scholarly journals Using Human-Centered Design to Build a Digital Health Advisor for Patients With Complex Needs: Persona and Prototype Development (Preprint)

2018 ◽  
Author(s):  
Onil Bhattacharyya ◽  
Kathryn Mossman ◽  
Lovisa Gustafsson ◽  
Eric C Schneider
Keyword(s):  
Health System ◽  
Care Delivery ◽  
Digital Health ◽  
Business Case ◽  
Cultural Barriers ◽  
Multiple Chronic Conditions ◽  
Complex Needs ◽  
Prototype Development ◽  
System Leaders ◽  
Key Features

BACKGROUND Twenty years ago, a “Guardian Angel” or comprehensive digital health advisor was proposed to empower patients to better manage their own health. This is now technically feasible, but most digital applications have narrow functions and target the relatively healthy, with few designed for those with the greatest needs. OBJECTIVE The goal of the research was to identify unmet needs and key features of a general digital health advisor for frail elderly and people with multiple chronic conditions and their caregivers. METHODS In-depth interviews were used to develop personas and use cases, and iterative feedback from participants informed the creation of a low-fidelity prototype of a digital health advisor. Results were shared with developers, investors, regulators, and health system leaders for suggestions on how this could be developed and disseminated. RESULTS Patients highlighted the following goals: “live my life,” “love my life,” “manage my health,” and “feel understood.” Patients and caregivers reported interest in four functions to address these goals: tracking and insights, advice and information, providing a holistic picture of the patient, and coordination and communication. Experts and system stakeholders felt the prototype was technically feasible, and that while health care delivery organizations could help disseminate such a tool, it should be done in partnership with consumer-focused organizations. CONCLUSIONS This study describes the key features of a comprehensive digital health advisor, but to spur its development, we need to clarify the business case and address the policy, organizational, and cultural barriers to creating tools that put patients and their goals at the center of the health system.

Digital health - Hope, Hype, and Halt (Preprint)

2018 ◽  
Author(s):  
Rajendra Pratap Gupta
Keyword(s):  
Large Scale ◽  
Care Delivery ◽  
Digital Health ◽  
New Technology ◽  
Business Case ◽  
Cost Of Care ◽  
Regulatory Frameworks ◽  
Health Conferences ◽  
The Cost

UNSTRUCTURED Over the past 40 years, the healthcare community has been repeatedly excited by the hope of providing better care through the effective adoption of the technology. In the hope that digital health is going to be the game changer, an aura of hype has been created amongst the stakeholders of healthcare industry. However, digital health is yet to witness a large-scale adoption that could match the hope created about its utility. There does not exist an example where digital health has successfully transformed the health system of a geography and has demonstrated a net positive return on the initial investment. Owing to the lack of a positive business case, the initiatives pertaining to digital health are losing steam. Corporates are shutting down digital health labs, staunching investments in digital health, digital health conferences are consolidating, and governments are re-evaluating the funding regimes for such initiatives. For the technology to be able to create desired impact in this sector, the principle stakeholders namely governments, hospitals, insurers, tech developers, medical professionals, and patients need to participate equitably. The resources need to be focused on high impact areas like epidemiology surveys, legal and regulatory frameworks, geriatric care, and human resources training. For a new technology to thrive, the industry competitors and governments must work in unison to develop solutions that are pragmatic, solves the problems, reduce the cost of care delivery, and are sustainable in the long-term. Digital health is not dead, but it is in a stage where its revival will be an up-hill task.

Games for Health

2013 ◽  
Vol 5 (3) ◽  
pp. 108-115
Author(s):  
Veronika Litinski
Keyword(s):  
Care Delivery ◽  
Innovation Management ◽  
Digital Health ◽  
Patient Activation ◽  
Business Case ◽  
Customer Engagement ◽  
Process Of Care ◽  
Healthcare Organizations ◽  
Patient Journey ◽  
Engagement Strategies

How to reduce cost, improve quality, and improve customer engagement are top of mind for healthcare leaders. Healthcare organizations are developing and testing comprehensive engagement strategies to support consumers across the care continuum. In this environment some form of priority setting must occur, and it requires establishing connections between proposed innovation to a process of care and the outcomes. Digital tools offer a promise of meaningful measures that are affordable, embedded in the care delivery system and truly reflect patients’ experiences through the patient journey. This paper proposes a pragmatic path for building a business case for innovative digital health tools in community care settings. It overlays value model for healthcare IT investments with patient activation measures and innovation management techniques. It proposes that the intersection of system-generated measures and psychometric methods for data collection and analysis may lead to development of feasible patient engagement measures for healthcare.

scholarly journals Health System Stakeholders’ Perspective on the Role of Mobile Health and Its Adoption in the Swiss Health System: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Myriam Lingg ◽  
Verena Lütschg
Keyword(s):  
Health Care ◽  
Health System ◽  
Mobile Health ◽  
Care Delivery ◽  
Digital Health ◽  
Full Potential ◽  
Semistructured Interview ◽  
Swiss Health ◽  
Recommendations For Action

BACKGROUND Digital health solutions have great potential to change the way health care is delivered, including better clinical outcomes and improved processes and access to health services. However, the adoption of mobile health (mHealth) solutions for patient monitoring has been rather slow in Switzerland. The reasons are complex, and a better understanding is needed to leverage the full potential of mHealth. OBJECTIVE This study aimed to deepen the understanding of the potential relevance and influence of mHealth for the health system and health care provision, and factors influencing its adoption. The findings will be used to provide an outlook on feasible recommendations for action. METHODS We conducted a qualitative survey using a maximum variation sample of a heterogeneous group of stakeholders (N=50) in the Swiss health care system with a profound knowledge of digital health and medical devices. A semistructured interview guide including open- and closed-ended questions was used to address questions around mHealth relevance and its influence on the health system, the relevance of selected determinants for mHealth adoption, and important influencing factors. A content analysis method was applied. RESULTS Overall, respondents thought that mHealth would have a beneficial impact on the Swiss health system but that its adoption would evolve slowly. We derived 23 key opportunities regarding patient and patient pathway, treatment of disease, and diseases and health conditions. High consistency in answers among respondents was observed for <i>treatment of disease</i>. Stakeholders’ attitudes toward mHealth adoption along the relevance of 23 preselected determinants were relatively consistent. However, we obtained diverging attitudes regarding the influence of <i>trends</i>, <i>enablers</i>, and <i>restraints</i> in Switzerland and translated them into 26 key themes influencing mHealth adoption. Relevant trends comprise <i>changing needs and expectations of patients</i>, <i>a rising need for efficient health care delivery</i>, <i>growing interest in improved outpatient care</i>, and <i>emerging technologies and progressing digitization</i>. Important enablers include <i>growing demand for new financing schemes and incentive concepts</i>, <i>rising demand for comprehensive information on and stronger body of evidence for mHealth use cases</i>, and <i>increasing need for easy to use alternate care approaches</i>. Challenging restraints are <i>rigidness of thinking and siloed actions of health system actors</i>, <i>complexity of changing the existing regulations and structures</i>, <i>little understanding of mHealth use and the role of clinicians</i>, and <i>risk of further polarization of the population</i>. CONCLUSIONS This study provides a comprehensive look at mHealth in the Swiss health system. It becomes apparent that strong governance is inevitable to foster a sustainable data strategy and to reconcile the different interests of stakeholders. The use of mHealth will add value but will not necessarily reduce the burden on the system caused by emerging societal needs and changing disease prevalence.

Drivers of preventable high health care utilization: a qualitative study of patient, physician and health system leader perspectives

2019 ◽  
Vol 25 (4) ◽  
pp. 220-228 ◽  
Author(s):  
Lala Tanmoy Das ◽  
Rainu Kaushal ◽  
Kelsey Garrison ◽  
Vanessa Carrillo ◽  
Zachary Grinspan ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Utilization ◽  
Health System ◽  
Care Delivery ◽  
Health Resources ◽  
The United States ◽  
Care Utilization ◽  
The Us ◽  
System Leaders

Objectives A small percentage of patients account for the bulk of population health care utilization and costs in many countries including the United States (US). In the US, 5% of the population has high health care utilization accounting for nearly 50% of health care costs. A subset of this utilization is deemed preventable, and thus potentially cost saving to patients as well as to the health care system. This study sought to identify drivers of preventable utilization from the perspectives of three stakeholder groups in the US: health system leaders; high-need, high-cost (HNHC) patients or their primary caregivers; and physicians. Methods We performed a qualitative study using interviews of health system leaders and focus groups of HNHC patients, caregivers and physicians. We used a mixed inductive deductive approach to analyse transcripts and identify themes. Results We identified three key drivers of preventable high health care utilization: (1) unmet behavioural health needs, (2) socio-economic determinants of health and (3) challenges associated with accessing health care delivery systems. Conclusions To be potentially more effective, interventions to reduce preventable high health care utilization should incorporate the perspectives of patients, health system leaders and physicians. Particularly important to stakeholders is increased access to mental-health resources, support for patients with low socio-economic resources and systemic changes that reduce wait times for primary care visits and allow providers more time during patient visits.

scholarly journals Health System Stakeholders’ Perspective on the Role of Mobile Health and Its Adoption in the Swiss Health System: Qualitative Study

10.2196/17315 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e17315
Author(s):  
Myriam Lingg ◽  
Verena Lütschg
Keyword(s):  
Health Care ◽  
Health System ◽  
Mobile Health ◽  
Care Delivery ◽  
Digital Health ◽  
Full Potential ◽  
Semistructured Interview ◽  
Swiss Health ◽  
Recommendations For Action

Background Digital health solutions have great potential to change the way health care is delivered, including better clinical outcomes and improved processes and access to health services. However, the adoption of mobile health (mHealth) solutions for patient monitoring has been rather slow in Switzerland. The reasons are complex, and a better understanding is needed to leverage the full potential of mHealth. Objective This study aimed to deepen the understanding of the potential relevance and influence of mHealth for the health system and health care provision, and factors influencing its adoption. The findings will be used to provide an outlook on feasible recommendations for action. Methods We conducted a qualitative survey using a maximum variation sample of a heterogeneous group of stakeholders (N=50) in the Swiss health care system with a profound knowledge of digital health and medical devices. A semistructured interview guide including open- and closed-ended questions was used to address questions around mHealth relevance and its influence on the health system, the relevance of selected determinants for mHealth adoption, and important influencing factors. A content analysis method was applied. Results Overall, respondents thought that mHealth would have a beneficial impact on the Swiss health system but that its adoption would evolve slowly. We derived 23 key opportunities regarding patient and patient pathway, treatment of disease, and diseases and health conditions. High consistency in answers among respondents was observed for treatment of disease. Stakeholders’ attitudes toward mHealth adoption along the relevance of 23 preselected determinants were relatively consistent. However, we obtained diverging attitudes regarding the influence of trends, enablers, and restraints in Switzerland and translated them into 26 key themes influencing mHealth adoption. Relevant trends comprise changing needs and expectations of patients, a rising need for efficient health care delivery, growing interest in improved outpatient care, and emerging technologies and progressing digitization. Important enablers include growing demand for new financing schemes and incentive concepts, rising demand for comprehensive information on and stronger body of evidence for mHealth use cases, and increasing need for easy to use alternate care approaches. Challenging restraints are rigidness of thinking and siloed actions of health system actors, complexity of changing the existing regulations and structures, little understanding of mHealth use and the role of clinicians, and risk of further polarization of the population. Conclusions This study provides a comprehensive look at mHealth in the Swiss health system. It becomes apparent that strong governance is inevitable to foster a sustainable data strategy and to reconcile the different interests of stakeholders. The use of mHealth will add value but will not necessarily reduce the burden on the system caused by emerging societal needs and changing disease prevalence.

scholarly journals Using Human-Centered Design to Build a Digital Health Advisor for Patients With Complex Needs: Persona and Prototype Development

10.2196/10318 ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. e10318 ◽  
Author(s):  
Onil Bhattacharyya ◽  
Kathryn Mossman ◽  
Lovisa Gustafsson ◽  
Eric C Schneider
Keyword(s):  
Digital Health ◽  
Human Centered Design ◽  
Complex Needs ◽  
Prototype Development

Shared Access to Patient Portals and Digital Health Equity (Preprint)

2021 ◽  
Author(s):  
Jennifer Wolff ◽  
Vadim Dukhanin ◽  
Julia Burgdorf ◽  
Cait DesRoches
Keyword(s):  
Health System ◽  
Health Equity ◽  
Care Delivery ◽  
Digital Health ◽  
Patient Portal ◽  
Patient Portals ◽  
Information Transparency ◽  
Care Partners ◽  
Challenges And Opportunities ◽  
Role Based

UNSTRUCTURED Growing reliance on the patient portal as a mainstream modality in health system interactions necessitates prioritizing digital health equity through systems-level strategies that acknowledge and support all persons. Older adults with physical, cognitive, sensory, and socio-economic vulnerabilities often rely on the involvement of family and friend care partners when navigating health system demands, but their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of systematic engagement of care partners through shared access to the patient portal that have been amplified in the context of the COVID-19 outbreak and recent implementation of federal information blocking rules that promote information transparency. We describe implementation considerations, and the promise of granular, role-based privacy controls in addressing the nuanced and dynamic nature of individual information sharing preferences and fostering person- and family-centered care delivery.

Taking Digital Health to the Next Level: Promoting Technologies That Empower Consumers and Drive Health System Transformation

2014 ◽  
Author(s):  
Sarah Klein Klein ◽  
Douglas McCarthy McCarthy ◽  
Martha Hostetter Hostetter
Keyword(s):  
Health System ◽  
Digital Health ◽  
System Transformation

scholarly journals Veterans Health Administration’s Whole Health System of Care: Supporting the Health, Well-Being, and Resiliency of Employees

2021 ◽  
Vol 10 ◽  
pp. 216495612110226
Author(s):  
Kavitha P Reddy ◽  
Tamara M Schult ◽  
Alison M Whitehead ◽  
Barbara G Bokhour
Keyword(s):  
Health System ◽  
Care Delivery ◽  
Health Planning ◽  
Well Being ◽  
Employee Health ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered ◽  
Foundational Work ◽  
Health And Well Being

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.

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