Role of health information technology in enhancing chronic disease management: a scoping review protocol

Abstract

Introduction

Chronic diseases, such as diabetes, hypertension and cardiovascular diseases, represent a significant burden on global health systems. Health information technology (HIT) offers innovative solutions to improve disease management, patient outcomes and healthcare efficiency. However, the diverse applications and impacts of HIT in chronic disease management are not well understood. The objective of this scoping review is to assess the extent and type of evidence on the role of HIT in enhancing chronic disease management.

Methods and analysis

This protocol outlines a scoping review to assess the extent and nature of the evidence on the role of HIT in managing chronic diseases. The review will be conducted in accordance with the JBI methodology for scoping reviews. This review will include studies involving adult patients with chronic diseases. The focus will be on various HIT interventions, including electronic health records (EHRs), telehealth services, mobile health (mHealth) applications, remote monitoring devices and health information exchanges (HIEs). Studies conducted in primary care, hospital and community health settings will be considered. Exclusions will include studies focused on paediatric populations or non-digital health interventions. We will include quantitative, qualitative and mixed-methods studies published from January 2013 to December 2024. A comprehensive search will be conducted across PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus and Google Scholar. Reference lists of included studies will be screened for additional sources. Two independent reviewers will screen titles, abstracts and full texts, extract data and resolve discrepancies through discussion or consultation with a third reviewer. The study is scheduled to begin in May 2025 and conclude by November 2025, and the process will be documented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The data will be presented as tables, charts and a narrative summary.

Ethics and dissemination

As this review involves the analysis of publicly available literature, ethical approval is not required. The results will be disseminated via peer-reviewed publications, conference presentations and engagements with stakeholders involved in chronic disease care and digital health policy. The authors will also explore opportunities to share supplementary materials in open-access repositories to promote transparency and reproducibility.

Correspondence to Dr. Chia-Hsuan Tsai; [email protected]

STRENGTHS AND LIMITATIONS OF THIS STUDY

• This protocol follows the Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist, ensuring methodological transparency.

• The review will map a wide range of health information technology (HIT) applications across multiple chronic diseases and care settings.

• Inclusion of diverse study designs allows comprehensive synthesis of evidence from both qualitative and quantitative sources.

• The study does not assess the quality or risk of bias of the included sources, in accordance with scoping review guidance.

• Grey literature and non-English studies may be under-represented despite our efforts to include a broad search.

Introduction

Chronic diseases, or non-communicable diseases (NCDs), represent a significant and escalating burden on global health systems.^{1 2} These conditions, including diabetes, hypertension, cardiovascular diseases and chronic respiratory diseases, are characterised by their prolonged duration, gradual progression and ongoing need for medical management.^1–3 NCDs are responsible for approximately 71% of all global deaths, emphasising the urgent demand for effective management strategies to mitigate their impact on health outcomes and healthcare systems.⁴

Health information technology (HIT) has emerged as a critical component in the management of chronic diseases, offering innovative solutions to enhance disease management, improve patient outcomes and reduce healthcare costs.^5–7 HIT encompasses a wide range of digital tools and systems designed to handle health information, enhance communication and support clinical decision-making.^{8 9} These technologies include electronic health records (EHRs), telehealth, mobile health (mHealth) applications, remote monitoring devices and health information exchanges (HIEs).^{10 11}

Electronic health records

EHRs serve as comprehensive digital records of patient health information, encompassing medical history, diagnoses, medications, treatment plans, immunisation dates, allergies, radiology images and laboratory test results.^{12 13} EHRs facilitate the seamless sharing of patient information among healthcare providers, ensuring continuity of care.¹⁴ In chronic disease management, EHRs enable tracking patients’ health over time, identifying trends and patterns and facilitating timely interventions.^{15 16} Studies have shown that EHRs can improve the quality of care by reducing medical errors, enhancing clinical decision-making and increasing adherence to evidence-based guidelines.¹⁷

Telehealth

Telehealth involves using telecommunications technologies to deliver healthcare services and information remotely.^{18 19} It encompasses various modalities, including video consultations, remote patient monitoring and mHealth applications. Telehealth has gained prominence, especially during the COVID-19 pandemic, to provide healthcare access while minimising the risk of virus transmission.^{20 21} For chronic disease management, telehealth offers numerous benefits, such as improving access to care for patients in remote or underserved areas, facilitating timely interventions and enhancing patient-provider communication.²² Remote monitoring devices, such as glucometers, blood pressure monitors and fitness wearables, support the continuous measurement of patients’ metrics and enable proactive care.

mHealth applications

mHealth involves leveraging smartphones, tablets and related devices to deliver health services and support patient self-care.²³ mHealth applications offer a range of functionalities, including appointment scheduling, medication reminders, health education and self-management tools. For individuals managing chronic conditions, mHealth apps encourage active involvement by enabling users to monitor their symptoms, track key health indicators and access tailored feedback.^{24 25} These applications can also facilitate communication between patients and healthcare providers, fostering a collaborative approach to disease management. They have been associated with greater patient engagement, improved treatment adherence and better outcomes in chronic care settings.²⁶

Health information exchanges

HIEs are systems that facilitate the secure sharing of health information across different healthcare organisations.²⁷ By enabling the exchange of patient data, HIEs promote coordinated care, reduce unnecessary repetition of tests and procedures, and improve clinical outcomes.^{28 29} In the context of chronic disease management, HIEs can ensure that all healthcare providers involved in a patient’s care have access to comprehensive and up-to-date information, enabling informed decision-making and continuity of care.

Rationale for a scoping review

The growing burden of chronic diseases has accelerated the adoption of HITs to enhance care coordination, patient engagement and system-level efficiency. However, the current literature on HIT for chronic disease management remains fragmented, with many studies limited by disease-specific, population-specific or technology-specific scopes. A comprehensive synthesis of the landscape of HIT applications across multiple chronic conditions and care settings is lacking.

Solomon conducted a systematic review of IT-based self-management systems, concluding that most tools focused narrowly on patient education and self-monitoring.³⁰ Although these systems showed promising outcomes in terms of knowledge and adherence, few incorporated provider–patient collaboration or addressed system integration, and the evidence on clinical outcomes was inconclusive due to methodological limitations.

Kim and Lee extended this analysis to smart device-based interventions for older adults, noting that even though the use of smartphones and tablets for self-management is rising, the research remains methodologically immature and often overlooks the geriatric perspective.³¹ Their review identified critical gaps in user support, clinical effectiveness and integration into routine care pathways.

Zaman et al further highlighted that while ICT tools—such as mHealth, EHRs and telehealth—are increasingly used by older adults, major barriers to uptake persist.³² These include usability issues, digital literacy gaps, infrastructural limitations and a lack of integration with routine care systems. They argue for the need to identify enablers and contextual factors to improve ICT adoption for chronic disease care in ageing populations.

Gammon et al examined the interface between ICT innovation and the chronic care model (CCM). Their scoping review found a lack of conceptual synergy between ICT design and system-level chronic care frameworks.³³ Many interventions focused on technology provision rather than leveraging CCM components such as delivery system redesign, decision support or community linkage.

Barr et al addressed the underexplored role of ICT in enhancing interprofessional collaboration in chronic disease management.³⁴ Their findings suggest that technology can improve communication but is often constrained by professional silos, inadequate implementation strategies and failure to support collaborative workflows.

Together, these reviews underscore the need for a comprehensive mapping of HIT applications that transcends individual diseases, age groups or device types and includes systemic, relational and implementation dimensions. No existing synthesis sufficiently addresses the types, functions, outcomes and implementation contexts of HIT in chronic care across disciplines and populations.

A scoping review is thus methodologically appropriate, as it allows the examination of broad and heterogeneous evidence, as outlined in the frameworks of Arksey and O’Malley (2005),³⁵ Levac et al (2010)³⁶ and the JBI Manual for Evidence Synthesis. Unlike systematic reviews focused on effect size or integrative reviews requiring synthesis across methodologies, scoping reviews facilitate the conceptual mapping of complex, interdisciplinary domains, identification of knowledge gaps and generation of questions for future inquiry. Our review aims to chart the full landscape of HIT-enabled chronic care and inform policy, practice and research across health systems.

Overarching review objective

The objective of this scoping review is to assess the extent and type of evidence available on the role of HIT in enhancing chronic disease management. Specifically, this review aims to:

Identify and categorise the types of HITs used in chronic disease management.

• Assess the impact of HIT on patient outcomes, adherence to treatment and healthcare utilisation in chronic disease management.

• Explore the barriers and facilitators to the implementation and adoption of HIT in managing chronic diseases.

• Identify gaps in the current literature and suggest areas for future research.

Review question

The overarching question for this scoping review, framed using the PCC (Population, Concept, Context) framework, is:

What is the extent and type of evidence available on the use of HIT in enhancing chronic disease management?

To address this overarching question, the review will explore the following subquestions:

• Population:

  • Which specific populations of patients with chronic disease have been studied in relation to HIT interventions?

  • Are there particular demographic characteristics (age, gender, ethnicity) or comorbidities within these populations that are commonly addressed?

• Concept:

  • What types of HIT are being used in chronic disease management?

  • How do these technologies impact patient outcomes, including disease control, quality of life and healthcare utilisation?

  • What evidence exists on the effectiveness of different HIT interventions in improving adherence to treatment regimens?

• Context:

  • In what healthcare settings (eg, primary care, hospitals, community health services) are HIT interventions for chronic disease management being implemented?

  • What are the common barriers and facilitators to the implementation and adoption of HIT in these settings?

Inclusion criteria

Participants

This scoping review will consider studies that examine the role of HIT in the management of chronic or long-term conditions. For the purposes of this review, long-term conditions are defined as NCDs requiring ongoing clinical management over a period of 6 months or more. These include, but are not limited to: diabetes mellitus, hypertension, cardiovascular diseases (eg, heart failure, coronary artery disease), chronic respiratory diseases (eg, asthma, COPD), chronic kidney disease, arthritis, cancer and mental health conditions. Studies focusing on paediatric populations (under 18 years of age) or acute conditions will be excluded.

Concept

The concept of interest is the use of HIT in the management of chronic diseases. HIT encompasses a wide range of digital tools and systems designed to manage health information, facilitate communication and support decision-making in healthcare. Specific HIT interventions include EHRs, telehealth services, mHealth applications, remote monitoring devices and HIEs. Studies that do not focus on HIT or that address non-digital health interventions will be excluded.

Context

The context of this review includes various healthcare settings where HIT is implemented for chronic disease management. This includes primary care facilities, hospitals, community health centres and other healthcare environments. Studies conducted in non-healthcare settings, such as purely academic settings without patient interaction, will be excluded. Consideration will also be given to cultural and subcultural factors, geographic locations and specific racial or gender-based interests that are relevant to the implementation and impact of HIT. Studies that do not provide context relevant to healthcare settings or chronic disease management will be excluded.

Types of sources

This scoping review will consider a diverse range of study designs and sources of evidence, including experimental and quasiexperimental studies (randomised controlled trials, non-randomised controlled trials, before-and-after studies and interrupted time-series studies), analytical observational studies (prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies) and descriptive observational studies (case series, individual case reports and descriptive cross-sectional studies). Qualitative studies focusing on designs such as phenomenology, grounded theory, ethnography, qualitative description, action research and feminist research will also be included. Additionally, systematic reviews that meet the inclusion criteria will be considered, along with relevant text and opinion papers that provide insights into the use of HIT in chronic disease management. This inclusive approach aims to capture a broad spectrum of evidence to map the scope of HIT use and identify knowledge gaps.

Methods

The proposed scoping review will be conducted following the JBI methodology for scoping reviews, as detailed in the JBI Manual for Evidence Synthesis.³⁷

Search strategy

The search strategy will involve a structured, three-stage process to locate both published and unpublished studies:

• Preliminary search: A targeted initial search of MEDLINE (PubMed), CINAHL (EBSCO) and Google Scholar will be conducted to identify relevant articles. Terms used in the titles, abstracts and index fields of these articles will help develop the final strategy.

• Comprehensive search: A refined search strategy will then be applied in PubMed, CINAHL and Scopus, with the syntax adapted to each database. The detailed search strategy appears in Appendix I.

• Reference screening: Reference lists of all selected articles will be screened to identify additional sources, including those found in prior reviews or related literature.

Studies published in any language from 2013 to 2024 will be included. Grey literature, including technical reports, theses and conference proceedings, will be considered, and other relevant studies may be located through search engines or by contacting study authors directly.

Study/source of evidence selection

On completion of the search, all identified citations will be systematically collated and uploaded into EndNote (Clarivate Analytics, PA, USA). This software will be used to organise references and eliminate duplicates. Then, titles and abstracts will be independently reviewed by two authors against the inclusion criteria. Subsequently, the titles and abstracts of the remaining citations will undergo an initial screening process. This will be conducted independently by at least two reviewers, who will assess each citation against the predefined inclusion criteria. This step helps to remove studies that clearly do not meet eligibility, enabling a more focused and manageable set of records for further assessment. For those citations that appear to meet the inclusion criteria based on their titles and abstracts, the full-text articles will be retrieved for a more comprehensive assessment. These full texts will then be imported into the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI), a specialised tool designed to support systematic review management and analysis. Each full-text article will be reviewed separately by two reviewers to determine its inclusion. This thorough evaluation ensures that only studies that are directly relevant and of sufficient quality are included in the final review. During this stage, if any disagreements arise between the reviewers regarding the eligibility of a study, these will be addressed through discussion to reach a consensus. If agreement cannot be reached, a third reviewer will be brought in to assist with the decision. To ensure transparency and reproducibility, the reasons for excluding studies at the full-text review stage will be carefully documented and reported in the final scoping review. Keeping a record of these exclusion decisions supports the rigour and traceability of the review process. Finally, the entire search and study selection process will be thoroughly documented and presented in the final scoping review. This entire selection procedure will be summarised in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The figure will provide a step-by-step visual summary of how studies were identified, screened and selected throughout the review process.

Data extraction

Data extraction from the included studies will be carried out by at least two independent reviewers to ensure accuracy and consistency. The reviewers will use a specially developed data extraction tool, which will be tailored to capture all relevant information pertinent to the review’s objectives. This tool will be structured to systematically collect data across key dimensions, including details about the participants, the specific HIT concept under investigation, the context in which the study was conducted, the study methods employed and the key findings that address the review questions. To ensure the reliability and effectiveness of the data extraction tool, a draft version of the extraction form will be applied using a small sample of included studies. This process will help the reviewers to identify any limitations in the form, such as unclear guidance or missing fields, and enable necessary revisions. Making these adjustments during piloting helps to confirm the tool’s clarity and usability. Any modifications made as a result of the piloting phase will be documented and described in the scoping review. The documentation contributes to methodological transparency and assists future researchers in replicating the process.

During the data extraction process, if any disagreements arise between the reviewers regarding the interpretation or inclusion of specific data, these will be addressed through discussion to reach a consensus. If consensus is not possible, a third reviewer will be engaged to help resolve the disagreement. In situations where key data are missing or additional clarification is needed, the authors of the included studies will be contacted directly. This step ensures that the extracted data are as complete and accurate as possible, allowing for a thorough and reliable synthesis of the evidence.

Data analysis and presentation

The evidence gathered from the included studies will be presented in a format that is carefully aligned with the review’s objectives and research questions. To support a clear and comprehensive understanding of the findings, the data will be visually summarised using tables, figures and other graphical elements. These visual formats will help readers interpret complex information efficiently, drawing attention to key trends, patterns and relationships across studies. During the protocol development phase, alternative options for presenting results will be explored and tested to determine the most effective approach for conveying the results. This stage is essential to ensure that the chosen formats are not only informative but also accessible and interpretable for the intended audience. It will involve testing various layouts, chart types and table designs to identify those that best represent the data and support the narrative of the review. In addition to the graphical presentations, a detailed narrative summary will be provided to contextualise and elaborate on the tabulated and charted data. This narrative will explain how the findings relate to the review’s specific objectives and questions, offering insights into the implications of the results. The narrative will also address any nuances or complexities in the data that may not be fully captured by the visual representations alone, ensuring a comprehensive and balanced interpretation of the evidence. By integrating visual summaries with an interpretive narrative, the final presentation will offer a coherent, comprehensive and informative synthesis that addresses the core questions of the scoping review.

Proposed timeline

The review will proceed according to the following timeline:

• Protocol finalisation and search strategy development: April–May 2025.

• Database searching and study selection: May–June 2025.

• Data extraction and charting: July–August 2025.

• Synthesis and reporting: September–October 2025.

• Manuscript drafting and submission: November 2025.

Protocol registration

This scoping review protocol is not registered in PROSPERO, as the platform currently excludes reviews that do not assess intervention effectiveness. To ensure transparency, this protocol follows the JBI methodology and PRISMA-ScR guidelines and is submitted for peer-reviewed publication.

Ethics and dissemination

As this scoping review involves the analysis of publicly available literature, ethical approval is not required. No human participants will be recruited, and no primary data will be collected. The findings of this review will be disseminated through peer-reviewed journal publications and conference presentations. Additionally, the authors plan to engage stakeholders involved in chronic disease management and digital health policy and will explore opportunities to share online supplemental materials in open-access repositories to promote transparency and reproducibility.

Administrative note on appraisal

As recommended in the JBI Manual for Evidence Synthesis, this scoping review will not undertake a critical appraisal or risk of bias assessment of the included studies, consistent with its objective to map the breadth and scope of the evidence.

Ethics statements

Patient consent for publication

Not applicable.

Footnote

Contributors The following authors were responsible for study conception and design: S-HW and C-HT; acquisition of the data: Y-LL and EC-YS; analysis and interpretation of the data: S-HW and Y-LL; drafting of the manuscript: S-HW; critical revision and revision during submission: C-HT and EC-YS. S-HW is the guarantor of this study. ChatGPT was used solely for grammatical checks and word choice enhancement in the submission.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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