scholarly journals Exploratory attitude survey of homeless persons regarding telecare services in shelters providing mid- and long-term accommodation: The importance of trust

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261145
Author(s):  
Zsuzsa Győrffy ◽  
Sándor Békási ◽  
Bence Döbrössy ◽  
Virág Katalin Bognár ◽  
Nóra Radó ◽  
...  
Keyword(s):  
Underserved Populations ◽  
Reference Group ◽  
Digital Health ◽  
Homeless People ◽  
Healthcare Services ◽  
Homeless Persons ◽  
Homeless Shelters ◽  
Health Technologies ◽  
Vulnerable Patient

Background With the expansion of digital health, it is imperative to consider intervention techniques in order not to be the cause of even more social health inequalities in underserved populations struggling with chronic diseases. Telemedicine solutions for homeless persons might compensate for shortcomings in access to valuable health services in different settings. The main aim of our research was to examine the attitudes and openness of homeless persons regarding telecare on a Hungarian sample. Methods Quantitative survey among homeless people (n = 98) was completed in 4 shelters providing mid- and long-term accommodation in Budapest, Hungary. Attitudes regarding healthcare service accessibility and telecare were measured by a self-developed questionnaire of the research team. Telecare attitude comparison was made with data of a Hungarian weighted reference group of non-homeless persons recruited from 2 primary care units (n = 110). Results A significant fraction of homeless people with mid- or long-term residency in homeless shelters did not oppose the use of telecare via live online video consultation and there was no difference compared to the national reference group (averages of 3.09 vs. 3.15, respectively). Results of the homeless group indicate that those more satisfied with healthcare services, in general, manifest more openness to telecare. It is clearly demonstrated by the multivariate analysis that those participants in the homeless group who had problems getting health care in the last year definitely preferred in-person doctor-patient consultations. Conclusion Digital health technologies offer a potentially important new pathway for the prevention and treatment of chronic conditions among homeless persons. Based on the attitudes towards telecare, initiating an on-site telecare program for mid- and long-term residents of homeless shelters might enable better care continuity. Our results draw attention to the key factors including building trust in the implementation of such programs among underserved and other vulnerable patient groups.

OP06 Past Speculations Of Future Health Technologies: What Did They Predict?

2017 ◽  
Vol 33 (S1) ◽  
pp. 4-4
Author(s):  
Lucy Doos ◽  
Claire Packer ◽  
Derek Ward ◽  
Sue Simpson ◽  
Andrew Stevens
Keyword(s):  
Healthcare Services ◽  
Strategic Decision ◽  
Healthcare Provision ◽  
Future Health ◽  
Health Technologies ◽  
Health Related ◽  
Future Technologies ◽  
The Cost ◽  
Technology Type

INTRODUCTION:Rapid technological innovation is leading to new health technologies and interventions becoming available to healthcare markets at increasing speed; these often cost more than current alternatives and significantly affect the cost of healthcare services and delivery (1). Identifying future technologies supports service preparedness, long-term planning, and strategic decision making. The aim of this study was to describe and classify health technologies predicted in fifteen forecasting studies according to their type, purpose and clinical use, and relate these to the original purpose and timing of the forecasting studies.METHODS:This was a descriptive study of predicted healthcare technologies identified in fifteen forecasting studies included in a previously published systematic review (2). Outcomes related to (i) each forecast study including country, year, intent and forecasting methods used, and (ii) the predicted technology type, purpose, targeted clinical area and forecast timeframe.RESULTS:We identified 896 predicted health-related topics, of which 685 were health technologies. Of these, 19.1 percent were diagnostic or imaging tests and 14.3 percent devices or biomaterials; 38.1 percent were intended to treat or manage disease and 21.6 percent to diagnose or monitor disease. The most frequent targeted clinical areas were infectious diseases followed by cancer, circulatory and nervous system disorders. The mean timeframe for technology forecast was 11.6 years (Standard Deviation, SD = 6.6). The forecasting timeframe significantly differed by technology type (p = .002), the intent of the forecasting group (p < .0001), and the methods used (p < .0001).CONCLUSIONS:Our description and classification of predicted health-related technologies from prior forecasting studies provides an overview of the technological and clinical frontiers of innovation in health and healthcare provision.

Inequities in Healthcare Services caused by the Adoption of Digital Health Technologies: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Rui Yao ◽  
Wenli Zhang ◽  
Richard Evans ◽  
Guang Cao ◽  
Lining Shen
Keyword(s):  
Systematic Review ◽  
Influencing Factors ◽  
Digital Health ◽  
Health Inequities ◽  
Healthcare Services ◽  
The United States ◽  
Future Research ◽  
Unequal Distribution ◽  
Health Technologies ◽  
Starting Point

BACKGROUND Digital health technologies are rapidly adapting to healthcare contexts to provide improved medical services to citizens. However, contrary to expectations, their rapid adoption appears to have led to health inequities. OBJECTIVE The aim of this study is to systematically review the inequities of healthcare services brought about by the adoption of digital health technologies. The influencing factors of inequities, as well as corresponding countermeasures to ensure the health equity between different groups of citizens, is also studied. METHODS A systematic review of literature published from 1990 to 2020 was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review process, and the electronic databases of Web of Science Core Collection, PubMed, and Scopus. Search, sorting, and data extraction processes were completed by two authors of the paper using Thomson Endnote. RESULTS In total, 1,895 studies were collected during the search process, of which 40 were identified for analysis. The earliest literature identified was published in 1993, with the number remaining below 2 for a long period of time. The number started to increase until 2016, with a peak thereafter being reached in 2020. The United States, the United Kingdom, and Norway ranked as the top three in terms of publication output. Health inequities caused by digital health technologies were mainly reflected by access and availability of digital technologies and the differences in healthcare outcomes. The factors that influenced inequities included: demographic factors (i.e., gender, age, race, region, economy, and education level), health conditions, and eHealth literacy. Finally, government agencies and medical institutions, digital health technology providers, and healthcare service receivers can all take actions to alleviate inequities, in future. CONCLUSIONS Findings provide a comprehensive starting point for future research allowing for further investigation into how digital health technologies may influence the unequal distribution of healthcare services. The interaction between individual subjective factors, as well as social support, and influencing factors should be included in future studies. In particular, access and availability to digital health technologies by vulnerable groups should be of paramount importance.

scholarly journals A research tool for measuring non-participation of older people in research on digital health

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Arianna Poli ◽  
Susanne Kelfve ◽  
Andreas Motel-Klingebiel
Keyword(s):  
Social Participation ◽  
Digital Health ◽  
Relevant Literature ◽  
Healthcare Services ◽  
Survey Questionnaire ◽  
Health Technologies ◽  
Underrepresented Groups ◽  
Self Selection ◽  
Use Of Technology ◽  
Digital Skills

Abstract Background Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research – deriving from the processes of non-recruitment of targeted individuals and self-selection – can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection. Methods Based on a review of the relevant literature, we designed an instrument – the NPART survey questionnaire – for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study. Results Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature. Conclusions The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.

scholarly journals Implementation of tele visit healthcare services triggered by the COVID-19 emergency: the Trentino Province experience

2021 ◽  
Author(s):  
Sara Testa ◽  
Oscar Mayora-Ibarra ◽  
Enrico Maria Piras ◽  
Olivia Balagna ◽  
Stefano Micocci ◽  
...  
Keyword(s):  
Healthcare System ◽  
Healthcare Service ◽  
Digital Health ◽  
Scale Up ◽  
Healthcare Services ◽  
Service Provisioning ◽  
User Perspective ◽  
Structural Integration ◽  
Local Healthcare

Abstract Aim In response to the SARS-CoV-2 emergency, the Competence Centre on digital health ‘TrentinoSalute4.0’ has developed TreC_Televisita, a tele visit solution that meets the needs of the Trentino healthcare system and maintains high-quality patient–doctor interactions while respecting social distancing. This paper highlights how ‘TreC_Televisita’ was integrated into the Trentino healthcare system and its potential to become a structural and durable solution for the future local healthcare service provisioning. Subject and methods This paper presents the multifactorial context that TreC_Televisita has faced for its implementation and the strategies adopted for its structural integration into the healthcare system. The analysis focuses on the main issues faced for the integration of the tele visits (e.g. privacy, payments) and how the context of TrentinoSalute4.0 permitted responding quickly to its implementation during the pandemic. It also describes how TreC_Televisita fits into the healthcare continuum from the organisational and technological standpoint, the end-user perspective and the barriers that could hamper the solution scalability. Results TreC_Televisita has demonstrated to be a technological solution that can be contextualised for different clinical domains beyond SARS-CoV-2. Moreover, it has shown its potential to scale up the solution beyond the COVID-19 emergency to the whole healthcare provisioning system in the long term. Conclusion Being a positive experience in the first months of its implementation, the long-term goal is to transform TreC_Televisita into a structural pillar of the Trentino healthcare system, setting the bases for a sustainable, win–win situation for all the stakeholders involved in healthcare service provisioning.

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

scholarly journals The Future of Long-Term Monitoring Following Catheter and Surgical Intervention for Atrial Fibrillation

2020 ◽  
Author(s):  
Graham Lohrmann ◽  
Rod Passman
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Decision Making ◽  
Digital Health ◽  
Clinical Decision ◽  
Monitoring Methods ◽  
Post Intervention ◽  
Surgical Ablation ◽  
Health Technologies ◽  
The Impact

Monitoring following catheter or surgical ablation for atrial fibrillation (AF) is an essential tool used to assess outcomes for research purposes and help guide clinical decision making. The most commonly used methods to monitor for post-intervention AF include a variety of ambulatory external electrocardiogram (ECG) monitors, cardiac implantable electronic devices (CIED), and more recently, direct to consumer digital health technologies. The traditional metric of ablation success, recurrence > 30 seconds at 1 year, is below the detection capabilities of almost all monitoring techniques yet still undervalues the efficacy of AF interventions. Measures of AF burden reduction and duration give a more complete assessment of the impact of AF surgeries and ablation. As it is increasingly being recognized that AF burden and duration is related to stroke risk, long-term, inexpensive, non-invasive monitoring methods are needed. Smart phones and watches with AF-detecting capabilities, which are increasingly being used by the majority of US adults, have emerged as viable options to achieve this goal, shifting the paradigm of AF monitoring to a more patient centered approach.

scholarly journals Building Better Clinical Relationships With Patients: An Argument for Digital Health Solutions With Black Men

2019 ◽  
Vol 12 ◽  
pp. 117863291983431
Author(s):  
Ledric D Sherman ◽  
Stuart W Grande
Keyword(s):  
Black Men ◽  
Information Exchange ◽  
Care Delivery ◽  
Digital Health ◽  
Rapid Evolution ◽  
Patient Centered ◽  
Health Technologies ◽  
Centered Care ◽  
The Impact

There is a rapid evolution of care delivery taking place across the globe in response to an explosion of novel health technologies. Growing in parallel to this expansion is the anticipation of mHealth technologies to drive patient-centered care into the future. Despite this hope, continuing reports of health inequities and lived experiences of substandard care fill national, state, and community health reports. The impact of these inequities is particularly pernicious on Black men and their long-term health status. As decades of robust evidence substantiates needed interventions, current progress is not seeing expected gains. In this commentary, we argue that at the heart of these inequities are issues of access, health literacy, institutional racism, and growing social distance between clinicians and Black men. To address these inequities, we suggest that digital interventions, designed to support decision-making, information exchange, and shared accountability have the best hope to overcome current inequities by promoting authentic relationships that ultimately drive better communication between Black men and their clinicians.

scholarly journals Designing the optimal digital health intervention for orthopedic patients: a qualitative exploration of digital technology design and functionality for patient use before and after elective surgery. (Preprint)

2020 ◽  
Author(s):  
Anna Robinson ◽  
Robert D Slight ◽  
Andrew K Husband ◽  
Sarah P Slight
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Digital Health ◽  
Digital Technologies ◽  
Patient Perspectives ◽  
Health Technologies ◽  
Surgical Success ◽  
Orthopaedic Patients ◽  
Behaviour Changes

BACKGROUND Health behaviour changes made by patients during the perioperative period can impact on the outcomes and success of elective surgeries. However, there remains a limited understanding of how best to support patients during this time, particularly through the use of digital health interventions. Recognizing and understanding the potential unmet needs of elective orthopaedic surgery patients is central to motivating healthier behaviour change, improving recovery and optimizing overall surgical success in the short- and long-term. OBJECTIVE This qualitative investigation explores patient perspectives on the key technology features that would help support them to change their lifestyle behaviours during the pre- and post-operative periods, and that could potentially maintain long-term healthy lifestyles following recovery. METHODS Semi-structured interviews with pre- and post-operative elective orthopaedic patients were conducted between May and June 2020, via telephone and video call-based software. Patient perspectives of using digital technologies to complement current surgical care and support with lifestyle behaviour change were discussed. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data, with NVivo (version 12) software facilitating data management. Ethical approval was obtained from the NHS Health Research Authority. RESULTS Eighteen participants were interviewed. Four themes were developed from the data regarding the design and functionality of digital technologies to best support the elective perioperative journey. These center around an intervention’s ability to: 1) deliver both general and specific surgical advice in a timely manner, 2) direct a descriptive and structured recovery, 3) enable customizable, patient-controlled settings, and 4) incorporate interactive, user-centered features. Pre-operative initiation of interventions, and post-operative continuation, were sought after by this cohort. Interventions designed with personalized milestones for patients were found to better guide through a structured recovery. Individualised tailoring of preparatory and recovery information was desired by patients with previously high levels of physical activity prior to surgery. Use of apps with personalized progression-based exercises further encouraged physical recovery; game-like rewards and incentives were regarded as motivational for making and sustaining health behaviour change. In-built video calling and messaging features offered connectivity with peers and clinicians for supported care delivery. CONCLUSIONS Specific intervention design and functionality features can provide better, structured support for elective orthopaedic patients across the whole perioperative journey, and beyond. This work provides much needed evidence relating to the optimal design and timing of digital interventions for elective orthopaedic surgical patients. Findings from this study suggest a desire for personalized perioperative care, in turn, supporting patients to make health behaviour changes to optimize surgical success. These findings should be used to influence future co-design projects to enable the design and implementation of patient-focused, tailored and targeted digital health technologies within modern healthcare settings.

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