scholarly journals Elements of Trust in Digital Health Systems: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Afua Adjekum ◽  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Scoping Review ◽  
Service Provider ◽  
Digital Health ◽  
Digital Technologies ◽  
Data Access ◽  
Building Blocks ◽  
Sociodemographic Factors ◽  
Health Technologies

BACKGROUND Information and communication technologies have long become prominent components of health systems. Rapid advances in digital technologies and data science over the last few years are predicted to have a vast impact on health care services, configuring a paradigm shift into what is now commonly referred to as digital health. Forecasted to curb rising health costs as well as to improve health system efficiency and safety, digital health success heavily relies on trust from professional end users, administrators, and patients. Yet, what counts as the building blocks of trust in digital health systems has so far remained underexplored. OBJECTIVE The objective of this study was to analyze what relevant stakeholders consider as enablers and impediments of trust in digital health. METHODS We performed a scoping review to map out trust in digital health. To identify relevant digital health studies, we searched 5 electronic databases. Using keywords and Medical Subject Headings, we targeted all relevant studies and set no boundaries for publication year to allow a broad range of studies to be identified. The studies were screened by 2 reviewers after which a predefined data extraction strategy was employed and relevant themes documented. RESULTS Overall, 278 qualitative, quantitative, mixed-methods, and intervention studies in English, published between 1998 and 2017 and conducted in 40 countries were included in this review. Patients and health care professionals were the two most prominent stakeholders of trust in digital health; a third—health administrators—was substantially less prominent. Our analysis identified cross-cutting personal, institutional, and technological elements of trust that broadly cluster into 16 enablers (altruism, fair data access, ease of use, self-efficacy, sociodemographic factors, recommendation by other users, usefulness, customizable design features, interoperability, privacy, initial face-to-face contact, guidelines for standardized use, stakeholder engagement, improved communication, decreased workloads, and service provider reputation) and 10 impediments (excessive costs, limited accessibility, sociodemographic factors, fear of data exploitation, insufficient training, defective technology, poor information quality, inadequate publicity, time-consuming, and service provider reputation) to trust in digital health. CONCLUSIONS Trust in digital health technologies and services depends on the interplay of a complex set of enablers and impediments. This study is a contribution to ongoing efforts to understand what determines trust in digital health according to different stakeholders. Therefore, it offers valuable points of reference for the implementation of innovative digital health services. Building on insights from this study, actionable metrics can be developed to assess the trustworthiness of digital technologies in health care.

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.

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

10.2196/20579 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e20579
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.

scholarly journals Social and Managerial Aspects of Using Digital Health Technologies

2021 ◽  
Author(s):  
Valery Igorevich Yudin
Keyword(s):  
Health Care ◽  
Information Technologies ◽  
Administrative Support ◽  
Digital Health ◽  
Health Sector ◽  
Digital Technologies ◽  
Critical Conditions ◽  
Maximum Information ◽  
Health Technologies ◽  
Digital Medicine

The development of the health sector around the world is linked to digital technologies, because there is a need to optimize the processes of medical care for the population. Every year there is an increase in this market by a quarter. The use of digital technologies helps to improve health care. The management and organization system implements unified effective systems using the technological capabilities of digitalization in the health care sector. The relevance of the study is related to the need to change the outdated health management system with access to a modern level of technical and administrative support for medical services.The actual tool of digital medicine is cooperative forms of network interaction. We are exploring the further development of digital medicine in the short term, what opportunities can be presented and what results can be obtained by residents. Network communications play an important role in uniting professional medical communities. More than 65% of people between the ages of 21 and 35 have become participants in network technologies, and their number is constantly increasing. Administrative and management staffs are most active in discussions (43%) on the Internet and all respondents have an idea about telemedicine. Patients have the opportunity to get advice by contacting doctors online. The next stage in the development of information technologies is associated with increasing the speed and volume of transmitted data, which will help to predict critical conditions that threaten the patient’s health as quickly as possible. Now there is a discussion about the possibility of not just consulting, but also making diagnoses when patients contact the doctor, discussing in which cases a personal meeting with the doctor is necessary and under what conditions it is enough to provide maximum information about the state of health for diagnosis. Keywords: digital healthcare, digital technologies, adaptation, medical specialists

scholarly journals How Women Use Digital Technologies for Health: Qualitative Interview and Focus Group Study (Preprint)

2018 ◽  
Author(s):  
Deborah Lupton ◽  
Sarah Maslen
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Online Social Networks ◽  
Digital Health ◽  
Family Members ◽  
Digital Technologies ◽  
Face To Face ◽  
Health Technologies ◽  
Health Related

BACKGROUND A range of digital technologies are available to lay people to find, share, and generate health-related information. Few studies have directed attention specifically to how women are using these technologies from the diverse array available to them. Even fewer have focused on Australian women’s use of digital health. OBJECTIVE The Australian Women and Digital Health Project aimed to investigate which types of digital technologies women used regularly for health-related purposes and which they found most helpful and useful. Qualitative methods—semistructured interviews and focus groups—were employed to shed light on the situated complexities of the participants’ enactments of digital health technologies. The project adopted a feminist new materialism theoretical perspective, focusing on the affordances, relational connections, and affective forces that came together to open up or close off the agential capacities generated with and through these enactments. METHODS The project comprised two separate studies including a total of 66 women. In study 1, 36 women living in the city of Canberra took part in face-to-face interviews and focus groups, while study 2 involved telephone interviews with 30 women from other areas of Australia. RESULTS The affordances of search engines to locate health information and websites and social media platforms for providing information and peer support were highly used and valued. Affective forces such as the desire for trust, motivation, empowerment, reassurance, control, care, and connection emerged in the participants’ accounts. Agential capacities generated with and through digital health technologies included the capacity to seek and generate information and create a better sense of knowledge and expertise about bodies, illness, and health care, including the women’s own bodies and health, that of their families and friends, and that of their often anonymous online social networks. The participants referred time and again to appreciating the feelings of agency and control that using digital health technologies afforded them. When the technologies failed to work as expected, these agential capacities were not realized. Women responded with feelings of frustration, disappointment, and annoyance, leading them to become disenchanted with the possibilities of the digital technologies they had tried. CONCLUSIONS The findings demonstrate the nuanced and complex ways in which the participants were engaging with and contributing to online sources of information and using these sources together with face-to-face encounters with doctors and other health care professionals and friends and family members. They highlight the lay forms of expertise that the women had developed in finding, assessing, and creating health knowledges. The study also emphasized the key role that many women play in providing advice and health care for family members not only as digitally engaged patients but also as digitally engaged carers.

scholarly journals “More like a support tool”: Ambivalences around digital health from medical developers’ perspective

2021 ◽  
Vol 8 (1) ◽  
pp. 205395172199673
Author(s):  
Sarah Lenz
Keyword(s):  
Health Care ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Central Element ◽  
Digital Technologies ◽  
Institutional Logics ◽  
Support Tool ◽  
Medical Practitioners ◽  
Health Technologies ◽  
Medical Ethos

Against the background of the increasing importance of digitization in health care, the paper examines how medical practitioners who are involved in the development of digital health technologies legitimate and criticize the implementation and use of digital health technologies. Adopting an institutional logics perspective, the study is based on qualitative interviews with persons working at the interface of medicine and digital technologies development in Switzerland. The findings indicate that the developers believe that digital health technologies could harmonize current conflicts between an increasing economization of the health care system and professional–ethical demands. At the same time, however, they show that digital technologies can undermine the demand for medical autonomy, a central element of the medical ethos.

scholarly journals Delivery of Compassionate Mental Health Care in a Digital Technology–Driven Age: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Jessica Kemp ◽  
Timothy Zhang ◽  
Fiona Inglis ◽  
David Wiljer ◽  
Sanjeev Sockalingam ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Scoping Review ◽  
Health Professionals ◽  
Digital Technology ◽  
Digital Health ◽  
Digital Technologies ◽  
Compassionate Care

BACKGROUND Compassion is a vital component to the achievement of positive health outcomes, particularly in mental health care. The rise of digital technologies may influence the delivery of compassionate care, and thus this relationship between compassion and digital health care needs to be better understood. OBJECTIVE This scoping review aimed to identify existing digital technologies being used by patients and health professionals in the delivery of mental health care, understand how digital technologies are being used in the delivery of compassionate mental health care, and determine the facilitators of and barriers to digital technology use among patients and health professionals in the delivery of compassionate mental health care. METHODS We conducted this scoping review through a search of Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process and EPub Ahead of Print, PsycINFO, and Web of Science for articles published from 1990 to 2019. RESULTS Of the 4472 articles screened, 37 articles were included for data extraction. Telemedicine was the most widely used technology by mental health professionals. Digital technologies were described as facilitating compassionate care and were classified using a conceptual model to identify each digital intersection with compassionate care. Facilitators of and barriers to providing compassionate care through digital technology were identified, including increased safety for providers, health care professional perceptions and abilities, and the use of <i>picture-in-picture</i> feedback to evaluate social cues. CONCLUSIONS Implementing digital technology into mental health care can improve the current delivery of compassionate care and create novel ways to provide compassion. However, as this is a new area of study, mental health professionals and organizations alike should be mindful that compassionate human-centered care is maintained in the delivery of digital health care. Future research could develop tools to facilitate and evaluate the enactment of compassion within digital health care.

scholarly journals Procurement of innovation terminology usage in health care: A scoping review protocol

2020 ◽  
Author(s):  
Margaret R. Andrews ◽  
Romualdo Ramos ◽  
Martina Ahlberg ◽  
Jan A. Hazelzet ◽  
Erik M. van Raaij ◽  
...  
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
New Technologies ◽  
Scientific Literature ◽  
Digital Health ◽  
Supply And Demand ◽  
Grey Literature ◽  
Health Care Settings ◽  
Health Technologies ◽  
Policy Tool

AbstractBackgroundAlthough procurement of innovation is an established policy tool used to stimulate collaboration between supply- and demand-side entities during the development of new technologies, there is little scientific literature describing the process as applied in health care settings. Furthermore, what literature exists contains inconsistencies of terms, definitions, and/or concepts related to procurement of innovation. This protocol details our process for a systematic scoping review to describe the current scope of literature and to provide terminology clarification.MethodsA search strategy will be used to search PubMed, EMBASE [OVID], CINAHL [EBSCO], PsycINFO [ProQUEST], ABI/INFORM, ISI Web of Knowledge, EBSCO, JSTOR, the Cochrane Database of Systematic Reviews, and Google Scholar; grey literature, non-scientific reports, policy documents and expert recommendations will also be considered as additional sources for texts. Two researchers will screen titles and abstracts for inclusion/exclusion criteria, followed by full texts. We will extract the following data, if applicable: title, authors, date, author affiliations, country, journal/publication characteristics, setting, aims/purpose, methodology, sample characteristics, assessment/evaluation tools, outcome parameters, key findings, relevance, and terminology usage/definitions. Results will be presented narratively and visually.DiscussionThis paper describes the steps of our proposed systematic scoping review to identify and analyse scientific and non-scientific literature related to procurement of innovation and/or innovation of procurement in health care settings, with a particular focus on digital health technologies. Results are intended to demonstrate the current scope of literature, to provide clarity in language and therefore to serve as a first step for further research in this growing field.

scholarly journals Use of Synchronous Digital Health Technologies for the Care of Children With Special Health Care Needs and Their Families: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Marissa Bird ◽  
Lin Li ◽  
Carley Ouellette ◽  
Kylie Hopkins ◽  
Michael H McGillion ◽  
...  
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Digital Health ◽  
Special Health Care Needs ◽  
Health Programs ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Health Technologies ◽  
Special Health

BACKGROUND Use of synchronous digital health technologies for care delivery to children with special health care needs (having a chronic physical, behavioral, developmental, or emotional condition in combination with high resource use) and their families at home has shown promise for improving outcomes and increasing access to care for this medically fragile and resource-intensive population. However, a comprehensive description of the various models of synchronous home digital health interventions does not exist, nor has the impact of such interventions been summarized to date. OBJECTIVE We aim to describe the various models of synchronous home digital health that have been used in pediatric populations with special health care needs, their outcomes, and implementation barriers. METHODS A systematic scoping review of the literature was conducted, guided by the Arksey and O’Malley Scoping Review Framework. MEDLINE, CINAHL, and EMBASE databases were searched from inception to June 2018, and the reference lists of the included systematic reviews and high-impact journals were hand-searched. RESULTS A total of 38 articles were included in this review. Interventional articles are described as feasibility studies, studies that aim to provide direct care to children with special health care needs, and studies that aim to support family members to deliver care to children with special health care needs. End-user involvement in the design and implementation of studies is evaluated using a human-centered design framework, and factors affecting the implementation of digital health programs are discussed in relation to technological, human, and systems factors. CONCLUSIONS The use of digital health to care for children with special health care needs presents an opportunity to leverage the capacity of technology to connect patients and their families to much-needed care from expert health care providers while avoiding the expenses and potential harms of the hospital-based care system. Strategies to scale and spread pilot studies, such as involving end users in the co-design techniques, are needed to optimize digital health programs for children with special health care needs.

scholarly journals Use of Synchronous Digital Health Technologies for the Care of Children With Special Health Care Needs and Their Families: Scoping Review

10.2196/15106 ◽  
2019 ◽  
Vol 2 (2) ◽  
pp. e15106 ◽  
Author(s):  
Marissa Bird ◽  
Lin Li ◽  
Carley Ouellette ◽  
Kylie Hopkins ◽  
Michael H McGillion ◽  
...  
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Digital Health ◽  
Special Health Care Needs ◽  
Health Programs ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Health Technologies ◽  
Special Health

Background Use of synchronous digital health technologies for care delivery to children with special health care needs (having a chronic physical, behavioral, developmental, or emotional condition in combination with high resource use) and their families at home has shown promise for improving outcomes and increasing access to care for this medically fragile and resource-intensive population. However, a comprehensive description of the various models of synchronous home digital health interventions does not exist, nor has the impact of such interventions been summarized to date. Objective We aim to describe the various models of synchronous home digital health that have been used in pediatric populations with special health care needs, their outcomes, and implementation barriers. Methods A systematic scoping review of the literature was conducted, guided by the Arksey and O’Malley Scoping Review Framework. MEDLINE, CINAHL, and EMBASE databases were searched from inception to June 2018, and the reference lists of the included systematic reviews and high-impact journals were hand-searched. Results A total of 38 articles were included in this review. Interventional articles are described as feasibility studies, studies that aim to provide direct care to children with special health care needs, and studies that aim to support family members to deliver care to children with special health care needs. End-user involvement in the design and implementation of studies is evaluated using a human-centered design framework, and factors affecting the implementation of digital health programs are discussed in relation to technological, human, and systems factors. Conclusions The use of digital health to care for children with special health care needs presents an opportunity to leverage the capacity of technology to connect patients and their families to much-needed care from expert health care providers while avoiding the expenses and potential harms of the hospital-based care system. Strategies to scale and spread pilot studies, such as involving end users in the co-design techniques, are needed to optimize digital health programs for children with special health care needs.

scholarly journals Delivery of Compassionate Mental Health Care in a Digital Technology–Driven Age: Scoping Review

10.2196/16263 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e16263 ◽  
Author(s):  
Jessica Kemp ◽  
Timothy Zhang ◽  
Fiona Inglis ◽  
David Wiljer ◽  
Sanjeev Sockalingam ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Scoping Review ◽  
Health Professionals ◽  
Digital Technology ◽  
Digital Health ◽  
Digital Technologies ◽  
Compassionate Care

Background Compassion is a vital component to the achievement of positive health outcomes, particularly in mental health care. The rise of digital technologies may influence the delivery of compassionate care, and thus this relationship between compassion and digital health care needs to be better understood. Objective This scoping review aimed to identify existing digital technologies being used by patients and health professionals in the delivery of mental health care, understand how digital technologies are being used in the delivery of compassionate mental health care, and determine the facilitators of and barriers to digital technology use among patients and health professionals in the delivery of compassionate mental health care. Methods We conducted this scoping review through a search of Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process and EPub Ahead of Print, PsycINFO, and Web of Science for articles published from 1990 to 2019. Results Of the 4472 articles screened, 37 articles were included for data extraction. Telemedicine was the most widely used technology by mental health professionals. Digital technologies were described as facilitating compassionate care and were classified using a conceptual model to identify each digital intersection with compassionate care. Facilitators of and barriers to providing compassionate care through digital technology were identified, including increased safety for providers, health care professional perceptions and abilities, and the use of picture-in-picture feedback to evaluate social cues. Conclusions Implementing digital technology into mental health care can improve the current delivery of compassionate care and create novel ways to provide compassion. However, as this is a new area of study, mental health professionals and organizations alike should be mindful that compassionate human-centered care is maintained in the delivery of digital health care. Future research could develop tools to facilitate and evaluate the enactment of compassion within digital health care.

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