1
|
Morelli S, Daniele C, D'Avenio G, Grigioni M, Giansanti D. Optimizing Telehealth: Leveraging Key Performance Indicators for Enhanced TeleHealth and Digital Healthcare Outcomes (Telemechron Study). Healthcare (Basel) 2024; 12:1319. [PMID: 38998854 PMCID: PMC11241174 DOI: 10.3390/healthcare12131319] [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: 06/04/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
Over the past decade, the use of telehealth has garnered increasing attention. The focus on quality aspects has seen significant growth in tandem with the telehealth expansion. Having useful indicators in this area is becoming increasingly strategic for fully integrating the technology into the health domain. These indicators can help monitor and evaluate the quality of telehealth services, guiding improvements and ensuring that these digital solutions meet the necessary standards for effective healthcare delivery. The purpose of this study is to analyze Key performance indicators (KPIs) in telehealth within institutional websites and the scientific dissemination world by means of a narrative review. A narrative review was proposed with these two specific points of view based on a standardized checklist and a quality control procedure for including scientific papers in the analysis. Results from scientific studies emphasize KPIs such as patient outcomes, operational efficiency, technical reliability, and cost-effectiveness. These include measures like improvements in condition management, patient satisfaction, consultation numbers, waiting times, and cost savings. Institutional documents from entities like the WHO also show diverse perspectives, focusing on equitable access, clinical excellence, patient prioritization, response times, and patient and staff satisfaction. The findings suggest that adopting a comprehensive set of KPIs and continuously monitoring and evaluating telehealth services can enhance their effectiveness, efficiency, and equity, ultimately improving healthcare outcomes and accessibility.
Collapse
Affiliation(s)
- Sandra Morelli
- Centro Nazionale per le Tecnologie Innovative in Sanità Pubblica, Istituto Superiore di Sanità, Via Regina Elena 299, 00161 Roma, Italy
| | - Carla Daniele
- Centro Nazionale per le Tecnologie Innovative in Sanità Pubblica, Istituto Superiore di Sanità, Via Regina Elena 299, 00161 Roma, Italy
| | - Giuseppe D'Avenio
- Centro Nazionale per le Tecnologie Innovative in Sanità Pubblica, Istituto Superiore di Sanità, Via Regina Elena 299, 00161 Roma, Italy
| | - Mauro Grigioni
- Centro Nazionale per le Tecnologie Innovative in Sanità Pubblica, Istituto Superiore di Sanità, Via Regina Elena 299, 00161 Roma, Italy
| | - Daniele Giansanti
- Centro Nazionale per le Tecnologie Innovative in Sanità Pubblica, Istituto Superiore di Sanità, Via Regina Elena 299, 00161 Roma, Italy
| |
Collapse
|
2
|
Lockwood KG, Kulkarni PR, Paruthi J, Buch LS, Chaffard M, Schitter EC, Branch OH, Graham SA. Evaluating a New Digital App-Based Program for Heart Health: Feasibility and Acceptability Pilot Study. JMIR Form Res 2024; 8:e50446. [PMID: 38787598 PMCID: PMC11161712 DOI: 10.2196/50446] [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: 06/30/2023] [Revised: 03/14/2024] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in the United States, affecting a significant proportion of adults. Digital health lifestyle change programs have emerged as a promising method of CVD prevention, offering benefits such as on-demand support, lower cost, and increased scalability. Prior research has shown the effectiveness of digital health interventions in reducing negative CVD outcomes. This pilot study focuses on the Lark Heart Health program, a fully digital artificial intelligence (AI)-powered smartphone app, providing synchronous CVD risk counseling, educational content, and personalized coaching. OBJECTIVE This pilot study evaluated the feasibility and acceptability of a fully digital AI-powered lifestyle change program called Lark Heart Health. Primary analyses assessed (1) participant satisfaction, (2) engagement with the program, and (3) the submission of health screeners. Secondary analyses were conducted to evaluate weight loss outcomes, given that a major focus of the Heart Health program is weight management. METHODS This study enrolled 509 participants in the 90-day real-world single-arm pilot study of the Heart Health app. Participants engaged with the app by participating in coaching conversations, logging meals, tracking weight, and completing educational lessons. The study outcomes included participant satisfaction, app engagement, the completion of screeners, and weight loss. RESULTS On average, Heart Health study participants were aged 60.9 (SD 10.3; range 40-75) years, with average BMI indicating class I obesity. Of the 509 participants, 489 (96.1%) stayed enrolled until the end of the study (dropout rate: 3.9%). Study retention, based on providing a weight measurement during month 3, was 80% (407/509; 95% CI 76.2%-83.4%). Participant satisfaction scores indicated high satisfaction with the overall app experience, with an average score of ≥4 out of 5 for all satisfaction indicators. Participants also showed high engagement with the app, with 83.4% (408/489; 95% CI 80.1%-86.7%) of the sample engaging in ≥5 coaching conversations in month 3. The results indicated that participants were successfully able to submit health screeners within the app, with 90% (440/489; 95% CI 87%-92.5%) submitting all 3 screeners measured in the study. Finally, secondary analyses showed that participants lost weight during the program, with analyses showing an average weight nadir of 3.8% (SD 2.9%; 95% CI 3.5%-4.1%). CONCLUSIONS The study results indicate that participants in this study were satisfied with their experience using the Heart Health app, highly engaged with the app features, and willing and able to complete health screening surveys in the app. These acceptability and feasibility results provide a key first step in the process of evidence generation for a new AI-powered digital program for heart health. Future work can expand these results to test outcomes with a commercial version of the Heart Health app in a diverse real-world sample.
Collapse
Affiliation(s)
| | | | | | | | | | - Eva C Schitter
- Roche Information Solutions, Santa Clara, CA, United States
| | | | | |
Collapse
|
3
|
Stara V, Rampioni M, Moșoi AA, Kristaly DM, Moraru SA, Paciaroni L, Paolini S, Raccichini A, Felici E, Cucchieri G, Antognoli L, Millevolte A, Antici M, di Rosa M. The Impact of a Multicomponent Platform Intervention on the Daily Lives of Older Adults. Healthcare (Basel) 2023; 11:3102. [PMID: 38131995 PMCID: PMC10742799 DOI: 10.3390/healthcare11243102] [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: 11/06/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Gerontechnology is an interdisciplinary field of research involving gerontology and technology in order to help older adults identify and slow down the effects of age-related physical and cognitive decline. It has enormous potential to allow individuals to remain in their own homes and improve their quality of life. This study aims to assess the impact of a multicomponent platform, consisting of an ambient sensor, wearable devices, and a cloud application, as an intervention in terms of usability and acceptance as primary outcomes and well-being, quality of life, and self-efficacy as secondary outcomes in a sample of 25 older adults aged over 65 after 21 days of non-supervised usage at home. This research involved the use of a mixed-methods approach, in which both qualitative and quantitative data were collected in three different measurements. Overall, the participants shared good engagement with the integrated platform. The system achieved positive results in terms of both usability and acceptance, especially the smartwatch. The state of complete well-being slightly improved over the period, whereas self-efficacy remained stable. This study demonstrates the ability of target users to use technology independently in their home environment: it strengthens the idea that this technology is ready for mainstream use and offers food for thought for developers who create products for the aging population.
Collapse
Affiliation(s)
- Vera Stara
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Margherita Rampioni
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Adrian Alexandru Moșoi
- Department of Psychology, Education and Teacher Training, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania;
| | - Dominic M. Kristaly
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (D.M.K.); (S.-A.M.)
| | - Sorin-Aurel Moraru
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (D.M.K.); (S.-A.M.)
| | - Lucia Paciaroni
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Monta-gnola 81, 60100 Ancona, Italy; (L.P.); (S.P.); (A.R.)
| | - Susy Paolini
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Monta-gnola 81, 60100 Ancona, Italy; (L.P.); (S.P.); (A.R.)
| | - Alessandra Raccichini
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Monta-gnola 81, 60100 Ancona, Italy; (L.P.); (S.P.); (A.R.)
| | - Elisa Felici
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Giacomo Cucchieri
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Luca Antognoli
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | | | - Marina Antici
- Laboratorio delle Idee, Via G.B. Miliani 36, 60044 Fabriano, Italy; (A.M.); (M.A.)
| | - Mirko di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA-National Institute of Health and Science on Aging, 60124 Ancona, Italy;
| |
Collapse
|
4
|
Pennestrì F, Banfi G. Primary Care of the (Near) Future: Exploring the Contribution of Digitalization and Remote Care Technologies through a Case Study. Healthcare (Basel) 2023; 11:2147. [PMID: 37570387 PMCID: PMC10418748 DOI: 10.3390/healthcare11152147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The Italian Government planned to invest €15 billion of European funds on National Health Service digitalization and primary care enhancement. The critical burden brought by the pandemic upon hospital care mean these investments could no longer be delayed, considering the extraordinary backlogs of many treatments and the ordinary gaps of fragmented long-term care, in Italy and abroad. National guidelines have been published to standardize interventions across the Italian regions, and telemedicine is frequently mentioned as a key innovation to achieve both goals. The professional resources needed to run the facilities introduced in primary care are defined with great precision, but no details are given on how digitalization and remote care technologies must be implemented in this context. Building on this policy case, this paper focuses on what contribution digitalization and telemedicine can offer to specific primary care innovations, drawing from implemented technology-driven policies which may support the effective stratification, prevention and management of chronic patient needs, including anticipatory healthcare, population health management, adjusted clinical groups, chronic care management, quality and outcomes frameworks, patient-reported outcomes and patient-reported experience. All these policies can benefit significantly from digitalization and remote care technology, provided that some risks and limitations are considered by design.
Collapse
Affiliation(s)
- Federico Pennestrì
- IRCCS Istituto Ortopedico Galeazzi, Via Belgioioso 4, 20161 Milan, Italy;
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Via Belgioioso 4, 20161 Milan, Italy;
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| |
Collapse
|
5
|
Zhai S, Chu F, Tan M, Chi NC, Ward T, Yuwen W. Digital health interventions to support family caregivers: An updated systematic review. Digit Health 2023; 9:20552076231171967. [PMID: 37223775 PMCID: PMC10201006 DOI: 10.1177/20552076231171967] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/10/2023] [Indexed: 05/25/2023] Open
Abstract
Objective Chronic diseases are the leading causes of death and disability in the U.S., and disease management largely falls onto patients' family caregivers. The long-term burden and stress of caregiving negatively impact caregivers' well-being and ability to provide care. Digital health interventions have the potential to support caregivers. This article aims to provide an updated review of interventions using digital health tools to support family caregivers and the scope of the Human-Centered Design (HCD) approaches. Methods We conducted a systematic search on July 2019 and January 2021 in PubMed, CINAHL, Embase, Cochrane Library, PsycINFO, ERIC, and ACM Digital Library, limiting to 2014-2021 to identify family caregiver interventions assisted by modern technologies. The Mixed Methods Appraisal Tool and the Grading of Recommendations Assessment, Development and Evaluation were used to evaluate the articles. Data were abstracted and evaluated using Rayyan and Research Electronic Data Capture. Results We identified and reviewed 40 studies from 34 journals, 10 fields, and 19 countries. Findings included patients' conditions and relationships with family caregivers, how the technology is used to deliver the intervention, HCD methods, theoretical frameworks, components of the interventions, and family caregiver health outcomes. Conclusion This updated and expanded review revealed that digitally enhanced health interventions were robust at providing high-quality assistance and support to caregivers by improving caregiver psychological health, self-efficacy, caregiving skills, quality of life, social support, and problem-coping abilities. Health professionals need to include informal caregivers as an essential component when providing care to patients. Future research should include more marginalized caregivers from diverse backgrounds, improve the accessibility and usability of the technology tools, and tailor the intervention to be more culturally and linguistically sensitive.
Collapse
Affiliation(s)
- Shumenghui Zhai
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Frances Chu
- School of Nursing, University of Washington, Seattle, WA, USA
- Providence Health System, Swedish First Hill, Seattle, WA, USA
| | - Minghui Tan
- School of Nursing, Peking Union Medical University, Beijing, China
| | - Nai-Ching Chi
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Teresa Ward
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA
| |
Collapse
|