The Family Physician of the Future in Management of Chronic Diseases

Since the existence of the first human, humankind has tried to find immortality. In line with these efforts, the field of medicine has developed and has received its share from the developing technology. Digital technologies aim to improve human health through data management and analysis, mobile technologies, social networks, wearable or high-level applications and tools, they can be placed on the body. These technologies and practices provide the physician or healthcare worker with simultaneous information about the individual's health status, thereby keeping the individual's health status under constant control. With these technologies, while monitoring the health status of the individual in terms of environmental, behavioral, psychological and physical aspects, a more controllable and effective health system can be pioneered. Telemedicine and virtual care, while keeping the physicians’ safe work during this period, where the COVID-19 pandemic negatively affected the world, has become an important tool in the care of patients. This review aims to determine the digital health technologies and applications, their advantages, disadvantages and the current situation in future chronic diseases used in future health services and healthcare user. Keywords: Family Physician, COVID-19, mobile health, pandemic, chronic disease

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Assessment of the health of medical students

Health Care of the Russian Federation ◽

10.46563/0044-197x-2020-64-3-132-138 ◽

2020 ◽

Vol 64 (3) ◽

pp. 132-138

Author(s):

Anastasiya A. Khablova ◽

Galina N. Bondar’ ◽

Pavel F. Kiku ◽

Natal’ya S. Tumanova ◽

Valentina N. Rasskazova ◽

...

Keyword(s):

Physical Activity ◽

Health Status ◽

Medical Students ◽

Healthy Lifestyle ◽

Well Being ◽

Component Composition ◽

The Body ◽

Spiritual Well Being ◽

Academic Workload ◽

The Individual

Human health, in addition to social and spiritual well-being, is determined by its physical condition, which reflects the functional capabilities of the body, features of physical development and ensures working capacity in any activity, including academic workload, which is extremely important for students in higher educational institutions. The purpose of the study is to assess the health status of students at the School of Biomedicine of the Far Eastern Federal University. Material and methods. The health status of 184 medical students (147 young women and 37 young men) was assessed using a sociological survey (questionnaire) and a study of the component composition of the body using bioimpedancemetry. Results. The low physical activity, detected in 68% of students and bad habits (smoking tobacco) have been established to negatively affect students’ health. Among smokers, 75% of students live in dormitories on the university campus. According to the results of bioimpedancemetry, significant deviations from the age norm were noted in terms of body mass index (BMI) (50% of cases) and fat mass (FM) (71% of cases). Significant gender differences in the individual components of the body were not identified. Discussion. The most aggressive factors that significantly affect the health of students are unbalanced nutrition, lack of compliance with the regime of study and rest, lack of sleep and stay in the fresh air, lack of physical activity, lack of motivation for a healthy lifestyle. Significant deviations in BMI and FM, identified by bioimpedancemetry, indicate the risks of developing arterial hypertension, metabolic syndrome, and nutritional status disorders. Medical students need to give recommendations for increasing motor activity and changing diet. Conclusion. The results of the study can be used in the future to determine the functional state of students and develop preventive measures to preserve the health of medical students.

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Queensland Digital Health Clinical Charter: a clinical consensus statement on priorities for digital health in hospitals

Australian Health Review ◽

10.1071/ah19067 ◽

2020 ◽

Vol 44 (5) ◽

pp. 661

Author(s):

Clair Sullivan ◽

Andrew Staib ◽

Keith McNeil ◽

David Rosengren ◽

Ian Johnson

Keyword(s):

Decision Making ◽

Digital Health ◽

Digital Technologies ◽

Executive Leadership ◽

Digital Transformation ◽

Decision Making Process ◽

Health Technologies ◽

Clinical Community ◽

Expected Benefits ◽

High Level

Digital transformation of Australian hospitals is occurring rapidly. Although the clinical community has had limited ability to influence high-level decision making and investments into digital health technologies, as these technologies increasingly transform the way patients are cared for, the clinical community must influence the digital health agenda and be an integral part of the decision-making process. This case study details the process and lessons learnt during the development of the state-wide consensus statement detailing the clinical requirements for digital health initiatives to form the Queensland Digital Health Clinical Charter. To the best of our knowledge, Queensland is the first Australian jurisdiction to create a Digital Clinical Charter to be specifically referenced in the investment in and governance of digital health in hospitals. By developing this clinical charter for digital health, and in articulating the needs of clinicians, a clinical framework will be added to both the decision-making process around the investments in digital health and the definition and realisation of the expected benefits from these sizable investments. What is known about the topic? Digital transformation of healthcare is occurring rapidly. The clinical community has had limited ability to influence high-level decision making and investments into these digital health technologies. Tension currently exists between the clinical community who must use the new digital technologies and the technical groups that govern the introduction of the new technologies. This tension can be manifest as clinicians refusing to adopt new systems, safety concerns and an inability to reach consensus on direction. There are few peer reviewed publications addressing this tension between the clinical community and technical providers. What does this paper add? This paper is the first attempt to create a list of clinical requirements for digital transformation that crosses professional streams and is endorsed by the state-wide executive leadership team to inform the acquisition and governance of digital health technologies. What are the implications for practitioners? Clinicians can feel excluded and marginalised during the decision-making process for new digital technologies, despite the fact that they are often using these technologies to deliver hands-on care to patients. This charter clearly articulates the requirements of clinicians for digital transformation and has been endorsed by the executive leadership team of Queensland Health. The charter adds a clinical framework to be referenced during the decision-making process around the investments in digital health, and the definition and realisation of the expected benefits from these sizable investments. As the digital landscape in public hospitals evolves, clinicians are becoming increasingly reliant upon digital technologies. It is critical that clinicians have a strong effect on technology acquisition and governance to maximise the quality and efficiency of the care they provide.

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Patient and Provider Cocreation of Mobile Texting Apps to Support Behavioral Health: Usability Study (Preprint)

10.2196/preprints.12655 ◽

2018 ◽

Author(s):

Armen C Arevian ◽

Jennifer O'Hora ◽

James Rosser ◽

Joseph D Mango ◽

David J Miklowitz ◽

...

Keyword(s):

Digital Health ◽

Text Messages ◽

Mobile Technologies ◽

Usability Study ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Health Technologies ◽

Development Platform ◽

Complete Treatment ◽

Personal Use

BACKGROUND Mobile technologies hold potential for improving the quality of care and engagement of patients. However, there are considerable challenges in ensuring that technologies are relevant, useful, and engaging. While end users such as patients and providers are increasingly involved in the design of health technologies, there are limited examples of their involvement in directly creating technologies for their personal use. OBJECTIVE We aim to evaluate the feasibility and acceptability of patients and providers creating mobile texting apps to support treatment goals. METHODS In an 11-month usability study, we enrolled 4 providers and 28 patients in an intensive outpatient program for obsessive-compulsive disorder. Patients and providers created their own mobile texting apps using a visual app development platform. A subsample of 10 patients and 4 providers completed a usability measure. RESULTS Participants created a total of 360 unique mobile text messages (1787 total messages sent). There were 4 types of messages identified, including personalized reminders, clinical exposures, interactive prompts, and encouraging/informational messages. A total of 9 out of 10 (90%) patients agreed that the messages were relevant to their recovery, and 8 out of 10 (80%) agreed that the messages were effective at helping complete treatment plans. CONCLUSIONS Enabling patients and providers to cocreate apps for their own use by using a visual application platform is feasible and holds potential for increasing the relevance, sustainability, and effectiveness of digital health technologies.

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Interpretation as luxury: Heart patients living with data doubt, hope, and anxiety

Big Data & Society ◽

10.1177/2053951720924436 ◽

2020 ◽

Vol 7 (1) ◽

pp. 205395172092443 ◽

Cited By ~ 1

Author(s):

Stine Lomborg ◽

Henriette Langstrup ◽

Tariq Osman Andersen

Keyword(s):

Ethical Dilemmas ◽

Digital Health ◽

Data Interpretation ◽

Personal Health ◽

Health Technologies ◽

Heart Patients ◽

The Individual ◽

Consumer Devices ◽

And Behavior ◽

The Relationship

Personal health technologies such as apps and wearables that generate health and behavior data close to the individual patient are envisioned to enable personalized healthcare - and self-care. And yet, they are consumer devices. Proponents of these devices presuppose that measuring will be helpful, and that data will be meaningful. However, a growing body of research suggests that self-tracking data does not necessarily make sense to users. Drawing together data studies and digital health research, we aim to further research on data ambivalence, a term we use to refer to the ambiguities and uncertainties people experience when interpreting their own data, as well as the critical obligation towards cultivating ethically sound uses and responses to such data in context. We develop the relationship between data, interpretation, and context as a central theoretical and practical problem in the datafication of healthcare. We then show how interpretation and context matter for data ambivalence through an empirical study of heart patients with an implanted advanced pacemaker who were offered a Fitbit wristband for self-tracking as part of a research project. We argue that the hope, anxiety, and doubt connected to the promise and accuracy of data are tempered by the context and purpose of self-tracking, and by individual circumstances. Finally, we link the findings on context-sensitivity in data interpretation to questions about response-ability in cloud-based care infrastructures. We discuss the ethical dilemmas associated with the use of commercial wellness-technologies in healthcare, and with researching such emerging practices.

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Addressing Healthcare Gaps in Sweden during the COVID-19 Outbreak: On Community Outreach and Empowering Ethnic Minority Groups in a Digitalized Context

Healthcare ◽

10.3390/healthcare8040445 ◽

2020 ◽

Vol 8 (4) ◽

pp. 445

Author(s):

Giuseppe Valeriani ◽

Iris Sarajlic Vukovic ◽

Tomas Lindegaard ◽

Roberto Felizia ◽

Richard Mollica ◽

...

Keyword(s):

Public Health ◽

Health Care Services ◽

Minority Groups ◽

Digital Health ◽

Community Outreach ◽

Patient Centered ◽

Public Health Response ◽

Health Technologies ◽

The Government ◽

The Individual

Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to the individual, has been criticized for not applying a dedicated and more diverse strategy for most disadvantaged migrants in dealing with the pandemic. In order to mitigate the unequal burden on the marginalized members of society, increasing efforts have been addressed to digital health technologies. Despite the strong potential of providing collective public health benefits, especially in a highly digitalized context as Sweden, need for a stronger cooperation between the public health authorities and migrant community leaders, representatives of migrant associations, religious leaders and other influencers of disadvantaged groups has emerged. Suggestions are presented on more culturally congruent, patient-centered health care services aimed to empower people to participate in a more effective public health response to the COVID-19 crisis.

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Understanding Decision Making in the Adoption of Digital Health Technology: The Role of Behavioural Economics’ Prospect Theory (Preprint)

10.2196/preprints.32709 ◽

2021 ◽

Author(s):

Waqas Ullah Khan ◽

Aviv Shachak ◽

Emily Seto

Keyword(s):

Decision Making ◽

Prospect Theory ◽

Digital Health ◽

Health Technology ◽

Behavioural Economics ◽

Individual Level ◽

Health Technologies ◽

Research Article ◽

The Individual

UNSTRUCTURED The decision to accept or reject new digital health technologies remains an ongoing discussion. Over the past few decades, interest in understanding the choice to adopt technology has led to the development of numerous theories and models. In 1979, however, psychologists Kahneman and Tversky published their seminal research article that has pioneered the field of behavioural economics. They named their model the “prospect theory” and used it to explain decision making behaviours under conditions of risk and uncertainty as well as to provide an understanding of why individuals may make irrational or inconsistent decisions. Although the prospect theory has been used to explain decision making in economics, law, political science, and clinically at the individual level, its application to understanding choice in the adoption of digital health technology has not been explored.

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A Homeopathic View of the Influence of Chronic Diseases in the Manifestation of COVID-19

Homeopathy ◽

10.1055/s-0040-1718746 ◽

2021 ◽

Vol 110 (01) ◽

pp. 067-069

Author(s):

Fernanda Maria Simões da Costa Fujino ◽

Ana Amélia Campos Claro Olandim ◽

Vagner Doja Barnabé ◽

Jennifer Anne Coggan ◽

Nilson Roberti Benites

Keyword(s):

Chronic Disease ◽

Health Status ◽

Chronic Diseases ◽

Pulmonary Infection ◽

Severe Form ◽

Epidemic Disease ◽

Chronic Disease Patients ◽

The Face ◽

The Individual ◽

The Relationship

AbstractCOVID-19 (coronavirus disease 2019) may present variable symptoms among infected individuals, with chronic disease patients appearing as the group most susceptible to present severe pulmonary infection, while having a higher risk of developing complications from the disease. This study demonstrates the relationship between the manifestation of COVID-19 and the presence of chronic miasmatic disease, based on the works of Samuel Hahnemann. The reaction of the individual who previously presented chronic miasmatic disease, when in contact with the stimulus of the epidemic disease, depends on the type of response that the organism was generating in the face of the pre-existing situation: if it is an intense reaction and greater than that which the stimulus of COVID-19 can generate, this individual will not develop the severe form of the epidemic disease; if the reaction is less than that generated by COVID-19, more intense symptoms may appear. Understanding that the presence of a chronic miasmatic disease interferes with the manifestation of COVID-19, which may have repercussions on other organs, can change how one must act on the treatment, as this can alter the individual's health status.

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From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

Frontiers in Pharmacology ◽

10.3389/fphar.2021.612602 ◽

2021 ◽

Vol 12 ◽

Author(s):

Grzegorz Bulaj ◽

Jacqueline Clark ◽

Maryam Ebrahimi ◽

Elizabeth Bald

Keyword(s):

Chronic Diseases ◽

Digital Health ◽

Patient Empowerment ◽

Self Care ◽

Digital Technologies ◽

Combination Therapies ◽

Lifestyle Modifications ◽

Pharmacological Interventions ◽

Health Technologies ◽

Breathing Exercises

To improve long-term outcomes of therapies for chronic diseases, health promotion and lifestyle modifications are the most promising and sustainable strategies. In addition, advances in digital technologies provide new opportunities to address limitations of drug-based treatments, such as medication non-adherence, adverse effects, toxicity, drug resistance, drug shortages, affordability, and accessibility. Pharmaceutical drugs and biologics can be combined with digital health technologies, including mobile medical apps (digital therapeutics), which offer additional clinical benefits and cost-effectiveness. Promises of drug+digital combination therapies are recognized by pharmaceutical and digital health companies, opening opportunities for integrating pharmacotherapies with non-pharmacological interventions (metapharmacology). Herein we present unique features of digital health technologies which can deliver personalized self-care modalities such as breathing exercises, mindfulness meditation, yoga, physical activity, adequate sleep, listening to preferred music, forgiveness and gratitude. Clinical studies reveal how aforementioned complimentary practices may support treatments of epilepsy, chronic pain, depression, cancer, and other chronic diseases. This article also describes how digital therapies delivering “medicinal” self-care and other non-pharmacological interventions can also be personalized by accounting for: 1) genetic risks for comorbidities, 2) adverse childhood experiences, 3) increased risks for viral infections such as seasonal influenza, or COVID-19, and 4) just-in-time stressful and traumatic circumstances. Development and implementation of personalized pharmacological-behavioral combination therapies (precision metapharmacology) require aligning priorities of key stakeholders including patients, research communities, healthcare industry, regulatory and funding agencies. In conclusion, digital technologies enable integration of pharmacotherapies with self-care, lifestyle interventions and patient empowerment, while concurrently advancing patient-centered care, integrative medicine and digital health ecosystems.

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Patient and Provider Cocreation of Mobile Texting Apps to Support Behavioral Health: Usability Study

JMIR mhealth and uhealth ◽

10.2196/12655 ◽

2020 ◽

Vol 8 (7) ◽

pp. e12655 ◽

Cited By ~ 1

Author(s):

Armen C Arevian ◽

Jennifer O'Hora ◽

James Rosser ◽

Joseph D Mango ◽

David J Miklowitz ◽

...

Keyword(s):

Digital Health ◽

Text Messages ◽

Mobile Technologies ◽

Usability Study ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Health Technologies ◽

Development Platform ◽

Complete Treatment ◽

Personal Use

Background Mobile technologies hold potential for improving the quality of care and engagement of patients. However, there are considerable challenges in ensuring that technologies are relevant, useful, and engaging. While end users such as patients and providers are increasingly involved in the design of health technologies, there are limited examples of their involvement in directly creating technologies for their personal use. Objective We aim to evaluate the feasibility and acceptability of patients and providers creating mobile texting apps to support treatment goals. Methods In an 11-month usability study, we enrolled 4 providers and 28 patients in an intensive outpatient program for obsessive-compulsive disorder. Patients and providers created their own mobile texting apps using a visual app development platform. A subsample of 10 patients and 4 providers completed a usability measure. Results Participants created a total of 360 unique mobile text messages (1787 total messages sent). There were 4 types of messages identified, including personalized reminders, clinical exposures, interactive prompts, and encouraging/informational messages. A total of 9 out of 10 (90%) patients agreed that the messages were relevant to their recovery, and 8 out of 10 (80%) agreed that the messages were effective at helping complete treatment plans. Conclusions Enabling patients and providers to cocreate apps for their own use by using a visual application platform is feasible and holds potential for increasing the relevance, sustainability, and effectiveness of digital health technologies.

Download Full-text