scholarly journals Nonadversarially Driven Toxicities

2021 ◽  
pp. 104-124
Author(s):  
Eric D. Perakslis ◽  
Martin Stanley
Keyword(s):  
Life Support ◽  
Digital Health ◽  
Self Care ◽  
Appointment Scheduling ◽  
The Internet ◽  
Medical Conditions ◽  
Medical Appointment ◽  
Medical Terms ◽  
Widespread Availability

The Internet and digital health tools have brought us the convenience of online medical appointment scheduling, quick access to definitions of medical terms, and many other conveniences and capabilities, but these are not without concurrent risks of harm. Widespread availability of self-care tools has the potential for overdiagnosis and overtreatment. Fixation upon potential medical conditions has led to increased cyberchondria; and convenience, when taken to far, can drive risky practices and overdependence on tools that are meant to aid in care but not intended to be reliable life support. In this chapter we examine the five nonadversarially driven toxicities of digital health in order to understand how human frailty, habit, and bias may exacerbate the risks of otherwise harmless and helpful digital health aids.

Abstract P135: The Role Of Digital Health In The Management Of Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Onoriode Kesiena ◽  
Kofi Seffah ◽  
Navin Kumar ◽  
Eunice Hama
Keyword(s):  
Medication Adherence ◽  
Health Information ◽  
Digital Health ◽  
The Internet ◽  
Chi Square ◽  
Health Technologies ◽  
Medical Appointment ◽  
Use Of Technology ◽  
Use Of The Internet ◽  
Chi Square Analysis

Introduction: Digital health involves the use of technology to delivery health care. It is associated with improved clinical outcomes in various populations. We assessed its role in medication adherence in adults with hypertension. Methods: Data from the 2018 National Health Interview Survey data was used. We analyzed 8,224 respondents with hypertension representing about 69 million United States adults. The independent variables were: Use of the internet to (1) to look up health information (2) to fill a prescription and (3) to schedule a medical appointment and use of an email (4) to communicate with a healthcare provider. The dependent variable was anti-hypertensive medication adherence. Chi-square analysis was used to identify group differences and a logistic regression was used to analyze the association between digital health utilization and anti-hypertensive medication adherence. Results: Of the study population, 7,387/8,224 (89.8%) of the respondents reported adherence to anti-hypertensive medications. Those who were adherent were predominantly > 65 years of age, 4141/7387 (47.8%) and earned > $75,000/yearly, 580/2581 (25.2%). The use of internet to look up health information as compared to those who do not, was associated with 30% reduced odds of medication adherence [OR 0.71, 95% CI 0.59, 0.86, p=<.001]. However, this was insignificant after adjusting for covariates [AOR 0.92, 95% CI 0.89, 1.22, p=0.551]. Using the internet to fill up prescription as compared to those who do not, was associated with 47% odds of medication adherence [OR 1.47, CI 1.14,1.90, p=0.003]. This odd increased further after adjusting for covariates [AOR 1.95, CI 1.37,2.78, p=<.001]. No significant association was found in the relationship between medication adherence and scheduling a medical appointment with the internet or communicating with a provider via email even after adjusting for covariates. Conclusion: Increase adherence to anti-hypertensive medications is associated with online refill of prescriptions. This means that the use of digital health technologies in hypertensive populations can lead to better health outcomes. Future studies should evaluate other aspects of digital health use in hypertensive populations.

scholarly journals Assimilation of Medical Appointment Scheduling Systems and Their Impact on the Accessibility of Primary Care: Mixed Methods Study

10.2196/30485 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e30485
Author(s):  
Guy Paré ◽  
Louis Raymond ◽  
Alexandre Castonguay ◽  
Antoine Grenier Ouimet ◽  
Marie-Claude Trudel
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Medical Care ◽  
Digital Health ◽  
Appointment Scheduling ◽  
Survey Study ◽  
Equation Modeling ◽  
Valuable Insight ◽  
Health Technologies ◽  
Medical Appointment

Background The COVID-19 pandemic has prompted the adoption of digital health technologies to maximize the accessibility of medical care in primary care settings. Medical appointment scheduling (MAS) systems are among the most essential technologies. Prior studies on MAS systems have taken either a user-oriented perspective, focusing on perceived outcomes such as patient satisfaction, or a technical perspective, focusing on optimizing medical scheduling algorithms. Less attention has been given to the extent to which family medicine practices have assimilated these systems into their daily operations and achieved impacts. Objective This study aimed to fill this gap and provide answers to the following questions: (1) to what extent have primary care practices assimilated MAS systems into their daily operations? (2) what are the impacts of assimilating MAS systems on the accessibility and availability of primary care? and (3) what are the organizational and managerial factors associated with greater assimilation of MAS systems in family medicine clinics? Methods A survey study targeting all family medicine clinics in Quebec, Canada, was conducted. The questionnaire was addressed to the individual responsible for managing medical schedules and appointments at these clinics. Following basic descriptive statistics, component-based structural equation modeling was used to empirically explore the causal paths implied in the conceptual framework. A cluster analysis was also performed to complement the causal analysis. As a final step, 6 experts in MAS systems were interviewed. Qualitative data were then coded and extracted using standard content analysis methods. Results A total of 70 valid questionnaires were collected and analyzed. A large majority of the surveyed clinics had implemented MAS systems, with an average use of 1 or 2 functionalities, mainly “automated appointment confirmation and reminders” and “online appointment confirmation, modification, or cancellation by the patient.” More extensive use of MAS systems appears to contribute to improved availability of medical care in these clinics, notwithstanding the effect of their application of advanced access principles. Also, greater integration of MAS systems into the clinic’s electronic medical record system led to more extensive use. Our study further indicated that smaller clinics were less likely to undertake such integration and therefore showed less availability of medical care for their patients. Finally, our findings indicated that those clinics that showed a greater adoption rate and that used the provincial MAS system tended to be the highest-performing ones in terms of accessibility and availability of care. Conclusions The main contribution of this study lies in the empirical demonstration that greater integration and assimilation of MAS systems in family medicine clinics lead to greater accessibility and availability of care for their patients and the general population. Valuable insight has also been provided on how to identify the clinics that would benefit most from such digital health solutions.

scholarly journals Digital Health Information as Friend or Foe: The Question of (Mis)Trust Among Older Internet Users

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 410-410
Author(s):  
Gul Seckin ◽  
Patricia Campbell ◽  
Megan Lawson
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Health Information ◽  
Internet Use ◽  
Digital Health ◽  
Self Care ◽  
Positive Association ◽  
Older Age ◽  
The Internet ◽  
Health Related

Abstract Gathering health information is among the major motivations for getting online among older adults who want to be better prepared with knowledge to manage their health and personal care. Prior research also showed significant gender differences in health-related use of the Internet. This research examined the effect of Internet use for health information on (a) mistrust of physician, (b) empowerment, (c) self-care, and (d) worry and/or anxiety. The sample (N=710; Mean= 48.82, SD=16.43) was randomly drawn from a national probability-based online panel. We performed gender-stratified sub-sample analyses of older respondents (age ≥60, N= 194). Hierarchical linear regression analyses showed that there is a negative association between older age and feeling empowered because of using the internet for health information (β = -.23, p &lt; .05) and a positive association between older age and mistrust of diagnosis and/or treatment of physician (β = .19, p &lt; .05). Study respondents did not report better self-care as a result of obtaining information from the Internet (β = -.15, p &gt; .05). Lastly, older adults reported less worry and/or anxiety because of information stumbled upon the Internet that may not be accurate (β = -.25, p &lt; .05). Sub-sample analyses showed that there are gender differences. Particularly, older men reported greater mistrust (β = .32, p &lt; .05), and less worry (β = -.44, p ≤ .01) while these associations were not significant among older women. Results call for examination of the synergy of age and gender in perceived benefits of health-related Internet use.

scholarly journals Assimilation of Medical Appointment Scheduling Systems and Their Impact on the Accessibility of Primary Care: Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Guy Paré ◽  
Louis Raymond ◽  
Alexandre Castonguay ◽  
Antoine Grenier Ouimet ◽  
Marie-Claude Trudel
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Medical Care ◽  
Digital Health ◽  
Appointment Scheduling ◽  
Survey Study ◽  
Equation Modeling ◽  
Valuable Insight ◽  
Health Technologies ◽  
Medical Appointment

BACKGROUND The COVID-19 pandemic has prompted the adoption of digital health technologies to maximize the accessibility of medical care in primary care settings. Medical appointment scheduling (MAS) systems are among the most essential technologies. Prior studies on MAS systems have taken either a user-oriented perspective, focusing on perceived outcomes such as patient satisfaction, or a technical perspective, focusing on optimizing medical scheduling algorithms. Less attention has been given to the extent to which family medicine practices have assimilated these systems into their daily operations and achieved impacts. OBJECTIVE This study aimed to fill this gap and provide answers to the following questions: (1) to what extent have primary care practices assimilated MAS systems into their daily operations? (2) what are the impacts of assimilating MAS systems on the accessibility and availability of primary care? and (3) what are the organizational and managerial factors associated with greater assimilation of MAS systems in family medicine clinics? METHODS A survey study targeting all family medicine clinics in Quebec, Canada, was conducted. The questionnaire was addressed to the individual responsible for managing medical schedules and appointments at these clinics. Following basic descriptive statistics, component-based structural equation modeling was used to empirically explore the causal paths implied in the conceptual framework. A cluster analysis was also performed to complement the causal analysis. As a final step, 6 experts in MAS systems were interviewed. Qualitative data were then coded and extracted using standard content analysis methods. RESULTS A total of 70 valid questionnaires were collected and analyzed. A large majority of the surveyed clinics had implemented MAS systems, with an average use of 1 or 2 functionalities, mainly “automated appointment confirmation and reminders” and “online appointment confirmation, modification, or cancellation by the patient.” More extensive use of MAS systems appears to contribute to improved availability of medical care in these clinics, notwithstanding the effect of their application of advanced access principles. Also, greater integration of MAS systems into the clinic’s electronic medical record system led to more extensive use. Our study further indicated that smaller clinics were less likely to undertake such integration and therefore showed less availability of medical care for their patients. Finally, our findings indicated that those clinics that showed a greater adoption rate and that used the provincial MAS system tended to be the highest-performing ones in terms of accessibility and availability of care. CONCLUSIONS The main contribution of this study lies in the empirical demonstration that greater integration and assimilation of MAS systems in family medicine clinics lead to greater accessibility and availability of care for their patients and the general population. Valuable insight has also been provided on how to identify the clinics that would benefit most from such digital health solutions.

scholarly journals Can digital health save democracy? Meeting the cosmopolitical challenge of digital worlds

2018 ◽  
Vol 6 (2) ◽  
pp. 631-643 ◽  
Author(s):  
Elena Gonzalez-Polledo
Keyword(s):  
Social Media ◽  
Health Services ◽  
Public Participation ◽  
Digital Health ◽  
Self Care ◽  
Digital Technologies ◽  
Individual Autonomy ◽  
Medical Conditions ◽  
Health Technologies ◽  
Challenges And Opportunities

This article explores the challenges and opportunities of social media health activisms to shape public participation in the digital future of healthcare. As health becomes ever more entangled with digital technologies, a growing ecology of digital health services promise greater individual autonomy to learn about and managing medical conditions, as well as accessing health services and engaging in forms of self-care. Cautioning against optimist visions of digital health and their promise of empowerment and autonomy, the article explores how health activisms on social media are reclaiming visions of healthcare that move beyond individual and depoliticised models of health technologies. The notion of cosmopolitics is employed to conceptualise relations between technology and health that implicate human and non-human interests in entanglements between health, morality and technology.

Integration of diagnostic and communication technologies

2009 ◽  
Vol 15 (7) ◽  
pp. 323-326 ◽  
Author(s):  
Nafees N Malik
Keyword(s):  
Health Care ◽  
Biomarker Discovery ◽  
Point Of Care ◽  
Communication Technologies ◽  
The Internet ◽  
Medical Conditions ◽  
Doctor Who ◽  
Point Of Care Testing ◽  
Wide Range ◽  
Widespread Availability

Three key areas in diagnostics will drive the convergence of diagnostic and communication technologies: point-of-care testing, micro-electromechanical systems and biomarker discovery. In addition, the communications revolution means that increasing numbers of people will be able to send data from their home to their doctor using the Internet. Also, the widespread availability of broadband opens up the possibly of realtime videoconferencing with clinicians. It is already possible for patients at home to monitor simple variables, such as heart rate and blood pressure, and send their results using communication technologies to their doctors, who can promptly review the information to diagnose problems. As diagnostic and communication technologies converge, it will be feasible for patients to transmit more complex health-care data periodically to their doctor, who will be able to identify problems early on and thus modify disease management to prevent exacerbations of patients' medical conditions. This will allow improved patient care in a wide range of health-care situations, from acute medical conditions to chronic disease.

Overbooked and Overlooked: Machine Learning and Racial Bias in Medical Appointment Scheduling

2019 ◽  
Author(s):  
Michele Samorani ◽  
Shannon Harris ◽  
Linda Goler Blount ◽  
Haibing Lu ◽  
Michael A. Santoro
Keyword(s):  
Machine Learning ◽  
Racial Bias ◽  
Appointment Scheduling ◽  
Medical Appointment

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.

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