Understanding digital health ecosystem from Australian citizens’ perspective: A scoping review

Background Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. Materials and methods A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. Results Of 3811 articles, 98 articles met the inclusion criteria with research-based articles–as opposed to review articles or white papers– comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were “consumer/user”, “health care”, “technology”, “use and usability”, “data and information”. These elements were further found to be associated with 127 subcategories. Conclusions This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens’ perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens’ experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.

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Opportunities and Challenges Surrounding the Use of Data From Wearable Sensor Devices in Health Care: Qualitative Interview Study (Preprint)

10.2196/preprints.19542 ◽

2020 ◽

Author(s):

Ijeoma Azodo ◽

Robin Williams ◽

Aziz Sheikh ◽

Kathrin Cresswell

Keyword(s):

Health Care ◽

Digital Health ◽

Wearable Sensors ◽

Unintended Consequences ◽

Wearable Sensor ◽

Use Of Data ◽

Qualitative Interview Study ◽

Sensor Devices ◽

Care Technology ◽

International Experts

BACKGROUND Wearable sensors connected via networked devices have the potential to generate data that may help to automate processes of care, engage patients, and increase health care efficiency. The evidence of effectiveness of such technologies is, however, nascent and little is known about unintended consequences. OBJECTIVE Our objective was to explore the opportunities and challenges surrounding the use of data from wearable sensor devices in health care. METHODS We conducted a qualitative, theoretically informed, interview-based study to purposefully sample international experts in health care, technology, business, innovation, and social sciences, drawing on sociotechnical systems theory. We used in-depth interviews to capture perspectives on development, design, and use of data from wearable sensor devices in health care, and employed thematic analysis of interview transcripts with NVivo to facilitate coding. RESULTS We interviewed 16 experts. Although the use of data from wearable sensor devices in health and care has significant potential in improving patient engagement, there are a number of issues that stakeholders need to negotiate to realize these benefits. These issues include the current gap between data created and meaningful interpretation in health and care contexts, integration of data into health care professional decision making, negotiation of blurring lines between consumer and medical care, and pervasive monitoring of health across previously disconnected contexts. CONCLUSIONS Stakeholders need to actively negotiate existing challenges to realize the integration of data from wearable sensor devices into electronic health records. Viewing wearables as active parts of a connected digital health and care infrastructure, in which various business, personal, professional, and health system interests align, may help to achieve this.

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ESRC Review

The Oxford Handbook of Digital Technology and Society ◽

10.1093/oxfordhb/9780190932596.013.3 ◽

2020 ◽

pp. 55-78

Author(s):

Simeon J. Yates ◽

Leanne Townsend ◽

Monica Whitty ◽

Ronald E. Rice ◽

Elinor Carmi

Keyword(s):

Health Care ◽

Technology Use ◽

Rapid Change ◽

Well Being ◽

Future Research ◽

Main Question ◽

Qualitative Approaches ◽

Cross Platform ◽

Care Technology ◽

Health And Well Being

This chapter describes the analyses and results for the ESRC Domain of Health and Well-Being, guided by a three-part main question: “whether technology makes us healthier, better educated, and more productive.” It first provides an initial overview of the major insights from the literature review and analysis, the Delphi surveys, and workshop discussions about the relevant range of the concepts of health and well-being in a digital age. The resulting focus is initially mostly about the technology but later on users, health, and research. Eight main topics emerged, including health care, measures and measurement, mobile and smartphone devices, social support, and weight loss. The analyses also highlighted theory, methods, and approaches in the literature, showing a relatively even distribution of deductive–inductive approaches and quantitative–qualitative approaches, using several well-known theories from psychology (e.g., theories of behavior change) and sociology (social networks). The review provides examples of literature from the project’s study period that illustrate these topics. The chapter concludes with a discussion of future research directions (e.g., cross-platform or holistic assessments examining the effects of broad, everyday digital technology use on health and well-being) and research challenges (e.g., methods, rapid change in health care technology, big data for health, and linking of personal and clinical health data with well-being outcomes).

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Procurement of innovation terminology usage in health care: A scoping review protocol

10.1101/2020.01.17.19015107 ◽

2020 ◽

Author(s):

Margaret R. Andrews ◽

Romualdo Ramos ◽

Martina Ahlberg ◽

Jan A. Hazelzet ◽

Erik M. van Raaij ◽

...

Keyword(s):

Health Care ◽

Scoping Review ◽

New Technologies ◽

Scientific Literature ◽

Digital Health ◽

Supply And Demand ◽

Grey Literature ◽

Health Care Settings ◽

Health Technologies ◽

Policy Tool

AbstractBackgroundAlthough procurement of innovation is an established policy tool used to stimulate collaboration between supply- and demand-side entities during the development of new technologies, there is little scientific literature describing the process as applied in health care settings. Furthermore, what literature exists contains inconsistencies of terms, definitions, and/or concepts related to procurement of innovation. This protocol details our process for a systematic scoping review to describe the current scope of literature and to provide terminology clarification.MethodsA search strategy will be used to search PubMed, EMBASE [OVID], CINAHL [EBSCO], PsycINFO [ProQUEST], ABI/INFORM, ISI Web of Knowledge, EBSCO, JSTOR, the Cochrane Database of Systematic Reviews, and Google Scholar; grey literature, non-scientific reports, policy documents and expert recommendations will also be considered as additional sources for texts. Two researchers will screen titles and abstracts for inclusion/exclusion criteria, followed by full texts. We will extract the following data, if applicable: title, authors, date, author affiliations, country, journal/publication characteristics, setting, aims/purpose, methodology, sample characteristics, assessment/evaluation tools, outcome parameters, key findings, relevance, and terminology usage/definitions. Results will be presented narratively and visually.DiscussionThis paper describes the steps of our proposed systematic scoping review to identify and analyse scientific and non-scientific literature related to procurement of innovation and/or innovation of procurement in health care settings, with a particular focus on digital health technologies. Results are intended to demonstrate the current scope of literature, to provide clarity in language and therefore to serve as a first step for further research in this growing field.

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Using the concept of hubots to understand the work entailed in using digital technologies in healthcare

Journal of Health Organization and Management ◽

10.1108/jhom-12-2016-0231 ◽

2017 ◽

Vol 31 (5) ◽

pp. 556-566 ◽

Cited By ~ 1

Author(s):

Catherine Pope ◽

Joanne Turnbull

Keyword(s):

Health Care ◽

Digital Health ◽

Digital Technologies ◽

Urgent Care ◽

Structured Interviews ◽

Content Type ◽

Mixed Methods Case Study ◽

Care Services ◽

Ethnographic Studies ◽

Care Technology

Purpose The purpose of this paper is to explore the human work entailed in the deployment of digital health care technology. It draws on imagined configurations of computers and machines in fiction and social science to think about the relationship between technology and people, and why this makes implementation of digital technology so difficult. The term hubots is employed as a metaphorical device to examine how machines and humans come together to do the work of healthcare. Design/methodology/approach This paper uses the fictional depiction of hubots to reconceptualise the deployment of a particular technology – a computer decision support system (CDSS) used in emergency and urgent care services. Data from two ethnographic studies are reanalysed to explore the deployment of digital technologies in health services. These studies used comparative mixed-methods case study approaches to examine the use of the CDSS in eight different English NHS settings. The data include approximately 900 hours of observation, with 64 semi-structured interviews, 47 focus groups, and surveys of some 700 staff in call centres and urgent care centres. The paper reanalyses these data, deductively, using the metaphor of the hubot as an analytical device. Findings This paper focuses on the interconnected but paradoxical features of both the fictional hubots and the CDSS. Health care call handling using a CDSS has created a new occupation, and enabled the substitution of some clinical labour. However, at the same time, the introduction of the technology has created additional work. There are more tasks, both physical and emotional, and more training activity is required. Thus, the labour has been intensified. Practical implications This paper implies that if we want to realise the promise of digital health care technologies, we need to understand that these technologies substitute for and intensify labour. Originality/value This is a novel analysis using a metaphor drawn from fiction. This allows the authors to recognise the human effort required to implement digital technologies.

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What evidence exists on the effectiveness of the techniques and management approaches used to improve the productivity of field-grown tomatoes under conditions of water-, nitrogen- and/or phosphorus-deficit? A systematic map

Environmental Evidence ◽

10.1186/s13750-021-00229-9 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Fanny Tran ◽

Jonathan E. Holland ◽

Nora Quesada ◽

Mark Young ◽

Damian Bienkowski ◽

...

Keyword(s):

Research Question ◽

Grey Literature ◽

Relevant Literature ◽

Management Strategies ◽

The United States ◽

Systematic Map ◽

Eligibility Criteria ◽

Tomato Yield ◽

Geographical Regions ◽

Management Approaches

Abstract Background Agriculture is facing an unprecedented challenge in having to reduce its environmental footprint whilst ensuring food security to an ever-growing global population. Towards this end, several strategies have been investigated and implemented to help maintain or improve crop yield under reduced water and/or nutrient provision for key commercial commodities such as tomatoes. Despite the high commercial, nutritional, and food-cultural value, there is no synthesis of evidence regarding yield maintenance of tomato (as a model crop) under resource-deficit. This systematic map therefore provides an overview of the evidence that exists on the effectiveness of techniques and management approaches aimed at improving the productivity of field-grown tomatoes under conditions of water-, nitrogen- (N) and/or phosphorus (P)-deficit. Methods Following the published map protocol, systematic searches of peer reviewed- and grey-literature were conducted using research publication databases, and specialist websites. A total of 14,377 unique articles were identified as potentially relevant to our research question, of which 927 were screened at the full-text level. Of that subset, 291 articles met all the pre-defined eligibility criteria. Basic information and meta-data on the interventions reported were recorded for these articles and a systematic map was compiled with the extracted data. Results The articles included in the systematic map database were used to identify several significant points including: (1) from the year 2000, the number of articles investigating strategies to improve field-grown tomato yield under conditions of water and/or nutrient deficit follows an upward trend; (2) large evidence bases (> 50%) originated from the United States, India, and Italy; (3) most studies addressed water alone as a resource (49%), with only 18% of studies focussing on N and 4% on P alone. Only 4% of records assessed all three resources simultaneously; (4) most evidence (77%) aims to improve resource use-efficiency via either irrigation, fertilisation, or crop and soil management strategies; and (5) different geographical regions appear to focus on different groups of interventions. Conclusions This systematic map identifies a range of interventions that have been successfully implemented in fields to improve the yield of commercial tomatoes under conditions of water, N and/or P deficit. However, only half of the relevant literature reported evidence on more than one intervention, which highlights the need for more integrated approaches to assess multiple interventions to adapt to deficits of key-resources simultaneously. In addition, the use of ‘techno-chemical’, ‘breeding and genetic’ and ‘computational’ interventions are only reported in a small number of records (< 8% of the gathered evidence). Hence, these interventions may also be considered as subjects to prioritise in future funding strategies.

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Care of inflammatory bowel disease patients during coronavirus disease‐19 pandemic using digital health‐care technology

JGH Open ◽

10.1002/jgh3.12498 ◽

2021 ◽

Author(s):

Uday C Ghoshal ◽

Shikha Sahu ◽

Sugata N Biswas ◽

Prashant Singh ◽

Moni Chaudhary ◽

...

Keyword(s):

Health Care ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Digital Health ◽

Health Care Technology ◽

Inflammatory Bowel ◽

Care Technology

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Benefits of Digital Health Resources for Substance Use Concerns in Women: A Scoping Review (Preprint)

10.2196/preprints.25952 ◽

2020 ◽

Author(s):

Lena Quilty ◽

Branka Agic ◽

Michelle Coombs ◽

Betty-Lou Kristy ◽

Jill Shakespeare ◽

...

Keyword(s):

Substance Use ◽

Scoping Review ◽

Digital Health ◽

Grey Literature ◽

Health Resources ◽

Funding Agency ◽

Eligibility Criteria ◽

Quantitative Evidence ◽

Wide Range ◽

Mobile Interventions

BACKGROUND Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research demonstrates that these resources have promise, the available evidence for their benefit in women requires further investigation. OBJECTIVE The objective of the current investigation was to evaluate the evidence supporting the efficacy or effectiveness for online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma. METHODS This scoping review is based on an academic search in MEDLINE, APA PsycINFO, EMBASE, Cochrane Central, and CINAHL, as well as a grey literature search in U.S. and Canadian government and funding agency websites. Of the 4977 records identified, 355 remained following title and abstract screening. Of these, 121 met all eligibility criteria and were reviewed and synthesized. RESULTS The 121 records reflected 96 distinct studies, and 85 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Digital health resources evaluated included multi-session and brief session interventions, with a wide range of therapeutic elements. More intensive online and mobile interventions exhibited moderate to strong effects in the vast majority of studies, whereas brief interventions demonstrated smaller effect sizes at short-term follow-up periods. Most investigations did not assess gender identity, or conduct sex- or gender-based analyses. Only 10 investigations that included trauma were located. CONCLUSIONS Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence for efficacy or effectiveness of interventions in females or women specifically is weak.

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Comparison of financial support for family caregivers of people at the end of life across six countries: A descriptive study

Palliative Medicine ◽

10.1177/0269216319861925 ◽

2019 ◽

Vol 33 (9) ◽

pp. 1189-1211 ◽

Cited By ~ 3

Author(s):

Clare Gardiner ◽

Beth Taylor ◽

Jackie Robinson ◽

Merryn Gott

Keyword(s):

Health Care ◽

End Of Life ◽

Family Caregivers ◽

Financial Support ◽

Health Care Systems ◽

Financial Burden ◽

Grey Literature ◽

The United States ◽

Eligibility Criteria ◽

Care Systems

Background: Family caregivers of people at the end of life can face significant financial burden. While appropriate financial support can reduce the burden for family caregivers, little is known about the range and adequacy of financial support, welfare and benefits for family caregivers across countries with similarly developed health care systems. Aim: The aim is o identify and compare sources of financial support for family caregivers of people approaching the end of life, across six countries with similarly performing health care systems (Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States). Design: A survey of financial support, welfare and benefits for end of life family caregivers was completed by 99 palliative care experts from the six countries. Grey literature searches and academic database searches were also conducted. Comparative analyses of all data sources documented financial support within and between each country. Results: Some form of financial support for family caregivers is available in all six countries; however the type, extent and reach of support vary. Financial support is administered by multiple agencies, eligibility criteria for receiving support are numerous and complex, and there is considerable inequity in the provision of support. Conclusion: Numerous barriers exist to the receipt of financial support, welfare and benefits. We identified several areas of concern, including a lack of clarity around eligibility, inconsistent implementation, complexity in process and limited support for working carers. Nonetheless, there is significant potential for policymakers to learn from other countries’ experiences, particularly with regard to the scope and operationalisation of financial support.

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Opportunities and Challenges Surrounding the Use of Data From Wearable Sensor Devices in Health Care: Qualitative Interview Study

Journal of Medical Internet Research ◽

10.2196/19542 ◽

2020 ◽

Vol 22 (10) ◽

pp. e19542

Author(s):

Ijeoma Azodo ◽

Robin Williams ◽

Aziz Sheikh ◽

Kathrin Cresswell

Keyword(s):

Health Care ◽

Digital Health ◽

Wearable Sensors ◽

Unintended Consequences ◽

Wearable Sensor ◽

Use Of Data ◽

Qualitative Interview Study ◽

Sensor Devices ◽

Care Technology ◽

International Experts

Background Wearable sensors connected via networked devices have the potential to generate data that may help to automate processes of care, engage patients, and increase health care efficiency. The evidence of effectiveness of such technologies is, however, nascent and little is known about unintended consequences. Objective Our objective was to explore the opportunities and challenges surrounding the use of data from wearable sensor devices in health care. Methods We conducted a qualitative, theoretically informed, interview-based study to purposefully sample international experts in health care, technology, business, innovation, and social sciences, drawing on sociotechnical systems theory. We used in-depth interviews to capture perspectives on development, design, and use of data from wearable sensor devices in health care, and employed thematic analysis of interview transcripts with NVivo to facilitate coding. Results We interviewed 16 experts. Although the use of data from wearable sensor devices in health and care has significant potential in improving patient engagement, there are a number of issues that stakeholders need to negotiate to realize these benefits. These issues include the current gap between data created and meaningful interpretation in health and care contexts, integration of data into health care professional decision making, negotiation of blurring lines between consumer and medical care, and pervasive monitoring of health across previously disconnected contexts. Conclusions Stakeholders need to actively negotiate existing challenges to realize the integration of data from wearable sensor devices into electronic health records. Viewing wearables as active parts of a connected digital health and care infrastructure, in which various business, personal, professional, and health system interests align, may help to achieve this.

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Revealing the shape of knowledge using an intersectionality lens: results of a scoping review on the health and health care of ethnocultural minority older adults

Ageing and Society ◽

10.1017/s0144686x12000013 ◽

2012 ◽

Vol 33 (3) ◽

pp. 437-464 ◽

Cited By ~ 37

Author(s):

SHARON KOEHN ◽

SHEILA NEYSMITH ◽

KAREN KOBAYASHI ◽

HAMISH KHAMISA

Keyword(s):

Older Adults ◽

Health Care ◽

Scoping Review ◽

Health Care Access ◽

Minority Groups ◽

Health Care Systems ◽

South Asians ◽

Grey Literature ◽

Care Providers ◽

Eligibility Criteria

ABSTRACTThis paper uses an intersectionality theoretical lens to interrogate selected findings of a scoping review of published and grey literature on the health and health-care access of ethnocultural minority older adults. Our focus was on Canada and countries with similar immigrant populations and health-care systems. Approximately 3,300 source documents were reviewed covering the period 1980–2010: 816 met the eligibility criteria; 183 were Canadian. Summarised findings were presented to groups of older adults and care providers for critical review and discussion. Here we discuss the extent to which the literature accounts for the complexity of categories such as culture and ethnicity, recognises the compounding effects of multiple intersections of inequity that include social determinants of health as well as the specificities of immigration, and places the experience of those inequities within the context of systemic oppression. We found that Canada's two largest immigrant groups – Chinese and South Asians – had the highest representation in Canadian literature but, even for these groups, many topics remain unexplored and the heterogeneity within them is inadequately captured. Some qualitative literature, particularly in the health promotion and cultural competency domains, essentialises culture at the expense of other determinants and barriers, whereas the quantitative literature suffers from oversimplification of variables and their effects often due to the absence of proportionally representative data that captures the complexity of experience in minority groups.

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