scholarly journals A new hope for early psychosis care: the evolving landscape of digital care tools

2019 ◽  
Vol 214 (5) ◽  
pp. 269-272 ◽  
Author(s):  
John Torous ◽  
Jessica Woodyatt ◽  
Matcheri Keshavan ◽  
Laura M. Tully
Keyword(s):  
Predictive Models ◽  
Global Mental Health ◽  
Digital Health ◽  
Treatment Options ◽  
Health Technology ◽  
Early Interventions ◽  
Clinical Heterogeneity ◽  
Health Technologies ◽  
Early Course ◽  
Advance Care

SummaryImproving understanding of and outcomes for early-course psychosis (ECP) is a recognised global mental health priority. We argue digital health technologies can advance care for ECP by better accounting for clinical heterogeneity, offering better predictive models, increasing access to early interventions and enhancing existing treatment options.Declaration of interestL.M.T. owns shares in Safari Health Inc – a digital health technology company.

OP348 Assessing The Potential Value Of Wearable Digital Health Technologies In Chronic Kidney Disease Using Early Health Technology Assessment Methods

2021 ◽  
Vol 37 (S1) ◽  
pp. 15-16
Author(s):  
Vijay S. Gc ◽  
Andrea Manca ◽  
Alexander J. Casson ◽  
Steven Antrobus ◽  
Cynthia Iglesias
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Cost Effective ◽  
Health Technology ◽  
Self Management ◽  
Health Technologies ◽  
Early Health Technology Assessment ◽  
Early Health

IntroductionWearable digital health technologies (WDHTs) offer several solutions in terms of disease monitoring, management and delivery of specific interventions. In chronic conditions, WDHTs can be used to support individuals’ self-management efforts, potentially improving adherence to (and outcomes resulting from) interventions. Early health technology assessment (HTA) methods can inform considerations about the potential clinical and economic benefits of technology in the initial phases of the product's lifecycle, facilitating identification of those Research & Development (R&D) investments with the greatest potential stakeholders’ payoff. We report our experience of using early HTA methods to support R&D decisions relating to novel WDHT being designed to support self-management of chronic kidney disease (CKD).MethodsWe performed a literature review, focus-group interviews with patients, and qualitative interviews with the prototype development team to understand the relevant characteristics of WDHTs, quantify relevant clinical indications and existing technological constraints. An early economic evaluation was used to identify the key drivers of value for money, and a discrete choice experiment shed light onto patient preferences towards what key features the WDHT should have for the users to adopt it. Then a model-based cost-effectiveness analysis was undertaken incorporating headroom analysis, return on investment, one-way sensitivity analysis and scenario analyses using data from secondary sources.ResultsThe review of the literature, focus groups with CKD patients, and qualitative interviews with technology developers helped to understand relevant characteristics of WDHT and user preferences helped inform the next R&D iteration. Compared to the standard care, WDHT that support stage ≥3 CKD patients self-management at home by measuring blood pressure and monitor mobility has the potential to be cost-effective at conventional cost-effectiveness threshold levels. From the headroom analysis, novel WDHT can be priced up to GBP280 (EUR315, USD360) and still be cost-effective compared to standard home blood pressure monitoring.ConclusionsOur study provides valuable information for the further development of the WDHT, such as defining a go/no-go decision, as well as providing a template for performing early HTA of Digital Health Interventions.

Six Digital Health Technologies That Will Transform Diabetes

2021 ◽  
pp. 193229682110434
Author(s):  
Alexander N. Klonoff ◽  
Wei-An (Andy) Lee ◽  
Nicole Y. Xu ◽  
Kevin T. Nguyen ◽  
Ashley DuBord ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Digital Health ◽  
Health Technology ◽  
The United States ◽  
Digital Data ◽  
Sensor Data ◽  
Communication Tools ◽  
Health Technologies ◽  
The People ◽  
Key Questions

The digital health revolution is transforming the landscape of medicine through innovations in sensor data, software, and wireless communication tools. As one of the most prevalent chronic diseases in the United States, diabetes is particularly impactful as a model disease for which to apply innovation. As with any other newly developed technologies, there are three key questions to consider: 1) How can the technology benefit people with diabetes?, 2) What barriers must be overcome to further advance the technology?, and 3) How will the technology be applied in the future?. In this article, we highlight six areas of innovation that have the potential to reduce the burden of diabetes for individuals living with the condition and their families as well as provide measurable benefits for all stakeholders involved in diabetes care. The six technologies which have the potential to transform diabetes care are (i) telehealth, (ii) incorporation of diabetes digital data into the electronic health record, (iii) qualitative hypoglycemia alarms, (iv) artificial intelligence, (v) cybersecurity of diabetes devices, and (vi) diabetes registries. To be successful, a new digital health technology must be accessible and affordable. Furthermore, the people and communities that would most likely benefit from the technology must be willing to use the innovation in their management of diabetes.

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.

Application of a health technology assessment framework to digital health technologies that manage chronic disease: a systematic review

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Amy von Huben ◽  
Martin Howell ◽  
Joseph Carrello ◽  
Sarah Norris ◽  
Sally Wortley ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Digital Health ◽  
Investment Decisions ◽  
Health Technology ◽  
Cochrane Library ◽  
Primary Research ◽  
Health Technologies

Abstract Background As health services increasingly make investment decisions in digital health technologies (DHTs), a DHT-specific and comprehensive health technology assessment (HTA) process is crucial in assessing value-for-money. Research in DHTs is ever-increasing, but whether it covers the content required for HTA is unknown. Objectives To summarize current trends in primary research on DHTs that manage chronic disease at home, particularly the coverage of content recommended for DHT-specific and comprehensive HTA. Methods Medline, Embase, Econlit, CINAHL, and The Cochrane Library (1 January 2015 to 20 March 2020) were searched for primary research studies using keywords related to DHT and HTA domains. Studies were assessed for coverage of the most frequently recommended content to be considered in a nine domain DHT-specific HTA previously developed. Results A total of 178 DHT interventions were identified, predominantly randomized controlled trials targeting cardiovascular disease/diabetes in high- to middle-income countries. A coverage assessment of the cardiovascular and diabetes DHT studies (112) revealed less than half covered DHT-specific content in all but the health problem domain. Content common to all technologies but essential for DHTs was covered by more than half the studies in all domains except for the effectiveness and ethical analysis domains. Conclusions Although DHT research is increasing, it is not covering all the content recommended for a DHT-specific and comprehensive HTA. The inability to conduct such an HTA may lead to health services making suboptimal investment decisions. Measures to increase the quality of trial design and reporting are required in DHT primary research.

scholarly journals The Ethics of Emergent Health Technologies: Implications of the 21st Century Cures Act for Nursing

2020 ◽  
Vol 21 (4) ◽  
pp. 195-201
Author(s):  
Margaret Martin
Keyword(s):  
21St Century ◽  
Digital Health ◽  
Public Awareness ◽  
Health Technology ◽  
The United States ◽  
Practice Research ◽  
Health Technologies ◽  
Ethical Implications ◽  
Systems Research ◽  
21St Century Cures Act

The 21st Century Cures Act, passed in December 2016 by the United States Congress, is a public law aimed at accelerating the time it takes to get pharmaceutical drugs and medical devices into the market, in addition to shifting connected review processes from randomized controlled trials to real-world efficacy tests. As of December 2019, efforts are underway to introduce a “Cures Act 2.0” bill, with particular attention to the implementation of digital health within health systems. Research on the development of emergent health technologies is nascent; research examining health technology implications of 21st Century Cures Act for the health care workforce is nonexistent. This article fills a crucial gap in public awareness, discussing ethical implications of the 21st Century Cures Act and centering nursing. Nursing is a profession frequently acknowledged as practicing on “the front lines of care” and frequently responsible for the trialing of products in clinical settings. The article summarizes and evaluates key components of the 21st Century Cures Act related to health technology development. Discrete health technologies addressed are (a) breakthrough devices, (b) digital health software, and (c) combination products. It then connects these provisions to ethical considerations for nursing practice, research, and policy. The article concludes by discussing the relevance of emerging digital health technologies to the crafting of a “Cures 2.0” bill, with particular attention to this moment in light of digital care precedents set during the COVID-19 pandemic.

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 ◽  
Valuable Insight ◽  
Individual Level ◽  
Health Technologies ◽  
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. Herein, we discuss how the prospect theory can provide valuable insight on why healthcare patients/clients, technology companies, and policymakers may decide to accept or reject digital health technologies.

scholarly journals Utilizing Digital Health Technologies for Patient Education in Lifestyle Medicine

2019 ◽  
Vol 14 (2) ◽  
pp. 137-142
Author(s):  
Anne Kuwabara ◽  
Sharlene Su ◽  
Jeffrey Krauss
Keyword(s):  
Patient Education ◽  
Learning Styles ◽  
Health Information ◽  
Technology Development ◽  
Care Delivery ◽  
Digital Health ◽  
Health Technology ◽  
Sufficient Evidence ◽  
Lifestyle Medicine ◽  
Health Technologies

Technology has redefined the way patients and providers communicate and obtain health information. The realm of digital health encompasses a diverse set of technologies, including mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalized medicine. These technologies have begun to improve care delivery without the traditional constraints of distance, location, and time. A growing body of evidence supports the use of digital health technology for improving patient education and implementation of skills and behaviors integral to lifestyle medicine. Patient education can now be delivered in standard formats (eg, articles, written messages) as well a wide array of multimedia (video, audio, interactive games, etc), which may be more appropriate for certain topics and learning styles. In addition, patient engagement in their care plays an important role in improving health outcomes. Despite digital health technology development often outpacing its research, there is sufficient evidence to support the use of many current technologies in clinical practice. Digital health tools will continue to grow in their ability to cost-effectively monitor and encourage healthy behaviors at scale, and better methods of evaluation will likely increase clinician confidence in their use.

scholarly journals Social Representations of Digital Health Technology in different contexts: Why People Keep or Quit Using It?

2021 ◽  
Author(s):  
Géraldine Escriva-Boulley ◽  
Camille Bernetière ◽  
Marie Préau ◽  
Françoise Paquienseguy ◽  
Tanguy Leroy
Keyword(s):  
Intervention Studies ◽  
Social Representations ◽  
Digital Health ◽  
Well Being ◽  
The Elderly ◽  
Health Technology ◽  
Drop Out ◽  
Information Transparency ◽  
Health Technologies ◽  
Wide Range

Objectives: The use of digital health technologies (DHT) is increasingly ubiquitous in intervention studies aimed at reducing health risks or improving the management of chronic diseases such as cancer. However, although DHT clearly show promises for a variety of applications, one third of users quit using DHT less than six months after the purchase, which may limit their effectiveness. This study aims to identify social representations (SR) of DHT, and to highlight why individuals adopt or are reluctant to adopt DHT, as well as the reasons for their drop-out.Methods: Five focus groups were lead with 18 participants (Mage = 43.72 years, Women = 13) whose personal uses of DHT were heterogeneous and controlled. They completed three tasks designed to elicit a wide range of SR of DHT.Results: Results showed that individuals’ concerns about DHT were focused on four themes: 1) health versus well-being purposes, 2) price, 3) data protection and, 4) difficulties for the elderly. The main reason for adopting DHT was that their use met a need, an interest. Most participants made a fairly strong distinction between the DHT which promote health and those promoting wellbeing. Reasons for reluctance and drop-out were related to a lack of knowledge, information, transparency and mastery.Conclusions: These findings may help DHT designers to understand what kind of information are needed and relevant to users. This study also highlights users’ SR of DHT, as well as their expectations and fears which should be taken into account when implementing interventions.

scholarly journals Digital-Health Tourism Research-Methodology Coronavirus-Vaccination Trials: A Study Interpreting Geometa-Data Profiling to use Mobile-Health Technologies Nigeria

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Wan Rozaini Sheik Osman ◽  
◽  
Hapini Awang ◽  
Abdullahi Hassan Abdullahi Hassan ◽  
◽  
...  
Keyword(s):  
Learning Strategies ◽  
Mobile Health ◽  
Primary Healthcare ◽  
Research Methodology ◽  
Digital Health ◽  
Health Technology ◽  
Health Tourism ◽  
Health Technologies ◽  
Behavior Intention ◽  
Data Profiling

Digital-Health Tourism Innovation (DTI) worldwide is in its infancy due to the emergent of coronavirus (COVID-19) disease. With the growth of open geometa data, use of government electronic services including electronic health (e-health), electronic commerce (e-commerce) and mobile health (m-health), Artificial Intelligence (AI) and machine learning strategies. Health and primary healthcare sectors are currently adopting these innovations for socio-economic wellbeing. Digital-health (also termed as e-health) is part of digital tourism innovation. Adapting geometa data profiling to develop a digital-health tourism framework for Primary Healthcare Workers (PHWs) to use mobile health technologies in COVID-19 vaccination trials are the key challenges of this study. Nevertheless, digital health tourism skills have been launched in developing Nations that created thousands of jobs to protect digital tourism businesses from potential vulnerabilities. Despite the benefits of this novel innovation, its deployment and implementation have been treated by inadequate of ICT facilities, lack of geometa data pre-processing to remove noise, data integrity, insufficient of academic research fundings, and reliable research methodology beyond COVID-19 vaccination trials to highlight these aspects. Therefore, qualitative, and quantitative research methods using Precaution Adoption Model Process (PAMP) questionnaire are employed to enable new ways of pre-processing behavior intention factors items. Eight academic researchers who were conversant with digital health technology validated 28 behavior intention factors with average factor loading values of 50% to 75%. Pilot survey conducted among 700 respondents from March 18, 2020, to September 10, 2021, among them are undergraduate students that may use this technology for research purposes. Pre-processed geometa data have shown percentage frequency counts of internet access and other online services 8% to 95%, adapted training factors 49% to 92% and factor items 34% to 78.3% for hypothesis generation towards development of digital health tourism framework in finding explanation to COVID-19 economic challenges. Except behavior intention factors and factor items insights are known and mapped, mobile health technology design process may result in poor conclusions. Thus, patients recovered from COVID-19 infection can still be infected again.

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

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