Integrated Digital Health Systems Design

2009 ◽  
Vol 2 (2) ◽  
pp. 15-33
Author(s):  
Wullianallur Raghupathi ◽  
Amjad Umar
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
Systems Design

Integrated Digital Health Systems Design

2011 ◽  
pp. 585-604
Author(s):  
Wullianallur Raghupathi ◽  
Amjad Umar
Keyword(s):  
Health Systems ◽  
Service Oriented Architecture ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Systems Design ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Soft Systems Methodology ◽  
Soft Systems ◽  
Service Oriented

The application of information technology in healthcare has focused primarily on the implementation of specific systems such as electronic health records (EHRs) and clinical decision support systems (CDSSs), mainly for intra-enterprise use. However, for the integrated health system (IHS) to function effectively in a complex inter-enterprise healthcare delivery environment, designers must focus on approaches such as soft systems methodology (SSM) to enable the design of robust integrated digital health systems (IDHSs). A service-oriented architecture (SOA) offers a flexible framework for IDHSs to become de-centralized, fully functional and modular systems with interoperability. This article identifies the design issues in IDHS and explores the potential of an SSM methodology-based SOA for the development of interoperable IDHSs. In the process we compare and contrast the functionalist socio-technical approach to the interpretive SSM. We also describe a prototype SOA application for an IDHS setting and discuss challenges in the application of SOA to healthcare.

A free, open-source, offline digital health system for refugee care (Preprint)

2021 ◽  
Author(s):  
Henry Ashworth ◽  
Senan Ebrahim ◽  
Hassaan Ebrahim ◽  
Zahra Bhaiwala ◽  
Michael Chilazi
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Mobile Clinic ◽  
Low Resource ◽  
Displaced Populations ◽  
Weather Events ◽  
Displaced People

BACKGROUND Rise of conflict, extreme weather events, and pandemics have led to larger displaced populations worldwide. Displaced populations have unique acute and chronic health needs that need to be met by low resource health systems. Electronic Health Records (EHRs) have been shown to improve health outcomes in displaced populations but need to be adapted to meet the constraints of these health systems. OBJECTIVE To describe the development and deployment of a EHR designed to care for displaced populations in low resource settings. METHODS Using a human-centered design approach we conducted in-depth interviews and focus groups with patients, healthcare providers, and administrators in Lebanon and Jordan to identify the essential EHR features. These features including modular workflows, multilingual interfaces, and offline-first capabilities led to the development of the Hikma Health EHR which has been deployed in Lebanon and Nicaragua. RESULTS We report the successes and challenges from 12 months of Hikma Health EHR deployment in a mobile clinic providing care to Syrian Refugees in the Bekaa Valley, Lebanon. Successes include the EHR’s ability to (1) increase clinical efficacy by providing detailed patient records, (2) prove adaptable to the threats of COVID-19, and (3) improve organizational planning. Lessons learned include technical fixes to methods of identifying patients through name or their medical record ID. CONCLUSIONS As the number of displaced people continues to rise globally, it is imperative that solutions are created to help maximize the healthcare they receive. Free, open-sourced and adaptable EHRs can enable organizations to better provide for displaced populations.

scholarly journals Elements of Trust in Digital Health Systems: Scoping Review

10.2196/11254 ◽  
2018 ◽  
Vol 20 (12) ◽  
pp. e11254 ◽  
Author(s):  
Afua Adjekum ◽  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Health Systems ◽  
Scoping Review ◽  
Digital Health

scholarly journals Digital health literacy of health care profession students

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Dratva ◽  
S Juvalta ◽  
M Gemperle ◽  
D Händler-Schuster ◽  
M Scheermesser ◽  
...  
Keyword(s):  
Health Literacy ◽  
Digital Media ◽  
Health Information ◽  
Health Systems ◽  
Health Professionals ◽  
Digital Health ◽  
Critical Evaluation ◽  
Health Professions ◽  
Information Resources ◽  
Personal Health Information

Abstract Background Digital transformation in health and health systems is a chance and a challenge for health professionals irrespective of their field. To maximize the benefit for patients high digital health literacy is required. A requirement not represented in health professions’ curricula in Switzerland. Little is known on the digital health competencies of students, on their utilization and views of digital media in the context of health, thus a cross-sectional survey was performed at a School of Health Professsions in Switzerland. Methods All BSc. students (N = 1200; nursing, midwifery, occupational health, physiotherapy and health promotion) received an online questionnaire covering utilization of various information resources, views on digital health & media and the German eHealth Literacy Scale (eHEALS, score 0 - 40). Descriptive and group analyses were performed, further adjusted analyses will be run. Results 453 students responded (female N = 368, male N = 26). Participation was 38% and highest in 1st students. Personal health information resources used most were: internet 82%, familiy&friends 70%, health professionals 66%, textbooks 40%. A majority rated digital media as important (66%) or rather important (30%) for their future professional activities. The overall eHeals-score was 28.6 (sd 4.93); critical evaluation and confidence in applying information scored lowest. Preliminary group analyses show significant increase by study year (1st 28.0, 2nd 28.9, 3rd 29.7, p = 0.01), while scores by gender or health profession were non-significantly different. Conclusions Almost all students in health professions use digital media for their own health information needs and consider digital media as highly relevant for their future career. Critical evaluation skills need to be strenghtend. Digital Health Literacy is only slightly higher in 3rd year students. Longitudinal data are needed to differentiate cohort from learning effects. Key messages Digital media are increasingly important in health systems, a view shared by future health professionals. Data indicate only a small increase of digital health literacy across three years of study. Curricula should include digital health competencies to ensure a highly digitally skilled health work force.

scholarly journals Digital Health and Health Systems of the Future

2018 ◽  
Vol 6 (Supplement 1) ◽  
pp. S1-S4 ◽  
Author(s):  
Alain Labrique ◽  
Lavanya Vasudevan ◽  
Garrett Mehl ◽  
Ellen Rosskam ◽  
Adnan A. Hyder
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
The Future

scholarly journals A Digital Innovation for the Personalized Management of Adherence: Analysis of Strengths, Weaknesses, Opportunities, and Threats

2020 ◽  
Vol 2 ◽  
Author(s):  
Anna-Elisa Hein ◽  
Bernard Vrijens ◽  
Mickael Hiligsmann
Keyword(s):  
Clinical Practice ◽  
Personalized Medicine ◽  
Health Systems ◽  
Swot Analysis ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Medication Management ◽  
Data Generation ◽  
Structured Interviews ◽  
Personalized Management

Introduction: Personalized medicine and management of adherence are potential solutions for the suboptimal use of medicines. Digital medication management innovations currently under development combine both aspects. This research aims to investigate facilitators for and barriers to the translation of digital innovations for personalized medicine and adherence management into clinical practice from the policymaker and regulator perspective.Methods: A mixed-method study was used combining a scoping review to identify main interests, semi-structured interviews (n = 5) with representatives of European health policymaking and regulatory organizations, and a supplementary literature review to investigate key subthemes. The SWOT analysis was used for the qualitative analysis.Results: The literature reviews and the qualitative interviews suggested that digital solutions can facilitate the personalized management of medications and improve quality and safety, especially as the openness for digital health solutions is increasing. Digital solutions may, on the other hand, add complexity to the treatment, which can be perceived as a potential barrier for their uptake. As more multidisciplinary and participative structures are emerging, digital solutions can promote the implementation of new services. Nevertheless, change progresses slowly in the task-oriented structures of health systems. Integration of digital solutions depends on all stakeholders' willingness and abilities to co-create this change. Patients have different capabilities to self-manage their medical conditions and use digital solutions. Personalization of digital health solutions and integration in existing service structures are crucial to ensure equality among population segments. Developments in the digital infrastructure, although they are partly slow and not well-aligned, enable the implementation of innovations in clinical practice leading to further advances in data generation and usage for future innovations.Discussion: This study suggests that digital solutions have the potential to facilitate high-quality medication management and improve adherence to medications, enable new service structures, and are essential to drive further innovations in health care. Nevertheless, increasing the self-responsibility of patients can have undesirable effects on health outcomes, especially within vulnerable population segments. Digital health solutions can be an opportunity to optimize the use of medicines and thus their efficiency. Well-conceived development and implementation processes are needed to also realize improvements in equality and solidarity within health systems.

scholarly journals Workshop: EUPHA and Europe-wide action on digital public health

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Digital Health ◽  
Digital Technologies ◽  
Digital Transformation ◽  
Health System Strengthening ◽  
World Health ◽  
Collaborative Action ◽  
European Public ◽  
The World

Abstract The World Health Assembly Resolution on Digital Health unanimously approved by WHO Member States in May 2018 demonstrated a collective recognition of the value of digital technologies to contribute to advancing universal health coverage (UHC) and other health aims of the Sustainable Development Goals (SDGs). The World Health Organization has just released first ever guideline on digital interventions for health system strengthening. Et the European level, in June 2018 the WHO Regional Office for Europe launched the WHO/Europe initiative for Digitalization of Health Systems and in February 2019 organized the first Symposium on the Future of Digital Health Systems in the European Region. The European Commission in April 2018 published a Communication on Digital transformation of health and care in the digital single market and requested the Expert Panel on effective ways of investing in health (EXPH) to release an evidence-based opinion on how to assess the impact of digital transformation of health services. In such context, the European Public Health Association (EUPHA) has at an early stage acknowledged and understood the crucial importance of applying the potential offered by digitalization to public health. Not only its most prominent members work and research as WHO and EC experts on how to plan, implement and evaluate effective digital public health interventions, but EUPHA itself - as umbrella organization representing public health associations and institutes across Europe had: i) actively participated to the WHO Euro Symposium successfully co-organizing a session on the ‘beautiful marriage’ between digitalization and public health, ii) supported the publication of a EJPH supplement on digital health and iii) has planned to create a EUPHA Section on Digital Health. With the overall goal of positioning the proposed EUPHA Section on Digital Health in the enriching and constructive context of the European Public Health Conference the workshop specifically aims to: present a comprehensive conceptual framework for the application of digital technologies to public health in Europe;present and report on EUPHA collaborative action on digital health, aligned with European institutions;present the structure and content of the EJPH supplement on digital health;present the general aim, specific objectives, scope, mission and preliminary outputs of the proposed EUPHA Section on Digital Health, as well as its synergy with other EUPHA’s Section workPresent the results of two/three specific projects on digital public health to serve as concrete examples of the application of digital solutions to public healthEngage with the audience to promote the active participation of the broader EUPHA community to the activities of the Section, collect interests and best practices, and share ideas and projects worth scaling up at the Section-level. Key messages The ‘beautiful marriage’ between digitalization and public health has to be concretely planned, implemented and evaluated. EUPHA action on digital public health can be further strengthened through the collaborative action and work of its dedicated Section.

scholarly journals Digital health Systems in Kenyan Public Hospitals: a mixed-methods survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Mike English ◽  
Hamish Fraser ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
New Technologies ◽  
Digital Health ◽  
Structured Interview ◽  
Public Hospitals ◽  
Adoption Process ◽  
Efficient System ◽  
Wide Range ◽  
The Government

Abstract Background As healthcare facilities in Low- and Middle-Income Countries adopt digital health systems to improve hospital administration and patient care, it is important to understand the adoption process and assess the systems’ capabilities. This survey aimed to provide decision-makers with information on the digital health systems landscape and to support the rapidly developing digital health community in Kenya and the region by sharing knowledge. Methods We conducted a survey of County Health Records Information Officers (CHRIOs) to determine the extent to which digital health systems in public hospitals that serve as internship training centres in Kenya are adopted. We conducted site visits and interviewed hospital administrators and end users who were at the facility on the day of the visit. We also interviewed digital health system vendors to understand the adoption process from their perspective. Semi-structured interview guides adapted from the literature were used. We identified emergent themes using a thematic analysis from the data. Results We obtained information from 39 CHRIOs, 58 hospital managers and system users, and 9 digital health system vendors through semi-structured interviews and completed questionnaires. From the survey, all facilities mentioned purchased a digital health system primarily for administrative purposes. Radiology and laboratory management systems were commonly standalone systems and there were varying levels of interoperability within facilities that had multiple systems. We only saw one in-patient clinical module in use. Users reported on issues such as system usability, inadequate training, infrastructure and system support. Vendors reported the availability of a wide range of modules, but implementation was constrained by funding, prioritisation of services, users’ lack of confidence in new technologies and lack of appropriate data sharing policies. Conclusion Public hospitals in Kenya are increasingly purchasing systems to support administrative functions and this study highlights challenges faced by hospital users and vendors. Significant work is required to ensure interoperability of systems within hospitals and with other government services. Additional studies on clinical usability and the workflow fit of digital health systems are required to ensure efficient system implementation. However, this requires support from key stakeholders including the government, international donors and regional health informatics organisations.

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