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Voigt I, Fischer S, Proschmann U, Konofalska U, Richter P, Schlieter H, Berger T, Meuth SG, Hartung HP, Akgün K, Ziemssen T. Consensus quality indicators for monitoring multiple sclerosis. Lancet Reg Health Eur 2024; 40:100891. [PMID: 38585674 PMCID: PMC10998202 DOI: 10.1016/j.lanepe.2024.100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
Multiple sclerosis (MS) as a chronic, degenerative autoimmune disease of the central nervous system has a longitudinal and heterogeneous course with increasing treatment options and risk profiles requiring constant monitoring of a growing number of parameters. Despite treatment guidelines, there is a lack of strategic and individualised monitoring pathways, including respective quality indicators (QIs). To address this, we systematically developed transparent, traceable, and measurable QIs for MS monitoring. Through literature review, expert discussions, and consensus-building, existing QIs were identified and refined. In a two-stage online Delphi process involving MS specialists (on average 53 years old and with 25 years of professional experience), the QIs were evaluated for content, clarity, and intelligibility, resulting in a set of 24 QIs and checklists to assess the quality of care. The final QIs provide a structured approach to document, monitor, and enhance the quality of care for people with MS across their treatment journey.
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Affiliation(s)
- Isabel Voigt
- Center of Clinical Neuroscience, Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, Dresden 01307, Germany
| | - Stefanie Fischer
- Center of Clinical Neuroscience, Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, Dresden 01307, Germany
| | - Undine Proschmann
- Center of Clinical Neuroscience, Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, Dresden 01307, Germany
| | - Urszula Konofalska
- Center of Clinical Neuroscience, Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, Dresden 01307, Germany
| | - Peggy Richter
- Research Group Digital Health, Faculty of Business and Economics, TUD Dresden University of Technology, Dresden 01062, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, TUD Dresden University of Technology, Dresden 01062, Germany
| | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria
| | - Sven G. Meuth
- Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany
| | - Katja Akgün
- Center of Clinical Neuroscience, Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, Dresden 01307, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, Dresden 01307, Germany
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Schlieter H, Gand K, Marsch LA, Chan WS, Kowatsch T. Editorial: Scaling-up health-IT-sustainable digital health implementation and diffusion. Front Digit Health 2024; 6:1296495. [PMID: 38686176 PMCID: PMC11056544 DOI: 10.3389/fdgth.2024.1296495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Affiliation(s)
- Hannes Schlieter
- Research Group Digital Health, Technische Universität Dresden, Dresden, Germany
| | - Kai Gand
- Research Group Digital Health, Technische Universität Dresden, Dresden, Germany
| | - Lisa A. Marsch
- Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, United States
| | - Wai Sze Chan
- Department of Psychology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
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Wenk J, Voigt I, Inojosa H, Schlieter H, Ziemssen T. Building digital patient pathways for the management and treatment of multiple sclerosis. Front Immunol 2024; 15:1356436. [PMID: 38433832 PMCID: PMC10906094 DOI: 10.3389/fimmu.2024.1356436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Recent advances in the field of artificial intelligence (AI) could yield new insights into the potential causes of multiple sclerosis (MS) and factors influencing its course as the use of AI opens new possibilities regarding the interpretation and use of big data from not only a cross-sectional, but also a longitudinal perspective. For each patient with MS, there is a vast amount of multimodal data being accumulated over time. But for the application of AI and related technologies, these data need to be available in a machine-readable format and need to be collected in a standardized and structured manner. Through the use of mobile electronic devices and the internet it has also become possible to provide healthcare services from remote and collect information on a patient's state of health outside of regular check-ups on site. Against this background, we argue that the concept of pathways in healthcare now could be applied to structure the collection of information across multiple devices and stakeholders in the virtual sphere, enabling us to exploit the full potential of AI technology by e.g., building digital twins. By going digital and using pathways, we can virtually link patients and their caregivers. Stakeholders then could rely on digital pathways for evidence-based guidance in the sequence of procedures and selection of therapy options based on advanced analytics supported by AI as well as for communication and education purposes. As far as we aware of, however, pathway modelling with respect to MS management and treatment has not been thoroughly investigated yet and still needs to be discussed. In this paper, we thus present our ideas for a modular-integrative framework for the development of digital patient pathways for MS treatment.
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Affiliation(s)
- Judith Wenk
- Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Isabel Voigt
- Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Hernan Inojosa
- Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Schlieter H, Kählig M, Hickmann E, Fürstenau D, Sunyaev A, Richter P, Breitschwerdt R, Thielscher C, Gersch M, Maaß W, Reuter-Oppermann M, Wiese L. [Digital health applications (DiGA) in the area of tension between progress and criticism : Discussion paper from the "Digital health" specialist group of the German Informatics Society]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:107-114. [PMID: 38086924 PMCID: PMC10776708 DOI: 10.1007/s00103-023-03804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/07/2023] [Indexed: 01/10/2024]
Abstract
Since December 2019, digital health applications (DiGA) have been included in standard care in Germany and are therefore reimbursed by the statutory health insurance funds to support patients in the treatment of diseases or impairments. There are 48 registered DiGA listed in the directory of the Federal Institute of Drugs and Medical Devices (BfArM), mainly in the areas of mental health; hormones and metabolism; and muscles, bones, and joints. In this article, the "Digital Health" specialist group of the German Informatics Society describes the current developments around DiGA as well as the current sentiment on topics such as user-centricity, patient and practitioner acceptance, and innovation potential. In summary, over the past three years, DiGA have experienced a positive development, characterized by a gradually increasing availability of various DiGA and coverage areas as well as prescription numbers. Nevertheless, significant regulatory adjustments are still required in some areas to establish DiGA as a well-established instrument in long-term routine healthcare. Key challenges include user-centeredness and the sustainable use of the applications.
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Affiliation(s)
- Hannes Schlieter
- Forschungsgruppe Digital Health, Fakultät Wirtschaftswissenschaften, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Maren Kählig
- Forschungsgruppe Digital Health, Fakultät Wirtschaftswissenschaften, Technische Universität Dresden, Dresden, Sachsen, Deutschland.
| | - Emily Hickmann
- Forschungsgruppe Digital Health, Fakultät Wirtschaftswissenschaften, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Daniel Fürstenau
- Department of Business IT, IT University of Copenhagen, Kopenhagen, Dänemark
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Ali Sunyaev
- Institut für Angewandte Informatik und Formale Beschreibungsverfahren, Karlsruher Institut für Technologie, Karlsruhe, Baden-Württemberg, Deutschland
| | - Peggy Richter
- Forschungsgruppe Digital Health, Fakultät Wirtschaftswissenschaften, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Rüdiger Breitschwerdt
- Professur für Wirtschaftsinformatik und Medizinische Informatik, Wilhelm Büchner Hochschule, Darmstadt, Hessen, Deutschland
| | - Christian Thielscher
- KompetenzCentrum für Medizinoekonomie, FOM Hochschule, Essen, Nordrhein-Westfalen, Deutschland
| | - Martin Gersch
- Fachbereich Wirtschaftswissenschaften, Freie Universität Berlin, Berlin, Deutschland
| | - Wolfgang Maaß
- Lehrstuhl für Betriebswirtschaftslehre, insbesondere Wirtschaftsinformatik, German Research Center for Artificial Intelligence Universität Saarland, Saarbrücken, Saarland, Deutschland
| | - Melanie Reuter-Oppermann
- Faculty of Behavioural, Management and Social Sciences, Center for Healthcare Operations Improvement and Research, University of Twente, Enschede, Niederlande
| | - Lena Wiese
- Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Leader Research Group Bioinformatics, Hannover, Niedersachsen, Deutschland
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Lăcraru AE, Busnatu ȘS, Pană MA, Olteanu G, Șerbănoiu L, Gand K, Schlieter H, Kyriazakos S, Ceban O, Andrei CL, Sinescu CJ. Assessing the Efficacy of a Virtual Assistant in the Remote Cardiac Rehabilitation of Heart Failure and Ischemic Heart Disease Patients: Case-Control Study of Romanian Adult Patients. Int J Environ Res Public Health 2023; 20:3937. [PMID: 36900948 PMCID: PMC10002163 DOI: 10.3390/ijerph20053937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of mortality in Europe, with potentially more than 60 million deaths per year, with an age-standardized rate of morbidity-mortality higher in men than women, exceeding deaths from cancer. Heart attacks and strokes account for more than four out of every five CVD fatalities globally. After a patient overcomes an acute cardiovascular event, they are referred for rehabilitation to help them to restore most of their normal cardiac functions. One effective way to provide this activity regimen is via virtual models or telerehabilitation, where the patient can avail themselves of the rehabilitation services from the comfort of their homes at designated timings. Under the funding of the European Union's Horizon 2020 Research and Innovation program, grant no 769807, a virtual rehabilitation assistant has been designed for elderly patients (vCare), with the overall objective of supporting recovery and an active life at home, enhancing patients' quality of life, lowering disease-specific risk factors, and ensuring better adherence to a home rehabilitation program. In the vCare project, the Carol Davila University of Bucharest (UMFCD) was in charge of the heart failure (HF) and ischemic heart disease (IHD) groups of patients. By creating a digital environment at patients' homes, the vCare system's effectiveness, use, and feasibility was evaluated. A total of 30 heart failure patients and 20 ischemic heart disease patients were included in the study. Despite the COVID-19 restrictions and a few technical difficulties, HF and IHD patients who performed cardiac rehabilitation using the vCare system had similar results compared to the ambulatory group, and better results compared to the control group.
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Affiliation(s)
- Andreea-Elena Lăcraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Ștefan-Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Maria-Alexandra Pană
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Gabriel Olteanu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Liviu Șerbănoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Kai Gand
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, 7400 Aarhus, Denmark
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, University of Economic Studies, 010374 Bucharest, Romania
| | - Cătălina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Crina-Julieta Sinescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
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Otto L, Schlieter H, Harst L, Whitehouse D, Maeder A. The telemedicine community readiness model-successful telemedicine implementation and scale-up. Front Digit Health 2023; 5:1057347. [PMID: 36910573 PMCID: PMC9995762 DOI: 10.3389/fdgth.2023.1057347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
To successfully scale-up telemedicine initiatives (TIs), communities play a crucial role. To empower communities fulfilling this role and increase end users' acceptance of TIs, support tools (from now on entitled artifacts) are needed that include specific measures to implement and scale up telemedicine. Addressing this need, the article introduces the Telemedicine Community Readiness Model (TCRM). The TCRM is designed to help decision-makers in communities to create a favorable environment that facilitates the implementation and scale-up of TIs. The TCRM is a practical tool to assess communities' readiness to implement TIs and identify aspects to improve this readiness. The development process follows a design-science procedure, which integrates literature reviews and semi-structured expert interviews to justify and evaluate design decisions and the final design. For researchers, the paper provides insights into factors that influence telemedicine implementation and scale-up (descriptive role of knowledge) on the community level. For practitioners, it provides a meaningful tool to support the implementation and scale-up of TIs (prescriptive role of knowledge). This should help to realize the potential of telemedicine solutions to increase access to healthcare services and their quality.
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Affiliation(s)
- Lena Otto
- Research Group Digital Health, Technische Universität Dresden, Dresden, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Technische Universität Dresden, Dresden, Germany
| | - Lorenz Harst
- Center for Evidence-Based Healthcare, Branch Office at the Medical Campus Chemnitz of the TU Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Diane Whitehouse
- European Health Telematics Association (EHTEL), Brussels, Belgium
| | - Anthony Maeder
- Flinders Digital Health Research Centre, Flinders University, Adelaide, SA, Australia
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Del Pino R, Díez-Cirarda M, Ustarroz-Aguirre I, Gonzalez-Larragan S, Caprino M, Busnatu S, Gand K, Schlieter H, Gabilondo I, Gómez-Esteban JC. Costs and effects of telerehabilitation in neurological and cardiological diseases: A systematic review. Front Med (Lausanne) 2022; 9:832229. [PMID: 36523783 PMCID: PMC9745081 DOI: 10.3389/fmed.2022.832229] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/07/2022] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Telerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system. METHODS The systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out. RESULTS A total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies assessed telerehabilitation in cardiological diseases (chronic heart failure, coronary heart disease, acute coronary syndrome, and cardiovascular diseases). The duration of the telerehabilitation ranged from 6 to 48 weeks. The studies included cost-analysis, cost-benefit, cost-effectiveness, or cost-utility. In total, four studies found significant cost/savings per person between $565.66 and $2,352.00 (p < 0.05). In contrast, most studies found differences in costs and clinical effects between the telerehabilitation performed and the rehabilitation performed at the clinic. Just one study found quality-adjusted life years (QALY) significant differences between groups [Incremental cost-effectiveness ratio (ICER) per QALY ($-21,666.41/QALY). DISCUSSION Telerehabilitation is an excellent alternative to traditional center rehabilitation, which increases the accessibility to rehabilitation to more people, either due to the geographical situation of the patients or the limitations of the health systems. Telerehabilitation seems to be as clinical and cost-effective as traditional rehabilitation, even if, generally, telerehabilitation is less costly. More research is needed to evaluate health-related quality of life and cost-effectiveness in other neurological diseases. SYSTEMATIC REVIEW REGISTRATION [https://figshare.com/articles/journal_ contribution/Review_Protocol_Costs_and_effects_of_Telerehabilitation_in_ Neurological_and_Cardiological_Diseases_A_Systematic_Review/19619838], identifier [19619838].
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Affiliation(s)
- Rocio Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Maria Díez-Cirarda
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | | | | | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico Spa, Milano, Italy
| | - Stefan Busnatu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Kai Gand
- Technische Universität Dresden, Faculty of Business and Economics, Research Group Digital Health, Dresden, Germany
| | - Hannes Schlieter
- Technische Universität Dresden, Faculty of Business and Economics, Research Group Digital Health, Dresden, Germany
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Ikerbasque, The Basque Foundation for Science, Bilbao, Spain
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain
- Department of Neuroscience, University of the Basque Country (Universidad del Pais Vasco/Euskal Herriko Unibertsitatea), Leioa, Spain
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Hickmann E, Richter P, Schlieter H. All together now - patient engagement, patient empowerment, and associated terms in personal healthcare. BMC Health Serv Res 2022; 22:1116. [PMID: 36056354 PMCID: PMC9440506 DOI: 10.1186/s12913-022-08501-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Patients as active partners in their personal healthcare are key drivers to reducing costs, securing an effective usage of resources, and ensuring patient-provider satisfaction. Even though these benefits are acknowledged, a theoretical framework for the plethora of concepts used in this context, such as patient engagement, patient empowerment, or patient involvement is missing. Furthermore, the heterogeneous or synonymous usage of these terms leads to miscommunication, missing standard conceptual measures, and a deficiency in theory building and testing. Our objective is to show what the relationships and distinctions between concepts focussing on patients as active partners in their personal healthcare are. Methods A systematic literature review was conducted to consolidate terms related to patients’ having an active role in their healthcare. From 442 articles screened in PubMed, a final set of 17 papers was included. Any articles conceptualising or presenting relationships between the concepts were included. Information was synthesised, and contradictions were unravelled systematically. The concepts and their relationships are structured and represented by employing a concept map. Results Patient-centredness is a concept dominantly influenced by health care providers and can enhance patients’ competencies, attitudes, and behaviours towards their personal healthcare. Enabling patients to become more empowered can ultimately lead to their greater involvement and engagement. Fostering an active role of patients can also increase their adherence to the care pathway. In general, patient engagement seems to be the most conclusive and furthest developed concept in terms of turning patients into active partners in their personal healthcare. Conclusions We plead for a stricter demarcation and therefore a terminological standardisation of the terms in the future to avoid further ambiguity and miscommunication. The concept map presents a basis for a uniform understanding and application of the concepts. Through a comprehensive understanding of the terms and their dimensions, relationships between the concepts can be utilised, measures can be derived, and theory building and testing can be enhanced, leading to better acceptance and utilisation of concepts in healthcare services. Furthermore, patient engagement is presented to be the most conclusive and furthest developed concept in the subject area. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08501-5.
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Affiliation(s)
- Emily Hickmann
- Faculty of Business and Economics, Research Group Digital Health, Technische Universität Dresden, Helmholtzstr. 10, 01069, Dresden, Germany.
| | - Peggy Richter
- Faculty of Business and Economics, Research Group Digital Health, Technische Universität Dresden, Helmholtzstr. 10, 01069, Dresden, Germany
| | - Hannes Schlieter
- Faculty of Business and Economics, Research Group Digital Health, Technische Universität Dresden, Helmholtzstr. 10, 01069, Dresden, Germany
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Busnatu ȘS, Pană MA, Lăcraru AE, Jercălău CE, Paun N, Caprino M, Gand K, Schlieter H, Kyriazakos S, Andrei CL, Sinescu CJ. Patient Perception When Transitioning from Classic to Remote Assisted Cardiac Rehabilitation. Diagnostics (Basel) 2022; 12:diagnostics12040926. [PMID: 35453974 PMCID: PMC9030505 DOI: 10.3390/diagnostics12040926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 12/10/2022] Open
Abstract
Cardiac rehabilitation is an individualized outpatient program of physical exercises and medical education designed to accelerate recovery and improve health status in heart disease patients. In this study, we aimed for assessment of patients’ perception of the involvement of technology and remote monitoring devices in cardiac recovery. During the Living Lab Phase of the Virtual Coaching Activities for Rehabilitation in Elderly (vCare) project, we evaluated eleven patients (five heart failure patients and six ischemic heart disease patients). Patient admission in the UMFCD cardiology clinical department served as a shared inclusion criterion for both study groups. In addition, the presence of II or III heart failure NYHA stage status was considered an inclusion criterion for the heart failure study group and patients diagnosed with ischemic heart disease for the second one. We conducted a system usability survey to assess the patients’ perception of the system’s technical and medical functions. The survey had excellent preliminary results in the heart failure study group and good results in the ischemic heart disease group. The limited access of patients to cardiac rehabilitation in Romania has led to increased interest and motivation in this study. The final version of the product is designed to adapt to patient needs and necessities; therefore, patient perception is necessary.
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Affiliation(s)
- Ștefan-Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (Ș.-S.B.); (A.E.L.); (C.-E.J.); (C.L.A.); (C.-J.S.)
| | - Maria-Alexandra Pană
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (Ș.-S.B.); (A.E.L.); (C.-E.J.); (C.L.A.); (C.-J.S.)
- Correspondence: ; Tel.: +40-746243990
| | - Andreea Elena Lăcraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (Ș.-S.B.); (A.E.L.); (C.-E.J.); (C.L.A.); (C.-J.S.)
| | - Cosmina-Elena Jercălău
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (Ș.-S.B.); (A.E.L.); (C.-E.J.); (C.L.A.); (C.-J.S.)
| | - Nicolae Paun
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Clinical Hospital “Theodor Burghele”, 020021 Bucharest, Romania;
| | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, 20144 Milano, Italy;
| | - Kai Gand
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, 01062 Dresden, Germany; (K.G.); (H.S.)
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, 01062 Dresden, Germany; (K.G.); (H.S.)
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, 7400 Aarhus, Denmark;
| | - Cătălina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (Ș.-S.B.); (A.E.L.); (C.-E.J.); (C.L.A.); (C.-J.S.)
| | - Crina-Julieta Sinescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (Ș.-S.B.); (A.E.L.); (C.-E.J.); (C.L.A.); (C.-J.S.)
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10
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Schlieter H, Marsch LA, Whitehouse D, Otto L, Londral AR, Teepe GW, Benedict M, Ollier J, Ulmer T, Gasser N, Ultsch S, Wollschlaeger B, Kowatsch T. Scale-up of Digital Innovations in Health Care: Expert Commentary on Enablers and Barriers. J Med Internet Res 2022; 24:e24582. [PMID: 35275065 PMCID: PMC8956989 DOI: 10.2196/24582] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/17/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022] Open
Abstract
Health care delivery is undergoing a rapid change from traditional processes toward the use of digital health interventions and personalized medicine. This movement has been accelerated by the COVID-19 crisis as a response to the need to guarantee access to health care services while reducing the risk of contagion. Digital health scale-up is now also vital to achieve population-wide impact: it will only accomplish sustainable effects if and when deployed into regular health care delivery services. The question of how sustainable digital health scale-up can be successfully achieved has, however, not yet been sufficiently resolved. This paper identifies and discusses enablers and barriers for scaling up digital health innovations. The results discussed in this paper were gathered by scientists and representatives of public bodies as well as patient organizations at an international workshop on scaling up digital health innovations. Results are explored in the context of prior research and implications for future work in achieving large-scale implementations that will benefit the population as a whole.
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Affiliation(s)
- Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | | | - Lena Otto
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Ana Rita Londral
- Value for Health CoLAB, NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal.,Comprehensive Health Research Center, NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Gisbert Wilhelm Teepe
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
| | - Martin Benedict
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Joseph Ollier
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
| | - Tom Ulmer
- Institute of Information and Process Management, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | | | - Sabine Ultsch
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Bastian Wollschlaeger
- Research Group Digital Health, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
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11
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Seregni A, Tricomi E, Tropea P, Del Pino R, Gómez-Esteban JC, Gabilondo I, Díez-Cirarda M, Schlieter H, Gand K, Corbo M. Virtual Coaching for Rehabilitation: The Participatory Design Experience of the vCare Project. Front Public Health 2021; 9:748307. [PMID: 34926373 PMCID: PMC8674451 DOI: 10.3389/fpubh.2021.748307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
End-user involvement constitutes an essential goal during the development of innovative solution, not only for the evaluation, but also in codesign, following a user-centered strategy. Indeed, it is a great asset of research to base the work in a user-centered approach, because it allows to build a platform that will respond to the real needs of users. The aims of this work are to present the methodology adopted to involve end-users (i.e., neurological patients, healthy elderly, and health professionals) in the evaluation of a novel virtual coaching system based on the personalized clinical pathways and to present the results obtained from these preliminary activities. Specific activities involving end-users were planned along the development phases and are referred to as participatory design. The user experience of participatory design is constituted by the two different phases: the “end-user's perspective” phase where the user involvement in experiential activities is from an observational point of view, whereas the “field study” phase is the direct participation in these activities. Evaluation tools (i.e., scales, questionnaires, and interviews) were planned to assess different aspects of the system. Thirty patients [14 with poststroke condition and 16 with Parkinson's disease (PD)], 13 healthy elderly, and six health professionals were enrolled from two clinical centers during the two phases of participatory design. Results from “end-user's perspective” phase showed globally a positive preliminary perception of the service. Overall, a positive evaluation (i.e., UEQ median score > 1) was obtained for each domain of the scale in both groups of patients and healthy subjects. The evaluation of the vCare system during the “field study” phase was assessed as excellent (>80 points) from the point of view of both patients and health professionals. According to the majority of patients, the rehabilitation service through the solution was reported to be interesting, engaging, entertaining, challenging and useful for improving impaired motor functions, and making patients aware of their cognitive abilities. Once refined and fine-tuned in the aspects highlighted in the this work, the system will be clinically tested at user's home to measure the real impact of the rehabilitative coaching services.
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Affiliation(s)
- Agnese Seregni
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Enrica Tricomi
- Institut für Technische Informatik (ZITI), Heidelberg University, Heidelberg, Germany
| | - Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Rocio Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - Inigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurology, Cruces University Hospital, Barakaldo, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
| | - María Díez-Cirarda
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Hannes Schlieter
- Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Kai Gand
- Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
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12
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Kyriazakos S, Schlieter H, Gand K, Caprino M, Corbo M, Tropea P, Judica E, Sterpi I, Busnatu S, Philipp P, Rovira J, Martínez A, Lange M, Gabilondo I, Del Pino R, Carlos Gomez-Esteban J, Pannese L, Bøttcher M, Lynggaard V. A Novel Virtual Coaching System Based on Personalized Clinical Pathways for Rehabilitation of Older Adults-Requirements and Implementation Plan of the vCare Project. Front Digit Health 2021; 2:546562. [PMID: 34713034 PMCID: PMC8521911 DOI: 10.3389/fdgth.2020.546562] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/19/2020] [Indexed: 11/14/2022] Open
Abstract
Home-based rehabilitation after an acute episode or following an exacerbation of a chronic disease is often problematic with a clear lack of continuity of care between hospital and home care. Secondary prevention is an essential element of long-term rehabilitation where strategies oriented toward risk reduction, treatment adherence, and optimization of quality of life need to be applied. Frail and sometimes isolated, the patient fails to adhere to the proposed post-discharge clinical pathway due to lack of appropriate clinical, emotional, and informational support. Providing a suitable rehabilitation after an acute episode or a chronic disease is a major issue, as it helps people to live independently and enhance their quality of life. However, as the rehabilitation period usually lasts some months, the continuity of care is often interrupted in the transition from hospital to home. Virtual coaches could help these patients to engage in a personalized rehabilitation program that complies with age-related conditions. These coaches could be a key technology for empowering patients toward increasing their adherence to the care plan and to improve their secondary prevention measures. In this paper, we are presenting a novel virtual coaching system that will address these challenges by combining recent technological advances with clinical pathways, based on joint research and validation activities from researchers from the medical and information and communication technology (ICT) domains.
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Affiliation(s)
- Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Hannes Schlieter
- Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Kai Gand
- Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milano, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milano, Italy
| | - Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milano, Italy
| | - Elda Judica
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milano, Italy
| | - Irma Sterpi
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milano, Italy
| | - Stefan Busnatu
- Universitatea de Medicina si Farmacie "Carol Davila" din Bucuresti, Bucuresti, Romania
| | - Patrick Philipp
- FZI Forschungszentrum Informatik am Karlsruher Institut für Technologie, Karlsruhe, Germany
| | | | | | - Marc Lange
- European Health Telematics Association, Brussels, Belgium
| | | | - Rocio Del Pino
- Biocruces-Bizkaia Health Research Institute, Bilbao, Spain
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13
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Haase R, Voigt I, Scholz M, Schlieter H, Benedict M, Susky M, Dillenseger A, Ziemssen T. Profiles of eHealth Adoption in Persons with Multiple Sclerosis and Their Caregivers. Brain Sci 2021; 11:brainsci11081087. [PMID: 34439706 PMCID: PMC8392753 DOI: 10.3390/brainsci11081087] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/07/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023] Open
Abstract
(1) Background: Persons with multiple sclerosis (pwMS) are often characterized as ideal adopters of new digital healthcare trends, but it is worth thinking about whether and which pwMS will be targeted and served by a particular eHealth service like a patient portal. With our study, we wanted to explore needs and barriers for subgroups of pwMS and their caregivers when interacting with eHealth services in care and daily living. (2) Methods: This study comprises results from two surveys: one collecting data from pwMS and their relatives (as informal caregivers) and another one providing information on the opinions and attitudes of healthcare professionals (HCPs). Data were analyzed descriptively and via generalized linear models. (3) Results: 185 pwMS, 25 informal caregivers, and 24 HCPs in the field of MS participated. Nine out of ten pwMS used information technology on a daily base. Individual impairments like in vision and cognition resulted in individual needs like the desire to actively monitor their disease course or communicate with their physician in person. HCPs reported that a complete medication overview, additional medication information, overview of future visits and a reminder of medication intake would be very helpful eHealth features for pwMS, while they themselves preferred features organizing and enriching future visits. (4) Conclusions: A closer look at the various profiles of eHealth adoption in pwMS and their caregivers indicated that there is a broad and robust enthusiasm across several subgroups that does not exclude anyone in general, but constitutes specific areas of interest. For pwMS, the focus was on eHealth services that connect previously collected information and make them easily accessible and understandable.
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Affiliation(s)
- Rocco Haase
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany; (I.V.); (M.S.); (A.D.); (T.Z.)
- Correspondence:
| | - Isabel Voigt
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany; (I.V.); (M.S.); (A.D.); (T.Z.)
| | - Maria Scholz
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany; (I.V.); (M.S.); (A.D.); (T.Z.)
| | - Hannes Schlieter
- Faculty of Business and Economics, Technical University of Dresden, 01062 Dresden, Germany; (H.S.); (M.B.); (M.S.)
| | - Martin Benedict
- Faculty of Business and Economics, Technical University of Dresden, 01062 Dresden, Germany; (H.S.); (M.B.); (M.S.)
| | - Marcel Susky
- Faculty of Business and Economics, Technical University of Dresden, 01062 Dresden, Germany; (H.S.); (M.B.); (M.S.)
| | - Anja Dillenseger
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany; (I.V.); (M.S.); (A.D.); (T.Z.)
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany; (I.V.); (M.S.); (A.D.); (T.Z.)
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14
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Harst L, Otto L, Timpel P, Richter P, Lantzsch H, Wollschlaeger B, Winkler K, Schlieter H. An empirically sound telemedicine taxonomy – applying the CAFE methodology. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01558-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Abstract
Aim
Because the field of information systems (IS) research is vast and diverse, structuring it is a necessary precondition for any further analysis of artefacts. To structure research fields, taxonomies are a useful tool. Approaches aiming to develop sound taxonomies exist, but they do not focus on empirical development. We aimed to close this gap by providing the CAFE methodology, which is based on quantitative content analysis.
Subject and methods
Existing taxonomies are used to build a coding scheme, which is then validated on an IS project database. After describing the methodology, it is applied to develop a telemedicine taxonomy.
Results
The CAFE methodology consists of four steps, including applicable methods. It helps in producing quantitative data for statistical analysis to empirically ground any newly developed taxonomy. By applying the methodology, a taxonomy for telemedicine is presented, including, e.g. application types, settings or the technology involved in telemedicine initiatives.
Conclusion
Taxonomies can serve in identifying both components and outcomes to analyse. As such, our empirically sound methodology for deriving those is a contribution not only to evaluation research but also to the development of future successful telemedicine or other digital applications.
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15
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Loewenbrück KF, Stein DB, Amelung VE, Bitterlich R, Brumme M, Falkenburger B, Fehre A, Feige T, Frank A, Gißke C, Helmert C, Kerkemeyer L, Knapp A, Lang C, Leuner A, Lummer C, Minkman MMN, Müller G, van Munster M, Schlieter H, Themann P, Zonneveld N, Wolz M. Parkinson Network Eastern Saxony (PANOS): Reaching Consensus for a Regional Intersectoral Integrated Care Concept for Patients with Parkinson's Disease in the Region of Eastern Saxony, Germany. J Clin Med 2020; 9:E2906. [PMID: 32911841 PMCID: PMC7563971 DOI: 10.3390/jcm9092906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023] Open
Abstract
As integrated care is recognized as crucial to meet the challenges of chronic conditions such as Parkinson's disease (PD), integrated care networks have emerged internationally and throughout Germany. One of these networks is the Parkinson Network Eastern Saxony (PANOS). PANOS aims to deliver timely and equal care to PD patients with a collaborative intersectoral structured care pathway. Additional components encompass personalized case management, an electronic health record, and communicative and educative measures. To reach an intersectoral consensus of the future collaboration in PANOS, a structured consensus process was conducted in three sequential workshops. Community-based physicians, PD specialists, therapists, scientists and representatives of regulatory authorities and statutory health insurances were asked to rate core pathway-elements and supporting technological, personal and communicative measures. For the majority of core elements/planned measures, a consensus was reached, defined as an agreement by >75% of participants. Additionally, six representatives from all partners involved in the network-design independently assessed PANOS based on the Development Model for Integrated Care (DMIC), a validated model addressing the comprehensiveness and maturity of integrated care concepts. The results show that PANOS is currently in an early maturation state but has the potential to comprehensively represent the DMIC if all planned activities are implemented successfully. Despite the favorable high level of consensus regarding the PANOS concept and despite its potential to become a balanced integrated care concept according to the DMIC, its full implementation remains a considerable challenge.
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Affiliation(s)
- Kai F. Loewenbrück
- Department of Neurology, University Hospital Dresden, 01307 Dresden, Germany; (R.B.); (B.F.); (T.F.); (A.F.)
- Clinical Trial Unit, German Center for Neurodegenerative Diseases (DZNE) Dresden, 01307 Dresden, Germany
| | - Doron B. Stein
- Institute for Applied Health Services Research (inav), Schiffbauerdamm 12, 10117 Berlin, Germany; (D.B.S.); (V.E.A.); (M.B.); (L.K.); (C.L.)
| | - Volker E. Amelung
- Institute for Applied Health Services Research (inav), Schiffbauerdamm 12, 10117 Berlin, Germany; (D.B.S.); (V.E.A.); (M.B.); (L.K.); (C.L.)
| | - Robert Bitterlich
- Department of Neurology, University Hospital Dresden, 01307 Dresden, Germany; (R.B.); (B.F.); (T.F.); (A.F.)
| | - Martin Brumme
- Institute for Applied Health Services Research (inav), Schiffbauerdamm 12, 10117 Berlin, Germany; (D.B.S.); (V.E.A.); (M.B.); (L.K.); (C.L.)
| | - Björn Falkenburger
- Department of Neurology, University Hospital Dresden, 01307 Dresden, Germany; (R.B.); (B.F.); (T.F.); (A.F.)
- Clinical Trial Unit, German Center for Neurodegenerative Diseases (DZNE) Dresden, 01307 Dresden, Germany
| | - Annekathrin Fehre
- Department of Neurology, Elblandklinikum Meißen, 01662 Meißen, Germany; (A.F.); (A.L.); (M.W.)
| | - Tim Feige
- Department of Neurology, University Hospital Dresden, 01307 Dresden, Germany; (R.B.); (B.F.); (T.F.); (A.F.)
| | - Anika Frank
- Department of Neurology, University Hospital Dresden, 01307 Dresden, Germany; (R.B.); (B.F.); (T.F.); (A.F.)
- Clinical Trial Unit, German Center for Neurodegenerative Diseases (DZNE) Dresden, 01307 Dresden, Germany
| | - Carola Gißke
- Chair of Business Informatics, esp. Systems Development, Faculty of Business and Economics, Technical University of Dresden, 01062 Dresden, Germany; (C.G.); (H.S.)
| | - Claudia Helmert
- Center for Evidence-based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (C.H.); (A.K.); (C.L.); (G.M.)
| | - Linda Kerkemeyer
- Institute for Applied Health Services Research (inav), Schiffbauerdamm 12, 10117 Berlin, Germany; (D.B.S.); (V.E.A.); (M.B.); (L.K.); (C.L.)
| | - Andreas Knapp
- Center for Evidence-based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (C.H.); (A.K.); (C.L.); (G.M.)
| | - Caroline Lang
- Center for Evidence-based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (C.H.); (A.K.); (C.L.); (G.M.)
| | - Annegret Leuner
- Department of Neurology, Elblandklinikum Meißen, 01662 Meißen, Germany; (A.F.); (A.L.); (M.W.)
| | - Carina Lummer
- Institute for Applied Health Services Research (inav), Schiffbauerdamm 12, 10117 Berlin, Germany; (D.B.S.); (V.E.A.); (M.B.); (L.K.); (C.L.)
| | - Mirella M. N. Minkman
- Vilans, National Centre of Expertise in Long Term Care, 3527 GV Utrecht, The Netherlands; (M.M.N.M.); (N.Z.)
- Tilburg University/TIAS School for Business and Society, 5037 AB Tilburg, The Netherlands
| | - Gabriele Müller
- Center for Evidence-based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (C.H.); (A.K.); (C.L.); (G.M.)
| | - Marlena van Munster
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany;
| | - Hannes Schlieter
- Chair of Business Informatics, esp. Systems Development, Faculty of Business and Economics, Technical University of Dresden, 01062 Dresden, Germany; (C.G.); (H.S.)
| | - Peter Themann
- Department of Neurology, Klinik am Tharandter Wald Hetzdorf, Herzogswalder Straße 1, 09633 Halsbrücke, Germany;
| | - Nick Zonneveld
- Vilans, National Centre of Expertise in Long Term Care, 3527 GV Utrecht, The Netherlands; (M.M.N.M.); (N.Z.)
- Tilburg University/TIAS School for Business and Society, 5037 AB Tilburg, The Netherlands
| | - Martin Wolz
- Department of Neurology, Elblandklinikum Meißen, 01662 Meißen, Germany; (A.F.); (A.L.); (M.W.)
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16
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Voigt I, Benedict M, Susky M, Scheplitz T, Frankowitz S, Kern R, Müller O, Schlieter H, Ziemssen T. A Digital Patient Portal for Patients With Multiple Sclerosis. Front Neurol 2020; 11:400. [PMID: 32670174 PMCID: PMC7326091 DOI: 10.3389/fneur.2020.00400] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Multiple Sclerosis is a chronic inflammatory disease of the central nervous system that requires a complex, differential, and lifelong treatment strategy, which involves high monitoring efforts and the accumulation of numerous medical data. A fast and broad availability of care, as well as patient-relevant data and a stronger integration of patients and participating care providers into the complex treatment process is desirable. The aim of the ERDF-funded project "Integrated Care Portal Multiple Sclerosis" (IBMS) was to develop a pathway-based care model and a corresponding patient portal for MS patients and health care professionals (HCPs) as a digital tool to deliver the care model. Methods: The patient portal was created according to a patient-centered design approach which involves both the patients' and the professionals' view. Buurmann's five iterative phases were integrated into a design science research process. A problem analysis focusing on functions and user interfaces was conducted through surveys and workshops with MS patients and HCPs. Based on this, the patient portal was refined and a prototype of the portal was implemented using an agile software development strategy. Results: HCPs and patients already use digital hardware and are open to new technologies. Nevertheless, they desire improved (digital) communication and coordination between care providers. Both groups require a number of functions for the patient portal, which were implemented in the prototype. Usability tests with patients and HCPs are planned to consider whether the portal is deemed as usable, acceptable as well as functional to prepare for any needed ameliorations. Discussion: After testing the patient portal for usability, acceptability, and functionality, it will most likely be a useful and high-quality electronic health (eHealth) tool for patient management from day care to telerehabilitation. It implements clinical pathways in a manner which is comprehensible for patients. Future developments of the patient portal modules could include additional diseases, the integration of quality management and privacy management tools, and the use of artificial intelligence to personalize treatment strategies.
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Affiliation(s)
- Isabel Voigt
- Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Martin Benedict
- Chair of Wirtschaftsinformatik, Especially Systems Development, Faculty of Business and Economics, Technical University of Dresden, Dresden, Germany
| | - Marcel Susky
- Chair of Wirtschaftsinformatik, Especially Systems Development, Faculty of Business and Economics, Technical University of Dresden, Dresden, Germany
| | - Tim Scheplitz
- Chair of Wirtschaftsinformatik, Especially Systems Development, Faculty of Business and Economics, Technical University of Dresden, Dresden, Germany
| | | | | | | | - Hannes Schlieter
- Chair of Wirtschaftsinformatik, Especially Systems Development, Faculty of Business and Economics, Technical University of Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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17
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Otto L, Harst L, Timpel P, Wollschlaeger B, Richter P, Schlieter H. Defining and Delimitating Telemedicine and Related Terms - An Ontology-Based Classification. Stud Health Technol Inform 2020; 268:113-122. [PMID: 32141883 DOI: 10.3233/shti200010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The way health care is delivered changes continuously and is increasingly supported by digital technologies, such as telemedicine. Many terms in that context exist, which are not defined consistently and therefore used ambiguously. This makes it difficult to assess the evidence base. Ontologies bring structure and clarity to the discourse around telemedicine and related terms. We use this tool to provide definitions of relevant terms and show their interrelations. The results provided will be applied to different case studies to show their applicability. We aim to provide a more evidence-based understanding of relevant terms in digital health.
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Affiliation(s)
- Lena Otto
- Chair of Wirtschaftsinformatik, esp. Systems Development, Technische Universität Dresden, Dresden, Germany
| | - Lorenz Harst
- Research Association Public Health Saxony, Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Patrick Timpel
- Prevention of Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bastian Wollschlaeger
- Chair of Technical Information Systems, Technische Universität Dresden, Dresden, Germany
| | - Peggy Richter
- Chair of Wirtschaftsinformatik, esp. Systems Development, Technische Universität Dresden, Dresden, Germany
| | - Hannes Schlieter
- Chair of Wirtschaftsinformatik, esp. Systems Development, Technische Universität Dresden, Dresden, Germany
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Kowatsch T, Otto L, Harperink S, Cotti A, Schlieter H. A design and evaluation framework for digital health interventions. it - Information Technology 2019. [DOI: 10.1515/itit-2019-0019] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Digital health interventions (DHIs) have the potential to help the growing number of chronic disease patients better manage their everyday lives. However, guidelines for the systematic development of DHIs are still scarce. The current work has, therefore, the objective to propose a framework for the design and evaluation of DHIs (DEDHI). The DEDHI framework is meant to support both researchers and practitioners alike from early conceptual DHI models to large-scale implementations of DHIs in the healthcare market.
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Affiliation(s)
- Tobias Kowatsch
- Center for Digital Health Interventions, Institute of Technology Management , 27215 University of St. Gallen , Dufourstrasse 40a , St. Gallen , Switzerland
- Department of Management, Technology, and Economics , ETH Zurich , Weinbergstrasse 56/58 , Zurich , Switzerland
| | - Lena Otto
- Chair of Wirtschaftsinformatik, esp. Systems Development , Technische Universität Dresden , Dresden , Germany
| | - Samira Harperink
- Center for Digital Health Interventions, Institute of Technology Management , 27215 University of Saint Gallen (ITEM-HSG) , Dufourstrasse 40a , St. Gallen , Switzerland
| | - Amanda Cotti
- Center for Digital Health Interventions, Institute of Technology Management , 27215 University of Saint Gallen (ITEM-HSG) , Dufourstrasse 40a , St. Gallen , Switzerland
| | - Hannes Schlieter
- Chair of Wirtschaftsinformatik, esp. Systems Development , Technische Universität Dresden , Dresden , Germany
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Abstract
Artificial intelligence (AI) is not intelligent in the human meaning-AI works on the basis of algorithms created by humans and the results of AI are based on real-world data. AI is regulated by all legal frameworks that also apply in other scenarios, in particular data protection law and medical device law. AI delivers results that are as good as the database that formed the learning content of the AI enables. If, for example, the data on which the AI is based contain discrimination, this discrimination is "learned" by the AI; since the AI does not really think, the AI cannot reflect its own results either-it can only make a comparison within the parameters of the specifications by the software developers. If AI is used, the question of the algorithms implemented and the database on which the decision is based must therefore be clarified beforehand and a check must be carried out based on this to determine whether the AI is suitable for use. Due to the missing possibility of real human thinking, AI cannot replace physicians, but can assist them in their daily work.
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Affiliation(s)
- B Schütze
- Arbeitsgruppe "Datenschutz und IT-Sicherheit im Gesundheitswesen" (DIG), Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS), Industriestraße 154, 50996, Köln, Deutschland.
| | - H Schlieter
- Fachgruppe Digital Health, Gesellschaft für Informatik e. V. (GI), Bonn, Deutschland
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Tropea P, Schlieter H, Sterpi I, Judica E, Gand K, Caprino M, Gabilondo I, Gomez-Esteban JC, Busnatu S, Sinescu C, Kyriazakos S, Anwar S, Corbo M. Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review. J Med Internet Res 2019; 21:e12805. [PMID: 31573902 PMCID: PMC6774233 DOI: 10.2196/12805] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations. OBJECTIVE This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care. METHODS We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes. RESULTS After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain. CONCLUSIONS Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.
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Affiliation(s)
- Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Hannes Schlieter
- Chair of Wirtschaftsinformatik, esp. Systems Development, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Irma Sterpi
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Elda Judica
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Kai Gand
- Chair of Wirtschaftsinformatik, esp. Systems Development, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Inigo Gabilondo
- Neurology Department, Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
| | - Juan Carlos Gomez-Esteban
- Neurology Department, Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Stefan Busnatu
- Universitatea de Medicina si Farmacie "Carol Davila", Bucuresti, Romania
| | - Crina Sinescu
- Universitatea de Medicina si Farmacie "Carol Davila", Bucuresti, Romania
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Sadia Anwar
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
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21
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Harst L, Timpel P, Otto L, Wollschlaeger B, Richter P, Schlieter H. Identifying Obstacles and Research Gaps of Telemedicine Projects: Approach for a State-of-the-Art Analysis. Stud Health Technol Inform 2018; 247:121-125. [PMID: 29677935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper presents an approach for an evaluation of finished telemedicine projects using qualitative methods. Telemedicine applications are said to improve the performance of health care systems. While there are countless telemedicine projects, the vast majority never makes the threshold from testing to implementation and diffusion. Projects were collected from German project databases in the area of telemedicine following systematically developed criteria. In a testing phase, ten projects were subject to a qualitative content analysis to identify limitations, need for further research, and lessons learned. Using Mayring's method of inductive category development, six categories of possible future research were derived. Thus, the proposed method is an important contribution to diffusion and translation research regarding telemedicine, as it is applicable to a systematic research of databases.
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Affiliation(s)
- Lorenz Harst
- Research Association Public Health Saxony, Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Patrick Timpel
- Prevention and Care of Diabetes, Department of Medicine III, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Lena Otto
- Wirtschaftsinformatik, esp. Systems Development, Technische Universität Dresden, Dresden, Germany
| | - Bastian Wollschlaeger
- Technical Information Management Systems, Technische Universität Dresden, Dresden, Germany
| | - Peggy Richter
- Wirtschaftsinformatik, esp. Systems Development, Technische Universität Dresden, Dresden, Germany
| | - Hannes Schlieter
- Wirtschaftsinformatik, esp. Systems Development, Technische Universität Dresden, Dresden, Germany
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Beckmann MW, Schlieter H, Richter P, Wesselmann S. Considerations on the Improved Integration of Medical Guidelines into Routine Clinical Practice - a Review and Concept Proposal. Geburtshilfe Frauenheilkd 2016; 76:369-376. [PMID: 27134291 DOI: 10.1055/s-0042-102056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Medical guidelines have become established as the standard for the comprehensive synopsis of all available information (scientific trials, expert opinion) on diagnosis and treatment recommendations. The transfer of guidelines to clinical practice and subsequent monitoring has however proven difficult. In particular the potential interaction between guideline developers and guideline users has not been fully utilised. This review article analyses the status quo and existing methodological and technical information solutions supporting the guideline life cycle. It is shown that there are numerous innovative developments that in isolation do not provide comprehensive support. The vision of the "Living Guidelines 2.0" is therefore presented. This outlines the merging of guideline development and implementation on the basis of clinical pathways and guideline-based quality control, and building on this, the generation of information for guideline development and research.
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Affiliation(s)
- M W Beckmann
- Frauenklinik des Universitätsklinikums Erlangen, Erlangen
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23
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Burwitz M, Benedict M, Schlieter H. CDA Templates - Utilizing the MediCUBE. Stud Health Technol Inform 2016; 228:481-485. [PMID: 27577429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The specification and customization of clinical document types are tasks that need a strong collaboration between domain experts and IT specialists. However, these collaborators are often faced with difficulties due to different interpretation of domain knowledge. Therefore, an adequate method for sharing domain knowledge about documents is necessary. Even though there are some tools that help to define medical document types, there is a lack of approaches that focus on the understandability of the specification for the domain experts. This paper proposes a modeling approach based on the Clinical Document Architecture to address this gap.
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Affiliation(s)
- Martin Burwitz
- Wirtschaftsinformatik, esp. Systems Development, TU Dresden, Germany
| | - Martin Benedict
- Wirtschaftsinformatik, esp. Systems Development, TU Dresden, Germany
| | - Hannes Schlieter
- Wirtschaftsinformatik, esp. Systems Development, TU Dresden, Germany
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Benedict M, Schlieter H. Governance guidelines for digital healthcare ecosystems. Stud Health Technol Inform 2015; 212:233-240. [PMID: 26063282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Advanced Information and Communication Technologies (ICT) solutions are the key instrument to enable modern integrated care. They are not limited the traditional boundaries. Moreover, their aim is to provide medical care at the right point, in the right manner, at the right time without technological, institutional boundaries or integration issues, esp. for comorbidity treatment cases. Open digital ecosystems enabled by eHealth platforms can help to create a prospering eHealth environment. However, the creation of digital ecosystems in the health care domain is an ambitious task. The conditions how an open system can be achieved are often consented in complex projects, but they are not often scientific questioned. Conducting an action design research process, the paper contributes 13 guidelines for implementing eHealth platforms by reflection of the work in an EU-funded infrastructure project, which can be used as input for further research to provide generic guidelines for eHealth ecosystem projects.
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Affiliation(s)
- Martin Benedict
- Dresden University of Technology, Chair of Wirtschaftsinformatik, esp. Systems Development, Dresden, Germany
| | - Hannes Schlieter
- Dresden University of Technology, Chair of Wirtschaftsinformatik, esp. Systems Development, Dresden, Germany
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