Project overview
In European countries, 40% of adults have long-term conditions (LTCs), and 25% have multiple long-term chronic conditions (MLTCs). Healthcare systems are ill-equipped to handle this current rise of MLTCs as they rely mainly on consultations that are reactive rather than proactive, fragmented, limited in time and space (i.e., care can only be sought during business-hours at designated locations) and clinician- or disease-centered rather than patient-centered.
Healthcare organizations are therefore investigating blended care models that augment traditional face-to-face interactions with technology-mediated ones. Blended care tools form a continuum from active communication tools, such as video consultation, phone calls, or asynchronous message exchanges, to continuous remote patient monitoring tools and automated just-in-time interventions. Blended care models can:
Support person-centered, proactive care
Reduce the need for face-to-face visits
Offer care tailored to the patients' lives
Enhance patient-clinician relationships
Digital-CACTUS aims to provide health authorities with evidence on which technological solutions should be implemented and how, to optimize the delivery of patient-centered healthcare services.
Chronic care systems are still largely organised around episodic, face-to-face consultations, which can limit continuity of care and responsiveness to patients' day-to-day needs. At the same time, the rapid expansion of digital health solutions offers new opportunities to redesign care pathways and strengthen patient engagement.
Digital-CACTUS was created to address this challenge by exploring how digital tools can transform the organisation and delivery of care for people living with chronic conditions. Rather than simply adding technology to existing models, the project seeks to understand how these innovations can be meaningfully embedded into routine practice to support more coordinated, personalised, and patient-centred care.
To achieve this vision, the project is structured around three interrelated work packages:
Work package 1 examines how the use of digital tools impacts patient-clinician relationships.
This work package will leverage both a multi-country qualitative study involving both patients and clinicians and a meta-synthesis of the medical literature. These two studies will explore the impact of digital tools on communication, trust, and the overall experience of care between patients and clinicians.
Work package 2 develops and validates an innovative patient-reported measurement tool.
This work package will leverage design studies to develop an interactive tool to reconstruct the care journey of patients with chronic conditions. The tool will be implemented by SKEZI, a technological company based in France.
Work package 3 evaluates the potential impact of digital health solutions across healthcare systems.
Using the tool developed in WP2, this work package conducts a large international study to map and compare the care journey of patients in five different countries. Results will be used to understand where and how digital tools could help reduce pain points (i.e., unmet needs, adverse events, unnecessary care) in the care of patients.
Multidisciplinary: transforming healthcare systems is complex because of their intricated funding models, interconnected components, and end-user diversity (from patients, clinicians, and managers to policymakers). To answer complexity, we have adopted a comprehensive approach by a multidisciplinary consortium from Medical Sciences; Public Health (epidemiology and statistics), and Social Sciences.
Mixed-methods: We will combine the depth of qualitative inquiries to capture patients' and clinicians' needs and experience; and the breadth of a large international survey to estimate the type and volume of face-to-face interactions that could be avoided, replaced or enriched by technological solutions.
Participative: We will involve patients, clinicians, and policymakers in developing a novel type of experience measurement tool usable by care organizations to help build an optimal blended care model. Our approach is original because it focuses on measuring patients’ experiences of “failures in care,” not as an average value, but by pinpointing situations where even tiny mismanagement can affect their perceived quality of life.
Public/private partnership: Our research consortium of academic research teams has excellent knowledge of end-users' needs and methodological expertise in developing valid and reliable patient-reported tools. Our private partner combines the resource and expertise required to transform a prototype into a final product usable by care organizations by the end of the project.
Digital-CACTUS will provide evidence-based and patient-centric results for transforming the system.
First, our project aims to define how a care system could be augmented by digital solutions tailored to the needs of individuals. Our focus on patients' experience will ensure that this novel blended care model aligns with societal expectations and promotes patient satisfaction and well-being. By involving patients in co-creating a care system that better fits their needs, our project operates a paradigm shift: the system is not designed by a few experts but by many end-users using evidence-based tools.
Second, our project will identify patients' precise requirements and needs regarding blended care solutions. This targeted approach will help optimize resource allocation and avoid unnecessary resource waste (e.g., investments in tools or services that may not be necessary or effective in specific contexts).
Third, our project will make the proof of concept for a novel type of patient-reported experience measurement that will be replicable in other contexts and for different needs.
Finally, results will be ready-to-use for policymakers, aiding them in developing evidence-based policies that align with the needs and expectations of patients.
