From RCT to Scale: Can a Digital Health Innovation Make the Leap?

2022 ◽  
Author(s):  
Phiona Marongwe ◽  
Beatrice Wasunna ◽  
Vernon Murenje ◽  
Jacqueline Gavera ◽  
Farai Gwenzi ◽  
...  
Keyword(s):  
Digital Health ◽  
Health Innovation

scholarly journals A Digital Health Innovation to Prevent Relapse and Support Recovery in Youth Receiving Specialized Services for First-Episode Psychosis: Protocol for a Pilot Pre-Post, Mixed Methods Study of Horyzons-Canada (Phase 2) (Preprint)

2021 ◽  
Author(s):  
Shalini Lal ◽  
John F Gleeson ◽  
Simon D'Alfonso ◽  
Geraldine Etienne ◽  
Ridha Joober ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Digital Health ◽  
First Episode Psychosis ◽  
Funding Agency ◽  
First Episode ◽  
Health Innovation ◽  
Potential Efficacy ◽  
Episode Psychosis ◽  
Support Recovery

BACKGROUND Psychotic disorders are among the most disabling of all mental disorders. The first-episode psychosis (FEP) often occurs during adolescence or young adulthood. Young people experiencing FEP often face multiple barriers in accessing a comprehensive range of psychosocial services, which have predominantly been delivered in person. New models of service delivery that are accessible, sustainable, and engaging are needed to support recovery in youth diagnosed with FEP. OBJECTIVE In this paper, we describe a protocol to implement and evaluate the acceptability, safety, and potential efficacy of an online psychosocial therapeutic intervention designed to sustain recovery and prevent relapses in young adults diagnosed with FEP. This intervention was originally developed and tested in Australia and has been adapted for implementation and evaluation in Canada and is called Horyzons-Canada (HoryzonsCa). METHODS This cohort study is implemented in a single-center and applies a pre-post mixed methods (qualitative-quantitative convergent) design. The study involves recruiting 20 participants from a specialized early intervention program for psychosis located in Montreal, Canada and providing them with access to the HoryzonsCa intervention for 8 weeks. Data collection includes interview-based psychometric measures, self-reports, focus groups, and interviews. RESULTS This study received funding from the Brain and Behavior Research Foundation (United States), the Quebec Health Research Funding Agency (Canada), and the Canada Research Chairs Program. The study was approved by the Research Ethics Board of the Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l'Île-de-Montréal on April 11, 2018 (#IUSMD 17-54). Data were collected from August 16, 2018, to April 29, 2019, and a final sample of 20 individuals participated in the baseline and follow-up interviews, among which 9 participated in the focus groups. Data analysis and reporting are in process. The results of the study will be submitted for publication in 2021. CONCLUSIONS This study will provide preliminary evidence on the acceptability, safety, and potential efficacy of using a digital health innovation adapted for the Canadian context to deliver specialized mental health services to youth diagnosed with FEP. CLINICALTRIAL ISRCTN Registry ISRCTN43182105; https://www.isrctn.com/ISRCTN43182105 INTERNATIONAL REGISTERED REPORT RR1-10.2196/28141

A Pharmaco-cybernetics Approach to Designing an Oncology Drug Interaction Database for Clinical Practice

2021 ◽  
pp. 169-227
Keyword(s):  
Drug Interaction ◽  
Clinical Practice ◽  
Digital Health ◽  
Innovation Process ◽  
User Feedback ◽  
Clinical Usefulness ◽  
Health Innovation ◽  
Interaction Database ◽  
Oncology Practice

This chapter describes how OncoRx-MI, a pharmaco-informatics platform for detecting chemotherapy interactions, was designed through a pharmaco-cybernetics approach targeting the 5 activities of the digital health innovation process. This is the first database of its kind that is able to provide interaction information for anticancer drugs and chemotherapy regimen cocktails. In order to identify the gap and determine the usefulness of this database in clinical oncology practice, the quality of online anticancer drug interactions was assessed, and the perceptions of oncology practitioners were sought. The results showed that the accuracy of drug interaction content and the clinical usefulness of the database was highly regarded by these practitioners. In addition, evidence of its relevance and credibility was demonstrated through user feedback on the database.

scholarly journals Identifying and Overcoming Policy‐Level Barriers to the Implementation of Digital Health Innovation in Ontario: Qualitative Study

2020 ◽  
Vol 55 (S1) ◽  
pp. 112-113
Author(s):  
C. Soobiah ◽  
L. Desveaux ◽  
S. Bhatia ◽  
J. Shaw
Keyword(s):  
Qualitative Study ◽  
Digital Health ◽  
Health Innovation ◽  
Policy Level

Digital Health Innovation Ecosystems

2019 ◽  
Vol 8 (2) ◽  
pp. 1-14 ◽  
Author(s):  
Gloria Ejehiohen Iyawa ◽  
Marlien Herselman ◽  
Adele Botha
Keyword(s):  
Developing Countries ◽  
Qualitative Study ◽  
Digital Health ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Innovation Ecosystem ◽  
Health Innovation ◽  
Innovation Ecosystems ◽  
Governmental Organizations ◽  
Key Participants

The purpose of this paper was to identify key participants, benefits, and challenges of a digital health innovation ecosystem in Namibia. The paper also aimed to identify strategies for implementing digital health innovation ecosystems in Namibia. This is a qualitative study that adopted semi-structured interviews in meeting the objectives of the study. The findings suggest that implementing digital health innovation ecosystems within the Namibian context will result in better processes of delivering healthcare services to patients. However, implementing such an ecosystem would require resources from both academic and governmental organizations. The need for skilled experts for managing the ecosystem would also be required. Hence, adopting the guidelines for implementing a digital health innovation ecosystem in developing countries, the study proposed guidelines which would make a digital health innovation ecosystem work for the Namibian context. The findings of this study can be used by healthcare managers within the Namibian context.

scholarly journals Digital Health Innovation: Exploring Adoption of COVID-19 Digital Contact Tracing Apps

2020 ◽  
pp. 1-17 ◽  
Author(s):  
Shavneet Sharma ◽  
Gurmeet Singh ◽  
Rashmini Sharma ◽  
Paul Jones ◽  
Sascha Kraus ◽  
...  
Keyword(s):  
Digital Health ◽  
Contact Tracing ◽  
Health Innovation

Catalyzing healthcare transformation with digital health: Performance indicators and lessons learned from a Digital Health Innovation Group

Healthcare ◽  
2018 ◽  
Vol 6 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Jocelyn Tseng ◽  
Sonia Samagh ◽  
Donna Fraser ◽  
Adam B. Landman
Keyword(s):  
Performance Indicators ◽  
Digital Health ◽  
Lessons Learned ◽  
Health Innovation ◽  
Health Performance ◽  
Healthcare Transformation

scholarly journals Identifying and Overcoming Policy-Level Barriers to the Implementation of Digital Health Innovation: Qualitative Study

10.2196/14994 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e14994 ◽  
Author(s):  
Laura Desveaux ◽  
Charlene Soobiah ◽  
R Sacha Bhatia ◽  
James Shaw
Keyword(s):  
Health System ◽  
Driving Forces ◽  
Digital Health ◽  
Critical Role ◽  
Qualitative Description ◽  
System Level ◽  
Health Innovation ◽  
Innovation Activities ◽  
Challenges And Opportunities ◽  
The Government

Background High-level policy barriers impede widespread adoption for even the most well-positioned innovations. Most of the work in this field assumes rather than analyzes the driving forces of health innovation. Objective: The aim of this study was to explore the challenges and opportunities experienced by health system stakeholders in the implementation of digital health innovation in Ontario. Objective The aim of this study was to explore the challenges and opportunities experienced by health system stakeholders in the implementation of digital health innovation in Ontario. Methods We completed semistructured interviews with 10 members of senior leadership across key organizations that are engaged in health care–related digital health activities. Data were analyzed using qualitative description. Results A total of 6 key policy priorities emerged, including the need for (1) a system-level definition of innovation, (2) a clear overarching mission, and (3) clearly defined organizational roles. Operationally, there is a need to (4) standardize processes, (5) shift the emphasis to change management, and (6) align funding structures. Conclusions These findings emphasize the critical role of the government in developing a vision and creating the foundation upon which innovation activities will be modeled.

scholarly journals Adaptation of a Digital Health Innovation to Prevent Relapse and Support Recovery in Youth Receiving Services for First-Episode Psychosis: Results From the Horyzons-Canada Phase 1 Study (Preprint)

2020 ◽  
Author(s):  
Shalini Lal ◽  
John Gleeson ◽  
Lysanne Rivard ◽  
Simon D'Alfonso ◽  
Ridha Joober ◽  
...  
Keyword(s):  
Digital Health ◽  
First Episode Psychosis ◽  
Lessons Learned ◽  
Mobile Technologies ◽  
Rural Setting ◽  
First Episode ◽  
Health Innovation ◽  
Episode Psychosis ◽  
Support Recovery ◽  
Age Range

BACKGROUND Developing a digital health innovation can require a substantial amount of financial and human resource investment before it can be scaled for implementation across geographical, cultural, and health care contexts. As such, there is an increased interest in leveraging eHealth innovations developed and tested in one country or jurisdiction and using these innovations in local settings. However, limited knowledge exists on the processes needed to appropriately adapt digital health innovations to optimize their transferability across geographical, cultural, and contextual settings. OBJECTIVE We report on the results of an adaptation study of Horyzons, a digital health innovation originally developed and tested in Australia. Horyzons is designed to prevent relapses and support recovery in young people receiving services for first-episode psychosis (FEP). The aim of this study is to assess the initial acceptability of Horyzons and adapt it in preparation for pilot testing in Canada. METHODS This research took place in 2 specialized early intervention clinics for FEP, located in 1 urban and 1 urban-rural setting, in 2 Canadian provinces. A total of 26 participants were recruited: 15 clinicians (age range 26-56 years) and 11 patients (age range 19-37 years). Following the digital health adaptation framework developed by our team, we used a mixed methods approach, combining descriptive quantitative and qualitative methods across 3 stages of data collection (focus groups, interviews, and consultations), analysis, and adaptations. RESULTS Overall, patients and clinicians appreciated the strengths-based approach and social media features of Horyzons. However, participants expressed concerns related to implementation, especially in relation to capacity (eg, site moderation, crisis management, internet speed in rural locations). They also provided suggestions for adapting content and features, for example, in relation to community resources, volume of text, universal accessibility (eg, for individuals with limitations in vision), and optimization of platform accessibility through mobile devices. Additional aspects of the innovation were flagged for adaptation during the final stages of preparing it for live implementation. These included terms of use, time zone configuration to reflect local time and date, safety and moderation protocols, the <i>need help now</i> feature, and the list of trigger words to flag posts indicative of potential risk. CONCLUSIONS In the context of the COVID-19 pandemic and public health guidelines for social distancing, there is an increasing interest and need to leverage the internet and mobile technologies for delivering youth mental health services. As countries look to one another for guidance on how to navigate changing social dynamics, knowledge on how to utilize and adapt existing innovations across contexts is now more important than ever. Using a systematic approach, this study illustrates the methods, processes, results, and lessons learned on adapting a digital health innovation to enhance its local acceptability. INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.8810

scholarly journals Barriers to Creating Scalable Business Models for Digital Health Innovation in Public Systems: Qualitative Case Study (Preprint)

2020 ◽  
Author(s):  
Leah Taylor Kelley ◽  
Jamie Fujioka ◽  
Kyle Liang ◽  
Madeline Cooper ◽  
Trevor Jamieson ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Business Models ◽  
Digital Health ◽  
Digital Technologies ◽  
Economic Incentives ◽  
Barriers To Entry ◽  
Health Innovation ◽  
Health Technologies

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.

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