Clinical Integration of Digital Solutions in Health Care: An Overview of the Current Landscape of Digital Technologies in Cancer Care

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Shivank Garg ◽  
Noelle L. Williams ◽  
Andrew Ip ◽  
Adam P. Dicker
Keyword(s):  
Quality Of Life ◽  
Artificial Intelligence ◽  
Health Care ◽  
Data Collection ◽  
Patient Outcomes ◽  
Cancer Care ◽  
Digital Health ◽  
Health Technologies ◽  
Health Care Value

Digital health constitutes a merger of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to artificial intelligence, each associated with widely disparate interaction and data collection models. In this review, we focus on the landscape of the current integration of digital health technology in cancer care by subdividing digital health technologies into the following sections: connected devices, digital patient information collection, telehealth, and digital assistants. In these sections, we give an overview of the potential clinical impact of such technologies as they pertain to key domains, including patient education, patient outcomes, quality of life, and health care value. We performed a search of PubMed ( www.ncbi.nlm.nih.gov/pubmed ) and www.ClinicalTrials.gov for numerous terms related to digital health technologies, including digital health, connected devices, smart devices, wearables, activity trackers, connected sensors, remote monitoring, electronic surveys, electronic patient-reported outcomes, telehealth, telemedicine, artificial intelligence, chatbot, and digital assistants. The terms health care and cancer were appended to the previously mentioned terms to filter results for cancer-specific applications. From these results, studies were included that exemplified use of the various domains of digital health technologies in oncologic care. Digital health encompasses the integration of a vast array of technologies with health care, each associated with varied methods of data collection and information flow. Integration of these technologies into clinical practice has seen applications throughout the spectrum of care, including cancer screening, on-treatment patient management, acute post-treatment follow-up, and survivorship. Implementation of these systems may serve to reduce costs and workflow inefficiencies, as well as to improve overall health care value, patient outcomes, and quality of life.

scholarly journals Evidence-Based Integrative Health Care to Promote Quality of Life in Older Adults With Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 609-610
Author(s):  
Robin Majeski ◽  
Delia Chiaramonte
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Care ◽  
Cancer Care ◽  
Symptom Burden ◽  
Integrative Approach ◽  
Evidence Based ◽  
Cancer Symptoms ◽  
Integrative Health

Abstract Cancer disproportionately affects older adults and presents significant challenges to patients’ quality of life. Use of complementary medicine is increasing among older adults with cancer and these modalities have the potential for both benefit and harm. Thus, it is important that health care professionals are knowledgeable about the evidence-supported benefits and risks of complementary and integrative health approaches in the care of older adults with cancer. Integrative cancer care provides a comprehensive approach to reducing symptom burden in patients suffering with cancer symptoms and side effects of cancer treatment. Symptoms such as pain, fatigue, nausea, sleep disturbance, mood disorder, perceived stress, and reduced quality of life are common in this population.This session will discuss an evidence-based integrative approach to cancer care which incorporates both pharmacologic and non-pharmacologic modalities to decrease symptom burden, enhance patient well-being, and improve quality of life. Non-pharmacologic modalities used in the integrative approach to care will be described and relevant evidence for risks, benefits and indications will be presented. Case studies will be discussed to demonstrate the integration of these techniques into conventional western medical treatment plans for older adults with cancer. Diversity and inclusion issues relevant to integrative medicine for underserved cancer patients will be addressed, as well as recommendations for future research to expand access of underserved populations to evidence-supported integrative cancer care. A resource list will be provided to participants.

Accounting for digital innovations in healthcare

2021 ◽  
pp. 40-46
Author(s):  
L.V. Chkhutiashvili
Keyword(s):  
Quality Of Life ◽  
Regional Differences ◽  
Digital Health ◽  
Digital Technologies ◽  
Well Being ◽  
Quality Of Healthcare ◽  
State Policies ◽  
Health Technologies ◽  
Advanced Technologies

The article analyzes digital innovations and their reflection in accounting for healthcare institutions. The healthcare system should be modern, digitalized, and focused on a specific person. The use of digital technologies remains at a low level, and there are significant regional differences in the level of implementation of digital health technologies, which is a big problem. Special attention should be paid to the development of state policies that would ensure the development of advanced technologies in healthcare, in order to bring Russia among the leading countries in the digital economy in order to improve the quality of life and expand the opportunities for self-realization of each person, increase the well-being of the entire population, and therefore the quality of healthcare.

scholarly journals Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study (Preprint)

2019 ◽  
Author(s):  
Erin E Michalak ◽  
Emma Morton ◽  
Steven J Barnes ◽  
Rachelle Hole ◽  
Greg Murray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Mixed Methods ◽  
Chronic Disease ◽  
Knowledge Translation ◽  
Digital Health ◽  
Self Management ◽  
Web Based ◽  
Health Technologies

BACKGROUND Self-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms. OBJECTIVE The aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre. METHODS The project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points—preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention. RESULTS A total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos. CONCLUSIONS This study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.

scholarly journals Self-efficacy and quality of life after strokeİnme sonrası öz etkililik ve yaşam kalitesi

2017 ◽  
Vol 14 (2) ◽  
Author(s):  
Serpil Topçu ◽  
Sıdıka Oğuz
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Patient Outcomes ◽  
Health Care System ◽  
Self Efficacy ◽  
Treatment Process ◽  
Treatment Plan ◽  
Stroke Patients ◽  
The World

limitations in the world and Turkey. For this reason, Stroke symptoms can be very stressful for caregivers and it can be a burden of health care system. Positive patient outcomes can be achieved with proper management of the treatment process. Treatment plan according to stroke patients psychologic adaptations such as self-efficacy and patient ability to self-care activities. The aim of this study is to provide a context of relationship with self-efficacy, quality of life and stroke.  Özetİnme tüm dünyada ve ülkemizde sakatlıklara ve kısıtlılıklara neden olan ciddi bir sağlık sorunudur. Bu özelliği nedeni ile hasta, hasta ailesi, tıbbi personel ve sağlık sistemine ağır yükler getirmektedir. Tedavi sürecinin doğru yönetilmesi ile olumlu hasta çıktılarına ulaşmak mümkündür. Tedaviye yön vermek için, hastaların mevcut yapabilirlik düzeyinin analiz edilmesi, tedavi ve bakıma katılım için hazır oluş durumunun bilinmesi gereklidir.  Bu derlemede, inme hastalarının tedavi planını düzenlemede rehber olacağı düşünülen, yaşam kalitesi ve öz etkililik kavramları ve bu kavramların inme ile ilişkisinin tartışılması amaçlanmıştır.

Digital Therapeutics: Health Care Wired for the Future

2020 ◽  
Vol 35 (8) ◽  
pp. 338-344
Author(s):  
Joanne Kaldy
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Data Collection ◽  
Digital Health ◽  
Lifestyle Changes ◽  
Emergency Department Visits ◽  
Health Care Environment ◽  
Care Environment ◽  
Health Technologies ◽  
Share Data

Digital therapeutics (DTx)—treatment or therapy that uses digital health technologies to spur changes in patient behavior—increasingly are making their way into the health care environment. This evolution is especially apparent as health care moves to valuebased care, silos between settings are breaking down, and data collection/analysis and teamwork play key roles. These technologies, whether they are apps, software programs, or sensors, are helping patients adhere to treatments and lifestyle changes, set and meet viable care goals, and avoid costly emergency department visits and hospitalizations. At the same time, DTx are helping practitioners ensure the best possible outcomes; streamline costs; monitor patient progress; and receive, analyze, and share data.

Financial toxicity and cancer-related distress among melanoma survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9588-9588
Author(s):  
Joanne S Buzaglo ◽  
Melissa F Miller ◽  
Alexandra K Zaleta ◽  
Jamese Johnson ◽  
Niraj K. Gupta
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cancer Care ◽  
Financial Burden ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Financial Impact ◽  
Out Of Pocket Costs

9588 Background: Melanoma survivors are at risk for significant financial burden due to cancer care and out of pocket costs. We explored 1) the financial impact of melanoma and its relationship to cancer-related distress, and 2) survivors’ experiences discussing financial burden with their health care team. Methods: Of 110 melanoma survivors enrolled in the Cancer Support Community’s online Cancer Experience Registry, 56 completed questions about financial impact of cancer and cost of care communication. Participants rated concern (0 = not at all; 4 = very seriously) about 27 items encompassing psychological, emotional, physical and practical concerns; items were summed into a total distress score (mean = 33, SD = 21, range 0-88). Financial impact and overall distress were examined via regression analysis. Results: Participants were 71% female, 89% Caucasian, median age 54, and median time since diagnosis 2.5 years. Total annual income: 34% < $60K; 46% $60K+; 20% not reported. 24% spent $101-250/month on melanoma out of pocket costs; 20% spent $251-500; and 24% spent ≥$500. The top concern was health insurance/money worries (69% moderately to very seriously concerned). Due to medical costs, 57% depleted their savings, 20% borrowed against or used retirement money, 20% used pharmaceutical assistance programs, 13% skipped medicine dosages at least sometimes, and 17% postponed filling prescriptions. Only 28% reported that their health care team spoke to them about cost of care, and 28% were asked about financial distress; 42% desired financial assistance. Financial impact was associated with an increase in overall distress for those with income < $60K (p < .05; interaction p < 0.05). Conclusions: Substantial proportions of melanoma survivors experience financial burden that can impact quality of life, particularly lower income individuals. Although oncologists are encouraged to discuss treatment costs, most patients report they have not had these discussions with providers. These results support the development/evaluation of interventions to enhance doctor-patient communication, and financial counseling to minimize financial burden of melanoma and the risks it can confer for quality of life, course of cancer care, and health outcomes.

Measuring cost-effectiveness of secondary health care: Feasibility and potential utilization of results

2005 ◽  
Vol 21 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Pirjo Räsänen ◽  
Harri Sintonen ◽  
Olli-Pekka Ryynänen ◽  
Marja Blom ◽  
Virpi Semberg-Konttinen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cost Effectiveness ◽  
Data Collection ◽  
Treatment Effectiveness ◽  
Life Data ◽  
Secondary Health Care ◽  
Related Quality ◽  
Health Related

Objectives: Whether cost-effectiveness of secondary health care can be measured in a simple, yet commensurate way was studied.Methods: Approximately 4,900 patients' health-related quality of life scores before and after treatment were measured. Used were a combination of quality of life data with diagnostic and financial indicators routinely collected in the hospital.Results: Seventy percent of patients returned the first questionnaire and the informed written consent to participate. Of these patients, 80 percent also returned the second questionnaire sent out 3 to 12 months after treatment, depending on clinical specialty and diagnostic category. The routine of sending out questionnaires could be automated in such a way that data collection required only a limited amount of extra work. Patients were generally satisfied with the fact that the hospital was interested in their well-being also after treatment. No physician offered the chance to participate refused data collection in the patient group he or she was responsible for. The attitudes of the nursing staff were generally positive toward data collection, although it caused some extra work for some of them. The possibility of relating already routinely collected financial performance indicators with a relevant measure of treatment effectiveness, opened prospects for refined analysis of cost-effectiveness of secondary health care.Conclusions: Routine collection of health-related quality of life data as an indicator of treatment effectiveness is feasible, requires only a small amount of extra work, and is potentially very useful when combined with existing measures of hospital performance.

scholarly journals Biomedical Engineering in Nepal: Opportunities and Challenges

2021 ◽  
Vol 1 (1) ◽  
pp. 52-54
Author(s):  
Sambardhan Dabadi ◽  
Raju Raj Dhungel
Keyword(s):  
Quality Of Life ◽  
Artificial Intelligence ◽  
Health Care ◽  
Biomedical Engineering ◽  
Medical Science ◽  
Improve Health Care ◽  
Engineering Discipline ◽  
Improve Health ◽  
Science Professional

Biomedical engineering is the blend of engineering and medical science, professional with a combination of knowledge of various engineering discipline to improve health care and quality of life. While biomedical engineering formally came up as major course in 1950s, the course started in Nepal just a decade back with its importance being acknowledged and biomedical engineers have been recruited by various institutes. Accounting for artificial intelligence, robotic surgery, 3-d printing, which are believed to be the future of medical science, it is necessary to strengthen the biomedical engineering. This article aims to highlight the overview as well as opportunities and challenges of biomedical engineering in Nepal.

scholarly journals Pragmatic Randomized Trial Assessing the Impact of Digital Health Technology on Quality of Life in Patients With Congestive Heart Failure: Design and Rationale

2021 ◽  
Author(s):  
Angela M. Victoria-Castro ◽  
Melissa Martin ◽  
Yu Yamamoto ◽  
Tariq Ahmad ◽  
Tanima Arora ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Digital Health ◽  
Digital Technologies ◽  
Management Tool ◽  
Self Management ◽  
Health Technologies ◽  
The Impact

Heart failure is a complex syndrome that contributes significantly to mortality and morbidity in the Unites States. Self- management is an ACC/AHA-recommended management tool for chronic conditions, however, those with congestive heart failure have historically poor compliance, low health literacy, and comorbidities that lead to reduced adherence to therapies and lifestyle modifications. Digital health technologies have the potential to enhance care and improve self-management. This manuscript describes the rationale and challenges of the design and implementation of a pragmatic randomized controlled trial to evaluate the efficacy of three digital health technologies in the management of congestive heart failure. Leveraging the use of a fully electronic enrollment and consent platform, the trial will randomize 200 patients across heart failure clinics in the Yale New Haven Health system to receive either usual care or one of three distinct digital technologies designed to promote self-management and provide critical data to clinicians. Our primary outcome will measure the change in quality of life as assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ) at 3 months. Initial recruitment efforts have highlighted the large digital divide in our population of interest. Assessing not only clinical outcomes, but patient usability and ease of clinical integration of digital technologies will prove beneficial in determining the feasibility and success of the integration of such technologies into the healthcare system. Future learnings will illustrate strategies to improve patient engagement with, and integration of, digital health technologies to enhance the patient-clinician relationship.

scholarly journals Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study

10.2196/13493 ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. e13493 ◽  
Author(s):  
Erin E Michalak ◽  
Emma Morton ◽  
Steven J Barnes ◽  
Rachelle Hole ◽  
Greg Murray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Mixed Methods ◽  
Chronic Disease ◽  
Knowledge Translation ◽  
Digital Health ◽  
Self Management ◽  
Web Based ◽  
Health Technologies

Background Self-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms. Objective The aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre. Methods The project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points—preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention. Results A total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos. Conclusions This study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.

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