**Background:** The global population aged 65 and over reached 703 million in 2019 and is expected to exceed 1.5 billion by 2050. Older adults face increasing physical and mental decline, with rising prevalence of mobility loss, cognitive decline, hearing impairment, and visual impairment, leading to complex health and social care needs. The WHO forecasts a global shortage of 18 million healthcare workers by 2030. Integrated care, supported by information and communication technology (ICT), has been identified as a key strategy to address these challenges. This scoping review aimed to synthesize evidence on the experience and practice of ICT-based integrated care for older adults, examining practice models, initial effects, barriers, and facilitators.
**Methods:** The review followed the Arksey and O'Malley framework and was reported according to the PRISMA-ScR checklist. A systematic search was conducted for studies published between 1 January 2000 and 30 March 2022 across nine electronic databases (PubMed, Web of Science, EBSCO, Scopus, MEDLINE, EMBASE, CINAHL, Cochrane Library, Joanna Briggs Institute), three specialist journals, three key institutional websites (WHO, International Foundation for Integrated Care, European Commission), 11 integrated care project websites, Google Scholar, and reference lists. Two reviewers independently screened and extracted data. Thematic analysis was used to identify core elements, barriers, and facilitators.
**Key Results:** From 30,280 retrieved articles (25,318 from databases, 4,962 from journals), 7,437 duplicates were removed. After title/abstract screening (22,520 excluded) and full-text review, 77 studies were included (71 published, 1 grey literature, 5 working papers). These covered 36 ICT-based integrated care practice models implemented across 29 countries: Europe (22, 75.9%), Asia (4, 13.8%), North America (2, 6.9%), and Oceania (1, 3.4%). Study designs included 11 RCTs, 10 cluster RCTs, 16 quasi-experimental studies, 9 qualitative studies, 4 retrospective cohort studies, and others; 60.5% were interventional studies published from 2003 to 2022.
Seven core elements of ICT-based integrated care were identified: (1) single entry point (often using GPs or primary care), (2) comprehensive geriatric assessment (multidimensional functional health and needs assessment), (3) personalized care planning (evidence-based, guideline-driven), (4) multidisciplinary case conferences (regular team meetings, sometimes virtual), (5) coordinated care (vertical and horizontal integration), (6) case management (nurses, social workers, or volunteers as case managers), and (7) patient empowerment (shared decision-making, self-management support). ICT tools included digital communication (61.1%), electronic health records (33.3%), clinician/patient information systems (33.3%), electronic medical records (16.7%), electronic assessment tools (13.9%), wearable devices and sensors (8.3%), personal health folders (5.6%), digital educational materials (5.6%), electronic prescriptions (2.8%), and social robots (2.8%).
Intervention duration ranged from 3 to 36 months. Positive effects included improved quality of life, enhanced chronic disease self-management, reduced unplanned emergency visits and hospital admissions, prevention of functional decline, and reduced caregiver burden. Eleven practice models were cost-effective. However, eight models failed to improve quality of life or functional capacity, and four showed no net monetary benefit due to high operating costs.
BARRIERS WERE GROUPED INTO FOUR THEMES
demand-side factors (fear/lack of confidence in IT, lack of patient skills, distrust of smart monitoring devices), supply-side factors (lack of provider skills, resistance to IT innovation, human resource shortages), technical factors (inadequate ICT infrastructure, poor compatibility between eHealth tools, complex device/application processes, privacy/security issues), and systemic factors (inadequate legislative frameworks, insufficient funding, uncertainty about cost-effectiveness). Facilitators included adequate human resources, multidisciplinary team involvement, training and regular communication, continuous review and feedback, structured funding, clinical leadership involvement, user-friendly ICT systems, active participation of older adults, and digital integration of health information.
**Clinical Implications:** ICT-based integrated care shows promise for improving outcomes for older adults, particularly frail older adults, those with physical/cognitive impairments, and those with multiple morbidities. However, heterogeneity in outcomes highlights the need for further research to identify optimal care pathways. Successful implementation requires addressing technophobia through age-friendly platforms and training programs, strengthening human resources and provider ICT skills, ensuring interoperable and secure ICT systems, and establishing sustainable funding mechanisms. The findings support the WHO's ICOPE framework and suggest that policymakers should incentivize multi-source financing and develop comprehensive, convenient platforms that meet both supply- and demand-side requirements.