scholarly journals Why Are Digital Health Care Systems Still Poorly Designed, and Why Is Health Care Practice Not Asking for More? Three Paths Toward a Sustainable Digital Work Environment

10.2196/26694 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e26694
Author(s):  
Johanna Persson ◽  
Christofer Rydenfält
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Work Environment ◽  
Digital Health ◽  
Health Care Systems ◽  
Digital Systems ◽  
User Context ◽  
Care Systems ◽  
Digital Work ◽  
And Task

Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better tools for evaluating the digital work environment in the field; (2) generic formulations of qualitative requirements related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of digital ergonomics as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.

scholarly journals Why Are Digital Health Care Systems Still Poorly Designed, and Why Is Health Care Practice Not Asking for More? Three Paths Toward a Sustainable Digital Work Environment (Preprint)

2020 ◽  
Author(s):  
Johanna Persson ◽  
Christofer Rydenfält
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Work Environment ◽  
Digital Health ◽  
Health Care Systems ◽  
Digital Systems ◽  
User Context ◽  
Care Systems ◽  
Digital Work ◽  
And Task

UNSTRUCTURED Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better <i>tools for evaluating the digital work environment in the field</i>; (2) <i>generic formulations of qualitative requirements</i> related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of <i>digital ergonomics</i> as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.

scholarly journals Trends and Visibility of “Digital Health” as a Keyword in Articles by JMIR Publications in the New Millennium: Bibliographic-Bibliometric Analysis

10.2196/10477 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e10477 ◽  
Author(s):  
Alireza Ahmadvand ◽  
David Kavanagh ◽  
Michele Clark ◽  
Judy Drennan ◽  
Lisa Nissen
Keyword(s):  
Health Care ◽  
Bibliometric Analysis ◽  
Digital Health ◽  
Health Care Systems ◽  
Internet Research ◽  
Translational Science ◽  
Science Center ◽  
The Past ◽  
Care Systems ◽  
Research Networking

Background Digital health has become an advancing phenomenon in the health care systems of modern societies. Over the past two decades, various digital health options, technologies, and innovations have been introduced; many of them are still being investigated and evaluated by researchers all around the globe. However, the actual trends and visibility of peer-reviewed publications using “digital health” as a keyword to reflect the topic, published by major relevant journals, still remain to be quantified. Objective This study aimed to conduct a bibliographic-bibliometric analysis on articles published in JMIR Publications journals that used “digital health” as a keyword. We evaluated the trends, topics, and citations of these research publications to identify the important share and contribution of JMIR Publications journals in publishing articles on digital health. Methods All JMIR Publications journals were searched to find articles in English, published between January 2000 and August 2019, in which the authors focused on, utilized, or discussed digital health in their study and used “digital health” as a keyword. In addition, a bibliographic-bibliometric analysis was conducted using the freely available Profiles Research Networking Software by the Harvard Clinical and Translational Science Center. Results Out of 1797 articles having “digital health” as a keyword, published mostly between 2016 and 2019, 277 articles (32.3%) were published by JMIR Publications journals, mainly in the Journal of Medical Internet Research. The most frequently used keyword for the topic was “mHealth.” The average number of times an article had been cited, including self-citations, was above 2.8. Conclusions The reflection of “digital health” as a keyword in JMIR Publications journals has increased noticeably over the past few years. To maintain this momentum, more regular bibliographic and bibliometric analyses will be needed. This would encourage authors to consider publishing their articles in relevant, high-visibility journals and help these journals expand their supportive publication policies and become more inclusive of digital health.

scholarly journals Harnessing Digital Health Technologies During and After the COVID-19 Pandemic: Context Matters (Preprint)

2020 ◽  
Author(s):  
Francesco Petracca ◽  
Oriana Ciani ◽  
Maria Cucciniello ◽  
Rosanna Tarricone
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Organizational Context ◽  
Digital Health ◽  
Health Care Systems ◽  
Health Technologies ◽  
Digital Reconstruction ◽  
Depth Analysis ◽  
Care Systems

UNSTRUCTURED A common development observed during the COVID-19 pandemic is the renewed reliance on digital health technologies. Prior to the pandemic, the uptake of digital health technologies to directly strengthen public health systems had been unsatisfactory; however, a relentless acceleration took place within health care systems during the COVID-19 pandemic. Therefore, digital health technologies could not be prescinded from the organizational and institutional merits of the systems in which they were introduced. The Italian National Health Service is strongly decentralized, with the national government exercising general stewardship and regions responsible for the delivery of health care services. Together with the substantial lack of digital efforts previously, these institutional characteristics resulted in delays in the uptake of appropriate solutions, territorial differences, and issues in engaging the appropriate health care professionals during the pandemic. An in-depth analysis of the organizational context is instrumental in fully interpreting the contribution of digital health during the pandemic and providing the foundation for the digital reconstruction of what is to come after.

Safe Care for Pediatric Patients: A Scoping Review Across Multiple Health Care Settings

2017 ◽  
Vol 57 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Antonia Stang ◽  
Denise Thomson ◽  
Lisa Hartling ◽  
Jocelyn Shulhan ◽  
Megan Nuspl ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Scoping Review ◽  
Health Care Systems ◽  
Health Care Settings ◽  
Safety Concerns ◽  
Safety Research ◽  
Safety Interventions ◽  
Care Systems ◽  
Analytic Models

Children are particularly vulnerable to patient safety concerns due to pediatric-specific and general health care challenges. This scoping review identifies and describes the vulnerabilities of those aged 0 to 18 years to iatrogenic harm in various health care settings. Six databases were searched from 1991 to 2012. Primary studies were categorized using predetermined groupings. Categories were tallied and descriptive statistics were employed. A total of 388 primary studies exploring interventions that improved patient safety, deficiencies, or errors leading to safety concerns were included. The most common issues were medication (189 studies, 48.7%) and general medical (81 studies, 20.9%) errors. Sixty studies (15.5%) evaluated or described patient safety interventions, 206 studies (53.1%) addressed health care systems and technologies, 17 studies (4.4%) addressed caregiver perspectives and 20 studies (5.2%) discussed analytic models for patient safety. Further work is needed to ensure consistency of definitions in patient safety research to facilitate comparison and collation of results.

scholarly journals The Development of Complex Digital Health Solutions: Formative Evaluation Combining Different Methodologies (Preprint)

2017 ◽  
Author(s):  
Anne Lee ◽  
Marianne Sandvei ◽  
Hans Christian Asmussen ◽  
Marie Skougaard ◽  
Joanne Macdonald ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Participatory Design ◽  
Formative Evaluation ◽  
Digital Health ◽  
Health Care Systems ◽  
Real Life ◽  
Evaluation Process ◽  
Stakeholder Groups ◽  
Care Systems

BACKGROUND The development of digital health solutions for current health care settings requires an understanding of the complexities of the health care system, organizational setting, and stakeholder groups and of the underlying interplay between stakeholders and the technology. The digital health solution was founded on the basis of an information and communication technology platform and point-of-care devices enabling home-based monitoring of disease progression and treatment outcome for patients with rheumatoid arthritis (RA). OBJECTIVE The aim of this paper is to describe and discuss the applicability of an iterative evaluation process in guiding the development of a digital health solution as a technical and organizational entity in three different health care systems. METHODS The formative evaluation comprised the methodologies of contextual understanding, participatory design, and feasibility studies and included patients, healthcare professionals, and hardware and software developers. In total, the evaluation involved 45 patients and 25 health care professionals at 3 clinical sites in Europe. RESULTS The formative evaluation served as ongoing and relevant input to the development process of the digital health solution. Through initial field studies key stakeholder groups were identified and knowledge obtained about the different health care systems, the professional competencies involved in routine RA treatment, the clinics’ working procedures, and the use of communication technologies. A theory-based stakeholder evaluation achieved a multifaceted picture of the ideas and assumptions held by stakeholder groups at the three clinical sites, which also represented the diversity of three different language zones and cultures. Experiences and suggestions from the patients and health care professionals were sought through participatory design processes and real-life testing and actively used for adjusting the visual, conceptual, and practical design of the solution. The learnings captured through these activities aided in forming the solution and in developing a common understanding of the overall vision and aim of this solution. During this process, the 3 participating sites learned from each other’s feed-back with the ensuing multicultural inspiration. Moreover, these efforts also enabled the consortium to identify a ‘tipping point’ during a pilot study, revealing serious challenges and a need for further development of the solution. We achieved valuable learning during the evaluation activities, and the remaining challenges have been clarified more extensively than a single-site development would have discovered. The further obstacles have been defined as has the need to resolve these before designing and conducting a real-life clinical test to assess the outcome from a digital health solution for RA treatment. CONCLUSIONS A formative evaluation process with ongoing involvement of stakeholder groups from 3 different cultures and countries have helped to inform and influence the development of a novel digital health solution, and provided constructive input and feedback enabling the consortium to control the development process.

scholarly journals Harnessing Digital Health Technologies During and After the COVID-19 Pandemic: Context Matters

10.2196/21815 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e21815
Author(s):  
Francesco Petracca ◽  
Oriana Ciani ◽  
Maria Cucciniello ◽  
Rosanna Tarricone
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Organizational Context ◽  
Digital Health ◽  
Health Care Systems ◽  
Health Technologies ◽  
Digital Reconstruction ◽  
Depth Analysis ◽  
Care Systems

A common development observed during the COVID-19 pandemic is the renewed reliance on digital health technologies. Prior to the pandemic, the uptake of digital health technologies to directly strengthen public health systems had been unsatisfactory; however, a relentless acceleration took place within health care systems during the COVID-19 pandemic. Therefore, digital health technologies could not be prescinded from the organizational and institutional merits of the systems in which they were introduced. The Italian National Health Service is strongly decentralized, with the national government exercising general stewardship and regions responsible for the delivery of health care services. Together with the substantial lack of digital efforts previously, these institutional characteristics resulted in delays in the uptake of appropriate solutions, territorial differences, and issues in engaging the appropriate health care professionals during the pandemic. An in-depth analysis of the organizational context is instrumental in fully interpreting the contribution of digital health during the pandemic and providing the foundation for the digital reconstruction of what is to come after.

Understanding the Trauma/Acute Care Surgery Workforce

2019 ◽  
Vol 85 (6) ◽  
pp. 638-644 ◽  
Author(s):  
K. Michael Hughes ◽  
Zachary T. Ewart ◽  
Theodore D. Bell ◽  
Stanley J. Kurek ◽  
Krystal K. Swasey
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Work Environment ◽  
Acute Care ◽  
Professional Growth ◽  
Health Care Systems ◽  
Acute Care Surgery ◽  
Care Systems ◽  
Care Surgery ◽  
Workforce Strategies

As the roles of trauma/acute care surgeons continue to evolve, it is imperative that health-care systems adapt to meet workforce needs. Tailoring retention strategies that elicit workforce satisfaction ensure continued coverage that is mutually beneficial to surgeons and health-care systems. We sought to elicit factors related to career characteristics and expectations of the trauma/acute care surgery (ACS) workforce to assist with such future progress. In this study, 1552 Eastern Association for the Surgery of Trauma members were anonymously surveyed. Data collected included demographics, career expectations, and motivators of trauma/ACS. Four hundred eight (26%) Eastern Association for the Surgery of Trauma members responded. Respondents were 78 per cent male and had a median age of 47.3 years. Forty-six per cent of surgeons reported earning $351K–$475K and 23 per cent >$475K. At this point in their career, 49 per cent of surgeons felt quality of life was “most important”, followed by 31 per cent career ambitions and 13 per cent salary. Prominent career satisfiers were patient care and teaching. Greatest detractors were burnout, bureaucracy, and work environment. Eighty per cent would change jobs in the final 10 years of practice, 31 per cent because of family/retirement, 29 per cent because of professional growth, 24 per cent because of workload, and 7 per cent because of salary. This study could be used to help develop trauma/ACS workforce strategies. This workforce remains mobile into late career; personal happiness and patient ownership overshadow financial rewards, and most prefer a total and shared patient care model compared with no patient ownership. Burnout, bureaucracy, and work environment are dominant detractors of job satisfaction among surveyed trauma/ACS surgeons.

scholarly journals Impact of COVID-19 on Lung Transplant Activity in Germany—A Cross-Sectional Survey

2020 ◽  
Author(s):  
Sebastian Michel ◽  
Christian Witt ◽  
Jens Gottlieb ◽  
Clemens Aigner
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Severe Acute Respiratory Syndrome ◽  
Lung Transplant ◽  
Health Care Systems ◽  
Time Frame ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Variable Extent ◽  
Care Systems

AbstractThe current COVID-19 pandemia affects health care systems worldwide, however, to a variable extent depending on the caseload in each country. We aimed to provide a cross-sectional overview of current limitations or adaptions in lung transplant programs in Germany in from January to May 2020 due to the COVID-19 pandemia caused by severe acute respiratory syndrome coronavirus 2. A cross-sectional survey assessing various aspects of lung transplant activity was sent to all active lung transplant programs (n = 12) in Germany. Eight centers (66%) responded to the survey within the requested time frame. Four centers (50%) reported their activity is not restricted at all and four centers (50%) reported on moderate general limitations. The overall lung transplant activity in Germany from January to May 2020 contains 128 bilateral and 11 single lung transplantations, which is similar to the same period in the year 2019 (126 bilateral transplantations and 12 single lung transplantations). The results suggest that the influence of the COVID-19 pandemia on lung transplantation activity in Germany has been moderate so far. Nevertheless, adaptions such as extensive testing of donors and recipients were introduced to reduce the likelihood of infections and increase patient safety. Alertness to changes in COVID-19 reproduction rates might be required until effective antiviral therapy or vaccination is available.

scholarly journals Trends and Visibility of “Digital Health” as a Keyword in Articles by JMIR Publications in the New Millennium: Bibliographic-Bibliometric Analysis (Preprint)

2018 ◽  
Author(s):  
Alireza Ahmadvand ◽  
David Kavanagh ◽  
Michele Clark ◽  
Judy Drennan ◽  
Lisa Nissen
Keyword(s):  
Health Care ◽  
Bibliometric Analysis ◽  
Digital Health ◽  
Health Care Systems ◽  
Internet Research ◽  
Translational Science ◽  
Science Center ◽  
The Past ◽  
Care Systems ◽  
Research Networking

BACKGROUND Digital health has become an advancing phenomenon in the health care systems of modern societies. Over the past two decades, various digital health options, technologies, and innovations have been introduced; many of them are still being investigated and evaluated by researchers all around the globe. However, the actual trends and visibility of peer-reviewed publications using “digital health” as a keyword to reflect the topic, published by major relevant journals, still remain to be quantified. OBJECTIVE This study aimed to conduct a bibliographic-bibliometric analysis on articles published in JMIR Publications journals that used “digital health” as a keyword. We evaluated the trends, topics, and citations of these research publications to identify the important share and contribution of JMIR Publications journals in publishing articles on digital health. METHODS All JMIR Publications journals were searched to find articles in English, published between January 2000 and August 2019, in which the authors focused on, utilized, or discussed digital health in their study and used “digital health” as a keyword. In addition, a bibliographic-bibliometric analysis was conducted using the freely available Profiles Research Networking Software by the Harvard Clinical and Translational Science Center. RESULTS Out of 1797 articles having “digital health” as a keyword, published mostly between 2016 and 2019, 277 articles (32.3%) were published by JMIR Publications journals, mainly in the <italic>Journal of Medical Internet Research</italic>. The most frequently used keyword for the topic was “mHealth.” The average number of times an article had been cited, including self-citations, was above 2.8. CONCLUSIONS The reflection of “digital health” as a keyword in JMIR Publications journals has increased noticeably over the past few years. To maintain this momentum, more regular bibliographic and bibliometric analyses will be needed. This would encourage authors to consider publishing their articles in relevant, high-visibility journals and help these journals expand their supportive publication policies and become more inclusive of digital health.

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