scholarly journals Adoption of Digital Health Technologies in the Practice of Behavioral Health: Qualitative Case Study of Glucose Monitoring Technology

10.2196/18119 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e18119
Author(s):  
Suepattra G May ◽  
Caroline Huber ◽  
Meaghan Roach ◽  
Jason Shafrin ◽  
Wade Aubry ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Technology Adoption ◽  
Data Management ◽  
Patient Engagement ◽  
Care Delivery ◽  
Digital Health ◽  
Glucose Monitoring ◽  
Health Technologies ◽  
Monitoring Technologies

Background Evaluation of patients with serious mental illness (SMI) relies largely on patient or caregiver self-reported symptoms. New digital technologies are being developed to better quantify the longitudinal symptomology of patients with SMI and facilitate disease management. However, as these new technologies become more widely available, psychiatrists may be uncertain about how to integrate them into daily practice. To better understand how digital tools might be integrated into the treatment of patients with SMI, this study examines a case study of a successful technology adoption by physicians: endocrinologists’ adoption of digital glucometers. Objective This study aims to understand the key facilitators of and barriers to clinician and patient adoption of digital glucose monitoring technologies to identify lessons that may be applicable across other chronic diseases, including SMIs. Methods We conducted focus groups with practicing endocrinologists from 2 large metropolitan areas using a semistructured discussion guide designed to elicit perspectives of and experiences with technology adoption. The thematic analysis identified barriers to and facilitators of integrating digital glucometers into clinical practice. Participants also provided recommendations for integrating digital health technologies into clinical practice more broadly. Results A total of 10 endocrinologists were enrolled: 60% (6/10) male; a mean of 18.4 years in practice (SD 5.6); and 80% (8/10) working in a group practice setting. Participants stated that digital glucometers represented a significant change in the treatment paradigm for diabetes care and facilitated more effective care delivery and patient engagement. Barriers to the adoption of digital glucometers included lack of coverage, provider reimbursement, and data management support, as well as patient heterogeneity. Participant recommendations to increase the use of digital health technologies included expanding reimbursement for clinician time, streamlining data management processes, and customizing the technologies to patient needs. Conclusions Digital glucose monitoring technologies have facilitated more effective, individualized care delivery and have improved patient engagement and health outcomes. However, key challenges faced by the endocrinologists included lack of reimbursement for clinician time and nonstandardized data management across devices. Key recommendations that may be relevant for other diseases include improved data analytics to quickly and accurately synthesize data for patient care management, streamlined software, and standardized metrics.

scholarly journals Adoption of Digital Health Technologies in the Practice of Behavioral Health: Qualitative Case Study of Glucose Monitoring Technology (Preprint)

2020 ◽  
Author(s):  
Suepattra G May ◽  
Caroline Huber ◽  
Meaghan Roach ◽  
Jason Shafrin ◽  
Wade Aubry ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Technology Adoption ◽  
Data Management ◽  
Patient Engagement ◽  
Care Delivery ◽  
Digital Health ◽  
Glucose Monitoring ◽  
Health Technologies ◽  
Monitoring Technologies

BACKGROUND Evaluation of patients with serious mental illness (SMI) relies largely on patient or caregiver self-reported symptoms. New digital technologies are being developed to better quantify the longitudinal symptomology of patients with SMI and facilitate disease management. However, as these new technologies become more widely available, psychiatrists may be uncertain about how to integrate them into daily practice. To better understand how digital tools might be integrated into the treatment of patients with SMI, this study examines a case study of a successful technology adoption by physicians: endocrinologists’ adoption of digital glucometers. OBJECTIVE This study aims to understand the key facilitators of and barriers to clinician and patient adoption of digital glucose monitoring technologies to identify lessons that may be applicable across other chronic diseases, including SMIs. METHODS We conducted focus groups with practicing endocrinologists from 2 large metropolitan areas using a semistructured discussion guide designed to elicit perspectives of and experiences with technology adoption. The thematic analysis identified barriers to and facilitators of integrating digital glucometers into clinical practice. Participants also provided recommendations for integrating digital health technologies into clinical practice more broadly. RESULTS A total of 10 endocrinologists were enrolled: 60% (6/10) male; a mean of 18.4 years in practice (SD 5.6); and 80% (8/10) working in a group practice setting. Participants stated that digital glucometers represented a significant change in the treatment paradigm for diabetes care and facilitated more effective care delivery and patient engagement. Barriers to the adoption of digital glucometers included lack of coverage, provider reimbursement, and data management support, as well as patient heterogeneity. Participant recommendations to increase the use of digital health technologies included expanding reimbursement for clinician time, streamlining data management processes, and customizing the technologies to patient needs. CONCLUSIONS Digital glucose monitoring technologies have facilitated more effective, individualized care delivery and have improved patient engagement and health outcomes. However, key challenges faced by the endocrinologists included lack of reimbursement for clinician time and nonstandardized data management across devices. Key recommendations that may be relevant for other diseases include improved data analytics to quickly and accurately synthesize data for patient care management, streamlined software, and standardized metrics. CLINICALTRIAL

Digital Health

2021 ◽  
Author(s):  
Eric D. Perakslis ◽  
Martin Stanley ◽  
Erin Brodwin
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Care Delivery ◽  
Digital Health ◽  
Detailed Examination ◽  
Medical Diagnostics ◽  
Medical Interventions ◽  
Health Technologies ◽  
Solid Models ◽  
Medical Side

Digital health has been touted as a true transformation of health care, but all medical interventions have associated risks that must be understood and quantified. The Internet has brought many advancements, which quickly jumped from our computers into our pockets via powerful and completely connected mobile devices that are now being envisioned as devices for medical diagnostics and care delivery. As health care struggles with cost, inequity, value, and rapid virtualization, solid models of benefit-risk determination, new regulatory approaches for biomedical products, and clear risk-based conversations with all stakeholders are essential. Detailed examination of emerging digital health technologies has revealed 10 categories of digital side effects or “toxicities” that must be understood, prevented when possible, and managed when not. These toxicities include cyberthreat, loss of privacy, cyberchondria and cyber addiction, threats to physical security, charlatanism, overdiagnosis and overtreatment, medical/user error, and the plague of medical misinformation. For digital health to realize its promise, these toxicities must be understood, measured, warned against, and managed as concurrent side effects, in the same fashion as any other medical side effect.

Evolution of Digital Technologies and Use of Virtual Assistants in Drug Development

2019 ◽  
pp. 1-20
Author(s):  
Manu Venugopal
Keyword(s):  
Drug Development ◽  
Digital Health ◽  
Critical Role ◽  
Life Sciences ◽  
Digital Technologies ◽  
Development Phase ◽  
Health Technologies ◽  
Daunting Task ◽  
The World

The drug development phase is one of the most time-consuming and expensive stages in the lifecycle of a drug. Marred by patent expirations, price regulations, complexities in disease conditions, life sciences companies are facing a daunting task to bring new molecular entities into the market. Digital health technologies are playing a critical role in addressing some of the challenges faced during drug development. In this chapter, the author talks about the challenges and key trends in the world of drug development, use of new digital health technologies, and the future of drug development. As an example, the author dives into a specific case study on the use of virtual assistants in clinical trials and the benefits of its usage on patients, healthcare professionals, and life sciences companies.

Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Carolyn Foster ◽  
Dana Schinasi ◽  
Kristin Kan ◽  
Michelle Macy ◽  
Derek Wheeler ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Literacy ◽  
Care Delivery ◽  
Digital Health ◽  
Health Care Team ◽  
Models Of Care ◽  
Health Data ◽  
Care Needs ◽  
Case Examples ◽  
Health Technologies

Remote patient monitoring (RPM) is a form of telemedicine that involves the collection and transmission of health data from a patient to their health care team by using digital health technologies. RPM can be leveraged to aggregate and visualize longitudinal patient-generated health data for proactive clinical management and engagement of the patient and family in a child’s health care. Collection of remote data has been considered standard of care for years in some chronic pediatric conditions. However, software limitations, gaps in access to the Internet and technology devices, digital literacy, insufficient reimbursement, and other challenges have prevented expansion of RPM in pediatric medicine on a wide scale. Recent technological advances in remote devices and software, coupled with a shift toward virtual models of care, have created a need to better understand how RPM can be leveraged in pediatrics to improve the health of more children, especially for children with special health care needs who are reliant on high-quality chronic disease management. In this article, we define RPM for the general pediatric health care provider audience, provide case examples of existing RPM models, discuss advantages of and limitations to RPM (including how data are collected, evaluated, and managed), and provide a list of current RPM resources for clinical practitioners. Finally, we propose considerations for expansion of this health care delivery approach for children, including clinical infrastructure, equitable access to digital health care, and necessary reimbursement. The overarching goal is to advance health for children by adapting RPM technologies as appropriate and beneficial for patients, families, and providers alike.

scholarly journals Hackathons as Stepping Stones in Health Care Innovation: Case Study With Systematic Recommendations

10.2196/17004 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17004 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Pablo-David Rojas ◽  
Joscha Hofferbert ◽  
Alvaro Valera Sosa ◽  
Felix Balzer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Digital Health ◽  
Participation Rate ◽  
Multidisciplinary Teams ◽  
Stepping Stones ◽  
Health Technologies ◽  
Health Community ◽  
Cost Efficient

Background Until recently, developing health technologies was time-consuming and expensive, and often involved patients, doctors, and other health care professionals only as passive recipients of the end product. So far, users have been minimally involved in the ideation and creation stages of digital health technologies. In order to best address users’ unmet needs, a transdisciplinary and user-led approach, involving cocreation and direct user feedback, is required. In this context, hackathon events have become increasingly popular in generating enthusiasm for user-centered innovation. Objective This case study describes preparatory steps and the performance of a health hackathon directly involving patients and health care professionals at all stages. Feasibility and outcomes were assessed, leading to the development of systematic recommendations for future hackathons as a vehicle for bottom-up innovation in health care. Methods A 2-day hackathon was conducted in February 2017 in Berlin, Germany. Data were collected through a field study. Collected field notes were subsequently discussed in 15 informal meetings among the research team. Experiences of conducting two further hackathons in December 2017 and November 2018 were included. Results In total, 30 participants took part, with 63% (19/30) of participants between 25 and 34 years of age, 30% (9/30) between 35 and 44 years of age, and 7% (2/30) younger than 25 years of age. A total of 43% (13/30) of the participants were female. The participation rate of medical experts, including patients and health care professionals, was 30% (9/30). Five multidisciplinary teams were formed and each tackled a specific health care problem. All presented projects were apps: a chatbot for skin cancer recognition, an augmented reality exposure-based therapy (eg, for arachnophobia), an app for medical neighborhood connectivity, a doctor appointment platform, and a self-care app for people suffering from depression. Patients and health care professionals initiated all of the projects. Conducting the hackathon resulted in significant growth of the digital health community of Berlin and was followed up by larger hackathons. Systematic recommendations for conducting cost-efficient hackathons (n≤30) were developed, including aspects of community building, stakeholder engagement, mentoring, themes, announcements, follow-up, and timing for each step. Conclusions This study shows that hackathons are effective in bringing innovation to health care and are more cost- and time-efficient and potentially more sustainable than traditional medical device and digital product development. Our systematic recommendations can be useful to other individuals and organizations that want to establish user-led innovation in academic hospitals by conducting transdisciplinary hackathons.

scholarly journals Hackathons as Stepping Stones in Health Care Innovation: Case Study With Systematic Recommendations (Preprint)

2019 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Pablo-David Rojas ◽  
Joscha Hofferbert ◽  
Alvaro Valera Sosa ◽  
Felix Balzer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Digital Health ◽  
Participation Rate ◽  
Multidisciplinary Teams ◽  
Stepping Stones ◽  
Health Technologies ◽  
Health Community ◽  
Cost Efficient

BACKGROUND Until recently, developing health technologies was time-consuming and expensive, and often involved patients, doctors, and other health care professionals only as passive recipients of the end product. So far, users have been minimally involved in the ideation and creation stages of digital health technologies. In order to best address users’ unmet needs, a transdisciplinary and user-led approach, involving cocreation and direct user feedback, is required. In this context, hackathon events have become increasingly popular in generating enthusiasm for user-centered innovation. OBJECTIVE This case study describes preparatory steps and the performance of a health hackathon directly involving patients and health care professionals at all stages. Feasibility and outcomes were assessed, leading to the development of systematic recommendations for future hackathons as a vehicle for bottom-up innovation in health care. METHODS A 2-day hackathon was conducted in February 2017 in Berlin, Germany. Data were collected through a field study. Collected field notes were subsequently discussed in 15 informal meetings among the research team. Experiences of conducting two further hackathons in December 2017 and November 2018 were included. RESULTS In total, 30 participants took part, with 63% (19/30) of participants between 25 and 34 years of age, 30% (9/30) between 35 and 44 years of age, and 7% (2/30) younger than 25 years of age. A total of 43% (13/30) of the participants were female. The participation rate of medical experts, including patients and health care professionals, was 30% (9/30). Five multidisciplinary teams were formed and each tackled a specific health care problem. All presented projects were apps: a chatbot for skin cancer recognition, an augmented reality exposure-based therapy (eg, for arachnophobia), an app for medical neighborhood connectivity, a doctor appointment platform, and a self-care app for people suffering from depression. Patients and health care professionals initiated all of the projects. Conducting the hackathon resulted in significant growth of the digital health community of Berlin and was followed up by larger hackathons. Systematic recommendations for conducting cost-efficient hackathons (n≤30) were developed, including aspects of community building, stakeholder engagement, mentoring, themes, announcements, follow-up, and timing for each step. CONCLUSIONS This study shows that hackathons are effective in bringing innovation to health care and are more cost- and time-efficient and potentially more sustainable than traditional medical device and digital product development. Our systematic recommendations can be useful to other individuals and organizations that want to establish user-led innovation in academic hospitals by conducting transdisciplinary hackathons.

scholarly journals Utilizing Digital Health Technologies for Patient Education in Lifestyle Medicine

2019 ◽  
Vol 14 (2) ◽  
pp. 137-142
Author(s):  
Anne Kuwabara ◽  
Sharlene Su ◽  
Jeffrey Krauss
Keyword(s):  
Patient Education ◽  
Learning Styles ◽  
Health Information ◽  
Technology Development ◽  
Care Delivery ◽  
Digital Health ◽  
Health Technology ◽  
Sufficient Evidence ◽  
Lifestyle Medicine ◽  
Health Technologies

Technology has redefined the way patients and providers communicate and obtain health information. The realm of digital health encompasses a diverse set of technologies, including mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalized medicine. These technologies have begun to improve care delivery without the traditional constraints of distance, location, and time. A growing body of evidence supports the use of digital health technology for improving patient education and implementation of skills and behaviors integral to lifestyle medicine. Patient education can now be delivered in standard formats (eg, articles, written messages) as well a wide array of multimedia (video, audio, interactive games, etc), which may be more appropriate for certain topics and learning styles. In addition, patient engagement in their care plays an important role in improving health outcomes. Despite digital health technology development often outpacing its research, there is sufficient evidence to support the use of many current technologies in clinical practice. Digital health tools will continue to grow in their ability to cost-effectively monitor and encourage healthy behaviors at scale, and better methods of evaluation will likely increase clinician confidence in their use.

scholarly journals Ethical Issues in Democratizing Digital Phenotypes and Machine Learning in the Next Generation of Digital Health Technologies

2021 ◽  
Author(s):  
Maurice D. Mulvenna ◽  
Raymond Bond ◽  
Jack Delaney ◽  
Fatema Mustansir Dawoodbhoy ◽  
Jennifer Boger ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Ethical Issues ◽  
Digital Health ◽  
Time Data ◽  
Digital Products ◽  
Health Technologies ◽  
Digital Phenotyping ◽  
Phenotype Data

AbstractDigital phenotyping is the term given to the capturing and use of user log data from health and wellbeing technologies used in apps and cloud-based services. This paper explores ethical issues in making use of digital phenotype data in the arena of digital health interventions. Products and services based on digital wellbeing technologies typically include mobile device apps as well as browser-based apps to a lesser extent, and can include telephony-based services, text-based chatbots, and voice-activated chatbots. Many of these digital products and services are simultaneously available across many channels in order to maximize availability for users. Digital wellbeing technologies offer useful methods for real-time data capture of the interactions of users with the products and services. It is possible to design what data are recorded, how and where it may be stored, and, crucially, how it can be analyzed to reveal individual or collective usage patterns. The paper also examines digital phenotyping workflows, before enumerating the ethical concerns pertaining to different types of digital phenotype data, highlighting ethical considerations for collection, storage, and use of the data. A case study of a digital health app is used to illustrate the ethical issues. The case study explores the issues from a perspective of data prospecting and subsequent machine learning. The ethical use of machine learning and artificial intelligence on digital phenotype data and the broader issues in democratizing machine learning and artificial intelligence for digital phenotype data are then explored in detail.

scholarly journals Patient and Family Engagement Approaches for Digital Health Initiatives: Protocol for a Case Study (Preprint)

2020 ◽  
Author(s):  
Nelson Shen ◽  
Damian Jankowicz ◽  
Gillian Strudwick
Keyword(s):  
Conceptual Framework ◽  
Digital Health ◽  
Family Engagement ◽  
Field Guide ◽  
Health Technologies ◽  
Effective Manner ◽  
Health Initiatives ◽  
Field Notes ◽  
Participant Observer

BACKGROUND Digital health initiatives such as patient portals, virtual care platforms, and smartphone-based applications are being implemented at a rapid pace in healthcare organizations worldwide. This is often done to improve access beyond traditional in-person care and enhance care quality. Recent studies have indicated that better outcomes of using these initiatives and technologies may be achieved when patients and their family members are engaged in all aspects of planning, implementation, use and evaluation. However, little guidance exists for how healthcare administrators can achieve effective engagement in digital health initiatives specifically. OBJECTIVE The objective of this study is to document processes related to planning and implementing patient and family engagement (PFE) in digital health initiatives. This information will be used to develop tangible resources (e.g. a field guide) that other organizations can use to implement PFE approaches for digital health initiatives in their organizations. METHODS A previously developed multi-dimensional conceptual framework for patient and family engagement in health and healthcare contexts will be used to guide this work. To understand the intricacies involved in utilizing PFE approaches in digital health strategies, a case study will be conducted. More specifically, this work will employ an embedded single-case design with PFE in digital health initiatives at a large Canadian mental health and addictions teaching hospital. Multiple digital health projects being undertaken at the study site will be explored to better understand where the PFE is intended to support the design, implementation, and operation of the digital health platform or technology. These projects will form the individual units of analysis. Data collection will involve field notes and artefact collection by a participant-observer, and interviews with the various digital health project teams. Data analysis will include a thematic analysis, and mapping of the findings to the previously identified conceptual framework used to guide this work. RESULTS Funding for this work was provided by the Canadian Institutes of Health Research, via a Health System Impact Fellowship. As of August 2020, digital health projects that will form the case study units have been identified, and the participant observer has started to embed themselves into these projects. While the development and collection of field notes and artefacts respectively have begun, interviews have not been conducted. These are anticipated to occur in early 2021. This study is expected to conclude in August 2021. Once this study is complete, the development of a field guide and resources to support the uptake of PFE strategies in digital health, will begin. CONCLUSIONS By better understanding the processes involved in PFE in digital health projects, guidance can be provided to relevant stakeholders and organizations about how to do this work in an effective manner. It is then anticipated that with the increasing use of PFE approaches, there may be improved uptake, experience and outcomes associated with using digital health technologies.

scholarly journals The role of health technologies in primary care interventions: A systematic review (Preprint)

2020 ◽  
Author(s):  
Geronimo Jimenez ◽  
David Matchar ◽  
Gerald Koh Choon Huat ◽  
MJJ Rianne van der Kleij ◽  
Niels H. Chavannes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Digital Health ◽  
Grey Literature ◽  
Chronically Ill ◽  
Prescribing Practices ◽  
Health Technologies ◽  
Monitoring Technologies ◽  
Multicomponent Interventions

BACKGROUND Several countries around the world have implemented multicomponent interventions to enhance primary care (PC), as a way of strengthening their health systems to cope with an ageing, chronically ill population, and rising costs. Some of these efforts have included technology-based enhancements as one of their features to support the overall intervention, but their details and impact have not been explored. OBJECTIVE To identify the role of digital/health technologies within wider, multi-feature interventions aimed at enhancing PC, and to describe the type of technologies used, aim and stakeholder, and potential impacts. METHODS A systematic review was performed, following Cochrane guidelines. An electronic search, supplemented with manual and grey literature searches, was conducted to identify multicomponent interventions which included at least one technology-based enhancement. After title/abstract and full text screening, selected articles were assessed for quality based on their study design. A descriptive, narrative synthesis was used for analysis and presentation of results. RESULTS Fourteen out of 37 articles (38%) described the inclusion of a technology-based innovation, as part of their multicomponent interventions to enhance PC. The most common identified technologies were the use of electronic health records, data monitoring technologies and online portals with messaging platforms. The most common aim of these technologies was to improve continuity of care and comprehensiveness, which resulted in increased patient satisfaction, increased PC visits compared to specialist visits, and the provision of more health prevention education and improved prescribing practices. Technologies seem also to increase costs and utilization for some parameters, such as increased consultation costs and increased number of drugs prescribed. CONCLUSIONS Technologies and digital health have not played a major role within comprehensive innovation efforts aimed at enhancing PC, reflecting that these technologies have not yet reached maturity or wider acceptance as a means for improving PC. Stronger policy and financial support is needed, as well as the advocacy of key stakeholders, to encourage the introduction of efficient technological innovations, backed by evidence-based research, so that digital technologies can fulfill the promise of supporting a strong, sustainable primary care.

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