Digital mHealth and Virtual Care Use in Pandemics: Part 1 – A Rapid Landscape Review of Interventions Used Internationally During COVID-19 in 4 Countries (Preprint)

2020 ◽  
Author(s):  
Alison Müller ◽  
Alessandro Cau ◽  
Muhammed Semakula ◽  
Peter Lodokiyiia ◽  
Osman Abdullahi ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Patient Care ◽  
Grey Literature ◽  
Text Message ◽  
Rapid Expansion ◽  
Contact Tracing ◽  
Virtual Care ◽  
Health Organization ◽  
The Uk

BACKGROUND As a result of the Coronavirus Disease-2019 (COVID-19) pandemic, significantly fewer patients are able to communicate with their health care practitioners (HCPs) as a result of internationally encouraged physical distancing. This has led to an unprecedented rapid expansion of digital tools to provide digitalized virtual care globally, especially mobile phone facilitated health interventions, called mHealth. To help keep abreast of different mHealth and virtual care technologies being used internationally to facilitate patient care and public health during the COVID-19 pandemic we did a rapid investigation of solutions being deployed and considered in 4 countries. OBJECTIVE To evaluate mHealth, and digital and contact tracing technologies being used in healthcare among 4 countries. METHODS This data was procured by accessing a variety of resources including grey literature, government & health organization websites, in addition to contacting our collaborators in Canada, the UK, Rwanda, and Kenya. We specifically requested information regarding various mHealth and virtual care interventions being used to facilitate patient care and public health, such as case contact tracing. RESULTS We identified a variety of technology in Canada, the UK, Rwanda, and Kenya being used for patient care and public health. The afore-mentioned countries are using both video and text-message based platforms to facilitate communication with HCPs (ex. WelTel, Zoom). Nationally-developed contact-tracing apps are provided free to the public, with most of them using Bluetooth-based technology. We identified that often multiple complimentary technologies are being utilized for different aspects of patient care and public health with the common purpose to disseminate information safely. CONCLUSIONS Virtual care and mHealth technologies have evolved rapidly as a tool for health care support for both patient care and public health. It is evident that, on an international level, a variety of mHealth and virtual care interventions, often in combination, are required to be able to address patient care and public health concerns during the COVID-19 pandemic. CLINICALTRIAL N/A

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

The UK COVID-19 contact tracing app as both an emerging technology and public health intervention: The need to consider promissory discourses

2021 ◽  
pp. 136345932110607
Author(s):  
Gabrielle Samuel ◽  
Rosie Sims
Keyword(s):  
Public Health ◽  
Rapid Development ◽  
Public Health Intervention ◽  
Health Intervention ◽  
Contact Tracing ◽  
The Public ◽  
Sociology Of Expectations ◽  
Short Period ◽  
The Media ◽  
The Uk

The UK’s National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and ‘save lives’. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors – in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities.

scholarly journals “Too Grey To Be True?” Sexual Violence in Older Adults: A Critical Interpretive Synthesis of Evidence

2020 ◽  
Vol 17 (11) ◽  
pp. 4117
Author(s):  
Anne Nobels ◽  
Christophe Vandeviver ◽  
Marie Beaulieu ◽  
Adina Cismaru Inescu ◽  
Laurent Nisen ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Older Adults ◽  
Health Care ◽  
Sexual Health ◽  
Sexual Violence ◽  
Old Age ◽  
Grey Literature ◽  
Health Needs ◽  
Second Phase

Sexual violence (SV) is an important public health issue with a major impact on victims and their peers, offspring and community. However, SV in older adults is under-researched. This paper aims to establish the prevalence and nature of SV in older adults in Europe, link this with existing policies and health care workers’ response to sexual health needs in older age, and critically revise the currently used frameworks in public health research. To fill this gap in the literature, we applied a Critical Interpretative Synthesis (CIS) approach. The CIS approach uses techniques from grounded theory and processes from systematic review. It allows to critically interpret key findings from both academic as well as grey literature, engendering theory refining. In the first phase of purposive sampling, we conducted a systematic review of academic sources and included 14 references. The cut-off age used to define old age varied between 60 and 70 years old among the included studies. Subsequently we added another 14 references in the second phase of theoretical sampling. We ultimately included 16 peer-reviewed articles and 12 documents from the grey literature. The CIS results demonstrate that knowledge of SV in older adults is still limited. The current research suggests that SV in older adults rarely occurs, however, prevalence rates are likely to be underestimated because of methodological shortcomings. The complexity of SV in older adults is not acknowledged in ongoing research due to the conflation of SV with other types of violence. Information on specific risk factors and about assailants committing SV in old age is absent. Policy documents dealing with sexual and reproductive health, rights and ageing make no mention of SV in older adults. In clinical practice, the sexual health needs of older adults often remain unmet. In conclusion, our findings suggest that older adults are forgotten in prevention and response to SV. Greater awareness about this topic could contribute to a revision of current policies and health care practices, leading to more tailored care for older victims of SV.

Inequalities in Health: What Health Systems Can and Cannot Do

1996 ◽  
Vol 1 (3) ◽  
pp. 179-182 ◽  
Author(s):  
Peggy Foster
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Health Status ◽  
Health Care Providers ◽  
Health Examination ◽  
Care Providers ◽  
Inequalities In Health ◽  
Department Of Health ◽  
The Uk

Health promotion activities are actively encouraged in most countries, including the UK. Meanwhile many health care providers and health experts are becoming increasingly concerned about the growing evidence of significant health inequalities between social groups in the UK, and in particular the strong association between relative deprivation and poor health. In 1995, a report for the British government entitled ‘Variations in health: What can the Department of Health and the NHS do?’, identified the need for the Department of Health and the NHS to play a key role in coordinating and implementing public health programmes intended to reduce inequalities in health. Examination of existing evidence on the effectiveness of health promotion and prevention programmes designed to improve the health status of the most vulnerable groups in society reveals very little evidence to support current enthusiasm for adopting public health strategies in order to reduce variations in health status between the affluent and the poor. Alternative and potentially more effective health care responses to inequalities in health status need to be considered.

scholarly journals Heterogeneity of the COVID-19 epidemic in Australia: What can we learn from it?

2021 ◽  
Author(s):  
Qiuli Chen ◽  
Yibeltal Assefa
Keyword(s):  
Public Health ◽  
Good Governance ◽  
System Capacity ◽  
World Health ◽  
Contact Tracing ◽  
South Wales ◽  
The World ◽  
Effective Community ◽  
One Year ◽  
Health Organization

Abstract It has been more than one year since the World Health Organization declared the pandemic of COVID-19. Countries around the world are still struggling to control their epidemics. Australia has shown its resilience in the fight against the epidemic by providing a comprehensive response involving the whole-of-government and whole-of-society. Despite the overall successful national response, the epidemic in Australia has been heterogeneous across states. We conducted a mixed-methods study to analyze the epidemic and explain the variable manifestation of the epidemic across states in Australia. Most of the COVID-19 cases and deaths were in Victoria and New South Wales states due to differences in governance of the epidemic and public health responses (quarantine and contact tracing) among states. Countries could learn not only from Australia’s overall successful response, through good governance, effective community participation, adequate public health and health system capacity and multisectoral actions, but also from the heterogeneity of the epidemic among states. Successful response to epidemics in countries with a decentralized administration requires multi-level governance with alignment and harmonization of the response.

scholarly journals Pakistan’s Response to COVID-19: Overcoming National and International Hypes to Fight the Pandemic (Preprint)

2021 ◽  
Author(s):  
Hashaam Akhtar ◽  
Maham Afridi ◽  
Samar Akhtar ◽  
Hamaad Ahmad ◽  
Sabahat Ali ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
World Health Organization ◽  
Public Health Emergency ◽  
World Health ◽  
High Population ◽  
Economic Systems ◽  
The World ◽  
Health Organization

UNSTRUCTURED The COVID-19 outbreak started as pneumonia in December 2019 in Wuhan, China. The subsequent pandemic was declared as the sixth public health emergency of international concern on January 30, 2020, by the World Health Organization. Pakistan could be a potential hotspot for COVID-19 owing to its high population of 204.65 million and its struggling health care and economic systems. Pakistan was able to tackle the challenge with relatively mild repercussions. The present analysis has been conducted to highlight the situation of the disease in Pakistan in 2020 and the measures taken by various stakeholders coupled with support from the community to abate the risk of catastrophic spread of the virus.

scholarly journals Protecting the Public Interest when Regulating Health Professionals Providing Virtual Care: A Scoping Review Protocol

2021 ◽  
Author(s):  
Kathleen Leslie ◽  
Sophia Myles ◽  
Tracey L Adams ◽  
Catharine Schiller ◽  
Jacob Shelley ◽  
...  
Keyword(s):  
Scoping Review ◽  
Public Interest ◽  
Health Professionals ◽  
Digital Health ◽  
Grey Literature ◽  
Regulatory Reform ◽  
Health Profession ◽  
Rapid Expansion ◽  
The Public ◽  
Virtual Care

Abstract Background: Virtual care is transforming the nature of healthcare, particularly with the accelerated shift to telehealth and virtual care during the COVID-19 pandemic. Health profession regulators face intense pressures to safely facilitate this type of healthcare while upholding their legislative mandate to protect the public. Challenges for health profession regulators have included providing practice guidance for virtual care, changing entry to practice requirements to include digital competencies, facilitating interjurisdictional virtual care through licensure and liability insurance requirements, and adapting disciplinary procedures. This scoping review will examine the literature on how the public interest is protected when regulating health professionals providing virtual care.Methods: This review will follow the Joanna Briggs Institute (JBI) scoping review methodology. Academic and grey literature will be retrieved from health sciences, social sciences, and legal databases using a comprehensive search strategy underpinned by Population-Concept-Context (PCC) inclusion criteria. Articles published in English since January 2015 will be considered for inclusion. Two reviewers will independently screen titles and abstracts and full-text sources against specific inclusion and exclusion criteria. Discrepancies will be resolved through discussion or by a third reviewer. One research team member will extract relevant data from the selected documents and a second will validate the extractions.Discussion: Results will be presented in a descriptive synthesis that highlights implications for regulatory policy and professional practice, as well as study limitations and knowledge gaps that warrant further research. Given the rapid expansion of virtual care provision by regulated health professionals in response to the COVID-19 pandemic, mapping the literature on how the public interest is protected in this rapidly evolving digital health sector may help inform future regulatory reform and innovation.Review registration: This protocol is registered with the Open Science Framework (10.17605/OSF.IO/BD2ZX).

scholarly journals Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research (Preprint)

2020 ◽  
Author(s):  
Sherif M Badawy ◽  
Ana Radovic
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Rapid Expansion ◽  
Care Providers ◽  
Financial Barriers ◽  
Pediatric Health ◽  
Pediatric Health Care ◽  
Research Areas

UNSTRUCTURED The global spread of the coronavirus disease (COVID-19) outbreak poses a public health threat and has affected people worldwide in various unprecedented ways, both personally and professionally. There is no question that the current global COVID-19 crisis, now more than ever, is underscoring the importance of leveraging digital approaches to optimize pediatric health care delivery in the era of this pandemic. In this perspective piece, we highlight some of the available digital approaches that have been and can continue to be used to streamline remote pediatric patient care in the era of the COVID-19 pandemic, including but not limited to telemedicine. <i>JMIR Pediatrics and Parenting</i> is currently publishing a COVID-19 special theme issue in which investigators can share their interim and final research data related to digital approaches to remote pediatric health care delivery in different settings. The COVID-19 pandemic has rapidly transformed health care systems worldwide, with significant variations and innovations in adaptation. There has been rapid expansion of the leveraging and optimization of digital approaches to health care delivery, particularly integrated telemedicine and virtual health. Digital approaches have played and will play major roles as invaluable and reliable resources to overcome restrictions and challenges imposed during the COVID-19 pandemic and to increase access to effective, accessible, and consumer-friendly care for more patients and families. However, a number of challenges remain to be addressed, and further research is needed. Optimizing digital approaches to health care delivery and integrating them into the public health response will be an ongoing process during the current COVID-19 outbreak and during other possible future pandemics. Regulatory changes are essential to support the safe and wide adoption of these approaches. Involving all relevant stakeholders in addressing current and future challenges as well as logistical, technological, and financial barriers will be key for success. Future studies should consider evaluating the following research areas related to telemedicine and other digital approaches: cost-effectiveness and return on investment; impact on quality of care; balance in use and number of visits needed for the management of both acute illness and chronic health conditions; system readiness for further adoption in other settings, such as inpatient services, subspecialist consultations, and rural areas; ongoing user-centered evaluations, with feedback from patients, families, and health care providers; strategies to optimize health equity and address disparities in access to care related to race and ethnicity, socioeconomic status, immigration status, and rural communities; privacy and security concerns for protected health information with Health Insurance Portability and Accountability Act (HIPAA)–secured programs; confidentiality issues for some specific populations, especially adolescents and those in need of mental health services; early detection of exposure to violence and child neglect; and integration of training into undergraduate and graduate medical education and subspecialty fellowships. Addressing these research areas is essential to understanding the benefits, sustainability, safety, and optimization strategies of telemedicine and other digital approaches as key parts of modern health care delivery. These efforts will inform long-term adoption of these approaches with expanded dissemination and implementation efforts.

scholarly journals Public health fault lines in the fight against COVID-19: Lessons from Africa

2021 ◽  
Vol 11 (2) ◽  
pp. 260-262
Author(s):  
Saikou Omar Sillah ◽  
Xu Yihua
Keyword(s):  
Public Health ◽  
Health Care ◽  
World Health Organization ◽  
Health Care System ◽  
Virus Disease ◽  
Public Health Emergency ◽  
World Health ◽  
Rapid Spread ◽  
The World ◽  
Health Organization

On 31st December 2019, the World Health Organization (WHO) was notified of a cluster of cases of pneumonia of unknown cause detected in the Wuhan, Hubei Province of China which eventually was named to be the Corona virus disease. In response to the rapid spread of the virus, WHO declared it a public health emergency of international concern (PHEIC) on 30th January, 2020. As per the quest to recharge the COVID-19 response power, there is seemingly little or no tangible plans to help permanently reorient Africa’s health care system. In the wake of widespread vaccine nationalism, donor countries continue to secure large quantities of vaccines from developers and manufacturers, causing global disparity in access to COVID-19 vaccines.

Hand Hygiene and Infection Control

Nursing OSCEs ◽  
2012 ◽  
Author(s):  
Jane Lovegrove
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Hand Hygiene ◽  
World Health ◽  
Health Care Students ◽  
Physical Burden ◽  
Health Organization ◽  
The Uk ◽  
Heath Care ◽  
Hospital Acquired

Each year hundreds of millions of people contract an infection while in the receipt of heath care. At any time 1.4 million people worldwide are suffering from an infectious complication associated with health care (WHO 2005). Health care acquired infections not only lead to pain discomfort, disability, and possible death for the recipient but also place a huge emotional and physical burden on relatives and carers. In England and Wales an average of one in 11,000 people die of a hospital acquired infection (HAI) each year; this figure rises to 1 in 300 for patients over the age of 80 (Bandolier 2006). Hospital admission is now a major risk factor for health care related infection (Gould 2009). In 2007 around 9,000 people in England died with an MRSA bloodstream infection or related Clostridium difficile infection (National Audit Office 2009). These figures do not include deaths from other HAIs so in fact the number of deaths from HAIs could be greater. In addition, it is also believed that many people die from a health care acquired infection which is not identified on the death certificate. In England, health care related infections have been estimated to cost a billion pounds annually (WHO 2005). The World Health Organization has identified hand hygiene as the primary measure to reduce infections (WHO 2009). Everyone involved in the provision of health care must be trained in effective hand decontamination (NICE 2003). Unclean hands move microorganisms from one place to another. Transmission of infection by hands has been identified with recent hospital outbreaks of MRSA and Clostridium difficile. Good hand hygiene is one of the most effective methods of reducing hospital acquired infections. Hand decontamination removes transient bacteria acquired from recent contact with an infected item or person. While hand decontamination is advocated before contact with every patient regardless of setting, patients in hospital are at greatest risk of acquiring an infection. In the UK 7.6% of patients admitted to hospital become infected. In England the figure is even higher at 8.19% (Nazarko 2008). It is essential for health care students to not only be able to perform effective hand washing, but also understand the principles of the procedure, as well as the possible physical, emotional and financial consequences of failing to perform hand hygiene.

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