Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

2021 ◽  
Vol 12 (05) ◽  
pp. 1135-1143
Author(s):  
Amalie Dyda ◽  
Magid Fahim ◽  
Jon Fraser ◽  
Marianne Kirrane ◽  
Ides Wong ◽  
...  
Keyword(s):  
Care Delivery ◽  
Digital Health ◽  
Clinical Care ◽  
Models Of Care ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Digital Data ◽  
Routine Practice ◽  
Action Research Project ◽  
Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

Electronic health record technology designed for the clinical encounter: MS neuroSHARE

2020 ◽  
pp. 10.1212/CPJ.0000000000000986
Author(s):  
Riley Bove ◽  
Christa A. Bruce ◽  
Chelsea K. Lunders ◽  
Jennifer R. Pearce ◽  
Jacqueline Liu ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Web Application ◽  
Care Delivery ◽  
Digital Health ◽  
Lessons Learned ◽  
Advisory Group ◽  
Health Record ◽  
Design Development ◽  
Design And Implementation ◽  
Electronic Health

ABSTRACTObjectives:Advances in medical discoveries have bolstered expectations of precise and complete care, but delivering on such a promise for complex, chronic neurological care delivery requires solving last-mile challenges. We describe the iterative human-centered design and pilot process for MS neuroSHARE, a digital health solution that brings practical information to the point-of-care so clinicians and patients with multiple sclerosis (MS) can view, discuss and make informed decisions together.Methods:We initiated a comprehensive human-centered process to iteratively design, develop and implement a digital health solution for managing MS in the routine outpatient setting of the nonprofit Sutter Health system in Northern California. The human-centered co-design process included three phases: Discovery and Design, Development, and Implementation and Pilot. Stakeholders included Sutter Health’s Research Development and Dissemination team, academic domain experts, neurologists, patients with MS, and an Advisory Group.Results:MS neuroSHARE went live in November 2018. It included a patient- and clinician-facing web application that launches from the electronic health record, visually displays a patient’s data relevant to MS, and prompts the clinician to comprehensively evaluate and treat the patient. Both patients and clinicians valued the ability to jointly view patient-generated and other data. Preliminary results suggest that MS neuroSHARE promotes patient-clinician communication and more active patient participation in decision-making.Conclusions:Lessons learned in the design and implementation of MS NeuroSHARE are broadly applicable to the design and implementation of digital tools aiming to improve the experience of delivering and receiving high-quality care for complex, neurological conditions across large health systems.

Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Carolyn Foster ◽  
Dana Schinasi ◽  
Kristin Kan ◽  
Michelle Macy ◽  
Derek Wheeler ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Literacy ◽  
Care Delivery ◽  
Digital Health ◽  
Health Care Team ◽  
Models Of Care ◽  
Health Data ◽  
Care Needs ◽  
Case Examples ◽  
Health Technologies

Remote patient monitoring (RPM) is a form of telemedicine that involves the collection and transmission of health data from a patient to their health care team by using digital health technologies. RPM can be leveraged to aggregate and visualize longitudinal patient-generated health data for proactive clinical management and engagement of the patient and family in a child’s health care. Collection of remote data has been considered standard of care for years in some chronic pediatric conditions. However, software limitations, gaps in access to the Internet and technology devices, digital literacy, insufficient reimbursement, and other challenges have prevented expansion of RPM in pediatric medicine on a wide scale. Recent technological advances in remote devices and software, coupled with a shift toward virtual models of care, have created a need to better understand how RPM can be leveraged in pediatrics to improve the health of more children, especially for children with special health care needs who are reliant on high-quality chronic disease management. In this article, we define RPM for the general pediatric health care provider audience, provide case examples of existing RPM models, discuss advantages of and limitations to RPM (including how data are collected, evaluated, and managed), and provide a list of current RPM resources for clinical practitioners. Finally, we propose considerations for expansion of this health care delivery approach for children, including clinical infrastructure, equitable access to digital health care, and necessary reimbursement. The overarching goal is to advance health for children by adapting RPM technologies as appropriate and beneficial for patients, families, and providers alike.

Cardiac nursing: Achieving Competent Practitioners

2005 ◽  
Vol 4 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Jillian Riley ◽  
Lyndell Brodie ◽  
Caroline Shuldham
Keyword(s):  
Care Delivery ◽  
Waiting Times ◽  
Models Of Care ◽  
Quality Of Services ◽  
Cardiac Care ◽  
Routine Practice ◽  
Knowledge And Skills ◽  
Career Pathway ◽  
Fit For Purpose

This paper describes how competency statements were integrated into an academic framework to provide a transparent yet flexible career pathway for the nurse working in acute cardiac care. Nurses are expanding and developing their roles and use wide ranging skills and knowledge to care for patients. Additionally, models of care delivery are changing and patients are cared for in a variety of settings. Where evidence exists, these models demonstrate improvement in the provision and quality of services and contribute to improved quality of life, maximise medication and therapy and reduce waiting times for investigations. However, whilst many studies have demonstrated benefit, translating these results into routine practice requires skilled nurses who are “fit for purpose”, and to support this, professional competencies can be used to measure competence in practice whilst informing educational initiatives. This paper outlines the development of competency statements that identify the knowledge and skills required for safe, effective and competent care and direct the cardiac nurse acquire skills and knowledge in a focused and coherent way.

Digital Connectivity: The Sixth Vital Sign

2021 ◽  
pp. 193229682110152
Author(s):  
David C. Klonoff ◽  
Trisha Shang ◽  
Jennifer Y. Zhang ◽  
Eda Cengiz ◽  
Chhavi Mehta ◽  
...  
Keyword(s):  
Vital Sign ◽  
Pressure Pulse ◽  
Digital Health ◽  
Clinical Care ◽  
Vital Signs ◽  
Personal Data ◽  
Skills Training ◽  
Digital Data ◽  
Digital Monitoring ◽  
Continuous Glucose Monitors

Digital health and telehealth connectivity have become important aspects of clinical care. Connected devices, including continuous glucose monitors and automated insulin delivery systems for diabetes, are being used increasingly to support personalized clinical decisions based on automatically collected data. Furthermore, the development, demand, and coverage for telehealth have all recently expanded, as a result of the COVID-19 pandemic. Medical care, and especially diabetes care, are therefore becoming more digital through the use of both connected digital health devices and telehealth communication. It has therefore become necessary to integrate digital data into the electronic health record and maintain personal data confidentiality, integrity, and availability. Connected digital monitoring combined with telehealth communication is known as virtual health. For this virtual care paradigm to be successful, patients must have proper skills, training, and equipment. We propose that along with the five current vital signs of blood pressure, pulse, respiratory rate, temperature, and pain, at this time, digital connectivity should be considered as the sixth vital sign. In this article, we present a scale to assess digital connectivity.

scholarly journals Teaching Digital Health Ethics – Considerations and Lessons in Hands on Learning.

2020 ◽  
Author(s):  
Arthi Kumaravel ◽  
Philip Henson ◽  
John Torous
Keyword(s):  
Mental Health ◽  
Care Delivery ◽  
Digital Health ◽  
Clinical Care ◽  
Ethical Principles ◽  
Privacy Policy ◽  
Assessment Framework ◽  
Patient Privacy ◽  
Smartphone Applications ◽  
General Data Protection Regulation

Abstract Background Educators need new tools to teach resident learners how to evaluate the privacy risks of and utilize the benefits of smartphone applications with their patients. To address this need for education addressing the changing landscape of mental health care delivery, we sought to create a simple tool that can be used in the clinic. Through this 10-point assessment framework for screening health apps based from ethical principles of the General Data Protection Regulation (GDPR), we propose a method that educators can utilize to teach residents about the privacy concerns of utilizing smartphone applications as part of clinical care with their patients. Methods We utilized an ethical-educational framework we developed from ethical principles of the GDPR with a group of 27 psychiatry residents from two academic centers for a simulation exercise to assess harms of using smartphone apps with a patient. Results All 27 raters completed the evaluations, but only 24 reported a time record for completion of the evaluation. The mean time to evaluate the privacy policy of the sample app’s privacy policy was 434.2 seconds (just over five minutes). Percentage agreement of each question on the survey ranged from a high of 81.5% to a low of 48.1%. Conclusions In this study, we developed an assessment framework based on the ethical principles contained within the GDPR to utilize for education of resident learners around digital health privacy. This is the first framework developed for resident learners to help them understand the potential risks to patient privacy with the use of smartphone applications for mental health. The discussion prompted by an examination of a privacy policy through this framework highlights the need for further educational tools built into the residency education curriculum regarding these risks as use of these applications become more wide spread.

scholarly journals Opportunities and Challenges of Telehealth in Remote Communities: Case Study of the Yukon Telehealth System (Preprint)

2018 ◽  
Author(s):  
Emily Seto ◽  
Dallas Smith ◽  
Matt Jacques ◽  
Plinio Pelegrini Morita
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Community Health Centers ◽  
Care Delivery ◽  
Clinical Care ◽  
Consumer Products ◽  
Lessons Learned ◽  
Easy Access ◽  
Remote Communities ◽  
Novel Technologies

BACKGROUND Telehealth has been shown to improve access to health care and to reduce costs to the patient and health care system, especially for patients living in rural settings. However, unique challenges arise when implementing telehealth in remote communities. OBJECTIVE The study aimed to explore the current use, challenges, and opportunities of the Yukon Telehealth System. The lessons learned from this study were used to determine important factors to consider when attempting to advance and expand telehealth programs in remote communities. METHODS A mixed methods approach was used to evaluate the Yukon Telehealth System and to determine possible future advances. Quantitative data were obtained through usage logs. Web-based questionnaires were administered to nurses in each of the 14 Yukon community health centers outside of Whitehorse and patients who had used telehealth. Qualitative data included focus groups and semistructured interviews with 36 telehealth stakeholders. RESULTS Since 2008, there has been a consistent number of telehealth sessions of about 1000 per year, with clinical care as the main use (69.06% [759/1099] of all sessions in 2015). From the questionnaire (11 community nurses and 10 patients) and the interview data, there was a consensus among the clinicians and patients that the system provided timely access and cost savings from reduced travel. However, they believed that it was underutilized, and the equipment was outdated. The following 4 factors were identified, which should be considered when trying to advance and expand a telehealth program: (1) patient and clinician buy-in: past telehealth experiences (eg, negative clinician experiences with outdated technology) should be considered when advancing the system. Expansion of services in orthopedics, dermatology, and psychiatry were found to be particularly feasible and beneficial in Yukon; (2) workflow: the use and scheduling of telehealth should be streamlined and automated as much as possible to reduce dependencies on the single Yukon telehealth coordinator; (3) access to telehealth technology: clinicians and patients should have easy access to up-to-date telehealth technology. The use of consumer products, such as mobile technology, should be leveraged as appropriate; and (4) infrastructure: the required human resources and technology need to be established when expanding and advancing telehealth. CONCLUSIONS While clinicians and patients had generally positive perceptions of the Yukon Telehealth System, there was consensus that it was underutilized. Many opportunities exist to expand the types of telehealth services and the number of telehealth sessions, including the expansion of services in several new specialty areas, updating telehealth equipment to streamline workflows and increase convenience and uptake, and integrating novel technologies. The identified barriers and recommendations from this evaluation can be applied to the development and expansion of telehealth in other remote communities to realize telehealth’s potential for providing efficient, safe, convenient, and cost-effective care delivery.

scholarly journals Redesigning models of patient care delivery and organisation: building collegial generosity in response to workplace challenges

2007 ◽  
Vol 31 (5) ◽  
pp. 109 ◽  
Author(s):  
E Mary Chiarella
Keyword(s):  
Care Delivery ◽  
New South ◽  
Models Of Care ◽  
Action Research Project ◽  
Care Organisation ◽  
South Wales ◽  
Care Project ◽  
Workplace Challenges ◽  
Patient Care Delivery

This case study describes the New South Wales Nursing and Midwifery Office (NaMO) Models of Care Project, a project designed to identify, encourage and disseminate innovations in nursing care organisation and delivery. The project is a 4- year action research project, using a range of interactive engagements including workshops, seminars, questionnaires and websites to achieve the goals. This case study briefly describes the main stimuli for review and redesign of models of care identified through analysis of the clinicians? presentations, and explores the range of responses to the workplace challenges.

scholarly journals The New Leadership Paradigm in Digital Health and Its Relations to Hospital Services

2021 ◽  
Vol 12 (2) ◽  
pp. 89-103
Author(s):  
Ede Surya Darmawan ◽  
Sidhi Laksono
Keyword(s):  
Digital Health ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Disruptive Innovation ◽  
Digital Transformation ◽  
Digital Information ◽  
Digital Products ◽  
The Future ◽  
Health Products ◽  
Digital Disruption

The current and future of the healthcare system will face various problems, ranging from digitizing the health system, digital transformation and disruption of the health world or the problem of digital application during the Covid-19 pandemic in Health 4.0 and Community 5.0 and its leadership. The objective of the study is to explore digital information and the role of leadership in healthcare services in the future. This research is a narrative literature review and searched relevant articles from ProQuest and PubMed. Digital health is transforming healthcare delivery around the world to meet the evolving challenges of an aging population with a variety of chronic conditions. Digital transformation and disruptive innovation illustrate a comprehensive reorientation of the industry, including its business model due to the advent of digital technology in the form of digitizing products, services, and processes. Digital health products can be in the form of electronic health (eHealth), cellular health (mHealth), health information technology, teleconsultation (telehealth/telemedicine). All these digital products, if they cannot be applied now and in the future, will cause digital disruption in traditional healthcare services in hospitals. The current world of health also has an impact because of the COVID-19 pandemic, where this situation is a race for Health 4.0 and Society 5.0 (super smart people). Where Health 4.0 will relax and reflect digital health and implement it in Society 5.0. The leadership strategies that can be selected are systems thinking, contextual intelligence, and metacognitive strategies.

scholarly journals Opportunities and Challenges of Telehealth in Remote Communities: Case Study of the Yukon Telehealth System

10.2196/11353 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e11353 ◽  
Author(s):  
Emily Seto ◽  
Dallas Smith ◽  
Matt Jacques ◽  
Plinio Pelegrini Morita
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Community Health Centers ◽  
Care Delivery ◽  
Clinical Care ◽  
Consumer Products ◽  
Lessons Learned ◽  
Easy Access ◽  
Remote Communities ◽  
Novel Technologies

Background Telehealth has been shown to improve access to health care and to reduce costs to the patient and health care system, especially for patients living in rural settings. However, unique challenges arise when implementing telehealth in remote communities. Objective The study aimed to explore the current use, challenges, and opportunities of the Yukon Telehealth System. The lessons learned from this study were used to determine important factors to consider when attempting to advance and expand telehealth programs in remote communities. Methods A mixed methods approach was used to evaluate the Yukon Telehealth System and to determine possible future advances. Quantitative data were obtained through usage logs. Web-based questionnaires were administered to nurses in each of the 14 Yukon community health centers outside of Whitehorse and patients who had used telehealth. Qualitative data included focus groups and semistructured interviews with 36 telehealth stakeholders. Results Since 2008, there has been a consistent number of telehealth sessions of about 1000 per year, with clinical care as the main use (69.06% [759/1099] of all sessions in 2015). From the questionnaire (11 community nurses and 10 patients) and the interview data, there was a consensus among the clinicians and patients that the system provided timely access and cost savings from reduced travel. However, they believed that it was underutilized, and the equipment was outdated. The following 4 factors were identified, which should be considered when trying to advance and expand a telehealth program: (1) patient and clinician buy-in: past telehealth experiences (eg, negative clinician experiences with outdated technology) should be considered when advancing the system. Expansion of services in orthopedics, dermatology, and psychiatry were found to be particularly feasible and beneficial in Yukon; (2) workflow: the use and scheduling of telehealth should be streamlined and automated as much as possible to reduce dependencies on the single Yukon telehealth coordinator; (3) access to telehealth technology: clinicians and patients should have easy access to up-to-date telehealth technology. The use of consumer products, such as mobile technology, should be leveraged as appropriate; and (4) infrastructure: the required human resources and technology need to be established when expanding and advancing telehealth. Conclusions While clinicians and patients had generally positive perceptions of the Yukon Telehealth System, there was consensus that it was underutilized. Many opportunities exist to expand the types of telehealth services and the number of telehealth sessions, including the expansion of services in several new specialty areas, updating telehealth equipment to streamline workflows and increase convenience and uptake, and integrating novel technologies. The identified barriers and recommendations from this evaluation can be applied to the development and expansion of telehealth in other remote communities to realize telehealth’s potential for providing efficient, safe, convenient, and cost-effective care delivery.

New digital models of care in ophthalmology, during and beyond the COVID-19 pandemic

2021 ◽  
pp. bjophthalmol-2020-317683
Author(s):  
Yih-Chung Tham ◽  
Rahat Husain ◽  
Kelvin Yi Chong Teo ◽  
Anna Cheng Sim Tan ◽  
Annabel Chee Yen Chew ◽  
...  
Keyword(s):  
Business Models ◽  
Digital Health ◽  
Models Of Care ◽  
Clinical Practices ◽  
Digital Models ◽  
Face To Face ◽  
Potential Barriers ◽  
Digital Business Models ◽  
Brick And Mortar ◽  
Clinical Models

COVID-19 has led to massive disruptions in societal, economic and healthcare systems globally. While COVID-19 has sparked a surge and expansion of new digital business models in different industries, healthcare has been slower to adapt to digital solutions. The majority of ophthalmology clinical practices are still operating through a traditional model of ‘brick-and-mortar’ facilities and ‘face-to-face’ patient–physician interaction. In the current climate of COVID-19, there is a need to fuel implementation of digital health models for ophthalmology. In this article, we highlight the current limitations in traditional clinical models as we confront COVID-19, review the current lack of digital initiatives in ophthalmology sphere despite the presence of COVID-19, propose new digital models of care for ophthalmology and discuss potential barriers that need to be considered for sustainable transformation to take place.

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