Digital Healthcare Services Research Articles

Experiences and Views of Older Adults of South Asian, Black African, and Caribbean Backgrounds About the Digitalization of Primary Care Services Since the COVID-19 Pandemic: Qualitative Focus Group Study.

The COVID-19 pandemic from 2020 to 2022 prompted governments worldwide to enforce lockdowns and social restrictions, alongside the rapid adoption of digital health and care services. However, there are concerns about the potential exclusion of older adults, who face barriers to digital inclusion, such as age, socioeconomic status, literacy level, and ethnicity. This study aims to explore the experiences of older adults from the 3 largest minoritized ethnic groups in England and Wales-people of South Asian, Black African, and Caribbean backgrounds-in the use of digitalized primary care services since the beginning of the COVID-19 pandemic. In total, 27 individuals participated in 4 focus groups (April and May 2023) either in person or via online videoconferencing. Patient and public involvement and engagement were sought through collaboration with community organizations for focus group recruitment and feedback on the topic guide. Data were analyzed using framework analysis. This paper summarizes the perspectives of 27 older adults from these 3 minoritized ethnic groups and identifies four key themes: (1) service accessibility through digital health (participants faced difficulties accessing digital health care services through online platforms, primarily due to language barriers and limited digital skills, with reliance on younger family members or community organizations for assistance; the lack of digital literacy among older community members was a prominent concern, and digital health care services were felt to be tailored for English speakers, with minimal consultation during the development phase), (2) importance of face-to-face (in-person) appointments for patient-clinician interactions (in-person appointments were strongly preferred, emphasizing the value of physical interaction and connection with health care professionals; video consultations were seen as an acceptable alternative), (3) stressors caused by the shift to remote access (the transition to remote digital access caused stress, fear, and anxiety; participants felt that digital health solutions were imposed without sufficient explanation or consent; and Black African and Caribbean participants reported experiences of racial discrimination within the health care system), and (4) digital solutions (evaluating technology acceptance; participants acknowledged the importance of digitalization but cautioned against viewing it as a one-size-fits-all solution; they advocated for offline alternatives and a hybrid approach, emphasizing the need for choice and a well-staffed clinical workforce). Digital health initiatives should address the digital divide, health inequalities, and the specific challenges faced by older adults, particularly those from minoritized ethnic backgrounds, ensuring accessibility, choice, and privacy. Overcoming language barriers involves more than mere translation. Maintaining in-person options for consultations, addressing sensitive issues, and implementing support systems at the practice level to support those struggling to access services are vital. This study recommends that policy makers ensure the inclusivity of older adults from diverse backgrounds in the design and implementation of digital health and social care services.

Smartphone Adoption and Healthcare Usage Among Older Adults in India

ABSTRACT The growing aging population globally requires accessible digital healthcare services to maintain a healthy lifestyle. Smartphones have the potential to connect individuals with digital healthcare services. However, whether older adults perceive smartphones as a convenient means of accessing these services remains uncertain. This study aimed to investigate the perspectives of older Indian adults regarding smartphone adoption and its usage in healthcare services. For this, a mixed-methods approach combining quantitative and qualitative methods was employed. A total of 59 older adults participated in the study, of whom 54 completed survey questionnaires, 15 engaged in semi-structured interviews, and 10 participated in both studies. The findings reveal that older adults have adopted smartphones for various purposes after initially facing hindrances, often with assistance from family members. However, the use of smartphone-based healthcare applications remains minimal. These findings suggest that addressing the challenges older adults face with user interface design will enhance their use of healthcare applications. Thus, healthcare applications must feature a user-friendly interface specifically tailored for older adults. Additionally, familiar and popular application-inspired interfaces, social and family support, co-designing, digital health awareness, and training programmes can further promote the adoption of smartphone-based healthcare applications among older adults.

Research Hotspots and Knowledge Framework of Digital Healthcare Service Management from the Perspective of the Silver Economy

Research Hotspots and Knowledge Framework of Digital Healthcare Service Management from the Perspective of the Silver Economy

A comparison Study on User Acceptance of Digital Healthcare Services Among M40 and B40 Community in Selangor: A Study on SELangkah Application

Over time, the global digital healthcare industry has started to take shape with the aim of offering benefits to all residents. Much effort has been put into improving the effectiveness and accessibility of the healthcare system in Malaysia for the benefit of its people. The Selangor state government is working to make all communities safer and healthier places, and one of its initiatives is the SELangkah application. Nonetheless, there are still concern over the take up of digital healthcare services among citizens especially those in the low-income and middle-income communities; B40 and M40. Previous study has shown that different economic status has an impact towards the acceptance level in technology services. Therefore, this study utilises qualitative research method to investigate the state of user acceptance in digital healthcare services among B40 and M40 users in Selangor through the case study of SELangkah application. Focus group discussion was conducted with over 10 participants from Selangor to evaluate and compare the acceptance level of digital healthcare services between both income group with the instrument development were guided by the Extended Technology Acceptance Model (ETAM). The area of group discussion covers users’ perceived usefulness, perceived ease of use, attitude, behaviour, external challenges, and actual use. The findings show that both M40 and B40 group find the application to be beneficial; in addition, they believe there should be more awareness campaign to promote the application to the public. A few clear differences between the acceptance level of the two groups would be the simplicity of the language used in the application, the recommended features, and future needs between the two groups. M40 group find no difficulties to navigate the application but B40 group mention that the used words can be simplify. While M40 group recommended for gamification and high engagement features; the B40 group is looking more at practicality such as more information or linkages to nearby clinic. Nevertheless, both groups did not find major difficulties and they see a lot of benefit of the application. This will form the fundamental basis for future research efforts aimed at closing the technology acceptance gap and enabling a wider population to use technology as a tool to have a healthier life.

Permissioned blockchain network for proactive access control to electronic health records

BackgroundAs digital healthcare services handle increasingly more sensitive health data, robust access control methods are required. Especially in emergency conditions, where the patient’s health situation is in peril, different healthcare providers associated with critical cases may need to be granted permission to acquire access to Electronic Health Records (EHRs) of patients. The research objective of this work is to develop a proactive access control method that can grant emergency clinicians access to sensitive health data, guaranteeing the integrity and security of the data, and generating trust without the need for a trusted third party.MethodsA contextual and blockchain-based mechanism is proposed that allows access to sensitive EHRs by applying prognostic procedures where information based on context, is utilized to identify critical situations and grant access to medical data. Specifically, to enable proactivity, Long Short Term Memory (LSTM) Neural Networks (NNs) are applied that utilize patient’s recent health history to prognose the next two-hour health metrics values. Fuzzy logic is used to evaluate the severity of the patient’s health state. These techniques are incorporated in a private and permissioned Hyperledger-Fabric blockchain network, capable of securing patient’s sensitive information in the blockchain network.ResultsThe developed access control method provides secure access for emergency clinicians to sensitive information and simultaneously safeguards the patient’s well-being. Integrating this predictive mechanism within the blockchain network proved to be a robust tool to enhance the performance of the access control mechanism. Furthermore, the blockchain network of this work can record the history of who and when had access to a specific patient’s sensitive EHRs, guaranteeing the integrity and security of the data, as well as recording the latency of this mechanism, where three different access control cases are evaluated. This access control mechanism is to be enforced in a real-life scenario in hospitals.ConclusionsThe proposed mechanism informs proactively the emergency team of professional clinicians about patients’ critical situations by combining fuzzy and predictive machine learning techniques incorporated in the private and permissioned blockchain network, and it exploits the distributed data of the blockchain architecture, guaranteeing the integrity and security of the data, and thus, enhancing the users’ trust to the access control mechanism.

Registered Nurses' Digital Client Work and Associating Factors: A Cross-Sectional Study.

To describe the frequency of digital client work among Finnish registered nurses, including video consultations, secured messaging and digital promotion of care without direct contact with the client. In addition, the study examines the association between various factors related to nurses' characteristics and work environment with digital client work and its frequency. A cross-sectional survey study. A total of 2970 nurses responded to a nationwide survey in spring 2023. Descriptive statistics were used to characterise the frequency of different types of digital client work. Binary logistic regression analyses were used to examine the associations. One-third of the respondents reported digital client work during the last 6 months. The majority had worked digitally with their clients daily or weekly. Secured messaging was the most frequently used type of digital client work, whereas video consultations were less frequent. Nurses working in acute care, home-based care or other environments worked more frequently digitally with their clients than those working in inpatient care. Nurses with higher digital dedication and collegial support had greater odds of digital client work than those with lower dedication. Among those who reported frequent digital client work, lower skills in information security were observed. Given the significant variation in the frequency of digital client work among nurses across different environments, assessing broader digitalisation adoption opportunities is essential. Organisations must ensure that nurses have sufficient skills for secure handling of client data, and efforts should be made in creating motivational and supportive work environments to facilitate digital client work. By understanding the factors influencing nurses' digital client work, organisations can create stronger structures to support their work. Enhancing digital service availability across different healthcare settings would offer clients more care options, thereby potentially improving their access to healthcare. This research addresses a knowledge gap regarding the current extent of nurses' digital client work in various healthcare environments and explores potential influencing factors. As governments aim to significantly expand the provision of digital healthcare services, understanding the variation in nurses' digital client work is crucial. This information can guide targeted interventions, such as continuous education, and organisational and collegial support, facilitating dedication to use digital technologies and ensuring secure and impactful advancements in digital healthcare. Our research will benefit healthcare organisations, decision-makers, nursing professionals and educational institutions. Our study adheres to the relevant EQUATOR guidelines and follows the STROBE checklist for cross-sectional studies. No patient or public contribution.

User profiles in digitalized healthcare: active, potential, and rejecting — a cross-sectional study using latent class analysis

BackgroundThere is evidence of different use by different groups of people for general health-related applications. Yet, these findings are lacking for digitalized healthcare services. It is also unclear whether typical use patterns can be found and how user types can be characterized.MethodsThe analyses are based on data from 1 821 respondents to the Health Related Beliefs and Health Care Experiences in Germany panel (HeReCa). Digitalized healthcare services, that were used to determine the user types, include for example sick notes before/after examination and disease related training. User types were determined by latent class analysis. Individual groups were characterized using multinomial logistic regressions, taking into account socioeconomic and demographic factors as well as individual attitudes towards digitalization in the healthcare system.ResultsThree types were identified: rejecting (27.9%), potential (53.8%) and active (18.3%). Active participants were less likely to be employed, less likely to be highly educated and less skeptical of digital technologies. Potential users were the youngest, most highly-educated and most frequently employed group, with less skepticism than those who rejected. Rejecters were the oldest group, more likely to be female and of higher socio-economic status.ConclusionsSocio-demographic and socio-economic differences were identified among three user types. It can therefore be assumed that not all population groups will benefit from the trend towards digitalization in healthcare. Steps should be taken to enhance access to innovations and ensure that everyone benefits from them.

디지털 헬스케어를 활용한 수원특례시 노인복지시스템 구축 연구

The pace of aging in Korea is the highest in the world, and Suwon City is also expected to enter a super-aged society in 2030, so preparations for the medical and welfare sectors for the elderly are urgent. In addition, interest in digital healthcare, which focuses on non-face-to-face treatment, has increased due to the COVID-19 pandemic crisis in 2019. In this study aimed to propose a plan to build an elderly welfare system for Suwon based on previous studies through literature review and expert focus group interviews As a result of literature survey, in developed countries, digital healthcare services have been developed mainly in the U.S., Japan, and Israel. In particular, the U.S., which has been promoting non-face-to-face telemedicine since early on due to its large land area, has developed a business centered on private companies, but has also been able to grow into a digital health powerhouse due to government support such as deregulation. In Korea, the development of the digital healthcare industry has been limited due to problems such as the regulation of telemedicine practices and unclear core. In addition, according to the results of the expert group interviews, those involved in the mobile healthcare project at the Suwon City Health Center pointed out errors in the system app and difficult input methods as the main factors for negative participation in the project. Therefore, it is expected that for self-healthcare through digital healthcare to be actively implemented, it is necessary not only for the right understanding and participation of the project targets, but also for the active cooperation of the government and private companies.

Needed competence for registered nurses working at a patient-centred telehealth service aimed to engage and empower people living with COPD: A five-month participatory observational study

BackgroundThe global population of older aged 65 and over is increasing, which means an increase in people living with long-term health conditions and multimorbidity. Implementing new digital health technologies enables increased patient empowerment and responsibility, and the ability to respond to changes in their condition themselves, with less involvement of healthcare professionals. Important parameters need to be addressed for this digitally enabled empowerment to be successful, these include increased individual and organizational health literacy, the establishment of joint decision-making activities among patients and healthcare professionals, and efforts that target the individual's ability to manage their condition, which include education to increase skills and providing technology for self-monitoring. ObjectiveTo identify needed competencies of digital healthcare professionals to be able to provide the needed services to service users with chronic obstructive pulmonary disease in a 24/7 digital healthcare service. MethodFive registered nurses' work was observed weekly for five months. In total 13 participatory observations were conducted. Data from the observations was transcribed and analysed through inductive content analysis. ResultsFive main categories were identified in the analysis; 1) tasks, 2) communication, 3) the relationships between the registered nurses, 4) service users, and 5) technology. These categories contain different competencies needed for registered nurses working in a digitalized healthcare system. ConclusionsFuture digital healthcare professionals will require several competencies, to be able to deliver proper care in a digital health community that goes beyond traditional healthcare competencies, including social, technological, and communication skills.

Quality of the digital gp visits and characteristics of the users: retrospective observational study

Objectives This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting. Design The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits. Setting Primary health care. Participants The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services. Main Outcome Measures The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization. Results Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments. Conclusion Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations.

Enhancing user experience in the digital service environment: A comprehensive study on the design and evaluation of internet-based healthcare products.

In the era of burgeoning digital technology, healthcare is a challenging transformative change towards virtual and digital platforms. Internet-based healthcare services are emerging as a popular trend within the medical area. User experience (UX) is paramount for the healthcare service, as it significantly influences experience satisfaction and fosters user viscosity. Gaining a profound understanding of users' demands and crafting services that align with their expectations is essential. Consequently, exploring an effective design approach for the digital healthcare service that prioritizes UX along with utilizing a comprehensive evaluation methodology to handle UX data, is of profound importance. This study introduces a design methodology for Internet-based healthcare products grounded in the UX and mental (UX-M) model. Aiming to refine the Internet-based healthcare product design by integrating insights from the experience data, it employs the Delphi-ANP and the fuzzy comprehensive evaluation to determine evaluation indexes and conduct experiential assessments. The UX evaluation results of existing schemes are compared with the proposed design scheme of the intelligent guidance and internet hospital. The findings indicate that the UX evaluation of Internet-based medical services with the proposed method outperforms the existing schemes. On the one hand, UX research of Internet-based healthcare products can significantly enhance service satisfaction for patients utilizing online medical treatments. On the other hand, the analysis of experience-based evaluation empowers designers to refine and improve UX design of Internet-based medical services. Such research endeavors are critical for enhancing the overall quality of service offerings and elevating user satisfaction in the digital healthcare landscape.

The perspectives of doing, being, belonging, becoming on older homecare recipients’ use and experiences with technologies in the Assisted Living Project in Norway

ABSTRACT The Assisted Living project (2016-2019) aimed to investigate older adults’ needs for digital technology for daily support and to develop technology solutions in collaboration with the user group. This paper presents data extracted from three sub-studies: Sub-study 1 investigated older homecare recipients’ use of and attitudes towards digital technology, sub-study 2 explored assisted living residents’ needs and requirements for technology, and sub-study 3 explored their experiences with environmental sensor technology to support safety and daily living. The aim was to explore how the occupational science concepts of doing, being, belonging, and becoming can provide a deeper understanding of technology use among participants in the Assisted Living Project. This study demonstrates that for older adults in the Assisted Living project to become technology users required both personal motivation and cognitive capacity for learning to use the device and become familiar with the technology, and access to internet and digital tools. Digitalization in society leads to new challenges for all citizens, especially those who are less familiar with using digital technology. By applying an occupational science perspective to technology use, this paper contributes to creating awareness about digital exclusion and occupational injustice. It provides a deeper understanding of use and non-use and the digital divide, such as the consequences of not having access to digital healthcare services, that may lead to breaches of democratic human rights.

반려동물의 구강관리를 위한 디지털 헬스케어 분야에서 인공지능 활용에 대한 고찰

The growing integration of artificial intelligence (AI) in digital healthcare services presents a promising opportunity for manage oral health of pets within the digital healthcare space. This study explores various applications of AI in management of oral health of pets and discusses the future market directions for this technology. In particular, the expansion of AI-based smart oral health management services and telemedicine offers pet owners the possibility of managing their pet’s oral health without direct face-to-face interactions with veterinarians. The development of dental imaging analysis and oral health management systems using AI technology is expected to aid in the early detection, prevention, and treatment of oral diseases in pets through rapid and accurate diagnosis. Additionally, AI can be utilizedin innovative tools such as genetic analysis and precision medicine to manage the oral health of pets. Therefore, AI can be leveraged in various digital healthcare fields to manage the oral health of pets. By considering aspects such as data privacy, accountability, reliability, and legal compliance, the quality of life for pet owners and their petscan be enhanced significantly.

Preferences, Needs, and Values of Patients With Chronic Obstructive Pulmonary Disease Attending a Telehealth Service: Qualitative Interview Study.

Digitally assisted health care services and technologies are gaining popularity. They assist patients in managing their conditions, thereby reducing the burden on health care staff. Digital health care enables individuals to receive care that is more tailored to their needs and preferences. When implemented properly, it can promote equity by considering each person's opportunities and limitations in the context of health care needs, preferences, values, and capabilities. This study aims to understand the needs, values, and preferences of individuals with chronic obstructive pulmonary disease (COPD) who are provided with a 24/7 digital health care service. Furthermore, we aim to understand the dynamics of the communities to which they belong and how these communities intersect. This will provide us with the essential knowledge to establish new methods of providing education, including the development of educational activities for health professionals to engage, train, and empower people living with COPD. The study included 7 informants diagnosed with COPD who received 24/7 digital health care service support from a regional project in Region Zealand, Denmark. The informants were visited 4 times during 2 months, including a "Hello" visit, a day with a semistructured interview, and 2 days with field observations. The informants participated in a semistructured interview, following participant observation and an ethnographic approach. The interview content was analyzed using an inductive methodology to categorize the empirical data. Using the inductive approach, we identified 3 main categories related to the informants' needs, values, and preferences: (1) Health, (2) Value Creation, and (3) Resources. These 3 main categories were based on 9 subcategories: (1) health and barriers, (2) self-monitoring, (3) medication, (4) behavior, (5) motivation, (6) hobbies, (7) social networks, (8) health professionals, and (9) technology. These findings revealed that the informants placed value on maintaining their daily activities and preserving their sense of identity before the onset of COPD. Furthermore, they expressed a desire not to be defined by their COPD, as conversations about COPD often shifted away from the topic. Digital health solutions and the health care professionals who offer them should prioritize the individuals they serve, considering their needs, values, and preferences rather than solely focusing on the medical condition. This approach ensures the highest level of daily living and empowerment for those living with long-term health conditions. The communities surrounding individuals must engage in constant interaction and collaboration. They should work together to incorporate people's needs, values, and preferences into future digital health services, thereby promoting empowerment and self-management. New educational programs aimed at developing the digital health service competencies of registered nurses should facilitate collaboration between the 2 communities. This collaboration is essential for supporting patients with long-term health conditions in their daily activities.

The role of governance in the digital transformation of healthcare: Results of a survey in the WHO Europe Region

Optimal governance is among the key facilitators of the digital transformation of health systems intended to improve access to healthcare, quality, safety, and efficiency, and to attain universal health coverage. This paper highlights the findings of a survey assessing the status of governance of digital health in the WHO European Region.The 2022 survey is a continuation of the 2015 WHO Global Survey on eHealth. The survey focused on national digital health governance, monitoring and evaluation of digital health interventions, and funding and investment in digital health and was conducted through April to October 2022. All 53 Member States of the WHO European Region participated in the survey.The results showed that 83% of the Member States reported having a national digital health strategy in place, and 79% of the Member States reported having a health information system strategy. Most of the priorities of the national digital health strategies were devoted to increasing the accessibility, quality, safety, and efficiency of the health systems, strengthening health information systems, and improving information sharing and interoperability of data. Measures to ensure equity in access to digital healthcare services were directed towards improving broadband connectivity, information and communication technology, digital literacy, and digital health promotion. Oversight for the implementation and operation of the national digital health strategies are mostly delegated to government agencies. The prime source of funding for digital health programs was public funding, though a combination of funding sources was also noted. This analysis revealed increasing adoption of national digital health strategies for access to healthcare and creation of digital health agencies and funding programs for digital health.

How Informal Carers Support Video Consulting in Physiotherapy, Heart Failure, and Cancer: Qualitative Study Using Linguistic Ethnography.

Informal carers play an important role in the everyday care of patients and the delivery of health care services. They aid patients in transportation to and from appointments, and they provide assistance during the appointments (eg, answering questions on the patient's behalf). Video consultations are often seen as a way of providing patients with easier access to care. However, few studies have considered how this affects the role of informal carers and how they are needed to make video consultations safe and feasible. This study aims to identify how informal carers, usually friends or family who provide unpaid assistance, support patients and clinicians during video consultations. We conducted an in-depth analysis of the communication in a sample of video consultations drawn from 7 clinical settings across 4 National Health Service Trusts in the United Kingdom. The data set consisted of 52 video consultation recordings (of patients with diabetes, gestational diabetes, cancer, heart failure, orthopedic problems, long-term pain, and neuromuscular rehabilitation) and interviews with all participants involved in these consultations. Using Linguistic Ethnography, which embeds detailed analysis of verbal and nonverbal communication in the context of the interaction, we examined the interactional, technological, and clinical work carers did to facilitate video consultations and help patients and clinicians overcome challenges of the remote and video-mediated context. Most patients (40/52, 77%) participated in the video consultation without support from an informal carer. Only 23% (12/52) of the consultations involved an informal carer. In addition to facilitating the clinical interaction (eg, answering questions on behalf of the patient), we identified 3 types of work that informal carers did: facilitating the use of technology; addressing problems when the patient could not hear or understand the clinician; and assisting with physical examinations, acting as the eyes, ears, and hands of the clinician. Carers often stayed in the background, monitoring the consultation to identify situations where they might be needed. In doing so, copresent carers reassured patients and helped them conduct the activities that make up a consultation. However, carers did not necessarily help patients solve all the challenges of a video consultation (eg, aiming the camera while laying hands on the patient during an examination). We compared cases where an informal carer was copresent with cases where the patient was alone, which showed that carers provided an important safety net, particularly for patients who were frail and experienced mobility difficulties. Informal carers play a critical role in making video consultations safe and feasible, particularly for patients with limited technological experience or complex needs. Guidance and research on video consulting need to consider the availability and work done by informal carers and how they can be supported in providing patients access to digital health care services.

The Impact and Opportunities of Digital Economy on Rural Revitalization

This study explores how the digital economy influences and provides opportunities for the rejuvenation of rural areas. Positioned as a crucial element in the contemporary global economy, the digital economy opens up fresh possibilities for the growth and revitalization of rural regions. The research reveals that the extensive application of digital technologies has transformed the operational methods in various sectors of rural economies, education, healthcare, finance, and agriculture. Digital technologies, such as rural e-commerce and smart agriculture, have provided rural residents with new economic opportunities, fostering economic growth and the sale of agricultural products. Remote education and digital skills training contribute to elevating the knowledge and skills of rural residents, thereby increasing employment prospects. Digital financial services enhance financial inclusivity in rural areas, aiding rural residents in better financial management. Furthermore, the development of digital healthcare services improves rural healthcare by providing opportunities for remote medical consultations and diagnoses. The digital economy's influence contributes to the enhancement of living standards among rural residents, fosters the development of rural infrastructure, and improves governance within rural communities. Digital technologies also contribute to enhancing the environmental sustainability of rural regions, reducing resource wastage and environmental pollution. These opportunities provide new impetus for rural revitalization and are expected to assist rural areas in achieving their sustainable development objectives. However, the digital economy also presents challenges, including the digital divide, privacy and security issues, barriers to technology adoption, knowledge and skill disparities, as well as social, cultural, navigating through these challenges demands thorough policies and strategies, aiming to optimize the digital economy's potential while guaranteeing that rural residents fully capitalize on the opportunities it offers. To sum up, the digital economy provides extensive possibilities for rejuvenating rural areas, enhancing living standards, fostering economic growth, and fostering sustainable development in rural communities. However, fully realizing these opportunities necessitates overcoming a series of challenges, devising appropriate policies, and enhancing the adoption and application of digital technologies. This will aid in attaining the objectives of rural rejuvenation and advancing sustainable development in rural areas.

Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization.

Social and geographical inequity in access to primary healthcare is an ongoing concern in Sweden. Digital care can potentially decrease geographical inequity. This study aimed to evaluate how urbanicity affects the utilization of a public digital primary healthcare service - PHC Online. We performed an ecological cross-sectional study of 4,482 PHC Online visits grouped by 83 public primary healthcare centers. Multiple linear regression analysis was performed with PHC Online visits per 1,000 registered patients as the dependent variable and urbanicity (municipalities grouped by number of inhabitants), socioeconomic status (Care Need Index), and morbidity (Adjusted Clinical Groups) per primary healthcare center as independent variables. Utilization of PHC Online was more common among those of a younger age (median 32 years) and among women (65%). Urbanicity did not affect utilization. Lower socioeconomic status and higher morbidity had negative effects on utilization (B -3.289, p = 0.001, B -7.728, p = 0.045). Geographical differences based on urbanicity do not seem to affect the utilization of PHC Online. Further studies are needed to clarify a possible association to geographical barriers in access to primary healthcare, specifically accounting for factors associated with urbanicity and distance to physical clinics, and how age and sex affect such an association. Lower utilization of PHC Online in low socioeconomic status and high morbidity populations raises questions on the effect of digital primary care on equitable access to primary healthcare.

Implementing digital sexual and reproductive health care services in youth clinics: a qualitative study on perceived barriers and facilitators among midwives in Stockholm, Sweden

BackgroundDigital health care services have the potential to improve access to sexual and reproductive health care for youth but require substantial implementation efforts to translate into individual and public health gains. Health care providers are influential both regarding implementation and utilization of the services, and hence, their perceptions of digital health care services and the implementation process are essential to identify and address. The aim of this study was to explore midwives’ perception of digital sexual and reproductive health care services for youth, and to identify perceived barriers and facilitators of the implementation of digital health care provision in youth clinics.MethodsWe performed semi-structured interviews with midwives (n = 16) working at youth clinics providing both on-site and digital sexual and reproductive health care services to youth in Stockholm, Sweden. Interview data were analyzed using a content analysis approach guided by the Consolidated Framework for Implementation Research (CFIR).ResultsMidwives acknowledged that the implementation of digital health care improved the overall access and timeliness of the services at youth clinics. The ability to accommodate the needs of youth regarding their preferred meeting environment (digital or on-site) and easy access to follow-up consultations were identified as benefits of digital health care. Challenges to provide digital health care included communication barriers, privacy and confidentiality concerns, time constraints, inability to offer digital appointments for social counselling, and midwives’ preference for in person consultations. Experiencing organizational support during the implementation was appreciated but varied between the respondents.ConclusionDigital sexual and reproductive health care services could increase access and are valuable complements to on-site services in youth clinics. Sufficient training for midwives and organizational support are crucial to ensure high quality health care. Privacy and safety concerns for the youth might aggravate implementation of digital health care. Future research could focus on equitable access and youth’ perceptions of digital health care services for sexual and reproductive health.

Digital psychiatry in Nigeria: A scoping review.

Mental healthcare workforce shortage in Nigeria poses a major obstacle to mental health services scale-up. Digital psychiatry may provide a veritable platform to bridge treatment gaps. To provide an overview of quantity and range of peer-reviewed publications on digital psychiatry in Nigeria. A comprehensive literature search encompassed all original, peer-reviewed research articles on digital psychiatry in Nigeria. PubMed, Google Scholar, and a direct exploration of relevant journal article reference lists were utilised. Inclusion criteria covered peer-reviewed original articles conducted in Nigeria between January 2013 and January 2023, regardless of quality. Exclusions comprised case reports, reviews, dissertations, and abstracts. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were adhered to, while methodological framework of Arksey and O'Malley was used to describe the review. Fourteen studies meeting inclusion criteria exhibited two primary research areas: implementation and intervention. Most studies focused on intervention strategies, showcasing efficacy of digital devices in enhancing outcomes in depression and clinic appointments. Implementation studies indicated favorable acceptance by both clients and healthcare practitioners. Digital technology seems acceptable to Nigerian patients and clinicians. Policies to operationalise provision of digital healthcare services will have positive impact in addressing unmet mental health needs. Finally, the quality of the evidence from majority of studies has to be enhanced, and additional studies are required to uncover gaps in some regions of the country. This research demonstrates that, despite some drawbacks, digital methods of providing mental healthcare are practical in Nigeria.