Digital Healthcare Services Research Articles

Integrating Blockchain Technology into Healthcare Through an Intelligent Computing Technique

The blockchain technology plays a significant role in the present era of information technology. In the last few years, this technology has been used effectively in several domains. It has already made significant differences in human life, as well as is intended to have noticeable impact in many other domains in the forthcoming years. The rapid growth in blockchain technology has created numerous new possibilities for use, especially for healthcare applications. The digital healthcare services require highly effective security methodologies that can integrate data security with the available management strategies. To test and understand this goal of security management in Saudi Arabian perspective, the authors performed a numerical analysis and simulation through a multi criteria decision making approach in this study. The authors adopted the fuzzy Analytical Hierarchy Process (AHP) for evaluating the effectiveness and then applied the fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) technique to simulate the validation of results. For eliciting highly corroborative and conclusive results, the study referred to a real time project of diabetes patients’ management application of Kingdom of Saudi Arabia (KSA). The results discussed in this paper are scientifically proven and validated through various analysis approaches. Hence the present study can be a credible basis for other similar endeavours being undertaken in the domain of blockchain research.

Promoting Adherence to Joint Exercise Using the Donation Model: Proof via a Motion-Detecting Mobile Exercise Coaching Application.

Maintaining or increasing user adherence to digital healthcare services is of great concern to service providers. This study aims to verify whether the donation model is an effective strategy to increase adherence to physical exercise using a mobile application. A total of 5618 users of a motion-detecting mobile exercise coaching application participated in a donation or self-reward exercise challenge with the same exercise protocol. The workout consisted of 50 squats daily for 14 days. The user's exercise was monitored through a smartphone camera, providing real-time visual and audio feedback. In the donation group, 6 USD was donated to the economically disadvantaged if a participant completed their workout each day. In the self-reward group, three people who completed the program and 20 people who completed ≥12 days of exercise were randomly selected and provided with goods worth 60 USD and 4.3 USD of online currency, respectively. The average daily exercise completion rate (% of participants who completed daily exercise) in the donation group was 1.8 times higher than that of the self-reward group (donation, 41.7%; self-reward, 22.7%; p<0.0001). The donation group completed more days of the program (donation, 5.8; self-reward, 3.2; p<0.0001). The completion rate of both groups decreased with time and decreased most on day two (donation, -9.9%; self-reward, -14.5%). The donation model effectively promoted adherence to mobile app-based exercise. This donation model is expected to effectively enhance user adherence to digital healthcare services.

Adoption of Mobile Health (m-Health) Services by Patients for Sustainable Healthcare Development: A Qualitative Exploration

Mobile health technology will enhance people's lives through raising healthcare awareness and knowledge, expanding the reach of healthcare services, and building a workforce of digitally competent healthcare workers. The adoption of mobile health is limited due to a lack of awareness, information, and interest among patients.Objective: This study aimed to explore stages of adoption process and factors impacting adoption of mobile health applicationsMethodology: The study was conducted in Mumbai. In total, 20 in-depth interviews were conducted. Respondents included users of fitness apps, people using mobile apps for online consultation and monitoring health parameters. Considering qualitative exploration, this study approached the investigation with three domains: stages in adoption process, hierarchy of involvement steps and various factors impacting adoption of mobile health applications.Results: Patients expressed their interest in mobile health applications specially related to fitness. Mobile Health is considered to be good option for monitoring various health parameters. Patient's attitude towards health plays an important role in adoption of mobile health applications. Various critical factors like trust on healthcare application, facilitating conditions and usefulness are driving adoption of mobile health applications. Contribution: This study will be useful for other researchers in the field of digital healthcare services. This will provide directional cues for developing m-health applications for enhancing adoption of such applications amongst patients which can be further validated through quantitative study.

Global trends in the digital transformation of the healthcare industry

National health systems are experiencing a number of common global challenges: population growth, demographic ageing, the prevalence of chronic noncommunicable diseases, the constant growth of health-care costs, while increasing resource scarcity, including staffing. At the same time, the rapid development of information technologies, including the accumulation of big data, artificial intelligence, telemedicine, remote patient monitoring, and the increasing availability of high-performance mobile devices and a high-speed Internet connection create truly unique prospects for the development of digital healthcare products and services. Growth of investment from tech giants and venture capital funds is one of the main drivers of digital healthcare transformation. More and more innovative products are being offered not to enhance the effectiveness of existing processes within health systems, but to create new alternative ways to receive medical care or reduce problems in its delivery. Thus, a key customer and a user of digital healthcare products is gradually becoming not the heads of medical organizations, public health authorities or doctors, but patients themselves. In this article, we present an analysis of the existing global trends and directions of development of the digital healthcare market, form our image of the future and the most prospective scenarios and technologies for products and services in this area.

Design of low power SRAM- based ubiquitous sensor for wireless body area networks

Purpose Smart ubiquitous sensors have been deployed in wireless body area networks to improve digital health-care services. As the requirement for computing power has drastically increased in recent years, the design of low power static RAM-based ubiquitous sensors is highly required for wireless body area networks. However, SRAM cells are increasingly susceptible to soft errors due to short supply voltage. The main purpose of this paper is to design a low power SRAM- based ubiquitous sensor for healthcare applications. Design/methodology/approach In this work, bias temperature instabilities are identified as significant issues in SRAM design. A level shifter circuit is proposed to get rid of soft errors and bias temperature instability problems. Findings Bias Temperature Instabilities are focused on in recent SRAM design for minimizing degradation. When compared to the existing SRAM design, the proposed FinFET-based SRAM obtains better results in terms of latency, power and static noise margin. Body area networks in biomedical applications demand low power ubiquitous sensors to improve battery life. The proposed low power SRAM-based ubiquitous sensors are found to be suitable for portable health-care devices. Originality/value In wireless body area networks, the design of low power SRAM-based ubiquitous sensors are highly essential. This design is power efficient and it overcomes the effect of bias temperature instability.

6.G. Workshop: Developing a consent model for health information – challenges in a rapidly changing digital world

Abstract Advances in eHealth and digital technologies have the potential to improve the quality of patient care and promote efficiency across a health service. The potential benefits have often not been realised, however, due to a sometimes greater focus on organisational needs rather than pursuing a person-centred approach. There are some concerns from the public in relation to the privacy and security of data, issues in relation to digital literacy and inadequate digital infrastructure, and the potential erosion of the patient-healthcare professional relationship. The introduction of new information systems requires clarity around consent to align with good information governance practices and support people's rights and involvement in relation to health information decisions. Internationally, the successful introduction of digital technologies in healthcare have been informed by effective public engagement and involvement from the outset. Public engagement helps to build trust and confidence in relation to health information use, and gives insight into important considerations for the development of a consent model. As part of this workshop, we will share the experiences of three different European countries who are at varying stages of development and implementation of eHealth solutions. Ireland is at the early stages of transition to a more digital healthcare service. In England, there are a number of eHealth systems in place although difficulties have been experienced at stages; understanding public expectations and involving the public in decision-making has been an important component of their progress. Estonia is recognised as a leader in eHealth and has much to offer in relation to the fundamental principles of successful implementation. The objectives of this workshop are to: 1) share experiences in relation to the process of public engagement across different contexts; 2) examine the eHealth landscape in relation to health information sharing; and 3) lead a discussion on the opportunities and challenges faced for the future of health information in a digital world. This workshop will be comprised of three presentations, from each of the above country perspectives, followed by a panel discussion with contributions invited from the audience. Key messages Building public trust, via public engagement, is essential for successful implementation of digital health technologies. Digital health can transform future health systems but success requires strong national leadership, information governance, robust standards, consent management, and access rights.

Common good in the era of data-intensive healthcare

In recent years, scholars studying data-intensive healthcare have argued that data-driven technologies bind together new actors and goals as part of healthcare. By combining the expectation studies with justification theory, this article adopts a novel theoretical perspective to understand how these actors and goals are enroled in healthcare. Drawing on a case study of Apotti, a Finnish social services and healthcare information system renewal project, the article shows how new emerging health data assemblages stress the aims of producing the common good in public healthcare. The project is studied by analysing interviews of the project’s key actors and various documents produced in the project. The paper shows how, in the collective expectations, the new information system is justified by multiple understandings of the common good, which might be contradictory with each other. Along with the established goals of improving public healthcare operations, the new information system is expected to empower clients and patients, audit and manage personnel, promote national digital social and healthcare service markets, provide better data and tools for research, and promote Finnish research and business in international competition. These expectations are not all based on the settled understanding of the common good of public healthcare as promoting health; the common good is also defined in other terms such as improving research, promoting markets and business, and making Finland famous and a leading country in the digital social services and healthcare field. These goals and expectations are purposely ambiguous to be loose enough to gain attention and maintain it even when the promises are not met. The paper identifies the ambiguity and plurality of the common good as strategies of data-intensive healthcare and raises concerns of how this might shape public healthcare in the future. As the plural understandings of the common good might not support each other, the paper calls for further assessments of how this will affect public healthcare’s core objectives and for seeking solutions that carefully balance the goals of the current and evolving multi-stakeholder environment of data-intensive healthcare.

A Blockchain and Artificial Intelligence-Based, Patient-Centric Healthcare System for Combating the COVID-19 Pandemic: Opportunities and Applications.

The world is facing multiple healthcare challenges because of the emergence of the COVID-19 (coronavirus) pandemic. The pandemic has exposed the limitations of handling public healthcare emergencies using existing digital healthcare technologies. Thus, the COVID-19 situation has forced research institutes and countries to rethink healthcare delivery solutions to ensure continuity of services while people stay at home and practice social distancing. Recently, several researchers have focused on disruptive technologies, such as blockchain and artificial intelligence (AI), to improve the digital healthcare workflow during COVID-19. Blockchain could combat pandemics by enabling decentralized healthcare data sharing, protecting users’ privacy, providing data empowerment, and ensuring reliable data management during outbreak tracking. In addition, AI provides intelligent computer-aided solutions by analyzing a patient’s medical images and symptoms caused by coronavirus for efficient treatments, future outbreak prediction, and drug manufacturing. Integrating both blockchain and AI could transform the existing healthcare ecosystem by democratizing and optimizing clinical workflows. In this article, we begin with an overview of digital healthcare services and problems that have arisen during the COVID-19 pandemic. Next, we conceptually propose a decentralized, patient-centric healthcare framework based on blockchain and AI to mitigate COVID-19 challenges. Then, we explore the significant applications of integrated blockchain and AI technologies to augment existing public healthcare strategies for tackling COVID-19. Finally, we highlight the challenges and implications for future research within a patient-centric paradigm.

Open Innovation Application to Digital Transformation of Healthcare Services

The pandemic of COVID-19 urged healthcare ecosystem to expedite the deployment and use of digital healthcare services. Digital healthcare services by nature require the integration of diverse external and internal knowledge provided by multiple stakeholders of the healthcare ecosystem. Thus, open innovation could significantly contribute to value-based digital healthcare performance. This article illustrates how different open innovation strategies contribute to different types of value created by digital healthcare services. Healthcare providers, policymakers and insurance companies while seeking to utilize digital healthcare services need to leverage between different strategies of open innovation (e.g., inside-out or inside-in). While orchestration of the strategies might provide the optimal results, special attention needs to be given to inside-in open innovation processes.

Cultural and dynamic capabilities factors facilitating digital transformation of healthcare services

Background Digital transformation of healthcare services was slow until the COVID-19 pandemic, however, global lockdown urged healthcare providers to accelerate the utilisation of advanced technologies in healthcare services. While the researchers focused on the role of technologies, the role of culture as an antecedent of dynamic capabilities responsible for digitalisation of the services, was undermined. Purpose The purpose of the paper is to explore the cultural and dynamic capabilities factors facilitating the digital transformation of healthcare services across three different countries. Methodology/Approach The exploratory multiple case study research design was applied, and data collected in Lithuania, the United States, and Spain. The multiple case study is based on 63 interviews of healthcare providers, start-ups, patients and secondary data analysis across three countries. Results Comparative analysis of the cultural dimensions, dynamic capabilities and performance of the digital healthcare services in Lithuania, California (United States), and Catalonia (Spain) shows that there is a tendency for strong dynamic capabilities to stimulate the more advanced performance of digital healthcare services. In addition, the manifestation of certain cultural dimensions, such as high masculinity and indulgency, might contribute to fostering dynamic capabilities. Conclusion Cultural context matters for developing strong dynamic capabilities in healthcare providers and, in turn, more advanced performance of digital healthcare services. Practice implications In order to accelerate the performance of digital healthcare services, healthcare providers are recommended to enhance dynamic capabilities, paying attention to the specifics of the national cultural dimensions.

Digital Health During COVID-19 Pandemic: Challenges and opportunities Review

Corona virus pandemic caused an enormous effect on medical care, public activity, and economies on a worldwide scale. Clearly, technology has a vital role to empower omnipresent and available digital health services in pandemic conditions just as against “reappearance” of COVID-19 disease in a post-pandemic period. Likewise, 5G systems and 5G-empowered e-health arrangements are principal. This paper features philosophies to adequately use 5G for e-health use cases and its job to empower significant digital healthcare services. It's anything but a comprehensive conversation of the implementation issues, potential cures and future research bearings for 5G to lighten the health challenges related to COVID-19.

The healthcare technology needs you

The growing evidence and technology in healthcare improve the patient's health across a continuum of services in clinical and community settings. A multidisciplinary team should work in tandem on this phenomenon. Therefore, innovative healthcare technology must be designed intensively to optimize productivity, provide new insight, and support the standard treatment for particular diseases. In the coming years, technology is needed to change the way of caring for the patient. The concept is a fundamental aspect because recent technology has shaped up in front of our practice with advances in digital healthcare services, such as 3D printing, robotics, nanotechnology, and even artificial intelligence (The Medical Futurist, 2021). Updated studies should be developed and published focusing on innovative technology, including in Medicine, Nursing, Pharmacy, and other health-related topics.&#x0D; Keywords: healthcare; innovation in technology; patient care; outcomes improvement; chronic illness

Smart Decentralization of Personal Health Records with Physician Apps and Helper Agents on Blockchain: Platform Design and Implementation Study.

BackgroundThe Health Avatar Platform provides a mobile health environment with interconnected patient Avatars, physician apps, and intelligent agents (termed IoA3) for data privacy and participatory medicine; however, its fully decentralized architecture has come at the expense of decentralized data management and data provenance.ObjectiveThe introduction of blockchain and smart contract technologies to the legacy Health Avatar Platform with a clinical metadata registry remarkably strengthens decentralized health data integrity and immutable transaction traceability at the corresponding data-element level in a privacy-preserving fashion. A crypto-economy ecosystem was built to facilitate secure and traceable exchanges of sensitive health data.MethodsThe Health Avatar Platform decentralizes patient data in appropriate locations (ie, on patients’ smartphones and on physicians’ smart devices). We implemented an Ethereum-based hash chain for all transactions and smart contract–based processes to guarantee decentralized data integrity and to generate block data containing transaction metadata on-chain. Parameters of all types of data communications were enumerated and incorporated into 3 smart contracts, in this case, a health data transaction manager, a transaction status manager, and an application programming interface transaction manager. The actual decentralized health data are managed in an off-chain manner on appropriate smart devices and authenticated by hashed metadata on-chain.ResultsMetadata of each data transaction are captured in a Health Avatar Platform blockchain node by the smart contracts. We provide workflow diagrams each of the 3 use cases of data push (from a physician app or an intelligent agents to a patient Avatar), data pull (request to a patient Avatar by other entities), and data backup transactions. Each transaction can be finely managed at the corresponding data-element level rather than at the resource or document levels. Hash-chained metadata support data element–level verification of data integrity in subsequent transactions. Smart contracts can incentivize transactions for data sharing and intelligent digital health care services.ConclusionsHealth Avatar Platform and interconnected patient Avatars, physician apps, and intelligent agents provide a decentralized blockchain ecosystem for health data that enables trusted and finely tuned data sharing and facilitates health value-creating transactions with smart contracts.

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem. Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0. Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respond-ents. Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare. Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64-$6.56 and $3.28 – $6.56, respectively. Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria. © 2021 Ahmad;.

Social impacts of the continuous usage of digital healthcare service: A case of South Korea

As untact communication is promoted in the era of the COVID-19 pandemic, special attention is paid to remote medical examination and customized healthcare trends. General digital healthcare services among social community members positively affect individuals’ healthcare and reduce medical social services’ burden, contributing to the development of society. Accordingly, it is necessary to induce healthcare behaviors through the continuous usage of digital healthcare services among social community members and to examine significant social impact factors in this regard. This study empirically analyzes the impact of three social impact factors – social capital, social support, and social value – on the continuous usage of digital healthcare service with healthcare behaviors and e-health literacy as media. To this end, a survey was conducted among 363 individuals who had used digital healthcare services in Korea, and the statistical data were analyzed. Social capital and social value were found to affect healthcare behaviors, e-health literacy, and continuous usage intentions, but social support did not. Based on this result, it was confirmed that the factors regarded by digital healthcare service users as necessary were the values and perceptions shared in society and the group, information and active communication rather than direct public support.

Medication Name Comprehension of Intelligent Virtual Assistants: A Comparison of Amazon Alexa, Google Assistant, and Apple Siri Between 2019 and 2021.

The current study was a replication and comparison of our previous research which examined the comprehension accuracy of popular intelligent virtual assistants, including Amazon Alexa, Google Assistant, and Apple Siri for recognizing the generic and brand names of the top 50 most dispensed medications in the United States. Using the exact same voice recordings from 2019, audio clips of 46 participants were played back to each device in 2021. Google Assistant achieved the highest comprehension accuracy for both brand medication names (86.0%) and generic medication names (84.3%), followed by Apple Siri (brand names = 78.4%, generic names = 75.0%), and the lowest accuracy by Amazon Alexa (brand names 64.2%, generic names = 66.7%). These findings represent the same trend of results as our previous research, but reveal significant increases of ~10–24% in performance for Amazon Alexa and Apple Siri over the past 2 years. This indicates that the artificial intelligence software algorithms have improved to better recognize the speech characteristics of complex medication names, which has important implications for telemedicine and digital healthcare services.

Mass Reliance on Digital Healthcare Services Risky?

Mass Reliance on Digital Healthcare Services Risky?

Re-Examining the Impact of Multidimensional Trust on Patients’ Online Medical Consultation Service Continuance Decision

Recent years have witnessed the rapid growth of an emerging digital healthcare service – online medical consultation (OMC). Despite its popularity, many OMC platforms have encountered issues in initial adoption and continuance use among patients. We posit that many of the hesitation and resistance may arise from a lack of trust toward OMC, which is a complex phenomenon that involves both interpersonal and technological-oriented considerations. This study seeks to clarify the conceptualization of online trust in the context of OMC. It compares two plausible explanations (i.e., trust as a direct cause vs. trust as a moderator) regarding how interpersonal and technological trust contributes to the service continuance decision in OMC. By contextualizing the valence framework, we identify the critical factors in making the risk-benefit assessment of patients’ OMC decision. We conduct an online survey of 365 experienced OMC users and analyze our structural model using a partial least square approach. Our results show that the multidimensional conceptualization approach, which incorporates both interpersonal and technological aspects of trust, is superior to the unitary approach. Besides, our findings suggest that the role trust plays in determining service continuance decisions in OMC is more of a direct cause than a qualifier that buffers the impacts of risk-benefit evaluation. We believe the findings can help both researchers and practitioners recognize the multidimensional perspective of trust and better understand the role trust plays in OMC and other online healthcare delivery problems.

Mass Reliance on Digital Health Care Services Risky?

Biomedical Safety & Standards: March 01, 2021 - Volume 51 - Issue 4 - p 32 doi: 10.1097/01.BMSAS.0000734776.15283.bf

Työterveyshuollon etänä toteutettavan neuvonnan ja ohjauksen käyttöönottoa edistävät ja estävät tekijät

Teknologiaa hyödyntämällä on mahdollista tarjota saavutettavia ja asiakaslähtöisiä työterveyshuollon tietojen annon, neuvonnan ja ohjauksen palveluita. Myös tarve etäpalveluille on kasvanut teknologian kehittymisen ja työterveyshuoltojen asiakasyritysten kansainvälistymisen myötä lisääntyneen mobiilin työn vuoksi. Tämän tutkimuksen tarkoituksena oli selvittää työterveyshuollon etänä toteutettavan tietojen annon, neuvonnan ja ohjauksen kehittämiseen ja käyttöönottoon liittyviä tekijöitä. Tutkimus toteutettiin kolmessa työterveyshuollossa vuosina 2016–2018. Tutkimus koostui työterveyshuoltojen neuvonnan ja ohjauksen nykykäytäntöjen määrittelystä sekä etänä toteutettavan neuvonnan ja ohjauksen yhteiskehittelystä, kokeiluista ja arvioinnista. Analyysissa hyödynnettiin realistisen arviointitutkimuksen menetelmää. Tulokset kuvaavat työterveyshuoltojen toimintaympäristöjä ja niissä syntyviä etäpalveluiden käyttöönottoa edistäviä ja estäviä tekijöitä. Tutkimus tuottaa tietoa työterveyshuollon etänä toteutettavan neuvonnan ja ohjauksen kehittämisen ja käyttöönoton tueksi.