Strengthening community-based health systems through e-health innovations?
Ageing populations with multifaceted health needs have shifted thinking away from hospicentric approaches towards more flexible models of care. E-health innovations have the potential to improve access to person-centred care and strengthen community-based health systems.
A recent innovation, referred to as Virtual Health Rooms (VHRs), is located within community structures and makes use of sophisticated technology to provide health services to remote rural areas. It is implemented through new partnerships between municipalities, county councils,community structures and patients. The overall aim of the research is to understand the circumstances under which e-health innovations in community-based health care delivery help achieve gains in access to care and strengthen health systems. This project is particularly interested in e-health innovations for elderly in rural areas. Using the case of VHRs in South Lapland we will address the gap in understanding of how such innovations might enhance integration between health systems partners, partnerships between the system and the community, and access to health services. We will implement a multiple case study and apply a realist evaluation by 1) developing an initial programme theory which suggests an explanation of how the e-health innovation improves access to health services for the elderly as well as strengthening community-based health systems, 2) testing of the initial programme theory through multiple case studies, 3)identifying the contextual conditions and mechanisms which lead to positive outcomes (access,integration and partnership) and 4) finally suggest a middle range theory that lead to recommendations to guide further implementation of VHRs. This project is part of an ongoing strong collaboration between Umeå University and the Västerbotten County Council which provides true opportunities for action learning and close interactions between researchers, decision makers and practitioners.