Digital Health Technologies Research Articles

Response: Commentary: Real-world post-deployment performance of a novel machine learning-based digital health technology for skin lesion assessment and suggestions for post-market surveillance

Response: Commentary: Real-world post-deployment performance of a novel machine learning-based digital health technology for skin lesion assessment and suggestions for post-market surveillance

Digital health technologies in enhancing patient and caregiver engagement in heart failure management: Opportunities and challenges

The management of heart failure has undergone significant evolution, advancing from the initial utilization of digitalis and diuretics to the contemporary practice of personalized medicine and sophisticated device therapy. Despite these advancements, the persistent challenge of high hospitalization and readmission rates underscores an urgent need for innovative solutions. This manuscript explores how the integration of digital health technologies into interventional cardiology marks a paradigm shift in the management of heart failure. These technologies are no longer mere adjuncts but have become foundational to a modern approach, providing tools for continuous monitoring, patient education, and improved outcomes post-intervention. Through an examination of current trends, this perspective article highlights the transformative impact of wearable technologies, telehealth platforms, and advanced analytical tools in reshaping patient engagement and enabling proactive care strategies. Case studies illustrate the practical advantages, including enhanced medication adherence, early detection of heart failure signs, and a reduction in healthcare facility burdens. Central to this new digital health landscape is the Information Technology Management (ITM) system, a framework poised to revolutionize patient and caregiver engagement and pave the way for the future of interventional cardiology. This manuscript delineates the ITM system's innovative architecture and its consequential role in refining current and prospective cardiological interventions.

Acceptance and adoption of tele-rehabilitation by physiotherapists from Nigeria, a low resource setting: a mixed-method study

BackgroundAdoption of tele-rehabilitation among physiotherapists in developed countries has risen exponentially to complement conventional physical contact physiotherapy. However, many low- and middle-income countries like Nigeria where barriers to utilization of tele-physiotherapy were earlier identified still demonstrates limited evidence on its acceptance and adoption till date.MethodThis was a mixed-method design of quantitative and qualitative study, aimed at investigating acceptance and adoption of tele-rehabilitation among physiotherapists in Nigeria. Respondents comprised 331 physiotherapists practising in Nigeria and registered with the Medical Rehabilitation Therapists (Registration) Board of Nigeria (MRTB). Quantitative approach involved completion of a 33-item structured questionnaire shared as Google Forms to respondents’ WhatsApp and emails. Qualitative aspect involved in-depth interview with 12 physiotherapists at the clinics, using a 10-item semi-structured interview guide, and recorded with a voice recorder. Quantitative data was analysed using descriptive and inferential statistics at p < 0.05 alpha level. Qualitative data was analysed using thematic content analysis.ResultsRespondents comprised 172 males and 159 females. Their mean age and years of experience were 33.42 ± 8.95 and 8.86 ± 8.037 years, respectively. Pre-lockdown, only 62 (18.7%) respondents offered tele-physiotherapy. During the 35-day total lockdown, 114 (34.4%) offered tele-physiotherapy. Majority (155 (46.8%)) used smartphone apps. Fifty-seven (17.2%) respondents were confident that tele-rehabilitation can complement conventional physiotherapy, while 72 (21.8%) kept offering post-lockdown. Use of digital technology was highest for patient education (97 (29.3%)), especially for musculoskeletal conditions (85 (25.7%)). There were significant associations between pre-lockdown duties (p = 0.036), post-lockdown duties (p = 0.005) and use of digital health technology (p = 0.001) with respondents’ age. Significant associations also existed between respondents’ years of practice and each of post-lockdown duties (p = 0.017) and use of digital health technology (p = 0.001). Qualitative approach revealed that facilitators to adoption and acceptance of tele-rehabilitation included patient education, training of physiotherapists, availability of evidence-based guidelines and tele-health software and hardware systems. Barriers were lack of or limited technological infrastructures, finances, hospital management support, and knowledge of information and communication technology.ConclusionsPhysiotherapists in Nigeria demonstrated moderate acceptance but low adoption of tele-rehabilitation, in varied comparison with clinicians and physiotherapists in other climes. Training of physiotherapists in tele-rehabilitation and provision of enabling technological environment by regulatory bodies and policy makers are recommended.

Community-Dwelling Older Adults' Readiness for Adopting Digital Health Technologies: Cross-Sectional Survey Study.

Digital health technologies offer the potential to improve the daily lives of older adults, maintain their health efficiently, and allow aging in place. Despite increasing evidence of benefits and advantages, readiness for adopting digital interventions among older people remains underexplored. This study aims to explore the relationships between sociodemographic-, health-, and lifestyle-related factors and technology use in everyday life and community-dwelling older adults' readiness to adopt telemedicine, smartphones with texting apps, wearables, and robotics. This was a cross-sectional, population-based survey study with a stratified probabilistic sample of adults aged 75 years or older living in South Tyrol (autonomous province of Bolzano/Bozen, Italy). A random sample of 3600 community-dwelling older adults living at home was invited to complete a questionnaire including single items (older adults' readiness to use health technology) and scales (PRISMA-7; Program of Research on Integration of Services for the Maintenance of Autonomy). Descriptive and logistic regression analyses were performed to analyze the data. In total, 1695 community-dwelling older adults completed the survey (for a response rate of 47%). In terms of potential digital health technology adoption, wearable devices were favored by 33.7% (n=571), telemedicine by 30.1% (n=510), smartphones and texting apps by 24.5% (n=416), and assistant robots by 13.7% (n=232). Sociodemographic-, health- and lifestyle-related factors, as well as the use of technology in everyday life, played a significant role in explaining readiness to adopt digital health technologies. For telemedicine, age ≥85 years (odds ratio [OR] 0.74, 95% CI 0.56-0.96), financial constraints (OR 0.68, 95% CI 0.49-0.95), and less than 2 hours of physical activity per week (OR 0.75, 95% CI 0.58-0.98) were associated with nonreadiness, while Italian-speaking participants (OR 1.54, 95% CI 1.16-2.05) and those regularly using computers (OR 1.74, 95% CI 1.16-2.60), smartphones (OR 1.69, 95% CI 1.22-2.35), and the internet (OR 2.26, 95% CI 1.47-3.49) reported readiness for adoption. Community-dwelling older adults display varied readiness toward the adoption of digital health technologies, influenced by age, mother tongue, living situation, financial resources, physical activity, and current use of technology. The findings underscore the need for tailored interventions and educational programs to boost digital health technology adoption among community-dwelling older adults.

Digital Health Support: Current Status and Future Development for Enhancing Dialysis Patient Care and Empowering Patients

Chronic kidney disease poses a growing global health concern, as an increasing number of patients progress to end-stage kidney disease requiring kidney replacement therapy, presenting various challenges including shortage of care givers and cost-related issues. In this narrative essay, we explore innovative strategies based on in-depth literature analysis that may help healthcare systems face these challenges, with a focus on digital health technologies (DHTs), to enhance removal and ensure better control of broader spectrum of uremic toxins, to optimize resources, improve care and outcomes, and empower patients. Therefore, alternative strategies, such as self-care dialysis, home-based dialysis with the support of teledialysis, need to be developed. Managing ESKD requires an improvement in patient management, emphasizing patient education, caregiver knowledge, and robust digital support systems. The solution involves leveraging DHTs to automate HD, implement automated algorithm-driven controlled HD, remotely monitor patients, provide health education, and enable caregivers with data-driven decision-making. These technologies, including artificial intelligence, aim to enhance care quality, reduce practice variations, and improve treatment outcomes whilst supporting personalized kidney replacement therapy. This narrative essay offers an update on currently available digital health technologies used in the management of HD patients and envisions future technologies that, through digital solutions, potentially empower patients and will more effectively support their HD treatments.

Assessment of Patient Medication Adherence Using Digital Health Technologies: A Research

Assessment of Patient Medication Adherence Using Digital Health Technologies: A Research

“FIT FUEL: A Diet Planner Platform Using Web Technology”

Abstract: In today's fast-paced world, maintaining a healthy lifestyle has become a significant concern for many individuals. The "FIT FUEL" project introduces a cutting-edge solution in the form of a web-based diet planner platform that leverages modern technology to assist users in achieving their fitness goals. By incorporating user-provided data such as height, weight, and desired weight management goals (gain, lose, or maintain weight), the platform calculates Basal Metabolic Rate (BMR) and suggests personalized diet plans for breakfast, lunch, and dinner. One of the key innovations of FIT FUEL is its integration of Application Programming Interfaces (APIs) to fetch a diverse range of recipes, ensuring that users have access to a wide variety of meal options that align with their nutritional requirements and preferences. This platform not only facilitates calorie tracking but also promotes balanced nutrition and dietary diversity. The research paper discusses the design, implementation, and functionality of the FIT FUEL platform, highlighting its usercentric approach and the utilization of web technology to deliver a seamless and engaging experience. Additionally, the paper explores the potential impact of such digital tools on promoting healthy eating habits and overall wellness among individuals. Through this research, FIT FUEL aims to contribute to the growing field of digital health technologies, offering a practical solution for individuals seeking a personalized and effective approach to managing their diet and fitness journey in today's digital age.

From office to digital primary care services: analysing income-related inequalities in utilization.

The use of digital technologies to deliver primary health care has increased over the past decade. While some technologies have been shown to be medically effective and efficient, the effects of digital primary care on the policy goal of equality in the use of such types of care have not been studied using large register data. The aim of this study was to analyse how digital contacts differ from officebased visits by income as an indicator of socioeconomic status. Specifically, we estimated differences in primary care utilization across income, factors of contribution to these inequalities, and applied a needs-based standardisation of utilization to estimate differences in equity.We used a purposively built consultation level dataset with 726 000 Swedish adult patients diagnosed with an infection, including clinical and sociodemographic variables. Applying concentration indexes (CI) and graphical illustrations we measured how the two types of services are distributed relative to income. We estimated how much of the inequalities were attributed to different sociodemographic factors by decomposing the concentration indexes. Standardised utilization for sex, age and comorbidity allowed for the estimation of horizontal inequity indexes for both types of services.Utilization by the two types of care showed large income inequalities. Office-based visits were propoor (CI -0.116), meaning lowincome patients utilized relatively more of these services, while digital contacts were prorich (CI 0.205). However, within the patient group who had at least one digital contact, the utilization was also propoor (CI -0,101), although these patients had higher incomes on average. The standardised utilization showed a smaller prorich digital utilization (CI 0.143), although large differences remained. Decomposing the concentration indexes showed that education level and being born in Sweden were strong attributes of prorich digital service utilization.The prorich utilization effects of digital primary care may risk undermining the policy goals of access and utilization to services regardless of socioeconomic status. As digital health technologies continue to expand, policy makers need to be aware of the risk.

Who is most at risk of digital exclusion within healthcare?

Abstract Introduction There has been a rapid growth in the use of digital technologies in healthcare to improve population health. However, due to digital exclusion (DE) (the unfair differences in motivation, access and use of these technologies), some demographic groups are unable to harness the health benefits of these technologies. Various frameworks have been designed to highlight groups vulnerable to health inequities, but none focus on DE. To provide better support for digitally excluded individuals, we must start by identifying demographic groups most at risk of DE. Aim Review the literature to identify demographic groups most at risk of DE within healthcare. Methods PubMed, Google Scholar and Scopus were searched on 22nd October 2022 in a non-systematic way to scope and examine emerging evidence surrounding groups at risk of DE within healthcare. English-language peer-reviewed articles and grey literature (e.g., government reports and regulatory organisation documents) identifying demographic groups at risk of DE and possible factors influencing exclusion were included. Search terms included words associated with DE and health inequity. Data extracted from the included articles included the different demographic groups highlighted and reasons for DE. Results Analysis of twenty-two included articles highlighted six common sociodemographic factors associated with DE that we compiled into six groups. These groups include Culture (ethnicity, language, religion), Limiting conditions (visual and hearing impairments), Education, Age, Residence (rural, deprived areas, homeless), and Socioeconomic status, forming the CLEARS framework. Cultural factors associated with DE included bias in artificial intelligence models used in healthcare technologies, low sensitivity in sensors when used across different ethnic backgrounds, and lack of consideration for different religious groups. Limiting conditions may make it difficult to use the technology, such as reading health information on small screens if visually impaired. Low educational attainment and old age (over 65) were frequently associated with poor digital literacy skills and poor understanding of the benefit of health technologies, thus reducing motivation and use of health technologies. Residential factors centred around barriers to accessing infrastructure to support connectivity (e.g. WiFi) and socioeconomic factors, including financial barriers to compatible devices and connectivity. Individuals who identify with two or more of these groups (intersectionality) are at even greater risk of DE. Conclusion This review identified six groups at risk of DE, the contributing reasons for exclusion, and the role of intersectionality. The CLEARS framework generated from this review can guide researchers and health technology developers in identifying groups that need to be involved in the co-design of digital health technologies to support inclusion. During the development of the CLEARS framework, groups in previous health inequities frameworks, such as the LGBTQ+ community, were considered, but later excluded due to the lack of representation within the literature. However, it is also important to recognise underserved groups are less likely to appear in the literature. Further work is needed to design tailored guidelines to support the development of inclusive digital health technologies that meet the needs of underserved groups.

Digital literacy within Master of Pharmacy curricula in the United Kingdom: a mixed-method study

Abstract Introduction As digital health technologies (DHTs) like electronic health records (EHRs), computerised clinical decision support (CCDS), and telehealth become integral to healthcare delivery, there is an increasing demand for digitally literate healthcare professionals, including pharmacists. The General Pharmaceutical Council (GPhC) has emphasised digital competencies in the United Kingdom’s (UK’s) Master of Pharmacy (MPharm) curriculum. The Health Education England (HEE) and the Topol review further emphasises this point, indicating the pressing need for a digitally ready healthcare workforce.[1,2] However, despite these efforts, evidence suggests that digital literacy remains underrepresented in undergraduate pharmacy training. Aim To explore the current and planned inclusion of digital literacy education in the MPharm curricula of UK pharmacy schools. Methods A two-phase study was conducted. Phase 1: we undertook a content analysis of curricula from all GPhC-accredited UK pharmacy schools (n=30) in April 2022. Curriculum materials were procured either directly from schools’ websites or via formal correspondence. The analytical approach was based on a preceding systematic scoping review and further refined through an inductive open coding methodology. Phase 2: a structured 14-item quantitative survey, informed by the HEE Digital Capabilities Framework for the Pharmacy Workforce, was emailed to academic representatives across all UK pharmacy institutions, soliciting data on digital literacy, pedagogical methodologies, and envisaged curriculum trajectories. Results Documents for the content analysis were obtained from 46.7% (14/30) of the UK pharmacy schools. Of these, 71.4% (10/14) included components of digital literacy education or training. We identified themes relating to digital literacy education including: the theoretical understanding of health informatics, applied informatics, information technology skills and the newly emerging field of DHTs including artificial intelligence, pharmacogenomics, and personalised therapies. A total of 53.3% (16/30) schools responded to the survey. Most schools who participated in the survey stated that they had integrated digital literacy into their curricula, with only one exception; alignment with the HEE framework varied. Digital literacy was typically integrated within other teaching sessions, taught through self-learning using online resources (66.7%; 12/18). EHRs and remote counselling were primary focus areas (94.4%; 17/18). Challenges in digital literacy education include expertise shortage (68.4%; 13/19), insufficient support from pharmacy organisations (68.4%; 13/19), and limited time (52.6%; 10/19). Conclusion Although the review of the MPharm curricula revealed evidence of UK pharmacy schools incorporating digital literacy, we identified gaps in training and education relating to the variability in topics across schools, misalignment with the HEE framework, and educators’ concerns about the adequacy of current digital literacy provisions. It is important to acknowledge that our study’s low response rate might introduce sample bias, including schools more proactive in teaching digital literacy, and may not be representative of the broader educational context. The observed gaps underscore the need for collaboration with professional bodies and industry experts to enhance training with the aim of ensuring that future pharmacists are prepared and competent to practice in the digital age.

Exploring Sociopsychological Determinants and Interventions for Enhancing Health Literacy: A Multifaceted Approach

Health literacy, the ability to obtain, understand, and utilize health information to make informed decisions, is essential for promoting public health and reducing health disparities. This paper examines the sociopsychological determinants of health literacy, focusing on individual factors, interpersonal dynamics, and societal contexts. Specifically, it explores the influence of cognitive abilities, health beliefs, socioeconomic status, social support, family and peer influences, healthcare systems, health policy, and cultural competence on health literacy levels. Additionally, the paper discusses interventions to enhance health literacy, including education and health promotion programs, community-based initiatives, and digital health technologies. By synthesizing insights from social psychology and social work, the paper underscores the importance of addressing multifaceted factors shaping health literacy and promoting equitable access to health information and services.

The information, control, and value models of mobile health-driven empowerment.

Mobile health tools are often said to empower users by providing them with the information they need to exercise control over their health. We aim to bring clarity to this claim, and in doing so explore the relationship between empowerment and autonomy. We have identified three distinct models embedded in the empowerment rhetoric: empowerment as information, empowerment as control, and empowerment as values. Each distinct model of empowerment gives rise to an associated problem. These problems, the Problem of Interpretation, the Value Alignment Problem, and the Priority Problem, show that mobile health tools in their current form are either insufficient for empowerment or are self-defeating. These digital health technologies encourage users to adopt an individualized conception of autonomy, one that may weaken the doctor-patient relationship and undermine practices in shared decision making, and ultimately may not deliver on improving the health outcomes for those that need it the most.

Behavior Change Approaches in Digital Technology-Based Physical Rehabilitation Interventions Following Stroke: Scoping Review.

Digital health technologies (DHTs) are increasingly used in physical stroke rehabilitation to support individuals in successfully engaging with the frequent, intensive, and lengthy activities required to optimize recovery. Despite this, little is known about behavior change within these interventions. This scoping review aimed to identify if and how behavior change approaches (ie, theories, models, frameworks, and techniques to influence behavior) are incorporated within physical stroke rehabilitation interventions that include a DHT. Databases (Embase, MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED) were searched using keywords relating to behavior change, DHT, physical rehabilitation, and stroke. The results were independently screened by 2 reviewers. Sources were included if they reported a completed primary research study in which a behavior change approach could be identified within a physical stroke rehabilitation intervention that included a DHT. Data, including the study design, DHT used, and behavior change approaches, were charted. Specific behavior change techniques were coded to the behavior change technique taxonomy version 1 (BCTTv1). From a total of 1973 identified sources, 103 (5%) studies were included for data charting. The most common reason for exclusion at full-text screening was the absence of an explicit approach to behavior change (165/245, 67%). Almost half (45/103, 44%) of the included studies were described as pilot or feasibility studies. Virtual reality was the most frequently identified DHT type (58/103, 56%), and almost two-thirds (65/103, 63%) of studies focused on upper limb rehabilitation. Only a limited number of studies (18/103, 17%) included a theory, model, or framework for behavior change. The most frequently used BCTTv1 clusters were feedback and monitoring (88/103, 85%), reward and threat (56/103, 54%), goals and planning (33/103, 32%), and shaping knowledge (33/103, 32%). Relationships between feedback and monitoring and reward and threat were identified using a relationship map, with prominent use of both of these clusters in interventions that included virtual reality. Despite an assumption that DHTs can promote engagement in rehabilitation, this scoping review demonstrates that very few studies of physical stroke rehabilitation that include a DHT overtly used any form of behavior change approach. From those studies that did consider behavior change, most did not report a robust underpinning theory. Future development and research need to explicitly articulate how including DHTs within an intervention may support the behavior change required for optimal engagement in physical rehabilitation following stroke, as well as establish their effectiveness. This understanding is likely to support the realization of the transformative potential of DHTs in stroke rehabilitation.

Digital Health Technology (DHT) in European Clinical Trials, How to Improve the Status-Quo of the Regulatory Landscape?

Digital health technology (DHT) is increasingly used to facilitate the conduct of clinical drug trials. The European regulatory environment would benefit from some adjustments to realize the full potential of DHTs. Considering current discussions such as the European Accelerating Clinical Trial Initiative (ACT EU), we propose four concrete adjustments to this regulatory landscape to introduce risk-based qualification approaches for DHTs. In our view, these changes would have the potential to facilitate the use of DHT in clinical research and thus provide access to innovative therapies in Europe.

Addressing Data Absenteeism and Technology Chauvinism in the Use of Gamified Wearable Gloves Among Older Adults: Moderated Usability Study.

Digital health technologies have the potential to improve health outcomes for older adults, especially for those recovering from stroke. However, there are challenges to developing these technologies, such as data absenteeism (where older adults' views are often underrepresented in research and development) and technology chauvinism (the belief that sophisticated technology alone is the panacea to addressing health problems), which hinder their effectiveness. In this study, we aimed to address these challenges by developing a wearable glove integrated with culturally relevant exergames to motivate older adults to exercise and, for those recovering from stroke, to adhere to rehabilitation. We conducted a moderated usability study with 19 older adults, of which 11 (58%) had a history of stroke. Our participants engaged in a 30-minute gameplay session with the wearable glove integrated with exergames, followed by a quantitative survey and an in-depth interview. We used descriptive analysis to compare responses to the System Usability Scale between those who had a history of stroke and those who did not. In addition, we analyzed the qualitative interviews using a bottom-up thematic analysis to identify key themes related to the motivations and barriers regarding the use of wearable gloves for rehabilitation and exercise. Our study generated several key insights. First, making the exergames exciting and challenging could improve exercise and rehabilitation motivation, but it could also have a boomerang effect, where participants may become demotivated if the games were very challenging. Second, the comfort and ease of use of the wearable gloves were important for older adults, regardless of their stroke history. Third, for older adults with a history of stroke, the functionality and purpose of the wearable glove were important in helping them with specific exercise movements. Our findings highlight the importance of providing contextual support for the effective use of digital technologies, particularly for older adults recovering from stroke. In addition to technology and usability factors, other contextual factors such as gamification and social support (from occupational therapists or caregivers) should be considered to provide a comprehensive approach to addressing health problems. To overcome data absenteeism and technology chauvinism, it is important to develop digital health technologies that are tailored to the needs of underserved communities. Our study provides valuable insights for the development of digital health technologies that can motivate older adults recovering from stroke to exercise and adhere to rehabilitation.

Challenges and opportunities for cancer nurses in implementing digital health technologies

Challenges and opportunities for cancer nurses in implementing digital health technologies

P121 Understanding barriers to digital inclusion from Urdu speakers’ perspective: remote monitoring of rheumatoid arthritis

Abstract Background/Aims Chronic musculoskeletal conditions are more prevalent in South Asian (SA) communities, particularly for women and older adults, who face existing barriers in accessing healthcare services. Remote patient monitoring (RPM) has the potential to enhance management of long-term conditions like rheumatoid arthritis, offering insights into disease activity and supporting shared decision-making. However, SA communities in the UK and elsewhere, are commonly underrepresented in the development and evaluation of digital health technologies where language and other barriers may limit adoption and use. This research aimed to explore perspectives of Urdu speaking members of South Asian communities on barriers for engaging with RPM using an app designed for people with rheumatoid arthritis (RA). The focus on Urdu speakers provides an example to ensure RPM benefits South Asian communities, and particularly where language may be a barrier. Methods The study included nine participants, primarily females with one male participant, aged 55-75, who were Urdu speakers and diagnosed with or suspected of having RA. They were recruited from community organisations in Greater Manchester and introduced to the RPM app for monitoring symptoms. Semi-structured interviews were conducted in Urdu to investigate barriers to digital inclusion. The interviews were transcribed and analysed in Urdu (by Urdu speaking members of the team) with selective translation into English. Thematic analysis was used to identify themes and subthemes related to digital exclusion and strategies for addressing these issues. Results Participants’ responses were themed into five key areas concerning digital inclusion and potential solutions: 1. Existing use of digital devices and resources ; most expressed limited use of digital technology in day to day living, 2. Concerns about privacy ; some expressing caution and lack of confidence in security, 3. Views about symptom tracking; many were positive about tracking symptoms to share with doctors, though some said they would not want the constant reminder of their condition, 4. Barriers to engagement with the app; women, older individuals, and those with limited tech exposure, emphasizing the need for translated versions and family support, 5.Social Support to engagement with technology; Suggestions included workshops to improve digital literacy, translated materials (including audio) and reminders, as well as family support. Conclusion The study revealed challenges faced by women, older individuals, and those with limited tech exposure when using the app, emphasizing the need for translated versions and family support. The study also highlighted a need to consider intersectional dimensions of inequality for tailoring solutions. Overall, the study emphasizes the significance of tailored support and accessibility measures for the diverse communities like SA Urdu community when implementing digital health solutions. Disclosure Y. Masood: None. S. Ali: None. H. Chadwick: None. K. Staniland: None. S. van der Veer: None. W. Dixon: Consultancies; WGD has received consultancy fees from Google unrelated to this work. C. Sanders: None.

The Growing Role of Digital Health Tools in the Care of Patients with Cancer: Current Use, Future Opportunities, and Barriers to Effective Implementation.

This article aims to describe the ways in which digital health technologies are currently being used to improve the delivery of cancer care, highlight opportunities to expand their use, and discuss barriers to effective and equitable implementation. The utilization of digital health tools and development of novel care delivery models that leverage such tools is expanding. Recent studies have shown feasibility and increased implementation in the setting of oncologic care. With technological advances and key policy changes, utilization of digital health tools has greatly increased over the past two decades and transformed how cancer care is delivered. As digital health tools are expanded and refined, there is potential for improved access to and quality and efficiency of cancer care. However, careful consideration should be given to key barriers of digital health tool adoption, such as infrastructural, patient-level, and health systems-level challenges, to ensure equitable access to care and improvement in health outcomes.

Perspectives on the implementation of health informatics curricula frameworks

Background The COVID-19 pandemic highlighted the necessity of equipping health professionals with knowledge and skills to effectively use digital technology for healthcare delivery. However, questions persist about the best approach to effectively educate future health professionals for this. A workshop at the 15th Nursing Informatics International Congress explored this issue. Objective To report findings from an international participatory workshop exploring pre-registration informatics implementation experiences. Methods A virtual workshop was held using whole and small group interactive methods aiming to 1) showcase international examples of incorporating health informatics into pre-registration education; 2) highlight essential elements and considerations for integrating health informatics into curricula; 3) identify integration models of health informatics; 4) identify core learning objectives, resources, and faculty capabilities for teaching informatics; and 5) propose curriculum evaluation strategies. The facilitators’ recorded data and written notes were content analysed. Results Fourteen participants represented seven countries and a range of educational experiences. Four themes emerged: 1) Design: scaffolding digital health and technology capabilities; 2) Development: interprofessional experience of and engagement with digital health technology capabilities; 3) implementation strategies; and 4) Evaluation: multifaceted, multi-stakeholder evaluation of curricula. These themes were used to propose an implementation framework. Discussion Workshop findings emphasise global challenges in integrating health informatics into curricula. While course development approaches may appear linear, the learner-centred implementation framework based on workshop findings, advocates for a more cyclical approach. Iterative evaluation involving stakeholders, such as health services, will ensure that health professional education is progressive and innovative. Conclusions The proposed implementation framework serves as a roadmap for successful health informatics implementation into health professional curricula. Prioritising engagement with health services and digital health industry is essential to ensure the relevance of implemented informatics curricula for the future workforce, acknowledging the variability in placement experiences and their influence on informatics exposure, experience, and learning.

Psychosocial Self-efficacy and its Association with Selected Potential Factors Among Adults with Type 1 Diabetes: A Cross-Sectional Survey Study.

The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person's psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes. A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (n = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables. Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy. In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.