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.

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.

Embodied Spatial Practices and the Power to Care

2019 ◽  
pp. 360-377
Author(s):  
Elise Paradis ◽  
Warren Mark Liew ◽  
Myles Leslie
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Ethnographic Study ◽  
Spatial Practices ◽  
Critical Care Units ◽  
Interprofessional Care ◽  
The Social

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.

scholarly journals Accelerating Innovation in Health Care: Insights From a Qualitative Inquiry Into United Kingdom and United States Innovation Centers

10.2196/19644 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e19644
Author(s):  
Kathrin Cresswell ◽  
Robin Williams ◽  
Narath Carlile ◽  
Aziz Sheikh
Keyword(s):  
United States ◽  
Health Care ◽  
United Kingdom ◽  
Health System ◽  
Digital Health ◽  
Qualitative Inquiry ◽  
Health Science ◽  
Innovation Ecosystem ◽  
Center Staff ◽  
Innovation Activities

Background Digital health innovations are being prioritized on international policy agendas in the hope that they will help to address the existing health system challenges. Objective The aim of this study was to explore the setup, design, facilities, and strategic priorities of leading United Kingdom and United States health care innovation centers to identify transferable lessons for accelerating their creation and maximizing their impact. Methods We conducted qualitative case studies consisting of semistructured, audio-recorded interviews with decision makers and center staff in 6 innovation centers. We also conducted nonparticipant observations of meetings and center tours, where we took field notes. Qualitative data were analyzed initially within and then across cases facilitated by QSR International’s NVivo software. Results The centers had different institutional arrangements, including university-associated institutes or innovation laboratories, business accelerators or incubators, and academic health science partnership models. We conducted interviews with 34 individuals, 1 group interview with 3 participants, and observations of 4 meetings. Although the centers differed significantly in relation to their mission, structure, and governance, we observed key common characteristics. These included high-level leadership support and incentives to engage in innovation activities, a clear mission to address identified gaps within their respective organizational and health system settings, physical spaces that facilitated networking through open-door policies, flat managerial structures characterized by new organizational roles for which boundary spanning was key, and a wider innovation ecosystem that was strategically and proactively engaged with the center facilitating external partnerships. Conclusions Although innovation in health care settings is unpredictable, we offer insights that may help those establishing innovation centers. The key in this respect is the ability to support different kinds of innovations at different stages through adequate support structures, including the development of new career pathways.

The Pediatric Nurse Associate

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 813-814
Author(s):  
Robert D. Burnett ◽  
Keyword(s):  
Health Care ◽  
Child Health ◽  
American Academy ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Child Health Care ◽  
Pediatric Nurse ◽  
The Past ◽  
American Academy Of Pediatrics

During the past several years as Chairman of the American Academy of Pediatrics' Committee on Pediatric Manpower I have witnessed the development of the concept of the pediatric nurse associate (PNA) within the specialty of pediatrics. In addition, I have also been aware of the controversies within the AAP membership regarding the role of the PNA in child health care delivery. Many of you will recall the concern of the mid-1960's which widely publicized an impending catastrophic shortage of pediatricians.

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.

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