Digital health and patient safety: Technology is not a magic wand

Improving Quality of Care for Patients Receiving Care through Telehealth in the Time of COVID-19 Global Pandemic and Beyond: HCI-based Leading Indicators for Virtual Visits

The COVID-19 pandemic expedited the growing rate of reliance on telehealth, as it provided a safer option for patients to seek the care they need and avoid potential negative consequences of being exposed to the COVID-19 virus. The aim of this study is to develop a series of Human-Computer Interaction (HCI)-based leading indicators to proactively analyze and evaluate the user interface in telehealth and virtual visits. Building on Nielsen's usability heuristics and mapping them to the six aspects of quality of care introduced by the Institute of Medicine, we identified the design features that had the highest impact on the quality of care and developed a list of leading indicators for each feature. Further, we developed corresponding checklists for each leading indicator to evaluate the features of the user. Beyond the benefits of telehealth for both patients and healthcare providers during atypical circumstances, the changes prompted by the COVID-19 public health emergency have possibly altered the position of telehealth to the point that communicating through video and audio has become the new normal. Therefore, the importance of designing an interface to facilitate user interaction with the system and consequently with one another is of utmost importance.

Medical device regulation (MDR) in health technology enterprises - perspectives of managers and regulatory professionals

BACKGROUND

In the European Union (EU), there are over half a million medical devices, varying from pacemakers to software. Medical devices play an important role in health care as they are used in diagnosis, prevention, monitoring, prediction, prognosis, treatment, or to alleviate disease. Medical devices are regulated in the EU by the Medical Device Regulation (MDR), which came into force on 25 April 2017 and into application on 26 May 2021. The demand for regulation arose from the need to establish a transparent, robust, predictable, and sustainable regulatory framework. This study aims to examine how the managers and regulatory professionals in health technology enterprises perceived the application of the MDR and what were their information needs regarding the MDR.

METHODS

A link to an online questionnaire was sent to 405 managers and regulatory professionals representing health technology enterprises in Finland. The study included 74 respondents. Descriptive statistics were used to describe and summarise the characteristics of the dataset.

RESULTS

Information related to the MDR was fragmented and the necessary information was sought from multiple information sources, while the Finnish Medicines Agency (Fimea) was regarded as the most important source of information and training provider. To some extent, the managers and regulatory professionals expressed their dissatisfaction with the performance of Fimea. The managers and regulatory professionals were not very familiar with the ICT systems provided by the EU. The size of an enterprise affected how many medical devices it manufactures and generally affected the views about the MDR.

CONCLUSIONS

The managers and regulatory professionals understood the role of the MDR regarding the safety and transparency of medical devices. The available information regarding the MDR did not properly fit the needs of users and there seemed to be a gap in information quality. The managers and regulatory professionals had some difficulties understanding the available information. Based on our findings, we believe it is paramount to evaluate the challenges faced by Fimea and how it could improve its performance. To some extent, the MDR is regarded as a burden for smaller enterprises. It is important to highlight the benefits of ICT systems and to develop them to better meet the information needs of enterprises.

Evaluating the safety and patient impacts of an artificial intelligence command centre in acute hospital care: a mixed-methods protocol

INTRODUCTION

This paper presents a mixed-methods study protocol that will be used to evaluate a recent implementation of a real-time, centralised hospital command centre in the UK. The command centre represents a complex intervention within a complex adaptive system. It could support better operational decision-making and facilitate identification and mitigation of threats to patient safety. There is, however, limited research on the impact of such complex health information technology on patient safety, reliability and operational efficiency of healthcare delivery and this study aims to help address that gap.

METHODS AND ANALYSIS

We will conduct a longitudinal mixed-method evaluation that will be informed by public-and-patient involvement and engagement. Interviews and ethnographic observations will inform iterations with quantitative analysis that will sensitise further qualitative work. Quantitative work will take an iterative approach to identify relevant outcome measures from both the literature and pragmatically from datasets of routinely collected electronic health records.

ETHICS AND DISSEMINATION

This protocol has been approved by the University of Leeds Engineering and Physical Sciences Research Ethics Committee (#MEEC 20-016) and the National Health Service Health Research Authority (IRAS No.: 285933). Our results will be communicated through peer-reviewed publications in international journals and conferences. We will provide ongoing feedback as part of our engagement work with local trust stakeholders.

The quality of digital health software: Should we be concerned?

The digitalization of healthcare fuelled by advances in technology and the increased prevalence of mobile smart devices and health-related internet of things can offer equitable access to expert-level healthcare globally. Growing demand for telemedicine, mobile health apps, and advanced data analytics have further established their role in a modern information society during the Covid-19 crisis. Digital health is, in essence, powered by software (DHSW), which has to operate in the specific digital health environment characteristics and is therefore highly and intrinsically complex and prone to software defects and faults. Given the lack of standardization regarding DHSW quality, we explored the available reviewed research on this crucial topic in this brief paper, using a synthetic thematic analysis approach. We assert that neither the volume, distribution nor scope of the DHSW quality research content is satisfactory, and significant research gaps exist. Based on the presented evidence, we can only conclude that we should be concerned and that the time to act is now to ensure that the unavoidable increase of usage and prevalence of DHSW will not – in the end – reduce the quality of care due to subpar software and software-based digital health systems.