Use of the Leva Pelvic Digital Health System in Women With Fecal Incontinence: a Pilot Study

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.

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Challenges for non-technical implementation of digital proximity tracing: early experiences from Switzerland (Preprint)

10.2196/preprints.25345 ◽

2020 ◽

Author(s):

Viktor von Wyl

Keyword(s):

Health System ◽

Resource Competition ◽

Digital Health ◽

Mitigation Measures ◽

Contact Tracing ◽

Implementation Challenges ◽

Early Experiences ◽

Multiple Challenges ◽

Media Reports ◽

Communication Needs

BACKGROUND Several countries have released digital proximity tracing (DPT) apps in addition to manual contact tracing (MCT) to combat the Sars-CoV-2 pandemic. The goal of DPT is to notify app users about proximity exposures to persons infected with Sars-CoV-2 so that they can self-quarantine. However, early press reports from Switzerland suggest multiple challenges for non-technical DPT implementation. OBJECTIVE Using media articles published during the first three months after the DPT app launch to describe non-technical implementation challenges reported by different stakeholders and to map these reports to the four constructs of normalization process theory (NPT), a framework to develop and evaluate complex digital health interventions. METHODS A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between 04.07.2020 and 03.10.2020. Topics were extracted manually from articles that were deemed pertinent in a structured process. Extracted topics were mapped to NPT constructs. RESULTS Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. These challenges included unclear DPT benefits, which affected commitment and raised fears among different health system actors regarding resource competition with established pandemic mitigation measures. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from certain health system actors. Finally, some reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. These challenges mapped well to the four constructs of NPT. CONCLUSIONS Early experiences from one of the first adopters of DPT indicate that non-technical implementation challenges warrant attention. The detected implementation challenges fit well into the framework of NPT, which seems well suited to guide the development and evaluation of complex DPT interventions.

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