eHealth, ICT and its relationship with self-reported health outcomes in the EU countries

Early child health in Africa: do ICT and democracy matter?

This article examines the effect of information and communication technologies (ICT) and democracy on early child health using data from 51 African countries. We first specify and estimate a panel data model using ordinary least squares and two-stage least squares over the period 2001-2019. We apply the Hodrick-Prescott filter before analysis. Our results show that the extension of mobile phone use significantly contributes to the improvement of early child health in Africa. This effect is indifferent to the state or the level of democracy. Also, the internet diffusion plays a positive role in early child health when the democracy environment improves and becomes better. We suggest policies in favour of a large access to ICT tools and internet infrastructure as well as the promotion of democracy in Africa to better prevent infant mortality.

Information and communication technology development and health gap nexus in Africa

Introduction

Development of information and communication technology has been identified as a tool for fast and effective information gathering and dissemination, and as a means through which almost every social and economic sector (including the health sector) could achieve economic, operational, and service delivery efficiencies that can enable the realization of targeted outcomes. ICT can serve as a tool for achieving international agreements (including the Alma Ata Declaration of 1978), thereby accelerating the achievement of various global development targets.

Methods

Consequently, based on a sample of 38 countries from 2000 to 2018, this study investigates the effect of ICT development on the health gap, and whether the effect varies by gender and sub-region in Africa. The dependent variable (health gap) was measured as the difference between the achieved life expectancy at birth of 60 years and the Alma Ata Declaration of 1978 targeted life expectancy at birth of 60 years. The main independent variables are ICT indicators (ICT index, mobile cellular subscriptions, and internet access), while the gross domestic product (GDP), which is the measure of economic growth, healthcare expenditure, urbanization, and labor market outcome, is employed as control variables. The effect was examined using Driscoll-Kraay standard errors, feasible generalized least squares (FGLS), and panel-corrected standard error (PCSE).

Results and discussion

The findings of the Driscoll-Kraay standard errors estimation technique supported by those of FGLS and PCSE suggest that ICT does act as an indispensable stimulator for Africa to significantly exceed the international health target of life expectancy at birth of 60 years. It can be concluded that African leaders need to take advantage and maximize the health-enhancing potential of the internet component of ICT through relevant policies that would improve internet coverage, connectivity, and access for individuals and health institutions.

The role of telehealth startups in healthcare service delivery: A systematic review

OBJECTIVES

The role of startups has been growing in healthcare delivery, particularly in telehealth and telemedicine. Yet, little has been published about their role in evolving digital healthcare ecosystem. This study aimed to review the literature on telehealth startups to understand their roles, challenges, business models, and directions for sustainable innovation and commercialization.

METHODS

Ten databases were screened: PubMed, Scopus, Web of Science, IEEE Xplore, ACM digital library, EBSCOhost, Embase, Medline, Cochrane review, and PsycINFO. The articles were shortlisted based on pre-determined screening criteria, and qualitative synthesis was performed. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Cohen's K was calculated to ensure the reliability of the authors scoring on the quality appraisal test and qualitative synthesis.

RESULTS

26 articles were included in the review. Findings are clubbed under five themes: remote and on-demand healthcare; healthcare data management; digital therapeutics; high-tech driven personalized care; and information integration and exchange. Technical infrastructure, regulation, and revenue generation were identified as major challenges for telehealth start-ups. Osterwalder business canvas was the predominantly used model. Value perspectives were recognized for a sustainable telehealth innovation and its commercialization.

CONCLUSION

Telehealth startups are evolving to meet digital healthcare needs and playing a significant role in teleconsultations, telemonitoring, and electronic health record solutions. Recently, their focus has shifted towards smartphone-enabled AI-driven personalized care, including digital therapeutics and wearable device innovation. They have significant technical and operational challenges in innovation and commercialization to optimize their role. The review also provides researchers with a new understanding of telehealth startups' sustainable innovation and commercialization through the systematic direction of value proposition, creation, and capture.

The Impact of Information and Communication Technologies (ICTs) on Health Outcomes: A Mediating Effect Analysis Based on Cross-National Panel Data

When ICTs (Information and Communications Technologies) are combined with healthcare, they can make a key contribution to gradually improve national health outcomes. The global outbreak of COVID-19 in 2020 further highlighted the important role of e-Health and m-Health service modes. This research structures a mediated effect model to explore dynamic relationships between ICT factors, ICT impacts, and national health outcomes, among which ICT factors are independent variables; ICT impacts are mediating variables, and national health outcome indicators selected from United Nations Millennium Development Goals (MDGs) and World Development Indicators are dependent variables. The fixed effect model is used to process a set of 141 countries’ panel data from 2012 to 2016 from World Bank and World Economic Forum, while the classical three-step test method and Sobel test combined with fixed effects are used to test the mediated effects of the panel data. The results show that there are significant associations between ICT factors and national health outcome indicators, while only some of the partial mediated effects are proved. ICT environment and ICT usage can influence both the under-five mortality rate and adolescent fertility rate via ICT social impact. However, the mediated effect of ICT social impact on maternal mortality ratio and life expectancy at birth has not been confirmed. Meanwhile, the mediated effect of ICT economic impact has not been proven. This research is an interdisciplinary research in the field of information and communication technology and public health and reveals the path and mechanism whereby ICT factors improve national health outcomes, which can help global policymakers drive the next phase of the implementation of the Sustainable Development Goals (SDGs) and continue to improve the overall health at the national level.

Nurses’ experience of using video consultation in a digital care setting and its impact on their workflow and communication

Sweden as many other countries uses video consultation to increase patients’ access to primary healthcare services particularly during the COVID-19 pandemic. Working in digital care settings and using new technologies, in this case video consultations, require learning new skills and adoption to new workflow. The aim of this study is to explore nurses’ experience of using video consultation in a digital care setting and its impact on their workflow and communication. Fifteen semi-structured interviews were carried out with registered nurses recruited from a private digital healthcare provider. Interviews were recorded, transcribed, and analysed using an abductive approach. Nurses’ workflow was modeled, and several categories and subcategories were identified: nurses’ workflow (efficiency, flexibility, and information accessibility); communication (interaction with patients and interprofessional communication); user experience (change and development of the platform, challenges, and combining digital and physical care). Even though providing online care has its limitations, the nurses were positive towards using video consultations.

Characterizing Wuhan residents' mask-wearing intention at early stages of the COVID-19 pandemic

OBJECTIVE

As an effective measure to prevent the COVID-19 pandemic, wearing mask is widely recommended in countries around the world. This study aims to identify factors that explain the behavioral intention of Wuhan City urban residents to wear masks.

METHODS

A theoretical model was extended on UTAUT by incorporating the feature on residents having relevant knowledge and sufficient awareness on the pandemic. During early stages of the COVID-19 outbreak, an online survey was conducted in Wuhan City and 728 valid samples were collected from 35 communities. Structural equations modeling and bootstrapping were applied.

RESULTS

Sample data present acceptable reliability and validity. Performance expectancy, effort expectancy, social influence, and knowledge about COVID-19 have positive effects on behavioral intention. Facilitating condition, knowledge, and behavioral intention have significant effects on use behavior. Gender, age, education, income, and current marital status are significant moderators in the theoretical model.

CONCLUSION

Having relevant knowledge on the pandemic, together with performance expectancy, effort expectancy, social influence, and facilitating condition, affects behavioral intention and usage behavior of Wuhan residents to wear masks at early stages of the COVID-19 pandemic. Subgroups have different psychological mechanisms based on their demographic characteristics.

PRACTICE IMPLICATIONS

Health policy makers should focus on enhancing residents' knowledge on infectious disease and their awareness of the risk mitigation, and develop personalized measures for different subgroups.

Willingness to share personal health information: impact of attitudes, trust and control

Purpose

This study aims to explicate the behavioral factors that determine willingness to share personal health data for secondary uses.

Design/methodology/approach

A theoretical model is developed and tested with structural equation modeling using survey data from Finland.

Findings

It is shown that attitude toward information sharing is the strongest factor contributing to the willingness to share personal health information (PHI). Trust and control serve as mediating factors between the attitude and willingness to share PHI.

Research limitations/implications

The measures of the model need further refinement to cover the various aspects of the behavioral concepts.

Practical implications

The model provides useful insights into the factors that affect the willingness for information sharing in health care and in other areas where personal information is distributed.

Social implications

Sharing of PHI for secondary purposes can offer social benefits through improvements in health-care performance.

Originality/value

A broad-scale empirical data gives a unique view of attitudes toward sharing of PHI in one national setting.

Recent quantitative research on determinants of health in high income countries: A scoping review

Background

Identifying determinants of health and understanding their role in health production constitutes an important research theme. We aimed to document the state of recent multi-country research on this theme in the literature.

Methods

We followed the PRISMA-ScR guidelines to systematically identify, triage and review literature (January 2013—July 2019). We searched for studies that performed cross-national statistical analyses aiming to evaluate the impact of one or more aggregate level determinants on one or more general population health outcomes in high-income countries. To assess in which combinations and to what extent individual (or thematically linked) determinants had been studied together, we performed multidimensional scaling and cluster analysis.

Results

Sixty studies were selected, out of an original yield of 3686. Life-expectancy and overall mortality were the most widely used population health indicators, while determinants came from the areas of healthcare, culture, politics, socio-economics, environment, labor, fertility, demographics, life-style, and psychology. The family of regression models was the predominant statistical approach. Results from our multidimensional scaling showed that a relatively tight core of determinants have received much attention, as main covariates of interest or controls, whereas the majority of other determinants were studied in very limited contexts. We consider findings from these studies regarding the importance of any given health determinant inconclusive at present. Across a multitude of model specifications, different country samples, and varying time periods, effects fluctuated between statistically significant and not significant, and between beneficial and detrimental to health.

Conclusions

We conclude that efforts to understand the underlying mechanisms of population health are far from settled, and the present state of research on the topic leaves much to be desired. It is essential that future research considers multiple factors simultaneously and takes advantage of more sophisticated methodology with regards to quantifying health as well as analyzing determinants’ influence.

Self-assessed health among older people in Europe and internet use

BACKGROUND

About ten years ago, an age-related digital divide was identified, where 'the elderly' denoted a group of people at risk of losing the benefits of a digital society. The aims of this work are to find a relationship between self-assessed health and internet use by older people in European countries and to ascertain whether this relationship differs in countries with a more developed eHealth policy.

MATERIALS AND METHODS

An ordered logistic regression is estimated for all countries in the sample and for two countries subsets which differ in their eHealth performance. Individual data is collected by SHARE. The classifying criterion of eHealth performance is based on the 'eHealth' policy dimension of the indicator used to construct the Digital Economy and Society Index. The average marginal effects are computed for the variable of internet use.

RESULTS

Results show that older people who use the internet tend to report better health status. This relationship however may not hold for low levels of health and it is stronger in countries with low eHealth performance.

CONCLUSION

Policy measures on eHealth not only contribute to people's health but also help to alleviate critical situations such as the one created by the Covid-19 pandemic.