Digital transformation in healthcare: Analyzing the current state-of-research

Abstract Digital transformation in healthcare is of increasing relevance for both scholars and practitioners in the field. Our article attempts to assess the research question how multiple stakeholders implement digital technologies for management and business purposes. To answer this question, we perform a systematic literature review about the state of the art of digital transformation in healthcare. Our findings show that prior research falls into five clusters: operational efficiency by healthcare providers; patient-centered approaches; organizational factors and managerial implications; workforce practices; and socio-economic aspects. These clusters are linked together into a model showing how these various forms of technology implementation lead to operational efficiencies for services providers. Various directions for future research and management implications are offered

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

ICT Framework to Support a Patient-Centric approach in Public Healthcare: A Case Study of Malawi

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings

Innovation in diabetic care : from patient-centered care to public policies to reduce the impact of diabetes

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022Introdução A diabetes, nomeadamente a diabetes tipo 2, é uma doença crónica, que necessita de cuidados de saúde em continuidade, de longa duração e muitas vezes multidisciplinares. A diabetes consome vastos recursos de saúde, financeiros e de assistência social, exigindo, em todos os níveis de cuidados de saúde, e às famílias um grande esforço. Sendo uma doença que exige capacitação do paciente, literacia, adesão ao tratamento e promoção de comportamentos saudáveis, é também o paradigma de uma doença onde a relação com os profissionais de saúde e o cuidado centrado no paciente são fatores fundamentais para seu controle. A saúde tem sido palco de muitas inovações, tanto tecnológicas, como também de gestão, prática clínica, farmacológicas, dispositivos vários e uso da informação. Os cuidados na diabetes e outras doenças crónicas estão na linha de frente do desenvolvimento, testagem e implementação destas inovações, o que iremos ilustrar ao longo deste trabalho. Objetivo Identificar e analisar como a inovação nos cuidados prestados aos doentes com diabetes tem vindo a alterar a capacidade de prestar cuidados centrados no doente, e demonstrar abertura a novas iniciativas e ao desenvolvimento de políticas públicas de gestão em saúde, financiamento, tecnologia/informação e sociais com vista providenciar melhores cuidados e reduzir os impactos desta doença. Neste contexto, é nosso objetivo descrever, conceptualizar e sistematizar como a inovação tem evoluído e influenciado os cuidados ao paciente diabético e identificar os respetivos impactos. Métodos Procedeu-se à revisão da literatura usando as bases de dados PubMed, Scopus e Word of Science, pesquisando a associação entre diabetes tipo 2 e inovação. Foram encontrados 254 artigos. A partir da seleção desses trabalhos foi efetuada uma busca manual de artigos a descrever, ilustrar e avaliar as inovações identificadas, num total de 69 artigos.Resultados No âmbito dos cuidados aos doentes com diabetes, foram identificados dezasseis processos de inovação com inegável relevância em quatro áreas – três casos de inovação em gestão, quatro financeiras, seis tecnológicas e três de ação social. Conclusão Constata-se que as diversas categorias de inovação estão interligadas e são complementares, possibilitando oferecer melhores cuidados centrados no paciente, ao mesmo tempo que vislumbram a necessidade de proceder ao “redesenho” dos sistemas e serviços de saúde. Admite-se que, no futuro, a sua adequada integração acarretaria melhores cuidados e permitiria reduzir o impacto da diabetes, podendo vir a ser o modelo a utilizar no manejo de outras doenças crónicas.Background Diabetes, namely type-2 diabetes, is a chronic disease that requires continuous, long-term, and often multidisciplinary medical care. Diabetes consumes a vast amount of health, financial and social care resources, demanding great efforts at all levels of health care and families. As a disease that requires patient training, literacy, adherence to treatment, and the promotion of healthy behaviors, it is also the paradigm of a disease where health professionals’ relationship and patient-centered care are key factors for its control. Health has been the scene of many innovations, both technological, as well as management, clinical practice, medication, a wide variety of devices, and information uses. Diabetic, and of other chronic diseases, is at the forefront of the development, testing, and implementation of these innovations, which we will illustrate throughout this work. Aim Identify and analyze how innovation in care provided to patients with diabetes has been changing the ability to provide patient-centered care, and open-up new initiatives and development of public policies in health, financing, technological/information and social management with the view to provide better care and reduce the impacts of this disease. In this context, we will describe, conceptualize and systematize how innovation has evolved and influenced diabetic patient care and identify the respective impacts. Methods A literature review was carried out using PubMed, Scopus, and Word of Science databases, investigating the association between type 2 diabetes and innovation. Two hundred and fifty-four articles were found. From the research, a manual search of articles aiming to describe, exemplify, and evaluate the innovations in diabetes care, was carried out, resulting in a total of 69 articles.Results Four main areas were identified within the scope of diabetes patients’ care, in which innovation processes are present with undeniable relevance – management, financial, technological, and social action, which will be analyzed on the course of this work. Conclusion It was possible to observe that the different categories of innovation are interconnected and complementary, making it possible to offer better patient-centered care, while at the same time envisioning the need to “redesign” of health systems and services. It is accepted that, in the future, their appropriate integration would lead to better care and reduce the impact of diabetes, as well as potentially become the model that could be used in the management of other chronic diseases

Empowering Diabetes Patient with Mobile Health Technologies

Chronic diseases, especially diabetes mellitus, are huge public health burden. Therefore, new health care models for sharing the responsibility for care among health care providers and patients themselves are needed. The concept of empowerment promotes patient’s active involvement and control over their own health. It can be achieved through education, self-management, and shared decision making. All these aspects can be covered by mobile health technologies, the so-called mHealth. This term comprises mobile phones, patient monitoring devices, tablets, personal digital assistants, other wireless devices, and numerous apps. Many challenges of diabetics can be addressed by mHealth, including glycemic control, nutrition control, physical activity, high blood pressure, medication adherence, obesity, education, diabetic retinopathy screening, diabetic foot screening, and psychosocial care. However, mHealth plays only minor role in diabetes management, despite numerous apps on the market. Namely, these apps have many shortcomings and the majority of them does not include important functions. Moreover, these apps lack the perceived additional benefit by the user and the ease of use, important factors for acceptance of mHealth. Studies of diabetes apps regarding usability and accessibility have shown moderate results. Beside improvements of apps usability, the future of diabetes mHealth lies probably in personalized education and self-management with the help of decision support systems. At the same time, work on artificial pancreas is in progress and smartphone could be used as user interface

Patient portals

Patient portals can give patients access to a personal health record and enable interaction with the health care system. Patient portals are creating unprecedented opportunities for using health IT to deliver care to patients, paving the way for benefits to patients, providers and the organizations that implement the portals. The objective of this dissertation has been to explore the role of the organizational context by identifying and describing factors affecting portals in different types of health service systems. We have let the following four questions guide the research. 1. What outcomes have been achieved through patient portals and how are these outcomes achieved? 2. How does the health service system context, in particular health service system integration or fragmentation, impact patient portal development and ability to achieve beneficial outcomes? 3. With focus on fragmented health service systems, how can patient portal development and achievement of beneficial outcomes be improved? 4. How can the existing evidence base inform patient portal development across health service systems and how can this evidence base be advanced? In answering these questions, we studied portals in integrated and fragmented health service systems in the United States and in the Netherlands. We relied on multiple qualitative methods, including literature review, document analysis, and interviews

Enhancing Confidentiality and Privacy Preservation in e-Health to Enhanced Security

Electronic health (e-health) system use is growing, which has improved healthcare services significantly but has created questions about the privacy and security of sensitive medical data. This research suggests a novel strategy to overcome these difficulties and strengthen the security of e-health systems while maintaining the privacy and confidentiality of patient data by utilising machine learning techniques. The security layers of e-health systems are strengthened by the comprehensive framework we propose in this paper, which incorporates cutting-edge machine learning algorithms. The suggested framework includes data encryption, access control, and anomaly detection as its three main elements. First, to prevent unauthorised access during transmission and storage, patient data is secured using cutting-edge encryption technologies. Second, to make sure that only authorised staff can access sensitive medical records, access control mechanisms are strengthened using machine learning models that examine user behaviour patterns. This research's inclusion of machine learning-based anomaly detection is its most inventive feature. The technology may identify variations from typical data access and usage patterns, thereby quickly spotting potential security breaches or unauthorised activity, by training models on past e-health data. This proactive strategy improves the system's capacity to successfully address new threats. Extensive experiments were carried out employing a broad dataset made up of real-world e-health scenarios to verify the efficacy of the suggested approach. The findings showed a marked improvement in the protection of confidentiality and privacy, along with a considerable decline in security breaches and unauthorised access events