Citizens’ Juries: When Older Adults Deliberate on the Benefits and Risks of Smart Health and Smart Homes

open access articleBackground: Technology-enabled healthcare or smart health has provided a wealth of products and services to enable older people to monitor and manage their own health conditions at home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite the growing ubiquity of smart health, innovations are often technically driven, and the older user does not often have input into design. The purpose of the current study was to facilitate a debate about the positive and negative perceptions and attitudes towards digital health technologies. Methods: We conducted citizens’ juries to enable a deliberative inquiry into the benefits and risks of smart health technologies and systems. Transcriptions of group discussions were interpreted from a perspective of life-worlds versus systems-worlds. Results: Twenty-three participants of diverse demographics contributed to the debate. Views of older people were felt to be frequently ignored by organisations implementing systems and technologies. Participants demonstrated diverse levels of digital literacy and a range of concerns about misuse of technology. Conclusion: Our interpretation contrasted the life-world of experiences, hopes, and fears with the systems-world of surveillance, e ciencies, and risks. This interpretation o ers new perspectives on involving older people in co-design and governance of smart health and smart homes

Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare

An overview of the research evidence on ethnicity and communication in healthcare

• The aim of the present study was to identify and review the available research evidence on 'ethnicity and communication' in areas relevant to ensuring effective provision of mainstream services (e.g. via interpreter, advocacy and translation services); provision of services targeted on communication (e.g. speech and language therapy, counselling, psychotherapy); consensual/ participatory activities (e.g. consent to interventions), and; procedures for managing and planning for linguistic diversity

Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application : a cross sectional exploratory study

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting. Objective To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care. Method Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed. Results There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice. Conclusions Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions

Patient Access to Electronic Health Records: Strengths, weaknesses and what’s needed to move forward

Electronic health records (EHRs) are desired by both physicians and patients, but the transition to and acceptance of sensitive health information online has been slow. This paper reviews the current literature on EHR adoption and outlines barriers, advantages and explicit steps for moving toward the EHR ubiquity. Potential benefits of EHRs to patients and physicians include reduced costs for patients, hospitals and insurance providers, patient empowerment, less errors in records and better health outcomes, but security and privacy concerns, cost of implementation and poor electronic records management system design have proved barriers to adoption

Towards a new framework for nursing education and training in developing countries

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The advancement in ICT in recent decades has transformed every aspect of life, including medical care. The most sophisticated example of this is electronic health (e-health), which in developed counties has been a major contributor to enhancing the overall quality of healthcare services. However, e-health remains primitive in developing countries, whether they are relatively poor like Jordan or wealthy like Qatar. Barriers to successful e-health adoption in developing countries are attributable either to superimposing the technology itself while ignoring staff preparedness to integrated e-health or financial inhibitions to making such fundamental changes to healthcare delivery. Staff preparedness is related to educating or training healthcare staff, particularly nurses, who have fewer opportunities to attend training, or are sometimes ignored. Hence, the focus of this research is to evaluate the preparedness of nursing community for e-health adaption in the developing countries, taking Qatar and Jordan as case studies, in order to identify existing challenges and the key requirements to establish an educational framework that can be integrated in nursing curricula or professional development to promote e-health adaptation by nurses. This research critically reviews previous literature related to the research project, identifying the challenges to e-health preparedness, and analyses nursing and midwifery curricula from different countries with regard to e-health and ICT. The findings show that e-health modules are not generally included in any higher education nursing programme, with only a few transcripts showing basic computing or ICT modules. E-health national strategies for both Jordan and Qatar were analysed to identify whether the inclusion of professional training on e-health has been considered as part of e-heath strategy. In addition, analysis of e-health national strategies for other leading countries in the field of e-heath was conducted, finding that there is a decided gap between developed and developing countries with regard to e-health. The level of readiness in nursing was investigated and to identify the main barriers for using e-health/e-nursing in Jordan and Qatar. The results showed the top challenges facing e-health are educational-related aspects, hence a plan for promoting and providing education on the benefits and use of ehealth processes and applications is advised, with prerequisite ICT training, as the results showed that nurses lack sufficient knowledge about e-health processes and applications. The findings from earlier tasks were used to identify the requirements and then propose the framework to achieve main goal of this research in providing a roadmap. The framework was constructed in accordance to with the Technology Acceptance Model (TAM), followed by evaluation by different expert groups. All the groups voted for the suggested structure of the framework to be taken to the next phase of deployment. The final task was to evaluate the attitude of the nursing community working towards the possibility of implementing an e-learning system, which has been presented as the main platform in the proposed framework. The findings have demonstrated a very positive attitude from the nursing staff towards the idea of using e-learning. There also does not appear to be any apparent obstacles to deploying the concept of e-health as the audience in question have the necessary computer skills. In summary, this research project has contributed in presenting framework and some useful findings related to e-health in general and in Qatar and Jordan in particular. The proposed framework can be as a roadmap for future e-heath/e-nursing projects, in addition, it can be utilised with some modifications to foster similar electronic applications

A cross-sectional study of discipline-based self-perceived digital literacy competencies of nursing students.

This study offers an empirical exploration of self-assessed digital competencies of students, most of whom studied in nursing courses, using a discipline-based self-assessment survey tool. A range of digital competencies were explored: information and communication technology proficiency and productivity, information literacy, digital creation, digital research, digital communication, digital learning and development, digital innovation, digital identity management and digital wellbeing. Quantitative data were collected from November to December 2021 via a questionnaire survey administered to students. Quantitative results were reported through descriptive statistical analysis. Mann-Whitney (U-test) and Kruskal-Wallis non-parametric statistical tests were used to identify statistically significant differences, based on age demographics and pre- or post-registration course. Thematic analysis was utilized for survey open-ended questions data. Students reported low competencies in the following digital literacy dimensions, all of which were imperative for their studies and for their future professional careers: information literacy, digital research, digital innovation. Significant statistical subgroup differences were found between age demographics and pre/post registration within most of the digital competence dimensions. The survey open-ended comments revealed that students encountered challenges around digital skills they had mostly developed via everyday life experiences, and trial-and-error approaches. Increasing awareness of existing digital gaps and offering tailored digital skills enhancement can empower students as future-proof evidence-based practitioners in an evolving digital healthcare landscape