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Isakov TM, Härkönen H, Atkova I, Wang F, Vesty G, Hyvämäki P, Jansson M. From challenges to opportunities: Digital transformation in hospital-at-home care. Int J Med Inform 2024; 192:105644. [PMID: 39393125 DOI: 10.1016/j.ijmedinf.2024.105644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/05/2024] [Accepted: 10/01/2024] [Indexed: 10/13/2024]
Abstract
BACKGROUND Digital transformation is an ongoing sosio-technological process that can create opportunities in the health sector. However, the current landscape of digital transformation in hospital-at-home care is unknown. AIM To describe healthcare providers' perspectives of digital transformation in hospital-at-home care. METHODS A total of 25 semi-structured interviews were conducted in September-October 2023 in all Finnish wellbeing services counties (n = 21), the city of Helsinki (n = 1), and private health care providers (n = 3). Snowball sampling was used (N = 46). The data underwent an inductive content analysis. RESULT The analysis revealed four main and 17 generic categories of challenges and opportunities of digital transformation in hospital-at-home care. These challenges and opportunities were related to 1) Health information exchange in and across hospital-at-home care; 2) Management of hospital-at-home care; 3) Logistics in hospital-at-home care planning and delivery; and 4) Digital health interventions in hospital-at-home care delivery. CONCLUSIONS The challenges and opportunities of digital transformation in the hospital-at-home care is intricately linked to the efficiency of health information exchange, management, logistics, and digital health interventions. Addressing the key areas of improvement in health information exchange can lead to more streamlined patient care processes and improved communication between healthcare professionals and patients. Digital transformation in management and logistics can improve overall efficiency within healthcare systems. Digital health interventions may promote equitable and universal access to high-quality healthcare. Continued focus on health care information infrastructure, in particular interoperability of electronic health records and optimization of information flow, will be essential to realize the full potential of digitalization.
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Affiliation(s)
- Terhi-Maija Isakov
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
| | - Henna Härkönen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
| | | | - Fan Wang
- Martti Ahtisaari Institute, Oulu Business School, University of Oulu, Finland.
| | - Gillian Vesty
- School of Accounting, RMIT University, Melbourne, Australia.
| | - Piia Hyvämäki
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Oulu University of Applied Sciences, Oulu, Finland.
| | - Miia Jansson
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; RMIT University, Melbourne, Australia.
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Akhiwu TO, Adewunmi C, Bilalaga M, Atarere JO, Gaddipati G, Chido-Amajuoyi OG, Eziuche DK, Onyeaka H, Amonoo HL. Clinical trial knowledge among cancer survivors in the United States: the role of health information technology. Cancer Causes Control 2024:10.1007/s10552-024-01928-7. [PMID: 39379678 DOI: 10.1007/s10552-024-01928-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 10/02/2024] [Indexed: 10/10/2024]
Abstract
PURPOSE Clinical trials are essential to the advancement of cancer care. However, clinical trial knowledge and participation remain critically low among adult patients with cancer. Health information technology (HIT) could play an important role in improving clinical trial knowledge and engagement among cancer survivors. METHODS We used data from 3,794 adults who completed the 2020 Health Information National Trends Survey, 626 (16.2%) of whom were cancer survivors. We examined the prevalence of HIT use in the study population and by cancer history using chi-squared tests. We used multivariable logistic regression models to examine the impact of HIT use on clinical trial knowledge for cancer survivors and respondents with no cancer history, respectively. RESULTS Approximately 63.8% of cancer survivors reported having some knowledge of clinical trials. Almost half of the cancer survivors used HIT to communicate with doctors (47.1%) and make health appointments (49.4%), 68.0% used HIT to look up health information online and 42.2% used it to check test results. In the adjusted models, the use of HIT in communicating with doctors [OR 2.79; 95% CI (1.41, 5.54)], looking up health information online [OR 2.84; 95% CI (1.04, 7.77)], and checking test results [OR 2.47; 95% CI (1.12, 5.43)] was associated with having some knowledge of clinical trials. CONCLUSION HIT use for engaging with the healthcare team and health information gathering is associated with higher clinical trial knowledge in cancer survivors. Given the rapid increase in mobile technology access globally and the increased use of HIT, digital technology can be leveraged to improve clinical trial knowledge and engagement among cancer survivors.
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Affiliation(s)
- Ted O Akhiwu
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.
- MedStar Health Internal Medicine Residency Program, 201 E University Parkway, Baltimore, MD, 21218, USA.
| | - Comfort Adewunmi
- Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA
| | - Mariah Bilalaga
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Joseph O Atarere
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Greeshma Gaddipati
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | | | - Diamond K Eziuche
- Department of Public Health, National Open University, Abuja, Nigeria
| | - Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
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Laukka E, Lakoma S, Harjumaa M, Hiltunen S, Härkönen H, Jansson M, Leskelä RL, Martikainen S, Pennanen P, Verho A, Torkki P. Older adults' preferences in the utilization of digital health and social services: a qualitative analysis of responses to open-ended questions. BMC Health Serv Res 2024; 24:1184. [PMID: 39367429 PMCID: PMC11451244 DOI: 10.1186/s12913-024-11564-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 09/10/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND While digital health and social services offer promising solutions, they often overlook the perspectives and needs of older adults. This study aims to comprehensively investigate the preferences of older adults regarding the use and development of digital health and social services. METHODS The survey spanned from 19 March to 31 March 2023. The study population comprised 1100 Finnish individuals aged 75 and over from across Finland. The study used qualitative inductive content analysis to examine the open-ended responses obtained in the survey. RESULTS We identified eight main categories for the older adults' preferences: usability, service design, and security; training, support, instructions, and information; flexibility of compatible devices; understandable language and interpretation of laboratory results; available and accessible services; desired functionalities; delivery of information for viewing, and personalization. CONCLUSIONS Older adults' involvement in digital services' strategy development is crucial, emphasizing value co-creation and segmentation while avoiding value co-destruction. Segmenting users and understanding their needs aids in customizing services, improving healthcare provision. Further research should assess the impact of segmentation-based training and digital device provision on older adults' adoption of digital health and social services.
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Affiliation(s)
- Elina Laukka
- Faculty of Medicine, Department of Public Health, University of Helsinki, P.O. BOX 00020, Helsinki, 00014, Finland.
- Nordic Healthcare Group, Vattuniemenranta 2, Helsinki, 00210, Finland.
- School of Wellbeing and Culture, Oulu University of Applied Sciences, P.O. BOX 222, 90101, Oulu, Finland.
| | - Sanna Lakoma
- Faculty of Medicine, Department of Public Health, University of Helsinki, P.O. BOX 00020, Helsinki, 00014, Finland
| | - Marja Harjumaa
- Nordic Healthcare Group, Vattuniemenranta 2, Helsinki, 00210, Finland
- Research Unit of Oulu Advanced Research on Service and Information Systems, University of Oulu, P.O. BOX 8000, Oulu, FI-90014, Finland
| | | | - Henna Härkönen
- Research Unit of Health Sciences and Technology (HST), University of Oulu, P.O. BOX 8000, Oulu, FI-90014, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Sciences and Technology (HST), University of Oulu, P.O. BOX 8000, Oulu, FI-90014, Finland
- RMIT University, GPO Box 2476, Melbourne, VIC, 3001, Australia
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Susanna Martikainen
- Nordic Healthcare Group, Vattuniemenranta 2, Helsinki, 00210, Finland
- Faculty of Social Sciences and Business Studies, Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Paula Pennanen
- Nordic Healthcare Group, Vattuniemenranta 2, Helsinki, 00210, Finland
| | - Anastasiya Verho
- Faculty of Medicine, Department of Public Health, University of Helsinki, P.O. BOX 00020, Helsinki, 00014, Finland
| | - Paulus Torkki
- Faculty of Medicine, Department of Public Health, University of Helsinki, P.O. BOX 00020, Helsinki, 00014, Finland
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Sorrentino M, Fiorilla C, Mercogliano M, Esposito F, Stilo I, Affinito G, Moccia M, Lavorgna L, Salvatore E, Maida E, Barbi E, Triassi M, Palladino R. Technological interventions in European dementia care: a systematic review of acceptance and attitudes among people living with dementia, caregivers, and healthcare workers. Front Neurol 2024; 15:1474336. [PMID: 39416661 PMCID: PMC11479966 DOI: 10.3389/fneur.2024.1474336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 09/23/2024] [Indexed: 10/19/2024] Open
Abstract
Background Alzheimer's and other neurodegenerative forms of dementia affect 8 million Europeans. Assistive technologies are suggested to reduce the burden of care and improve the quality of life of person living with dementia. Nonetheless, the acceptance and attitudes toward technological interventions pose challenges not only for people living with dementia and caregivers but also for healthcare workers. This review specifically aims to investigate how these key groups perceive and accept technology in European dementia care settings. Methods This systematic review was conducted to identify studies, published between 2013 and 2023, that examined the acceptance and attitude of assistive technologies in Alzheimer's and other dementia European settings, following the PRISMA guidelines. Rayyan AI was used for data extraction, and bias was assessed using the Mixed Methods Appraisal Tool. Results Among the 1,202 identified articles, 13 met the inclusion criteria, revealing a prevailing positivity toward technological interventions in dementia care. Nonetheless, several barriers to adoption, including technological unfamiliarity, and specific dementia-related symptoms that complicate usage were identified. They also unveiled varying attitudes, influenced by factors such as familiarity with technologies, perceived usefulness, and the broader context of the COVID-19 pandemic which accelerated telemedicine and digital solution acceptance during restricted mobility and social distancing. Conclusion Understanding attitudes toward technology in dementia care is crucial as it influences the adoption and utilization of tech-based interventions, impacting symptom management and quality of life. Addressing these attitudes through tailored interventions and education can enhance well-being and quality of life for people living with dementia, caregivers, and healthcare professionals.
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Affiliation(s)
- Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Claudio Fiorilla
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | | | - Federica Esposito
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Irene Stilo
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Giuseppina Affinito
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Marcello Moccia
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Luigi Lavorgna
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Elena Salvatore
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | - Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Elisa Barbi
- Meyer Children’s Research Institute, Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
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Liang X, Alam N, Sultana T, Bandara E, Shetty S. Designing A Blockchain-Empowered Telehealth Artifact for Decentralized Identity Management and Trustworthy Communication: Interdisciplinary Approach. J Med Internet Res 2024; 26:e46556. [PMID: 39320943 PMCID: PMC11464941 DOI: 10.2196/46556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 01/17/2024] [Accepted: 06/18/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks. OBJECTIVE The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance. METHODS We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype implementation. We used the design science research methodology to implement our overall design. We innovated over existing telehealth platforms with blockchain integration that improves health care delivery services in terms of security, privacy, and efficiency. We adopted a user-centric design approach and started with user requirement collection, followed by system functionality development. Overall system implementation facilitates user requirements, thus promoting user behavior for the adoption of the telehealth platform with decentralized identity management and an access control mechanism. RESULTS Our investigation identified key challenges to identity management and trustworthy communication processes in telehealth platforms used in the current health care domain. By adopting distributed ledger technology, we proposed a decentralized telehealth platform to support identity management and a trustworthy communication process. Our design and prototype implementation using a smart contract-driven telehealth platform to provide decentralized identity management and trustworthy communication with token-based access control addressed several security challenges. This was substantiated by testing with 10,000 simulated transactions across 5 peers in the Rahasak blockchain network. The proposed design provides resistance to common attacks while maintaining a linear time overhead, demonstrating improved security and efficiency in telehealth services. We evaluated the performance in terms of transaction throughput, smart contract execution time, and block generation time. To create a block with 10,000 transactions, it takes 8 seconds on average, which is an acceptable overhead for blockchain-based applications. CONCLUSIONS We identified technical limitations in current telehealth platforms. We presented several design innovations using blockchain to prototype a system. We also presented the implementation details of a unique distributed architecture for a trustworthy communication system. We illustrated how this design can overcome privacy, security, and scalability limitations. Moreover, we illustrated how improving these factors sets the stage for improving and standardizing the application and for the wide adoption of blockchain-enabled telehealth platforms.
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Affiliation(s)
- Xueping Liang
- Florida International University, Miami, FL, United States
| | - Nabid Alam
- Troy University, Troy, AL, United States
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Ali Sherazi B, Sayyed SA, Möllenhoff K, Läer S. Telepharmacy versus Face-to-Face Approach in Providing Inhaler Technique Training Service: A Non-Inferiority Assessment Among German Pharmacy Students. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2024; 13:165-180. [PMID: 39318441 PMCID: PMC11421451 DOI: 10.2147/iprp.s468881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/28/2024] [Indexed: 09/26/2024] Open
Abstract
Background The use of telepharmacy in delivering pharmaceutical care services has grown in the past few years; however, there are perceptions of its inappropriateness for providing medical device training among pharmacy students and practicing pharmacists. Objective The primary objective of this study was to determine if the telepharmacy approach for providing inhaler technique training service was non-inferior to the face-to-face approach regarding pharmacy students' performance in simulated patient encounters. Secondary objectives were to determine students' self-assessment of their ability to demonstrate and practice inhaler technique between the two modes of communication and their perceptions of telepharmacy. Methods A randomized crossover non-inferiority trial was conducted among undergraduate pharmacy students. Outcomes were measured by comparing Objective Structured Clinical Examination (OSCE) scores of participants' performance between two modes of communication while providing inhaler technique training service. Moreover, the participants also completed self-assessment and perception questionnaires. Results The telepharmacy approach was non-inferior to the face-to-face approach for demonstrating and practicing the correct inhaler technique based on OSCE scores and a predefined non-inferiority margin of -10%. The results also revealed no significant differences in student self-confidence between the two modes of communication. Moreover, participants had a largely positive perception of telepharmacy and its use in providing inhaler technique training service. Conclusion Considering our findings, telepharmacy is a viable alternative to traditional face-to-face consultations for providing inhaler technique training service. However, to address perceived difficulties and differences between virtual and face-to-face consultations, the pharmacy curriculum should include more telepharmacy-related didactic content with experiential learning and simulations.
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Affiliation(s)
- Bushra Ali Sherazi
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Düsseldorf, 40225, Germany
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, 54000, Pakistan
| | - Shahzad Ahmad Sayyed
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Düsseldorf, 40225, Germany
| | - Kathrin Möllenhoff
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, 50924, Germany
| | - Stephanie Läer
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Düsseldorf, 40225, Germany
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Tuitert I, Marinus JD, Dalenberg JR, van 't Veer JT. Digital Health Technology Use Across Socioeconomic Groups Prior to and During the COVID-19 Pandemic: Panel Study. JMIR Public Health Surveill 2024; 10:e55384. [PMID: 39269755 PMCID: PMC11437226 DOI: 10.2196/55384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/15/2024] [Accepted: 06/21/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Digital technologies have become more important in the health care sector in the past decades. This transition from conventional to digital health care has been accelerated by the impact of the COVID-19 pandemic, which poses the risk of creating a "digital divide," inadvertently placing those who are older, economically disadvantaged, and have a lower level of education at a disadvantage. OBJECTIVE This study focuses on the influence of socioeconomic factors on the adoption of digital health technology in the Frisian population and how this relation is affected by the COVID-19 pandemic. METHODS In 2019 and 2020, a panel study was conducted on digital health in the Frisian population in the Netherlands. In the survey, the use of digital health technology was operationalized in a broad sense, going beyond the care context by also including preventative health-promoting solutions generally available on the consumer market, such as wearables and lifestyle apps. First, to assess the influence of socioeconomic factors on the total use of digital health apps, a generalized linear model was fitted with use of digital health app as the dependent variable and socioeconomic factors as between-subject factors on the 2019 data. Second, to analyze whether the use of separate health apps increased from 2019 to 2020, we conducted chi-square tests on different digital health app types. Third, to examine the influence of COVID-19 on the use of digital health apps, a generalized linear mixed model was fitted with the use of digital health apps as the dependent variable, COVID-19 as the within-subject variable, and socioeconomic factors as between-subject factors. RESULTS The results indicated that prior to the COVID-19 pandemic, digital health technology use was higher in women, younger people, and those who are well educated and economically more privileged. Moreover, the percentage of people who reported using digital health technology rose from 70% (1580/2258) to 82.5% (1812/2197) due to the COVID-19 pandemic. This increase was significant for all separate types of digital health technology (all P<.001). In addition, we found the interaction effects of COVID-19 with age and education attainment, indicating that the lower total use among older people and people with lower education attainment became slightly less apparent from 2019 to 2020. CONCLUSIONS These findings on the influence of the COVID-19 pandemic on the digital divide indicated that the use of all types of digital health apps increased and that older individuals and people with a lower level of education caught up a little during COVID-19. Future research should gain more insight into this effect and examine whether it persists beyond the COVID-19 pandemic. Additionally, future endeavors should focus on vulnerable groups, ensuring they receive adequate attention to guarantee access to health care, preventative health-promoting solutions, and social services.
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Affiliation(s)
- Inge Tuitert
- Academy of Health & Social Studies, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Jesse D Marinus
- Planbureau Fryslân, Leeuwarden, Netherlands
- Campus Fryslân, University of Groningen, Leeuwarden, Netherlands
| | - Jelle R Dalenberg
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Job Tb van 't Veer
- Academy of Health & Social Studies, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
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Barkley JA, Scharff RL, Balada-Llasat JM, Kowalcyk B. Impact of the COVID-19 Pandemic on Foodborne Disease Healthcare-Seeking Behavior and Diagnoses at a Large Academic Medical System. Foodborne Pathog Dis 2024. [PMID: 39229760 DOI: 10.1089/fpd.2023.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
The objective of this study was to examine changes in healthcare-seeking behaviors and diagnostic practices around foodborne illness during the COVID-19 pandemic in a large university-based health system. A retrospective cohort study of individuals diagnosed with pathogens commonly transmitted through food between 2015 and 2020 was undertaken using electronic medical record data. Regression models were used to compare measured incidence rates of various foodborne pathogens as well as associated healthcare-seeking behaviors during the pandemic year of 2020 to previous years. Incidence of campylobacteriosis, cholera, and norovirus in 2020 significantly decreased, respectively, by 65.5% (p < 0.01), 90.1% (p = 0.02), and 73.0% (p = 0.03) compared with an average from 2017- to 019. Average annual visits for patients included in our sample significantly increased by 8.0% when comparing the average from 2017-2019 to 2020 (p < 0.01). These results suggest that the pandemic impacted healthcare use related to foodborne disease either due to reduced exposure to foodborne pathogens or reduced willingness to seek healthcare.
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Affiliation(s)
- James A Barkley
- Department of Food Science and Technology, Center for Foodborne Illness Research and Prevention, The Ohio State University, Columbus, Ohio, USA
| | - Robert L Scharff
- Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA
| | | | - Barbara Kowalcyk
- Department of Food Science and Technology, Center for Foodborne Illness Research and Prevention, Translational Data Analytics Institute, The Ohio State University, Columbus, Ohio, USA
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9
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Hansen MA, Chen R, Hirth J, Langabeer J, Zoorob R. Impact of COVID-19 lockdown on patient-provider electronic communications. J Telemed Telecare 2024; 30:1285-1292. [PMID: 36659875 PMCID: PMC9892807 DOI: 10.1177/1357633x221146810] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/30/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND SARS CoV-2 virus (COVID-19) impacted the practice of healthcare in the United States, with technology being used to facilitate access to care and reduce iatrogenic spread. Since then, patient message volume to primary care providers has increased. However, the volume and trend of electronic communications after lockdown remain poorly described in the literature. METHODS All incoming inbox items (telephone calls, refill requests, and electronic messages) sent to providers from patients amongst four primary care clinics were collected. Inbox item rates were calculated as a ratio of items per patient encountered each week. Trends in inbox rates were assessed during 12 months before and after lockdown (March 1st, 2020). Logistic regression was utilized to examine the effects of the lockdown on inbox item rate post-COVID-19 lockdown as compared to the pre-lockdown period. RESULTS Before COVID-19 lockdown, 2.07 new inbox items per encounter were received, which increased to 2.83 items after lockdown. However, only patient-initiated electronic messages increased after lockdown and stabilized at a rate higher than the pre-COVID-19 period (aRR 1.27, p-value < 0.001). In contrast, prescription refill requests and telephone calls quickly spiked, then returned to pre-lockdown levels. CONCLUSION Based on our observations, providers experienced a quick increase in all inbox items. However, only electronic messages had a sustained increase, exacerbating the workload of administrators, staff, and clinical providers. This study directly correlates healthcare technology adoption to a significant disruptive event but also shows additional challenges to the healthcare system that must be considered with these changes.
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Affiliation(s)
- Michael A. Hansen
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Health Management and Policy, University of Texas School of Biomedical Informatics, Houston, TX, USA
| | - Rebecca Chen
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jacqueline Hirth
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - James Langabeer
- Department of Health Management and Policy, University of Texas School of Biomedical Informatics, Houston, TX, USA
| | - Roger Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
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10
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Caiani EG, Kemps H, Hoogendoorn P, Asteggiano R, Böhm A, Borregaard B, Boriani G, Brunner La Rocca HP, Casado-Arroyo R, Castelletti S, Christodorescu RM, Cowie MR, Dendale P, Dunn F, Fraser AG, Lane DA, Locati ET, Małaczyńska-Rajpold K, Merșa CO, Neubeck L, Parati G, Plummer C, Rosano G, Scherrenberg M, Smirthwaite A, Szymanski P. Standardized assessment of evidence supporting the adoption of mobile health solutions: A Clinical Consensus Statement of the ESC Regulatory Affairs Committee: Developed in collaboration with the European Heart Rhythm Association (EHRA), the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the ESC, the Heart Failure Association (HFA) of the ESC, the ESC Young Community, the ESC Working Group on e-Cardiology, the ESC Council for Cardiology Practice, the ESC Council of Cardio-Oncology, the ESC Council on Hypertension, the ESC Patient Forum, the ESC Digital Health Committee, and the European Association of Preventive Cardiology (EAPC). EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2024; 5:509-523. [PMID: 39318699 PMCID: PMC11417493 DOI: 10.1093/ehjdh/ztae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 09/26/2024]
Abstract
Mobile health (mHealth) solutions have the potential to improve self-management and clinical care. For successful integration into routine clinical practice, healthcare professionals (HCPs) need accepted criteria helping the mHealth solutions' selection, while patients require transparency to trust their use. Information about their evidence, safety and security may be hard to obtain and consensus is lacking on the level of required evidence. The new Medical Device Regulation is more stringent than its predecessor, yet its scope does not span all intended uses and several difficulties remain. The European Society of Cardiology Regulatory Affairs Committee set up a Task Force to explore existing assessment frameworks and clinical and cost-effectiveness evidence. This knowledge was used to propose criteria with which HCPs could evaluate mHealth solutions spanning diagnostic support, therapeutics, remote follow-up and education, specifically for cardiac rhythm management, heart failure and preventive cardiology. While curated national libraries of health apps may be helpful, their requirements and rigour in initial and follow-up assessments may vary significantly. The recently developed CEN-ISO/TS 82304-2 health app quality assessment framework has the potential to address this issue and to become a widely used and efficient tool to help drive decision-making internationally. The Task Force would like to stress the importance of co-development of solutions with relevant stakeholders, and maintenance of health information in apps to ensure these remain evidence-based and consistent with best practice. Several general and domain-specific criteria are advised to assist HCPs in their assessment of clinical evidence to provide informed advice to patients about mHealth utilization.
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Affiliation(s)
- Enrico G Caiani
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, P.zza L. da Vinci 32, 20133 Milan, Italy
- IRCCS Istituto Auxiologico Italiano, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
| | - Hareld Kemps
- Department of Cardiology, Maxima Medical Centre, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Petra Hoogendoorn
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
| | - Riccardo Asteggiano
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Poliambulatori Gruppo LARC—Laboratorio Analisi e Ricerca Clinica, Cardiology, Turin, Italy
| | - Allan Böhm
- Premedix Academy NGO, Bratislava, Slovakia
- 3rd Department of Internal Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Hans-Peter Brunner La Rocca
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute, University of Maastricht, Maastricht, The Netherlands
| | - Ruben Casado-Arroyo
- Department of Cardiology, Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Silvia Castelletti
- IRCCS Istituto Auxiologico Italiano, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
| | - Ruxandra Maria Christodorescu
- Department V-Internal Medicine, University of Medicine and Pharmacy V.Babes Timisoara, Timisoara, Romania
- Research Center, Institute of Cardiovascular Diseases, Timisoara, Romania
| | - Martin R Cowie
- Late CVRM, Biopharmaceuticals R&D, Astrazeneca, Boston MA, USA
| | - Paul Dendale
- Department of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Cardiology, Hartcentrum Hasselt, Hasselt, Belgium
| | - Fiona Dunn
- Active Medical Devices, BSI, Milton Keynes, UK
- TEAM-NB, The European Association Medical devices of Notified Bodies, Sprimont, Belgium
| | - Alan G Fraser
- School of Medicine, Cardiff University, Heath Park, Cardiff, UK
| | - Deirdre A Lane
- Department of Cardiovascular Medicine and Liverpool Centre for Cardiovascular Sciences, University of Liverpool, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Emanuela T Locati
- Department of Arrhythmology & Electrophysiology, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Katarzyna Małaczyńska-Rajpold
- Department of Cardiology, Lister Hospital, East and North Hertfordshire NHS Trust, London, UK
- Heart Division, Arrhythmia Section, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Caius O Merșa
- Rhea, Research Center for Heritage and Anthropology, West University of Timișoara, Timișoara, Romania
| | - Lis Neubeck
- Centre for Cardiovascular Health, Edinburgh Napier University, Edinburgh, UK
| | - Gianfranco Parati
- IRCCS Istituto Auxiologico Italiano, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Chris Plummer
- Department of Cardiology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Giuseppe Rosano
- CAG Cardiovascular, St George’s University Hospital, London, UK
- Cardiology, San Raffaele Cassino Hospital, Cassino, Italy
| | - Martijn Scherrenberg
- Department of Cardiology, Hartcentrum Hasselt, Hasselt, Belgium
- Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | | | - Piotr Szymanski
- Center for Postgraduate Medical Education, Marymoncka, Warsaw, Poland
- Clinical Cardiology Center, National Institute of Medicine MSWiA, Wołoska, Warsaw, Poland
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van Kessel R, Ranganathan S, Anderson M, McMillan B, Mossialos E. Exploring potential drivers of patient engagement with their health data through digital platforms: A scoping review. Int J Med Inform 2024; 189:105513. [PMID: 38851132 DOI: 10.1016/j.ijmedinf.2024.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/11/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Patient engagement when providing patient access to health data results from an interaction between the available tools and individual capabilities. The recent digital advancements of the healthcare field have altered the manifestation and importance of patient engagement. However, a comprehensive assessment of what factors contribute to patient engagement remain absent. In this review article, we synthesised the most frequently discussed factors that can foster patient engagement with their health data. METHODS A scoping review was conducted in MEDLINE, Embase, and Google Scholar. Relevant data were synthesized within 7 layers using a thematic analysis: (1) social and demographic factors, (2) patient ability factors, (3) patient motivation factors, (4) factors related to healthcare professionals' attitudes and skills, (5) health system factors, (6) technological factors, and (7) policy factors. RESULTS We identified 5801 academic and 200 Gy literature records, and included 292 (4.83%) in this review. Overall, 44 factors that can affect patient engagement with their health data were extracted. We extracted 6 social and demographic factors, 6 patient ability factors, 12 patient motivation factors, 7 factors related to healthcare professionals' attitudes and skills, 4 health system factors, 6 technological factors, and 3 policy factors. CONCLUSIONS Improving patient engagement with their health data enables the development of patient-centered healthcare, though it can also exacerbate existing inequities. While expanding patient access to health data is an important step towards fostering shared decision-making in healthcare and subsequently empowering patients, it is important to ensure that these developments reach all sectors of the community.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands; Digital Public Health Task Force, Association of School of Public Health in the European Region (ASPHER), Brussels, Belgium.
| | | | - Michael Anderson
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
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Rauwerdink A, Spinazze P, Gijsbers H, Molendijk J, Zwolsman S, Schijven MP, Chavannes NH, Kasteleyn MJ. Approaches to Evaluating Digital Health Technologies: Scoping Review. J Med Internet Res 2024; 26:e50251. [PMID: 39196643 PMCID: PMC11391152 DOI: 10.2196/50251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 12/22/2023] [Accepted: 06/25/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Profound scientific evaluation of novel digital health technologies (DHTs) is key to enhance successful development and implementation. As such, we previously developed the eHealth evaluation cycle. The eHealth evaluation cycle contains 5 consecutive study phases: conceptual, development, feasibility, effectiveness, and implementation. OBJECTIVE The aim of this study is to develop a better understanding of the daily practice of the eHealth evaluation cycle. Therefore, the objectives are to conduct a structured analysis of literature data to analyze the practice of the evaluation study phases and to determine which evaluation approaches are used in which study phase of the eHealth evaluation cycle. METHODS We conducted a systematic literature search in PubMed including the MeSH term "telemedicine" in combination with a wide variety of evaluation approaches. Original peer-reviewed studies published in the year 2019 (pre-COVID-19 cohort) were included. Nonpatient-focused studies were excluded. Data on the following variables were extracted and systematically analyzed: journal, country, publication date, medical specialty, primary user, functionality, evaluation study phases, and evaluation approach. RStudio software was used to summarize the descriptive data and to perform statistical analyses. RESULTS We included 824 studies after 1583 titles and abstracts were screened. The majority of the evaluation studies focused on the effectiveness (impact; 304/824, 36.9%) study phase, whereas uptake (implementation; 70/824, 8.5%) received the least focus. Randomized controlled trials (RCTs; 170/899, 18.9%) were the most commonly used DHT evaluation method. Within the effectiveness (impact) study phase, RCTs were used in one-half of the studies. In the conceptual and planning phases, survey research (27/78, 35%) and interview studies (27/78, 35%) were most frequently used. The United States published the largest amount of DHT evaluation studies (304/824, 36.9%). Psychiatry and mental health (89/840, 10.6%) and cardiology (75/840, 8.9%) had the majority of studies published within the field. CONCLUSIONS We composed the first comprehensive overview of the actual practice of implementing consecutive DHT evaluation study phases. We found that the study phases of the eHealth evaluation cycle are unequally studied and most attention is paid to the effectiveness study phase. In addition, the majority of the studies used an RCT design. However, in order to successfully develop and implement novel DHTs, stimulating equal evaluation of the sequential study phases of DHTs and selecting the right evaluation approach that fits the iterative nature of technology might be of the utmost importance.
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Affiliation(s)
- Anneloek Rauwerdink
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Pier Spinazze
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Harm Gijsbers
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
- Digital Health, Amsterdam Public Health Institute, Amsterdam, Netherlands
- Department of Medical Informatics, eHealth Living & Learning Lab, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Juul Molendijk
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Sandra Zwolsman
- Digital Health, Amsterdam Public Health Institute, Amsterdam, Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
- Digital Health, Amsterdam Public Health Institute, Amsterdam, Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
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Hill A, Morrissey D, Marsh W. What characteristics of clinical decision support system implementations lead to adoption for regular use? A scoping review. BMJ Health Care Inform 2024; 31:e101046. [PMID: 39181544 PMCID: PMC11344512 DOI: 10.1136/bmjhci-2024-101046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Digital healthcare innovation has yielded many prototype clinical decision support (CDS) systems, however, few are fully adopted into practice, despite successful research outcomes. We aimed to explore the characteristics of implementations in clinical practice to inform future innovation. METHODS Web of Science, Trip Database, PubMed, NHS Digital and the BMA website were searched for examples of CDS systems in May 2022 and updated in June 2023. Papers were included if they reported on a CDS giving pathway advice to a clinician, adopted into regular clinical practice and had sufficient published information for analysis. Examples were excluded if they were only used in a research setting or intended for patients. Articles found in citation searches were assessed alongside a detailed hand search of the grey literature to gather all available information, including commercial information. Examples were excluded if there was insufficient information for analysis. The normalisation process theory (NPT) framework informed analysis. RESULTS 22 implemented CDS projects were included, with 53 related publications or sources of information (40 peer-reviewed publications and 13 alternative sources). NPT framework analysis indicated organisational support was paramount to successful adoption of CDS. Ensuring that workflows were optimised for patient care alongside iterative, mixed-methods implementation was key to engaging clinicians. CONCLUSION Extensive searches revealed few examples of CDS available for analysis, highlighting the implementation gap between research and healthcare innovation. Lessons from included projects include the need for organisational support, an underpinning mixed-methods implementation strategy and an iterative approach to address clinician feedback.
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Affiliation(s)
- Adele Hill
- Sport and Exercise Medicine, Queen Mary University, London, UK
| | - Dylan Morrissey
- Sport and Exercise Medicine, Queen Mary University, London, UK
| | - William Marsh
- Electronic Engineering and Computer Science, Queen Mary University, London, UK
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14
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El-Toukhy S, Hegeman P, Zuckerman G, Das AR, Moses N, Troendle J, Powell-Wiley TM. Study of Postacute Sequelae of COVID-19 Using Digital Wearables: Protocol for a Prospective Longitudinal Observational Study. JMIR Res Protoc 2024; 13:e57382. [PMID: 39150750 PMCID: PMC11364950 DOI: 10.2196/57382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/03/2024] [Accepted: 06/14/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Postacute sequelae of COVID-19 (PASC) remain understudied in nonhospitalized patients. Digital wearables allow for a continuous collection of physiological parameters such as respiratory rate and oxygen saturation that have been predictive of disease trajectories in hospitalized patients. OBJECTIVE This protocol outlines the design and procedures of a prospective, longitudinal, observational study of PASC that aims to identify wearables-collected physiological parameters that are associated with PASC in patients with a positive diagnosis. METHODS This is a single-arm, prospective, observational study of a cohort of 550 patients, aged 18 to 65 years, male or female, who own a smartphone or a tablet that meets predetermined Bluetooth version and operating system requirements, speak English, and provide documentation of a positive COVID-19 test issued by a health care professional within 5 days before enrollment. The primary end point is long COVID-19, defined as ≥1 symptom at 3 weeks beyond the first symptom onset or positive diagnosis, whichever comes first. The secondary end point is chronic COVID-19, defined as ≥1 symptom at 12 weeks beyond the first symptom onset or positive diagnosis. Participants must be willing and able to consent to participate in the study and adhere to study procedures for 6 months. RESULTS The first patient was enrolled in October 2021. The estimated year for publishing the study results is 2025. CONCLUSIONS This is a fully decentralized study investigating PASC using wearable devices to collect physiological parameters and patient-reported outcomes. The study will shed light on the duration and symptom manifestation of PASC in nonhospitalized patient subgroups and is an exemplar of the use of wearables as population-level monitoring health tools for communicable diseases. TRIAL REGISTRATION ClinicalTrials.gov NCT04927442; https://clinicaltrials.gov/study/NCT04927442. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57382.
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Affiliation(s)
- Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | - Phillip Hegeman
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | - Gabrielle Zuckerman
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | | | - Nia Moses
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | - James Troendle
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Tiffany M Powell-Wiley
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
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Al-Anezi F. Interlinking FinTech and eHealth: a qualitative study. Front Public Health 2024; 12:1398136. [PMID: 39157524 PMCID: PMC11328015 DOI: 10.3389/fpubh.2024.1398136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction This study investigates the integration of financial technology (FinTech) and electronic health (eHealth) to explore the opportunities, challenges, and implications arising from their interlinkage in Saudi Arabia. Methods Utilizing qualitative semi-structured interviews with 26 participants-including physicians, patients, technical and administrative managers, and FinTech consultants-the research adopts an inductive approach to understand diverse perspectives. Results Key findings reveal significant benefits such as improved efficiency in administrative processes, enhanced access to healthcare services, increased financial inclusion, better decision-making, improved patient experience, and the promotion of innovation and sustainability. However, barriers including regulatory challenges, data privacy and security concerns, interoperability issues, the digital divide, resistance to change, and cost implications were also identified. Conclusion Overall, the integration of FinTech and eHealth holds substantial promise for advancing healthcare delivery in Saudi Arabia. Future implications include the expansion of telehealth services, an increase in startups, the integration of wearable health devices, blockchain-based systems, evolving regulatory frameworks, and heightened collaborations. Addressing the identified challenges is crucial for realizing the full potential of this integration.
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Affiliation(s)
- Fahad Al-Anezi
- Department Management Information Systems, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Bîlbîie A, Puiu AI, Mihăilă V, Burcea M. Investigating Physicians' Adoption of Telemedicine in Romania Using Technology Acceptance Model (TAM). Healthcare (Basel) 2024; 12:1531. [PMID: 39120234 PMCID: PMC11312213 DOI: 10.3390/healthcare12151531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/24/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
This study investigates Romanian physicians' acceptance of telemedicine using the Technology Acceptance Model. We analyzed 1093 responses to an online survey distributed nationwide to physicians via email by the National Authority of Quality Management in Health, employing the partial least squares algorithm to estimate the relationship between the behavioral intention to adopt telemedicine and its potential determinants. Our findings reveal that the model accounts for 84.6% of the variance in behavioral intention to use telemedicine. Among the two constructs of the TAM model, perceived usefulness is a stronger predictor of behavioral intention than perceived ease of use. Additionally, subjective norms positively and significantly influence physicians' intention to use telemedicine and their perception of its usefulness. Furthermore, perceived incentives and accessibility to medical records also positively impact the behavioral intention to use telemedicine.
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Affiliation(s)
- Abigaela Bîlbîie
- Faculty of Theoretical and Applied Economics, The Academy of Economic Studies, 010552 Bucharest, Romania;
| | - Andreea-Ionela Puiu
- Department of Applied Economics and Quantitative Analysis, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania
| | - Viorel Mihăilă
- Department of Public Administration, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania; (V.M.); (M.B.)
| | - Marin Burcea
- Department of Public Administration, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania; (V.M.); (M.B.)
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Pedroso TM, Vasconcelos IM, de Amorim CL, Coelho LR, Corrêa MAM, de Aguiar VB, Mendes MS, Roever L, de Oliveira CRA, Marcolino MS. Medical students experience in working in a public COVID-19 telehealth program: a descriptive study. BMC MEDICAL EDUCATION 2024; 24:756. [PMID: 38997700 PMCID: PMC11245774 DOI: 10.1186/s12909-024-05722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Given the health and social needs generated by the COVID-19 pandemic, the Telehealth Network of Minas Gerais, Brazil, implemented a teleconsultation and telemonitoring program to assist patients with suspected or confirmed COVID-19, the TeleCOVID-MG program. The telemonitoring service was conducted by medical students, under the supervision of a physician. The main goal of this study was to analyze the experience of the students while collaborating on the aforementioned telemonitoring program. METHODS A questionnaire with 27 questions was developed to address the participation of the students in the telehealth program. The questionnaire included questions about the student's profile, the system usability, and the satisfaction in participating in such a telehealth program. The questionnaire was generated on Google Forms® platform and sent via email to each student who was part of the telemonitoring team. RESULTS Sixty students were included in the analysis (median age 25 years-old [interquartile range 24-26], 70% women). Of those, 61.6% collaborated on the telehealth program for more than 6 months, 65.1% performed more than 100 telemonitoring calls, 95.2% reported difficulties in contacting the patient through phone calls; 60.3% believe some patients might have felt insecure about being approached by medical students and not by graduate professionals; and 39.6% reported eventual system instabilities. The main strengths reported by the students were related to the system usability and to the self-perception of the quality of healthcare delivered to the patients. Even though 68.3% of the students mentioned technical difficulties, 96.6% reported that they were promptly solved. Finally, 98.3% believed that the program was useful and would recommend it to an acquaintance. CONCLUSION This study reports a successful experience of undergraduate medical students in a COVID-19 telemonitoring program. Overall, the medical students were satisfied with their participation, especially considering the continuity of clinical practice remotely during a period of classes suspension during the COVID-19 pandemic and their important role in the assistance of patients from low-income regions, which has minimized the health system burden in an emergency context.
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Affiliation(s)
- Thais Marques Pedroso
- School of Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil.
| | - Isabela Muzzi Vasconcelos
- School of Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil
| | - Caroline Lopes de Amorim
- Mucuri School of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Laryssa Reis Coelho
- Mucuri School of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Maria Augusta Matos Corrêa
- Mucuri School of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Virgílio Barroso de Aguiar
- Mucuri School of Medicine, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Mayara Santos Mendes
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, Belo Horizonte, Brazil
| | - Leonardo Roever
- Department of Clinical Research, Brazilian Evidence-Based Health Network, Uberlândia, Brazil; and Gilbert and Rose - Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Clara Rodrigues Alves de Oliveira
- School of Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil
- Telehealth Center, University Hospital, and Telehealth Network of Minas Gerais, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, Belo Horizonte, Brazil
| | - Milena Soriano Marcolino
- School of Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil
- Telehealth Center, University Hospital, and Telehealth Network of Minas Gerais, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, Belo Horizonte, Brazil
- Department of Internal Medicine, Medical School and Telehealth Center, Institute for Health Technology Assessment, Rua Ramiro Barcelos, 2350, building 21 - 507, Porto Alegre, Brazil
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Guillari A, Sansone V, Giordano V, Catone M, Rea T. Assessing digital health knowledge, attitudes and practices among nurses in Naples: a survey study protocol. BMJ Open 2024; 14:e081721. [PMID: 38925700 PMCID: PMC11208876 DOI: 10.1136/bmjopen-2023-081721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Digital competencies are essential for nurses to actively participate in the digitisation of healthcare systems. Therefore, it is important to assess their skill levels to identify strengths and areas for improvement. METHOD AND ANALYSIS This study aims to investigate nurses' knowledge, attitudes, behaviours, subjective norms and behavioural control regarding digital health. A knowledge-attitude-practice model guided the development of a structured questionnaire divided into six sections. A sample of 480 registered nurses of Naples will be involved in the study. After conducting a pretest, an invitation will be publicised through the institutional communication channels of Nurses Provincial Order of Naples. Nurses will respond via a unique link or quick response code sent through a PEC email system (a legally valid email system, which guarantees delivery and receipt). They will have 30 days to complete the survey, scheduled between May and July 2024. ETHICS AND DISSEMINATION No ethics committee approval was required, as the study does not involve minors, direct or indirect physical or physiological harm to participants, or clinical trials. Anonymity will be guaranteed at all data collection and processing levels. The results will be broadly distributed through conference presentations and peer-reviewed publications. The effective use of digital technologies by healthcare professionals can bring significant improvements to healthcare services and help improve the health of individuals and community health. The study's findings will serve as a foundation for developing and implementing educational programmes related to eHealth and telemedicine, promoting the harmonisation of such programmes.
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Affiliation(s)
- Assunta Guillari
- Public Health Department, Federico II University Hospital, Napoli, Campania, Italy
| | - Vincenza Sansone
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli School of Medicine and Surgery, Napoli, Campania, Italy
| | - Vincenza Giordano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | - Maria Catone
- Public Health Department, Federico II University Hospital, Napoli, Campania, Italy
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, Napoli, Campania, Italy
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Rafeh MA, Abbasi AZ, Hollebeek LD, Ali MA, Ting DH. The effect of consumer-perceived COVID-19 ad value on health-protective behavior: Mediating role of engagement. Health Mark Q 2024:1-32. [PMID: 38832765 DOI: 10.1080/07359683.2024.2355378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Though the pandemic has passed, social media-based messaging continues to exhibit COVID-19-related cues (e.g., wearing a face mask to stay safe), continuing to foster consumers' health-protective behavior. However, it remains unclear how social media communications (e.g., advertising) affect such behavior, exposing an important literature-based gap. Addressing this gap, we deploy Ducoffe's advertising value model to examine how pandemic-related advertisements (e.g., those urging consumers to stay safe, including post-the pandemic) impact their health-protective behavior. We also examine how consumer engagement (CE) mediates these associations. To explore these issues, we collected data from a sample of 301 Gen Z consumers, which was analyzed using partial least squares structural equation modeling (PLS-SEM). We find that informative, credible, irritating, and obtrusive ads raise consumer engagement and health-protective behavior. Engagement was also found to strengthen these associations, revealing their strategic value. We conclude by outlining important theoretical and practical implications that arise from our analyses.
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Affiliation(s)
- Mir Abdur Rafeh
- Department of Management Science, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Islamabad, Pakistan
| | - Amir Zaib Abbasi
- IRC for Finance and Digital Economy, King Fahd University of Petroleum & Minerals, Dhahran, Saudi Arabia
| | - Linda D Hollebeek
- Sunway Business School, Sunway University, Malaysia
- Department of Marketing, Vilnius University, Lithuania
- Department of Business Administration, Tallinn University of Technology, Estonia
- Umea School of Business, Economics & Statistics, Umea University, Sweden
- Department of Business Administration, Lund University, Sweden
- Department of Marketing Management, University of Johannesburg, South Africa
| | - Muhammad Asghar Ali
- Department of Management, Riphah International University, Sahiwal Campus, Pakistan
| | - Ding Hooi Ting
- Department of Management and Humanities, Universiti Teknologi PETRONAS, Tronoh, Malaysia
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20
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Figura HM, Saha FJ, Seibt S, Haller H, Bringmann HC, Kessler CS, Kugler J, Cramer H, Michalsen A, Kandil FI, Jeitler M. Effects of an Online Meditation Course on Quality of Life and Positive Emotions: A Prospective Observational Study (EXPANSION Study). JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:518-531. [PMID: 38011030 DOI: 10.1089/jicm.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: Several meditation interventions showed positive effects on physical and mental health. The aim of this study is a first evaluation of the (within-group) effects of a 21-day online meditation course of the "expansion method." Methods: For this exploratory observational study, parameters were assessed at baseline, at 1 month, and at a 3-month follow-up. Exploratory endpoints were health-related quality of life (PROMIS Preference Score), global health (PROMIS) with the subscales physical and mental health, stress perception (Perceived Stress Scale), positive and negative affect regulation (Positive and Negative Affect Schedule), flourishing (Flourishing Scale), self-efficacy (Short Scale for Measuring General Self-Efficacy Beliefs), gratitude and awe (Gratitude and Awe Questionnaire), resilience (Connor-Davidson Resilience Scale), spirituality (Aspects of Spirituality), and mysticism (Mysticism Scale) on validated inventories. In addition, self-constructed questions (NRS) assessed health status, lifestyle, and concept evaluation. Results: Data from 359 participants were included in this study (response rate: 68% at 1 month, 46% at 3 months). The main analysis was based on the complete cases at 1 month (n = 244 participants; 84% female; 51 ± 11 years; 89% German). Medium effect sizes were found for mental health (p < 0.0001; d = 0.6), flourishing (p < 0.0001; d = 0.63), and negative affect (p < 0.0001; d = 0.68) at 1 month. Small effect sizes were obtained for physical health, stress, positive affect, self-efficacy, spirituality, and mysticism at 3 months. In a sensitivity analysis, the strongest effects at 1 month were found in the subgroup that completed per-protocol (n = 140), followed by those with complete data at all time points (n = 159). Effects were lowest in the intention-to-treat analysis (n = 359). The content of the course was positively evaluated by the participants. Conclusions: The online meditation course based on the expansion method had potentially beneficial effects, especially on mental health parameters. Based on the feasibility results, further research using randomized controlled designs is warranted. Clinical Trial Registration: NCT04950543.
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Affiliation(s)
- Hannah Maja Figura
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Felix Joyonto Saha
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Sonja Seibt
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Heidemarie Haller
- Center for Integrative Medicine and Planetary Health, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Holger C Bringmann
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian S Kessler
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Joachim Kugler
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Holger Cramer
- Institute for General Practice and Interprofessional Care, Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
- Bosch Health Campus, Stuttgart, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Farid I Kandil
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
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21
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Fernandes S, von Gunten A, Verloo H. Using AI-Based Technologies to Help Nurses Detect Behavioral Disorders: Narrative Literature Review. JMIR Nurs 2024; 7:e54496. [PMID: 38805252 PMCID: PMC11167323 DOI: 10.2196/54496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/15/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND The behavioral and psychological symptoms of dementia (BPSD) are common among people with dementia and have multiple negative consequences. Artificial intelligence-based technologies (AITs) have the potential to help nurses in the early prodromal detection of BPSD. Despite significant recent interest in the topic and the increasing number of available appropriate devices, little information is available on using AITs to help nurses striving to detect BPSD early. OBJECTIVE The aim of this study is to identify the number and characteristics of existing publications on introducing AITs to support nursing interventions to detect and manage BPSD early. METHODS A literature review of publications in the PubMed database referring to AITs and dementia was conducted in September 2023. A detailed analysis sought to identify the characteristics of these publications. The results were reported using a narrative approach. RESULTS A total of 25 publications from 14 countries were identified, with most describing prospective observational studies. We identified three categories of publications on using AITs and they are (1) predicting behaviors and the stages and progression of dementia, (2) screening and assessing clinical symptoms, and (3) managing dementia and BPSD. Most of the publications referred to managing dementia and BPSD. CONCLUSIONS Despite growing interest, most AITs currently in use are designed to support psychosocial approaches to treating and caring for existing clinical signs of BPSD. AITs thus remain undertested and underused for the early and real-time detection of BPSD. They could, nevertheless, provide nurses with accurate, reliable systems for assessing, monitoring, planning, and supporting safe therapeutic interventions.
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Affiliation(s)
- Sofia Fernandes
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Sion, Switzerland
- Les Maisons de la Providence Nursing Home, Le Châble, Switzerland
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Henk Verloo
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Sion, Switzerland
- Service of Old Age Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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22
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Hayashi T, Bito S. Usage and limitations of medical consultation with patients' families using online video calls: a prospective cohort study. BMC Med Inform Decis Mak 2024; 24:139. [PMID: 38802921 PMCID: PMC11129502 DOI: 10.1186/s12911-024-02542-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Few studies have been conducted on the usage of telehealth focusing on consultations between patients' families and physicians. This study aimed to identify the usage and limitations of online medical consultations with patients' families compared to the traditional in-person consultations. METHODS We conducted a prospective cohort study from April 1, 2020, to September 30, 2021, at an educational acute-care hospital in Japan. The study included hospitalized patients aged 20 years or older and their family members for whom an online or in-person medical consultation between the family member and physician was conducted during the hospitalization period. The primary endpoints assessed were three topics pertaining to medical consultation: medical conditions and treatment plans, policies for life-threatening events, and post-discharge support. The secondary endpoint was the number of consultations required. RESULTS Online consultations and traditional in-person consultations were provided to 58 and 53 patients' families, respectively. Of the patients in the online consultation group who underwent multiple consultations, 46 (79%) also underwent in-person consultations. Regarding the topics, all the patients' families in both consultation groups had consultations on medical conditions and treatment plans; regarding the policy for life-threatening events, 47% of patient families in the online consultation group were consulted compared to 53% of those in the in-person group. Regarding post-discharge support, 59% of patient families in the online group were consulted compared to 40% in the in-person group. In the online consultation group of 58 patients' families, 188 consultations were conducted, including 95 online and 93 in-person consultations. Consultations on policy for life-threatening events were significantly more frequent in in-person consultations than in online consultations (p < 0.05). Regarding post-discharge support, online consultations were significantly more frequent than in-person consultations (p < 0.05). The number of family members who attended online consultations was significantly higher than those who attended in-person consultations (p < 0.05). CONCLUSIONS Online consultation between the physician and patient's family may be an alternative to in-person consultation for explaining medical conditions and treatment plans. However, in-person consultation still plays an important role in sensitive topics, such as policy consultation for life-threatening events.
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Affiliation(s)
- Tetsuro Hayashi
- Division of Clinical Epidemiology, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
| | - Seiji Bito
- Division of Clinical Epidemiology, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
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23
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Gitonga I, Desmond D, Maguire R. Who uses connected health technologies after a cancer diagnosis? evidence from the US Health Information National Trends Survey. J Cancer Surviv 2024:10.1007/s11764-024-01615-1. [PMID: 38744797 DOI: 10.1007/s11764-024-01615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 05/09/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE As the number of people living with and beyond cancer increases, connected health technologies offer promise to enhance access to care and support, while reducing costs. However, uptake of connected health technologies may vary depending on sociodemographic and health-related variables. This study aimed to investigate demographic and health predictors of connected health technology use among people living with and beyond cancer. METHODS Cross-sectional data from the US Health Information National Trends Survey Version 5 Cycle 4 (H5c4) was used. Regression analysis was used to examine associations between sociodemographic factors and the use of connected health technologies. The sample was restricted to individuals who self-reported a cancer diagnosis or history of cancer. RESULTS In this cycle, 626 respondents self-reported a cancer diagnosis, with 41.1% using connected health technologies (health and wellness apps and/or wearable devices). Most were female (58.9%) and white (82.5%); 43.4% had graduated college or higher education. One third (33.6%) had a household income of $75,000 or more. Respondents who were younger, have higher education, were living as married, had higher incomes, had higher self-rated health and had higher health-related self-efficacy were significantly more likely to use connected health technologies. There were no significant associations between gender, race, stratum, time since diagnosis, history of anxiety or depression, and use of connected health technologies among people living with and beyond cancer. CONCLUSIONS Connected health technology use among people living with and beyond cancer is associated with sociodemographic factors. Future research should examine these demographic disparities as the use of connected health technologies in healthcare continues to gather momentum. IMPLICATIONS FOR CANCER SURVIVORS The study underscores a disparity in connected heath technology usage among people living with and beyond cancer. There is a pressing need for research into adoption barriers and interventions to ensure equitable digital healthcare integration among this population, especially with the heightened adoption of technology post COVID-19 pandemic.
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Affiliation(s)
- Isaiah Gitonga
- Department of Psychology, Maynooth University, Maynooth, Ireland.
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland.
| | - Deirdre Desmond
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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Allcock JA, Zhuang M, Li S, Zhao X. Landscape of Digital Technologies Used in the National Health Service in England: Content Analysis. JMIR Form Res 2024; 8:e51859. [PMID: 38639996 PMCID: PMC11069097 DOI: 10.2196/51859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND In England, digital technologies are exploited to transform the way health and social care is provided and encompass a wide range of hardware devices and software that are used in all aspects of health care. However, little is known about the extent to which health care providers differ in digital health technology capabilities and how this relates to geographical and regional differences in health care capacities and resources. OBJECTIVE This paper aims to identify the set of digital technologies that have been deployed by the National Health Services clinical commissioning groups (NHS CCGs) in England. In doing this, we respond to calls to shed light on the internal dynamics and variation in the form of digital capability in England in terms of health service regional differences and health diversity, equity, and inclusion. METHODS We collected 135 annual reports that belong to 106 NHS CCGs in England, comprising more than 18,000 pages in total, released from 2020 to 2021. Using this data set, we identified 2163 pages related to digital technologies and labeled them using content analysis. We follow the construct taxonomy used by digital options theory, a theory from the management information systems field analyzing organizational resource investment choices, in classifying observed technologies according to digital themes-inherent design patterns that we identified and explained. We then used a hierarchical clustering method to extract groups of NHS CCGs that implement similar technology themes. RESULTS We found 31 technologies from the reports and grouped them into 9 digital themes. The 9 themes were further assigned to 1 of the 3 constructs of digital options theory, the identification of patients' requirements (we identified information portals [76/106], digital health engagement [67/106], and digital inclusion support [45/106]), the development of new work patterns (we identified telehealth [87/106], telemedicine [35/106], and care home technologies [40/106]), the realization of improvements in efficiency and public accessibility (we identified online booking [26/106], online triage [104/106], and digital mental health services [74/106]). The 3 clusters of CCGs are identified based on the 8 themes (Hopkins=0.9914, silhouette=0.186), namely (1) digitally disengaged, (2) digitally engaged, and (3) digital torchbearer. CONCLUSIONS Our findings show prominent digital themes within each construct group, namely information portals, telehealth, and online triage, covering people's fundamental health information needs. Almost half of CCGs fell into the digitally disengaged group, and all London CCGs (5/106) belonged to this group. We propose that practitioners should offer specialized assistance to regions with limited digital engagement, emphasizing digital health literacy, inclusion support, and ongoing evaluation, rather than concentrating solely on technical advancements.
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Affiliation(s)
- Jake Alan Allcock
- Department of Sociological Studies, University of Sheffield, Sheffield, United Kingdom
| | - Mengdie Zhuang
- Information School, University of Sheffield, Sheffield, United Kingdom
| | - Shuyang Li
- Business School, University of Birmingham, Birmingham, United Kingdom
| | - Xin Zhao
- Information School, University of Sheffield, Sheffield, United Kingdom
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Lorca LA, Ribeiro IL, Pizarro M, Martínez M, Vivallos J. Functional results and feasibility of a teleprehabilitation program in patients who are candidates for elective colorectal cancer surgery during the COVID-19 pandemic. Asia Pac J Clin Oncol 2024; 20:251-258. [PMID: 36698248 DOI: 10.1111/ajco.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/14/2022] [Accepted: 01/07/2023] [Indexed: 01/27/2023]
Abstract
AIM To assess the value of a prehabilitation program adapted to the current COVID-19 pandemic using a teleprehabilitation modality in a public Latin American hospital. METHODS The medical records of candidates for elective colorectal cancer surgery (CRC) and who completed a teleprehabiltation program were analyzed. Sociodemographic, clinical, and functional variables were analyzed, such as cardiorespiratory capacity with the sit-to-stand test (STST), independence in activities of daily living with the Barthel index, balance with the five-times STST (FSTST) and fatigue with Brief Inventory Fatigue (BFI). The feasibility of the program was analyzed in terms of recruitment, retention, user satisfaction, and reporting of adverse events. RESULTS Of 107 people recruited, 57 completed the program (54%, 68.78 ± 12.36 years). There was a significant difference in the BFI, FSTST, and STS 1-min scores after the intervention (p < .01), with an effect size (Cliff's delta) that varied between -.13 and .21. There were no differences in the Barthel index score. In relation to the viability of the program, 99% of patients referred for surgery could be recruited into the program, with 53% retention. Regarding user satisfaction with the program, seven items (77.7%) were rated as "very satisfied," and two items (22.3%) as "satisfied." No adverse events were recorded. CONCLUSION The structured prehabilitation program adapted to teleprehabilitation for CRC candidates for surgery was effective in optimizing functional results prior to surgery and was feasible to implement in a public hospital with limited resources during the COVID-19 pandemic.
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Affiliation(s)
- Luz Alejandra Lorca
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
| | - Ivana Leao Ribeiro
- Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Marta Pizarro
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
| | - Mónica Martínez
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Jessica Vivallos
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
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Härkönen H, Lakoma S, Verho A, Torkki P, Leskelä RL, Pennanen P, Laukka E, Jansson M. Impact of digital services on healthcare and social welfare: An umbrella review. Int J Nurs Stud 2024; 152:104692. [PMID: 38301306 DOI: 10.1016/j.ijnurstu.2024.104692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/27/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Digital services can be effective and cost-efficient options for treating non-communicable diseases, but generalizability is limited due to heterogeneous treatment effects. This umbrella review aims to evaluate the impact of digital services on population health, costs, and patient and healthcare professional satisfaction, and to identify facilitators and barriers to using digital services in healthcare and social welfare. METHODS The protocol of the study was registered on the 4th of September 2022 to the International Prospective Register of Systematic Reviews, PROSPERO (CRD42022355635). The review was performed using the Centre for Reviews and Dissemination, Cochrane, Ovid Medline, Scopus, and Web of Science in June 2022. The methodological quality of the included reviews was assessed. The impact of digital services was categorized as no evidence, no dominance, and mixed and positive effect. Inductive content analysis was used to identify facilitators and barriers. RESULTS A total of 66 studies were included in the review, 64 % of which were evaluated as high quality. Studies on the impact of digital services in social welfare were not identified. Sixty-five percent of reviews evaluated the impact of digital services on population health with mixed effects; 21 % were on costs with mixed effects; 27 % were on patient satisfaction with positive effects; and 7.6 % were on healthcare professionals' satisfaction with mixed effects. Various features, allocation, end-user support, organized services, and service development facilitated the use of digital services. Correspondingly, barriers were related to service limitations, digital competency, funding- and service strategies, resources and change management. CONCLUSIONS Compared to usual care, digital services had a mixed impact on population health and costs with high satisfaction in patients. Mixed healthcare professionals' satisfaction was associated with the use of digital services, and it was less studied. To ensure successful implementation and sustainability of digital services, attention must be paid to address barriers and supporting facilitators at all levels.
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Affiliation(s)
- Henna Härkönen
- University of Oulu, Research Unit of Health Sciences and Technology (HST), P.O. BOX 8000, FI-90014, Finland.
| | - Sanna Lakoma
- University of Helsinki, Faculty of Medicine, Department of Public Health, P.O. BOX 00020, 00014, Finland
| | - Anastasiya Verho
- University of Helsinki, Faculty of Medicine, Department of Public Health, P.O. BOX 00020, 00014, Finland
| | - Paulus Torkki
- University of Helsinki, Faculty of Medicine, Department of Public Health, P.O. BOX 00020, 00014, Finland
| | | | - Paula Pennanen
- Nordic Healthcare Group, Vattuniemenranta 2, 00210 Helsinki, Finland
| | - Elina Laukka
- Nordic Healthcare Group, Vattuniemenranta 2, 00210 Helsinki, Finland
| | - Miia Jansson
- University of Oulu, Research Unit of Health Sciences and Technology (HST), P.O. BOX 8000, FI-90014, Finland; RMIT University, GPO Box 2476, Melbourne, VIC 3001, Australia
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Underhill C, Freeman J, Dixon J, Buzza M, Long D, Burbury K, Sabesan S, McBurnie J, Woollett A. Decentralized Clinical Trials as a New Paradigm of Trial Delivery to Improve Equity of Access. JAMA Oncol 2024; 10:526-530. [PMID: 38358756 DOI: 10.1001/jamaoncol.2023.6565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Importance The need to maintain clinical trial recruitment during the COVID-19 pandemic has precipitated the rapid uptake of digital health for the conduct of clinical trials. Different terms are used in different jurisdictions and clinical contexts, including digital trials, networked trials, teletrials (TT), and decentralized clinical trials (DCT) with a need to agree to terms. Observations This clinical care review summarized publications and gray literature, including government policies for the safe conduct of clinical trials using digital health. It compares 2 frequently used methodologies, DCT and TT, first developed before the COVID-19 pandemic by trialists and stakeholders in Australia to improve access to cancer clinical trials for geographically dispersed populations. TT uses a networked approach to implement clinical trials to share care between facilities and uses an agreement between sites or a supervision plan to improve governance and safety. Government regulators have adapted existing regulations and invested in the rollout of the TT model. The term DCT emerged in the northern hemisphere and has been the subject of guidance from regulatory agencies. DCT uses digital health to deliver care in nontraditional sites, such as participants' homes, but does not mandate a networked approach between health facilities or require a supervision plan to be in place. Conclusions and Relevance TT can be considered as a specific type of DCT with several potential advantages, including upskilling across a network. DCT is a new paradigm for the use of digital health in the safe conduct of clinical trials and is a transformative issue in cancer care, addressing disparities in access to clinical trials and improving clinical outcomes.
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Affiliation(s)
- Craig Underhill
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, New South Wales, Australia
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
- University of NSW Rural Medical School, Albury, New South Wales, Australia
| | - Jessica Freeman
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
| | | | - Mark Buzza
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
| | - Donna Long
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, New South Wales, Australia
| | - Kate Burbury
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
- Peter MacCallum Cancer Centre Parkville, Victoria, Australia
| | - Sabe Sabesan
- James Cook University, Townsville, Queensland, Australia
- Townsville University Hospital, Townsville, Queensland, Australia
| | - Jacqueline McBurnie
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, New South Wales, Australia
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Lafferty L, Rautenbach C, McNulty A, Ryder N, Slattery C, Houghton R, Kenigsberg A, Murray C, Carrington N, Patel P. Client and staff perceptions of acceptability of MyCheck: a direct-to-pathology telehealth and e-testing service for comprehensive bloodborne virus and sexually transmissible infection screening. Sex Health 2024; 21:SH23194. [PMID: 38683938 DOI: 10.1071/sh23194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
Background Sydney Sexual Health Centre (SSHC) is the largest sexual health clinic in New South Wales (NSW), servicing clients at high risk of sexually transmissible infections and bloodborne viruses. SSHC piloted a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at one of the ~500 participating pathology collection centres located across NSW. This qualitative study sought to understand SSHC client and provider perspectives of acceptability of the MyCheck intervention. Methods Semi-structured in-depth interviews were conducted with 11 clients who underwent testing via the MyCheck pathway and eight staff members involved in implementing MyCheck. The seven components of Sekhon's Theoretical Framework of Acceptability informed this analysis. Results Participants broadly conveyed 'affective attitude' toward the MyCheck pathway. The telehealth intervention reduced client 'burden' and 'opportunity cost' through enabling greater testing convenience at a location suitable to them and provided timely results. Issues of 'ethicality' were raised by clients and staff as pathology centre staff were, on a few occasions, regarded as being judgmental of SSHC clients. 'Intervention coherence' issues were largely attributed to pathology centre personnel being unfamiliar with the intervention, with billing issues being a recurrent concern. Participants perceived MyCheck as an 'effective' testing pathway. SSHC staff were able to offer the intervention with ease through seamless IT integration ('self-efficacy'). Conclusion The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres.
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Affiliation(s)
- Lise Lafferty
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia; and Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney, NSW 2052, Australia
| | - Clinton Rautenbach
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia; and University of Johannesburg, PO Box 524, Auckland Park 2006, South Africa
| | - Anna McNulty
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia
| | - Nathan Ryder
- STI Programs Unit, NSW Ministry of Health, 150 Albion Street, Surry Hills, NSW 2010, Australia; and The Pacific Clinic, Level 2/670 Hunter Street, Newcastle West, NSW 2302, Australia
| | - Carolyn Slattery
- STI Programs Unit, NSW Ministry of Health, 150 Albion Street, Surry Hills, NSW 2010, Australia
| | - Rebecca Houghton
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia
| | - Aurelie Kenigsberg
- NSW Sexual Health Infolink, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia
| | - Carolyn Murray
- Centre for Population Health, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia
| | - Nigel Carrington
- Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia; and Centre for Population Health, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia
| | - Prital Patel
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia
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Dominiak M, Gędek A, Antosik AZ, Mierzejewski P. Mobile health for mental health support: a survey of attitudes and concerns among mental health professionals in Poland over the period 2020-2023. Front Psychiatry 2024; 15:1303878. [PMID: 38559395 PMCID: PMC10978719 DOI: 10.3389/fpsyt.2024.1303878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Mobile health (mHealth) has emerged as a dynamic sector supported by technological advances and the COVID-19 pandemic and have become increasingly applied in the field of mental health. Aim The aim of this study was to assess the attitudes, expectations, and concerns of mental health professionals, including psychiatrists, psychologists, and psychotherapists, towards mHealth, in particular mobile health self-management tools and telepsychiatry in Poland. Material and methods This was a survey conducted between 2020 and 2023. A questionnaire was administered to 148 mental health professionals, covering aspects such as telepsychiatry, mobile mental health tools, and digital devices. Results The majority of professionals expressed readiness to use telepsychiatry, with a peak in interest during the COVID-19 pandemic, followed by a gradual decline from 2022. Concerns about telepsychiatry were reported by a quarter of respondents, mainly related to difficulties in correctly assessing the patient's condition, and technical issues. Mobile health tools were positively viewed by professionals, with 86% believing they could support patients in managing mental health and 74% declaring they would recommend patients to use them. Nevertheless, 29% expressed concerns about the effectiveness and data security of such tools. Notably, the study highlighted a growing readiness among mental health professionals to use new digital technologies, reaching 84% in 2023. Conclusion These findings emphasize the importance of addressing concerns and designing evidence-based mHealth solutions to ensure long-term acceptance and effectiveness in mental healthcare. Additionally, the study highlights the need for ongoing regulatory efforts to safeguard patient data and privacy in the evolving digital health landscape.
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Affiliation(s)
- Monika Dominiak
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Gędek
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Praski Hospital, Warsaw, Poland
| | - Anna Z. Antosik
- Department of Psychiatry, Faculty of Medicine, Collegium Medicum, Cardinal Wyszynski University, Warsaw, Poland
| | - Paweł Mierzejewski
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
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Gauthier-Beaupré A, Kuziemsky C, Battistini BJ, Jutai JW. Framework for policymaking on self-management of health by older adults using technologies. Health Res Policy Syst 2024; 22:32. [PMID: 38443938 PMCID: PMC10913262 DOI: 10.1186/s12961-024-01119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/07/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, the use of information and communication technologies (ICTs) to support care management exponentially increased. Governments around the world adapted existing programs to meet the needs of patients. The reactivity of governments, however, led to changes that were inequitable, undermining groups such as older adults living with chronic diseases and disability. Policies that align with recent developments in ICTs can promote better health outcomes and innovation in care management. A framework for policymaking presents potential for overcoming barriers and gaps that exist in current policies. OBJECTIVE The goal of this study was to examine how well a provisional framework for policymaking represented the interactions between various components of government policymaking on older adults' self-management of chronic disease and disability using ICTs. METHODS Through an online survey, the study engaged policymakers from various ministries of the government of Ontario in the evaluation and revision of the framework. The data were analyzed using simple statistics and by interpreting written comments. RESULTS Nine participants from three ministries in the government of Ontario responded to the questionnaire. Overall, participants described the framework as useful and identified areas for improvement and further clarification. A revised version of the framework is presented. CONCLUSIONS Through the revision exercise, our study confirmed the relevance and usefulness for a policymaking framework on the self-management of disease and disability of older adults' using ICTs. Further inquiries should examine the application of the framework to jurisdictions other than Ontario considering the dissociated nature of Canadian provincial healthcare systems.
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Affiliation(s)
- Amélie Gauthier-Beaupré
- Faculty of Health Sciences and Life Research Institute, University of Ottawa, Ottawa, ON, Canada.
| | - Craig Kuziemsky
- School of Business, MacEwan University, Edmonton, AB, Canada
| | - Bruno J Battistini
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey W Jutai
- Faculty of Health Sciences and Life Research Institute, University of Ottawa, Ottawa, ON, Canada
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Lazar MS, Ganesh V, Naik B N, Singh A, Puri GD, Kaur S. Efficacy of remote audio-visual system versus standard onsite buddy system to monitor the doffing of personal protective equipment during COVID-19 pandemic: An observational study. Int J Health Plann Manage 2024; 39:530-540. [PMID: 38163283 DOI: 10.1002/hpm.3754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 09/17/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Literature states a higher self-contamination rate among healthcare workers (HCWs) while doffing personal protective equipment (PPE). During the Covid-19 pandemic, onsite trained observers were not always available to monitor PPE compliance. The remote audio-visual doffing surveillance (RADS) system has the potential to overcome this limitation. We aimed to compare the efficacy of this real-time RADS system against the onsite buddy system for monitoring the doffing of PPE. METHODS This prospective, observational study was carried out at our tertiary care centre in northern India. 200 HCWs who cared for Covid-19 patients in the intensive care units/operation theatres were included. Group A included HCWs who performed doffing with the help of an onsite trained observer and group B included HCWs who performed doffing with the RADS system. An independent observer noted the error at any step using the CDC doffing checklist, in both groups. An online questionnaire to analyse the level of satisfaction post-doffing was also surveyed. RESULTS The proportion of errors committed during doffing was significantly lower in group B compared to group A with a low relative risk of 0.34 (95% CI 0.22-0.51) (p < 0.001) (Figure 1A,B). In both groups, there was no difference in HCWs feedback regarding the ease of the system and fear of committing an error. Though the perceived quality of monitoring was felt better with onsite buddy, the overall confidence rating of being safe after doffing was better with the RADS system. CONCLUSION Real-time RADS system may be more effective than the onsite buddy system for ensuring the safety of HCWs during doffing PPE. HCWs level of satisfaction related to the ease and anxiety with the monitoring systems were comparable. RADS system can reduce reliance on HCW resources and can integrate well into existing healthcare systems.
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Affiliation(s)
- Michelle Shirin Lazar
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Venkata Ganesh
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Naik B
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Singh
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - G D Puri
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sukhpal Kaur
- National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Weik L, Fehring L, Mortsiefer A, Meister S. Understanding inherent influencing factors to digital health adoption in general practices through a mixed-methods analysis. NPJ Digit Med 2024; 7:47. [PMID: 38413767 PMCID: PMC10899241 DOI: 10.1038/s41746-024-01049-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024] Open
Abstract
Extensive research has shown the potential value of digital health solutions and highlighted the importance of clinicians' adoption. As general practitioners (GPs) are patients' first point of contact, understanding influencing factors to their digital health adoption is especially important to derive personalized practical recommendations. Using a mixed-methods approach, this study broadly identifies adoption barriers and potential improvement strategies in general practices, including the impact of GPs' inherent characteristics - especially their personality - on digital health adoption. Results of our online survey with 216 GPs reveal moderate overall barriers on a 5-point Likert-type scale, with required workflow adjustments (M = 4.13, SD = 0.93), inadequate reimbursement (M = 4.02, SD = 1.02), and high training effort (M = 3.87, SD = 1.01) as substantial barriers. Improvement strategies are considered important overall, with respondents especially wishing for improved interoperability (M = 4.38, SD = 0.81), continued technical support (M = 4.33, SD = 0.91), and improved usability (M = 4.20, SD = 0.88). In our regression model, practice-related characteristics, the expected future digital health usage, GPs' digital affinity, several personality traits, and digital maturity are significant predictors of the perceived strength of barriers. For the perceived importance of improvement strategies, only demographics and usage-related variables are significant predictors. This study provides strong evidence for the impact of GPs' inherent characteristics on barriers and improvement strategies. Our findings highlight the need for comprehensive approaches integrating personal and emotional elements to make digitization in practices more engaging, tangible, and applicable.
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Affiliation(s)
- Lisa Weik
- Health Care Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Leonard Fehring
- Helios University Hospital Wuppertal, Department of Gastroenterology, Witten/Herdecke University, Wuppertal, Germany
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Achim Mortsiefer
- General Practice II and Patient-Centredness in Primary Care, Institute of General Practice and Primary Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Sven Meister
- Health Care Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.
- Department Healthcare, Fraunhofer Institute for Software and Systems Engineering ISST, Dortmund, Germany.
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Clark EC, Neumann S, Hopkins S, Kostopoulos A, Hagerman L, Dobbins M. Changes to Public Health Surveillance Methods Due to the COVID-19 Pandemic: Scoping Review. JMIR Public Health Surveill 2024; 10:e49185. [PMID: 38241067 PMCID: PMC10837764 DOI: 10.2196/49185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/06/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Public health surveillance plays a vital role in informing public health decision-making. The onset of the COVID-19 pandemic in early 2020 caused a widespread shift in public health priorities. Global efforts focused on COVID-19 monitoring and contact tracing. Existing public health programs were interrupted due to physical distancing measures and reallocation of resources. The onset of the COVID-19 pandemic intersected with advancements in technologies that have the potential to support public health surveillance efforts. OBJECTIVE This scoping review aims to explore emergent public health surveillance methods during the early COVID-19 pandemic to characterize the impact of the pandemic on surveillance methods. METHODS A scoping search was conducted in multiple databases and by scanning key government and public health organization websites from March 2020 to January 2022. Published papers and gray literature that described the application of new or revised approaches to public health surveillance were included. Papers that discussed the implications of novel public health surveillance approaches from ethical, legal, security, and equity perspectives were also included. The surveillance subject, method, location, and setting were extracted from each paper to identify trends in surveillance practices. Two public health epidemiologists were invited to provide their perspectives as peer reviewers. RESULTS Of the 14,238 unique papers, a total of 241 papers describing novel surveillance methods and changes to surveillance methods are included. Eighty papers were review papers and 161 were single studies. Overall, the literature heavily featured papers detailing surveillance of COVID-19 transmission (n=187). Surveillance of other infectious diseases was also described, including other pathogens (n=12). Other public health topics included vaccines (n=9), mental health (n=11), substance use (n=4), healthy nutrition (n=1), maternal and child health (n=3), antimicrobial resistance (n=2), and misinformation (n=6). The literature was dominated by applications of digital surveillance, for example, by using big data through mobility tracking and infodemiology (n=163). Wastewater surveillance was also heavily represented (n=48). Other papers described adaptations to programs or methods that existed prior to the COVID-19 pandemic (n=9). The scoping search also found 109 papers that discuss the ethical, legal, security, and equity implications of emerging surveillance methods. The peer reviewer public health epidemiologists noted that additional changes likely exist, beyond what has been reported and available for evidence syntheses. CONCLUSIONS The COVID-19 pandemic accelerated advancements in surveillance and the adoption of new technologies, especially for digital and wastewater surveillance methods. Given the investments in these systems, further applications for public health surveillance are likely. The literature for surveillance methods was dominated by surveillance of infectious diseases, particularly COVID-19. A substantial amount of literature on the ethical, legal, security, and equity implications of these emerging surveillance methods also points to a need for cautious consideration of potential harm.
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Affiliation(s)
- Emily C Clark
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Sophie Neumann
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Stephanie Hopkins
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Alyssa Kostopoulos
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Leah Hagerman
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Dominiak M, Gędek A, Antosik AZ, Mierzejewski P. Prevalence, attitudes and concerns toward telepsychiatry and mobile health self-management tools among patients with mental disorders during and after the COVID-19 pandemic: a nationwide survey in Poland from 2020 to 2023. Front Psychiatry 2024; 14:1322695. [PMID: 38260801 PMCID: PMC10801431 DOI: 10.3389/fpsyt.2023.1322695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Mobile Health (mHealth) is a rapidly growing field of medicine that has the potential to significantly change everyday clinical practice, including in psychiatry. The COVID-19 pandemic and technological developments have accelerated the adoption of telepsychiatry and mobile solutions, but patient perceptions and expectations of mHealth remain a key factor in its implementation. Aim The aim of this study was to assess (1) the prevalence, (2) attitudes, preferences and (3) concerns about mobile mental health, including telepsychiatry and self-management tools, among patients with mental disorders over the period 2020-2023, i.e., at the onset, peak and after the expiration of the COVID-19 pandemic. Materials and methods A semi-structured survey was administrated to 354 patients with mental disorders in Poland. The questions were categorized into three section, addressing prevalence, attitudes, and concerns about telepsychiatry and mobile health self-management tools. The survey was conducted continuously from May 2020 to the end of May 2023. Result As many as 95.7% of patients with mental disorders used mobile devices at least once a week. Over the course of 3 years (from 2020 to 2023), there was a significant increase in the readiness of patients to embrace new technologies, with the percentage rising from 20% to 40%. In particular, a remarkable growth in patient preferences for telepsychiatry was observed, with a significant increase from 47% in 2020 to a substantial 96% in 2023. Similarly, mHealth self-management tools were of high interest to patients. In 2020, 62% of patients like the idea of using mobile apps and other mobile health tools to support the care and treatment process. This percentage also increased during the pandemic, reaching 66% in 2023. At the same time, the percentage of patients who have concerns about using m-health solutions has gradually decreased, reaching 35% and 28% in 2023 for telepsychiatry and for the reliability and safety of m-health self-management tools, respectively. Conclusion This study highlights the growing acceptance of modern technologies in psychiatric care, with patients showing increased readiness to use telepsychiatry and mobile health self-management tools, in particular mobile applications, after the COVID-19 pandemic. This was triggered by the pandemic, but continues despite its expiry. In the face of patient readiness, the key issue now is to ensure the safety and efficacy of these tools, along with providing clear guidelines for clinicians. It is also necessary to draw the attention of health systems to the widespread implementation of these technologies to improve the care of patients with mental disorders.
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Affiliation(s)
- Monika Dominiak
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Gędek
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Anna Z. Antosik
- Department of Psychiatry, Faculty of Medicine, Collegium Medicum, Cardinal Wyszynski University in Warsaw, Warsaw, Poland
| | - Paweł Mierzejewski
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
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Emedoli D, Houdayer E, Della Rosa PA, Zito A, Brugliera L, Cimino P, Padul JD, Tettamanti A, Iannaccone S, Alemanno F. Continuity of care for patients with dementia during COVID-19 pandemic: flexibility and integration between in-person and remote visits. Front Public Health 2024; 11:1301949. [PMID: 38259745 PMCID: PMC10800651 DOI: 10.3389/fpubh.2023.1301949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction During the pandemic, the Cognitive Disorders Unit of San Raffaele Hospital (Milan, Italy) offered patients the opportunity to undergo neuropsychological evaluations and cognitive training through telemedicine. Method We conducted an investigation to assess how patients responded to this option and to determine if telemedicine could ensure continuity of care. Results Between October 2019 and May 2022, a total of 5,768 telemedicine appointments and 8,190 in-person outpatient appointments were conducted, resulting in an increase in the rate of telemedicine activity from 16.81% in January 2020 to 23.21% in May 2022. Peaks in telemedicine activity reached 85.64% in May 2020 and 83.65% in February 2021, both representing a significant portion of the total activity. Interestingly, there was a notable positive correlation between telemedicine activity and the worsening of the Italian pandemic (r = 0.433, p = 0.027). Discussion During the peaks of contagion, the total number of visits remained stable, highlighting that telemedicine effectively served as a valuable and efficient tool to ensure continuity of care for vulnerable patients. This was evident from the integration of remote visits with in-person appointments.
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Affiliation(s)
- Daniele Emedoli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elise Houdayer
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Alice Zito
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigia Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Cimino
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jeffrey David Padul
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Tettamanti
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Alemanno
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Yang M, Al Mamun A, Gao J, Rahman MK, Salameh AA, Alam SS. Predicting m-health acceptance from the perspective of unified theory of acceptance and use of technology. Sci Rep 2024; 14:339. [PMID: 38172184 PMCID: PMC10764358 DOI: 10.1038/s41598-023-50436-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Addressing the growing popularity of mobile health (m-Health) technology in the health industry, the current study examined consumers' intention and behaviour related to the usage of digital applications based on the unified theory of acceptance and use of technology (UTAUT). In particular, this study quantitatively assessed the moderating role of perceived product value and mediating role of intention to use m-Health application among Indonesians. This study adopted a cross-sectional design and collected quantitative data from conveniently selected respondents through an online survey, which involved 2068 Telegram users in Indonesia. All data were subjected to the analysis of partial least square- structural equation modeling (PLS-SEM). The obtained results demonstrated the moderating effect of perceived product value on the relationship between intention to use m-Health application (m-health app) and actual usage of m-Health app and the mediating effects of intention to use m-Health app on the relationships of perceived critical mass, perceived usefulness, perceived convenience, perceived technology accuracy, and perceived privacy protection on actual usage of m-Health app. However, the intention to use m-Health app did not mediate the influence of health consciousness and health motivation on the actual usage of m-Health app. Overall, this study's findings on the significance of intention to use m-Health app and perceived product value based on the UTAUT framework serve as insightful guideline to expand the usage of m-Health app among consumers.
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Affiliation(s)
- Marvello Yang
- Faculty of Entrepreneurship, Institute of Technology and Business Sabda Setia Pontianak, Kota Pontianak, Kalimantan Barat, 78121, Indonesia
| | - Abdullah Al Mamun
- UKM - Graduate School of Business, Universiti Kebangsaan, Malaysia, UKM, 43600, Bangi, Selangor Darul Ehsan, Malaysia.
| | - Jingzu Gao
- UKM - Graduate School of Business, Universiti Kebangsaan, Malaysia, UKM, 43600, Bangi, Selangor Darul Ehsan, Malaysia
| | - Muhammad Khalilur Rahman
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Pengkalan Chepa, Malaysia
- Angkasa-Umk Research Academy, Universiti Malaysia Kelantan, Pengkalan Chepa, Malaysia
| | - Anas A Salameh
- College of Business Administration, Prince Sattam Bin Abdulaziz University, 11942, Al-Kharj, Saudi Arabia
| | - Syed Shah Alam
- UKM - Graduate School of Business, Universiti Kebangsaan, Malaysia, UKM, 43600, Bangi, Selangor Darul Ehsan, Malaysia
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Leena T, Jenna P, Carme C, Leeni L, Helena LK, Sònia M, Minna S, Virpi S, Heli V. Digital skills of health care professionals in cancer care: A systematic review. Digit Health 2024; 10:20552076241240907. [PMID: 38528966 PMCID: PMC10962045 DOI: 10.1177/20552076241240907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024] Open
Abstract
Background The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research. Methods Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis. Results The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs' required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified. Conclusion The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.
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Affiliation(s)
- Tuominen Leena
- Department of Nursing Science, University of Turku, Turku, Finland
- Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Poraharju Jenna
- Department of Nursing Science, University of Turku, Turku, Finland
- Intensive Care Unit, Helsinki University Hospital, Helsinki, Finland
| | - Carrion Carme
- Research of Faculty of Health Sciences Studies, Open University of Catalonia (Universitat Oberta de Catalunya, UOC), Barcelona, Spain
| | - Lehtiö Leeni
- Turku University Library, University of Turku, Turku, Finland
| | - Leino-Kilpi Helena
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Moretó Sònia
- Open University of Catalonia (Universitat Oberta de Catalunya, UOC), Barcelona, Spain
| | - Stolt Minna
- Department of Nursing Science, University of Turku, Turku, Finland
- Satakunta Wellbeing Services Country, Pori, Finland
| | - Sulosaari Virpi
- Turku University of Applied Sciences, Health and Well-being, Master School, Advancing Supportive Cancer and Palliative Care (CARE)—Research Group, European Oncology Nursing Society, Turku, Finland
| | - Virtanen Heli
- Department of Nursing Science, University of Turku, Turku, Finland
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Nissinen S, Pesonen S, Toivio P, Sormunen E. Exploring the use, usefulness and ease of use of digital occupational health services: A descriptive correlational study of customer experiences. Digit Health 2024; 10:20552076241242668. [PMID: 38601187 PMCID: PMC11005500 DOI: 10.1177/20552076241242668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Objective This study examined the customer experiences of use, perceived usefulness and ease of use of digital occupational health (OH) services. Methods A cross-sectional study based on an electronic survey was conducted between December 2022 and January 2023. A total of 9871 OH customers responded to the survey. The sample was restricted to respondents who used digital OH services (n = 7275). An analysis of variance was run to test the relationships between respondents' characteristics and the rate of usefulness, and ease of use variables. Results The most commonly used digital services were appointment booking, access to health information recorded by professionals and prescription renewal, and the digital services provided by physicians and nurses. Respondents expressed quite high satisfaction with the digital services, but not as much with their usefulness and ease of use. Females, individuals under 50 years of age, those with higher education, working in white-collar or managerial positions and possessing proficient information and communication technology (ICT) skills gave the most positive evaluations regarding usefulness and ease of use. Conclusions There was a certain level of mixed experiences among respondents regarding the usefulness and ease of use of digital OH services. We can also conclude that individuals who possess the necessary ICT skills can more easily take full advantage of the available digital services. When customers are proficient in using digital services, they can confidently interact with professionals. Regardless of the user's age, gender, education or profession, it is crucial for service providers always to strive to improve the usability of digital services.
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Affiliation(s)
- Sari Nissinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Sanna Pesonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Erja Sormunen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Grannell A, Hallson H, Gunlaugsson B, Jonsson H. Exercise therapy as a digital therapeutic for chronic disease management: consideration for clinical product development. Front Digit Health 2023; 5:1250979. [PMID: 38173910 PMCID: PMC10761443 DOI: 10.3389/fdgth.2023.1250979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Digital exercise therapies (DET) have the potential to bridge existing care gaps for people living with chronic conditions. Acting as either a standalone, embedded within multi-modal lifestyle therapy, or adjunct to pharmacotherapy or surgery, evidence-based DETs can favorably impact the health of a rapidly growing population. Given the nascent nature of digital therapeutics, the regulatory landscape has yet to mature. As such, in the absence of clear guidelines clinical digital product developers are responsible for ensuring the DET adheres to fundamental principles such as patient risk management and clinical effectiveness. The purpose of this narrative review paper is to discuss key considerations for clinical digital product developers who are striving to build novel digital therapeutic (DTx) solutions and thus contribute towards standardization of product development. We herein draw upon DET as an example, highlighting the need for adherence to existing clinical guidelines, human-centered design and an intervention approach that leverages the Chronic Care Model. Specific topics and recommendations related to the development of innovative and scalable products are discussed which ultimately allow for differentiation from a basic wellness tool and integration to clinical workflows. By embodying a code of ethics, clinical digital product developers can adequately address patients' needs and optimize their own future digital health technology assessments including appropriate evidence of safety and efficacy.
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Affiliation(s)
- Andrew Grannell
- Sidekick Health, Research & Development Unit, Kópavogur, Iceland
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Owen U, Månsdotter A, Guldbrandsson K, Lindström E. Alcohol, drug and tobacco prevention in Swedish municipalities - impact from the COVID-19 pandemic considering socio-demographic context. Eur J Public Health 2023; 33:1109-1114. [PMID: 37541832 PMCID: PMC10710339 DOI: 10.1093/eurpub/ckad127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic and measures to prevent the spread of the virus challenged public health practice at the local level in Sweden. The objective of this study was to explore the impact of the pandemic on the prevention of alcohol, drugs and tobacco (ADT) in Sweden during 2020-21 considering socio-demographic context. METHODS Data were collected through the Public Health Agency's survey on ADT prevention in Swedish municipalities (N = 290). This study used data from 2020 and 2021, with a response rate of 90% and 88%, respectively. Survey data were analyzed in logistic regression models (odds ratios, P < 0.05, 95% confidence intervals) against variables of education level, income level and population size from national registers. RESULTS A majority (n = 198, 76%) of the municipalities reported a decrease in ADT prevention during the pandemic. No correlation between the decrease in ADT prevention and socio-demographic conditions was detected. A majority (2020: n = 165, 63%; 2021: n = 174, 68%) of the municipalities also reported that ADT prevention was adapted, however less common in smaller municipalities and municipalities where residents had lower levels of education and lower incomes. CONCLUSION ADT prevention carried out by municipalities in Sweden was initially (2020) deeply affected by the preventive strategies against COVID-19. Adaptation of activities was less common in municipalities with more vulnerable socio-demographic situation. In policy, practice and research, the findings are important not only for continued progress on the national goal of equity in health but also for preparedness for future crises.
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Affiliation(s)
- Ulrika Owen
- Public Health Agency of Sweden, Living Conditions and Lifestyles, Solna and Östersund, Sweden
| | - Anna Månsdotter
- Public Health Agency of Sweden, Living Conditions and Lifestyles, Solna and Östersund, Sweden
- Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Karin Guldbrandsson
- Public Health Agency of Sweden, Living Conditions and Lifestyles, Solna and Östersund, Sweden
| | - Emma Lindström
- Public Health Agency of Sweden, Living Conditions and Lifestyles, Solna and Östersund, Sweden
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El-Toukhy S, Hegeman P, Zuckerman G, Anirban RD, Moses N, Troendle JF, Powell-Wiley TM. A prospective natural history study of post acute sequalae of COVID-19 using digital wearables: Study protocol. RESEARCH SQUARE 2023:rs.3.rs-3694818. [PMID: 38105936 PMCID: PMC10723530 DOI: 10.21203/rs.3.rs-3694818/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Post-acute sequelae of COVID-19 (PASC) is characterized by having 1 + persistent, recurrent, or emergent symptoms post the infection's acute phase. The duration and symptom manifestation of PASC remain understudied in nonhospitalized patients. Literature on PASC is primarily based on data from hospitalized patients where clinical indicators such as respiratory rate, heart rate, and oxygen saturation have been predictive of disease trajectories. Digital wearables allow for a continuous collection of such physiological parameters. This protocol outlines the design, aim, and procedures of a natural history study of PASC using digital wearables. Methods This is a single-arm, prospective, natural history study of a cohort of 550 patients, ages 18 to 65 years old, males or females who own a smartphone and/or a tablet that meets pre-determined Bluetooth version and operating system requirements, speak English, and provide documentation of a positive COVID-19 test issued by a healthcare professional or organization within 5 days before enrollment. The study aims to identify wearables collected physiological parameters that are associated with PASC in patients with a positive diagnosis. The primary endpoint is long COVID-19, defined as ≥ 1 symptom at 3 weeks beyond first symptom onset or positive diagnosis, whichever comes first. The secondary endpoint is chronic COVID-19, defined as ≥ 1 symptom at 12 weeks beyond first symptom onset or positive diagnosis. We hypothesize that physiological parameters collected via wearables are associated with self-reported PASC. Participants must be willing and able to consent to participate in the study and adhere to study procedures for six months. Discussion This is a fully decentralized study investigating PASC using wearable devices to collect physiological parameters and patient-reported outcomes. Given evidence on key demographics and risk profiles associated with PASC, the study will shed light on the duration and symptom manifestation of PASC in nonhospitalized patient subgroups and is an exemplar of use of wearables as population-level monitoring health tools for communicable diseases. Trial registration ClinicalTrials.gov NCT04927442.
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Affiliation(s)
| | - Phillip Hegeman
- National Institute on Minority Health and Health Disparities
| | | | | | - Nia Moses
- National Institute on Minority Health and Health Disparities
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Kim S, Jung T, Sohn DK, Chae Y, Kim YA, Kang SH, Park Y, Chang YJ. The Multidomain Metaverse Cancer Care Digital Platform: Development and Usability Study. JMIR Serious Games 2023; 11:e46242. [PMID: 38032697 PMCID: PMC10722376 DOI: 10.2196/46242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/17/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND As cancer treatment methods have diversified and the importance of self-management, which lowers the dependence rate on direct hospital visits, has increased, effective cancer care education and management for health professionals and patients have become necessary. The metaverse is in the spotlight as a means of digital health that allows users to engage in cancer care education and management beyond physical constraints. However, it is difficult to find a multipurpose medical metaverse that can not only be used in the field but also complements current cancer care. OBJECTIVE This study aimed to develop an integrated metaverse cancer care platform, Dr. Meta, and examine its usability. METHODS We conducted a multicenter, cross-sectional survey between November and December 2021. A descriptive analysis was performed to examine users' experiences with Dr. Meta. In addition, a supplementary open-ended question was used to ask users for their suggestions and improvements regarding the platform. RESULTS Responses from 70 Korean participants (male: n=19, 27% and female: n=51, 73%) were analyzed. More than half (n=37, 54%) of the participants were satisfied with Dr. Meta; they responded that it was an interesting and immersive platform (n=50, 72%). Less than half perceived no discomfort when using Dr. Meta (n=34, 49%) and no difficulty in wearing and operating the device (n=30, 43%). Furthermore, more than half (n=50, 72%) of the participants reported that Dr. Meta would help provide non-face-to-face and noncontact services. More than half also wanted to continue using this platform in the future (n=41, 59%) and recommended it to others (n=42, 60%). CONCLUSIONS We developed a multidomain metaverse cancer care platform that can support both health professionals and patients in non-face-to-face cancer care. The platform was uniquely disseminated and implemented in multiple regional hospitals and showed the potential to perform successful cancer care.
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Affiliation(s)
- Sunghak Kim
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Timothy Jung
- Faculty of Business and Law, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Yoon Chae
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Young Ae Kim
- National Cancer Survivorship Center, National Cancer Center, Goyang, Republic of Korea
| | - Seung Hyun Kang
- Planning Division, Korea Smart Healthcare Association, Seoul, Republic of Korea
| | - Yujin Park
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Yoon Jung Chang
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
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Mao L, Mohan G, Normand C. Use of information communication technologies by older people and telemedicine adoption during COVID-19: a longitudinal study. J Am Med Inform Assoc 2023; 30:2012-2020. [PMID: 37572310 PMCID: PMC10654849 DOI: 10.1093/jamia/ocad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/15/2023] [Accepted: 08/11/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES To investigate how information communication technology (ICT) factors relate to the use of telemedicine by older people in Ireland during the pandemic in 2020. Furthermore, the paper tested whether the supply of primary care, measured by General Practitioner's (GP) accessibility, influenced people's telemedicine options. METHOD Based on 2 waves from The Irish Longitudinal Study on Ageing, a nationally representative sample, multivariate logistic models were applied to examine the association between pre-pandemic use of ICTs and telemedicine usage (GP, pharmacist, hospital doctor), controlling for a series of demographic, health, and socioeconomic characteristics. RESULTS Previously reported having Internet access was a statistically positive predictor for telemedicine usage. The availability of high-speed broadband Internet did not exhibit a statistical association. The association was more prominent among those under 70 years old and non-Dublin urban areas. People with more chronic conditions, poorer mental health, and private health insurance had higher odds of using telemedicine during the period of study. No clear pattern between telemedicine use and differential geographic access to GP was found. DISCUSSION The important role of ICT access and frequent engagement with the Internet in encouraging telemedicine usage among older adults was evidenced. CONCLUSION Internet access was a strong predictor for telemedicine usage. We found no evidence of a substitution or complementary relationship between telemedicine and in-person primary care access.
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Affiliation(s)
- Likun Mao
- Department of Economics, University of Aberdeen, King’s College, Aberdeen AB24 3FX, United Kingdom
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Trinity Central, Dublin D02 R590, Republic of Ireland
| | - Gretta Mohan
- Economic and Social Research Institute, Dublin 2 D02 K138, Republic of Ireland
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, Dublin 2, Republic of Ireland
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Kings College London, London SE5 9PJ, United Kingdom
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Alanzi T, Almahdi R, Alghanim D, Almusmili L, Saleh A, Alanazi S, Alshobaki K, Attar R, Al Qunais A, Alzahrani H, Alshehri R, Sulail A, Alblwi A, Alanzi N, Alanzi N. Factors Affecting the Adoption of Artificial Intelligence-Enabled Virtual Assistants for Leukemia Self-Management. Cureus 2023; 15:e49724. [PMID: 38161825 PMCID: PMC10757561 DOI: 10.7759/cureus.49724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 01/03/2024] Open
Abstract
AIM AND PURPOSE The purpose of this study is to analyze the various influencing factors affecting the adoption of artificial intelligence (AI)-enabled virtual assistants (VAs) for self-management of leukemia. METHODS A cross-sectional survey design is adopted in this study. The questionnaire included eight factors (performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of AI-enabled virtual assistants. A total of 397 leukemia patients participated in the online survey. RESULTS Performance expectancy (μ = 3.14), effort expectancy (μ = 3.05), and personal innovativeness (μ = 3.14) were identified to be the major influencing factors of AI adoption. Statistically significant differences (p < .05) were observed between the gender-based and age groups of the participants in relation to the various factors. In addition, perceived privacy risks were negatively correlated with all other factors. CONCLUSION Although there are negative factors such as privacy risks and ethical issues in AI adoption, perceived effectiveness and ease of use among individuals are leading to greater adoption of AI-enabled VAs.
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Affiliation(s)
- Turki Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Reham Almahdi
- College of Medicine, Al Baha University, Al Baha, SAU
| | - Danya Alghanim
- College of Medicine and Surgery, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Amani Saleh
- Faculty of Pharmacy, Ibnsina National College of Medical Studies, Jeddah, SAU
| | - Sarah Alanazi
- Department of Pharmacy, Almoosa Specialist Hospital, Al Mubarraz, SAU
| | | | - Renad Attar
- College of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Haneen Alzahrani
- Department of Hematology, Armed Forces Hospital at King Abdulaziz Airbase Dhahran, Dhahran, SAU
| | | | - Amenah Sulail
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Ali Alblwi
- College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Nawaf Alanzi
- Department of Blood Bank, Regional Laboratory and Blood Banks Arar, Arar, SAU
| | - Nouf Alanzi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Jouf, SAU
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Amiri P, Nadri H, Bahaadinbeigy K. Facilitators and barriers of mHealth interventions during the Covid-19 pandemic: systematic review. BMC Health Serv Res 2023; 23:1176. [PMID: 37898755 PMCID: PMC10613392 DOI: 10.1186/s12913-023-10171-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND With the spread of Covid-19 disease, health interventions related to the control, prevention, and treatment of this disease and other diseases were given real attention. The purpose of this systematic review is to express facilitators and barriers of using mobile health (mHealth) interventions during the Covid-19 pandemic. METHODS In this systematic review, original studies were searched using keywords in the electronic database of PubMed until August 2022. The objectives and outcomes of these studies were extracted. Finally, to identify the facilitators and barriers of mHealth interventions, a qualitative content analysis was conducted based on the strengths, weaknesses, opportunities, and threats (SWOT) analysis method with Atlas.ti 8 software. We evaluated the studies using the Mixed Methods Appraisal Tool (MMAT). RESULTS In total, 1598 articles were identified and 55 articles were included in this study. Most of the studies used mobile applications to provide and receive health services during the Covid-19 pandemic (96.4%). The purpose of the applications was to help prevention (17), follow-up (15), treatment (12), and diagnosis (8). Using SWOT analysis, 13 facilitators and 18 barriers to patients' use of mHealth services were identified. CONCLUSION Mobile applications are very flexible technologies that can be customized for each person, patient, and population. During the Covid-19 pandemic, the applications designed due to lack of interaction, lack of time, lack of attention to privacy, and non-academic nature have not met their expectations of them.
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Affiliation(s)
- Parastoo Amiri
- Department of Health Information Technology, School of Allied Medical Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hamed Nadri
- Department of Health Information Technology, , School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Hamid M, Mirtorabi N, Ghumman A, Khalid A, Noormohamed MS, Kapoulas S, Singhal R, Nijjar R, Richardson M, Wiggins T. Tackling a Post-COVID-19 Cholecystectomy Waiting List: Are We Meeting the Challenge? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1872. [PMID: 37893590 PMCID: PMC10608591 DOI: 10.3390/medicina59101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/27/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: The COVID-19 pandemic has led to a tremendous backlog in elective surgical activity. Our hospital trust adopted an innovative approach to dealing with elective waiting times for cholecystectomy during the recovery phase from COVID-19. This study aimed to evaluate trends in overall cholecystectomy activity and the effect on waiting times. Materials and Methods: A prospective observational study was undertaken, investigating patients who received a cholecystectomy at a large United Kingdom hospital trust between February 2021 and February 2022. There were multiple phased strategies to tackle a 533-patient waiting list: private sector, multiple sites including emergency operating, mobile theatre, and seven-day working. The correlation of determination (R2) and Kruskal-Wallis analysis were used to evaluate trends in waiting times across the study period. Results: A total of 657 patients underwent a cholecystectomy. The median age was 49 years, 602 (91.6%) patients had an ASA of 1-2, and 494 (75.2%) were female. A total of 30 (4.6%) patients were listed due to gallstone pancreatitis, 380 (57.8%) for symptomatic cholelithiasis, and 228 (34.7%) for calculous cholecystitis. Median waiting times were reduced from 428 days (IQR 373-508) to 49 days (IQR 34-96), R2 = 0.654, p < 0.001. For pancreatitis specifically, waiting times had decreased from a median of 218 days (IQR 139-239) to 28 (IQR 24-40), R2 = 0.613, p < 0.001. Conclusions: This study demonstrates the methodology utilised to safely and effectively tackle the cholecystectomy waiting list locally. The approach utilised here has potential to be adapted to other units or similar operation types in order to reduce elective waiting times.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tom Wiggins
- University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham B9 5SS, UK
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Oussi N, Forsberg E, Dahlberg M, Enochsson L. Tele-mentoring - a way to expand laparoscopic simulator training for medical students over large distances: a prospective randomized pilot study. BMC MEDICAL EDUCATION 2023; 23:749. [PMID: 37817201 PMCID: PMC10566045 DOI: 10.1186/s12909-023-04719-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Studies have shown the clinical benefits of laparoscopic simulator training. Decreasing numbers of operations by surgical residents have further increased the need for surgical simulator training. However, many surgical simulators in Sweden are often insufficiently used or not used at all. Furthermore, large geographical distances make access to curriculum-based surgical simulator training at established simulator centres difficult. The aim of this study was to evaluate whether tele-mentoring (TM) could be well tolerated and improve basic laparoscopic surgical skills of medical students 900 km away from the teacher. METHODS Twenty students completed an informed consent and a pre-experimental questionnaire. The students were randomized into two groups: (1) TM (N = 10), receiving instructor feedback via video-link and (2) control group (CG, N = 10) with lone practice. Initial warm-up occurred in the Simball Box simulator with one Rope Race task followed by five consecutive Rope Race and three Peg Picker tasks. Afterwards, all students completed a second questionnaire. RESULTS The whole group enjoyed the simulator training (prescore 73.3% versus postscore 89.2%, P < 0.0001). With TM, the simulator Rope Race overall score increased (prescore 30.8% versus postscore 43.4%; P = 0.004), and the distance that the laparoscopic instruments moved decreased by 40% (P = 0.015), indicating better precision, whereas in the CG it did not. In Peg Picker, the overall scores increased, whereas total time and distance of the instruments decreased in both groups, indicating better performance and precision. CONCLUSIONS Simulation training was highly appreciated overall. The TM group showed better overall performance with increased precision in what we believe to be the visuospatially more demanding Rope Race tasks compared to the CG. We suggest that surgical simulator tele-mentoring over long distances could be a viable way to both motivate and increase laparoscopic basic skills training in the future.
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Affiliation(s)
- Ninos Oussi
- Centre for Clinical Research, Region Sörmland, Uppsala University, Eskilstuna, Sweden
- Division of Urology, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Emil Forsberg
- Department of Surgical and Perioperative Sciences, Division of Surgery, Umeå University, Umeå, Sweden
| | - Michael Dahlberg
- Department of Surgical and Perioperative Sciences, Division of Surgery, Umeå University, Umeå, Sweden
- Department of Surgery, Sunderby Hospital, Luleå, 971 80, Sweden
| | - Lars Enochsson
- Department of Surgical and Perioperative Sciences, Division of Surgery, Umeå University, Umeå, Sweden.
- Department of Surgery, Sunderby Hospital, Luleå, 971 80, Sweden.
- Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
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Sharma A, Marques P, Zhang G, Oulousian E, Chung SH, Ganni E, Lopes RD, Razaghizad A, Avram R. Voice-assisted Artificial Intelligence-enabled Screening for Severe Acute Respiratory Syndrome Coronavirus 2 Exposure in Cardiovascular Clinics: Primary Results of the VOICE-COVID-19-II Randomized Trial. J Card Fail 2023; 29:1456-1460. [PMID: 37224994 PMCID: PMC10201196 DOI: 10.1016/j.cardfail.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Voice-assisted artificial intelligence-based systems may streamline clinical care among patients with heart failure (HF) and caregivers; however, randomized clinical trials are needed. We evaluated the potential for Amazon Alexa (Alexa), a voice-assisted artificial intelligence-based system, to conduct screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a HF clinic. METHODS AND RESULTS We enrolled 52 participants (patients and caregivers) from a HF clinic who were randomly assigned with a subsequent cross-over to receive a SARS-CoV-2 screening questionnaire via Alexa or health care personnel. The primary outcome was overall response concordance, as measured by the percentage of agreement and unweighted kappa scores between groups. A postscreening survey evaluated comfort with using the artificial intelligence-based device. In total, 36 participants (69%) were male, the median age was 51 years (range 34-65 years) years and 36 (69%) were English speaking. Twenty-one participants (40%) were patients with HF. For the primary outcome, there were no statistical differences between the groups: Alexa-research coordinator group 96.9% agreement and unweighted kappa score of 0.92 (95% confidence interval 0.84-1.00) vs research coordinator-Alexa group 98.5% agreement and unweighted kappa score of 0.95 (95% confidence interval 0.88-1.00) (P value for all comparisons > .05). Overall, 87% of participants rated their screening experience as good or outstanding. CONCLUSIONS Alexa demonstrated comparable performance to a health care professional for SARS-CoV-2 screening in a group of patients with HF and caregivers and may represent an attractive approach to symptom screening in this population. Future studies evaluating such technologies for other uses among patients with HF and caregivers are warranted. NCT04508972.
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Affiliation(s)
- Abhinav Sharma
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; DREAM-CV Lab, Centre for Outcomes Research, McGill University, Montreal, Quebec, Canada.
| | - Pedro Marques
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; DREAM-CV Lab, Centre for Outcomes Research, McGill University, Montreal, Quebec, Canada
| | - Guang Zhang
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; DREAM-CV Lab, Centre for Outcomes Research, McGill University, Montreal, Quebec, Canada
| | - Emily Oulousian
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; DREAM-CV Lab, Centre for Outcomes Research, McGill University, Montreal, Quebec, Canada
| | - Seok Hoon Chung
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; DREAM-CV Lab, Centre for Outcomes Research, McGill University, Montreal, Quebec, Canada
| | - Elie Ganni
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; DREAM-CV Lab, Centre for Outcomes Research, McGill University, Montreal, Quebec, Canada
| | - Renato D Lopes
- Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Amir Razaghizad
- Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Robert Avram
- Montreal Heart Institute, University of Montreal, Quebec, Canada; Heartwise AI Lab, Montreal Heart Institute Research Center, Quebec, Canada
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Chugh R, Liu AW, Idomsky Y, Bigazzi O, Maiorano A, Medina E, Pierce L, Odisho AY, Mahadevan U. A Digital Health Intervention to Improve the Clinical Care of Inflammatory Bowel Disease Patients. Appl Clin Inform 2023; 14:855-865. [PMID: 37586416 PMCID: PMC10599806 DOI: 10.1055/a-2154-9172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a chronic condition that requires close monitoring. Digital health virtual care platforms can enable self-monitoring and allow providers to remotely surveil patients and efficiently identify those with active disease. OBJECTIVES The primary aim was to design and implement an IBD remote monitoring program, identify predictors of patient engagement, and determine who found the chat to be a valuable tool. METHODS We developed the IBD Virtual Care Chat, an electronic health record (EHR)-integrated chat to monitor electronic patient reported outcomes (ePROs), medication changes, and disease activity, and subsequently report concerning findings to providers via the EHR. All patients in the IBD practice over age 18 with a clinical encounter in the preceding 12 months were eligible to be enrolled. The primary aim was to identify predictors of patient engagement and determine who found the chat to be a valuable tool. RESULTS Between May 2021 and March 2022, 2,934 patients were enrolled. A total of 1,160 engaged at least once and 687 (23.4%) continually engaged, submitting at least three ePROs. Disease severity (based on Harvey-Bradshaw Index or Simple Clinical Colitis Activity Index) did not impact ePRO submissions. Patients were significantly more likely to be continually engaged if they self-reported the presence of extraintestinal manifestations (7%, 95% confidence interval: 0.01-0.14; p = 0.04). Patient satisfaction remained moderately high with a median score of 8 (interquartile range: 5-10) on a scale of 1 (poor) to 10 (good). CONCLUSION Our program demonstrates the potential for EHR-integrated digital health as part of routine IBD care to achieve sustained engagement with high patient satisfaction.
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Affiliation(s)
- Rishika Chugh
- Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Andrew W. Liu
- Center for Digital Health Innovation, University of California San Francisco, California, United States
| | - Yelena Idomsky
- Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Olivia Bigazzi
- Center for Digital Health Innovation, University of California San Francisco, California, United States
| | - Ali Maiorano
- Center for Digital Health Innovation, University of California San Francisco, California, United States
| | - Eli Medina
- Center for Digital Health Innovation, University of California San Francisco, California, United States
| | - Logan Pierce
- Center for Digital Health Innovation, University of California San Francisco, California, United States
- Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Anobel Y. Odisho
- Center for Digital Health Innovation, University of California San Francisco, California, United States
- Department of Urology, University of California San Francisco, San Francisco, California, United States
| | - Uma Mahadevan
- Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, United States
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Abstract
OBJECTIVE In an increasingly competitive healthcare climate, ensuring an innovative nursing workforce is essential for organizational success and survival. BACKGROUND The authors aimed to evaluate the literature examining the association between leadership styles and innovative behaviors in the nursing workforce. METHODS A systematic review of articles from 5 databases was conducted from August 2022 to October 2022. RESULTS A total of 21 articles published in the English language were included in the review. This study provides evidence for the vital role of "relationship-oriented" leadership styles in fostering innovative behaviors among nurses. However, more research is needed to examine how "task-oriented" leadership styles contribute to innovativeness in nurses. Twelve mediators linking leadership styles to healthcare workers' innovative behaviors were identified and clustered into motivation-based, relation-based, and affective mediators. CONCLUSION Organizational strategies to foster relationship-based leadership styles among healthcare leaders are vital to support nurses' innovative behaviors.
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Affiliation(s)
- Leodoro J Labrague
- Author Affiliations: Clinical Assistant Professor (Dr Labrague) and Instructor (Toquero), Marcella Niehoff School of Nursing, Loyola University Chicago, Illinois
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