John Ovretveit

As the prevalence of chronic illness increases, the demands on healthcare services change. The few hours per year that persons with chronic conditions see healthcare professionals represent a mere fraction of their 24/7 lived experience of coping with their condition. Without patient participation no treatment can be carried out

thus healthcare services are co-produced. This reality requires a shift from professional-oriented care toward patient-oriented supported self-care. Co-care refers to the decisions and activities shared by patients, their informal caregivers, and professionals, aimed at achieving goals valued by the patient. Consequently, in contrast to involve patients in healthcare, healthcare needs to get involved in people’s self-care, to the extent that the patient needs and desires. Making this shift, however, has been challenging for health care practice.Given this implementation gap, the current program is based on five patient-driven co-care innovations and aims to study how new models of self-care and co-care are best implemented in everyday health care practice and patients’ lives, supported by eHealth. This program is collaboration with patients, their informal caregivers and healthcare providers, to ensure that the research meets patients’ needs. The program is conducted in two phases studying: 1) the implementation of the five patient-driven co-care innovations and the development of patient-valued outcome measures and 2) the impact of the co-care innovations on clinical practice, care organization and patient-valued outcomes, the spread and scaling up of the innovations and production of best practice guidelines. Multiple research designs (e.g. comparative case studies, participatory workshops, adaptive intervention design) will be used. The program generates knowledge that enables people with chronic conditions, their informal caregivers and formal healthcare providers to effectively engage in co-care.