Strategic scenarios for the digitalisation of chronic disease care management: A 10-year foresight case study in Lisbon's primary healthcare setting
本研究通过前瞻性案例方法，探索了里斯本南部初级医疗中数字化工具支持慢性病护理的三种未来情景，分析了技术、治理和环境变化的影响，对政策制定者和医疗管理者有参考价值。
Background Managing chronic diseases in Primary Healthcare (PHC) settings presents persistent challenges, particularly in accessibility, communication, and care coordination. While the implementation of digital technologies remains inconsistent, these tools hold significant potential to improve healthcare efficiency and patient engagement. Objectives This study explores how digital tools can support chronic care in PHC settings in southern Lisbon. It examines enabling factors, integration barriers, and the role of policy in shaping digital transformation. Methods Using a foresight case study approach, the study analyses the long-term impact of digital health implementation by 2032. Participatory workshops and scenario planning were employed to identify strategic uncertainties and plausible future scenarios. Results Three scenarios—Digital PHC, NHS Transition, and Climate Exigency—show the effects of technology, governance shifts, and environmental change. Key enablers are interoperability, AI decision-making, and workforce training. Barriers include infrastructure gaps and low digital health literacy. Findings suggest that digitalisation improves care continuity, resource efficiency, and patient engagement. Conclusions The findings highlight the transformative potential of digital health in PHC-based chronic care, given supportive policies, infrastructure investment, and ongoing workforce training. Future research should explore implementation strategies and governance models to support scalable, equitable, and sustainable digital health adoption in PHC.