development on targeting PE. The ICT4PEM-based evaluation revealed strength and weaknesses of C3-Cloud and EMPARK related to their design, interventions, evaluation and expected long-term effects. It also demonstrated a utility of ICT4PEM for retrospective HIT project evaluation. In summary, the thesis provides strong evidence and reveals shortcomings about HIT efficacy to promote PE. The novel ICT4PEM framework address and resolve these shortcomings with the capacity to guide future HIT developments which aim to empower patients