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Utilization of Digital Health Interventions in U.S. Primary Care Settings to Improve Preventive Care: A Scoping Review

Speaker(s)

Craig KJ1, Willis VC2, Jabbarpour Y3, Rhee KB4, Bazemore A5
1IBM Watson Health, Centennial, CO, USA, 2IBM Watson Health, Cambridge, MA, USA, 3American Academy of Family Physicians, Washington, DC, USA, 4CVS Health, Woonsocket, RI, USA, 5The American Board of Family Medicine, Lexington, KY, USA

OBJECTIVES:

Prior studies have examined the impact of individual digital health interventions (DHIs) on preventive service receipt, but no comprehensive review of these modalities has been synthesized. A scoping review with a subgroup analysis was conducted to understand how DHIs are being used in United States (US) primary care settings to enhance and support the delivery of preventive care.

METHODS:

A scoping review was conducted to identify articles from MEDLINE via PubMed, Embase, and the Cochrane Library databases that examined patients, providers, and/or population stakeholders in US primary care (e.g, outpatient, ambulatory, or long-term care) settings that used at least one digital health technology as an intervention for prevention (e.g., primary, secondary, tertiary, or quaternary) and reported beneficial outcomes on health, healthcare performance, and/or implementation science.

RESULTS:

Literature searches identified 5,274 citations and 1,060 full-text studies. Following the subgroup analysis, 241 articles met inclusion criteria. Studies primarily examined DHIs among health information technology including electronic health records (EHRs) (69%), clinical decision support (37%), telehealth (37%), or multiple technologies (61%). DHIs were predominantly used for tertiary prevention (55%). Of the core primary care functions, comprehensiveness was addressed most frequently (87%). DHI users were providers (85%), patients (46%), or multiples (37%). Reported outcomes were primarily clinical (70%) and statistically significant improvements were common (69%). Results were summarized across five topics for the most novel/distinct DHIs: population-centered, patient-centered, care access expansion, panel-centered (dashboarding), and application-driven DHIs. Quality of the included studies was moderate-to-low.

CONCLUSIONS:

The utilization of preventive DHIs in US primary care settings was associated with meaningful improvements in both clinical and non-clinical outcomes across user types; however, adoption and implementation of DHIs were primarily limited to EHRs with clinicians being the most frequent user receiving care management alerts for patients with chronic disease burden.

Code

MT18

Topic

Clinical Outcomes, Medical Technologies, Study Approaches

Topic Subcategory

Clinical Outcomes Assessment, Digital Health, Literature Review & Synthesis

Disease

Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders, Medical Devices, Personalized and Precision Medicine