scholarly journals Guiding Pay-As-You-Live Health Insurance Models Toward Responsible Innovation in Health

10.2196/19586 ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. e19586
Author(s):  
Hassane Alami ◽  
Lysanne Rivard ◽  
Robson Rocha de Oliveira ◽  
Pascale Lehoux ◽  
Stéphanie Bernadette Mafalda Cadeddu ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Systems ◽  
Data Privacy ◽  
Digital Health ◽  
Burden Of Proof ◽  
Mobile Technologies ◽  
Responsible Innovation ◽  
Potential Threat ◽  
Critical Issues ◽  
Proof Of Compliance

While the transition toward digitalized health care and service delivery challenges many publicly and privately funded health systems, patients are already producing a phenomenal amount of data on their health and lifestyle through their personal use of mobile technologies. To extract value from such user-generated data, a new insurance model is emerging called Pay-As-You-Live (PAYL). This model differs from other insurance models by offering to support clients in the management of their health in a more interactive yet directive manner. Despite significant promises for clients, there are critical issues that remain unaddressed, especially as PAYL models can significantly disrupt current collective insurance models and question the social contract in so-called universal and public health systems. In this paper, we discuss the following issues of concern: the quantification of health-related behavior, the burden of proof of compliance, client data privacy, and the potential threat to health insurance models based on risk mutualization. We explore how more responsible health insurance models in the digital health era could be developed, particularly by drawing from the Responsible Innovation in Health framework.

scholarly journals Guiding Pay-As-You-Live Health Insurance Models Toward Responsible Innovation in Health (Preprint)

2020 ◽  
Author(s):  
Hassane Alami ◽  
Lysanne Rivard ◽  
Robson Rocha de Oliveira ◽  
Pascale Lehoux ◽  
Stéphanie Bernadette Mafalda Cadeddu ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Systems ◽  
Data Privacy ◽  
Digital Health ◽  
Burden Of Proof ◽  
Mobile Technologies ◽  
Responsible Innovation ◽  
Potential Threat ◽  
Critical Issues ◽  
Proof Of Compliance

UNSTRUCTURED While the transition toward digitalized health care and service delivery challenges many publicly and privately funded health systems, patients are already producing a phenomenal amount of data on their health and lifestyle through their personal use of mobile technologies. To extract value from such user-generated data, a new insurance model is emerging called Pay-As-You-Live (PAYL). This model differs from other insurance models by offering to support clients in the management of their health in a more interactive yet directive manner. Despite significant promises for clients, there are critical issues that remain unaddressed, especially as PAYL models can significantly disrupt current collective insurance models and question the social contract in so-called universal and public health systems. In this paper, we discuss the following issues of concern: the quantification of health-related behavior, the burden of proof of compliance, client data privacy, and the potential threat to health insurance models based on risk mutualization. We explore how more responsible health insurance models in the digital health era could be developed, particularly by drawing from the Responsible Innovation in Health framework.

Inconsistencies in Overdose Suicide Death Investigation Practice and Potential Remedies Using Technology: A Centers for Disease Control and Prevention Consultation Meeting Summary

2021 ◽  
pp. 192536212110224
Author(s):  
Melissa C. Mercado ◽  
Deborah M. Stone ◽  
Caroline W. Kokubun ◽  
Aimée-Rika T. Trudeau ◽  
Elizabeth Gaylor ◽  
...  
Keyword(s):  
System Integration ◽  
Data Privacy ◽  
Burden Of Proof ◽  
The United States ◽  
Privacy And Security ◽  
Death Scene ◽  
Undetermined Intent ◽  
Control And Prevention ◽  
Scene Description ◽  
Death Investigation

Introduction: It is widely accepted that suicides—which account for more than 47 500 deaths per year in the United States—are undercounted by 10% to 30%, partially due to incomplete death scene investigations (DSI) and varying burden-of-proof standards across jurisdictions. This may result in the misclassification of overdose-related suicides as accidents or undetermined intent. Methods: Virtual and in-person meetings were held with suicidologists and DSI experts from five states (Spring-Summer 2017) to explore how features of a hypothetical electronic DSI tool may help address these challenges. Results: Participants envisioned a mobile DSI application for cell phones, tablets, or laptop computers. Features for systematic information collection, scene description, and guiding key informant interviews were perceived as useful for less-experienced investigators. Discussion: Wide adoption may be challenging due to differences in DSI standards, practices, costs, data privacy and security, and system integration needs. However, technological tools that support consistent and complete DSIs could strengthen the information needed to accurately identify overdose suicides.

A free, open-source, offline digital health system for refugee care (Preprint)

2021 ◽  
Author(s):  
Henry Ashworth ◽  
Senan Ebrahim ◽  
Hassaan Ebrahim ◽  
Zahra Bhaiwala ◽  
Michael Chilazi
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Mobile Clinic ◽  
Low Resource ◽  
Displaced Populations ◽  
Weather Events ◽  
Displaced People

BACKGROUND Rise of conflict, extreme weather events, and pandemics have led to larger displaced populations worldwide. Displaced populations have unique acute and chronic health needs that need to be met by low resource health systems. Electronic Health Records (EHRs) have been shown to improve health outcomes in displaced populations but need to be adapted to meet the constraints of these health systems. OBJECTIVE To describe the development and deployment of a EHR designed to care for displaced populations in low resource settings. METHODS Using a human-centered design approach we conducted in-depth interviews and focus groups with patients, healthcare providers, and administrators in Lebanon and Jordan to identify the essential EHR features. These features including modular workflows, multilingual interfaces, and offline-first capabilities led to the development of the Hikma Health EHR which has been deployed in Lebanon and Nicaragua. RESULTS We report the successes and challenges from 12 months of Hikma Health EHR deployment in a mobile clinic providing care to Syrian Refugees in the Bekaa Valley, Lebanon. Successes include the EHR’s ability to (1) increase clinical efficacy by providing detailed patient records, (2) prove adaptable to the threats of COVID-19, and (3) improve organizational planning. Lessons learned include technical fixes to methods of identifying patients through name or their medical record ID. CONCLUSIONS As the number of displaced people continues to rise globally, it is imperative that solutions are created to help maximize the healthcare they receive. Free, open-sourced and adaptable EHRs can enable organizations to better provide for displaced populations.

The regulation of health care in Scandinavia: professionals, the public interest and trust

2018 ◽  
pp. 61-76
Author(s):  
Karsten Vrangbæk
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Health Insurance ◽  
Health System ◽  
Health Systems ◽  
Public Interest ◽  
State Level ◽  
Professional Regulation ◽  
The Public ◽  
Voluntary Health Insurance

Scandinavian health systems have traditionally been portrayed as relatively similar examples of decentralised, public integrated health systems. However, recent decades have seen significant public policy developments in the region that should lead us to modify our understanding. Several dimensions are important for understanding such developments. First, several of the countries have undergone structural reforms creating larger governance units and strengthening the state level capacity to regulate professionals and steer developments at the regional and municipal levels. Secondly, the three Nordic countries studied experienced an increase in the purchase of voluntary health insurance and the use of private providers. This introduces several issues for the equality of users and the efficiency of the system. This paper will investigate such trends and address the question: Is the Nordic health system model changing, and what are the consequences for trust, professional regulation and the public interest?

scholarly journals Elements of Trust in Digital Health Systems: Scoping Review

10.2196/11254 ◽  
2018 ◽  
Vol 20 (12) ◽  
pp. e11254 ◽  
Author(s):  
Afua Adjekum ◽  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Health Systems ◽  
Scoping Review ◽  
Digital Health

scholarly journals Design of a Machine Learning-Based Intelligent Middleware Platform for a Heterogeneous Private Edge Cloud System

Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7701
Author(s):  
Sayed-Chhattan Shah
Keyword(s):  
Machine Learning ◽  
Data Storage ◽  
Smart City ◽  
Data Privacy ◽  
Mobile Technologies ◽  
Cloud System ◽  
Multilayer Network ◽  
Network Applications ◽  
Data Rates ◽  
5G Network

Recent advances in mobile technologies have facilitated the development of a new class of smart city and fifth-generation (5G) network applications. These applications have diverse requirements, such as low latencies, high data rates, significant amounts of computing and storage resources, and access to sensors and actuators. A heterogeneous private edge cloud system was proposed to address the requirements of these applications. The proposed heterogeneous private edge cloud system is characterized by a complex and dynamic multilayer network and computing infrastructure. Efficient management and utilization of this infrastructure may increase data rates and reduce data latency, data privacy risks, and traffic to the core Internet network. A novel intelligent middleware platform is proposed in the current study to manage and utilize heterogeneous private edge cloud infrastructure efficiently. The proposed platform aims to provide computing, data collection, and data storage services to support emerging resource-intensive and non-resource-intensive smart city and 5G network applications. It aims to leverage regression analysis and reinforcement learning methods to solve the problem of efficiently allocating heterogeneous resources to application tasks. This platform adopts parallel transmission techniques, dynamic interface allocation techniques, and machine learning-based algorithms in a dynamic multilayer network infrastructure to improve network and application performance. Moreover, it uses container and device virtualization technologies to address problems related to heterogeneous hardware and execution environments.

scholarly journals Potential Benefits and Risks Resulting From the Introduction of Health Apps and Wearables Into the German Statutory Health Care System: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Alexandra Heidel ◽  
Christian Hagist
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Data Privacy ◽  
Digital Health ◽  
Treatment Quality ◽  
Exclusion Criterion ◽  
Health Apps ◽  
Risks And Benefits ◽  
Care System

BACKGROUND Germany is the first country worldwide that has introduced a digital care act as an incentive system to enhance the use of digital health devices, namely health apps and wearables, among its population. The act allows physicians to prescribe statutory financed and previously certified health apps and wearables to patients. This initiative has the potential to improve treatment quality through better disease management and monitoring. OBJECTIVE The aim of this paper was to outline the key concepts related to the potential risks and benefits discussed in the current literature about health apps and wearables. Furthermore, this study aimed to answer the research question: Which risks and benefits may result from the implementation of the digital care act in Germany? METHODS We conducted the scoping study by searching the databases PubMed, Google Scholar, and JMIR using the keywords health apps and wearables. We discussed 55 of 136 identified articles published in the English language from 2015 to March 2019 in this paper using a qualitative thematic analysis approach. RESULTS We identified four key themes within the articles: Effectivity of health apps and wearables to improve health; users of health apps and wearables; the potential of bring-your-own, self-tracked data; and concerns and data privacy risks. Within these themes, we identified three main stages of benefits for the German health care system: Usage of health apps and wearables; continuing to use health apps and wearables; and sharing bring-your-own; self-tracked data with different agents in the health care sector. CONCLUSIONS The digital care act could lead to an improvement in treatment quality through better patient monitoring, disease management, personalized therapy, and better health education. However, physicians should play an active role in recommending and supervising health app use to reach digital-illiterate or health-illiterate people. Age must not be an exclusion criterion. Yet, concerns about data privacy and security are very strong in Germany. Transparency about data processing should be provided at all times for continuing success of the digital care act in Germany.

Comparative analysis of health system performance in Montreal and New York: the importance of context for interpreting indicators

2018 ◽  
Vol 14 (1) ◽  
pp. 101-118 ◽  
Author(s):  
Michael K. Gusmano ◽  
Erin Strumpf ◽  
Julie Fiset-Laniel ◽  
Daniel Weisz ◽  
Victor G. Rodwin
Keyword(s):  
New York ◽  
Health Insurance ◽  
Ambulatory Care ◽  
Health Systems ◽  
Empirical Studies ◽  
Insurance Coverage ◽  
The United States ◽  
Necessary Condition ◽  
Access To Health Services ◽  
Financial Barriers

AbstractAlthough eliminating financial barriers to care is a necessary condition for improving access to health services, it is not sufficient. Given the contrasting health systems with regard to financing and organization of health insurance in the United States and Canada, there is a long history of comparing these countries. We extend the empirical studies on the Canadian and US health systems by comparing access to ambulatory care as measured by hospitalization rates for ambulatory care sensitive conditions (ACSC) in Montreal and New York City. We find that, in New York, ACSC rates were more than twice as high (12.6 per 1000 population) as in Montreal (4.8 per 1000 population). After controlling for age, sex, and number of diagnoses, significant differences in ACSC rates are present in both cities, but are more pronounced in New York. Our findings are consistent with the hypothesis that universal, first-dollar health insurance coverage has contributed to lower ACSC rates in Montreal than New York. However, Montreal’s surprisingly low ACSC rate calls for further research.

Critical Issues in Mobile Solution-Based Clinical Decision Support Systems

2021 ◽  
pp. 32-45
Author(s):  
Nalika Ulapane ◽  
Nilmini Wickramasinghe
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Support Systems ◽  
Digital Health ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Primary Objective ◽  
Critical Issues

The use of mobile solutions for clinical decision support is still a rather nascent area within digital health. Shedding light on this important application of mobile technology, this chapter presents the initial findings of a scoping review. The review's primary objective is to identify the state of the art of mobile solution based clinical decision support systems and the persisting critical issues. The authors contribute by classifying identified critical issues into two matrices. Firstly, the issues are classified according to a matrix the authors developed, to be indicative of the stage (or timing) at which the issues occur along the timeline of mobile solution development. This classification includes the three classes: issues persisting at the (1) stage of developing mobile solutions, (2) stage of evaluating developed solutions, and (3) stage of adoption of developed solutions. Secondly, the authors present a classification of the same issues according to a standard socio-technical matrix containing the three classes: (1) technological, (2) process, and (3) people issues.

Employing a Mixed Method to Explore Mobile Social Media Users' Big Data Privacy Concerns

2015 ◽  
pp. 302-320
Author(s):  
Kenneth C. C. Yang ◽  
Yowei Kang
Keyword(s):  
Social Media ◽  
Big Data ◽  
Social Networking ◽  
Data Privacy ◽  
Mobile Technologies ◽  
Personal Privacy ◽  
Privacy Concerns ◽  
Early 21St Century ◽  
Data Practices ◽  
Networking Technologies

Since its introduction in the early 21st century, mobile social media have played an indispensable part in contemporary human experiences. The convergence of social networking and mobile technologies and services creates a fascinating circumstance because the pervasive nature of mobile social networking technologies has impacted on users' privacy. The chapter employed a mixed research method to collect and analyze mobile social media users' experiences and privacy concerns in the age of Big Data. A total of 57 participants were included in this study. Collected data was analyzed by examining mobile social media users' experiences and their concerns over privacy. Findings from this study showed the rising concerns over personal privacy as a result of convergence of mobile social media and Big Data practices by the advertising industry. Theoretical and practical implications were discussed.

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