scholarly journals Mobile Health Technologies could enhance Public Private Mix for Tuberculosis care in Rural Southwestern Uganda: Qualitative Findings

2021 ◽  
Author(s):  
Wilson Tumuhimbise ◽  
Daniel Atwine ◽  
Fred Kaggwa ◽  
Angella Musiimenta
Keyword(s):  
Mobile Health ◽  
Mobile Apps ◽  
Text Messages ◽  
Public Hospitals ◽  
Future Research ◽  
Private Hospitals ◽  
Health Technologies ◽  
Private Healthcare ◽  
Public Private Mix ◽  
Tuberculosis Care

Abstract Background Despite some global progress in the implementation of the public-private mix for Tuberculosis care, the engagement of private healthcare providers remains wanting especially in high incidence countries such as Uganda. Although mobile health technologies are low-cost approaches that can enhance Tuberculosis care, there is a dearth of research about their application in fostering public-private mix. Objective To explore the potentials of mobile health technologies in fostering public-private mix for Tuberculosis care in Uganda. Methods This was a qualitative study design that involved in-depth interviews with 13 key informants (private healthcare workers) purposively selected between June and July 2020 due to their active involvement in Tuberculosis care from four private hospitals in Mbarara City. The interviews were transcribed and coded to identify key themes for analysis using content analysis. Results Mobile Health technologies (such as mobile apps, text messages) have the potential to map and link patients from private hospitals to the referral units, support patient medication adherence, notify and report Tuberculosis cases to the Ugandan Ministry of Health, and enhance patient care and monitoring. Conclusion Mobile Health technologies have the potential to revolutionize Tuberculosis care by establishing a centralized pathway for linking the referred patients from private hospitals to public hospitals. Future research should focus on assessing the utilization of mobile health technologies in enhancing access to referral units by presumptive Tuberculosis patients referred from private hospitals in low-resource settings.

Exclusion by Design: Lack of Information about Community Participation in COVID-19-related Mobile Apps and its Relationship to Digital Health Disparities (Preprint)

2021 ◽  
Author(s):  
Muhammed Yassin Idris ◽  
Maya Korin ◽  
Faven Araya ◽  
Sayeeda Chowdhury ◽  
Humberto Brown ◽  
...  
Keyword(s):  
Community Participation ◽  
Mobile Health ◽  
Medical Information ◽  
Mobile Apps ◽  
Digital Health ◽  
Community Based ◽  
Health Technologies ◽  
Community Needs ◽  
App Development ◽  
Communities Of Color

UNSTRUCTURED The rate and scale of transmission of COVID-19 overwhelmed healthcare systems worldwide, particularly in under-resourced communities of color that already faced a high prevalence of pre-existing health conditions. One way the health ecosystem has tried to address the pandemic is by creating mobile apps for telemedicine, dissemination of medical information, and disease tracking. As these new mobile health tools continue to be a primary format for healthcare, more attention needs to be given to their equitable distribution, usage, and accessibility. In this viewpoint collaboratively written by a community-based organization and a health app development research team, we present results of our systematic search and analysis of community engagement in mobile apps released between February and December 2020 to address the COVID-19 pandemic. We provide an overview of apps’ features and functionalities but could not find any publicly available information regarding whether these apps incorporated participation from communities of color disproportionately impacted by the pandemic. We argue that while mobile health technologies are a form of intellectual property, app developers should make public the steps taken to include community participation in app development. These steps could include community needs assessment, community feedback solicited and incorporated, and community participation in evaluation. These are factors that community-based organizations look for when assessing whether to promote digital health tools among the communities they serve. Transparency about the participation of community organizations in the process of app development would increase buy-in, trust, and usage of mobile health apps in communities where they are needed most.

scholarly journals Mobile Health Apps for Medical Emergencies: Systematic Review

10.2196/18513 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e18513
Author(s):  
Alejandro Plaza Roncero ◽  
Gonçalo Marques ◽  
Beatriz Sainz-De-Abajo ◽  
Francisco Martín-Rodríguez ◽  
Carlos del Pozo Vegas ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Mobile Apps ◽  
Current Status ◽  
Health Technologies ◽  
Health Apps ◽  
App Store ◽  
Mobile Health Apps ◽  
Medical Emergencies ◽  
Google Play

Background Mobile health apps are used to improve the quality of health care. These apps are changing the current scenario in health care, and their numbers are increasing. Objective We wanted to perform an analysis of the current status of mobile health technologies and apps for medical emergencies. We aimed to synthesize the existing body of knowledge to provide relevant insights for this topic. Moreover, we wanted to identify common threads and gaps to support new challenging, interesting, and relevant research directions. Methods We reviewed the main relevant papers and apps available in the literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used in this review. The search criteria were adopted using systematic methods to select papers and apps. On one hand, a bibliographic review was carried out in different search databases to collect papers related to each application in the health emergency field using defined criteria. On the other hand, a review of mobile apps in two virtual storage platforms (Google Play Store and Apple App Store) was carried out. The Google Play Store and Apple App Store are related to the Android and iOS operating systems, respectively. Results In the literature review, 28 papers in the field of medical emergency were included. These studies were collected and selected according to established criteria. Moreover, we proposed a taxonomy using six groups of applications. In total, 324 mobile apps were found, with 192 identified in the Google Play Store and 132 identified in the Apple App Store. Conclusions We found that all apps in the Google Play Store were free, and 73 apps in the Apple App Store were paid, with the price ranging from US $0.89 to US $5.99. Moreover, 39% (11/28) of the included studies were related to warning systems for emergency services and 21% (6/28) were associated with disaster management apps.

scholarly journals Archetypes of Gamification: Analysis of mHealth Apps

10.2196/19280 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e19280
Author(s):  
Manuel Schmidt-Kraepelin ◽  
Philipp A Toussaint ◽  
Scott Thiebes ◽  
Juho Hamari ◽  
Ali Sunyaev
Keyword(s):  
Best Practices ◽  
Health Behavior ◽  
Health Behaviors ◽  
Mobile Health ◽  
Positive Reinforcement ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Future Research ◽  
Research Approach ◽  
Health Related

Background Nowadays, numerous health-related mobile apps implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors. Objective We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile apps by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile apps and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes. Methods A 3-step research approach is employed. As a first step, a database of 143 pertinent gamified health-related mobile apps from the Apple App Store and Google Play Store is set up. Second, the gamification approach of each app within the database is classified based on an established taxonomy for gamification in health-related apps. Finally, a 2-step cluster analysis is conducted in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile apps. Results Eight archetypes of gamification emerged from the analysis of health-related mobile apps: (1) competition and collaboration, (2) pursuing self-set goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) internal rewards for self-set goals, (6) continuous assistance through positive reinforcement, (7) positive and negative reinforcement without rewards, and (8) progressive gamification for health professionals. The results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted. Conclusions By unveiling salient best practices and discussing their relationship to targeted health behaviors, this study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances the knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health apps.

scholarly journals What Ibero-American hospitals do when things go wrong? A cross-sectional international study

2020 ◽  
Vol 32 (5) ◽  
pp. 313-318
Author(s):  
José Joaquín Mira ◽  
Irene Carrillo ◽  
Ezequiel García-Elorrio ◽  
Daniela Campos D E Andrade-Lourenção ◽  
Patricia Campos Pavan-Baptista ◽  
...  
Keyword(s):  
Action Plan ◽  
International Study ◽  
Public Hospitals ◽  
Future Research ◽  
Strategic Action ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Private Hospitals ◽  
Hospital Managers ◽  
Depth Analysis

Abstract Objective To know what hospital managers and safety leaders in Ibero-American countries are doing to respond effectively to the occurrence of adverse events (AEs) with serious consequences for patients. Design Cross-sectional international study. Setting Public and private hospitals in Ibero-American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Portugal and Spain). Participants A convenience sample of hospital managers and safety leaders from eight Ibero-American countries. A minimum of 25 managers/leaders from each country were surveyed. Interventions A selection of 37 actions for the effective management of AEs was explored. These were related to the safety culture, existence of a crisis plan, communication and transparency processes with the patients and their families, attention to second victims and institutional communication. Main Outcome Measure Degree of implementation of the actions studied. Results A total of 190 managers/leaders from 126 (66.3%) public hospitals and 64 (33.7%) private hospitals participated. Reporting systems, in-depth analysis of incidents and non-punitive approaches were the most implemented interventions, while patient information and care for second victims after an AE were the least frequent interventions. Conclusions The majority of these hospitals have not protocolized how to act after an AE. For this reason, it is urgent to develop and apply a strategic action plan to respond to this imperative safety challenge. This is the first study to identify areas of work and future research questions in Ibero-American countries.

scholarly journals Mobile Health Apps for Medical Emergencies: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Alejandro Plaza Roncero ◽  
Gonçalo Marques ◽  
Beatriz Sainz-De-Abajo ◽  
Francisco Martín-Rodríguez ◽  
Carlos del Pozo Vegas ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Mobile Apps ◽  
Current Status ◽  
Health Technologies ◽  
Health Apps ◽  
App Store ◽  
Mobile Health Apps ◽  
Medical Emergencies ◽  
Google Play

BACKGROUND Mobile health apps are used to improve the quality of health care. These apps are changing the current scenario in health care, and their numbers are increasing. OBJECTIVE We wanted to perform an analysis of the current status of mobile health technologies and apps for medical emergencies. We aimed to synthesize the existing body of knowledge to provide relevant insights for this topic. Moreover, we wanted to identify common threads and gaps to support new challenging, interesting, and relevant research directions. METHODS We reviewed the main relevant papers and apps available in the literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used in this review. The search criteria were adopted using systematic methods to select papers and apps. On one hand, a bibliographic review was carried out in different search databases to collect papers related to each application in the health emergency field using defined criteria. On the other hand, a review of mobile apps in two virtual storage platforms (Google Play Store and Apple App Store) was carried out. The Google Play Store and Apple App Store are related to the Android and iOS operating systems, respectively. RESULTS In the literature review, 28 papers in the field of medical emergency were included. These studies were collected and selected according to established criteria. Moreover, we proposed a taxonomy using six groups of applications. In total, 324 mobile apps were found, with 192 identified in the Google Play Store and 132 identified in the Apple App Store. CONCLUSIONS We found that all apps in the Google Play Store were free, and 73 apps in the Apple App Store were paid, with the price ranging from US $0.89 to US $5.99. Moreover, 39% (11/28) of the included studies were related to warning systems for emergency services and 21% (6/28) were associated with disaster management apps.

scholarly journals Pain as the fifth vital sign—A comparison between public and private healthcare systems

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259535
Author(s):  
Daniel Humberto Pozza ◽  
Luís Filipe Azevedo ◽  
José Manuel Castro Lopes
Keyword(s):  
Staff Training ◽  
Vital Sign ◽  
Good Clinical Practice ◽  
Emergency Department Visits ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
Validated Questionnaires ◽  
Private Healthcare ◽  
Public And Private Hospitals

Background The assessment of pain as the fifth vital sign (P5VS) is of paramount importance since it leads to the management of undertreated pain, consequently reducing suffering, readmissions and emergency department visits after hospital discharge. Objective To evaluate the implementation of P5VS in public and private hospitals. Methods Data analysis on validated questionnaires was sent to all 171 Portuguese hospitals via an official letter. Results When compared to private hospitals, public hospitals presented a higher adherence to the process related to the P5VS. It has demonstrated superiority in the charts properly placed to record P5VS, in the number of emergency departments recording P5VS, in the regularity of audits, and in the existence of guidelines and staff training on pain assessment and management. Conclusion The standardization of both evaluation and recording of pain intensity constitutes a measure of good clinical practice. Public hospitals demonstrated better commitment to these procedures that should be properly carried out in all health care institutions.

scholarly journals Archetypes of Gamification: Analysis of mHealth Apps (Preprint)

2020 ◽  
Author(s):  
Manuel Schmidt-Kraepelin ◽  
Philipp A. Toussaint ◽  
Scott Thiebes ◽  
Juho Hamari ◽  
Ali Sunyaev
Keyword(s):  
Best Practices ◽  
Health Behavior ◽  
Health Behaviors ◽  
Mobile Health ◽  
Positive Reinforcement ◽  
Mobile Apps ◽  
Health Behavior Change ◽  
Future Research ◽  
Research Approach ◽  
Health Related

BACKGROUND Nowadays, numerous health-related mobile apps implement gamification in an attempt to draw on the motivational potential of video games and thereby increase user engagement or foster certain health behaviors. However, research on effective gamification is still in its infancy and researchers increasingly recognize methodological shortcomings of existing studies. What we actually know about the phenomenon today stems from fragmented pieces of knowledge, and a variety of different perspectives. Existing research primarily draws on conceptual knowledge that is gained from research prototypes, and isolated from industry best practices. We still lack knowledge on how gamification has been successfully designed and implemented within the industry and whether certain gamification approaches have shown to be particularly suitable for certain health behaviors. OBJECTIVE We address this lack of knowledge concerning best practices in the design and implementation of gamification for health-related mobile apps by identifying archetypes of gamification approaches that have emerged in pertinent health-related mobile apps and analyzing to what extent those gamification approaches are influenced by the underlying desired health-related outcomes. METHODS A 3-step research approach is employed. As a first step, a database of 143 pertinent gamified health-related mobile apps from the Apple App Store and Google Play Store is set up. Second, the gamification approach of each app within the database is classified based on an established taxonomy for gamification in health-related apps. Finally, a 2-step cluster analysis is conducted in order to identify archetypes of the most dominant gamification approaches in pertinent gamified health-related mobile apps. RESULTS Eight archetypes of gamification emerged from the analysis of health-related mobile apps: (1) competition and collaboration, (2) pursuing self-set goals without rewards, (3) episodical compliance tracking, (4) inherent gamification for external goals, (5) internal rewards for self-set goals, (6) continuous assistance through positive reinforcement, (7) positive and negative reinforcement without rewards, and (8) progressive gamification for health professionals. The results indicate a close relationship between the identified archetypes and the actual health behavior that is being targeted. CONCLUSIONS By unveiling salient best practices and discussing their relationship to targeted health behaviors, this study contributes to a more profound understanding of gamification in mobile health. The results can serve as a foundation for future research that advances the knowledge on how gamification may positively influence health behavior change and guide practitioners in the design and development of highly motivating and effective health-related mobile health apps.

scholarly journals Effects of Six Sigma initiatives in Malaysian private hospitals

2019 ◽  
Vol 10 (1) ◽  
pp. 44-57 ◽  
Author(s):  
Selim Ahmed ◽  
Noor Hazilah Abd Manaf ◽  
Rafikul Islam
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Process Improvement ◽  
Six Sigma ◽  
Public Hospitals ◽  
Medical Laboratory ◽  
Future Research ◽  
Private Hospitals ◽  
Content Type ◽  
Six Sigma Methodology

Purpose This study aims to investigate applications of Six Sigma methodology in Malaysian private hospitals. It measures Six Sigma initiatives of the private hospitals based on demographics such as gender, position and working experience. Design/methodology/approach The present study measures Six Sigma initiatives of private hospitals and used stratified random sampling to collect data from eight selected hospitals in Peninsular Malaysia. The respondents of the study include doctors, nurses, pharmacists and medical laboratory technologists. In this study, 520 questionnaires were distributed to respondents who are working in Malaysian private hospitals. In total, 251 responses were received (48.27 per cent response rate). The descriptive analysis, independent samples t-test and one-way ANOVA were undertaken using SPSS version 23. Findings The findings of this study indicate that male respondents have better perception on four aspects of Six Sigma applications such as process improvement tools, process improvement methods, manage quality improvement activities and formal planning process compared to female respondents. The research findings also indicate that doctors have better perception regarding process improvement tools to measure quality improvement process, leadership to continuous improvement processes, training in process improvement tools for employees’ skill improvement compared to nurses, pharmacists, medical laboratory technologists. Research limitations/implications The present research focussed solely on the Malaysian private hospitals, and thus the results might not be applicable to other countries. This study focussed on Six Sigma initiatives of private hospitals in Malaysia, while the future research may consider investigating the difference or conformance between private and public hospitals on Six Sigma initiatives and its relationship with quality performance. In addition, present study findings are expected to provide guidelines to enhance the applications of Six Sigma methodology in private hospitals in Malaysia as well as other countries. Originality/value This research provides theoretical and practical contributions for the Six Sigma initiatives in private hospitals. Most of the past studies of Six Sigma initiatives are centred on manufacturing sector, but few empirical studies have been conducted on the health-care organisation. Thus, findings of the present study on the health-care sector contribute to the on-going pursuit of knowledge in the area of Six Sigma by using the strength of related theories and parent disciplines.

scholarly journals Medical Mobile App Classification Using the National Institute for Health and Care Excellence Evidence Standards Framework for Digital Health Technologies: Interrater Reliability Study

10.2196/17457 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17457 ◽  
Author(s):  
Khine Nwe ◽  
Mark Erik Larsen ◽  
Natalie Nelissen ◽  
David Chi-Wai Wong
Keyword(s):  
Mobile Health ◽  
Mobile Apps ◽  
Digital Health ◽  
Mobile App ◽  
Evaluation Framework ◽  
Tier 2 ◽  
Level Of Evidence ◽  
Health Technologies ◽  
Mobile Health Apps ◽  
Classification Agreement

Background Clinical governance of medical mobile apps is challenging, and there is currently no standard method for assessing the quality of such apps. In 2018, the National Institute for Health and Care Excellence (NICE) developed a framework for assessing the required level of evidence for digital health technologies (DHTs), as determined by their clinical function. The framework can potentially be used to assess mobile apps, which are a subset of DHTs. To be used reliably in this context, the framework must allow unambiguous classification of an app’s clinical function. Objective The objective of this study was to determine whether mobile health apps could be reliably classified using the NICE evidence standards framework for DHTs. Methods We manually extracted app titles, screenshots, and content descriptions for all apps listed on the National Health Service (NHS) Apps Library website on July 12, 2019; none of the apps were downloaded. Using this information, 2 mobile health (mHealth) researchers independently classified each app to one of the 4 functional tiers (ie, 1, 2, 3a, and 3b) described in the NICE digital technologies evaluation framework. Coders also answered contextual questions from the framework to identify whether apps were deemed to be higher risk. Agreement between coders was assessed using Cohen κ statistic. Results In total, we assessed 76 apps from the NHS Apps Library. There was classification agreement for 42 apps. Of these, 0 apps were unanimously classified into Tier 1; 24, into Tier 2; 15, into Tier 3a; and 3, into Tier 3b. There was disagreement between coders in 34/76 cases (45%); interrater agreement was poor (Cohen κ=0.32, 95% CI 0.16-0.47). Further investigation of disagreements highlighted 5 main explanatory themes: apps that did not correspond to any tier, apps that corresponded to multiple tiers, ambiguous tier descriptions, ambiguous app descriptions, and coder error. Conclusions The current iteration of the NICE evidence standards framework for DHTs did not allow mHealth researchers to consistently and unambiguously classify digital health mobile apps listed on the NHS app library according to their functional tier.

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