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Introduction
The economic pressures of increasing health care costs and the rise of chronic diseases in an aging population are driving the search for new approaches to the delivery of health services. In this context patients are considered important contributors to a more effective health care. For instance, in Europe several initiatives are currently being implemented with the aim to organize and coordinate care around patients’ needs and advocating their active involvement (Norwegian Ministry of Health, 2008; European Commission, 2012). In this initiatives technology is seen as instrumental to increase information access and patient participation. The use of e-health tools is expected to offer numerous potential benefits and there is a growing consensus that digital technologies should be used more effectively to improve health care (Wilson, 2009).
Although many patients, especially those affected by chronic conditions, already do much of their own coordination and care to cope with the current way care services are delivered, the underlying assumption of e-health tools for patients is that individuals will have to take even more responsibility for and control of their own health and health care (Storni, 2014; Piras and Zanutto, 2014). Thus e-health tools are considered a vehicle to engage patients, support their learning and ownership of care, offer more transparency on care processes and decision making, and enhance their communication with health providers. Such transition is often depicted as a shift from a provider-centered care model to a patient-centered care model, and also as a shift to ensure patient empowerment (Breen et al., 2009; Holmström and Röing, 2010). Both approaches stress how digital technologies contribute to transitioning health delivery toward a new configuration among actors where the traditional relation between patient and health provider is put into question and novel modes of interactions are proposed (Vikkelsø, 2010; Sharf and Street, 1997; Wilson, 2009).
A growing body of literature examines how e-health tools may support patient-centeredness and empower patients. One main concern is how to evaluate the effects of technology use on health care. For instance studies investigate how e-health tools for patient have beneficial impact on their health in the form of, for example, clinical outcomes, compliance with treatment or coping ability (McMahon et al., 2005; Dohan and Tan, 2014; Ghosh et al.,...