Table 2 Digital solution characteristics

Hyperlink in electronic test communication [12]

Hyperlink / ICT^a

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) [20,21,22, 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.