Healthcare Innovation Research Articles

Flipping healthcare by including the patient perspective in integrated care pathway design: A scoping review

BackgroundDespite the recognized benefits of integrating patient perspectives into healthcare design and clinical decision support, theoretical approaches and standardized methods are lacking. Various strategies, such as developing pathways, have evolved to address these challenges. Previous research emphasized the need for a framework for care pathways that includes theoretical principles, extensive user involvement, and data from electronic health records to bridge the gap between different fields and disciplines. Standardizing the representation of the patient perspective could facilitate its sharing across healthcare organizations and domains and its integration into journal systems, shifting the balance of power from the provider to the patient. ObjectivesThis study aims to 1) Identify research approaches taken to develop patient-centred, integrated, care pathways supported by electronic health records 2) Propose a socio-technical framework for designing patient-centred care pathways across multiple healthcare levels that integrates the voice of the patient with the knowledge of the care provider and technological perspectives. MethodsThis study conducted a scoping review following the Joanna Briggs Institute guidelines and PRISMA-ScR protocol. The databases PubMed, Scopus, Web of Science, ProQuest, IEEE, and Google Scholar were searched using a key term search strategy including variations of patient-centred, integrated care, pathway, framework and model to identify relevant studies. Eligible articles included peer-reviewed literature documenting methodologies for mapping patient-centred, integrated care pathways in healthcare service design. ResultsThis review summarizes the application of care pathway modelling practices across various areas of healthcare innovation. The search resulted in 410 studies, with 16 articles included after the full review and grey literature search. ConclusionsOur research illustrated incorporating patient perspectives into modelling care pathways and healthcare service design. Regardless of the medical domain, our methodology proposes an approach for modelling patient-centred, integrated care pathways across the care continuum, including using electronic health records to support the pathways.

DIGITAL TRANSFORMATION IN HEALTHCARE FOR EFFECTIVE INFORMATION GOVERNANCE

Serving as the first Chief Information Governance Officer (CIGO) at a venerable healthcare facility, this paper provides a thorough and strategic framework for switching from traditional paper-based record-keeping to an advanced Electronic Health Records (EHR) system. The organisation's long history spanning more than 50 years and its enormous, diversified data gathering present serious problems relating to data integrity, privacy, and security to this significant transformation that aims to improve patient care and operational efficiency. An in-depth discussion of information governance in healthcare is provided in this paper, with particular attention paid to data quality management, stringent privacy and security regulations, and the tactical use of data to spur innovation in healthcare. Along with providing a comprehensive overview of the digital transformation in healthcare, it critically examines the effects on patient care of emerging digital technologies such as wearable health devices, big data analytics, and the Internet of Things (IoT). An extensive literature review and an annotated bibliography bolster these analyses. Moreover, the paper offers a thorough plan for digital transformation that will guarantee compliance with legal and moral requirements, improve patient care, and establish the company as a pioneer in patient data management and healthcare innovation. In addition to addressing concerns such as data integrity problems brought on by a lack of solid administrative control and data handling standards, the study examines social media's potential as a marketing tool while considering pertinent legal and policy considerations. Finally, the paper offers particular metrics to evaluate the impact and efficacy of the information governance program, ensuring that it aligns with the organisation's objectives and the changing landscape of digital healthcare to guarantee these initiatives' successful implementation and oversight.

Business Innovations in Healthcare: Emerging Models for Sustainable Growth

Today’s healthcare sector is a dynamic industry that can only support innovations in the business world that address the needs of clients. The purpose of this paper is to identify some of the growing trends of innovation in the context of the healthcare organization and practice with specific reference to technology, delivery of heath services, and system optimization. Analyzing the case studies or the current tendencies, the paper reveals the effects of these innovations on the quality of the caring service, on the effectiveness of a healthcare organization, and the future stability of a healthcare system. Furthermore, the paper examines the obstacles that hinder innovation and the legal frameworks that affect the business environment for sustainable growth and development recommendations. It is for this reason that the paper’s insights concretely highlight both the centrality and enduring importance of sustained innovation in realizing enduring positive changes in healthcare services as well as delivery.

Synergizing human insight and machine learning: A dual-lens approach to uncovering healthcare research and innovation outcomes

Many healthcare organisations have extensive documentation detailing the processes behind their various research and innovation projects. Analysing this data can provide valuable insights into why some projects succeed without major issues, others encounter and overcome problems, and some ultimately fail. This study introduces an approach that combines narrative interviews and Natural Language Processing (NLP) to identify patterns associated with innovation project outcomes. We analysed 618 documents from 67 projects provided by ZonMw, a major Dutch healthcare research funder, and conducted 32 narrative interviews across seven cases of healthcare innovation projects. By using narrative interviews to inform and pre-train a text embedding model, we demonstrate the potential to create a proxy for human judgement, allowing for a more natural identification of contextual patterns in project documentation. The findings indicate that successful projects are more likely to adopt a proactive approach to role changes and uncertainty (due to ambiguous laws and regulations) and to allow flexibility, which enhances stakeholder engagement, compared to failed projects. However, while we were able to conduct descriptive analysis to gain these insights, significant interpretation is still required to fully understand the findings. Our study makes two primary contributions: first, it offers a new approach for future research on the factors that determine project success or failure, closely aligning with Structuration Theory. Additionally, it suggests potential efficiency improvements in theory development by enabling multiple pattern configurations within Grounded Theory. Second, it offers practical strategies for organisations to more effectively capture and use contextual information in their project documentation for future success.

Perceptions of impure innovation: Health professionals’ experiences and management of stigmatization when working as digital innovators

The healthcare sector has increasingly adopted digital innovations. Nonetheless, medical professionals have also resisted a variety of digital innovations. While the range of factors driving such resistance to innovation are well documented, less clear is how such resistance is experienced and managed by professionals attempting to innovate. We conducted a qualitative study of English and German ‘dual-role’ professionals, who worked both as clinical practitioners and digital innovators. Inductively theorizing from our interview data, we explain how individual professionals experience different intensities of stigmatization from colleagues when working with digital innovations. We theorize that the more central a dual-role professional is within an organization and the more their innovation deviates from standard professional duties, the more likely the innovation is to be viewed as impure within a professional group and be the target of stigmatization. We identify a range of professional, social, and personal strategies employed by dual-role innovators to manage their experiences of stigmatization and consider the implications for healthcare innovation.

Rogues, Inertia, and the Dogma of Innovation in Health Care

Rogues, Inertia, and the Dogma of Innovation in Health Care

Enhancing rural healthcare through internet-based remote collaborative outpatient services: A comprehensive evaluation in Changzhi, Shanxi Province.

The advancement of digital technology, particularly telemedicine, has become crucial in improving healthcare access in rural areas. By integrating cloud computing and mHealth technologies, Internet-based Collaborative Outpatient Clinics offer a promising solution to overcome the limitations of traditional healthcare delivery in underserved communities. A trial was conducted in 4 counties of Changzhi City in Shanxi Province, China. The system extended to 495 rural communities and served over 5000 rural residents. Deep learning algorithms were employed to analyze medical data patterns to increase the accuracy of diagnoses and the quality of personalized treatment recommendations. After the implementation of the system, there was a significant improvement in the satisfaction levels of rural residents regarding medical services; the accuracy of medical consultations increased by 30%, and the convenience of medical access improved by 50%. There was also a notable enhancement in overall health management. Satisfaction rates among healthcare professionals and rural inhabitants were over 90% and 85%, respectively, indicating that the system has had a significant positive impact on the quality of health-care services. The study confirms the feasibility of implementing telemedicine services in rural areas and offers evidence and an operational framework for promoting innovative healthcare models on a large scale.

Blockchain-Based LSTM Approach for Secure Data Transmission in IoT-Enabled Healthcare System

Blockchain technology can help with a number of issues facing the healthcare sector. Its potential as trust brokers includes the provision of incentive machines and the facilitation of innovative healthcare solutions. Additionally, its potential as trust brokers includes the facilitation of novel business models that offer fresh perspectives on the interactions between patients and providers, among other diverse healthcare stakeholders. Blockchain, for instance, makes incentive structures easier to implement and promotes decentralised trust in patient-centered healthcare models and global health information exchange (HIE). On the other hand, blockchain is characterised as a decentralised network or service that can help remove obstacles in the healthcare sector. The healthcare sector has benefited greatly from the effective resolution of problems relating to adoption and technological obstacles, interoperability and integration with current systems, cost unpredictability, scale, and regulatory compliance through the use of Blockchain technology. This work proposed discusses fault tolerance techniques in relation to sharing health-related data.

How to build and operationalise a hospital command centre

In the ever-evolving healthcare landscape, hospitals routinely grapple with daily disruptions and unforeseen events affecting resources and capacity. This paper explores the implementation and impact of the Rochester Hospital Operations Command Center (RHOCC) as a strategic response to challenges faced by the Mayo Clinic Hospital campuses in Rochester. The RHOCC, developed with an expedited timeline in response to capacity issues, exacerbated by COVID-19, serves as a centralised hub for real-time monitoring, coordination and decision-making related to patient flow. The process of establishing the command centre involved role identification, skill set determination, location of important personnel in an organised central space and vendor selection to develop the necessary infrastructure. Dashboards were developed to provide real-time actionable insights into external transfers, surgical and other planned admissions, emergency department status, patient throughput and discharges. These dashboards include colour-coded keys highlighting thresholds related to patient flow metrics and are used to facilitate daily huddles and enhance transparency and data-driven decision-making among hospital stakeholders. The outcomes of implementing the RHOCC include improved efficiency and collaboration, as well as a significantly enhanced ability to proactively respond to factors affecting census. The development of a command centre — driven by leadership endorsement and a commitment to continuous improvement — emerges as a transformative strategy in healthcare innovation. The RHOCC’s approach of building capability, fostering inclusion and articulating a vision of providing superior care while driving impactful improvements, positions it as a leading force in creating operational efficiencies to define healthcare delivery.

Development and implementation of the Capstone Program on integrating career exploration and medical humanities at a medical school in Korea.

This study aimed to implement and evaluate the outcomes, perceptions, and satisfaction of the Capstone Program developed at the Catholic University of Korea, which integrates career exploration and medical humanities. This study was conducted with fourth-year medical students from 2017 to 2019. First, the study analyzed the trends in the results of Capstone Projects conducted by students as part of their career exploration, where they independently explored areas of interest and selected topics. Second, it qualitatively analyzed the content of individual reports in which students reflected on their experiences from a "medical humanities perspective" through the Capstone Program. Third, it examined students' perceptions and satisfaction with the Capstone Program. The analysis revealed that students chose research topics from a wide range of fields, including basic medicine, clinical medicine, global healthcare, and integrated healthcare systems and innovation. The students reported positive perceptions of their career exploration and research experiences through the Capstone Program, particularly valuing sessions like "Meetings with Seniors" within the conference framework. Students indicated that the Capstone Program enhanced their ability to think introspectively from a humanities perspective, deepening their understanding of their roles and responsibilities as medical professionals. The Capstone Program provides a significant opportunity for medical students to explore their career paths and engage in introspective reflection from the viewpoint of medical humanities and social sciences. Thus, the integration of programs like capstone into the broader medical curriculum, focusing on career guidance and the reinforcement of medical humanities education, is imperative.

Large Language Model Prompting Techniques for Advancement in Clinical Medicine.

Large Language Models (LLMs have the potential to revolutionize clinical medicine by enhancing healthcare access, diagnosis, surgical planning, and education. However, their utilization requires careful, prompt engineering to mitigate challenges like hallucinations and biases. Proper utilization of LLMs involves understanding foundational concepts such as tokenization, embeddings, and attention mechanisms, alongside strategic prompting techniques to ensure accurate outputs. For innovative healthcare solutions, it is essential to maintain ongoing collaboration between AI technology and medical professionals. Ethical considerations, including data security and bias mitigation, are critical to their application. By leveraging LLMs as supplementary resources in research and education, we can enhance learning and support knowledge-based inquiries, ultimately advancing the quality and accessibility of medical care. Continued research and development are necessary to fully realize the potential of LLMs in transforming healthcare.

A stakeholder co-design approach to designing a dental service for adults experiencing homelessness.

The homeless population faces a "cliff edge of inequality" when trying to access essential dental services. There are several additional barriers to accessing dental care in comparison to the general population and the heterogeneous nature of patients presents a significant challenge when designing dental services to meet their needs. Following the Smile4Life report in 2009, there is limited up-to-date and population-specific evidence available for the optimal model of service delivery. This study aimed to co-design principles for a prospective dental service for adults experiencing homelessness. A qualitative methodology was used to incorporate experts-by-experience into elements of co-designing a dental service for adults experiencing homelessness. The study combined elements of an experienced-based co-design framework for healthcare innovation with community-based participatory research. Focus groups with people experiencing homelessness and healthcare practitioners were conducted to identify principles for any prospective dental service, as well as several barriers and enablers to establishing a homeless dental service. The findings were transcribed and analysed using thematic analysis on Nvivo software. From the qualitative analysis five key themes emerged: (1) Impact and expectations of oral health while experiencing homelessness, (2) Barriers to accessing dental care; (3) Practitioner's views about homelessness and access to care; (4) Barriers to designing a homeless service and (5) Enablers for co-designing a new model of dental care delivery for the homeless population.Five key principles for a new model of homeless dental service were identified: (i) Services designed to address the needs of patients; (ii) Services delivered in a safe and welcoming environment (iii) Training and consistency of staff; (iv) Focus on dental education (v) Developing peer mentoring and peer support. While the barriers to accessing dental care while homeless are well established and understood by healthcare practitioners, more work is required to gain consensus on the most effective way to deliver an innovative a sustainable dental service for patients experiencing homelessness. Previous negative experiences, lack of readily available information on services and barriers to access in the current system could be addressed by developing peer mentors within the homeless community, empowering individuals to share their knowledge and skills to support others in improving their oral health.

What characteristics of clinical decision support system implementations lead to adoption for regular use? A scoping review

IntroductionDigital healthcare innovation has yielded many prototype clinical decision support (CDS) systems, however, few are fully adopted into practice, despite successful research outcomes. We aimed to explore the characteristics of...

The impact of counselors’ values and religious beliefs on their role identity and perspectives on heritable genome editing: a qualitative interview study

The implementation of the noninvasive prenatal test has shown the importance of involving future care providers in healthcare innovations at an early stage. Therefore, in this explorative study in-depth interviews were performed with Dutch midwife counselors who explicitly identify as religious, to explore how they currently deal with their worldview during counseling for prenatal anomaly screening and regarding their perspectives on heritable genome editing (HGE). HGE is a potentially disruptive technology in which a pregnancy is initiated with a modified embryo or gamete, thus passing on modified genes to a future child and the following generations. Currently, a significant majority of countries prohibit HGE. However, implications for healthcare policy and practice are discussed in an ongoing scientific and societal dialogue. Eleven counselors participated: eight Christians and three Muslims. Two main themes were identified: ‘a search for role identity as a healthcare counselor’ and ‘concerns about the application of HGE’. Our findings showed that both values and underlying worldview-based beliefs influence perspectives on current and emerging reproductive techniques. Healthcare counselors search for ways to harmonize their professional role with contrasting values based on worldview-based beliefs. Moreover, for HGE, counselors fear ‘slippery slopes’ regarding the boundaries between treatment and enhancement, the severity assessment of certain conditions, and society’s appreciation for the quality of life of people with disabilities. Regarding future implementation, counselors’ medical education might benefit from a focus not only on qualification (acquiring knowledge) but also on balancing between socialization (e.g., adhering the norm of nondirective counseling) and subjectification (being a ‘self’ in relation to everything learned). In the global call for broad public and stakeholder engagement to explore the acceptability of HGE, the influence of both values and beliefs should be deliberated.

Women’s experiences of risk-stratified breast cancer screening in the MyPeBS trial: a qualitative comparative study across two European countries

Objective Risk-stratification should improve the benefits-to-harms ratio for breast screening, whereby higher-risk women receive additional screening and low-risk women are screened less. This study investigated the effects of healthcare context by comparing how women in England and France experienced risk-based breast screening. Methods and measures Fifty-two women were purposively sampled from participants who underwent risk-based screening in the MyPeBS trial. Women received objectively-derived 5-year breast cancer risk estimates (low = < 1%, average = 1–1.66%, high = ≥ 1.67 to <6%, very-high-risk = ≥ 6%). This determined future trial-related screening schedules and prevention options. Semi-structured interviews were transcribed for thematic framework analysis. Results Two overarching themes were produced: the importance of supported risk communication and accessibility of risk management. Overall, risk-based breast screening was viewed positively. However, trial procedures, especially in risk estimate provision, differed across sites. Women at increased risk were more reassured when appointments were with specialist healthcare professionals (HCP). When absent, this resulted in reduced satisfaction with risk communication and greater uncertainty about its personal relevance. Low-risk women’s views on extended mammogram schedules seemed linked to how health services are organised differently. Conclusions Context is an important consideration regarding acceptability of healthcare innovations such as risk-stratified screening: it should not be assumed that findings from one country apply universally.

Enhancing Healthcare Efficiency: Integrating ChatGPT in Nursing Documentation.

Our study at Chi Mei Medical Center introduced "A+ Nurse," a ChatGPT-based LLM tool, into the nursing documentation process to enhance efficiency and accuracy. The tool offers optimized recording and critical reminders, reducing documentation time from 15 to 5 minutes per patient while maintaining record quality. Nurses appreciated the tool's intuitive design and its effectiveness in improving documentation. This successful integration of AI-generated content in healthcare illustrates the potential of AI to streamline processes and improve patient care, setting a precedent for future AI-driven healthcare innovations.

Opportunities, Risks, Strengths and Weaknesses of Robotic Systems in Early Neurological Rehabilitation.

Given the conference's focus on innovative healthcare solutions, our investigation into robotic assistance systems highlights crucial advancements in early motor rehabilitation, aligning closely with emerging healthcare priorities. In combination with conventional therapy, the assistance systems offer new possible therapy programs. They can be used to mobilize and move patients as early as possible. The paper discusses the possibilities that arise from their use and considers the obstacles that arise. As part of a qualitative survey, nine expert interviews from different fields were conducted to guide them on robotic assisted living systems. The results obtained were summarized by coding into categories and evaluated. Our analysis of 148 coding points from nine expert interviews reveals significant insights into the strengths and weaknesses of robotic systems in neurorehabilitation. Each point was meticulously categorized to reflect its impact on both practice and patient outcomes, highlighting the practical implications of our findings. The results of the survey and the literature indicate a positive effect of robotic assistance systems in early rehabilitation. Their use requires intensive monitoring and studies on the long-term application of the systems.

Development of an mHealth App by Experts for Queer Individuals' Sexual-Reproductive Health Care Services and Needs: Nominal Group Technique Study.

Queer individuals continue to be marginalized in South Africa; they experience various health care challenges (eg, stigma, discrimination, prejudice, harassment, and humiliation), mental health issues (eg, suicide and depression), and an increased spread of HIV or AIDS and sexually transmitted illnesses (STIs; chlamydia, gonorrhea, and syphilis). Mobile health (mHealth) apps have the potential to resolve the health care deficits experienced by health care providers when managing queer individuals and by queer individuals when accessing sexual-reproductive health care services and needs, thus ensuring inclusivity and the promotion of health and well-being. Studies have proven that the nominal group technique (NGT) could be used to solve different social and health problems and develop innovative solutions. This technique ensures that different voices are represented during decision-making processes and leads to robust results. This study aims to identify important contents to include in the development of an mHealth app for addressing the sexual-reproductive health care services and needs of queer individuals. We invited a group of 13 experts from different fields, such as researchers, queer activists, sexual and reproductive health experts, private practicing health care providers, innovators, and private health care stakeholders, to take part in a face-to-face NGT. The NGT was conducted in the form of a workshop with 1 moderator, 2 research assistants, and 1 principal investigator. The workshop lasted approximately 2 hours 46 minutes and 55 seconds. We followed and applied 5 NGT steps in the workshop for experts to reach consensus. The main question that experts were expected to answer was as follows: Which content should be included in the mHealth app for addressing sexual-reproductive health care services and needs for queer individuals? This question was guided by user demographics and background, health education and information, privacy and security, accessibility and inclusivity, functionality and menu options, personalization and user engagement, service integration and partnerships, feedback and improvement, cultural sensitivity and ethical considerations, legal and regulatory compliance, and connectivity and data use. Overall, experts voted and ranked the following main icons: menu options (66 points), privacy and security (39 points), user engagement (27 points), information hub (26 points), user demographics (20 points), connectivity (16 points), service integration and partnerships (10 points), functionalities (10 points), and accessibility and inclusivity (7 points). Conducting an NGT with experts from different fields, possessing vast skill sets, knowledge, and expertise, enabled us to obtain targeted data on the development of an mHealth app to address sexual-reproductive health care services and needs for queer individuals. This approach emphasized the usefulness of a multidisciplinary perspective to inform the development of our mHealth app and demonstrated the future need for continuity in using this approach for other digital health care innovations and interventions.

Detection and analysis of disease entities based on lung conditions

The article presents a method for detecting and analysing disease entities associated with lung diseases. The results are related to work on the design of a medical diagnostic system based on impedance tomography. One of the key features of the solution is its ability to diagnose respiratory diseases, particularly chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS) and pneumothorax (PTX). The article describes the results of a classification model that effectively distinguishes between healthy and sick patients, achieving an impressive accuracy of 99.86%. This result underscores the robustness and reliability of the model. The conclusions of the presented research can serve as a basis for further work on improving diagnostic methods and introducing innovative healthcare solutions for patients with respiratory diseases, which may enable faster and more accurate diagnoses of lung diseases and provide more effective treatment and care for patients.

Ethical challenges in healthcare innovation: A leadership perspective.

Innovation is essential for advancing and sustaining healthcare systems, particularly in hospitals. While innovation offers solutions to challenges such as chronic disease management, access to care, and patient safety, it also introduces significant ethical dilemmas for health leaders. This column explores the broad ethical issues associated with healthcare innovation, focusing on resource allocation, support for diverse healthcare professions, equitable access to care, and the emphasis on technology-based innovations. It highlights the complexities of funding innovation through government, private sector, universities, donors, and the unpaid work of healthcare providers. The column also addresses the disparities in innovation support across different professions and the potential for innovation to exacerbate healthcare inequities. Potential solutions are proposed, including the establishment of interdisciplinary councils, dedicated innovation funds, and public-private partnerships. By prioritizing ethical leadership and balanced innovation strategies, health leaders can ensure that advancements benefit all stakeholders, fostering a more equitable and sustainable healthcare system in Canada.