scholarly journals Development of a decision-making checklist tool to support technology selection in digital health research

2019 ◽  
Vol 10 (4) ◽  
pp. 1004-1015 ◽  
Author(s):  
Camille Nebeker ◽  
Rebecca J Bartlett Ellis ◽  
John Torous
Keyword(s):  
Decision Making ◽  
Digital Technology ◽  
Technology Use ◽  
Digital Health ◽  
Technology Selection ◽  
Ethical Principles ◽  
Personal Health ◽  
Privacy Risk ◽  
Health Technologies ◽  
Selection For

Abstract Digital technologies offer researchers new approaches to test personalized and adaptive health interventions tailored to an individual. Yet, research leveraging technologies to capture personal health data involve technical and ethical consideration during the study design phase. No guidance exists to facilitate responsible digital technology selection for research purposes. A stakeholder-engaged and iterative approach was used to develop, test, and refine a checklist designed to aid researchers in selecting technologies for their research. First, stakeholders (n = 7) discussed and informed key decision-making domains to guide app/device selection derived from the American Psychiatric Association’s framework that included safety, evidence, usability, and interoperability. We added “ethical principles” to the APA’s hierarchical model and created a checklist that was used by a small group of behavioral scientists (n = 7). Findings revealed the “ethical principles” domains of respect, beneficence, and justice cut across each decision-making domains and the checklist questions/prompts were revised accordingly and can be found at thecore.ucsd.edu. The refined checklist contains four decision-making domains with prompts/questions and ethical principles embedded within the domains of privacy, risk/benefit, data management, and access/evidence. This checklist is the first step in leading the narrative of decision-making when selecting digital health technologies for research. Given the dynamic and rapidly evolving nature of digital health technology use in research, this tool will need to be further evaluated for usefulness in technology selection.

Appropriate decision making in energy technology selection for developing countries: The Life Cycle Assessment approach

2021 ◽  
pp. 83-89
Author(s):  
Abeer Ali Khan
Keyword(s):  
Decision Making ◽  
Developing Countries ◽  
Life Cycle Assessment ◽  
Life Cycle ◽  
Technology Selection ◽  
Energy Technology ◽  
High Demand ◽  
Environmentally Conscious ◽  
Assessment Approach ◽  
Selection For

As the high demand of energy of the developing countries is met by importing energy and different energy technology, it has become increasingly necessary to discuss the environmental impacts throughout the life cycle of those technologies and make better decisions. Developed in the late 1960s, Life Cycle Assessment (LCA) has become a wide-ranging tool used to determine impacts of products or systems over several environmental and resource issues. The LCA approach has become more prevalent in research, industry and policy with growing concern for the environment. Therefore, the aim of this paper is to introduce the use of LCA in the decision-making process while selecting an energy technology. In this way, more environmentally conscious decisions will be made as LCAs can provide a better basis for this process.

Queensland Digital Health Clinical Charter: a clinical consensus statement on priorities for digital health in hospitals

2020 ◽  
Vol 44 (5) ◽  
pp. 661
Author(s):  
Clair Sullivan ◽  
Andrew Staib ◽  
Keith McNeil ◽  
David Rosengren ◽  
Ian Johnson
Keyword(s):  
Decision Making ◽  
Digital Health ◽  
Digital Technologies ◽  
Executive Leadership ◽  
Digital Transformation ◽  
Decision Making Process ◽  
Health Technologies ◽  
Clinical Community ◽  
Expected Benefits ◽  
High Level

Digital transformation of Australian hospitals is occurring rapidly. Although the clinical community has had limited ability to influence high-level decision making and investments into digital health technologies, as these technologies increasingly transform the way patients are cared for, the clinical community must influence the digital health agenda and be an integral part of the decision-making process. This case study details the process and lessons learnt during the development of the state-wide consensus statement detailing the clinical requirements for digital health initiatives to form the Queensland Digital Health Clinical Charter. To the best of our knowledge, Queensland is the first Australian jurisdiction to create a Digital Clinical Charter to be specifically referenced in the investment in and governance of digital health in hospitals. By developing this clinical charter for digital health, and in articulating the needs of clinicians, a clinical framework will be added to both the decision-making process around the investments in digital health and the definition and realisation of the expected benefits from these sizable investments. What is known about the topic? Digital transformation of healthcare is occurring rapidly. The clinical community has had limited ability to influence high-level decision making and investments into these digital health technologies. Tension currently exists between the clinical community who must use the new digital technologies and the technical groups that govern the introduction of the new technologies. This tension can be manifest as clinicians refusing to adopt new systems, safety concerns and an inability to reach consensus on direction. There are few peer reviewed publications addressing this tension between the clinical community and technical providers. What does this paper add? This paper is the first attempt to create a list of clinical requirements for digital transformation that crosses professional streams and is endorsed by the state-wide executive leadership team to inform the acquisition and governance of digital health technologies. What are the implications for practitioners? Clinicians can feel excluded and marginalised during the decision-making process for new digital technologies, despite the fact that they are often using these technologies to deliver hands-on care to patients. This charter clearly articulates the requirements of clinicians for digital transformation and has been endorsed by the executive leadership team of Queensland Health. The charter adds a clinical framework to be referenced during the decision-making process around the investments in digital health, and the definition and realisation of the expected benefits from these sizable investments. As the digital landscape in public hospitals evolves, clinicians are becoming increasingly reliant upon digital technologies. It is critical that clinicians have a strong effect on technology acquisition and governance to maximise the quality and efficiency of the care they provide.

scholarly journals Interpretation as luxury: Heart patients living with data doubt, hope, and anxiety

2020 ◽  
Vol 7 (1) ◽  
pp. 205395172092443 ◽  
Author(s):  
Stine Lomborg ◽  
Henriette Langstrup ◽  
Tariq Osman Andersen
Keyword(s):  
Ethical Dilemmas ◽  
Digital Health ◽  
Data Interpretation ◽  
Personal Health ◽  
Health Technologies ◽  
Heart Patients ◽  
The Individual ◽  
Consumer Devices ◽  
And Behavior ◽  
The Relationship

Personal health technologies such as apps and wearables that generate health and behavior data close to the individual patient are envisioned to enable personalized healthcare - and self-care. And yet, they are consumer devices. Proponents of these devices presuppose that measuring will be helpful, and that data will be meaningful. However, a growing body of research suggests that self-tracking data does not necessarily make sense to users. Drawing together data studies and digital health research, we aim to further research on data ambivalence, a term we use to refer to the ambiguities and uncertainties people experience when interpreting their own data, as well as the critical obligation towards cultivating ethically sound uses and responses to such data in context. We develop the relationship between data, interpretation, and context as a central theoretical and practical problem in the datafication of healthcare. We then show how interpretation and context matter for data ambivalence through an empirical study of heart patients with an implanted advanced pacemaker who were offered a Fitbit wristband for self-tracking as part of a research project. We argue that the hope, anxiety, and doubt connected to the promise and accuracy of data are tempered by the context and purpose of self-tracking, and by individual circumstances. Finally, we link the findings on context-sensitivity in data interpretation to questions about response-ability in cloud-based care infrastructures. We discuss the ethical dilemmas associated with the use of commercial wellness-technologies in healthcare, and with researching such emerging practices.

Understanding Decision Making in the Adoption of Digital Health Technology: The Role of Behavioural Economics’ Prospect Theory (Preprint)

2021 ◽  
Author(s):  
Waqas Ullah Khan ◽  
Aviv Shachak ◽  
Emily Seto
Keyword(s):  
Decision Making ◽  
Prospect Theory ◽  
Digital Health ◽  
Health Technology ◽  
Behavioural Economics ◽  
Individual Level ◽  
Health Technologies ◽  
Research Article ◽  
The Individual

UNSTRUCTURED The decision to accept or reject new digital health technologies remains an ongoing discussion. Over the past few decades, interest in understanding the choice to adopt technology has led to the development of numerous theories and models. In 1979, however, psychologists Kahneman and Tversky published their seminal research article that has pioneered the field of behavioural economics. They named their model the “prospect theory” and used it to explain decision making behaviours under conditions of risk and uncertainty as well as to provide an understanding of why individuals may make irrational or inconsistent decisions. Although the prospect theory has been used to explain decision making in economics, law, political science, and clinically at the individual level, its application to understanding choice in the adoption of digital health technology has not been explored.

Selecting digital health technologies for validation and piloting by healthcare providers: a decision-making perspective from ontario

2019 ◽  
Vol 35 (1) ◽  
pp. 1-4
Author(s):  
Amarjit Chahal ◽  
Abraham Rudnick
Keyword(s):  
Decision Making ◽  
Digital Health ◽  
Healthcare Providers ◽  
Healthcare Organizations ◽  
Health Technologies ◽  
Health Apps ◽  
Strategic Direction ◽  
Academic Hospitals ◽  
Health Related ◽  
Alternative Approaches

AbstractDigital health technologies (DHTs) such as health apps are rapidly emerging as a major disruptor of health care. Yet there is no well-established process of decision making for selecting DHTs that are worthy of investing resources in their validation to determine whether they are ready (safe, effective, and not too costly) for health related use. We report here on an Ontario-based initiative to support such decision making. Specifically, we developed a decision-making algorithm that uses approved criteria including the strategic direction of the health research institute and the hospital, and availability of resources. The Council of Academic Hospitals of Ontario has adapted our approach for other hospitals. We hope that other healthcare organizations, in and beyond Ontario, will consider this and alternative approaches, and that research will be conducted to evaluate such approaches.

scholarly journals Stakeholder perspectives and requirements to guide the development of digital technology for palliative cancer services: a multi-country, cross-sectional, qualitative study in Nigeria, Uganda and Zimbabwe

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kennedy Bashan Nkhoma ◽  
Bassey Ebenso ◽  
David Akeju ◽  
Samuel Adejoh ◽  
Michael Bennett ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Advanced Cancer ◽  
Digital Technology ◽  
Technology Use ◽  
Cancer Care ◽  
Digital Health ◽  
Digital Technologies ◽  
Cross Sectional ◽  
Improve Access

Abstract Introduction Coverage of palliative care in low and middle-income countries is very limited, and global projections suggest large increases in need. Novel approaches are needed to achieve the palliative care goals of Universal Health Coverage. This study aimed to identify stakeholders’ data and information needs and the role of digital technologies to improve access to and delivery of palliative care for people with advanced cancer in Nigeria, Uganda and Zimbabwe. Methods We conducted a multi-country cross-sectional qualitative study in sub-Saharan Africa. In-depth qualitative stakeholder interviews were conducted with N = 195 participants across Nigeria, Uganda and Zimbabwe (advanced cancer patients n = 62, informal caregivers n = 48, health care professionals n = 59, policymakers n = 26). Verbatim transcripts were subjected to deductive and inductive framework analysis to identify stakeholders needs and their preferences for digital technology in supporting the capture, transfer and use of patient-level data to improve delivery of palliative care. Results Our coding framework identified four main themes: i) acceptability of digital technology; ii) current context of technology use; iii) current vision for digital technology to support health and palliative care, and; iv) digital technologies for the generation, reporting and receipt of data. Digital heath is an acceptable approach, stakeholders support the use of secure data systems, and patients welcome improved communication with providers. There are varying preferences for how and when digital technologies should be utilised as part of palliative cancer care provision, including for increasing timely patient access to trained palliative care providers and the triaging of contact from patients. Conclusion We identified design and practical challenges to optimise potential for success in developing digital health approaches to improve access to and enhance the delivery of palliative cancer care in Nigeria, Uganda and Zimbabwe. Synthesis of findings identified 15 requirements to guide the development of digital health approaches that can support the attainment of global health palliative care policy goals.

scholarly journals Integration of eMental health technologies into traditional community-based interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Turmaine ◽  
C Picot Ngo ◽  
A Le Jeannic ◽  
J L Roelandt ◽  
K Chevreul ◽  
...  
Keyword(s):  
Mental Health ◽  
Digital Technology ◽  
Digital Health ◽  
Local Level ◽  
World Health ◽  
Local Network ◽  
Local Health ◽  
Community Based ◽  
Health Technologies ◽  
Health Programmes

Abstract Background Very little research has been conducted to appraise the merits of including municipalities and their local health providers in the promotion of digital health programmes. While more and more municipalities have locally implemented a health strategic plan and have focused on building local network of professionals, how do the latter react to the implementation of innovative e-mental health community-based programmes? Methods In 2018, 42 French municipalities volunteered to promote StopBlues, a digital health tool aimed at preventing mental distress and suicide. In each municipality, a local delegate was responsible for the promotion of the tool. Using observations, questionnaires and interviews with the delegates, we analysed how the promotion of StopBlues® was conducted in each setting. 2/3 of these municipalities started the promotion directly, and in 2019, a second wave of municipalities launched the promotion with a stronger support from the research team backed by the French World Health Organization Collaborating Centre for Research and Training in Mental Health (WHOCC). Results The use of digital technology in the implementation of a mental health programme received a mixed reception from the local health professionals because of its innovative aspect. 2/3 of the delegates declared that they were struggling to create a stronger network of local partners including private medical practioners. 63% of the respondents stated that their municipalities got involved in the programme for networking purposes. Conclusions Digital technologies have initiated a paradigm shift in the way community-based health programmes are set up but need to strengthen their territorial anchorage in order to be accepted and used at the local level. Key messages Digital technology can be a strong lever against health inequities but its effectiveness has to be studied carefully. Digital technolgy has to be implemented in local settings with the collaboration of local actors in order to be accepted and used.

scholarly journals Older Adults Engage With Personalized Digital Coaching Programs at Rates That Exceed Those of Younger Adults

2021 ◽  
Vol 3 ◽  
Author(s):  
Sarah A. Graham ◽  
Natalie Stein ◽  
Fjori Shemaj ◽  
OraLee H. Branch ◽  
Jason Paruthi ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Use ◽  
Chronic Conditions ◽  
Digital Health ◽  
Cost Effective ◽  
Health Programs ◽  
Care Providers ◽  
Younger Adults ◽  
Health Technologies ◽  
Healthcare Needs

Background: The US population is aging and has an expanding set of healthcare needs for the prevention and management of chronic conditions. Older adults contribute disproportionately to US healthcare costs, accounting for 34% of total healthcare expenditures in 2014 but only 15% of the population. Fully automated, digital health programs offer a scalable and cost-effective option to help manage chronic conditions. However, the literature on technology use suggests that older adults face barriers to the use of digital technologies that could limit their engagement with digital health programs. The objective of this study was to characterize the engagement of adults 65 years and older with a fully automated digital health platform called Lark Health and compare their engagement to that of adults aged 35–64 years.Methods: We analyzed data from 2,169 Lark platform users across four different coaching programs (diabetes prevention, diabetes care, hypertension care, and prevention) over a 12-month period. We characterized user engagement as participation in digital coaching conversations, meals logged, and device measurements. We compared engagement metrics between older and younger adults using nonparametric bivariate analyses.Main Results: Aggregate engagement across all users during the 12-month period included 1,623,178 coaching conversations, 588,436 meals logged, and 203,693 device measurements. We found that older adults were significantly more engaged with the digital platform than younger adults, evidenced by older adults participating in a larger median number of coaching conversations (514 vs. 428) and logging more meals (174 vs. 89) and device measurements (39 vs. 28) all p ≤ 0.01.Conclusions: Older adult users of a commercially available, fully digital health platform exhibited greater engagement than younger adults. These findings suggest that despite potential barriers, older adults readily adopted digital health technologies. Fully digital health programs may present a widely scalable and cost-effective alternative to traditional telehealth models that still require costly touchpoints with human care providers.

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