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.

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.

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.

Mediators of marginalisation in discharge planning with older adults

2016 ◽  
Vol 37 (9) ◽  
pp. 1747-1769 ◽  
Author(s):  
EVELYNE DUROCHER ◽  
BARBARA E. GIBSON ◽  
SUSAN RAPPOLT
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older Adult ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Discharge Planning ◽  
Health Care Systems ◽  
Urban Setting ◽  
Care Services ◽  
Care Systems

ABSTRACTReturning home or moving to a more supportive setting upon discharge from inpatient health-care services can have a tremendous impact on the lives of older adults and their families. Institutional concerns with patient safety and expedience can overshadow health-care professionals' commitments to collaborative discharge planning. In light of many competing demands and agendas, it can be unclear what is driving discharge-planning processes and outcomes. This paper presents the results of a study examining discharge planning in an older adult rehabilitation unit in a Canadian urban setting. Using microethnographic case studies, we explored the perspectives of older adults, family members and health-care professionals. Drawing on concepts of relational autonomy to guide the analysis, we found that discourses of ageing-as-decline, beliefs privileging health-care professionals' expertise and conventions guiding discharge planning intersected to marginalise older adult patients in discharge-planning decision making. Discharge planning in the research setting was driven by norms of ‘protecting physical safety’ at the expense of older adults’ self-declared interests and values. Such practices resulted in frequent recommendations of 24-hour care, which have significant personal, social and financial implications for older adults and their families, and ultimately might undermine clients' or health-care systems' aims. The analysis revealed social, political and institutional biases that diminish the rights and autonomy of older adults.

scholarly journals User perspectives and preferences regarding a mobile health cough application: A qualitative study during the coronavirus disease pandemic in Denmark

2021 ◽  
Vol 7 ◽  
pp. 205520762110455
Author(s):  
Stine Thestrup Hansen ◽  
Humira Ehrari ◽  
Susanne Kristiansen ◽  
Lotte Schelde Olsen ◽  
Rasmus Stig Jensen ◽  
...  
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Health Care Services ◽  
Health Care Systems ◽  
Management Strategies ◽  
Seek Health Care ◽  
Health Technologies ◽  
Care Systems ◽  
User Expectations ◽  
User Perspectives

Introduction Health care systems worldwide are currently facing major challenges because of the coronavirus disease pandemic. When individuals experience coronavirus disease symptoms, they often have to decide whether to seek health care services and render themselves vulnerable to infection or stay home and monitor their condition. Coronavirus disease management strategies should aim to reduce transmission, promote disease control, and facilitate self-monitoring within the population. In this regard, mobile health technologies serve as supportive tools, and acquiring knowledge about user perspectives will facilitate the development and integration of coronavirus disease-related applications. Accordingly, this study aimed to examine user perspectives on applications that monitor coronavirus disease-related physical signs and identify discrepancies between user expectations and developer design perspectives within the Danish context. Materials and methods A qualitative research design was adopted. Semi-structured telephone interviews were conducted to examine user expectations during the first wave of the coronavirus disease pandemic in April 2020. The theoretical framework, which was inspired by the concept of health literacy, was developed using a six-step thematic analytic approach. Results The analysis yielded two major themes that captured user experiences: (1) coronavirus disease-related applications may serve as digital tools that foster safety when physical signs are monitored and (2) the acceptability of coronavirus disease-related applications depends on the adoption of a personalised and user-friendly design.

scholarly journals Turning the Crisis Into an Opportunity: Digital Health Strategies Deployed During the COVID-19 Outbreak (Preprint)

2020 ◽  
Author(s):  
Pol Pérez Sust ◽  
Oscar Solans ◽  
Joan Carles Fajardo ◽  
Manuel Medina Peralta ◽  
Pepi Rodenas ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Care Systems ◽  
Public Health Care ◽  
Health Technologies ◽  
Health Strategy ◽  
Care Systems

UNSTRUCTURED Digital health technologies offer significant opportunities to reshape current health care systems. From the adoption of electronic medical records to mobile health apps and other disruptive technologies, digital health solutions have promised a better quality of care at a more sustainable cost. However, the widescale adoption of these solutions is lagging behind. The most adverse scenarios often provide an opportunity to develop and test the capacity of digital health technologies to increase the efficiency of health care systems. Catalonia (Northeast Spain) is one of the most advanced regions in terms of digital health adoption across Europe. The region has a long tradition of health information exchange in the public health care sector and is currently implementing an ambitious digital health strategy. In this viewpoint, we discuss the crucial role digital health solutions play during the coronavirus disease (COVID-19) pandemic to support public health policies. We also report on the strategies currently deployed at scale during the outbreak in Catalonia.

scholarly journals Turning the Crisis Into an Opportunity: Digital Health Strategies Deployed During the COVID-19 Outbreak

10.2196/19106 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19106 ◽  
Author(s):  
Pol Pérez Sust ◽  
Oscar Solans ◽  
Joan Carles Fajardo ◽  
Manuel Medina Peralta ◽  
Pepi Rodenas ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Care Systems ◽  
Public Health Care ◽  
Health Technologies ◽  
Health Strategy ◽  
Care Systems

Digital health technologies offer significant opportunities to reshape current health care systems. From the adoption of electronic medical records to mobile health apps and other disruptive technologies, digital health solutions have promised a better quality of care at a more sustainable cost. However, the widescale adoption of these solutions is lagging behind. The most adverse scenarios often provide an opportunity to develop and test the capacity of digital health technologies to increase the efficiency of health care systems. Catalonia (Northeast Spain) is one of the most advanced regions in terms of digital health adoption across Europe. The region has a long tradition of health information exchange in the public health care sector and is currently implementing an ambitious digital health strategy. In this viewpoint, we discuss the crucial role digital health solutions play during the coronavirus disease (COVID-19) pandemic to support public health policies. We also report on the strategies currently deployed at scale during the outbreak in Catalonia.

scholarly journals Future Perspectives of Health Care: Closing Remarks

2021 ◽  
pp. 375-380
Author(s):  
Gørill Haugan ◽  
Monica Eriksson
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Health Care Services ◽  
Health Care Systems ◽  
Health Sector ◽  
Care Services ◽  
Care Systems ◽  
Health Promoting ◽  
Professional Leadership ◽  
Salutogenic Model

AbstractThe Covid-19 pandemic has demonstrated the vulnerability of our health care systems as well as our societies. During the year of 2020, we have witnessed how whole societies globally have been in a turbulent state of transformation finding strategies to manage the difficulties caused by the pandemic. At first glance, the health promotion perspective might seem far away from handling the serious impacts caused by the Covid-19 pandemic. However, as health promotion is about enabling people to increase control over their health and its determinants, paradoxically health promotion seems to be ever more important in times of crisis and pandemics. Probably, in the future, pandemics will be a part of the global picture along with the non-communicable diseases. These facts strongly demand the health care services to reorient in a health promoting direction.The IUHPE Global Working Group on Salutogenesis suggests that health promotion competencies along with a reorientation of professional leadership towards salutogenesis, empowerment and participation are required. More specifically, the IUHPE Group recommends that the overall salutogenic model of health and the concept of SOC should be further advanced and applied beyond the health sector, followed by the design of salutogenic interventions and change processes in complex systems.

scholarly journals Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews

2017 ◽  
Vol 11 (1) ◽  
pp. 108-123 ◽  
Author(s):  
Mary Halter ◽  
Ferruccio Pelone ◽  
Olga Boiko ◽  
Carole Beighton ◽  
Ruth Harris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Systematic Reviews ◽  
Health Care Services ◽  
Health Care Systems ◽  
Large Body ◽  
Review Literature ◽  
Adult Health ◽  
Turnover Rates ◽  
Care Systems

Background: Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. Objective: We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. Method: We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Results: Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. Conclusion: We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

scholarly journals Patient Rounds With Video-Consulted Relatives: Qualitative Study on Possibilities and Barriers From the Perspective of Healthcare Providers (Preprint)

2018 ◽  
Author(s):  
Christina Østervang ◽  
Lene Vedel Vestergaard ◽  
Karin Brochstedt Dieperink ◽  
Dorthe Boe Danbjørg
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
New Technology ◽  
Work And Family ◽  
Focus Group Interviews ◽  
Work Routines ◽  
Care Systems ◽  
Group Interviews

BACKGROUND In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited. OBJECTIVE This study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds. METHODS The design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis. RESULTS Field observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted. Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives. CONCLUSIONS This study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.

scholarly journals Forum: equity in access to health care. Introduction

2008 ◽  
Vol 24 (5) ◽  
pp. 1159-1161 ◽  
Author(s):  
Claudia Travassos
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
Care Access ◽  
Unethical Practices ◽  
Access To Health ◽  
Care Systems ◽  
Equity In Access

The Introduction outlines this issue's special Forum on equity in access to health care, including three Articles and a Postscript. The Forum represents a continuation of the debates raised during a seminar organized by the Oswaldo Cruz Foundation in the city of Rio de Janeiro, Brazil, in 2006, in collaboration with UNICEF, UNDP, World Bank, the WHO Special Program for Research and Training in Tropical Diseases, and the United Nations Research Institute for Social Development. The authors approach health care access and equity from a comprehensive and contemporaneous perspective, introducing a new conceptual framework for access, in which information plays a central role. Trust is proposed as an important value for an equitable health care system. Unethical practices by health administrators and health care professionals are highlighted as hidden critical aspects of inequities in health care. As a whole, the articles represent a renewed contribution for understating inequalities in access, and for building socially just health care systems.

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