Innovation In Healthcare Systems Research Articles

Integration as innovation in healthcare systems.

Healthcare systems in Canada are under pressure and require change-the status quo is no longer fit for purpose, if it ever was. Innovation is often held up as a cure for what ails us, but shiny new things or novel technologies alone have not been enough. This article will explore the concepts of differentiation and integration as being important drivers in the evolution of living organisms, ecosystems, and complex human organizations. The implications of this deep pattern of systems change are essential to understanding the roles of specialization in medicine, and optionality in primary care. Specifically, overspecialization without attention to the principles of healthcare integration can lead to fragmentation of care and worse patient outcomes. Finally, this article will describe some practical examples of system integration as innovation in the form of better public health and care delivery connections, health homes, and community care coordination centres.

The Impact of COVID on Health Systems: The Workforce and Telemedicine Perspective

The COVID-19 pandemic significantly strained global health systems, leading to the rapid adoption of telemedicine and changes in workforce management. Previously underused, telemedicine became an essential means of delivering healthcare while adhering to physical distancing guidelines. This transition addressed longstanding barriers like connectivity issues. Simultaneously, the radiology sector innovated by widely implementing remote reading stations, which helped manage exposure risks and conserve human resources. Moreover, the pandemic highlighted the critical role of technological advancements beyond telemedicine, such as the accelerated integration of AI in diagnostics and management. This article examines these comprehensive effects, emphasizing the remote work adaptations and innovations in healthcare systems that have reshaped both healthcare delivery and workforce dynamics during the pandemic.

Instructional strategies and challenges for implementing teledentistry in dental hygiene curricula: A qualitative study.

Research has documented the implementation of telecommunications and virtual technology use in health care disciplines to expand accessibility. Despite the current trend of digital innovations in healthcare systems, telehealth technology is not readily adopted in the dental hygiene profession yet. Currently, no standardized educational framework exists in dental hygiene curricula to prepare professionals with the technical skill set and professional knowledge necessary for telehealth applications. The aims and objectives of this research were (1) to investigate existing dental hygiene educators' pedagogical frameworks for incorporating telehealth technology into dental hygiene curricula, (2) explore these educators' instructional strategies for teaching telehealth technology, and (3) examine the theoretical implications and practical outcomes of teaching telehealth technology for professional development and transferrable work-force ready skills. A nine-item, open-ended, semi-structured interview guide was prepared and approved by the Institutional Review Board (IRB) in January 2023 to qualitatively investigate accredited entry-level dental hygiene programs in the United States. Thematic interpretational analysis was conducted using NVivo software. A total of 54 of the 328 dental hygiene programs volunteered for participation. Thirteen full-time and part-time dental hygiene educators met inclusion criteria. The core salient themes identified included (a) curriculum mapping, (b) technology integration, (c) professional collaboration, and (d) supplemental skill set. These findings provide guidance to dental hygiene programs for bridging the teledentistry knowledge gap in curriculum development. Incorporating telehealth applications into dental hygiene curricula prepares future dental hygienists with the specialized training needed to function as a member of contemporary health care teams addressing access to care.

Community health workers in Belgium

Abstract Despite the fact that Belgium implemented various reforms to make Primary Health Care (PHC) more affordable and accessible, inequalities in access to care are still increasing. The COVID-19 pandemic has additionally exacerbated the access to care challenges for people living in socio-economic vulnerable circumstances in Belgium. In order to achieve Sustainable Development Goal 3 (Good health and well-being for all), a healthcare system innovation is clearly needed. The COVID-19 pandemic provided impetus for introducing community health workers (CHWs) throughout Belgium at the start of 2021 - instigated by the Belgian Federal Government and executed by Intermut. The CHWs are, however, not fully integrated in the healthcare system. This presentation will provide an overview of the current state of CHWs in Belgium. To explore the potential of integrating CHWs in the Belgian health system, the research team is designing a new CHW-model. Since the country is also confronted with increasing health demands and limited budgets, there is impetus to tap into the potential of innovations from low and middle-income countries (LMICs). A review of health innovations in LIMCs and a theoretical analysis on the required characteristics of such a new model resulted in a CHW intervention - inspired by the Family Health System in Brazil and Re-engineering PHC in South Africa. The CHWs play a central part in both countries’ innovative health models which use designated health teams - consisting of one physician, one nurse, one nurse aide, and from four to twelve full-time CHWs. Each team interacts with all households in a geographically defined community. The team is the first entry point into the healthcare system and provides a wide range of primary care services to all individuals in a household over the life course in a pro-active manner. In this presentation we will show, how we can learn from innovation CHW-models in LMICs to address access to healthcare challenges in Belgium.

The need for innovations in healthcare systems using patient experience and advancing information technology

In the recent past we have observed improvements in information technology and associated computational science advance the healthcare eco system. This advancement is happening in many parts of the healthcare eco system. The aforementioned observed phenomenon is a transdisciplinary and transformative process underway and many of us are positively affected by this transformation. In this special issue the authors have commented on some of the critical regions of this change namely: user-centred postpartum care, communication channels of knowledge, diabetes care, and natural language processing health research. It must be observed that the observed innovations may have many facets such as improving user perception, reduction in time and cost for healthcare delivery, and more importantly providing key decision tools for clinicians; thereby, improving their performance in terms of time and efficiency. It is to be noted that the core purpose of these advancements is to improve patient experience.

The alleviating effect and mechanism of GLP-1 on ulcerative colitis.

Ulcerative Colitis (UC) is a major type of chronic inflammatory bowel disease of the colonic mucosa and exhibits progressive morbidity. The incidence and prevalence of UC is increasing worldwide. The global burden of UC, which can substantially reduce quality of life, is clearly increasing. These data highlight the need for research into prevention of UC and innovations in health-care systems to manage this complex and costly disease. Glucagon-like peptide-1 (GLP-1), a new antidiabetic drug, is used to treat Type 2 Diabetes Mellitus (T2DM). Accumulating evidence suggests that GLP-1 has additional roles other than glucose-lowering effects. Despite the abundance of GLP-1 research, studies in UC have been less consistent, especially body weight; for example, body weight, colon length, colon injury score, intestinal microbiota, remain to be studied further. To date, the molecular mechanism of the protective effect of GLP-1 on UC remains obscure. The effect of GLP-1 was studied by using a dextran sulfate sodium (DSS)-induced colitic mice and lipopolysaccharide (LPS) treated RAW264.7 cells (macrophage cell line) under in vivo and in vitro conditions, respectively. Our results indicate that GLP-1 significantly relieves ulcerative colitis as it represses the production of proinflammatory mediators. In addition, GLP-1 blocks the activation of the protein kinase B (AKT)/nuclear factor-κB (NF-κB), and mitogen-activated protein kinase (MAPK) signaling pathways. GLP-1 also alleviates DSS-induced injury to the intestinal mucosa and dysbiosis of gut microbiota. Altogether, GLP-1 has protection effect on ulcerative colitis. Thus, GLP-1 can be considered as a potential therapeutic candidate for the treatment of UC.

Healthcare system innovation - the case of adoption of telemedicine in Ghana

Healthcare system innovation - the case of adoption of telemedicine in Ghana

A Brief Review of Healthcare System Transformation Directions

The health care systems globally are undergoing constant changes and redesign processes within the framework of increasing patient expectations and increasingly challenging objectives related to the health of populations, cost reduction and improvement of health care quality. New approaches of healthcare reimbursement and payment are being implemented with the aim to contain costs. In parallel, there are relentless efforts to improve the quality of care through the reorganization of the healthcare team, increasingly relying on evidence, putting the patients at the centre of care, and greater participation of the patients in the process of healthcare. Overcoming the fragmentation of health systems is a major challenge for most countries of the world. In this light, healthcare system innovation and transformation, in order to meet the expectations of the patients, healthcare professionals and other stakeholders involved is of critical importance. System thinking offers an opportunity for healthcare professionals and experts of health system administration, management and strategic planning to fine-tune the health system so that it can fulfil its aspirations.

What can healthcare systems learn from looking at tensions in innovation processes? A systematic literature review

BackgroundUntil now, scholarship on innovation processes in healthcare systems lack an in-depth appreciation of tensions. Tensions often revolve around barriers and result from individual assessments and prioritizations that guide actions to eventually overcome these barriers. In order to develop a more differentiated understanding of tensions’ role in healthcare innovation processes, this paper aims to shed light on the multifaceted ways in which tensions emerge, are being dealt with, and how they hinder or, at times, facilitate innovation processes.MethodsA systematic review of published and grey literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. The review involved searching three databases for original research articles and manually searching citations. Twenty-nine original full texts were identified, evaluated, and coded. These include papers on innovation in healthcare systems that investigated innovation-related organizational tensions. The findings were synthesized into different types of tensions in healthcare system innovation and the descriptions of the conflicting elements. We also analyzed the investigated innovations by type, process stages, and across different countries and healthcare systems.ResultsA total of forty-two tensions were identified and grouped into nine categories. Organizing tensions were predominant, followed by learning/belonging, performing, and performing/organizing tensions. Tensions most frequently occurred in the implementation phase and in the form of a dilemma. Included studies were conducted mainly in government-funded healthcare systems.ConclusionOur data suggest that innovation processes in healthcare systems are impaired by conflicts between contradictory elements, working cultures, and convictions and the organizational and regulatory context. Since the majority of the tensions we collected in our study can be addressed, future policy-making and research should take advantage of this fact and develop strategies that significantly influence the successful management of tensions and thus improve the implementation of innovations.

Digital innovation and organizational changes in the healthcare sector: Multiple case studies of telemedicine project implementation

Over the past two decades, different drivers have prompted institutional players to adopt digital innovations in healthcare systems. Telemedicine represents a digital innovation solution to guaranteeing the continuity of care, and patient and personnel safety. However, despite its potential benefits (such as improving care access in rural areas, reduction in hospitalization stay, and saving time for patients and healthcare professionals) and its rapid acceleration in use during the Covid-19 pandemic, the diffusion of telemedicine services remains limited and uneven across Europe. Adopting an explorative approach, this paper analyzes the implementation of telemedicine projects, investigating not only the factors but also the ways in which the analyzed organizations, in order to move from the design to implementation phase, managed the change needed to overcome barriers and to leverage enabling factors. Our research focus is on Southern Italy; a disadvantaged area in comparison to other Italian and European regions. The goal of the paper is to shed light on the characterization of leverages and barriers, as well as the related managerial actions for change implemented in a context whereby the diffusion of telemedicine remains limited.

Healthcare System Innovation The Case of Adoption of Telemedicine in Ghana

Healthcare System Innovation The Case of Adoption of Telemedicine in Ghana

Socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis

Annotation. At the turn of the 21st century, chronic inflammatory bowel disease (CIBD) has become a global disease with accelerating morbidity in industrialized countries with a prevalence exceeding 0.3%. These data underscore the need for research into the prevention of inflammatory bowel disease and innovations in health care systems to manage this complex and costly disease. The information from a personal anamnesis of 40 women patients with ulcerative colitis (clinical group (main). In the second group (control), 30 practically healthy pregnant women with a physiological course of gestation were included, which did not have in their history of inflammatory intestinal diseases. Statistical processing of research results was performed using the software package Statistica 6.0. The arithmetic mean (M) and the standard deviation error (± m) (p<0.05) were determined, as well as the odds ratio (OR), confidence interval (CI) at p=95%. It was found that for women with ulcerative colitis is characterized by the presence of a history of obstetric pathology, such as: spontaneous miscarriage of OR 3.33, 95% CI [1.06-10.53], p=0.04 and blood secretions of OR 3.0, 95% CI [1.00-8.98], p=0.0496; among extragenital pathology in the anamnesis: children's infectious diseases of OR 4.85, 95% CI [1.25-18.85], p=0.02, chronic bronchitis of OR 7.54, 95% CI [1,56-36, 41], p=0.01, varicose veins OR 4.33, 95% CI [1.11-16.95], p=0.035, chronic gastritis OR 6.0, 95% CI [1,23-29, 31], p=0.03, anemia of OR 15.0, 95% CI [4.53-49.68], p<0.0001, allergy history of OR 6.65, 95% CI [1.73-25.60], p=0.006; among gynecological complications – premenstrual syndrome OR 6.0, 95% CI [1.55-23.15], p=0.009, algomenorrhea OR 8.14, 95% CI [2.12-31.24], p=0.002 , salpingo-oophoritis, OR 7.54, 95% CI [1.56-36.41], p=0.01. Because CIBD during pregnancy is associated with an increased risk of adverse effects on the mother and fetus, information on socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis will be useful to health care providers in making decisions about CIBD during pregnancy.

Healthcare System Innovation: the vital systemic approach for new healthcare professionals

In light of the requirements associated with the Health goals set in the National Health Plan or in Regional HealthPlans and by the consequential creation of the new health professions, there has been an enlargement of the NationalHealth System network in recent years.Growing focus testified by the reform of ordinances enacted by Law 3 of 2018 (Lorenzin Law), and the clear newtopics related to bioethics, ethics and professional deontology issues put up new questions which need answers andsolutions. Innovation in the Italian Healthcare system therefore takes on a central role in scientific debates demanding new solutions which, necessarily, must first of all aim to protect individual and collective health, in order tosubsequently focus upon the governance of new professional healthcare workers.The systematic complexity of establishing new healthcare professionals in the three afferent areas: Care Techniqueand Diagnostic Technique, Rehabilitation and Prevention, generates of course many new opportunities, requiringrapid detection and set up rapidly the organic structure of the wider Healthcare System. This is the framework withinWHO’s Project “ Healthcare System Innovation: the vital systemic approach for new healthcare professionals”, seeking specific solutions and suggestions in order to contribute to the innovation and governance of the new healthcareprofessionals

Healthcare System Innovation: the vital systemic approach for new healthcare professionals

In light of the requirements associated with the Health goals set in the National Health Plan or in Regional Health Plans and by the consequential creation of the new health professions, there has been an enlargement of the National Health System network in recent years. Growing focus testified by the reform of ordinances enacted by Law 3 of 2018 (Lorenzin Law), and the clear new topics related to bioethics, ethics and professional deontology issues put up new questions which need answers and solutions. Innovation in the Italian Healthcare system therefore takes on a central role in scientific debates demanding new solutions which, necessarily, must first of all aim to protect individual and collective health, in order to subsequently focus upon the governance of new professional healthcare workers. The systematic complexity of establishing new healthcare professionals in the three afferent areas: Care Technique and Diagnostic Technique, Rehabilitation and Prevention, generates of course many new opportunities, requiring rapid detection and set up rapidly the organic structure of the wider Healthcare System. This is the framework within WHO's Project " Healthcare System Innovation: the vital systemic approach for new healthcare professionals", seeking specific solutions and suggestions in order to contribute to the innovation and governance of the new healthcare professionals.

Health plan adaptations to a mailed outreach program for colorectal cancer screening among Medicaid and Medicare enrollees: the BeneFIT study

BackgroundPromoting uptake of evidence-based innovations in healthcare systems requires attention to how innovations are adapted to enhance their fit with a given setting. Little is known about real-world variation in how programs are delivered over time and across multiple populations and contexts, and what motivates adaptations.MethodsAs part of the BeneFIT study of mailed fecal immunochemical tests (FIT) to increase colorectal cancer screening, we interviewed 9 leaders from two participating Medicaid/Medicare health insurance plans to examine adaptations to their health plan-initiated mailed FIT outreach programs in the second year of implementation. We applied an adaptation and modification model developed by Stirman and colleagues to document content and context modifications made to the two programs.ResultsBoth health plans made substantial changes to their programs in the second year; adaptations differed substantially across health plans. In Health Plan Oregon, adaptations generally targeted health centers and member populations, most content adaptations involved tailoring program components, and the program was expanded to four additional health centers. In contrast, Health Plan Washington’s second-year content adaptations were primarily at the level of members, and generally involved adding program components. Moreover, Health Plan Washington undertook large-scale context adaptations to the setting where the program was led (local vs. national), the personnel who administered the program (vendor and staffing), and the population selected for outreach (limiting outreach to dual-eligible members).ConclusionsBoth programs implemented a variety of adaptations that reflected the values and incentives of the broader health plan contexts. Financial incentives for screening allowed Health Plan Oregon to expand but led Health Plan Washington to offer more targeted outreach to a subset of eligible enrollees. The breadth of changes made by each health system reflects the necessity of evaluating programs in context and adjusting to specific challenges as they are identified. Further research is needed to understand the effects of these types of adaptations on program efficiency and enrollee and health system outcomes.

Improvisation during a crisis: hidden innovation in healthcare systems

BackgroundCrises, such as the COVID-19 pandemic, risk overwhelming health and social care systems. As part of their responses to a critical situation, healthcare professionals necessarily improvise. Some of these local...

Global variation in prevalence and incidence of amyotrophic lateral sclerosis: a systematic review and meta-analysis

Amyotrophic lateral sclerosis (ALS) is a global disease, which adversely affects the life quality of patients and significantly increases the burden of families and society. We aimed to assess the changing incidence, prevalence of ALS around the world. We searched Medline, Embase, Web of Science, and Cochrane library to identify articles published until September 9, 2018. Each included study was independently reviewed for methodological quality by two reviewers. We used a random-effects model to summarize individual studies and assessed heterogeneity (I2) with the χ2 test on Cochrane's Q statistic. We identified 124 studies that were eligible for final inclusion, including 110 studies of incidence and 58 studies of prevalence. The overall crude worldwide ALS prevalence and incidence were 4.42 (95% CI 3.92-4.96) per 1,00,000 population and 1.59 (95% CI 1.39-1.81) per 1,00,000 person-years, respectively. ALS prevalence and incidence increased by age until the age of 70-79. Since 1957, incidence has been significantly rising year by year, and this upward trend was weakened after standardization. The longest survival time were in Asia (ranging from 3.74years in South Asia to 9.23years in West Asia). With the aggravation of population aging and the rapid growth of economy, developing regions following the development pattern of the developed regions may suffer rising ALS prevalence and incidence which may increase their disease burden as well. These data highlight the need for research into underlying mechanism and innovations in health-care systems.

Sustainable Adoption of Digital Health Innovations: Perspectives From a Stakeholder Workshop.

BackgroundThere are various complex reasons that influence sustainable adoption of innovations in health care systems. Low adoption can be caused by a lack of support from one or more stakeholders because their needs and expectations are not always considered or aligned.ObjectiveThis study aimed to identify stakeholders’ perceptions of barriers and facilitators toward the sustainable adoption of digital health innovations.MethodsA stakeholder workshop was attended by 12 participants with a range of backgrounds on August 25, 2017, including people representing the views from patients, carers, local hospitals, pharmacy retailers, health insurers, health services researchers, engineers, and technology and pharmaceutical companies in Switzerland. On the basis of adoption of innovation frameworks, we asked participants to interview each other about 3 factors influencing the adoption of digitally delivered health interventions: (1) Facilitators and barriers in the external system, (2) Needs and expectations of stakeholders, and (3) Safety, quality, and usability of innovations. The worksheets and videos generated from the workshop were qualitatively analyzed and summarized.ResultsFacilitators for adoption mentioned were high levels of income and education, and digital health is a high priority to stakeholders. Main common interests of different stakeholders were patient satisfaction and job protection. Health care spending was a misaligned interest: although some stakeholders were keen on spending more to obtain or provide the highest quality of care, others were focused on reducing health care spending to provide cost-effective services. Switzerland’s diversity and complexity, in terms of its organization with 26 cantons (administrative divisions), were barriers as these made it harder to ensure interoperability of interventions. A culture of innovation was considered a push factor, but adoption was inhibited by persistent paper-based systems, a fear of change, and unwillingness to share data. The sustainability of interventions can be promoted by making them patient-centered, meaning that patients should be involved throughout their development.ConclusionsPromoting sustainable adoption of digital health remains challenging despite various push factors being in place. Barriers related to fragmentation, patient-centeredness, data security, privacy, trust, and job security need to be addressed. A strength is that people from a wide range of backgrounds attended the workshop. A limitation is that the findings are focused on the macro level. In-depth case studies of specific issues need to be conducted in different settings.

A cross-sectional study on adaptability and pertinence of the "Health Promoting Hospitals" (HPH) initiative in Iran: health professionals' perspectives.

Despite the expansion of the HPH approach and its application in several countries of the world, the conception is still not ascertained in Iran. The main purpose of this study was to investigate the Iranian health professionals' ideas on applicability of the HPH standards in day-to-day practices of the Iranian hospitals. A cross-sectional study. The study respondents were 354 physicians, nurses and general managers working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences in Tabriz the capital city of the East Azarbaijan province, North West of Iran. A validated self-assessment tool was used for data collection about adaptability of the HPH standards i.e. management policy, patient assessment, patient information, healthy workplace promotion and inter-sectional cooperation from September to November 2016. The mean adaptability score of the HPH standards (60.0, SD: 13.0, range: 0- 136) represents ambivalent sentiment of the Iranian health professionals. The inter-sectoral cooperation and patient information standards were suggested to be the most and lest adaptable elements respectively. Only 32% of the study respondents endorsed the HPH standards' overall appositeness in the studied hospitals. Mean adaptability score of the HPH standards was significantly different between male and female health professionals, specialized and general hospitals, small oppose to the medium and large hospitals and those without prior knowledge and the knowledgeable respondents about the HPH standards (P< 0.05). This study gave an overall snapshot regarding the applicability of the HPH strategy in typical Iranian education hospitals through a wide range of health professionals' point of views. Understanding the limitations that constrain generalizability of the findings, the study results reflected a part of the gaps existing for application of the HPH strategy in the Iranian hospitals and challenges that might impede its successful conduct.

Board Work Groups on Innovation, Wellness Have Synergistic Missions

Board Work Groups on Innovation, Wellness Have Synergistic Missions