Table 2.
Digital solution characteristics
| Digital solution | Solution type | Targeted condition(s) | Disease incidence/prevalence in Denmark | Local / national | Purpose | Status |
|---|---|---|---|---|---|---|
| Hyperlink in electronic test communication [12] | Hyperlink / ICTa | Breast cancer | 4.870 incident cases per year (mean from years 2016–2020) [34]. 74.235 prevalent cases at the end of 2019 [34]. | Central Denmark Region | To increase access to existing, patient-oriented information about the disease and its treatment via the web for GPs. | Tested in 148 GP clinics from June to October 2009 |
| Data Capture Module (DCM) for improvement of diabetes care through the National Danish General Practice Database (DAMD) [13] | Pop-ups, diabetes feedback reports on a report server, and access to an online display of data capture | Type 2 diabetes | 252.516 prevalent cases as of 2017, equivalent to 4.8% of the Danish population [35]. Approximately 18.700 incident cases per year [35]. | Nationwide | To provide GPs access to updated data on the quality of care from their own practice, to identify patients that are not optimally treated. | From April 2011 every Danish GP was obliged within two years to participate in the DCM. |
| Disease management program (DMP) for Chronic Obstructive Pulmonary Disease (COPD) [14, 27, 28] | DMP including a patient identification algorithm and clinical decision support system | COPD | Prevalence is estimated to 300.000 to 400.000 patients and approximately 14% among individuals aged 35 years and above [36]. | Ringkoebing-Skjern Municipality, Denmark | To change/improve the management of COPD in general practice. Effect was measured on planned and additional preventive consultations, performed spirometries, and admissions. | RCT conducted from November 2008 to December 2010 |
| Online decision support system for Prostate-Specific Antigen (PSA) tests [15] | Hyperlink in an electronic medical record system | Prostate cancer | 4.542 incident cases per year (mean from years 2016–2020) [37]. 45.610 prevalent cases at the end of 2019 [37]. | Central Denmark Region | To aid GPs in deciding if a patient should have a PSA test done, to guide the interpretation of PSA results, or to guide the pathway in a fast-track diagnostic program. | Tested in 114 practices from January 1st 2010 to June 30th 2011 |
| GP reminders on follow-up of abnormal cervical cytology [16] | Electronic GP reminder | Cervical cancer | 342 incident cases per year (mean from years 2016–2020) [38]. 8.962 prevalent cases at the end of 2019 [38]. | Nationwide | To reduce loss to follow-up in cervical cancer screening | Implemented in 2012 |
| TeleCare North [17, 29] | Telemonitoring patient data made available to GPs through an electronic monitoring database | COPD | Prevalence is estimated to 300.000 to 400.000 patients and approximately 14% among individuals aged 35 years and above [36]. | North Denmark Region | To improve the management of COPD patients by providing GPs with telemonitoring data on oxygen level, blood pressure, pulse, weight, and symptoms to support GP decision-making. | Implemented in 2012–2014 |
| Electronic Major Depression Inventory (eMDI) [18] | Through WebPatient the eMDI score is automatically returned to the GP’s electronic patient record upon filling out from patients | Depression | It is estimated that around 10% of the adult Danish population has depression (estimated on 2013 data) [39]. This is equivalent to around 300.000-375.000 prevalent cases [40]. | Nationwide | To test psychometric testing of potentially depressive patients in general practice through a telemedicine solution | WebPatient and the possibility to order eMDI testing was implemented nationally in 2015 |
| Electronic Decision Support (EDS) to support end-of-life care [19] | The EDS consisted of a pop-up window in the patient’s medical record and a list of patients with end-of-life needs and key elements in their care | Cancer and COPD | COPD prevalence is estimated to 300.000 to 400.000 patients and approximately 14% among individuals aged 35 years and above [36]. | Central Denmark Region | To support end-of-life care in general practice for patients with cancer or COPD | Pilot-tested in the Central Denmark Region in 2014 |
| Early Detection and Prevention (TOF) [20–22, 32, 33] | Patient results from a risk stratification model and a digital data collection tool were made available to GPs through a digital health folder | Multiple lifestyle-related diseases | Not applicable as the definition included a range of lifestyle-related diseases and risk behavior. | Varde and Haderslev municipalities | To develop a health intervention for early detection of citizens at risk of developing lifestyle-related disease and initiation of preventive care | TOF pilot study took place from September 2016 to December 2016 |
| AI to identify patients at risk of cancer [23] | AI risk score to predict cancer within 90 days | Cancer | 45.205 incident cancer cases as of 2020 [41]. 362.715 prevalent cases as of 2020 [41]. | Region of Southern Denmark | The AI risk score could be a useful tool in decision-making and support GP triage. | Developed on data from the period November 29th 2011 to December 31st 2018. Not yet tested or implemented in general practice. |
| Digital individualized coaching and lifestyle treatment intervention of T2D (DICTA) [24, 30, 31] | The intervention comprises, among other elements, an algorithm-based decision support for GPs implemented in the GP software system XMO | Type 2 diabetes | 252.516 prevalent cases as of 2017, equivalent to 4.8% of the Danish population [35]. Approximately 18.700 incident cases per year [35]. | Region of Southern Denmark and Region Zealand | The algorithm-based decision support can support GPs in prescribing the correct medical treatment. |
The intervention was developed with GPs and pilot-tested in general practices in the Region of Southern Denmark in 2019. The intervention is rolled out in a RCT running from January 2021 to end in 2023. |
| Electronic patient data overview with alerts for management of T2D patients [25] | Electronic overview of T2D patients including red flags for patients not receiving treatment as recommended by guidelines. | Type 2 diabetes | 252.516 prevalent cases as of 2017, equivalent to 4.8% of the Danish population [35]. Approximately 18.700 incident cases per year [35]. | Nationwide | To increase GP prescriptions of lipid-lowering drugs in T2D patients. | The overview was available to Danish GPs in the period from 2011 to 2014. |
| AI for identification of liver fibrosis patients (LiverAID models) [26] | AI algorithm to predict liver stiffness. | Liver fibrosis | Approximately 1000 incident cases per year of alcoholic liver cirrhosis and an estimated prevalence of 12–14.000 [42]. For non-alcoholic fatty liver disease, there is an estimated prevalence of around 1.000.000 individuals [43]. | Region of Southern Denmark | The LiverAID models could be used for the early detection of patients with asymptomatic chronic liver diseases in primary care. | The LiverAID models were developed with data from patients recruited in the period 2013 to 2020. Not yet tested or implemented in general practice. |
a: Information and communication technology