Digital Health, COVID-19 Pandemic, and Cybersecurity Issues

Author(s):  
Lev R. Klebanov ◽  
◽  
Svetlana V. Polubinskaya ◽  

The article focuses on a wide range of cybersecurity issues related to the use of digital technologies in healthcare. Many countries are increasingly adopting digital innovations into their national health systems and therefore raise their cybersecurity risks. The number of cyberattacks on health care organizations is steadily increasing; and the COVID-19 pandemic, which has required more frequent use of digital technologies to address public health challenges, has also influenced the proliferation of criminal cyberattacks. The aim of the study was to describe the main types of criminal, mostly digital, risks for digital health and identify the most important ways to counteract them. The article includes an analysis of international and national regulatory documents, foreign scientific literature, reports of organizations dealing with cybersecurity issues. In preparing it, the authors used general and specific scientific methods including analysis, synthesis, formal and legal analysis, historical method, interdisciplinary research, and expert assessment. The authors conclude that the increasing use of digital technologies in health care, especially in the context of the COVID-19 pandemic, expands the number of targets for cybercriminals. Three main types of digital health criminal risks are identified: attacks on health care organizations, attacks on devices used for medical purposes, including those associated with the Internet of Medical Things, and the theft and disclosure of digitally stored confidential medical information. The latter group of acts is committed by both outsiders and employees of healthcare organizations. The vast majority of registered cybercrimes are profit motivated ones, and the most common cybercrime is extortion with the use of malicious software (ransomware). To counter criminal risks for digital health, the authors propose a set of actions divided into three groups such as legal, technical, and educational. According to the authors, international and national criminal law should immediately respond to digital criminal threats to healthcare systems, in particular by making relevant international agreements and by including the manner in which such crimes are committed into criminal laws as an aggravating circumstance. In addition, the authors note the formation of a special direction in cybersecurity research and practice - healthcare cybersecurity - which requires the development of an appropriate industry, with respective hardware, software, informational and educational products that would be aimed at eliminating and reducing the risks for digital health.

Author(s):  
Sharafat Hussain ◽  
Prof. Mohd. Abdul Azeem

Adoption of social media amongst health care organizations is thriving. Healthcare providers have begun to connect with patients via social media. While some healthcare organizations have taken the initiative, numerous others are attempting to comprehend this new medium of opportunity. These organizations are finding that social networking can be an effective way to monitor brand, connecting with patients, community, and patient education and acquiring new talent. This study is conducted to identify the purpose of using social media, concerns, policy and its implementation and the overall experience of healthcare organizations with social media. To collect first hand data, online questionnaire was sent via LinkedIn to 400 US healthcare organizations and representatives out of which 117 responded and were taken further for analsysis. The results of this study confirm the thriving adoption, increased opportunities and cautious use of social media by healthcare organizations. The potential benefits present outweigh the risk and concerns associated with it. Study concluded that social media presence will continue to grow into the future and the field of healthcare is no exception.


2021 ◽  
Author(s):  
Neta Kela ◽  
Eleanor Eytam ◽  
Adi Katz

UNSTRUCTURED The desire for healthcare organizations to reduce the cost of chronic care and to prevent disease from occurring to begin with, has coincided with the development of new technology that is revolutionizing digital health. Numerous health-oriented mobile phone applications (referred to as mHealth apps) have been developed and are available for download into smartphones. These mHealth apps serve a wide range of functions. There are apps that monitor data to treat or avoid chronic illness; apps for managing daily activities and diet; apps promoting healthy choices for people who want to maintain and improve their overall health, and many others. While it is generally recognized that mHealth apps have a significant potential for promoting public health, little research has been done to determine user preferences for such apps. Understanding what users want in their mHealth apps can help increase their acceptability and encourage healthy lifestyles. The research in this article tests the major product qualities of such apps, asking two key questions: Do users seek interaction with a live physician, or are they willing to rely on artificial intelligence to analyze data from their app? Which aspects of their app do they consider as having a positive instrumental, aesthetic, or symbolic value? Next, the research presented here tests how these judgments influence product preference. The contribution of this paper is its focus on user preferences which may help in the design of mHealth apps to better address peoples’ needs—thus encouraging a wide, frequent, and effective use of such tools which promote public health.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C You ◽  
V Lissillour ◽  
A Lefébure

Abstract Background The increase of life expectancy creates critical health needs that developed countries health systems have to deal with. They are also confronted to persistent health inequalities. A common vision of these issues may not be shared by the health care professionals, decision-makers and citizens. In the context of the launch of new public health laws in France, the French School of Public Health (EHESP) decided to offer a MOOC entitled “Public Health and Health System: transition and transformation” (2019). Objectives The MOOC intends to raise awareness and increase understanding of public health challenges. It is designed for a wide audience of professionals, decision-makers and citizens in the French speaking world. The content was designed by a multidisciplinary team of academics from the EHESP (N = 50) and a network of health professionals (N = 21). The 6 modules address major themes of the recent health policies, e.g. social and territorial inequalities in health, health care security, health pathways, innovation or health democracy. Results Over the course of 6 consecutive weeks, almost 7800 people have enrolled in this e-learning. They are provided with short teaching videos (109 capsules of 4-5’) and webinars, have access to a number of supplementary reading material and a variety of self-assessment. Active learning is enhanced via forum involving peers and teaching staff. The full course represents around 20 hours of teaching. So far, completion rate has attained 13% which compares well with usual rate for MOOCs. Participants include a wide range of professionals, students and citizens from 87 different countries (72% from France) and 50% had a master or higher degree. The overall satisfaction rate is 98%. Conclusions This MOOC attracted the attention of a wide and diverse audience regarding the major public health issues. Some public health agencies have expressed interest in implementing the MOOC into their professional development program of their staff. Key messages Health system reforms are constantly implemented to face new public health challenges. A multidisciplinary MOOC can help raise awareness and understanding of the issue being addressed by new policies.


2006 ◽  
Vol 41 (5) ◽  
pp. 470-476 ◽  
Author(s):  
Elizabeth A. Shlom ◽  
Sondra K. May

This continuing feature highlights the experiences of various health care organizations in implementing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Medication Management Standards and National Patient Safety Goals. Practical information on what worked and how organizations have been surveyed regarding the standards and goals will be provided along with updates on revisions and recommendations being established by JCAHO. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Medication Management Standards are guidelines for health care organizations to improve patient medication safety and quality of care. Medication Management Standard 7.10 states, “The hospital develops processes for managing high-risk or high-alert medications.” An institution's list of high-risk medications can be derived from published lists, retrospective review of hospital-specific incidents, and/or prospective evaluation as new drugs are added to the formulary. The hospital's policy will include the list of high-risk medications and the risk-reduction strategies that it is undertaking to reduce medication errors associated with them. One method of identifying risk-reduction strategies is to conduct a failure mode and effects analysis (FMEA). The process of conducting an FMEA is described and a list of risk-reduction strategies from two hospitals are provided.


Kybernetes ◽  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rocco Palumbo ◽  
Capolupo Nicola ◽  
Paola Adinolfi

PurposePromoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The digitization of health-care calls for a reframing of health literacy in the cyber-physical environment. The article systematizes current scientific knowledge about digital health literacy and investigates the role of health-care organizations in delivering health literate health-care services in a digital environment.Design/methodology/approachA literature review was accomplished. A targeted query to collect relevant scientific contributions was run on PubMed, Scopus and Web of Science. A narrative approach was undertaken to summarize the study findings and to envision avenues for further development in the field of digital health literacy.FindingsDigital health literacy has peculiar attributes as compared with health literacy. Patients may suffer from a lack of human touch when they access health services in the digital environment. This may impair their ability to collect health information and to appropriately use it to co-create value and to co-produce health promotion and risk prevention services. Health-care organizations should strive for increasing the patients’ ability to navigate the digital health-care environment and boosting the latter’s value co-creation capability.Practical implicationsTailored solutions should be designed to promote digital health literacy at the individual and organizational level. On the one hand, attention should be paid to the patients’ special digital information needs and to avoid flaws in their ability to contribute to health services’ co-production. On the other hand, health-care organizations should be involved in the design of user-friendly e-health solutions, which aim at engaging patients in value co-creation.Originality/valueThis contribution is a first attempt to systematize extant scientific knowledge in the field of digital health literacy specifically focused on the strategies and initiatives that health-care organizations may take to address the limited digital health literacy pandemic.


2020 ◽  
Author(s):  
Leah Taylor Kelley ◽  
Jamie Fujioka ◽  
Kyle Liang ◽  
Madeline Cooper ◽  
Trevor Jamieson ◽  
...  

BACKGROUND Health systems are increasingly looking toward the private sector to provide digital solutions to address health care demands. Innovation in digital health is largely driven by small- and medium-sized enterprises (SMEs), yet these companies experience significant barriers to entry, especially in public health systems. Complex and fragmented care models, alongside a myriad of relevant stakeholders (eg, purchasers, providers, and producers of health care products), make developing value propositions for digital solutions highly challenging. OBJECTIVE This study aims to identify areas for health system improvement to promote the integration of innovative digital health technologies developed by SMEs. METHODS This paper qualitatively analyzes a series of case studies to identify health system barriers faced by SMEs developing digital health technologies in Canada and proposed solutions to encourage a more innovative ecosystem. The Women’s College Hospital Institute for Health System Solutions and Virtual Care established a consultation program for SMEs to help them increase their innovation capacity and take their ideas to market. The consultation involved the SME filling out an onboarding form and review of this information by an expert advisory committee using guided considerations, leading to a recommendation report provided to the SME. This paper reports on the characteristics of 25 SMEs who completed the program and qualitatively analyzed their recommendation reports to identify common barriers to digital health innovation. RESULTS A total of 2 central themes were identified, each with 3 subthemes. First, a common barrier to system integration was the lack of formal evaluation, with SMEs having limited resources and opportunities to conduct such an evaluation. Second, the health system’s current structure does not create incentives for clinicians to use digital technologies, which threatens the sustainability of SMEs’ business models. SMEs faced significant challenges in engaging users and payers from the public system due to perverse economic incentives. Physicians are compensated by in-person visits, which actively works against the goals of many digital health solutions of keeping patients out of clinics and hospitals. CONCLUSIONS There is a significant disconnect between the economic incentives that drive clinical behaviors and the use of digital technologies that would benefit patients’ well-being. To encourage the use of digital health technologies, publicly funded health systems need to dedicate funding for the evaluation of digital solutions and streamlined pathways for clinical integration.


2018 ◽  
Author(s):  
Afua Adjekum ◽  
Alessandro Blasimme ◽  
Effy Vayena

BACKGROUND Information and communication technologies have long become prominent components of health systems. Rapid advances in digital technologies and data science over the last few years are predicted to have a vast impact on health care services, configuring a paradigm shift into what is now commonly referred to as digital health. Forecasted to curb rising health costs as well as to improve health system efficiency and safety, digital health success heavily relies on trust from professional end users, administrators, and patients. Yet, what counts as the building blocks of trust in digital health systems has so far remained underexplored. OBJECTIVE The objective of this study was to analyze what relevant stakeholders consider as enablers and impediments of trust in digital health. METHODS We performed a scoping review to map out trust in digital health. To identify relevant digital health studies, we searched 5 electronic databases. Using keywords and Medical Subject Headings, we targeted all relevant studies and set no boundaries for publication year to allow a broad range of studies to be identified. The studies were screened by 2 reviewers after which a predefined data extraction strategy was employed and relevant themes documented. RESULTS Overall, 278 qualitative, quantitative, mixed-methods, and intervention studies in English, published between 1998 and 2017 and conducted in 40 countries were included in this review. Patients and health care professionals were the two most prominent stakeholders of trust in digital health; a third—health administrators—was substantially less prominent. Our analysis identified cross-cutting personal, institutional, and technological elements of trust that broadly cluster into 16 enablers (altruism, fair data access, ease of use, self-efficacy, sociodemographic factors, recommendation by other users, usefulness, customizable design features, interoperability, privacy, initial face-to-face contact, guidelines for standardized use, stakeholder engagement, improved communication, decreased workloads, and service provider reputation) and 10 impediments (excessive costs, limited accessibility, sociodemographic factors, fear of data exploitation, insufficient training, defective technology, poor information quality, inadequate publicity, time-consuming, and service provider reputation) to trust in digital health. CONCLUSIONS Trust in digital health technologies and services depends on the interplay of a complex set of enablers and impediments. This study is a contribution to ongoing efforts to understand what determines trust in digital health according to different stakeholders. Therefore, it offers valuable points of reference for the implementation of innovative digital health services. Building on insights from this study, actionable metrics can be developed to assess the trustworthiness of digital technologies in health care.


10.2196/17475 ◽  
2021 ◽  
Vol 23 (8) ◽  
pp. e17475
Author(s):  
Konstantin Koshechkin ◽  
Georgy Lebedev ◽  
George Radzievsky ◽  
Ralf Seepold ◽  
Natividad Madrid Martinez

Background One of the most promising health care development areas is introducing telemedicine services and creating solutions based on blockchain technology. The study of systems combining both these domains indicates the ongoing expansion of digital technologies in this market segment. Objective This paper aims to review the feasibility of blockchain technology for telemedicine. Methods The authors identified relevant studies via systematic searches of databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The suitability of each for inclusion in this review was assessed independently. Owing to the lack of publications, available blockchain-based tokens were discovered via conventional web search engines (Google, Yahoo, and Yandex). Results Of the 40 discovered projects, only 18 met the selection criteria. The 5 most prevalent features of the available solutions (N=18) were medical data access (14/18, 78%), medical service processing (14/18, 78%), diagnostic support (10/18, 56%), payment transactions (10/18, 56%), and fundraising for telemedical instrument development (5/18, 28%). Conclusions These different features (eg, medical data access, medical service processing, epidemiology reporting, diagnostic support, and treatment support) allow us to discuss the possibilities for integration of blockchain technology into telemedicine and health care on different levels. In this area, a wide range of tasks can be identified that could be accomplished based on digital technologies using blockchains.


2020 ◽  
Author(s):  
Stuart McLennan ◽  
Leo Anthony Celi ◽  
Alena Buyx

UNSTRUCTURED The coronavirus disease (COVID-19) pandemic is very much a global health issue and requires collaborative, international health research efforts to address it. A valuable source of information for researchers is the large amount of digital health data that are continuously collected by electronic health record systems at health care organizations. The European Union’s General Data Protection Regulation (GDPR) will be the key legal framework with regard to using and sharing European digital health data for research purposes. However, concerns persist that the GDPR has made many organizations very risk-averse in terms of data sharing, even if the regulation permits such sharing. Health care organizations focusing on individual risk minimization threaten to undermine COVID-19 research efforts. In our opinion, there is an ethical obligation to use the research exemption clause of the GDPR during the COVID-19 pandemic to support global collaborative health research efforts. Solidarity is a European value, and here is a chance to exemplify it by using the GDPR regulatory framework in a way that does not hinder but actually fosters solidarity during the COVID-19 pandemic.


10.2196/21108 ◽  
2020 ◽  
Vol 7 (8) ◽  
pp. e21108 ◽  
Author(s):  
Katharine Smith ◽  
Edoardo Ostinelli ◽  
Orla Macdonald ◽  
Andrea Cipriani

Background The coronavirus disease (COVID-19) presents unique challenges in health care, including mental health care provision. Telepsychiatry can provide an alternative to face-to-face assessment and can also be used creatively with other technologies to enhance care, but clinicians and patients may feel underconfident about embracing this new way of working. Objective The aim of this paper is to produce an open-access, easy-to-consult, and reliable source of information and guidance about telepsychiatry and COVID-19 using an evidence-based approach. Methods We systematically searched existing English language guidelines and websites for information on telepsychiatry in the context of COVID-19 up to and including May 2020. We used broad search criteria and included pre–COVID-19 guidelines and other digital mental health topics where relevant. We summarized the data we extracted as answers to specific clinical questions. Results Findings from this study are presented as both a short practical checklist for clinicians and detailed textboxes with a full summary of all the guidelines. The summary textboxes are also available on an open-access webpage, which is regularly updated. These findings reflected the strong evidence base for the use of telepsychiatry and included guidelines for many of the common concerns expressed by clinicians about practical implementation, technology, information governance, and safety. Guidelines across countries differ significantly, with UK guidelines more conservative and focused on practical implementation and US guidelines more expansive and detailed. Guidelines on possible combinations with other digital technologies such as apps (eg, from the US Food and Drug Administration, the National Health Service Apps Library, and the National Institute for Health and Care Excellence) are less detailed. Several key areas were not represented. Although some special populations such as child and adolescent, and older adult, and cultural issues are specifically included, important populations such as learning disabilities, psychosis, personality disorder, and eating disorders, which may present particular challenges for telepsychiatry, are not. In addition, the initial consultation and follow-up sessions are not clearly distinguished. Finally, a hybrid model of care (combining telepsychiatry with other technologies and in-person care) is not explicitly covered by the existing guidelines. Conclusions We produced a comprehensive synthesis of guidance answering a wide range of clinical questions in telepsychiatry. This meets the urgent need for practical information for both clinicians and health care organizations who are rapidly adapting to the pandemic and implementing remote consultation. It reflects variations across countries and can be used as a basis for organizational change in the short- and long-term. Providing easily accessible guidance is a first step but will need cultural change to implement as clinicians start to view telepsychiatry not just as a replacement but as a parallel and complementary form of delivering therapy with its own advantages and benefits as well as restrictions. A combination or hybrid approach can be the most successful approach in the new world of mental health post–COVID-19, and guidance will need to expand to encompass the use of telepsychiatry in conjunction with other in-person and digital technologies, and its use across all psychiatric disorders, not just those who are the first to access and engage with remote treatment.


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