Digital Technologies In Healthcare Research Articles

Informing the Product Development of an mHealth Solution for People with Multiple Sclerosis Through Early Health Technology Assessment.

The potential of mHealth is enormous for chronic conditions, yet the integration of these technologies into the clinical infrastructures and healthcare pathways remains an ongoing challenge. Digi-HTA has been developed to support health technology assessment activities for novel digital healthcare technologies. The use of Early Health Technology Assessment (EHTA) can help product development. The present study describes the way in which EHTA can guide the development of a product to anticipate future needs and market access.

The drivers of the digital transformation in the healthcare industry: An empirical analysis in Italian hospitals

In recent years, driven by the spread of the COVID-19 pandemic, digital transformation in the healthcare sector is becoming increasingly important. Digital healthcare technologies, if adopted in a targeted manner and implemented in a cost-effective way, make it possible to reduce healthcare inequalities, improve the quality of healthcare provided and increase the well-being of citizens. The importance of digital transformation in healthcare is also attracting interest from academics. However, at present, there are few studies aimed at examining the degree of digital transformation in healthcare and the drivers of the adoption and implementation of digital solutions by healthcare facilities. This study aims to fill this gap by analysing the level of digital transformation of Italian hospitals and the factors that can affect this level of digital transformation. The analysis, conducted on a sample of 103 hospitals, shows a positive and significant impact of the hospital size, hospital age and hospital teaching status on the level of digital transformation. Furthermore, in relation to hospital complexity, it shows a positive effect of the presence of the emergency room and a non-significant influence of the number of hospital departments on the level of digital transformation.

A Study on E-Health Infrastructure in Rural India

In last decade or so healthcare has been a focus area for government and non-government agencies both. There is huge expansion in healthcare sector, with various schemes being launched by central and state government, and also expansion in health infrastructure with almost equal stake by government/private. With rise in digital technologies, e-health (digital health), though mostly unregulated has started embracing electronic Health Record (EHR), tele-medicine, tele-health, and AI. In COVID pandemic times and prior to it, using digital technology in healthcare have improved over the most recently. According to the World Bank report in 2018, India had 0.857 practicing doctors per 1,000 populations, and in villages the ratio might be even lower. So lot of focus is required to build strong digital health infrastructure in India, so expansion and optimal usage of health facilities can be ensured. This paper reviews the current scenario of e-health process and infrastructure in India and also discusses the challenges alongside its expansion.

Medical Students' Perceptions towards Digitization and Artificial Intelligence: A Mixed-Methods Study.

Digital technologies in health care, including artificial intelligence (AI) and robotics, constantly increase. The aim of this study was to explore attitudes of 2020 medical students’ generation towards various aspects of eHealth technologies with the focus on AI using an exploratory sequential mixed-method analysis. Data from semi-structured interviews with 28 students from five medical faculties were used to construct an online survey send to about 80,000 medical students in Germany. Most students expressed positive attitudes towards digital applications in medicine. Students with a problem-based curriculum (PBC) in contrast to those with a science-based curriculum (SBC) and male undergraduate students think that AI solutions result in better diagnosis than those from physicians (p < 0.001). Male undergraduate students had the most positive view of AI (p < 0.002). Around 38% of the students felt ill-prepared and could not answer AI-related questions because digitization in medicine and AI are not a formal part of the medical curriculum. AI rating regarding the usefulness in diagnostics differed significantly between groups. Higher emphasis in medical curriculum of digital solutions in patient care is postulated.

Цифровые технологии в механизме реализации конституционного права граждан на охрану здоровья: достижения и риски

This article applies the use of digital technologies in healthcare through the prism of the constitutional right of citizens to health care. The author analyzes the concepts of digital technologies and digital medicine, and concludes that it is possible to secure data at the level of responsibility. The article discusses the foundations of the constitution, as well as the use of industrial digital technologies in medical practice.

The COVID-19 coronavirus pandemic as an impetus to digital technology development in Latin America

Subject. This article discusses the development of digital technologies during the COVID-19 pandemic. Objectives. The article aims to assess the impact of the pandemic on the development of digital technologies in Latin America. Methods. For the study, we used logical, comparative, and statistical analyses. Results. Most Latin American countries have a low level of infrastructure development and digital literacy of the population. In Chile, the State stimulates digital development, and this country is the leader among the countries of Latin America in terms of the level of development and introduction of digital technologies. Conclusions. The Latin American region has significant potential for digital growth, but at the moment, the level of development of this region is below the world average. The COVID-19 pandemic has accelerated the adoption of digital technologies in healthcare, education and public administration, and it has intensified the use of artificial intelligence, robots, and Big Data in Latin American countries.

The Clinical Effects of Type 2 Diabetes Patient Management Using Digital Healthcare Technology: A Systematic Review and Meta-Analysis.

The disease control rate is very low (at less than 30%) for diabetes. The use of digital healthcare technology is increasing recently for continuous management in daily life. In this study, a meta-analysis was conducted to evaluate the clinical effects of digital healthcare technology for patients with type 2 diabetes management. For a review of the literature, databases such as PubMed, Embase, and Cochrane Library were searched using Medical Subject Heading (MeSH) terms published up to 9 August 2021. As a result, 2354 articles were identified, and 12 randomized controlled trial articles were finally included. Digital healthcare technology combined management for type 2 diabetes significantly decreased HbA1c (p < 0.00001, standardized mean difference (SMD) = −0.49) and marginally decreased triglyceride, compared with usual care (p = 0.06, SMD = −0.18). However, it did not significantly affect BMI (p = 0.20, SMD = −0.47), total cholesterol (p = 0.13, SMD = −0.19), HLD-C (p = 0.89, SMD = −0.01), LDL-C (p = 0.95, SMD = −0.01), systolic BP (p = 0.83, SMD = 0.03), or diastolic BP (p = 0.23, SMD = 0.65), compared with usual care. These results indicate that digital healthcare technology can improve HbA1c and triglyceride levels of type 2 diabetes patients. Further well-designed randomized controlled clinical trials are needed to confirm the clinical effect of digital healthcare technology.

Цифровизация медицины и этические проблемы в условиях пандемии COVID‑19

The article addresses problems associated with healthcare digitalization. It analyzes the primary drivers of digitalization in medicine and the direction it is taking, specifically in the context of public health emergencies, such as COVID‑19. The article focuses on ethical challenges associated with the implementation of digital technologies in healthcare and emphasizes the important role of bioethics.

Application of Theory of Reasoned Action (TRA) to Explain Continued Intention to Adopt (CIA) MHealth Services

MHealth is a digital healthcare technology with big data adoption. Identification of the factors that encourage consumers CIA mHealth application needs to be considered. The study aimed to describe influence of service quality perception (SQP), perceived vulnerability (PV), TRA toward CIA mHealth. Sampling was done online using an e-questionnaire and analyzed with PLS (partial Least Square) using SEM. A total of 429 respondents were involved, and 170 of them were met the inclusion criteria. The existent result implies that SQP and attitude significantly affect CIA. Meanwhile, PV and subjective norm (SN) not significantly influence the CIA. Effects of attitudes were able to partially mediate SQP and CIA. On the other hand, attitude cannot mediate perceived vulnerability and CIA. Empirical substation was expected to provide future analysis about CIA. Furthermore, improvements of service quality would induce the frequent use of mHealth application.

How to understand modern digital technologies so as not to fall into the traps of cybercriminals and misinformation online

The digital world with all its gadgets, sites and useful services has become too comprehensive and comprehensive to fundamentally ignore it. The digital world offers significant opportunities for both individual users and institutions. Reforming the health care sector in Ukraine involves a significant emphasis on not using an increasing number of digital tools in the daily work of both medical institutions and doctors. Every day patients try to communicate with doctors through messengers, sending the latter their questions, test results, and other medical data. And although such online consultations are mostly not institutionalized, patients are primarily guided by the logic of convenience, accessibility and time saving, pressing the «send» button in the messenger to send a message to the doctor. At the same time, the use of digital technologies in health care is gaining more and more expressive forms due to the introduction of telemedicine, electronic prescriptions, or the availability of publicly available dashboards from the National Health Service. The dashboards contain arrays of data on the provision of medical services at the level of hospitals and the corresponding payments under contracts with the National Health Service. Access to all these benefits of the digital space requires at least a basic understanding of digital technologies to use them effectively. The article explains principals of digital literacy with emphasize on health care providers and explains how to understand modern digital technologies and not to fall into the traps of cybercriminals and misinformation online.

ЦИФРОВЫЕ ТЕХНОЛОГИИ В БОРЬБЕ С COVID-19

Significance. During the spread of the new coronavirus infection (COVID-19), digital technologies have proved to be promising organizational solutions, opening up new opportunities for managing the epidemiological process and enhancing adaptability of healthcare systems to the increased workload. Studying the experience of using computer technologies in a difficult epidemiological situation is necessary to identify main directions, results and problems related to the implementation of digital transformation in health during a pandemic. The purpose of the study is to summarize the experience of using modern digital technologies to optimize performance of healthcare systems in the context of the COVID-19 pandemic. Material and Methods. The following databases were searched for publications: PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, eLibrary. Various combinations of the words "COVID-19", "digital health", "telemedicine", "artificial intelligence", "machine learning", "internet of things (IoT)", "chatbot" were used as keywords. A total of 362 publications were analyzed, from which 36 studies corresponding to the chosen topic were selected. Results. Analysis of the experience of using modern digital technologies to optimize performance of healthcare systems in the context of the COVID-19 pandemic has shown that digital solutions can reduce burden on healthcare institutions and contribute to organizing an accessible and high-quality medical care by automated processes of diagnosis and triage. Care delivery through remote technologies has both reduced the risk of infection for patients and doctors by eliminating personal contacts and opened up new avenues of work of medical personnel. However, many issues related to the use of digital technologies in health remain unresolved, for example, patient data confidentiality, access to digital technologies among population, legal regulation, economic feasibility, etc. Conclusion. In a number of countries digital technologies have much supported the healthcare system during the COVID-19 pandemic. Further improvement of digital health tools, scale-up and analysis of medical, social and cost-effectiveness of their use can play an important role in optimizing the processes of diagnosis, treatment and prevention of not only the COVID-19, but also other diseases. To ensure a widespread and viability of digital technologies in healthcare, it is necessary to address the legal and financial issues associated with their use.

СТРАТЕГИЧЕСКИЕ ПРИОРИТЕТЫ РЕАЛИЗАЦИИ ПРОГРАММЫ МОДЕРНИЗАЦИИ ПЕРВИЧНОГО ЗВЕНА ЗДРАВООХРАНЕНИЯ НА РЕГИОНАЛЬНОМ УРОВНЕ

The market for healthcare services provided with the widespread use of digital technologies, according to Kvint, is a global emerging market. In order to account for the development trends of this market, strategizing technologies are needed. In this work we base on foreign experience to reveal the main trends in the process of strategic management of the modernization of primary health care at the global level and in a number of countries of the world. An attempt is made to apply these approaches to Russian practice, taking into account the existing strategic documents. Based on the study of world experience, it is shown that the process of research-based strategizing, using a comprehensive set of strategic tools based on digital technologies of knowledge-intensive management, is a key strategic priority for the development of the primary healthcare at the regional level. It is assumed that the best option would be to return, at least in part, to the well-thought-out Digital Health sub-programme, which was not included in the 2017 Digital Economy program. To get an overall picture of the use of digital technologies in healthcare, it is necessary to monitor the scientific, technological, human resource, organizational and logistical (equipment) components of this picture. In recent years, numerous regulations have been adopted that are directly or indirectly related to the digitalization of healthcare and medical activities. At the same time, their key provisions are related to the lack a systemic integration of digitalization into the healthcare development process as a whole. Similar processes should be carried out as part of the creation and development of regional segments of the digital platform.

Scent-delivery devices as a digital healthcare tool for olfactory training: A pilot focus group study in Parkinson's disease patients

Parkinson's disease (PD) patients display a combination of motor and non-motor symptoms. The most common non-motor symptom is scent (olfactory) impairment, occurring at least four years prior to motor symptom onset. Recent and growing interest in digital healthcare technology used in PD has resulted in more technologies developed for motor rather than non-motor symptoms. Human–computer interaction (HCI), which uses computer technology to explore human activity and work, could be combined with digital healthcare technologies to better understand and support olfaction via scent training – leading to the development of a scent-delivery device (SDD). In this pilot study, three PD patients were invited to an online focus group to explore the association between PD and olfaction, understand HCI and sensory technologies and were demonstrated a new multichannel SDD with an associated mobile app. Participants had a preconceived link, a result of personal experience, between olfactory impairment and PD. Participants felt that healthcare professionals did not take olfactory dysfunction concerns seriously prior to PD diagnosis. Two were not comfortable with sharing scent loss experiences with others. Participants expected the multichannel SDD to be small, portable and easy-to-use, with customisable cartridges to deliver chosen scents and the mobile app to create a sense of community. None of the participants regularly performed scent training but would consider doing so if some scent function could be regained. Standardised digital SDDs for regular healthcare check-ups may facilitate improvement in olfactory senses in PD patients and potential earlier PD diagnosis, allowing earlier therapeutic and symptomatic PD management.

Digital health for allergen immunotherapy.

In the recent past, digital healthcare technologies are experiencing a significant leap in development, with an additional unforeseen acceleration in implementation due to the SARS-CoV-2 pandemic. The increased use of mobile applications as well as communication technologies to search for services and support hold particular advantages for the management of chronic diseases requiring medium- to long-term treatments and regular follow-up visits. Allergen immunotherapy (AIT), requiring regular application of treatment, represents an optimal scenario for feasible digital support. From patient stratification and care pathways, over personalized decision support for complex clinical scenarios, towards a close and flexible patient-doctor communication in blended care settings: the current article summarizes the latest knowledge on the use and potential of digital health technologies in the area of AIT .

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.

A Road Map for Remote Digital Health Technology for Motor Neuron Disease.

Despite recent and potent technological advances, the real-world implementation of remote digital health technology in the care and monitoring of patients with motor neuron disease has not yet been realized. Digital health technology may increase the accessibility to and personalization of care, whereas remote biosensors could optimize the collection of vital clinical parameters, irrespective of patients’ ability to visit the clinic. To facilitate the wide-scale adoption of digital health care technology and to align current initiatives, we outline a road map that will identify clinically relevant digital parameters; mediate the development of benefit-to-burden criteria for innovative technology; and direct the validation, harmonization, and adoption of digital health care technology in real-world settings. We define two key end products of the road map: (1) a set of reliable digital parameters to capture data collected under free-living conditions that reflect patient-centric measures and facilitate clinical decision making and (2) an integrated, open-source system that provides personalized feedback to patients, health care providers, clinical researchers, and caregivers and is linked to a flexible and adaptable platform that integrates patient data in real time. Given the ever-changing care needs of patients and the relentless progression rate of motor neuron disease, the adoption of digital health care technology will significantly benefit the delivery of care and accelerate the development of effective treatments.

Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-Based Primary Care: Mixed Methods Study.

BackgroundOwing to the shortage of medical professionals, as well as demographic and structural challenges, new care models have emerged to find innovative solutions to counter medical undersupply. Team-based primary care using medical delegation appears to be a promising approach to address these challenges; however, it demands efficient communication structures and mechanisms to reinsure patients and caregivers receive a delegated, treatment-related task. Digital health care technologies hold the potential to render these novel processes effective and demand driven.ObjectiveThe goal of this study is to recreate the daily work routines of general practitioners (GPs) and medical assistants (MAs) to explore promising approaches for the digital moderation of delegation processes and to deepen the understanding of subjective and perceptual factors that influence their technology assessment and use.MethodsWe conducted a combination of 19 individual and group interviews with 12 GPs and 14 MAs, seeking to identify relevant technologies for delegation purposes as well as stakeholders’ perceptions of their effectiveness. Furthermore, a web-based survey was conducted asking the interviewees to order identified technologies based on their assessed applicability in multi-actor patient care. Interview data were analyzed using a three-fold inductive coding procedure. Multidimensional scaling was applied to analyze and visualize the survey data, leading to a triangulation of the results.ResultsOur results suggest that digital mediation of delegation underlies complex, reciprocal processes and biases that need to be identified and analyzed to improve the development and distribution of innovative technologies and to improve our understanding of technology use in team-based primary care. Nevertheless, medical delegation enhanced by digital technologies, such as video consultations, portable electrocardiograms, or telemedical stethoscopes, can counteract current challenges in primary care because of its unique ability to ensure both personal, patient-centered care for patients and create efficient and needs-based treatment processes.ConclusionsTechnology-mediated delegation appears to be a promising approach to implement innovative, case-sensitive, and cost-effective ways to treat patients within the paradigm of primary care. The relevance of such innovative approaches increases with the tremendous need for differentiated and effective care, such as during the ongoing COVID-19 pandemic. For the successful and sustainable adoption of innovative technologies, MAs represent essential team members. In their role as mediators between GPs and patients, MAs are potentially able to counteract patients’ resistance toward using innovative technology and compensate for patients’ limited access to technology and care facilities.

Patient connectivity with healthcare professionals and health insurer using digital health technologies during the COVID-19 pandemic: a German cross-sectional study

BackgroundDigital health technologies enable patients to make a personal contribution to the improvement of their health by enabling them to manage their health. In order to exploit the potential of digital health technologies, Internet-based networking between patients and health care providers is required. However, this networking and access to digital health technologies are less prevalent in sociodemographically deprived cohorts. The paper explores how the use of digital health technologies, which connect patients with health care providers and health insurers has changed during the COVID-19 pandemic.MethodsThe data from a German-based cross-sectional online study conducted between April 29 and May 8, 2020, were used for this purpose. A total of 1.570 participants were included in the study. Accordingly, the influence of sociodemographic determinants, subjective perceptions, and personal competencies will affect the use of online booking of medical appointments and medications, video consultations with providers, and the data transmission to health insurers via an app.ResultsThe highest level of education (OR 1.806) and the presence of a chronic illness (OR 1.706) particularly increased the likelihood of using online booking. With regard to data transmission via an app to a health insurance company, the strongest increase in the probability of use was shown by belonging to the highest subjective social status (OR 1.757) and generation Y (OR 2.303). Furthermore, the results show that the higher the subjectively perceived restriction of the subjects' life situation was due to the COVID-19 pandemic, the higher the relative probability of using online booking (OR 1.103) as well as data transmission via an app to a health insurance company (OR 1.113). In addition, higher digital literacy contributes to the use of online booking (OR 1.033) and data transmission via an app to the health insurer (OR 1.034).ConclusionsSocially determined differences can be identified for the likelihood of using digital technologies in health care, which persist even under restrictive conditions during the COVID-19 pandemic. Thus, the results indicate a digital divide with regard to the technologies investigated in this study.

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.

Digitalization in distress: Digital technologies in healthcare and challenges of ecosystem adoption

Our study provides an in-depth analysis of digital technologies in healthcare and the ecosystem challenges newly developing platforms face here. Based on three case studies of digital technology applications that transform the healthcare industry in different ways, we provide recommendations to help overcome these challenges. First, scaling in healthcare ecosystems tends to be more gradual, but this can be accelerated if it is coordinated by higher level umbrella associations. Second, digital healthcare technologies can only have a transformational impact if processes within healthcare organizations are realigned. This transformation process is driven by a value proposition that requires organizations to develop new competencies. Third, in complex regulated fields such as healthcare, rather than the commonly observed supply-side unipolar governance, multipolar governance is required to manage the ecosystem, leading to co-specialization between supply side technology providers and demand side actors and activities. Fourth, in healthcare ecosystems we observe across multiple levels potential challenges to, as well as potential solutions for, the development of the value proposition. These different levels need to be aligned for the newly developing value proposition to successfully emerge.