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.

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

10.2196/16444 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e16444 ◽  
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.

scholarly journals Towards Excellence in Asthma Management: Final Report of an Eight-Year Program Aimed at Reducing Care Gaps in Asthma Management in Quebec

2008 ◽  
Vol 15 (6) ◽  
pp. 302-310 ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Eileen Dorval ◽  
Manon Labrecque ◽  
Michel Turgeon ◽  
Terrence Montague ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Final Report ◽  
Asthma Care ◽  
Treatment Needs ◽  
Care Gaps ◽  
Care System

BACKGROUND AND OBJECTIVES: Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or ‘care gaps’, in which all stakeholders of the health care system (including patients) are involved, was proposed.METHODS: Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed.RESULTS: Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners.CONCLUSIONS: Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

scholarly journals Toward Comprehensive Patient-Centric Care by Integrating Digital Health Technology With Direct Clinical Contact in Australia (Preprint)

2018 ◽  
Author(s):  
Penelope Schofield ◽  
Tim Shaw ◽  
Michaela Pascoe
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Digital Health ◽  
Integrated Health Care ◽  
Care Model ◽  
Current Health ◽  
System P ◽  
Integrated Health ◽  
Integrated Health Care System ◽  
Care System

BACKGROUND There is an escalating crisis in health care, locally and internationally. The current health care model is unable to meet the increasing health care demands. OBJECTIVE The aim of this study was to reconceptualize the provision of health care to produce better outcomes at no greater cost, by placing individuals in the position of authority to direct their own care, in a personalized, integrated health care system. METHODS In this study, we used the Australian health care system as a model. We reviewed the current landscape of digital health in Australia and discussed how electronic medical records (EMRs) can be further developed into a personalized, integrated health care system. RESULTS Some components of an EMR and digital health system are already being used in Australia, but the systems are not linked. A personalized, integrated health care model that is responsive to consumer needs requires not just a passive repository of medical information; it would require a team approach, including the government, health care funders, industries, consumers and advocacy groups, health care professionals, community groups, and universities. CONCLUSIONS Implementation of a personalized, integrated health care system can result in reduced pressure on the current health care system, and it can result in the delivery of best-practice health care, regardless of location. Importantly, a personalized, integrated health care system could serve as an education platform, “upskilling” not only clinicians but also, more importantly, patients and carers by providing them with accurate information about their condition, treatment options, medications, and management strategies. By proposing personalized, integrated health care, we offer an intelligent model of health care that is ubiquitous, efficient, and continuously improving.

Privacy protection laws and public perception of data privacy

2018 ◽  
Vol 25 (6) ◽  
pp. 1883-1902 ◽  
Author(s):  
Jawahitha Sarabdeen ◽  
Immanuel Azaad Moonesar
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Health Care System ◽  
Data Protection ◽  
Privacy Protection ◽  
Data Privacy ◽  
Health Data ◽  
Content Type ◽  
Care System ◽  
Laws And Regulations

Purpose The move toward e-health care in various countries is envisaged to reduce the cost of provision of health care, improve the quality of care and reduce medical errors. The most significant problem is the protection of patients’ data privacy. If the patients are reluctant or refuse to participate in health care system due to lack of privacy laws and regulations, the benefit of the full-fledged e-health care system cannot be materialized. The purpose of this paper is to investigate the available e-health data privacy protection laws and the perception of the people using the e-health care facilities. Design/methodology/approach The researchers used content analysis to analyze the availability and comprehensive nature of the laws and regulations. The researchers also used survey method. Participants in the study comprised of health care professionals (n=46) and health care users (n=187) who are based in the Dubai, United Arab Emirates. The researchers applied descriptive statistics mechanisms and correlational analysis to analyze the data in the survey. Findings The content analysis revealed that the available health data protection laws are limited in scope. The survey results, however, showed that the respondents felt that they could trust the e-health services systems offered in the UAE as the data collected is protected, the rights are not violated. The research also revealed that there was no significance difference between the nationality and the privacy data statements. All the nationality agreed that there is protection in place for the protection of e-health data. There was no significance difference between the demographic data sets and the many data protection principles. Originality/value The findings on the users’ perception could help to evaluate the success in realizing current strategies and an action plan of benchmarking could be introduced.

Digital Health Literacy and Preparedness: Comparison of Veterans Health Affairs Users and Other Veterans Nationally (Preprint)

2021 ◽  
Author(s):  
Charlie Wray ◽  
Janet Tang ◽  
Amy Byers ◽  
Salomeh Keyhani
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Social Isolation ◽  
Health Care System ◽  
Digital Health ◽  
The Internet ◽  
Social Risk ◽  
Veterans Health ◽  
Va Health Care System ◽  
Care System

BACKGROUND As health care systems shift to greater use of telemedicine and digital tools, an individual’s digital health literacy has become an important skill set. The Veterans Health Administration (VA) has invested resources in providing digital health care; however, to date, no study has compared the digital health literacy and preparedness of Veterans receiving care in the VA to Veterans receiving care outside the VA. OBJECTIVE Describe digital health literacy and preparedness among Veterans who receive care within and outside the VA health care system and examine whether receiving care in the VA is associated with digital preparedness (having >2 digital health literacy skills) after accounting for demographic and social risk factors. METHODS We used cross-sectional data from the 2016-18 National Health Interview Survey to identify Veterans (age>18) who obtain health care either within or outside the VA health care system. We used multivariable logistic regression models to examine the association of sociodemographic (age, sex, race, ethnicity), social risk factors (economic instability, disadvantaged neighborhood, low educational attainment, and social isolation), and health care delivery location (VA and non-VA) with digital preparedness. RESULTS Those who received health care within the VA health care system (n=3,188) were younger (age 18-49: 33.3% [30.7-36.0] vs. 24.2% [21.9-26.5], p<0.01), were more often female (34.7% [32.0-37.3] vs. 6.6% [5.5-7.6], p<0.01) and identified as Black (13.1% [11.2-15.0] vs. 10.2% [8.7-11.8], p<0.01), and reported greater economic instability (8.3% [6.9-9.8] vs. 5.5% [4.6-6.5], p<0.01) and social isolation (42.6% [40.3-44.9] vs. 35.4% [33.4-37.5], p<0.01) compared to Veterans who received care outside the VA (n=3,393). Veterans who obtained care within the VA reported higher digital health literacy than those who obtained care outside the VA, endorsing greater rates of looking up health information on the internet (51.8% [49.2-54.4] vs. 45.0% [42.6-47.3], p<0.01), filling a prescription using the internet (16.2% [14.5-18.0] vs. 11.3% [9.6-13.0], p<0.01), scheduling a health care appointment on the internet (14.1% [12.4-15.8] vs. 11.6% [10.1-13.1], p=0.02), and communicating with a health care provider by email (18.0% [16.1-19.8] vs. 13.3% [11.6-14.9], p<0.01). In adjusted analysis, age >75 (aOR: 0.59, 95% CI 0.45-0.76), low educational attainment (aOR: 0.40, 95% CI 0.34-0.48) and social isolation (aOR: 0.78, 95% CI 0.66-0.92) were associated with a lower likelihood of being digitally prepared. Receiving health care from the VA was the only characteristic associated with higher odds (aOR: 1.36, 95% CI 1.12-1.65) of being digitally prepared. CONCLUSIONS Despite these demographic disadvantages to digital uptake, Veterans who receive care in the VA have higher digital health literacy and appear more digitally prepared than Veterans who do not receive care within the VA – suggesting a positive, system-level influence on this cohort.

Abgewickelte Gesundheitsinstitutionen als (Quasi-)Innovationen

2020 ◽  
Vol 69 (6-7) ◽  
pp. 467-487
Author(s):  
Marlene Haupt ◽  
Christian Römhild ◽  
Charlotte Fechter
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Profit Maximization ◽  
Well Being ◽  
Consumer Sovereignty ◽  
Prävention Und Gesundheitsförderung ◽  
German Healthcare System ◽  
Prevention And Health Promotion ◽  
Care System

Zusammenfassung Zum Abbau von Ineffizienzen im deutschen Gesundheitssystem wurden Institutionen wieder eingeführt, welche in ähnlicher Form bereits im Gesundheitssystem der DDR existiert haben. Drei Beispiele wurden ausgewählt: Die heutigen Medizinischen Versorgungszentren ähneln den Polikliniken der DDR, die Disease-Management-Programme sind mit der Dispensaire-Versorgung der DDR vergleichbar und die Bereiche Prävention und Gesundheitsförderung gab es in der DDR in Form der Gesundheitserziehung. Diese heutigen Institutionen werden dahingehend untersucht, inwiefern sie dazu beitragen, Ineffizienzen abzubauen und vor dem Hintergrund der Ökonomisierung im deutschen Gesundheitswesen zur Steigerung des Patientenwohls beitragen. Dabei wird betrachtet, wie sie hinsichtlich der Dimensionen Gewinnmaximierung, Wettbewerb, Preisbildung und Kundensouveränität wirken. Abstract: Liquidated Healthcare Institutions as (Quasi-)innovations To reduce inefficiencies in the German health care system, institutions have been reintroduced that have already existed in a similar form in the health care system of the GDR. Three examples have been selected: Today’s medical care centers (MVZ) are similar to the GDR’s so called „Polikliniken“, the disease management programs are comparable to the GDR’s dispensaire care, and the prevention and health promotion today were called health education („Gesundheitserziehung“) in the GDR. These institutions are being examined to what extent they serve to reduce inefficiencies and, regarding the economization in the German healthcare system, contribute to increasing patient well-being. In detail, this analysis uses the dimensions of profit maximization, competition, pricing and consumer sovereignty.

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