Delphi Assessment of Home-Based Digital Healthcare for Aging Patients: A Biopsychosocial Perspective

The development of home-based clinical interventions and healthcare supported by digital tools has rapidly advanced in recent years, promising improvements in preventive and personalized treatment, especially for aging chronic patients. However, many systems are launched without feedback from healthcare experts, essential for understanding their strengths, limitations, and areas for improvement. This study had two objectives: first, to gather expert opinions on the qualities and limitations of current home-centred healthcare trends for aging patients; second, as a case study, to obtain feedback on a novel system, Time-Integrated Healthcare (TI-Health), integrating these trends. TI-Health uses real-time data to combine bio-psycho-social information through big data and machine learning, enabling health status prediction, diagnosis, prevention, and treatment.

A Delphi group of 60 experts from 9 countries, all with experience using digital health systems, was surveyed. A questionnaire was administered to the group focused on the limitations and qualities of current home-based digital healthcare trends. In addition, the Delphi group provided feedback on the TI-Health system.

A majority of experts believed that personalized healthcare delivered in the patient's home will shape the future of healthcare services. The Delphi group identified key qualities of these trends: improved service integration, enhanced patient comfort, cost reduction, and a deeper understanding of the patient's context. They also highlighted challenges, such as barriers to inter-agency collaboration and data sharing, resistance to change among healthcare professionals, and the need for strong leadership to drive the adoption of new systems. Based on the insights from the Delphi group, this work presents a refined conceptualization of the TI-Health system.

Designing home-based clinical systems such as TI-Health should prioritize effective inter-agency coordination, ensuring data protection and fostering collaborative leadership throughout the implementation process. These factors are crucial to the successful adoption and utilization of new home-based digital health solutions.