scholarly journals Non-invasive smart implants in healthcare: Redefining healthcare services delivery through sensors and emerging digital health technologies

2022 ◽  
pp. 100156
Author(s):  
Goabaone Gaobotse ◽  
Elliot Mbunge ◽  
John Batani ◽  
Benhildah Muchemwa
Keyword(s):  
Digital Health ◽  
Healthcare Services ◽  
Health Technologies ◽  
Non Invasive ◽  
Services Delivery

Inequities in Healthcare Services caused by the Adoption of Digital Health Technologies: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Rui Yao ◽  
Wenli Zhang ◽  
Richard Evans ◽  
Guang Cao ◽  
Lining Shen
Keyword(s):  
Systematic Review ◽  
Influencing Factors ◽  
Digital Health ◽  
Health Inequities ◽  
Healthcare Services ◽  
The United States ◽  
Future Research ◽  
Unequal Distribution ◽  
Health Technologies ◽  
Starting Point

BACKGROUND Digital health technologies are rapidly adapting to healthcare contexts to provide improved medical services to citizens. However, contrary to expectations, their rapid adoption appears to have led to health inequities. OBJECTIVE The aim of this study is to systematically review the inequities of healthcare services brought about by the adoption of digital health technologies. The influencing factors of inequities, as well as corresponding countermeasures to ensure the health equity between different groups of citizens, is also studied. METHODS A systematic review of literature published from 1990 to 2020 was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review process, and the electronic databases of Web of Science Core Collection, PubMed, and Scopus. Search, sorting, and data extraction processes were completed by two authors of the paper using Thomson Endnote. RESULTS In total, 1,895 studies were collected during the search process, of which 40 were identified for analysis. The earliest literature identified was published in 1993, with the number remaining below 2 for a long period of time. The number started to increase until 2016, with a peak thereafter being reached in 2020. The United States, the United Kingdom, and Norway ranked as the top three in terms of publication output. Health inequities caused by digital health technologies were mainly reflected by access and availability of digital technologies and the differences in healthcare outcomes. The factors that influenced inequities included: demographic factors (i.e., gender, age, race, region, economy, and education level), health conditions, and eHealth literacy. Finally, government agencies and medical institutions, digital health technology providers, and healthcare service receivers can all take actions to alleviate inequities, in future. CONCLUSIONS Findings provide a comprehensive starting point for future research allowing for further investigation into how digital health technologies may influence the unequal distribution of healthcare services. The interaction between individual subjective factors, as well as social support, and influencing factors should be included in future studies. In particular, access and availability to digital health technologies by vulnerable groups should be of paramount importance.

scholarly journals A research tool for measuring non-participation of older people in research on digital health

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Arianna Poli ◽  
Susanne Kelfve ◽  
Andreas Motel-Klingebiel
Keyword(s):  
Social Participation ◽  
Digital Health ◽  
Relevant Literature ◽  
Healthcare Services ◽  
Survey Questionnaire ◽  
Health Technologies ◽  
Underrepresented Groups ◽  
Self Selection ◽  
Use Of Technology ◽  
Digital Skills

Abstract Background Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research – deriving from the processes of non-recruitment of targeted individuals and self-selection – can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection. Methods Based on a review of the relevant literature, we designed an instrument – the NPART survey questionnaire – for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study. Results Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature. Conclusions The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.

scholarly journals Exploratory attitude survey of homeless persons regarding telecare services in shelters providing mid- and long-term accommodation: The importance of trust

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261145
Author(s):  
Zsuzsa Győrffy ◽  
Sándor Békási ◽  
Bence Döbrössy ◽  
Virág Katalin Bognár ◽  
Nóra Radó ◽  
...  
Keyword(s):  
Underserved Populations ◽  
Reference Group ◽  
Digital Health ◽  
Homeless People ◽  
Healthcare Services ◽  
Homeless Persons ◽  
Homeless Shelters ◽  
Health Technologies ◽  
Vulnerable Patient

Background With the expansion of digital health, it is imperative to consider intervention techniques in order not to be the cause of even more social health inequalities in underserved populations struggling with chronic diseases. Telemedicine solutions for homeless persons might compensate for shortcomings in access to valuable health services in different settings. The main aim of our research was to examine the attitudes and openness of homeless persons regarding telecare on a Hungarian sample. Methods Quantitative survey among homeless people (n = 98) was completed in 4 shelters providing mid- and long-term accommodation in Budapest, Hungary. Attitudes regarding healthcare service accessibility and telecare were measured by a self-developed questionnaire of the research team. Telecare attitude comparison was made with data of a Hungarian weighted reference group of non-homeless persons recruited from 2 primary care units (n = 110). Results A significant fraction of homeless people with mid- or long-term residency in homeless shelters did not oppose the use of telecare via live online video consultation and there was no difference compared to the national reference group (averages of 3.09 vs. 3.15, respectively). Results of the homeless group indicate that those more satisfied with healthcare services, in general, manifest more openness to telecare. It is clearly demonstrated by the multivariate analysis that those participants in the homeless group who had problems getting health care in the last year definitely preferred in-person doctor-patient consultations. Conclusion Digital health technologies offer a potentially important new pathway for the prevention and treatment of chronic conditions among homeless persons. Based on the attitudes towards telecare, initiating an on-site telecare program for mid- and long-term residents of homeless shelters might enable better care continuity. Our results draw attention to the key factors including building trust in the implementation of such programs among underserved and other vulnerable patient groups.

Barriers to and facilitators of the uptake of digital health technology in cardiology: a systematic review

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Whitelaw ◽  
D Pellegrini ◽  
H.G.C Van Spall
Keyword(s):  
Digital Health ◽  
Healthcare Delivery ◽  
Health Technology ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Clinical Workflow ◽  
Eligibility Criteria ◽  
Health Technologies ◽  
Patient Level ◽  
Use Of Technology

Abstract Background Digital health technology has the potential to revolutionize the quality and efficiency of healthcare delivery. However, the uptake of digital health technology has been low in clinical practice. The factors that contribute to the limited adoption of digital health technology, particularly in cardiology, are unclear. Purpose We identified and synthesized the barriers to and facilitators of digital health technology uptake in cardiology, with a focus on provider- and patient- level barriers and facilitators. Methods We searched MEDLINE, EMBASE and CINAHL databases for studies published January 2000 - December 2019 that reported barriers to and/or facilitators of digital health technology adoption in cardiology. Two reviewers screened and extracted data independently. We conducted a thematic analysis to identify major themes pertaining to digital health technology uptake by both providers and patients. Results The search identified 3062 unique studies, of which 23 qualitative studies met eligibility criteria. Seventeen studies included semi-structured interviews and 6 included focus groups. Five (22%) studies reported provider-level facilitators, which included technology usability, integration into clinical workflow, and improved patient outcomes. Eighteen (78%) studies reported patient-level facilitators, which included ongoing technical support, improved access to healthcare services, and improved self-management. Six (26%) studies reported provider-level barriers, which included lack of integration into clinical workflow, increased healthcare costs, and lack of validation and reliability of technology. Finally, 19 (83%) studies reported patient-level barriers which included lack of knowledge about technology, limited internet access, and physical impairments making use of technology difficult. Conclusions Identifying barriers to and facilitators of digital health technology could help improve its uptake in cardiology. The findings of this study can be used to inform researchers, clinicians, and stakeholders who wish to develop and implement digital health technologies that meet the needs of providers and patients. Funding Acknowledgement Type of funding source: None

Policy Review: Dubai Health Authority’s COVID-19 Rapid Response

2020 ◽  
Vol 5 (Special) ◽  
Keyword(s):  
United Arab Emirates ◽  
Well Being ◽  
Healthcare Services ◽  
Rapid Response ◽  
Policy Implications ◽  
World Health ◽  
Healthcare Sector ◽  
Services Delivery ◽  
First Case ◽  
The World

Dubai Health Authority (DHA) is the entity regulating the healthcare sector in the Emirate of Dubai, ensuring high quality and safe healthcare services delivery to the population. The World Health Organization (WHO) declared COVID-19 a pandemic on the 11th of March 2020, indicating to the world that further infection spread is very likely, and alerting countries that they should be ready for possible widespread community transmission. The first case of COVID-19 in the United Arab Emirates was confirmed on 29th of January 2020; since then, the number of cases has continued to grow exponentially. As of 8th of July 2020 (end of the day), 53,045 cases of coronavirus have been confirmed with a death toll of 327 cases. The UAE has conducted over 3,720,000 COVID-19 tests among UAE citizens and residents over the past four months, in line with the government’s plans to strengthen virus screening to contain the spread of COVID-19. There were vital UAE policies, laws, regulations, and decrees that have been announced for immediate implementation to limit the spread of COVID- 19, to prevent panic and to ensure the overall food, nutrition, and well-being are provided. The UAE is amongst the World’s Top 10 for COVID-19 Treatment Efficiency and in the World’s Top 20 for the implementation of COVID-19 Safety measures. The UAE’s mission is to work towards resuming life after COVID-19 and enter into the recovery phases. This policy research paper will discuss the Dubai Health Authority’s rapid response initiatives towards combating the control and spread of COVID-19 and future policy implications and recommendations. The underlying factors and policy options will be discussed in terms of governance, finance, and delivery.

scholarly journals The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia J. Lucas ◽  
Alastair D. Hay ◽  
Christie Cabral
Keyword(s):  
Social Networks ◽  
Social Status ◽  
Digital Health ◽  
Self Care ◽  
Social Resources ◽  
Health Interventions ◽  
Structured Interviews ◽  
Health Technologies ◽  
Digital Skills ◽  
Care Support

Abstract Background Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aims To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups. Methods A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically. Results A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender. Conclusion This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.

scholarly journals Digital Progression Biomarkers as Novel Endpoints in Clinical Trials: A Multistakeholder Perspective

2021 ◽  
pp. 1-7
Author(s):  
Diane Stephenson ◽  
Reham Badawy ◽  
Soania Mathur ◽  
Maria Tome ◽  
Lynn Rochester
Keyword(s):  
Disease Progression ◽  
Digital Health ◽  
Low Cost ◽  
Unmet Need ◽  
Disease Status ◽  
Standard Test ◽  
Imaging Biomarkers ◽  
Health Technologies ◽  
Therapeutic Development ◽  
The Rich

The burden of Parkinson’s disease (PD) continues to grow at an unsustainable pace particularly given that it now represents the fastest growing brain disease. Despite seminal discoveries in genetics and pathogenesis, people living with PD oftentimes wait years to obtain an accurate diagnosis and have no way to know their own prognostic fate once they do learn they have the disease. Currently, there is no objective biomarker to measure the onset, progression, and severity of PD along the disease continuum. Without such tools, the effectiveness of any given treatment, experimental or conventional cannot be measured. Such tools are urgently needed now more than ever given the rich number of new candidate therapies in the pipeline. Over the last decade, millions of dollars have been directed to identify biomarkers to inform progression of PD typically using molecular, fluid or imaging modalities). These efforts have produced novel insights in our understanding of PD including mechanistic targets, disease subtypes and imaging biomarkers. While we have learned a lot along the way, implementation of robust disease progression biomarkers as tools for quantifying changes in disease status or severity remains elusive. Biomarkers have improved health outcomes and led to accelerated drug approvals in key areas of unmet need such as oncology. Quantitative biomarker measures such as HbA1c a standard test for the monitoring of diabetes has impacted patient care and management, both for the healthcare professionals and the patient community. Such advances accelerate opportunities for early intervention including prevention of disease in high-risk individuals. In PD, progression markers are needed at all stages of the disease in order to catalyze drug development—this allows interventions aimed to halt or slow disease progression, very early, but also facilitates symptomatic treatments at moderate stages of the disease. Recently, attention has turned to the role of digital health technologies to complement the traditional modalities as they are relatively low cost, objective and scalable. Success in this endeavor would be transformative for clinical research and therapeutic development. Consequently, significant investment has led to a number of collaborative efforts to identify and validate suitable digital biomarkers of disease progression.

scholarly journals A technology-assisted life of recovery from psychosis

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Dror Ben-Zeev ◽  
Benjamin Buck ◽  
Sarah Kopelovich ◽  
Suzanne Meller
Keyword(s):  
Early Detection ◽  
Symptom Management ◽  
Digital Health ◽  
Digital Technologies ◽  
Clinical Population ◽  
Illness Management ◽  
Illness Management And Recovery ◽  
Health Technologies ◽  
Health Innovations ◽  
Schizophrenia Spectrum

Abstract Developments in digital health technologies have the potential to expedite and strengthen the path towards recovery for people with psychosis. This perspective piece provides a snapshot of how a range of digital technologies can be deployed to support a young adult’s efforts to cope with schizophrenia-spectrum illness. In conjunction with a day in the life of this individual, we provide examples of innovations in digital health research designed for this clinical population, as well as brief summaries of the evidence supporting the usability, feasibility, or effectiveness of each approach. From early detection to ongoing symptom management and vocational rehabilitation, this day-in-the-life vignette provides an overview of the ways in which digital health innovations could be used in concert to augment, scaffold, and enhance schizophrenia-spectrum illness management and recovery.

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.

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