Digital Transformation Of Health Research Articles

COViD-19 is a Game Changer for Digital Health Transformation in Belgium

In December 2019, health authorities in Wuhan, China, reported a cluster of patients with pneumonia of unknown cause. A new type of coronavirus has been identified as the cause. Since then, the epidemic has spread to many countries on all continents. The corona pandemic has put just about every vital social component in trouble, especially testing the limits of our health care systems. But there was also a major impact in many economic sectors that were obliged to cease their activities from the first lockdown. After more than 15 months of crisis with a long-term curtailment of personal freedoms, the psychosocial consequences are now also incalculable. The length of the lockdowns, the disappearance of social contact and the constant delay of perspective take their toll the longer, the more.

The Promise of Remote Patient Monitoring: Lessons Learned During the COVID-19 Surge in New York City.

The coronavirus pandemic catalyzed a digital health transformation, placing renewed focus on using remote monitoring technologies to care for patients outside of hospitals. At NewYork-Presbyterian, the authors expanded remote monitoring infrastructure and developed a COVID-19 Hypoxia Monitoring program—a critical means through which discharged COVID-19 patients were followed and assessed, enabling the organization to maximize inpatient capacity at a time of acute bed shortage. The pandemic tested existing remote monitoring efforts, revealing numerous operating challenges including device management, centralized escalation protocols, and health equity concerns. The continuation of these programs required addressing these concerns while expanding monitoring efforts in ambulatory and transitions of care settings. Building on these experiences, this article offers insights and strategies for implementing remote monitoring programs at scale and improving the sustainability of these efforts. As virtual care becomes a patient expectation, the authors hope hospitals recognize the promise that remote monitoring holds in reenvisioning health care delivery.

Digital transformation of community health and social services for ageing cohorts

Municipalities in the European Union are ageing fast. However, achieving societal and environmental change with a focus on the development of an age-friendly environment, ambient assisted living, eHealth, public spaces that facilitate active ageing and wellbeing for all generations and social support networks for older adults with declining functional capacities represent a major challenge for European municipalities. Additionally, developing and financing smart social infrastructure to support a growing number of older adults with declining functional capacities so that they can postpone moving to a nursing home and live longer in the community is a major challenge for European municipalities. Social innovations for the digital transformation of health care and social care delivery systems can help older adults live autonomously and independently in their own communities and postpone or even avoid entering a nursing home. The innovations will lead to a more efficient combination of the existing societal resources in the communities for fulfilling the health care and social needs of the ageing members of the society who are dependent on the help of others due to illness or functional decline. On the supply side, new scientific (optimisation of the supply networks), organisational (self-managed communities) and technological innovations, such as robotics, domotics, CPS based on the Internet of Things and cloud computing, offer new utilities and create new businesses for the supply of goods and services to older people and also provide new job opportunities for young people. The aim of this paper is to consider the development and financing of community and smart social infrastructure and present the case for Slovenia.

An Innovative Approach to Designing Digital Health Solutions Addressing the Unmet Needs of Obese Patients in Europe.

According to the World Health Organization (WHO), the worldwide obesity rate has tripled since 1975. In Europe, more than half of the population is overweight and obese. Around 2.8 million people die each year worldwide as a result of conditions linked to being overweight or obese. This study aimed to analyze the policies, approaches, and solutions that address the social and health unmet needs of obese patients, at different levels, in order to simulate the definition of an integrated approach, and to provide and share examples of innovative solutions supporting health promotion, disease prevention, and integration of services to improve the collaboration between the different health and care stakeholders involved across the country and in the lives of obese patients. A collaborative approach involving various levels of government and regional experts from different European countries was applied to identify, explore, and evaluate different aspects of the topic, from the innovation perspective and focusing on a European and a regional vision. Currently, people prefer more foods rich in fats, sugars, and salt/sodium than fruits, vegetables, and fiber. This behavior leads to a significant negative impact on their health-related quality of life. Changes in healthcare systems, healthy policy, and approaches to patient care and better implementation of the different prevention strategies between all the stakeholders are needed, taking advantage of the digital transformation of health and care. Such changes can support obese patients in their fight against an unhealthy lifestyle and at the same time reduce healthcare costs.

Digital health and precision prevention: shifting from disease-centred care to consumer-centred health.

Digital disruption and transformation of health care is occurring rapidly. Concurrently, a global syndemic of preventable chronic disease is crippling healthcare systems and accelerating the effect of the COVID-19 pandemic. Healthcare investment is paradoxical; it prioritises disease treatment over prevention. This is an inefficient break-fix model versus a person-centred predict-prevent model. It is easy to reward and invest in acute health systems because activity is easily measured and therefore funded. Social, environmental and behavioural health determinants explain ~70% of health variance; yet, we cannot measure these community data contemporaneously or at population scale. The dawn of digital health and the digital citizen can initiate a precision prevention era, where consumer-centred, real-time data enables a new ability to count and fund population health, making disease prevention 'matter'. Then, precision decision making, intervention and policy to target preventable chronic disease (e.g. obesity) can be realised. We argue for, identify barriers to, and propose three horizons for digital health transformation of population health towards precision prevention of chronic disease, demonstrating childhood obesity as a use case. Clinicians, researchers and policymakers can commence strategic planning and investment for precision prevention of chronic disease to advance a mature, value-based model that will ensure healthcare sustainability in Australia and globally.

Digital health projects financing: challenges and opportunities

The article summarizes current trends in financial support for digital health in Ukraine, considering the requirements and recommendations of international institutions. The research goal is to identify problems and challenges in public funding in Ukraine and find effective ways to solve them based on world experience. The systematization of scientific sources and approaches to solving the problem of financing digital health projects has shown that most studies present the results on finding effective mechanisms for financing health care or technical aspects of digital health and its components. However, under the WHO report, the lack or insufficient level of sustainable funding is an insuperable obstacle for implementing digital health projects in most countries. Thus, the above confirmed the relevance of the investigated scientific problem. Methodical tools of this research were systematization, structural and comparative analyses, logical generalization. The practical implementation of the study was carried out using the tools of Excel 2016. In the study, the start point for gathering data was 2016, which is the beginning of the digital health transformation in Ukraine. For gaining the research goal, this study was conducted in the following logical sequence: analyzing the effectiveness and stability of budget funding for the electronic health record projects in Ukraine within the eHealth initiative; defining the current state of Telemedicine and Mobile Medicine financings; identifying the potential directions for solving the problem of lack of funding based on world experience; determining the innovative digital medicine projects implemented by startups; setting the relationship between the amount of venture financing, the maturity and number of employees of companies. Following the findings, the authors developed the recommendations to use AI, Big Data, blockchain technologies, the Internet of Things to establish cooperation between the private, public sectors, academia, and non-governmental organizations.

A multi-perspective approach to developing the Saudi Health Informatics Competency Framework

BackgroundDetermining the key sets of competencies necessary for a Health Informatics (HI) professional to practice effectively either solo or as a member of a multidisciplinary team has been challenging for the regulator and registration body responsible for the healthcare workforce in Saudi Arabia, which is the Saudi Commission for Health Specialties (SCFHS). ObjectiveThe aim of this study was to develop a HI competency framework to guide SCFHS to introduce a HI certification program that meets local healthcare needs and is aligned with the national digital health transformation strategy. MethodologyA two-phase mixed methods approach was used in this study. For phase 1, a scoping review was conducted to identify HI competencies that have been published in the relevant literature. Out of a total 116 articles found relevant, 20 were included for further analysis. For phase 2, Saudi HI stakeholders (N = 24) that included HI professionals, administrators, academics, and healthcare professionals were identified and participated in an online survey, and asked to rank the importance of HI competencies distinguished in phase 1. To further validate and contextualize the competency framework, multiple focus groups and expert panel meetings were undertaken with the key stakeholders. ResultsFor phase 1, about 1315 competencies were initially extracted from the included studies. After iterative reviews and refinements of codes and themes, 6 preliminary domains, 23 sub-domains and 152 competencies were identified. In phase 2, a total of 24 experts participated in the online surveys and ranked 58 out of 152 competencies as ‘very important/required’, each received 75 % or more of votes. The remaining competencies (N = 94) were included in a list for a further discussion in the focus groups. A Total of fourteen HI experts accepted and joined in the focus groups. The multiphase approach resulted in a competency framework that included 92 competencies, that were grouped into 6 domains and 22 subdomains. The six key domains are: Core Principles; Information and Communication Technology (ICT); Health Sciences; Health Data Analytics; Education and Research; Leadership and Management. ConclusionThe study developed the Saudi Health Informatics Competency Framework (SHICF) that is based on an iterative, evidence-based approach, with validation from key stakeholders. Future work should continue the validation, review, and development of the framework with continued collaboration from relevant stakeholders representing both the healthcare and educational communities. We anticipate that this work will be expanded and adopted by relative professional and scientific bodies in the Gulf Cooperation Council (GCC) region.

Health Data Privacy: Research Fronts, Hot Topics and Future Directions.

Health data privacy is an important research stream due to the high impacts on the success of digital health transformation and implementation. Neglecting to safeguard data confidentially and integrity and mitigate risks associated with unauthorized access will lead to failures in materializing benefit from digital health. This study aims to present a bibliometric analysis of health data privacy and provide a platform for future directions. We conducted a literature search between 2010 and 2020 in the Web of Science (WoS) database, resulted in 1,752 records. As part of the bibliometric analysis, concept mapping of health data privacy researches was depicted by network visualization and overlay visualization. These two visualizations represent five research fronts and emerging topics (e.g., digital health, blockchain, the internet of things (IoT)). Finally, we chart directions for future research on health data privacy, highlighting emerging topics, and boundary-breaking alternatives (e.g., GDPR, contact tracing apps in the context of pandemics).

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.

Building on innovation and lessons learnt during the COVID‐19 pandemic

Building on innovation and lessons learnt during the COVID‐19 pandemic

Assessing the digital health transformation with the SCIROCCO Exchange tool in Puglia Region

Abstract Have we progressed integrated care in Europe? The EU Health Programme funded project, SCIROCCO Exchange addresses this question by providing online self-assessment tool for integrated care. Among the project partners, Puglia Region and the Strategic Regional Agency for Health and Social Care (AReSS), assessed the integrated care maturity level of the six Puglia' Local Health Authorities. The SCIROCCO Exchange project provides a 12-dimensions online tool for European regions to assess their maturity in the provision of integrated care, including identification of strengths, weaknesses and areas for improvement. The methodology provides the following steps: 1) selection of key stakeholders participating in the assessment; 2) conducting the individual assessments; 3) building the consensus among the involved stakeholders. The outcomes of the assessment were captured in the form of spider diagrams, highlighting Puglia' strengths and weaknesses in integrated care. The research has provided a multi-dimensional representation of the integrated care maturity level of the Puglia' Local Health Authorities. With reference to the SCIROCCO Exchange tool dimensions, major strengths include: Digital Infrastructure; Population Approach; Process Co-ordination; and Citizen Empowerment. Among the areas for improvement: Finance & Funding; Removal of Inhibitors; and Evaluation Methods were identified. The experience of using the SCIROCCO Exchange Tool have demonstrated benefits and added value of the Tool in guiding involved stakeholders towards the implementation of integrated care in Puglia and in stimulating multi-stakeholders discussions and participants' engagement. The assessment results will be used to orient an Action Plan to facilitate much more effective and tailored knowledge transfer process and provide better digital care services in Puglia.

Artificial intelligence or manufactured stupidity? The need for injury informaticians in the big data era

The volume, velocity and variety of data collected about individuals have increased exponentially over the last decade, presenting new injury surveillance opportunities to identify risk factors, monitor trends, and evaluate...

Advancing nursing participation in user-centred design.

What is the role of nursing in the digital health transformation of the 21st century? The answer to this critical question may rely on how prepared nursing is to enter into design processes associated with this evolution. The purpose of this paper is to introduce foundational terminology and tools to support increased nursing participation in user-centred design. Situated within a six-step design process, this includes a new analytic framework combining the disciplinary expertise of computer science with the nursing methodology Interpretive Description. The analytic framework and recommended research process were developed over the course of two projects each employing a similar collaborative mixed-methods design. Primary methodological drivers were drawn from the software development life-cycle and Interpretive Description in these digital health intervention studies. Using aspects of software development practice, an analytic framework was conceived as part of an interdisciplinary research process allowing nurses to integrate their disciplinary expertise in user-centred digital design. The framework allows nurses to parse collected data into a robust set of functional and non-functional requirements for software developers while still engaging in a fulsome interpretive analysis. There is a need for nursing to occupy a more significant role in the advancement of technology innovation in healthcare. However, a lack of familiarity with design-thinking and associated practical experience impedes nursing voices in this area. Tools and processes are introduced to enhance an existing nursing methodology as a means to extend our disciplinary design capacity.

Aligning the Good Practice MASK With the Objectives of the European Innovation Partnership on Active and Healthy Ageing.

The reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Santé good practice Mobile Airways Sentinel networK was reviewed to meet the objectives of the EIP on AHA. It included 1) Management of care process, 2) Blueprint of digital transformation, 3) EIP on AHA, innovation to market, 4) Community for monitoring and assessment framework, 5) Political, organizational, technological and financial readiness, 6) Contributing to European co-operation and transferability, 7) Delivering evidence of impact against the triple win approach, 8) Contribution to the European Digital Transformation of Health and Care and 9) scale of demonstration and deployment of innovation

Workshop: EUPHA and Europe-wide action on digital public health

Abstract The World Health Assembly Resolution on Digital Health unanimously approved by WHO Member States in May 2018 demonstrated a collective recognition of the value of digital technologies to contribute to advancing universal health coverage (UHC) and other health aims of the Sustainable Development Goals (SDGs). The World Health Organization has just released first ever guideline on digital interventions for health system strengthening. Et the European level, in June 2018 the WHO Regional Office for Europe launched the WHO/Europe initiative for Digitalization of Health Systems and in February 2019 organized the first Symposium on the Future of Digital Health Systems in the European Region. The European Commission in April 2018 published a Communication on Digital transformation of health and care in the digital single market and requested the Expert Panel on effective ways of investing in health (EXPH) to release an evidence-based opinion on how to assess the impact of digital transformation of health services. In such context, the European Public Health Association (EUPHA) has at an early stage acknowledged and understood the crucial importance of applying the potential offered by digitalization to public health. Not only its most prominent members work and research as WHO and EC experts on how to plan, implement and evaluate effective digital public health interventions, but EUPHA itself - as umbrella organization representing public health associations and institutes across Europe had: i) actively participated to the WHO Euro Symposium successfully co-organizing a session on the ‘beautiful marriage’ between digitalization and public health, ii) supported the publication of a EJPH supplement on digital health and iii) has planned to create a EUPHA Section on Digital Health. With the overall goal of positioning the proposed EUPHA Section on Digital Health in the enriching and constructive context of the European Public Health Conference the workshop specifically aims to: present a comprehensive conceptual framework for the application of digital technologies to public health in Europe;present and report on EUPHA collaborative action on digital health, aligned with European institutions;present the structure and content of the EJPH supplement on digital health;present the general aim, specific objectives, scope, mission and preliminary outputs of the proposed EUPHA Section on Digital Health, as well as its synergy with other EUPHA’s Section workPresent the results of two/three specific projects on digital public health to serve as concrete examples of the application of digital solutions to public healthEngage with the audience to promote the active participation of the broader EUPHA community to the activities of the Section, collect interests and best practices, and share ideas and projects worth scaling up at the Section-level. Key messages The ‘beautiful marriage’ between digitalization and public health has to be concretely planned, implemented and evaluated. EUPHA action on digital public health can be further strengthened through the collaborative action and work of its dedicated Section.

EU level actions and instruments to support the implementation of integrated care

Abstract Issue/Problem The significance of integrated care as a means for improving health outcomes and the effectiveness and sustainability of health and care systems is acknowledged in several policies at national and EU level, for example: the European Commission’s Communication on effective, accessible and resilient health systems, the 2017 European Semester: Communication on Country Reports, the Joint Report on Health Care and Long-Term Care Systems and Fiscal Sustainability by the European Commission and the Economic Policy Committee, the Companion Report 2017 of the State of Health in the EU and the most recent Commission Communication on the digital transformation of health and care in the Digital Single Market. As such, there may be no doubt about whether one needs to transform the health and care model and move to integrate care, but the question is how to design and implement integrated care successfully. One pre-condition for this to happen, is for health authorities to have adequate capacity and relevant know-how. Results The European Commission aims at assisting Member State authorities at national, regional and local levels to fulfil this pre-condition and proceed with their health system reforms. There is a number of instruments, initiatives and funding support to raise the capacity of national and regional healthcare authorities to adopt and scale up integrated care. Lessons There is an increasing demand and need to provide support and assistance to Member states to drive the transformation of healthcare systems towards more coordinated, integrated and sustainable healthcare systems.

Digital health for COPD care: the current state of play.

Chronic obstructive pulmonary disease (COPD) imposes a huge burden to our healthcare systems and societies. To alleviate the burden, digital health-"the use of digital technologies for health"-has been recognized as a potential solution for improving COPD care at scale. The aim of this review is to provide an overview of digital health interventions in COPD care. We accordingly reviewed recent and emerging evidence on digital transformation approaches for COPD care focusing on (I) self-management, (II) in-hospital care, (III) post-discharge care, (IV) hospital-at-home, (V) ambient environment, and (VI) public health surveillance. The emerging approaches included digital-technology-enabled homecare programs, electronic records, big data analytics, and environment-monitoring applications. The digital health approaches of telemonitoring, telehealth and mHealth support the self-management, post-discharge care, and hospital-at-home strategy, with prospective effects on reducing acute COPD exacerbations and hospitalizations. Electronic records and classification tools have been implemented; and their effectiveness needs to be further evaluated in future studies. Air pollution concentrations in the ambient environment are associated with declined lung functions and increased risks for hospitalization and mortality. In all the digital transformation approaches, clinical evidence on reducing mortality, the ultimate goal of digital health intervention, is often inconsistent or insufficient. Digital health transformation provides great opportunities for clinical innovations and discovery of new intervention strategies. Further research remains needed for achieving reliable improvements in clinical outcomes and cost-benefits in future studies.

Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs.

BackgroundDigital health tools comprise a wide range of technologies to support health processes. The potential of these technologies to effectively support health care transformation is widely accepted. However, wide scale implementation is uneven among countries and regions. Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations.ObjectiveThe aim of this study was to analyze the implementation of digital health tools to support health care and social care services, as well as to facilitate the longitudinal assessment of these services, in 17 selected integrated chronic care (ICC) programs from 8 European countries.MethodsA program analysis based on thick descriptions—including document examinations and semistructured interviews with relevant stakeholders—of ICC programs in Austria, Croatia, Germany, Hungary, the Netherlands, Norway, Spain, and the United Kingdom was performed. A total of 233 stakeholders (ie, professionals, providers, patients, carers, and policymakers) were interviewed from November 2014 to September 2016. The overarching analysis focused on the use of digital health tools and program assessment strategies.ResultsSupporting digital health tools are implemented in all countries, but different levels of maturity were observed among the programs. Only few ICC programs have well-established strategies for a comprehensive longitudinal assessment. There is a strong relationship between maturity of digital health and proper evaluation strategies of integrated care.ConclusionsNotwithstanding the heterogeneity of the results across countries, most programs aim to evolve toward a digital transformation of integrated care, including implementation of comprehensive assessment strategies. It is widely accepted that the evolution of digital health tools alongside clear policies toward their adoption will facilitate regional uptake and scale-up of services with embedded digital health tools.

Mobile Technology in Allergic Rhinitis: Evolution in Management or Revolution in Health and Care?

Smart devices and Internet-based applications (apps) are largely used in allergic rhinitis and may help to address some unmet needs. However, these new tools need to first of all be tested for privacy rules, acceptability, usability, and cost-effectiveness. Second, they should be evaluated in the frame of the digital transformation of health, their impact on health care delivery, and health outcomes. This review (1) summarizes some existing mobile health apps for allergic rhinitis and reviews those in which testing has been published, (2) discusses apps that include risk factors of allergic rhinitis, (3) examines the impact of mobile health apps in phenotype discovery, (4) provides real-world evidence for care pathways, and finally (5) discusses mobile health tools enabling the digital transformation of health and care, empowering citizens, and building a healthier society.

Citizen Perspectives on Cross-Border eHealth Data Exchange: A European Survey.

Efficient and secure cross-border eHealth data exchange has been recently identified by the European Commission as one of the top-three priorities for the digital transformation of health and care in the European Union. To this end, various organizational, legal, ethical, and technical challenges, related to citizens' privacy and health data security arise. This paper discusses an online survey that was conducted with the participation of European citizens, aiming to identify how they feel about exchanging their health data with healthcare professionals or eHealth service providers and to what extent they are aware of the privacy, legal, security, and technology acceptance issues (e.g. use of biometrics, mobile apps, etc.). The survey rationale, structure, and results are presented, while potential barriers and facilitators regarding cross-border health data exchange and the adoption of eHealth solutions at large are discussed.