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Innovations in self care and close care made during COVID 19 pandemic: a narrative review

John Øvretveit (Karolinska Institutet (KI), Medical Management Center, Stockholm, Sweden) (SLSO, Region Stockholm, Stockholm, Sweden)

International Journal of Health Governance

ISSN: 2059-4631

Article publication date: 30 March 2021

Issue publication date: 4 June 2021




Previously, health self-care and informal or “close-care” for family and friends were receiving increasing attention, but became more important during the COVID-2019 pandemic. Sometimes, this was because formal services became less physically accessible to patients and were overburdened by patients ill with COVID-2019. The purpose of this paper is to give an overview of this phenomenon and consider the implications for clinical governance.


A five-step search and narrative review method were used, and case examples were selected to illustrate some of these developments.


Examples discovered and described include innovations in websites, social media support groups, systems for matching volunteers to people needing of help, computer and mobile phone applications, digital devices and virtual health rooms run by peer volunteers to help others to learn and use digital technologies.


In response to their health self-care needs not being met, some patients and carers and their associations developed new digital technologies or adapted existing ones. This use and their innovation separate from health care have been largely unreported in the scientific and professional literature. This is the first review of grey literature and other reports of this growing phenomena.



The authors wish to acknowledge the funding support of the medical management centre that this research draws on for the 2007 review of digital health by patients in the Nordic countries and the Forte research funding agency for the “co-care” project 2015–2020 and for the “Patients in Front” programme 2019–2025.


Øvretveit, J. (2021), "Innovations in self care and close care made during COVID 19 pandemic: a narrative review", International Journal of Health Governance, Vol. 26 No. 2, pp. 88-99.



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