Development Of Health Technologies Research Articles

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.

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.

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.

Biobank donation in search of public benefits and the potential impact of intellectual property rights over access to health-technologies developed: A focus on the bioethical implications.

The availability of biomaterials is a key component of health research and the development of new health-technologies (including, diagnostics, medicines, and vaccines). People are often encouraged by biobanks to donate samples altruistically to such biobanks. While empirical evidence suggests many donors are motivated by the desire to contribute towards developing new health-technologies for society. However, a tension can arise as health-technologies whose development is contributed to by donors' biomaterials will often be protected by intellectual property rights (IPRs), including patents. Patents give rightsholders control over how patented technologies are used and can be used in a way that impedes public access to technologies developed. Yet, there are no binding European legal obligations mandating disclosure to donors of how IPRs can operate over downstream health-technologies and how they could impact access to health-technologies developed, nor are there legally binding obligations to ensure public accessibility of technologies developed. Focusing on the bioethical implications posed, this article argues that the current situation can impact donors' autonomy and dignity interests. A more holistic approach is needed for biobank donation, which embeds a consideration of donors' expectations/interests from the point of donation through to how such samples are used and how health-technologies developed are accessed. We put forward avenues that seek to address such issues.

Clinical practice guidelines for diagnostic and treatment of the chronic heart failure.

Chronic heart failure continues to be one of the main causes of impairment in the functioning and quality of life of people who suffer from it, as well as one of the main causes of mortality in our country and around the world. Mexico has a high prevalence of risk factors for developing heart failure, such as high blood pressure, diabetes, and obesity, which makes it essential to have an evidence-based document that provides recommendations to health professionals involved in the diagnosis and treatment of these patients. This document establishes the clinical practice guide (CPG) prepared at the initiative of the Mexican Society of Cardiology (SMC) in collaboration with the Iberic American Agency for the Development and Evaluation of Health Technologies, with the purpose of establishing recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. This document complies with international quality standards, such as those described by the US Institute of Medicine (IOM), the National Institute of Clinical Excellence (NICE), the Intercollegiate Network for Scottish Guideline Development (SIGN) and the Guidelines International Network (G-I-N). The Guideline Development Group was integrated in a multi-collaborative and interdisciplinary manner with the support of methodologists with experience in systematic literature reviews and the development of CPG. A modified Delphi panel methodology was developed and conducted to achieve an adequate level of consensus in each of the recommendations contained in this CPG. We hope that this document contributes to better clinical decision making and becomes a reference point for clinicians who manage patients with chronic heart failure in all their clinical stages and in this way, we improve the quality of clinical care, improve their quality of life and reducing its complications.

Advocating Values through Meaningful Participation: Introducing a Method to Elicit and Analyze Values for Enriching Data Donation Practices in Healthcare

The secondary use of routinely collected patient data made possible by the broad consent form is seen as a prerequisite for developing data-driven health technologies. In Germany, relevant stakeholder groups (e.g., ethics committees and data protection authorities) specified the broad consent form; however, only one group of patient representatives was consulted, which may indicate asymmetries in engagement. This situation informed our research on medical data donation and emphasized foregrounding patient values. Drawing on participatory design, value sensitive design, and emerging research on value-led participation, we propose a method consisting of (1) a workshop concept for participatory value elicitation composed of four carefully coordinated phases and (2) an analysis procedure to examine the empirical data collected. This analysis allowed us to derive design requirements for medical data donation user interfaces. We conducted three workshops with patient advocates of vulnerable groups and patients in residential care of a psychosomatic unit. Our findings provide new directions to improve user interfaces for medical data donation: First, user interfaces need to enhance patients' reflective thinking about the potential consequences of their data donation; second, a decision facilitator supporting patients' value-based decision-making (e.g., by providing simple language or tailoring descriptions to patient needs); and finally, a data intermediary relieving patients' decision-making and giving them control over their data after donation. Moreover, we emphasize the need to increase the use of participatory approaches in health technology development.

Implementing the EU HTA regulation: Insights from semi-structured interviews on patient expectations, Belgian and European institutional perspectives, and industry outlooks.

Introduction: The goal of the Health Technology Assessment (HTA) Regulation 2021/2282 is to establish a more harmonized HTA framework, fostering member states cooperation and enabling equal patient access to innovative health technologies in Europe. This research aimed to assess the impact of the regulation on national HTAs, the strategic implications for health technology developers, and its influence on price and reimbursement negotiations. Methods: A scoping literature review encompassing peer-reviewed literature as well as grey literature was conducted. Between February and March 2023, semi-structured interviews (n = 20) were performed with stakeholders from Belgian governmental institutions, European institutions, advanced therapy medicinal product developers, academics, and sickness funds. The interviews were analyzed using the framework analysis method. Results: Numerous steps, such as the development of implementing acts and procedural guidelines remain to be taken. At member state level, national/regional HTA bodies and payers must act to adopt the new concepts of Joint Scientific Consultations (JSC) and Joint Clinical Assessments (JCA) within their national legislation, as well as revise their timelines and prepare for interactions at a European level. Compiling a harmonized PICO (Population, Intervention, Comparator, and Outcome), adapting local procedures, and increasing capacity to actively take part in the JSC and JCA are seen as primary barriers by several stakeholders. Training and education will help HTA bodies, payers, and health technology developers to participate in the European processes. Conclusion: While practical and legal challenges were identified, recommendations (such as actively preparing for the upcoming changes and increasing capacity while providing training) were provided to adapt national and European procedures to the needs of the HTA Regulation 2021/2282. The importance of fostering collaborations and aligning local HTA procedures with the new way of working set out by the Regulation was demonstrated with this study.

Pressure Injuries in Different Disciplines: A Bibliometric Analysis

Introduction: Despite developing health technologies and many preventive approaches, pressure injuries are still among the current health problems for health professionals and health costs. Aim: This study was conducted to examine the features of the studies on pressure injuries in different disciplines like authors, journals, and the number of citations and provide a perspective for further studies.Material and Methods: The study used the bibliometric analysis method, MS Excel program, and Vosviwer. The data were searched using the keywords “pressure ulcer”, “pressure wound”, pressure injuries”, bedsore”, “pressure sores”, “decubitus ulcer”, and “decubitus” Results: A total of 4224 research articles, book chapters, and review articles were analyzed for the study criteria. The results showed that the first article was published in 1949, the highest number of studies was done in 2021, 87.2% of the studies were nursing, and 13.3% were published in the Journal of Wound Care. 87.9% of the studies were published in English, and 26.7% were published in the United States of America. It was determined that there was a positive relationship between the number of publications and the gross national product of the countries (r=0.774, p<0.009). Conclusion and sugestions: It was concluded that despite the increasing number of studies on pressure injury over the years, there was a decrease in author collaboration, the studies were primarily conducted in nursing and published in relevant journals, and there was a lack of a multidisciplinary approach. With this research, new researchers will be asked research to be conducted on the subject when researching pressure injury, it provides researchers with which keywords they can use, which authors’ articles they can review, and collaborative research by the authors. Based on the research results, encouraging interdisciplinary collaboration and interdisciplinary cooperation is recommended for pressure injury prevention.

Tele-DM: development of a mobile health technology for non-invasive type-2 diabetes mellitus patients with assistive physical activities and vital signs monitoring

Tele-DM: development of a mobile health technology for non-invasive type-2 diabetes mellitus patients with assistive physical activities and vital signs monitoring

Development of a low-cost device for photobiomodulation using 3D printing

INTRODUCTION: Photobiomodulation therapy (PBM) is a non-pharmacological and non-invasive therapeutic strategy that has shown promising results in several health conditions. Despite important advances in knowledge of its modulatory effects at the molecular, cellular, and tissue levels, the cost of PBM equipment still greatly limits its use in the clinical setting, especially in developing countries. In this context, the use of new technologies such as 3D printing has presented several possibilities for application in the health area. OBJECTIVES: To develop a 3D printing PBM device and test its technical and operational viability. METHODS AND MATERIALS: Development of Health Technology on a Photobiomodulation Device with 3D Printing Tests of the safety, emission, and support of the light beams were carried out. RESULTS: The PBM device demonstrated operational safety and good quality in the maintenance of light beams. CONCLUSION: A three-dimensional (3D) printed LED PBM device is technically, operationally, and financially viable. However, more experimental tests and clinical validation are required before this prototype can be used in human health applications.

An Inclusive Civil Society Dialogue for Successful Implementation of the EU HTA Regulation: Call to Action to Ensure Appropriate Involvement of Stakeholders and Collaborators.

Stakeholder involvement has long been considered a success factor for a joint European health technology assessment (HTA) process, and its relevance is now anchored in the EU HTA Regulation's (EU HTAR) legislative wording. Therefore, we aimed to explore the roles, challenges, and most important activities to increase the level of involvement per stakeholder group. At the 2022 Fall Convention of the European Access Academy (EAA), working groups addressed the involvement of patients, clinicians, regulators, health technology developers (HTD), and national HTA bodies and payers within the EU HTA process. Each working group revisited the pre-convention survey results, determined key role characteristics for each stakeholder, and agreed on the most important activities to fulfill the role profile. Finally, the activities suggested per group were prioritized by plenary group. The prioritized actions for patients included training and capacity building, the establishment of a patient involvement committee, and the establishment of a patient unit at the EC secretariat. For clinicians, it included alignment on evidence assessment from a clinical vs. HTA point of view, capacity building, and standardization of processes. The most important actions for regulators are to develop joint regulatory-HTA guidance documents, align processes and interfaces under the regulation, and share discussions on post-licensing evidence generation. HTDs prioritized scientific advice capacity and the review of the scoping process, and further development of the scope of the assessment report fact checks. The top three actions for national HTA bodies and payers included clarification on the early HTD dialogue process, political support and commitment, and clarification on financial support. Addressing the activities identified as the most important for stakeholders/collaborators in the EU HTA process (e.g., in the implementation of the EU HTA Stakeholder Network and of the guidance documents developed by the EUnetHTA 21 consortium) will be key to starting an "inclusive civil society dialogue", as suggested by the European Commission's Pharmaceutical Strategy.

Therapist perspectives on telehealth-based virtual reality exposure therapy

Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists’ perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, previous experiences with VR, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16/18), enhanced therapy (61.1%, 11/18), and improved access to clients (38.9%, 7/18), but entailed problems with technology (61.1%, 11/18), uncontrolled settings (55.6%, 10/18), and communication difficulties (50%, 9/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12/18), preparing client expectations (55.6%, 10/18), and adjusting workflows (27.8%, 5/18). Most therapists had used VR before (72.2%, 13/18) and had positive impressions of VR (55.6%, 10/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14/18) and customizable interventions components (55.6%, 10/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14/18), costs (50%, 9/18), side effects and privacy (22.2%, 4/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3/18). These results reveal how combining telehealth and VRET may expand therapeutic options for mental healthcare providers and can help inform collaborative development of immersive health technologies.

Assessment of ownership of smart devices and the acceptability of digital health data sharing

Smart portable devices- smartphones and smartwatches- are rapidly being adopted by the general population, which has brought forward an opportunity to use the large volumes of physiological, behavioral, and activity data continuously being collected by these devices in naturalistic settings to perform research, monitor health, and track disease. While these data can serve to revolutionize health monitoring in research and clinical care, minimal research has been conducted to understand what motivates people to use these devices and their interest and comfort in sharing the data. In this study, we aimed to characterize the ownership and usage of smart devices among patients from an expansive academic health system in the southeastern US and understand their willingness to share data collected by the smart devices. We conducted an electronic survey of participants from an online patient advisory group around smart device ownership, usage, and data sharing. Out of the 3021 members of the online patient advisory group, 1368 (45%) responded to the survey, with 871 female (64%), 826 and 390 White (60%) and Black (29%) participants, respectively, and a slight majority (52%) age 58 and older. Most of the respondents (98%) owned a smartphone and the majority (59%) owned a wearable. In this population, people who identify as female, Hispanic, and Generation Z (age 18–25), and those completing higher education and having full-time employment, were most likely to own a wearable device compared to their demographic counterparts. 50% of smart device owners were willing to share and 32% would consider sharing their smart device data for research purposes. The type of activity data they are willing to share varies by gender, age, education, and employment. Findings from this study can be used to design both equitable and cost-effective digital health studies, leveraging personally-owned smartphones and wearables in representative populations, ultimately enabling the development of equitable digital health technologies.

MENTAL HEALTH AND DIGITAL TECHNOLOGY: A PUBLIC HEALTH REVIEW OF CURRENT TRENDS AND RESPONSES

The intersection of mental health and digital technology has become a critical focus in the realm of public health. This paper provides a concise overview of the current trends and responses within this evolving landscape. The widespread integration of digital technology into daily life has both positive and negative implications for mental health. On one hand, digital platforms offer innovative tools for mental health support, including virtual therapy, mental health apps, and online communities. These resources enhance accessibility and reduce barriers to seeking help. Conversely, concerns have arisen regarding the adverse impact of excessive digital screen time, social media use, and cyberbullying on mental well-being. The paper explores the prevalence of digital mental health interventions, emphasizing the need for evidence-based practices and regulatory frameworks to ensure their efficacy and user safety. Additionally, it addresses the growing recognition of the digital divide and disparities in access to mental health resources, emphasizing the importance of inclusivity in digital mental health initiatives. Responses to these challenges involve collaborative efforts among mental health professionals, technology developers, policymakers, and public health practitioners. The paper highlights the importance of research in understanding the nuanced relationship between digital technology and mental health, informing the development of targeted interventions. Furthermore, it emphasizes the need for comprehensive public health strategies that prioritize digital literacy, mental health education, and the promotion of positive online behaviors. The paper underscores the multifaceted nature of the relationship between mental health and digital technology, calling for a holistic and collaborative approach to address the evolving challenges and opportunities in this dynamic landscape.
 Keywords: Mental health, Digital technologies, Public health, Trends, Review.

MHealth Apps for the Self-Management of Low Back Pain: Systematic Search in App Stores and Content Analysis.

With the rapid development of mobile health (mHealth) technology, many health apps have been introduced to the commercial market for people with back pain conditions. However, little is known about their content, quality, approaches to care for low back pain (LBP), and associated risks of use. The aims of this research were to (1) identify apps for the self-management of LBP currently on the market and (2) assess their quality, intervention content, theoretical approaches, and risk-related approaches. The UK iTunes and Google Play stores were initially searched for apps related to the self-management of LBP in May 2022. A repeat search in June 2023 was conducted to ensure that any relevant new apps developed in the last year were incorporated into the review. A total of 3 keywords recommended by the Cochrane Back and Neck Group were used to search apps "low back pain," "back pain," and "lumbago." The quality of the apps was assessed by using the 5-point Mobile App Rating Scale (MARS). A total of 69 apps (25 iOS and 44 Android) met the inclusion criteria. These LBP self-management apps mainly provide recommendations on muscle stretching (n=51, 73.9%), muscle strengthening (n=42, 60.9%), core stability exercises (n=32, 46.4%), yoga (n=19, 27.5%), and information about LBP mechanisms (n=17, 24.6%). Most interventions (n=14, 78%) are consistent with the recommendations in the National Institute for Health and Care Excellence (NICE) guidelines. The mean (SD) MARS overall score of included apps was 2.4 (0.44) out of a possible 5 points. The functionality dimension was associated with the highest score (3.0), whereas the engagement and information dimension resulted in the lowest score (2.1). Regarding theoretical and risk-related approaches, 18 (26.1%) of the 69 apps reported the rate of intervention progression, 11 (15.9%) reported safety checks, only 1 (1.4%) reported personalization of care, and none reported the theoretical care model or the age group targeted. mHealth apps are potentially promising alternatives to help people manage their LBP; however, most of the LBP self-management apps were of poor quality and did not report the theoretical approaches to care and their associated risks. Although nearly all apps reviewed included a component of care listed in the NICE guidelines, the model of care delivery or embracement of care principles such as the application of a biopsychosocial model was unclear.

Towards Relevant and Viable Telehealth Technologies

Disruption of the healthcare system was more pronounced in low- to middle-income countries than in developed countries during the period of the COVID-19 pandemic.1 A reduction of about a third of the patient cases was observed, especially for the mild to moderate conditions.2 Considering that non-severe cases are most amenable to remote management throughtelehealth, the latter was a popular alternative to going to a health facility. Among its benefits include connecting patients with health providers at their convenient time and place, avoiding exposure to infection, saving time, responding early to medical emergencies, providing e-prescriptions, accessing even remote areas, among others.3
 In this issue of the journal, the article by Gonzales et al., on developing and implementing mobile health technologies presents the Philippine scenario in the development of mobile health (mHealth) technologies. It is noted that the average cost to develop and roll out mHealth is around PhP 4,018,907 (US $78,650). This figure may not be too onerous for those with the means but is challenging for most developers. Thus, the government plays an indispensable role in supporting these ventures for health especially during the pandemic. With taxpayers’ money going to these technologies, it is advantageous to weigh the benefits over the investment. Cost-benefit analyses are important to undertake before plunging into specific projects.
 During the pandemic, some of these telehealth services were funded by the government and the developers faced challenges inherent in public funding.4 When the government ceases to fund these projects, entrepreneurs have to rely on their own resources. Financial viability is linked to market success.
 To make any product or service successful in the market, it should be designed from the outset, based on the needs of its intended customers. The design thinking principles are important to consider in the design process of mobile health technologies.5 At the core of these principles is that the product is co-designed with the consumers. From the very start of the project, the ‘needs’ of the consumers and not just their expressed ‘wants’, should be well delineated. This can be teased out from qualitative interviews with consumers about their experiences so that the problematic areas can be explored more deeply to bring out the real needs that even the consumers themselves may not realize. In so doing, the developer can design the technology addressing those needs, thus making the product more relevant and acceptable in the market.
 For innovations emanating from the university, it is beneficial that academe-industry collaboration be established from the start. There are a number of mechanisms where this can be achieved. In the so-called “reverse-pitching”, companies present their needs to the professors and researchers for them to initiate studies to address those needs. Usually, innovators are the ones pitching their technologies to companies who may potentially take on the product to be commercialized. Often, the perspective of the industry sector is not heard which is key to having a marketable product. Thus, in reverse pitching, the companies present the market needs to the creators of the technology, resulting in more relevant and useful innovations.
 The academic community can co-create with the industry the relevant products and systems that the consumers will patronize. In some countries, there are laboratories and similar facilities built by the industrial companies within the university campus to facilitate the collaborative efforts between academe and industry in devising innovations. Those seminal workswill then be further developed and scaled by the company, and eventually be brought to market. Such mechanisms fuse the creative minds of the academe with the pragmatic acumen of the industry sector to address the needs of the community with better products and services.

Health Technology Assessment in China’s Health Care Sector: Development and Applications

ABSTRACT China’s health system is facing severe challenges from social transition and the double burden of population aging and non-communicable diseases. Addressing the tension between the public’s increasing demand for health services and the limited availability of medical resources has become a critical issue for health care policymakers and medical insurance fund administrators. In promoting its medical insurance system reform, China is actively developing health technology assessment (HTA) with principles and applications adapted to the Chinese context. This study aims to analyze the evolution of HTA in China with a focus on context, actors, process, content, and challenges encountered through applying a modified verson of Walt and Gilson’s policy triangle framework. Currently, HTA plays an indispensable part in the reform of China’s health care and medical insurance system, especially in the formulation and adjustment of the National Reimbursement Drug List (NRDL). While HTA is increasingly used in China, there remain challenges, such as the slow development of HTA related disciplines, lack of an independent national HTA authority, and limited scope in the use of HTA. Despite the identified challenges, HTA has the potential to support a wide range of applications in China’s health care sector, building on the progress achieved over the last three decades.

What are important areas where better technology would support women’s health? Findings from a priority setting partnership

BackgroundWomen’s health has historically lacked investment in research and development. Technologies that enhance women’s health (‘FemTech’) could contribute to improving this. However, there has been little work to understand which priority unmet needs should be a focus for women’s health technology development. The voices of clinicians and those who experience and utilise these technologies (including those used at home or encountered in clinical settings) are needed to ensure that device development aligns with need, without risking exacerbating or creating health inequities.MethodWe undertook a priority setting partnership project exploring unmet needs in women’s health and well-being where physical technologies or innovations could help. This comprised gathering feedback from: patients and clinicians using both qualitative surveys and discussions; collating and publishing these responses and asking for feedback; evidence checking unmet needs identified, and holding a partnership priority setting event to agree a top 10 and top 20 list of priorities.ResultsWe generated a ‘longlist’ of 54 suggestions for areas where better kit, devices or equipment could support women’s health. For three, we found evidence of existing technologies which mitigated against that need. We took the remaining 51 suggestions to a partnership priority setting meeting which brought together clinicians and service users. Through discussion as this group, we generated a list of the top 10 areas identified as priorities for technological development and improvement. These included better devices to manage examination, diagnosis and treatment of pelvic pain (including endometriosis), prolapse care, continence (treatment and prevention, related to pregnancy and beyond), menstruation, vaginal pain and vaginismus, point of care tests for common infections, and nipple care when breastfeeding.ConclusionThe top priorities suggest far-reaching areas of unmet need across women’s life course and across multiple domains of health and well-being, and opportunities where innovation in the devices that people use themselves or encounter in health settings could potentially enhance health and healthcare experiences.

Influence of Service Quality on Customer Satisfaction (Case Study of Outpatients of a Moslem Friendly Hospital in Gresik)

Hospitals are one of the health service providers that have an important task to provide the best health service to the community. Hospitals have the tasks of medical care, health recovery, maintenance and improvement of individual health, organizing personal education and research and development of health technology. This study aims to analyze the effect of service quality on customer satisfaction. The research method uses quantitative methods with non-probablility sampling techniques with 170 respondents. The analysis in this study uses IPA (Importance Performance Anlysis) and CSI (Customer Satisfaction Index). IPA research results, there are 2 attributes in quadrant I, 13 attributes in quadrant II, 7 atributes in quadrant III, 3 attributes in quadrant IV. CSI research calculation obtained results of 88.8%

Monipar: movement data collection tool to monitor motor symptoms in Parkinson's disease using smartwatches and smartphones.

Parkinson's disease (PD) is a neurodegenerative disorder commonly characterized by motor impairments. The development of mobile health (m-health) technologies, such as wearable and smart devices, presents an opportunity for the implementation of clinical tools that can support tasks such as early diagnosis and objective quantification of symptoms. This study evaluates a framework to monitor motor symptoms of PD patients based on the performance of standardized exercises such as those performed during clinic evaluation. To implement this framework, an m-health tool named Monipar was developed that uses off-the-shelf smart devices. An experimental protocol was conducted with the participation of 21 early-stage PD patients and 7 healthy controls who used Monipar installed in off-the-shelf smartwatches and smartphones. Movement data collected using the built-in acceleration sensors were used to extract relevant digital indicators (features). These indicators were then compared with clinical evaluations performed using the MDS-UPDRS scale. The results showed moderate to strong (significant) correlations between the clinical evaluations (MDS-UPDRS scale) and features extracted from the movement data used to assess resting tremor (i.e., the standard deviation of the time series: r = 0.772, p < 0.001) and data from the pronation and supination movements (i.e., power in the band of 1-4 Hz: r = -0.662, p < 0.001). These results suggest that the proposed framework could be used as a complementary tool for the evaluation of motor symptoms in early-stage PD patients, providing a feasible and cost-effective solution for remote and ambulatory monitoring of specific motor symptoms such as resting tremor or bradykinesia.