An action design research to facilitate the adoption of personal health records

Adoption and user perceptions are dominant on personal health records literature and have led to a better understanding of what individuals' behaviors and perceptions are about the adoption of personal health records. However, these insights are descriptive and are not actionable to allow creating personal health records that will overcome the adoption problems identified by users. This study uses action design research to provide actionable knowledge regarding user perceptions and adoption and their application in the case of the digital allergy card. To achieve this, we conducted interviews with patients and physicians as part of the evaluation of the digital allergy card mock-up and the first prototype. As results, we provided some research proposals regarding the benefits of, levers for, and barriers to adoption of the digital allergy card that can be tested for several other personal health records.

A Guide to Innovation in the Adoption of Alternative Digital Credentials

This chapter provides a guidance to universities that desire to adopt quality standards and effective procedures for the issuance of alternative digital credentials (ADCs). Its underlying message is that universities must become involved in issuing ADCs if they are to continue to serve the public in relevant ways. It lists the strong reasons for the institutional adoption of ADCs, the barriers to adoption, and then provides advice on how to design an institutional icon (badge), criteria for the issuance of ADCs, the standardization of ADC metadata, choosing an ADC platform, establishing governance and oversight, and establishing an administrative structure. This chapter argues strongly for the adoption of competency-based assessments in contrast to assessments focused only on learning achievement assessments. This comprehensive guide is based on the experience of three universities which have successfully implemented comprehensive ADC issuance programs.

Development and scale-up of bioprotectants to keep staple foods safe from aflatoxin contamination in Africa

Aflatoxins pose a significant public health risk, decrease productivity and profitability and hamper trade. To minimize aflatoxin contamination a biocontrol technology based on atoxigenic strains of Aspergillus flavus that do not produce aflatoxin is used widely in the United States. The technology, with the generic name Aflasafe, has been improved and adapted for use in Africa. Aflasafe products have been developed or are currently being developed in 20 African countries. Aflatoxin biocontrol is being scaled up for use in several African countries through a mix of public, private, and public-private interventions. Farmers in several countries have commercially treated nearly 400,000 ha of maize and groundnut achieving >90% reduction in aflatoxin contamination. This chapter summarizes the biology of aflatoxin-producing fungi and various factors affecting their occurence, including climate change. Various management practices for aflatoxin mitigation are then discussed. These include biological control, which is increasingly being adopted by farmers in several countries. We discuss biocontrol product development and commercialization in various African countries. Subsequently, we highlight some barriers to adoption and other challenges.

Mesowestern Blot: Simultaneous Analysis of Hundreds of Sub-Microliter Lysates

Western blotting is a widely-used technique for molecular-weight-resolved analysis of proteins and their post-translational modifications, but has been refractory to affordable scale-up. Here, we report the Mesowestern blot, which uses a 3D-printable gel-casting mold to enable affordable, high-throughput Western blotting with standard sample preparation and small (<1 uL) sample sizes. The casted polyacrylamide gel contains 336, 0.5 uL micropipette-loadable sample wells arranged within a standard microplate footprint. Polyacrylamide % can be altered to change molecular weight resolution range. Proof-of-concept experiments using both infrared-fluorescent molecular weight protein ladder as well as cell lysate (RIPA buffer) demonstrate protein loaded in Mesowestern gels is amenable to the standard Western blotting steps. The main difference between Mesowestern and traditional Western is that semi-dry horizontal instead of immersed vertical gel electrophoresis is used. The linear range of detection is approximately 2 orders of magnitude, with a limit of detection (for beta-actin) of around 30 ng of total protein from mammalian cell lysates (~30-3000 cells). Because the gel mold is 3D-printable, users have significant design freedom for custom layouts, and there are few barriers to adoption by the typical cell and molecular biology laboratory already performing Western blots.

U.S-Based Community Oncologists/Hematologists' Perceptions Regarding Future Use of Gene Therapies for Patients with Hematological Disorders

Introduction Gene therapies, defined as the introduction, removal, or change in genetic material into a patient's cells to treat a specific disease, represent a significant advance in medicine, with the potential to cure or significantly improve outcomes of various benign and malignant hematologic disorders (American Society of Gene Therapy). Gene therapies have received approvals for subsets of patients with spinal muscular atrophy or retinal dystrophy, and almost a thousand studies are actively recruiting patients for various gene therapy trials. Aside from CAR-T therapies, several gene therapies are in advanced clinical development in the U.S. for disorders such as hemophilia, hemoglobinopathies, and congenital immunodeficiency syndromes. Results of many such trials were presented at the 2020 ASH annual meeting. While approvals for some gene therapy products are expected in the near future, the complexity of treatment, knowledge gaps among providers, or barriers with accessibility or cost may limit the integration of these treatments into routine clinical practice. Therefore, the present study surveyed U.S.-based community oncologists/hematologists (cO/H) to evaluate their perceptions of the utility of gene therapies and barriers to adoption or integration into clinical practice. Methods Between February and April 2021, cO/H from across the U.S. were invited to complete a web-based survey about gene therapies. Physician demographics and practice characteristics were also captured in the survey. Responses were aggregated and analyzed using descriptive statistics. Results A total of 369 cO/H completed the survey; 36% identified as a medical oncologist and 63% as a hematologist/oncologist. cO/H had an average of 19 years of clinical experience and spent an average of 86% of their working time in direct patient care and saw an average of 17 patients per day on clinic days. Half of cO/H stated that they were not aware of recent data of gene therapies for adult hematology/oncology indications (35% "not very aware"; 15% "not at all aware"). When asked to report the number of approved gene therapy products (excluding CAR-T products) in the U.S. in early 2021, 27% of participants reported 0, 24% reported 1, and 20% reported 2 products were currently available. Regarding gene therapy use for adult hematologic/oncologic indications in the next 2 years, 53% of cO/H reported that they expect gene therapies to mostly be administered and managed by academic centers to which they will refer their patients; 27% reported that indications will be limited and unlikely to affect their practice (Table 1). cO/H perceived cost as the greatest barrier to adopting gene therapies into their clinical practice; specifically, cO/H cited cost limitations by payers (49%), the prohibitive cost to patients (46%), and the prohibitive cost to practices/hospitals (37%). Other barriers to adoption were limited real-world efficacy data (18%) and long-term complications (13%). Most cO/H reported a moderate (39%) or high (43%) comfort level with prescribing a gene therapy for adult hematology/oncology indications if it were reimbursed. Conclusions Many cO/H were not aware of recent data of gene therapy products, with over half expecting to refer their patients to large academic centers for gene therapies. While most cO/H would be comfortable prescribing gene therapies for their patients, cost was perceived as prohibitive. This information can inform various stakeholders, including patients, advocacy groups, pharmaceutical manufacturers, payers, and professional societies, in laying the foundations for gene therapy products in hematology. Future work should focus on enhancing education of gene therapy products to community providers as well as identifying support programs that lessen the burden of cost. Figure 1 Figure 1. Disclosures Gajra: Cardinal Health: Current Employment, Current equity holder in publicly-traded company. Fortier: Cardinal Health: Current Employment. Jeune-Smith: Cardinal Health: Current Employment. Feinberg: Cardinal Health: Current Employment.

Make-in-India and Industry 4.0: technology readiness of select firms, barriers and socio-technical implications

PurposeIn this research, the emphasis is multifold. First objective is to study differences amongst India's Make-in-India, Germany's Industry 4.0 and China's Made-in-China 2025 on a macro level. Second objective is to identify where does individual industry segment out of the five broad segments (prioritized by Make-in-India initiative) represented by ten firms in India stand in terms of adoption of Industry 4.0 technologies. Third objective is to identify key barriers for each of these five industry segments. Finally, socio-technical interventions are also proposed aimed at faster adoption of Industry 4.0 technologies.Design/methodology/approachA mixed methodological approach is followed to achieve the research objectives. First, for the macro-level comparison of three pertinent countries, extant research and industry literature have been relied upon. Thereafter, at a micro level, inputs from experts belonging to focal sectors are included in this study to ascertain the current level of readiness of adoption of Industry 4.0 technologies and the barriers to adoption. Finally, the authors argue for and propose some socio-technical interventions that are aimed at mitigation of barriers for adoption of Industry 4.0 technologies.FindingsIt has been ascertained that amongst the ten firms (two each from given focal sectors) considered in the study, the automotive and the software firm are perhaps best placed to adopt the Industry 4.0 technology, while the infrastructure project management firm is least ready for Industry 4.0 technologies. The common barriers to adoption of Industry 4.0 technologies, as elaborated by experts belonging to each of the ten firms, are also identified. These three commons barriers are resistance to change, unclear economic benefits and problems related to coordination and collaboration.Research limitations/implicationsThe study is one of first attempts to understand the nuances related to technology readiness across focal industries pertaining to the Make-in-India initiative and Industry 4.0. The study furthers the extant understanding of common and distinct barriers across industries. Employing the soft-systems methodology, the study advocates for a number of socio-technical interventions pertaining to establishment of e-skill ecosystem, community learning clusters and sector-focussed skill acquisition and augmentation. Since the study considers only two firms corresponding to each of the five focal sectors, including more firms across industries could have resulted in further validation of study as well.Practical implicationsContrasting the initiatives of the three countries results in identification of different thematic focus of the respective initiatives. While India's Make-in-India initiative has a strong social dimension, Germany's Industry 4.0 and Made-in-China 2025 have key objective related to integration of cyber-physical systems and to graduate to innovation-driven country, respectively. Further, analysis on the technology readiness for adoption of Industry 4.0 technologies based on the respective experts' assessment results in understanding of the underlying barriers.Social implicationsAdopting the soft-systems perspective linking nuances of stakeholders, socio-technical systems and socio-economic characteristics results in several propositions to further the social objectives of India's Make-in-India initiative. These propositions advocate for pathways in which extant strengths in terms of technology, people and existing socio-technical structures can be brought together to cater to the requirements related to employability and skill augmentation of new as well as existing workforce.Originality/valueExtant research literature is primarily focussed on certain specific topics within Industry 4.0 implementation and is mainly based on conceptual or theoretical basis. From a practitioners' perspective, only a few empirical papers could be found that too are typically focussed on single case studies resulting from pilot applications of Industry 4.0. However, such papers have not examined the broad implications of Industry 4.0 in terms of differences between key countries' manufacturing initiatives, readiness of key sectors, sectoral barriers and accompanying policy-level implications associated with implementation of Industry 4.0. Thus, the objective of this research is to abridge these research gaps.

Mobile Health Technology and Healthcare Providers: Systemic Barriers to Adoption

Objectives: Despite the growing use of mobile health (mHealth), certain barriers seem to be hindering the use of mHealth applications in healthcare. This article presents a systematic review of the literature on barriers associated with mHealth reported by healthcare professionals.Methods: This systematic review was carried out to identify studies published from January 2015 to December 2019 by searching four electronic databases (PubMed/MEDLINE, Web of Science, Embase, and Google Scholar). Studies were included if they reported perceived barriers to the adoption of mHealth from healthcare providers’ perspectives. Content analysis and categorization of barriers were performed based on a focus group discussion that explored researchers’ knowledge and experiences.Results: Among the 273 papers retrieved through the search strategy, 18 works were selected and 18 barriers were identified. The relevant barriers were categorized into three main groups: technical, individual, and healthcare system. Security and privacy concerns from the category of technical barriers, knowledge and limited literacy from the category of individual barriers, and economic and financial factors from the category of healthcare system barriers were chosen as three of the most important challenges related to the adoption of mHealth described in the included publications.Conclusions: mHealth adoption is a complex and multi-dimensional process that is widely implemented to increase access to healthcare services. However, it is influenced by various factors and barriers. Understanding the barriers to adoption of mHealth applications among providers, and engaging them in the adoption process will be important for the successful deployment of these applications.

Identifying the Potential of RFID in Disaster Healthcare: An International Delphi Study

Mainstream healthcare has been facing numerous challenges, and it is expected to see that these challenges become more severe and frequent when healthcare is dealing with disasters. This points to the necessity of utilising technologies to support healthcare and disaster managers in making quality decisions during chaotic and rapidly changing conditions in disaster situations. Therefore, in this research, the objective is to identify the role of RFID technology in healthcare-related activities before, during, and after disasters in terms of application areas and phases of the disaster management cycle (DMC). A Delphi approach was used in this research. Two rounds of questionnaires were administered to a panel of experts to evaluate the actual and potential use of RFID applications for healthcare within DMC. The Delphi participants were the field experts in the areas of disaster management, disaster medicine, and information systems. Based on the Delphi results, RFID applications were seen to be most useful in the response and recovery phases of disasters. RFID was seen as being most helpful for health-related supply management and casualty information. There were concerns that privacy and security may be barriers to adoption and use. Other applications identified by this study include identifying and tracking medical resources (including clinicians and first responders) and their accurate coordination in the response missions, determining idle resources, and maximising their utilisation during response activities. In this research, 35 potential scenarios of RFID applications for healthcare purposes within DMC and Disaster e-Health (DEH) were evaluated with the Delphi participants. RFID technologies could play an important role in DMC and DEH to provide more reliable and timely information to support healthcare during disasters. Based on the research results, managing the supply chain emerged as a major RFID application for supporting disaster healthcare.