Envisioning patient safety in Telehealth: a research perspective

This article explores the need for research into patient safety in large-scale Telehealth systems faced with the perspective of its development extended to healthcare systems. Telehealth systems give rise to significant advantages in improving the quality of healthcare services as well as bringing about the possibility of new types of risk. A theoretical framework is proposed for patient safety for its approach as an emerging property in complex socio-technical systems (CSTS) and their modelling in layers. As regards this framework, the differential characteristic Telehealth elements of the system have been identified, with a greater emphasis on the level of Telehealth system and its typical subsystems. The bases of the analysis are based on references in the literature and the experience accumulated by the researchers in the area. In particular, a case describing an example of Telehealth to control patients undergoing treatment with oral anticoagulants is used. As a result, a series of areas of research into and topics regarding Telehealth patient safety are proposed to cover the detectable gaps. Both the theoretical and practical implications of the study are discussed and future perspectives are reflected on.This research has been partially supported by grants FISPI09-90110 ‘Innovation Platform in new services based on telemedicine and e-health for chronic and dependent patients -PITES’ from the Ministry of Health & Consumer Affairs; and FISPI13-00508 ‘Innovation platform in new services based on Telemedicine and e- Health: definition, design and development of tools for interoperability, patient safety and support to decision (PITES-ISA)’ from the Ministry of Economy and Competitiveness (Secretary of State of Research, Development and Innovation). The funders had no role in the study, decision to publish, or drafting of the manuscript.S

Mobile Healthcare Design Research: A Special Issue for Information Systems Researchers

Special Section Editorial - Mobile Decision Support and Analytics for Healthcare: Citizen, Organization, Governmental and Technological Perspective

Kajian Tekno-Ekonomi pada Telehealth di Indonesia

Program telehealth di Indonesia dapat menjangkau masyarakat yang berada di daerah terluar dan perbatasan, dimana fasilitas pelayanan kesehatan belum merata ketersediaannya. Penelitian ini bertujuan memperoleh potensi implementasi telehealth di Indonesia dengan menggunakan pendekatan analisis dari segi ekonomi dan teknologi. Metode penelitian menggunakan pendekatan data kuantitatif yang didukung dengan data kualitatif. Perhitungan biaya program telehealth dalam penelitian ini direncanakan untuk puskesmas yang berada di daerah tertinggal di seluruh Indonesia dalam kurun waktu lima tahun (2016-2020). Hasil kajian menunjukkan bahwa biaya program telehealth untuk sektor kesehatan di Indonesia cukup besar. Biaya terbesar pada tahun keempat yaitu berkisar Rp 180 Miliar. Meskipun demikian biaya tersebut masih terjangkau dari anggaran pemerintah yang dialokasikan untuk Kementerian Kesehatan. Program telehealth juga dapat menjadi tonggak untuk implementasi Internet of Things di sektor kesehatan bagi masyarakat publik. Maka dari itu, implementasi telehealth sangat mungkin diterapkan di Indonesia.*****Telehealth program can reach people in the rural area, where health service facilities are not yet equitable. This study aims to obtain the potential implementation of telehealth in Indonesia by using techno-economic approach. The research method uses quantitative data approach supported by qualitative data. The results of the study indicate that the cost of the telehealth program for the health sector in Indonesia is quite large, but still affordable from the government budget allocated to the Ministry of Health. In addition, telehealth can also be a milestone for the implementation of the Internet of Things in the health sector for the public. Therefore, telehealth implementation is very possible to be applied in Indonesia

Telemedicine and Healthcare Implications for Central Virginia: A Systematic Review of the Literature

Background: Uncertainties and challenges associated with COVID-19 have affected the efficient delivery of health care in Central Virginia. Integrating and redesigning health systems could boost the quality and efficiency of care delivery. Telemedicine has been suggested as a viable solution to increase virtual access to patient advocacy healthcare education and training programs and has the potential to help facilitate the delivery of health services to rural and remote areas. It is projected that access to quality telehealth services can minimize the need for in-person hospital visitation amid the pandemic. The innovation also facilitates remote assessment of patients and monitoring of patient illness and treatment. For the rural population at risk of COVID-19 or any easily transmissible infection, telemedicine can provide convenient access to routine care without provider-patient contact, thus limiting the spread of the virus. Methods: A systematic literature review of peer-reviewed and grey literature was conducted. The authors used electronic databases including Embase, PubMed, CINAHIL and Web of Science to locate and access relevant articles based on their inclusion criteria. Studies were selected that investigated the implementation of telemedicine in the clinical and educational healthcare settings in rural or remote locations within the United States. Forty articles were identified for review. The identified articles were published between 2010 and 2021 that were used in the study. Results: There was no significant literature on telemedicine utilization in the Commonwealth of Virginia. Additionally, there were limited studies on rural and remote settings that utilized telehealth services during the COVID-19 pandemic. Evidence suggested that telemedicine could improve access to healthcare services and enable providers to monitor patients from a distance. Researchers identified six key factors associated with telemedicine\u27s success and sustainability: education, training, vision, ownership, adaptability, economics, efficiency, and equipment. Conclusions: Rural and remote communities experience healthcare disparities and poor patient outcomes due to limited access to quality care and inequalities in education, training, and resource allocation. A deficiency of technological skills, knowledge and or resistance to change may prevent a quality telehealth program from being able to serve patients adequately

[Editorial] Marketing as an integrator in integrated care

Purpose: Integrated care requires solutions that cannot be delivered without addressing the underlying multidisciplinary problems. Yet with a few notable exceptions, there is a lack of coordination between disciplines, to effectively integrate knowledge. The main aim of this special section is to provide a platform that explicitly coordinates and curates multidisciplinary research aimed at providing a shared understanding and knowledge base that directly addresses the fragmentation in this field, with an explicit focus on the role of Marketing as a key but often neglected partner. We identify four big challenges (Self, Society, Micro Systems and Macro Systems) to which Marketing can contribute, illustrating these potential contributions through the articles and accompanying practitioner commentaries of this special section. Methodology: Ferguson demonstrates how reflexive introspection can be used, beyond its therapeutic benefits, to bring a deeper understanding of the meaning of illness and treatments from a patient’s perspective. Orazi and Newton establish experimentally the positive impact of collaborative sources on health messaging receptivity. Taiminen, Saramieni and Parkinson survey physicians to evaluate acceptance of/barriers to incorporating digital self-services into overall care delivery. Cruz, Snuggs and Tsarenko utilise interviews to understand the patient’s negotiation of the service labyrinth and fragmentation. Findings: We demonstrate the scope and flexibility of marketing theories and methods and how these can be applied to the four main challenges of integrated care: Self; Society; Micro Systems; Macro Systems. Research Implications: We identify directions for future research as a means of stimulating fruitful multidisciplinary partnerships in the four key challenge areas. It is only by collaborating across disciplines that we can really develop and provide insights that inform policy, practitioners, society and consumers on how to future-proof our care services. Originality/Value: In addition to publishing new research, this special section directly encourages multidisciplinary collaboration between marketing, as a neglected partner, and health/social care disciplines by showcasing the theories and methods that can be used to address our identified four key challenges to integrated care. In a novel approach, practitioner commentaries evaluate the value of each study, placing them in the wider integrated care context and hence pointing out further directions for development

The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial

Background: home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care. Design: a study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC). Methods: participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873). Results: analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time). Conclusions: TC potentially contributes to the amelioration in the decline in users’ mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive U

mPeer: A Mobile Health Approach to Monitoring PTSD in Veterans

More than 2.2 million US service members have seen deployment to Iraq and Afghanistan over the past decade. As the number of veterans returning home has increased, the need for new and innovative approaches to the variety and severity of mental health issues experienced after deployment remains a national priority. Affecting between 15-20\% of the veteran population and largely treatment resistant, Post Traumatic Stress Disorder (PTSD) poses a challenging problem for the mental health community. Recent veteran related studies have suggested a paradigm shift in conceptualizing PTSD in terms of specific high-risk behaviors rather than traditional symptoms. Young and technology savvy, many veteran populations are uniquely poised to embrace mobile health (mHealth) approaches to monitoring and addressing health related issues. In this thesis, we document the design and implementation of a smartphone-based system that coordinates the collection of data potentially relevant for monitoring high-risk behavior in veterans. We describe the details of an unobtrusive smartphone application for the Android platform that collects data from a variety of smartphone sensors and administers daily self-report questionnaires. Finally, we confirm system performance with data from student volunteers