scholarly journals Digital medicine

JAHR ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 211-223 ◽  
Author(s):  
Elena Grebenshchikova
Keyword(s):  
Medical Information ◽  
Digital Health ◽  
Medical Documentation ◽  
Medical Care System ◽  
Health Technologies ◽  
Patient Interaction ◽  
Digital Medicine ◽  
Patient Relationships ◽  
The Impact

The digital health industry is developing rapidly: many new subjects are involved in the field of medicine; new opportunities for distant medical services, diagnostics, monitoring of patients’ health, and conducting medical research are emerging; electronic medical documentation is being developed, global medical information databases are being formed, etc. At the same time, the format of doctor-patient relationships is being transformed and new issues and challenges arise that require ethical evaluation. I identified three areas of digital medicine and analyzed issues of confidentiality, informed consent, autonomy and equity in each case. The impact of digital health technologies on the ethical contexts of medicine is uneven: telemedicine possesses the smallest revolutionary potential, which changes the mechanisms of doctor-patient interaction and actualizes issues of cultural differences. mHealth technologies significantly affect patient autonomy and change ways of sharing medical information. Artificial Intelligence (AI) is diverse in medicine, it can depersonalize relationships in medicine, radically change ideas about the role of the doctor and patient, lead to a radical restructuring of the medical care system in the center of which will be the new model of patient interaction with automated medical agents and systems.

Exclusion by Design: Lack of Information about Community Participation in COVID-19-related Mobile Apps and its Relationship to Digital Health Disparities (Preprint)

2021 ◽  
Author(s):  
Muhammed Yassin Idris ◽  
Maya Korin ◽  
Faven Araya ◽  
Sayeeda Chowdhury ◽  
Humberto Brown ◽  
...  
Keyword(s):  
Community Participation ◽  
Mobile Health ◽  
Medical Information ◽  
Mobile Apps ◽  
Digital Health ◽  
Community Based ◽  
Health Technologies ◽  
Community Needs ◽  
App Development ◽  
Communities Of Color

UNSTRUCTURED The rate and scale of transmission of COVID-19 overwhelmed healthcare systems worldwide, particularly in under-resourced communities of color that already faced a high prevalence of pre-existing health conditions. One way the health ecosystem has tried to address the pandemic is by creating mobile apps for telemedicine, dissemination of medical information, and disease tracking. As these new mobile health tools continue to be a primary format for healthcare, more attention needs to be given to their equitable distribution, usage, and accessibility. In this viewpoint collaboratively written by a community-based organization and a health app development research team, we present results of our systematic search and analysis of community engagement in mobile apps released between February and December 2020 to address the COVID-19 pandemic. We provide an overview of apps’ features and functionalities but could not find any publicly available information regarding whether these apps incorporated participation from communities of color disproportionately impacted by the pandemic. We argue that while mobile health technologies are a form of intellectual property, app developers should make public the steps taken to include community participation in app development. These steps could include community needs assessment, community feedback solicited and incorporated, and community participation in evaluation. These are factors that community-based organizations look for when assessing whether to promote digital health tools among the communities they serve. Transparency about the participation of community organizations in the process of app development would increase buy-in, trust, and usage of mobile health apps in communities where they are needed most.

Digital health technology enhances resilient behaviour: evidence from the ward

2019 ◽  
Vol 40 (1) ◽  
pp. 34-67 ◽  
Author(s):  
Iacopo Rubbio ◽  
Manfredi Bruccoleri ◽  
Astrid Pietrosi ◽  
Barbara Ragonese
Keyword(s):  
Patient Safety ◽  
Dynamic Capabilities ◽  
Digital Health ◽  
Digital Technologies ◽  
Healthcare Management ◽  
Content Type ◽  
Health Technologies ◽  
Management Domain ◽  
Operational Failure

PurposeIn the healthcare management domain, there is a lack of knowledge concerning the role of resilience practices in improving patient safety. The purpose of this paper is to understand the capabilities that enable healthcare resilience and how digital technologies can support these capabilities.Design/methodology/approachWithin- and cross-case research methodology was used to study resilience mechanisms and capabilities in healthcare and to understand how digital health technologies impact healthcare resilience. The authors analyze data from two Italian hospitals through the lens of the operational failure literature and anchor the findings to the theory of dynamic capabilities.FindingsFive different dynamic capabilities emerged as crucial for managing operational failure. Furthermore, in relation to these capabilities, medical, organizational and patient-related knowledge surfaced as major enablers. Finally, the findings allowed the authors to better explain the role of knowledge in healthcare resilience and how digital technologies boost this role.Practical implicationsWhen trying to promote a culture of patient safety, the research suggests healthcare managers should focus on promoting and enhancing resilience capabilities. Furthermore, when evaluating the role of digital technologies, healthcare managers should consider their importance in enabling these dynamic capabilities.Originality/valueAlthough operations management (OM) research points to resilience as a crucial behavior in the supply chain, this is the first research that investigates the concept of resilience in healthcare systems from an OM perspective, with only a few authors having studied similar concepts, such as “workaround” practices.

scholarly journals Developing a Novel Measurement of Sleep in Rheumatoid Arthritis: Study Proposal for Approach and Considerations

2021 ◽  
pp. 191-205
Author(s):  
Michelle Crouthamel ◽  
Robert J. Mather ◽  
Suraj Ramachandran ◽  
Kai Bode ◽  
Godhuli Chatterjee ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Drug Development ◽  
Sleep Disturbances ◽  
Digital Health ◽  
The Novel ◽  
Tool Selection ◽  
Health Technologies ◽  
Study Approach ◽  
Digital Medicine ◽  
Regulatory Strategy

The development of novel digital endpoints (NDEs) using digital health technologies (DHTs) may provide opportunities to transform drug development. It requires a multidisciplinary, multi-study approach with strategic planning and a regulatory-guided pathway to achieve regulatory and clinical acceptance. Many NDEs have been explored; however, success has been limited. To advance industry use of NDEs to support drug development, we outline a theoretical, methodological study as a use-case proposal to describe the process and considerations when developing and obtaining regulatory acceptance for an NDE to assess sleep in patients with rheumatoid arthritis (RA). RA patients often suffer joint pain, fatigue, and sleep disturbances (SDs). Although many researchers have investigated the mobility of joint functions using wearable technologies, the research of SD in RA has been limited due to the availability of suitable technologies. We proposed measuring the improvement of sleep as the novel endpoint for an anti-TNF therapy and described the meaningfulness of the measure, considerations of tool selection, and the design of clinical validation. The recommendations from the FDA patient-focused drug development guidance, the Clinical Trials Transformation Initiative (CTTI) pathway for developing novel endpoints from DHTs, and the V3 framework developed by the Digital Medicine Society (DiMe) have been incorporated in the proposal. Regulatory strategy and engagement pathways are also discussed.

Health Disparities and New Health Technologies – A Patients’ and Human Rights Perspective

2021 ◽  
pp. 1-23
Author(s):  
Mette Hartlev
Keyword(s):  
Human Rights ◽  
Health Disparities ◽  
Digital Health ◽  
Population Based ◽  
Human Right ◽  
Health Technologies ◽  
Left Behind ◽  
Human Rights Based Approach ◽  
Based Medicine ◽  
The Impact

Abstract The human right to health requires that everyone should have equal opportunities to enjoy the highest attainable standard of health. In practice, this is hard to achieve, as health is shaped by social determinants. This article explores the impact personalized medicine and use of big data may have on health disparities. New health technologies offer a lot of hope for more individual and better health promotion and care, which potentially could be beneficial for the most deprived. However, there are also concerns that not all population groups will profit equally from this new population-based medicine, and that new digital health technologies will maintain – or even reinforce – existing health disparities. This article suggests using insights from poverty studies combined with a patients’ and human rights-based approach to ensure that the most deprived are not left behind in the application of new health technologies.

scholarly journals EXPLORING THE POWER OF COMBINATORIAL HEALTH TECHNOLOGIES TO SUPPORT SELF-MANAGEMENT OF COPD AMONG OLDER PEOPLE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S443-S443
Author(s):  
Sandra Varey ◽  
Mandy Dixon ◽  
Alejandra Hernandez ◽  
Ceu Mateus ◽  
Tom Palmer ◽  
...  
Keyword(s):  
Older People ◽  
Large Scale ◽  
Digital Health ◽  
Self Management ◽  
Chronic Obstructive ◽  
Test Bed ◽  
Long Term Conditions ◽  
Health Technologies ◽  
Healthcare Needs ◽  
The Impact

Abstract Ways to address the increasing healthcare needs of older people are a priority for the National Health Service (NHS) in England. The NHS England Test Bed programme was designed to trial new models of care that are supported by digital health technologies. This paper reports on findings from one Test Bed programme, the Lancashire and Cumbria Innovation Alliance (LCIA) – a partnership between NHS England, industry and Lancaster University, which ran from 2016 to 2018. A key aim of the LCIA Test Bed was to explore the extent to which supported self-care telehealth technology helped older people with long-term conditions to better self-manage their own care, promoting independence and enabling them to remain at home for longer. Each patient received a combination of health technologies over a six-month period. This paper presents results from the qualitative data that formed part of a large-scale mixed-methods evaluation. Specifically it draws on the analysis of 34 observational interviews with 17 participants with chronic obstructive pulmonary disease (COPD) to understand the role of these technologies in the self-management of their care. The data revealed that the majority of participants felt more confident about self-managing COPD as a result of their participation in the programme. These increases in confidence were the result of participants’ increased knowledge and skills in managing their COPD. The paper demonstrates how patients learned to better manage their respiratory condition, the impact of this learning on their daily lives and that of their family carers, and the implications for healthcare practice.

OP71 Understanding Hospitals’ Performance Variability: Conceptual Framework

2019 ◽  
Vol 35 (S1) ◽  
pp. 17-18
Author(s):  
Americo Cicchetti ◽  
Marco Marchetti ◽  
Irene Gabutti ◽  
Stefania Boccia ◽  
Maria Lucia Specchia ◽  
...  
Keyword(s):  
Contextual Factors ◽  
Deep Understanding ◽  
Organizational Factors ◽  
Hospital Performance ◽  
Healthcare Sector ◽  
Extensive Literature ◽  
Managerial Accounting ◽  
Health Technologies ◽  
The Impact

IntroductionUnderstanding of the role of contextual factors in determining the real value of health technologies is one of the major challenges for the use of Health Technology Assessment (HTA) methodology within hospitals. Moreover, the responsibility of assessing hospital performance is problematic. Although a number of managerial tools are available to appraise outcomes, there is little evidence on the role of contextual variables and how they might contribute to hospital performance.MethodsBased on three extensive literature reviews, a pragmatic framework has been developed to understand interactions between organizational factors and health technologies on hospitals’ performance. Three main causal relationships emerge: (i) direct relationship between contextual factors and performance; (ii) an effect of contextual factors on the capability of technologies to “produce value”; (iii) an influence of organizational factors on clinical evidence-based decision-making. This pragmatic framework was designed within the IMPACT HTA EU Horizon 2020 Research Project.ResultsThe contextual dimensions are ascribable to five domains: organizational structure; managerial accounting tools; information, communication and technology (ICT) tools; human resource management (HRM) tools; hospital-based HTA procedures. The impact of contextual factors on technologies’ ability to produce value is highly overlooked in literature. Some effort in this sense exists only in the analysis of health information technologies. Moreover, among the contextual dimensions, only HRM tools have inspired a lively debate. The definition of hospital performance is amenable to multiple domains: accessibility, appropriateness, efficiency, safety and patient centeredness (continuity of care).ConclusionsAlthough hospital performance is a pivotal topic in the healthcare sector, a deep understanding of how contextual factors may affect it is missing. The theoretical framework developed provides a tool to understand the multiple dimensions able to affect hospital performance. On one hand contextual dimensions may provide a direct effect on hospital performance. On the other, they may affect the extent to which technologies are capable of producing value.

scholarly journals P105: Observational study of distribution of time and activities over the course of an emergency physician's shift

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S102-S103
Author(s):  
E. Feng ◽  
Z. Zia ◽  
C. Tong ◽  
N. Cornell
Keyword(s):  
Medical Information ◽  
Patient Flow ◽  
Second Phase ◽  
Time Motion ◽  
Patient Interaction ◽  
Physician Productivity ◽  
Motion Study ◽  
One Year ◽  
The Impact ◽  
Insight Into

Introduction: The growing scrutiny to improve Emergency Department (ED) wait times and patient flow have resulted in many efforts to increase efficiency and maximize patient throughput via systems improvements. This study investigates areas of efficiency improvement from the Emergency Physician (EP) perspective by examining EP workflow in a two phased observational time-motion study. In the initial phase, the distribution of time and activities of EPs were dissected to identify potential sources for streamlining to maximize physician productivity. The first phase was of the study was completed during the period immediately preceding the implementation of an Electronic Health Records (EHR). The second phase of the study will repeat the analysis one year post EHR implementation. This data will be dissected to again identify sources for streamlining in an EHR environment and to identify shifts in work flow from a paper-based system. Methods: An observational time motion study was conducted at St. Mary's Hospital ED, in Kitchener Ontario. An observer was paired with an EP for the duration of an 8 hour shift, to a total of 14 shifts in the first phase of the study. Nine task categories were measured concurrently with a stopwatch application on a tablet, along with the number of interruptions experienced by the EP. Means of each category were calculated and converted to percentages, representing the amount of time per 8 hour shift dedicated to each activity. The second phase will be repeated in Fall 2020, 1 year after EHR implementation. Results: A total of 14 shifts were observed, accounting for 112 hours of observation. EP's time was allocated amongst the following categories: direct patient interaction (40.8%), documentation (27.1%), reviewing patient results (18.4%), communicating with ED staff (7.63%), personal activities (5.7%), writing orders (5.1%), communicating with consultants (3.3%), teaching (1.7%) and medical information searches (1.3%). On average, EPs experienced 15.8 interruptions over the course of an 8 hour shift. Conclusion: In a paper charting system, the direct patient interaction accounts for the largest timeshare over the course of a given shift. However, the next two largest categories, documentation and reviewing patient data, both represent areas of potential streamlining via clerical improvements. Additionally, detailed measurements of EPs’ activities have proven feasible and provides the potential for future insight into the impact of EHR's on EP workflow.

scholarly journals Role of Digital Health and Artificial Intelligence in Inflammatory Bowel Disease: A Scoping Review

Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1465
Author(s):  
Kamila Majidova ◽  
Julia Handfield ◽  
Kamran Kafi ◽  
Ryan D. Martin ◽  
Ryszard Kubinski
Keyword(s):  
Artificial Intelligence ◽  
Scoping Review ◽  
Digital Health ◽  
Medication Management ◽  
Standard Of Care ◽  
Preliminary Evidence ◽  
Clinical Environment ◽  
Inflammatory Bowel ◽  
The Impact

Inflammatory bowel diseases (IBD), subdivided into Crohn’s disease (CD) and ulcerative colitis (UC), are chronic diseases that are characterized by relapsing and remitting periods of inflammation in the gastrointestinal tract. In recent years, the amount of research surrounding digital health (DH) and artificial intelligence (AI) has increased. The purpose of this scoping review is to explore this growing field of research to summarize the role of DH and AI in the diagnosis, treatment, monitoring and prognosis of IBD. A review of 21 articles revealed the impact of both AI algorithms and DH technologies; AI algorithms can improve diagnostic accuracy, assess disease activity, and predict treatment response based on data modalities such as endoscopic imaging and genetic data. In terms of DH, patients utilizing DH platforms experienced improvements in quality of life, disease literacy, treatment adherence, and medication management. In addition, DH methods can reduce the need for in-person appointments, decreasing the use of healthcare resources without compromising the standard of care. These articles demonstrate preliminary evidence of the potential of DH and AI for improving the management of IBD. However, the majority of these studies were performed in a regulated clinical environment. Therefore, further validation of these results in a real-world environment is required to assess the efficacy of these methods in the general IBD population.

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