Care coordination in a business-to-business and a business-to-consumer model for telemonitoring patients with chronic diseases

Towards A Framework for Implementing Remote Patient Monitoring From an Integrated Care Perspective: A Scoping Review

BACKGROUND

Remote patient monitoring (RPM) has been increasingly adopted over the last decade, with the COVID-19 pandemic fostering its rapid development. As RPM implementation is recognised as complex and highly demanding in terms of resources and processes, there are multiple challenges in providing RPM in an integrated logic.

METHODS

To examine the structural elements that are relevant for implementing RPM integrated care, a scoping review was conducted in PubMed, Scopus, and Web of Science, leveraging a search strategy that combines terms relative to (1) conceptual models and reallife initiatives; (2) RPM; and (3) care integration.

RESULTS

28 articles were included, covering nine conceptual models and 19 real-life initiatives. Eighteen structural elements of RPM integrated care implementation were identified among conceptual models, defining a structure for assessing real-life initiatives. 78.9% of those initiatives referred to at least ten structural elements, with patient education and self-monitoring promotion, multidisciplinary core workforce, ICTs (information and communications technologies) and telemonitoring devices, and health indicators measurement being present in all studies, and therefore being core elements to the design of RPM initiatives.

CONCLUSION

RPM goes far beyond technology, with underlying processes and involved actors playing a central role in care provision. The structural elements identified can guide RPM implementation and promote maturity in adoption. Future research may focus on assessing design completeness, evaluating impacts, and analysing related financial arrangements.

Telehealth Business Models and Their Components: Systematic Review

Background

Telehealth technology is an excellent solution to resolve the problems of health care delivery. However, this technology may fail during large-scale implementation. As a result, business models can be used to facilitate commercialization of telehealth products and services.

Objective

The purpose of this study was to review different types of business models or frameworks and their components used in the telehealth industry.

Methods

This was a systematic review conducted in 2020. The databases used for searching related articles included Ovid, PubMed, Scopus, Web of Science, Emerald, and ProQuest. Google Scholar was also searched. These databases and Google Scholar were searched until the end of January 2020 and duplicate references were removed. Finally, articles meeting the inclusion criteria were selected and the Critical Appraisal Skills Programme (CASP) checklist was used for appraising the strengths and limitations of each study. Data were extracted using a data extraction form, and the results were synthesized narratively.

Results

Initially, 4998 articles were found and after screening, 23 were selected to be included in the study. The results showed that new telehealth business models were presented in 13 studies, and the applications of the existing business models were reported in 10 studies. These studies were related to different types of services, namely, telemonitoring (4 studies), telemedicine (3 studies), mobile health (3 studies), telerehabilitation (3 studies), telehealth (2 studies), assisted living technologies (2 studies), sensor-based systems (2 studies), and mobile teledermoscopy, teleradiology, telecardiology, and teletreatment (1 study related to each area). In most of the business models, value proposition, financial variables, and revenue streams were the main components.

Conclusions

Applying business models in the commercialization of telehealth services will be useful to gain a better understanding of the required components, market challenges, and possible future changes. The results showed that different business models can be used for different telehealth technologies in various health systems and cultures. However, it is necessary to evaluate the effectiveness of these models in practice. Moreover, comparing the usefulness of these models in different domains of telehealth services will help identify the strengths and weaknesses of these models for future optimization.

Key components and critical factors for developing a telehealth business framework: a qualitative study

BACKGROUND

Telehealth technology and related products can help to solve the problems associated with providing health care services and equal distribution of resources. However, in order to run a telehealth business successfully, key components and critical factors need to be taken into account. A telehealth business framework can provide a rich understanding of these components and factors. Therefore, the present study aimed to identify the key components and critical factors for developing a telehealth business framework from the experts' perspectives.

METHODS

The present qualitative study was conducted in 2020. The participants were 22 experts in the fields of medical informatics, health information management, telemedicine, telehealth, health entrepreneurship, health insurance, and digital health start-ups. In depth semi-structured interviews were conducted to collect data, and the data were analyzed using framework analysis.

RESULTS

Four main themes derived from data analysis. The themes included key components for developing a telehealth business framework, success factors, challenges, and barriers of a telehealth business. Overall, the results indicated that the key components in a telehealth business framework included created value, key resources, key activities, key partners, licenses and permissions, product pricing, revenue, marketing, supporting services, and getting feedback from customers. Although receiving support from different individuals and organizations as well as economic benefits of telehealth services may consider as success factors, there are a number of challenges and barriers which should be taken into account. Otherwise, these factors may hinder the success of a telehealth business.

CONCLUSIONS

The development of a telehealth business framework might be an important step towards developing a more complete business plan, facilitating the commercialization of telehealth products, and providing a solution for product sustainability in a competitive market. In the current study, the key components and critical factors for developing a telehealth business framework were identified; however, further research is needed to explore how these components and factors can be helpful in developing business plans and running a successful telehealth business.

A systematic scoping review analysing clinical, technical and financial aspects of cost-effectiveness of Artificial Intelligence applied in medicine: A theory and framework of analysis (Preprint)

Background

Cost-effectiveness analysis of artificial intelligence (AI) in medicine demands consideration of clinical, technical, and economic aspects to generate impactful research of a novel and highly versatile technology.

Objective

We aimed to systematically scope existing literature on the cost-effectiveness of AI and to extract and summarize clinical, technical, and economic dimensions required for a comprehensive assessment.

Methods

A scoping literature review was conducted to map medical, technical, and economic aspects considered in studies on the cost-effectiveness of medical AI. Based on these, a framework for health policy analysis was developed.

Results

Among 4820 eligible studies, 13 met the inclusion criteria for our review. Internal medicine and emergency medicine were the clinical disciplines most frequently analyzed. Most of the studies included were from the United States (5/13, 39%), assessed solutions requiring market access (9/13, 69%), and proposed optimization of direct resources as the most frequent value proposition (7/13, 53%). On the other hand, technical aspects were not uniformly disclosed in the studies we analyzed. A minority of articles explicitly stated the payment mechanism assumed (5/13, 38%), while it remained unspecified in the majority (8/13, 62%) of studies.

Conclusions

Current studies on the cost-effectiveness of AI do not allow to determine if the investigated AI solutions are clinically, technically, and economically viable. Further research and improved reporting on these dimensions seem relevant to recommend and assess potential use cases for this technology.