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Can podcasts improve the integration of care pathways to benefit patients

Patient treatment and care are becoming increasingly complex in Denmark’s healthcare system, and many patients therefore have many different contacts in the healthcare system. The Novo Nordisk Foundation has therefore awarded grants for seven projects focusing on improving the integration of care pathways for patients with long or complicated courses of treatment.

The Novo Nordisk Foundation has awarded grants totalling DKK 6 million for seven research projects that will produce new knowledge on how to facilitate greater integration of care pathways to benefit patients in Denmark’s healthcare system.

Patient treatment and care in Denmark are increasingly complex and distributed across many sectors. One reason is that many patients have more than one disease, and many are chronically ill. Further, new digital healthcare technologies create both new opportunities and new challenges for Denmark’s healthcare system. New knowledge is therefore needed on how to optimally organize and integrate the often long courses of treatment to benefit patients.

The seven grants have been awarded for projects throughout Denmark, including in Aarhus, Kolding, Copenhagen and Region Zealand.

In one project now being initiated, a research group at Vejle Hospital will investigate whether podcasts can help to prepare patients better for hospital consultations, including examination and treatment.

Today, the information sent to patients before hospital consultations in Denmark is mostly written. According to the Danish Evaluation Institute, 16% of adults in Denmark lack basic reading skills, and some patients have difficulty in making decisions and following health advice if they do not properly understand the information. The research team will therefore investigate whether using podcasts can better prepare patients for their next hospital consultation. The researchers will also investigate how and when the individual patients and healthcare professionals use podcasts in preparing for their consultations to optimize the content and effectiveness of podcasts.

Vulnerable unemployed people
Another project will focus on the most vulnerable unemployed people in Denmark with major health problems that affect their lives and employment opportunities. A municipality can initiate a resource clarification process that includes a treatment plan to get them ready for the labour market, but inadequate coordination between the healthcare system and the employment authorities in municipalities leads to an incoherent process and no improvement for these people.

Researchers at the Department of Odontology (School of Dentistry) of the University of Copenhagen and the National Institute of Public Health of the University of Southern Denmark will collaborate in the project with the Municipality of Høje-Taastrup to elucidate how vulnerable unemployed people experience the treatment plan incorporated in the resource clarification process. The aim is to obtain knowledge about both barriers and the instruments that may facilitate the integration of care pathways. This knowledge can be used to optimize initiatives to improve these people’s health, labour market opportunities and quality of life.

Niels-Henrik von Holstein-Rathlou, Senior Vice President, Biomedicine and Health Sciences, Novo Nordisk Foundation, says: “Treatment and care in the healthcare system are changing, and there is a need to investigate how to better organize and integrate care pathways and use new technological opportunities to optimally benefit patients. We have received many highly qualified grant applications for exciting projects that can potentially improve the integration of patient treatment and care, and we are very much looking forward to following the seven projects.”

The seven grants are part of the Foundation’s focus on coherence in healthcare, through which the Foundation aims to support cross-sectoral research that facilitates greater integration of care pathways to benefit patients in Denmark’s healthcare system.

New application round open
The Foundation has already opened a new application round for Project Grants for Exploratory Studies on Integrated Care Pathways. The deadline for applications is 2 June 2021. Read more here (in Danish).

The grant recipients and their projects:

Grant recipient: Rigshospitalet
Amount: DKK 1 million
Project title: The effect of cross-sectoral patient empowerment on health service usage and quality of life
The researchers’ project description:
Some people have chronic conditions that result in consultations with many different practitioners (general practitioners, hospital doctors, physiotherapists and nurses) over a long period. It can be challenging to communicate the health state and treatment history among practitioners, doctors, and patients (the glue is missing). Over time, the patient may also have difficulty remembering how the situation was before and whether the current situation is better or worse.

This project aims to test a solution to these problems. Patients with chronic shoulder or lower back problems will be followed for two years. All patients will complete questionnaires (PRO-data) on their condition every two months. Half of the patients and their practitioners and doctors will be able to see their history, which will help in guiding further treatment. For the other half of the patients, neither practitioners, doctors, nor patients will have access to the PRO-data.

The results may guide new ways to organize healthcare.

Grant recipient: Region Zealand
Amount: DKK 987,000.
Project title: Designing Virtual-4-Meeting: aligning multimorbid patients’ and relatives’ wishes and goals in cross-sectoral rehabilitation processes
The researchers’ project description:
Virtual Cross-sectoral Cooperation Meeting is a forum where healthcare professionals from secondary and primary sectors meet with multimorbid patients and relatives (the 4 partners) to prepare and coordinate cross-sectoral rehabilitation processes in a digital environment (the Virtual-4-Meeting).

The aim is to develop structured guidelines for cross-sectoral Virtual-4-Meeting and test and evaluate its significance to strengthen the cross-sectoral collaboration. Patients’ wishes, goals and participation in planning rehabilitation processes are key elements in Virtual-4-Meeting.

Grant recipient: University of Aarhus
Amount: DKK 926,000
Project title: PeerCare – producing continuity of care in peer-led online communities for patients with chronic conditions
The researchers’ project description:
According to WHO, “continuity of care” as a concept “reflects the extent to which a series of discrete health care events is experienced by people as coherent and interconnected over time and consistent with their health needs and preferences” (WHO 2018, 9). Danish patients are increasingly experiencing a lack of care continuity – they feel they meet too many different health professionals, that there is too much waiting time, and that their treatment is coordinated ineffectively.  The aim of PeerCare is to understand if and how peer-led online communities are important for how chronic patients experience and deal with (dis)continuity of care.

The PeerCare project will break new ground by exploring how experiences of (dis)continuity of care are not only produced in encounters or relationships between people with chronic conditions and the healthcare system but also shared, compensated or even produced through patients’ interaction on social media.

Grant Recipient: Lillebælt Hospital (Vejle)
Amount: DKK 513,000 kr.
Project title: Using podcasts to prepare patients for hospital consultations: a qualitative evaluation of user experiences
The researchers’ project description:
Patient information prior to hospital consultations is most commonly provided in written form, for example in the form of leaflets or digital letters. Meanwhile, 16% of the adult Danish population has reading difficulties, and patients have a hard time making decisions and adhering to healthcare advice if information is not received or fully understood. This calls for new ways of communicating and engaging patients in collaborative care.

A questionnaire-based study has been initiated at the Department of Medicine at Vejle Hospital with the purpose of exploring the effects of introducing podcasts to prepare patients for hospital consultations. However, with the purpose of optimizing the content and delivery of the podcasts, the present supplementary study seeks to explore how and when individual patients and providers use podcasts in their clinical encounters through focus group interviews and video-based monitoring of consultations.

Grant recipient: Bispebjerg and Frederiksberg hospitals
Amount: DKK 1 million
Project title: PORT: Primary Organization and Relations Team
The researchers’ project description:
The proportion of persons living with several chronic diseases is increasing. Patients with multiple diseases and their caregivers are burdened with disease and reduced quality of life. Living with multiple diseases implies contact with many different healthcare professionals and organizational units in the healthcare system. In these fragmented healthcare trajectories, the patient and a caregiver can be the only persons with full knowledge of the patient’s situation.

The purpose of this project is therefore to develop and evaluate the Primary Organizational and Relations Team (PORT) – a model for joint cross-sectoral healthcare for patients with multiple chronic diseases.

PORT aims to create patient-centred healthcare trajectories and thereby reduce treatment burden and thereby improve quality of life. In addition, PORT seeks to improve the caregivers’ quality of life and alleviate the strain that may accompany the role as a caregiver.

Grant recipient: University of Copenhagen
Amount: DKK 662,000
Project title: Vulnerable unemployed citizens’ perspectives on coherence in care pathways
The researchers’ project description:
The most vulnerable unemployed citizens in Denmark have huge health problems, which affect their lives and employment prospects. A resource clarification programme including a healthcare plan can be initiated to bring them closer to employment. Unfortunately, poor coordination between the healthcare sector and municipality leads to incoherent care pathways and no progression for these citizens.

The Department of Odontology, University of Copenhagen and the National Institute of Public Health, University of Southern Denmark will collaborate with Høje-Taastrup Municipality on exploring vulnerable citizens’ views on the care pathway involved in the resource clarification programme through qualitative interviews and observations of encounters with the healthcare and municipal systems. Such in-depth understanding of barriers and facilitators for creating coherence in the care pathway for these citizens, can be used to optimize initiatives aiming at improving their health, labour market prospects, and life.

Grant recipient: Lillebælt Hospital (Kolding)
Amount: DKK 911,000
Project title: Rehabilitation for Life: implementation and assessment of a new pathway for older adults after hip fracture
The researchers’ project description:
When an older adult sustains a hip fracture, it is a life-shattering event with severe consequences. Half do not regain physical function and are readmitted due to complications or sickness in spite of systematic quality programmes. We believe the lack of success is due to a minor focus on cooperation with the older adults and health professionals between sectors.

With the Rehabilitation for Life project, we intend to improve the lives of older adults after a hip fracture by implementing and assessing a new pathway in the secondary and primary sectors. We want to establish close cooperation between sectors, to implement early rehabilitation and to conduct vital measurement shortly after discharge. We believe that older adults have to be seen as partners in the rehabilitation. Furthermore, we evaluate the new pathway from two other perspectives: a PhD study with a health economics perspective and a PhD study focusing on the perspective of patients and health professionals.

Further information

Christian Mostrup, Senior Programme Lead, +45 3067 4805, [email protected]