Factors that influence public engagement with eHealth: a literature review

Purpose: Public engagement with eHealth is generally viewed as beneficial. However, despite the potential benefits, public engagement with eHealth services remains variable. This article explores reasons for this variability through a review of published international literature. Methods: A focused search, conducted in January 2009, of three bibliographic databases, MEDLINE, CINAHL and EMBASE, returned 2622 unique abstracts. Results: Fifty articles met the inclusion criteria for the review. Four main types of eHealth service were identified: health information on the Internet; custom-made online health information; online support; and telehealth. Public engagement with these services appears to depend on a number of factors: characteristics of users; technological issues; characteristics of eHealth services; social aspects of use; and eHealth services in use. Conclusions: Recommendations for policy makers, developers, users and health professionals, include: targeting efforts towards those underserved by eHealth; improving access; tailoring services to meet the needs of a broader range of users; exploiting opportunities for social computing; and clarifying of the role of health professionals in endorsement, promotion and facilitation

Linking recorded data with emotive and adaptive computing in an eHealth environment

Telecare, and particularly lifestyle monitoring, currently relies on the ability to detect and respond to changes in individual behaviour using data derived from sensors around the home. This means that a significant aspect of behaviour, that of an individuals emotional state, is not accounted for in reaching a conclusion as to the form of response required. The linked concepts of emotive and adaptive computing offer an opportunity to include information about emotional state and the paper considers how current developments in this area have the potential to be integrated within telecare and other areas of eHealth. In doing so, it looks at the development of and current state of the art of both emotive and adaptive computing, including its conceptual background, and places them into an overall eHealth context for application and development

HITECH Revisited

Assesses the 2009 Health Information Technology for Economic and Clinical Health Act, which offers incentives to adopt and meaningfully use electronic health records. Recommendations include revised criteria, incremental approaches, and targeted policies

Telehealthcare for chronic obstructive pulmonary disease

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a disease of irreversible airways obstruction in which patients often suffer exacerbations. Sometimes these exacerbations need hospital care: telehealthcare has the potential to reduce admission to hospital when used to administer care to the pateint from within their own home. OBJECTIVES: To review the effectiveness of telehealthcare for COPD compared with usual face‐to‐face care. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register, which is derived from systematic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; last searched January 2010. SELECTION CRITERIA: We selected randomised controlled trials which assessed telehealthcare, defined as follows: healthcare at a distance, involving the communication of data from the patient to the health carer, usually a doctor or nurse, who then processes the information and responds with feedback regarding the management of the illness. The primary outcomes considered were: number of exacerbations, quality of life as recorded by the St George's Respiratory Questionnaire, hospitalisations, emergency department visits and deaths. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion and extracted data. We combined data into forest plots using fixed‐effects modelling as heterogeneity was low (I(2) < 40%). MAIN RESULTS: Ten trials met the inclusion criteria. Telehealthcare was assessed as part of a complex intervention, including nurse case management and other interventions. Telehealthcare was associated with a clinically significant increase in quality of life in two trials with 253 participants (mean difference ‐6.57 (95% confidence interval (CI) ‐13.62 to 0.48); minimum clinically significant difference is a change of ‐4.0), but the confidence interval was wide. Telehealthcare showed a significant reduction in the number of patients with one or more emergency department attendances over 12 months; odds ratio (OR) 0.27 (95% CI 0.11 to 0.66) in three trials with 449 participants, and the OR of having one or more admissions to hospital over 12 months was 0.46 (95% CI 0.33 to 0.65) in six trials with 604 participants. There was no significant difference in the OR for deaths over 12 months for the telehealthcare group as compared to the usual care group in three trials with 503 participants; OR 1.05 (95% CI 0.63 to 1.75). AUTHORS' CONCLUSIONS: Telehealthcare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital. However, further research is needed to clarify precisely its role since the trials included telehealthcare as part of more complex packages

Developing a systems and informatics based approach to lifestyle monitoring within eHealth:part I - technology and data management

Lifestyle monitoring forms a subset of telecare in which data derived from sensors located in the home is used to identify variations in behaviour which are indicative of a change in care needs. Key to this is the performance of the sensors themselves and the way in which the information from multiple sources is integrated within the decision making process. The paper therefore considers the functions of the key sensors currently deployed and places their operation within the context of a proposed multi-level system structure which takes due cognisance of the requisite informatics framework

Briefing to the incoming Minister of Health 2014

Executive summary This briefing provides you, as the incoming Minister, with information on challenges and opportunities facing the New Zealand health and disability system, and how the Ministry can advise and support you to implement your Government’s priorities for health. The Ministry looks forward to discussing with you how to progress your health policies, including: providing high-quality health services; healthy communities; a strong and engaged health workforce; quality aged care and mental health services. The New Zealand health and disability sector provides world-class services, is driven by a trusted, passionate and skilled workforce, across a spectrum of public, NGOs and private providers, and serves a population that can generally access the care it needs, when it needs it. There are, however, many pressures and environmental changes that require both immediate management and longer-term strategic change. As Minister, you have a number of levers at your disposal to guide system change through setting policy direction, legislation and regulations, funding models and performance management, as well as influencing culture and leadership. Every New Zealander will, at some point in their lives, rely on our health and disability system. It is a large and complex system with multiple decision-makers and mixed public and private ownership models. It operates in a dynamic, continually changing environment characterised by well-known global and local challenges, including:  &nbsp;changing population health needs and burden of disease (especially the rising impact of long- term conditions and risk factors, such as diabetes and obesity)  &nbsp;the growing impact of health-care associated infections, antimicrobial resistance and emerging infectious diseases, eg, Ebola  &nbsp;rapid advances in technology, developments in personalised medicine and changing public expectations  &nbsp;an ageing population, and a workforce that is ageing along with the population  &nbsp;a constrained funding environment for the foreseeable future  &nbsp;a growing fiscal sustainability challenge as health consumes an increasing proportion of total government expenditure. These challenges are placing pressure and new demands on the way public health and disability services are currently delivered. Significant gains in the overall health of New Zealanders could be achieved by concentrating on people who have poorer health outcomes, complex health needs or who need a stronger voice. These might include vulnerable children, older people, people with long-term conditions, people with mental health and addiction problems and people with disabilities. Health and disability services need to build on current progress and adapt to future needs. The health system’s ability to provide a sustainable, quality public health service depends on keeping ahead of the challenges. This briefing provides some suggestions for where we could work with you to meet these challenges. There are opportunities to make better use of existing resources, people, facilities and funding, through new ways of delivering services that keep people well with better prevention and early Briefing to the Incoming Minister of Health v intervention. Significant gains could be made by developing a longer-term focus on preventing disability and illness in the first place. There are new opportunities for the health workforce to work in different ways with a broader range of colleagues across the health and wider social sectors, and with partners in the community. To better equip the New Zealand health and disability system for the future, we suggest focusing on four areas. 1 &nbsp;Better integrate services within health and across the social sector: Strengthening integration within health and across government to support the most vulnerable, reduce inequities and address issues outside the health and disability system that impact on health. 2 &nbsp;Improve the way services are purchased and provided: Ensuring funding models support change, building and supporting the key enablers and drivers of change: workforce, health information and capital. 3 &nbsp;Lift quality and performance: Driving performance through measuring and rewarding the right things to improve quality. 4 &nbsp;Support leadership and capability for change: Supporting strong governance, clinical and executive leadership and capability across the health sector.&nbsp

Business Case and Technology Analysis for 5G Low Latency Applications

A large number of new consumer and industrial applications are likely to change the classic operator's business models and provide a wide range of new markets to enter. This article analyses the most relevant 5G use cases that require ultra-low latency, from both technical and business perspectives. Low latency services pose challenging requirements to the network, and to fulfill them operators need to invest in costly changes in their network. In this sense, it is not clear whether such investments are going to be amortized with these new business models. In light of this, specific applications and requirements are described and the potential market benefits for operators are analysed. Conclusions show that operators have clear opportunities to add value and position themselves strongly with the increasing number of services to be provided by 5G.Comment: 18 pages, 5 figure

A new track for technology: Can ICT take care for healthier lifestyles?

The paper takes a look on potential contribution of Information and Communication Technologies to abate public health challenges caused by demographics and lifestyle. From the current convergence of mhealth, and sport market products emerge targeting normal athletes to control their training in a quantified manner. The resulting feedback and transparency foster a healthier lifestyle. These products and services help overcome limitations to innovation typical to the health care market. The paper is based on research by the European Commission's Institute for Prospective Technological Studies on Integrated Personal Health/Care services. --eHealth,Integrated Personal Health/Care services,sport,training,lifestyle related disease,innovation