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van der Zee C, Chang-Wolf J, Koopmanschap MA, van Leeuwen R, Wisse RPL. Assessing the Carbon Footprint of Telemedicine: A Systematic Review. Health Serv Insights 2024; 17:11786329241271562. [PMID: 39139395 PMCID: PMC11320403 DOI: 10.1177/11786329241271562] [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: 10/23/2023] [Accepted: 06/28/2024] [Indexed: 08/15/2024] Open
Abstract
Background Healthcare is responsible for 4% to 10% of carbon emissions worldwide, of which 22% is related to transport. Telemedicine emerged as a potential solution to reduce the footprint, for example, by reducing travel. However, a need to understand which variables to include in carbon footprint estimations in telemedicine limits our understanding of the beneficial impact telemedicine might have on our environment. This paper aims to systematically assess the reported carbon footprint and include variables assessed by the literature, comparing telemedicine with usual care. Methods The systematic review followed the PRISMA guidelines in PubMed, Medline, Embase and Scopus. A quality assessment was performed using a transparency checklist for carbon footprint calculators. Carbon emissions were evaluated based on four categories, including patient travel, and streamlined life cycle assessment (LCA) for assessing included variables relevant to telemedicine. Results We included 33 articles from 1117 records for analysis. The average transparency score was 38% (range 18%-68%). The median roundtrip travel distance for each patient was 131 km (interquartile range [IQR]: 60.8-351), or 25.6 kgCO2 (IQR: 10.6-105.6) emissions. There is high variance among included variables. Saved emissions are structurally underestimated by not including external factors such as a streamlined LCA. Conclusions Telemedicine aids in reducing emissions, with travel distance being the most significant contributor. Additionally, we recommend accounting for the LCA since it highlights important nuances. This review furthers the debate on assessing carbon footprint savings due to telemedicine.
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Affiliation(s)
- Casper van der Zee
- Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jennifer Chang-Wolf
- Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marc A Koopmanschap
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
| | - Redmer van Leeuwen
- Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
- Dutch Workgroup of Sustainable Ophthalmology, Utrecht, The Netherlands
| | - Robert PL Wisse
- Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
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Weik L, Fehring L, Mortsiefer A, Meister S. Big 5 Personality Traits and Individual- and Practice-Related Characteristics as Influencing Factors of Digital Maturity in General Practices: Quantitative Web-Based Survey Study. J Med Internet Res 2024; 26:e52085. [PMID: 38252468 PMCID: PMC10845021 DOI: 10.2196/52085] [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: 08/22/2023] [Revised: 11/18/2023] [Accepted: 12/16/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Various studies propose the significance of digital maturity in ensuring effective patient care and enabling improved health outcomes, a successful digital transformation, and optimized service delivery. Although previous research has centered around inpatient health care settings, research on digital maturity in general practices is still in its infancy. OBJECTIVE As general practitioners (GPs) are the first point of contact for most patients, we aimed to shed light on the pivotal role of GPs' inherent characteristics, especially their personality, in the digital maturity of general practices. METHODS In the first step, we applied a sequential mixed methods approach involving a literature review and expert interviews with GPs to construct the digital maturity scale used in this study. Next, we designed a web-based survey to assess digital maturity on a 5-point Likert-type scale and analyze the relationship with relevant inherent characteristics using ANOVAs and regression analysis. RESULTS Our web-based survey with 219 GPs revealed that digital maturity was overall moderate (mean 3.31, SD 0.64) and substantially associated with several characteristics inherent to the GP. We found differences in overall digital maturity based on GPs' gender, the expected future use of digital health solutions, the perceived digital affinity of medical assistants, GPs' level of digital affinity, and GPs' level of extraversion and neuroticism. In a regression model, a higher expected future use, a higher perceived digital affinity of medical assistants, a higher digital affinity of GPs, and lower neuroticism were substantial predictors of overall digital maturity. CONCLUSIONS Our study highlights the impact of GPs' inherent characteristics, especially their personality, on the digital maturity of general practices. By identifying these inherent influencing factors, our findings support targeted approaches to drive digital maturity in general practice settings.
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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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Alanazi A, Alanazi M, Aldosari B. Personal Health Record (PHR) Experience and Recommendations for a Transformation in Saudi Arabia. J Pers Med 2023; 13:1275. [PMID: 37623525 PMCID: PMC10455360 DOI: 10.3390/jpm13081275] [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: 07/13/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
A Personal Health Record (PHR) is a patient-managed platform for health data. Most hospitals provide a PHR as an extension of the Electronic Medical Record (EMR). However, there are unresolved issues around the adoption rate, functionalities, barriers and, more importantly, the impact of the PHR on patients' health. A cross-sectional, survey-based descriptive study was conducted in which patients from four main tertiary hospitals in Saudi Arabia were targeted from September 2022 to February 2023. The survey was tested and validated to address the objectives of the study. The survey covered components related to intention to use the PHR, required functions, obstacles and expected outcomes. This study involved 396 participants from the top four hospitals. It was discovered that the majority of them had intentions to use the PHR (93%) and believed it to be useful (94%) and easy to use (94%). It was widely agreed that accessing medical records (77%), scheduling appointments (88%), renewing medication (90%), tracking patient data (70%) and receiving personalized education (78%) were essential aspects of the PHR. Furthermore, the survey revealed that 54% of respondents saw a positive effect on their health status. A significant number of participants, around 54%, expressed concerns about the privacy of their PHR, and 46% reported concerns about the accuracy of their information. The study found that demographic factors and the type of hospital did not have a statistically significant association with the intention to use the PHR. Our findings showed that there were no significant barriers to adopting the PHR. Additionally, we found that less than half of the participants believed that their current PHR helped them to improve their health. This highlights the need for healthcare organizations to focus on improving the PHR's functionality and overall purpose. Instead of simply providing basic features, the PHR should allow patients to manage their health information comprehensively, including compiling information from hospitals and patient-generated data. Having a PHR is crucial in improving an individual's overall health. As technology advances, more data are being generated that should be included in the PHR to ensure an accurate and comprehensive view of the patient's health. Expanding the scope of the PHR to include capabilities beyond merely hospital data is important. Achieving this requires an open and honest discussion about the role of the PHR, potential obstacles and how to coordinate efforts among different stakeholders.
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Affiliation(s)
- Abdullah Alanazi
- Health Informatics Department, King Saud Ibn Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia (B.A.)
- King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia
| | - Mohammed Alanazi
- Health Informatics Department, King Saud Ibn Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia (B.A.)
- King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia
| | - Bakheet Aldosari
- Health Informatics Department, King Saud Ibn Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia (B.A.)
- King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia
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Liaw ST, Godinho MA. Digital health and capability maturity models-a critical thematic review and conceptual synthesis of the literature. J Am Med Inform Assoc 2023; 30:393-406. [PMID: 36451257 PMCID: PMC9846694 DOI: 10.1093/jamia/ocac228] [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: 08/22/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE A literature review of capability maturity models (MMs) to inform the conceptualization, development, implementation, evaluation, and mainstreaming of MMs in digital health (DH). METHODS Electronic databases were searched using "digital health," "maturity models," and related terms based on the Digital Health Profile and Maturity Assessment Toolkit Maturity Model (DHPMAT-MM). Covidence was used to screen, identify, capture, and achieve consensus on data extracted by the authors. Descriptive statistics were generated. A thematic analysis and conceptual synthesis were conducted. FINDINGS Diverse domain-specific MMs and model development, implementation, and evaluation methods were found. The spread and pattern of different MMs verified the essential DH foundations and five maturity stages of the DHPMAT-MM. An unanticipated finding was the existence of a new category of community-facing MMs. Common characteristics included:1. A dynamic lifecycle approach to digital capability maturity, which is:a. responsive to environmental changes and may improve or worsen over time;b. accumulative, incorporating the attributes of the preceding stage; andc. sequential, where no maturity stage must be skipped.2. Sociotechnical quality improvement of the DH ecosystem and MM, which includes:a. investing in the organization's human, hardware, and software resources andb. a need to engage and improve the DH competencies of citizens. CONCLUSIONS The diversity in MMs and variability in methods and content can create cognitive dissonance. A metamodel like the DHPMAT-MM can logically unify the many domain-specific MMs and guide the overall implementation and evaluation of DH ecosystems and MMs over the maturity lifecycle.
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Affiliation(s)
- Siaw-Teng Liaw
- WHO Collaborating Centre for eHealth (AUS-135), School of Population Health, UNSW Sydney, Sydney, Australia
| | - Myron Anthony Godinho
- WHO Collaborating Centre for eHealth (AUS-135), School of Population Health, UNSW Sydney, Sydney, Australia
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Teixeira F, Li E, Laranjo L, Collins C, Irving G, Fernandez MJ, Car J, Ungan M, Petek D, Hoffman R, Majeed A, Nessler K, Lingner H, Jimenez G, Darzi A, Jácome C, Neves AL. Digital maturity and its determinants in General Practice: A cross-sectional study in 20 countries. Front Public Health 2023; 10:962924. [PMID: 36711349 PMCID: PMC9880412 DOI: 10.3389/fpubh.2022.962924] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Abstract
Background The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarcely evaluated. Objectives This study assessed the digital maturity in General Practice (GP) globally and evaluated its association with participants' demographic characteristics, practice characteristics and features of Electronic Health Records (EHRs) use. Methods GPs across 20 countries completed an online questionnaire between June and September 2020. Demographic data, practice characteristics, and features of EHRs use were collected. Digital maturity was evaluated through a framework based on usage, resources and abilities (divided in this study in its collective and individual components), interoperability, general evaluation methods and impact of digital technologies. Each dimension was rated as 1 or 0. The digital maturity score was calculated as the sum of the six dimensions and ranged between 0 to 6 (maximum digital maturity). Multivariable linear regression was used to model the total score, while multivariable logistic regression was used to model the probability of meeting each dimension of the score. Results One thousand six hundred GPs (61% female, 68% Europeans) participated. GPs had a median digital maturity of 4 (P25-P75: 3-5). Positive associations with digital maturity were found with: male gender [B = 0.18 (95% CI 0.01; 0.36)], use of EHRs for longer periods [B = 0.45 (95% CI 0.35; 0.54)] and higher frequencies of access to EHRs [B = 0.33 (95% CI 0.17; 0.48)]. Practicing in a rural setting was negatively associated with digital maturity [B = -0.25 (95%CI -0.43; -0.08)]. Usage (90%) was the most acknowledged dimension while interoperability (47%) and use of best practice general evaluation methods (28%) were the least. Shorter durations of EHRs use were negatively associated with all digital maturity dimensions (aOR from 0.09 to 0.77). Conclusion Our study demonstrated notable factors that impact digital maturity and exposed discrepancies in digital transformation across healthcare settings. It provides guidance for policymakers to develop more efficacious interventions to hasten the digital transformation of General Practice.
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Affiliation(s)
- Fábia Teixeira
- Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Edmond Li
- Institute of Global Health Innovation, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Liliana Laranjo
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | | | - Greg Irving
- Health Research Institute, Edge Hill University, Ormskirk, United Kingdom
| | - Maria Jose Fernandez
- Galicia South Health Research Institute, Vigo, Spain,Leiro Health Center, Leiro, Spain
| | - Josip Car
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Mehmet Ungan
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Türkiye
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Robert Hoffman
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Katarzyna Nessler
- Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Heidrun Lingner
- Center for Public Health and Healthcare, German Center for Lung Research (DZL), Giessen, Germany,BREATH Hannover, Hannover Medical School, Hanover, Germany
| | - Geronimo Jimenez
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Ara Darzi
- Institute of Global Health Innovation, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Cristina Jácome
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Ana Luísa Neves
- Institute of Global Health Innovation, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom,CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal,*Correspondence: Ana Luísa Neves ✉
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Liu L, Zuo W, Hu Q, Zeng L. RESEARCH ON PROPERTY SERVICE MODE INNOVATION IN THE CONTEXT OF TRANSFORMATION AND UPGRADING. INTERNATIONAL JOURNAL OF STRATEGIC PROPERTY MANAGEMENT 2022. [DOI: 10.3846/ijspm.2022.17588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Property service mode innovation is the basic means of property service enterprise management. Discussing the property service mode in terms of transformation and upgrading is of rich research significance, taking Wenzhou Sapphire Property Service Co. LTD. in China (hereafter referred to as “Sapphire Service”) as an example. First, based on the development of property service in China, this paper summarizes the 4E mode of traditional property service, ensuring cleaning, ensuring greening, ensuring maintenance and ensuring security, and analyzes the existing problems. Second, combined with the development needs of the property service industry, this paper proposes the 4R mode of modern property service, realizing quality requirements, realizing pleasure service, realizing social responsibility and realizing green health, and summarizes its basic characteristics. Finally, based on the above modes in the practice at Sapphire Service, some management implications are put forward for the industrial transformation and upgrading requirements.
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Affiliation(s)
- Lijun Liu
- Zhejiang College, Shanghai University of Finance and Economics, Jinhua, China
| | - Wenjin Zuo
- Zhejiang College, Shanghai University of Finance and Economics, Jinhua, China
| | - Qiang Hu
- Zhejiang College, Shanghai University of Finance and Economics, Jinhua, China
| | - Lanting Zeng
- Economics and Trade College, Fujian Jiangxia University, Fuzhou, China
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Digital Future of Emergency Medical Services: Envisioning and Usability of Electronic Patient Care Report System. ADVANCES IN HUMAN-COMPUTER INTERACTION 2022. [DOI: 10.1155/2022/6012241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite the efforts of emerging technologies in the healthcare system, there is still a slower rate of acceleration in prehospital settings compared with the hospitals in digital transformation adaptation. The acknowledgment that digital transformation is significant to healthcare is reflected in planning for the future of digital healthcare. Thus, this study aimed to measure the usability of the electronic patient care report (ePCR) system among emergency medical services (EMS) staff who work in prehospital settings. A descriptive cross-sectional correlation study was used. Two hundred fifty EMS staff who are working in the prehospital setting at Saudi Red Crescent Authority in the Kingdom of Saudi Arabia were surveyed, and the response rate was 79.2% (198). An adapted tool of the Computer System Usability Questionnaire survey was used to collect data. The data were coded numerically and subjected to descriptive and inferential statistical analysis including Pearson’s correlation coefficient using the statistical software (SPSS 21). The majority of the participants rate their ePCR system as “useable” at a high level with a score of 3.41 (SD = 1.021). The overall mean of the ePCR system’s three subscales: system usefulness, information quality, interface quality, and overall satisfaction were 3.39 (SD = 1.152), 3.30 (SD = 1.052), 3.57 (SD = 1.064), and 3.37 (SD = 1.239), respectively. The least liked aspect of ePCR system software was information quality 81 (40.9%). Furthermore, there was a significant correlation between the age of EMS staff and the usability of the ePCR system (r = −0.150
,
). The results suggest that healthcare institutions’ policy and decision-makers pay close attention to performing standardized training for the staff on their ePCR system before going to the field to increase efficiency and productivity. Furthermore, the users in this study identified other system features that, if included, could have enhanced usability, and improved functions and capabilities of the design to meet the EMS staff’s expectations.
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Koebe P, Bohnet-Joschko S. The Impact of Digital Transformation on Inpatient Care: A Mixed Design Study (Preprint). JMIR Public Health Surveill 2022; 9:e40622. [PMID: 37083473 PMCID: PMC10163407 DOI: 10.2196/40622] [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: 06/29/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND In the context of the digital transformation of all areas of society, health care providers are also under pressure to change. New technologies and a change in patients' self-perception and health awareness require rethinking the provision of health care services. New technologies and the extensive use of data can change provision processes, optimize them, or replace them with new services. The inpatient sector, which accounts for a particularly large share of health care spending, plays a major role in this regard. OBJECTIVE This study examined the influences of current trends in digitization on inpatient service delivery. METHODS We conducted a scoping review. This was applied to identify the international trends in digital transformation as they relate to hospitals. Future trends were considered from different perspectives. Using the defined inclusion criteria, international peer-reviewed articles published between 2016 and 2021 were selected. The extracted core trends were then contextualized for the German hospital sector with 12 experts. RESULTS We included 44 articles in the literature analysis. From these, 8 core trends could be deduced. A heuristic impact model of the trends was derived from the data obtained and the experts' assessments. This model provides a development corridor for the interaction of the trends with regard to technological intensity and supply quality. Trend accelerators and barriers were identified. CONCLUSIONS The impact analysis showed the dependencies of a successful digital transformation in the hospital sector. Although data interoperability is of particular importance for technological intensity, the changed self-image of patients was shown to be decisive with regard to the quality of care. We show that hospitals must find their role in new digitally driven ecosystems, adapt their business models to customer expectations, and use up-to-date information and communications technologies.
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Affiliation(s)
- Philipp Koebe
- Faculty of Management, Economics and Society, Witten/Herdecke University, Witten, Germany
| | - Sabine Bohnet-Joschko
- Faculty of Management, Economics and Society, Witten/Herdecke University, Witten, Germany
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Duncan R, Eden R, Woods L, Wong I, Sullivan C. Synthesizing Dimensions of Digital Maturity in Hospitals: Systematic Review. J Med Internet Res 2022; 24:e32994. [PMID: 35353050 PMCID: PMC9008527 DOI: 10.2196/32994] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/02/2021] [Accepted: 12/28/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Digital health in hospital settings is viewed as a panacea for achieving the "quadruple aim" of health care, yet the outcomes have been largely inconclusive. To optimize digital health outcomes, a strategic approach is necessary, requiring digital maturity assessments. However, current approaches to assessing digital maturity have been largely insufficient, with uncertainty surrounding the dimensions to assess. OBJECTIVE The aim of this study was to identify the current dimensions used to assess the digital maturity of hospitals. METHODS A systematic literature review was conducted of peer-reviewed literature (published before December 2020) investigating maturity models used to assess the digital maturity of hospitals. A total of 29 relevant articles were retrieved, representing 27 distinct maturity models. The articles were inductively analyzed, and the maturity model dimensions were extracted and consolidated into a maturity model framework. RESULTS The consolidated maturity model framework consisted of 7 dimensions: strategy; information technology capability; interoperability; governance and management; patient-centered care; people, skills, and behavior; and data analytics. These 7 dimensions can be evaluated based on 24 respective indicators. CONCLUSIONS The maturity model framework developed for this study can be used to assess digital maturity and identify areas for improvement.
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Affiliation(s)
- Rhona Duncan
- School of Information Systems, Queensland University of Technology, Brisbane, Australia
| | - Rebekah Eden
- School of Information Systems, Queensland University of Technology, Brisbane, Australia
| | - Leanna Woods
- Centre for Health Services Research, The University of Queensland, Herston, Australia
- Digital Health Cooperative Research Centre, Australian Government, Sydney, Australia
- Digital Health Research Network, The University of Queensland, Brisbane, Australia
| | - Ides Wong
- Clinical Excellence Queensland, Queensland Health, Brisbane, Australia
| | - Clair Sullivan
- Centre for Health Services Research, The University of Queensland, Herston, Australia
- Digital Health Research Network, The University of Queensland, Brisbane, Australia
- Metro North Hospital and Health Service, Brisbane, Australia
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10
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Williams PAH, Lovelock B, Cabarrus T. A Sense of Coherence approach to improving patient experience using information infrastructure modelling. JMIR Form Res 2022; 6:e35418. [PMID: 35307641 PMCID: PMC9044153 DOI: 10.2196/35418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Health care provider organizations are complex and dynamic environments. Consequently, how the physical and social environment of such organizations interact with an individual is a primary driver of an individual’s experience. Increasingly, the capabilities required for them to successfully interact with those within their care are critically dependent on the information infrastructure they have in place, which enables people, both patients and staff, to work optimally together to deliver their clinical and operational objectives. Objective This study aims to design a framework to address the challenge of how to assemble information systems in health care to support an improved sense of coherence for patients, as well as potentially innovate patients’ experiences, by connecting and orchestrating the synergy among people, processes, and systems. Methods It is necessary to understand the needs of health care providers and patients to address this challenge at a level relevant to information process design and technology development. This paper describes the design science research method used to combine the sense of coherence, which is a core concept within the Antonosky salutogenic approach to health and well-being, with an established information infrastructure maturity framework, demonstrating the coalescence of 2 distinct conceptual perspectives on care delivery. This paper provides an approach to defining a positive and supportive health care experience and linking this to the capabilities of an information- and technology-enabled environment. Results This research delivers a methodology for describing the patient experience in a form relevant to information infrastructure design, articulating a pathway from information infrastructure to patient experience. It proposes that patient experience can be viewed pragmatically in terms of the established sense of coherence concept, with its ability to identify and guide resources to modulate a patient’s environmental stressors. This research establishes a framework for determining and optimizing the capability of a facility’s information infrastructure to support the sense of coherence defined by the experiences of its patients. Conclusions This groundbreaking research provides a framework for health care provider organizations to understand and assess the ability of their information infrastructure to support and improve the patient experience. The tool assists providers in defining their technology-dependent operational goals around patient experience and, consequently, in identifying the information capabilities needed to support these goals. The results demonstrate how a fundamental shift in thinking about the use of information infrastructure can transform the patient experience. This study details an approach to describing information infrastructure within an experience-oriented framework that enables the impact of technology on experience to be designed explicitly. The contribution to knowledge is a new perspective on modeling how information infrastructure can contribute to supportive health-promoting environments. Furthermore, it may significantly affect the design and deployment of future digital infrastructures in health care.
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Affiliation(s)
- Patricia Anne Helen Williams
- Flinders-Cisco Digital Health Design Lab, Flinders Digital Health Research Centre, College of Science and Engineering, Flinders University, Tonsley CampusGPO Box 2100, Adelaide, SA, AU
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Cross-site transportability of an explainable artificial intelligence model for acute kidney injury prediction. Nat Commun 2020; 11:5668. [PMID: 33168827 PMCID: PMC7653032 DOI: 10.1038/s41467-020-19551-w] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/20/2020] [Indexed: 12/29/2022] Open
Abstract
Artificial intelligence (AI) has demonstrated promise in predicting acute kidney injury (AKI), however, clinical adoption of these models requires interpretability and transportability. Non-interoperable data across hospitals is a major barrier to model transportability. Here, we leverage the US PCORnet platform to develop an AKI prediction model and assess its transportability across six independent health systems. Our work demonstrates that cross-site performance deterioration is likely and reveals heterogeneity of risk factors across populations to be the cause. Therefore, no matter how accurate an AI model is trained at the source hospital, whether it can be adopted at target hospitals is an unanswered question. To fill the research gap, we derive a method to predict the transportability of AI models which can accelerate the adaptation process of external AI models in hospitals. Artificial intelligence (AI) has demonstrated promise in predicting acutekidney injury (AKI), however, clinical adoption of these models requires interpretability and transportability across sites. Here, the authors develop an AKI prediction model and a measure for model transportability across six independent health systems.
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12
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Kim SJ, Roh JW, Kim S, Park JY, Choi D. Current State and Strategy for Establishing a Digitally Innovative Hospital: Memorial Review Article for Opening of Yongin Severance Hospital. Yonsei Med J 2020; 61:647-651. [PMID: 32734727 PMCID: PMC7393291 DOI: 10.3349/ymj.2020.61.8.647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/27/2022] Open
Abstract
The emergence of new technologies, especially digital transformation, influences the entire society, including the medical aspects. Therefore, the concept of digital hospital has been emerging. Here we present the Yongin Severance Hospital, which has developed various novel solutions to serve as foundations for the establishment of a digitally innovative hospital. Further strategies have also been provided to implement consistent and long-term planning.
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Affiliation(s)
- Soo Jeong Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Korea
| | - Ji Woong Roh
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, Korea
| | - Sungwon Kim
- Department of Radiology and Research Institute of Radiological Science, Center for Digital Health, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Donghoon Choi
- Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
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Baltaxe E, Czypionka T, Kraus M, Reiss M, Askildsen JE, Grenkovic R, Lindén TS, Pitter JG, Rutten-van Molken M, Solans O, Stokes J, Struckmann V, Roca J, Cano I. Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs. J Med Internet Res 2019; 21:e14956. [PMID: 31573914 PMCID: PMC6794072 DOI: 10.2196/14956] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 12/31/2022] Open
Abstract
Background Digital health tools comprise a wide range of technologies to support health processes. The potential of these technologies to effectively support health care transformation is widely accepted. However, wide scale implementation is uneven among countries and regions. Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations. Objective The aim of this study was to analyze the implementation of digital health tools to support health care and social care services, as well as to facilitate the longitudinal assessment of these services, in 17 selected integrated chronic care (ICC) programs from 8 European countries. Methods A program analysis based on thick descriptions—including document examinations and semistructured interviews with relevant stakeholders—of ICC programs in Austria, Croatia, Germany, Hungary, the Netherlands, Norway, Spain, and the United Kingdom was performed. A total of 233 stakeholders (ie, professionals, providers, patients, carers, and policymakers) were interviewed from November 2014 to September 2016. The overarching analysis focused on the use of digital health tools and program assessment strategies. Results Supporting digital health tools are implemented in all countries, but different levels of maturity were observed among the programs. Only few ICC programs have well-established strategies for a comprehensive longitudinal assessment. There is a strong relationship between maturity of digital health and proper evaluation strategies of integrated care. Conclusions Notwithstanding the heterogeneity of the results across countries, most programs aim to evolve toward a digital transformation of integrated care, including implementation of comprehensive assessment strategies. It is widely accepted that the evolution of digital health tools alongside clear policies toward their adoption will facilitate regional uptake and scale-up of services with embedded digital health tools.
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Affiliation(s)
- Erik Baltaxe
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.,Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | | | | | | | | | - Renata Grenkovic
- Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, Croatia
| | | | | | - Maureen Rutten-van Molken
- School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands.,Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Oscar Solans
- Oficina eSalut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Jonathan Stokes
- Health Organisation, Policy, and Economics, Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom
| | - Verena Struckmann
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Josep Roca
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.,Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Isaac Cano
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.,Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
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