Heart failure is a highly prevalent clinical syndrome, associated with high costs to the national health system and with a negative impact on patients' quality of life. In order to reduce mortality, the rate of hospitalisations and improve quality of life, the empowerment of the patient for self-care from self-monitoring of signs and symptoms, taking medication, education about the disease, is a pillar of the treatment so that they can recognise signs of exacerbation of the disease in time and resort to health services early. Mobile health apps (mHealthh) have shown promise as a tool to engage and promote patient self-care, decreasing mortality and hospitalisations. However, to improve outcomes, more robust studies are needed on the development of the applications with regard to their contents, functions and usability, so as to overcome the obstacles to their use and ensure greater evidence of the benefits of their use.
TopDigital Health
The development of technologies in general and information technologies has in recent years given rise to new management concepts and models, particularly in health services management.
Digital Health is a health and wellness management model that aims to maximise resources by providing and optimising flexible electronic options for citizens based on information and communication technologies. It is a broad concept still evolving, but with several examples of application in all phases of healthcare delivery (Matos et al., 2014).
Telehealth is one of the tools of digital health that aims to use information and communication technologies to manage, monitor and support health at a distance, in the different aspects of care provision, organisation of health services and training of professionals and users, encompassing e-learning, telemonitoring, structured telephone support, telerehabilitation, teleconsultation and m-health applications.
As the centralization of care in citizens is becoming increasingly urgent, the use of telehealth contributes to overcome geographic and time barriers in order to improve access to health care, as well as to promote greater coordination, integration and continuity of care, contributing to the integration of the various levels of health care provision.
Telehealth includes the provision of remote services of prevention, diagnosis, treatment, monitoring or recovery in health, which takes the form of a relationship between the citizen/caregiver and a health service, with articulation and capacity for referral to a face-to-face provision (Azeredo et al., 2023).
Examples of telehealth already present in the National Health System in Portugal are teleconsultation, telemonitoring, telemedicine and tele-rehabilitation, which consist in providing a health service at a distance, with interaction between the user and/or carer and the health professional.
Despite the dissemination of digital health tools, their application is still underused. Several barriers to their use are identified, from the point of view of patients, professionals, ethics, interoperability of systems and health system organisations.