Evaluation of mobile apps for treatment of patients at risk of developing gestational diabetes

This study evaluates mobile apps using a theory-based evaluation framework to discover their applicability for patients at risk of gestational diabetes. This study assessed how well the existing mobile apps on the market meet the information and tracking needs of patients with gestational diabetes and evaluated the feasibility of how to integrate these apps into patient care. A search was conducted in the Apple iTunes and Google Play store for mobile apps that contained keywords related to the following concepts of nutrition: diet, tracking, diabetes, and pregnancy. Evaluation criteria were developed to assess the mobile apps on five dimensions. Overall, the apps scored well on education and information functions and scored poorly on engagement functions. There are few apps that provide comprehensive evidence-based educational content, tracking tools, and integration with electronic health records. This study demonstrates the need to develop apps that have comprehensive content, tracking tools, and ability to bidirectionally share data

Suitability of Fast Healthcare Interoperability Resources (FHIR) for Wellness Data

Wellness data generated by patients using smart phones and portable devices can be a key part of Personal Health Record (PHR) data and offers healthcare service providers (healthcare providers) patient health information on a daily basis. Prior research has identified the potential for improved communication between healthcare provider and patient. However the practice of sharing patient generated wellness data has not been widely adopted by the healthcare sector; one of the reasons being the lack of interoperability preventing successful integration of such device generated data into the PHR and Electronic Health Record (EHR) systems. To address the interoperability issue it is important to make sure that wellness data can be supported in healthcare information exchange standards. Fast Healthcare Interoperability Resources (FHIR) is used in the current research study to identify the technical feasibility for patient generated wellness data. FHIR is expected to be the future healthcare information exchange standard in the healthcare industry. \ A conceptual data model of wellness data was developed for evaluation using FHIR standard. The conceptual data model contained blood glucose readings, blood pressure readings and Body Mass Index (BMI) data and could be extended to accept other types of wellness data. The wellness data model was packaged in an official FHIR resource called Observation. The research study proved the flexibility of adding new data elements related to wellness in Observation. It met the requirements in FHIR to include such data elements useful in self-management of chronic diseases. It also had the potential in sharing it with the healthcare provider system.

Health information technology implementation - Impacts and policy considerations: a comparison between Israel and Portugal

The use of Information and Communications Technology (ICT) in health systems is increasing worldwide. While it is assumed that ICT holds great potential to make health services more efficient and grant patients more empowerment, research on these trends is at an early stage. Building on a study of the impact of ICT on physicians and patients in Israel, a Short Term Scientific Mission (STSM) sponsored by COST Net in conjunction with CIES/ISCTE IUL (Portugal) facilitated a comparison of ICT in health in Israel and Portugal. The comparison focused on patient empowerment, physician behavior and the role of government in implementing ICT. The research in both countries was qualitative in nature. In-depth interviews with the Ministry of Health (MOH), the private sector, patients associations, health plans and researchers were used to collect data. Purposeful sampling was used to select respondents, and secondary sources were used for triangulation. The findings indicate that respondents in both countries feel that patient empowerment has indeed been furthered by introduction of ICT. Regarding physicians, in both countries ICT is seen as providing more information that can be used in medical decision making. Increased access of patients to web-based medical information can strengthen the role of patients in decision making and improve the physician-patient relationship, but also shift the latter in ways that may require adjustments in physician orientation. Physician uptake of ICT in both countries involves overcoming certain barriers, such as resistance to change. At the national level, important differences were found between the two countries. While in Israel, ICT was promoted and adopted by the meso level of the health system, in particular the health plans and government intervention can be found in a later stage, in Portugal the government was the main developer and national strategies were built from the beginning. These two approaches present different advantages and disadvantages. Government involvement in earlier stages could provide benefit in terms of interoperability of systems between different healthcare organizations. However, innovation could be slowed down due to government bureaucracy or lack of leadership. The work provides information in order to understand and improve ICT services. Additionally, it provides input regarding impact of ICT on the physician/patient relationship and national policies in the area.info:eu-repo/semantics/publishedVersio

Patient generated health data and electronic health record integration, governance and socio-technical issues: A narrative review

Patients’ health records have the potential to include patient generated health data (PGHD), which can aid in the provision of personalized care. Access to these data can allow healthcare professionals to receive additional information that will assist in decision-making and the provision of additional support. Given the diverse sources of PGHD, this review aims to provide evidence on PGHD integration with electronic health records (EHR), models and standards for PGHD exchange with EHR, and PGHD-EHR policy design and development. The review also addresses governance and socio-technical considerations in PGHD management. Databases used for the review include PubMed, Scopus, ScienceDirect, IEEE Xplore, SpringerLink and ACM Digital Library. The review reveals the significance, but current deficiency, of provenance, trust and contextual information as part of PGHD integration with EHR. Also, we find that there is limited work on data quality, and on new data sources and associated data elements, within the design of existing standards developed for PGHD integration. New data sources from emerging technologies like mixed reality, virtual reality, interactive voice response system, and social media are rarely considered. The review recommends the need for well-developed designs and policies for PGHD-EHR integration that promote data quality, patient autonomy, privacy, and enhanced trust

Evaluation of data usability generated by wearables & IoT-enabled home use medical devices via Telehealth to identify if blockchain can solve potential challenges

The adoption of blockchain shows a variety of benefits owing to an incorruptible digital ledger and a decentralized database. This has eliminated the need for a gatekeeper to oversee all associated transactions. Blockchain, the underlying technology behind bitcoin and other crypto-currencies, has found use in many industries besides finance, such as healthcare, where it has shown promise in several use-cases. Patient data is collected using a plethora of devices, such as wearables or IoT-enabled home use medical devices. These types of devices are utilized in telehealth and provide the ability to remotely monitor the patient’s health condition. This requires the patient to perform measurements themselves in their home (such as vital signs), which puts the burden of reliable and precised patient exam data in the hands of the patients. The purpose of this quantitative study is to increase the understanding of what factors affect data usability generated by these devices, with the findings that the surveyed medical professionals are concerned that patients may have issues setting up the device in the home, operating the device properly (including not positioning themselves or the device correctly), the provider not knowing where the patient resides during measurement, or the patient’s inability to determine when a device has malfunctioned. Upon analyzing blockchain’s capabilities, it was discovered that blockchain cannot fix all identified hurdles, however, it can be used (in conjunction with smart contracts) to limit invalid data transmission to the provider. It was discussed that blockchain may also be utilized to overcome interoperability issues caused by the inability of most Electronic Medical Records (EMRs – sometimes also referred to as Electronic Health Record – EHR) to communicate and provide the patient governance of his/her own medical record. While there are interoperability issues amongst blockchain themselves, Estonia, for instance, has harnessed the power of a single blockchain for digital security and has overcome this interoperability issue

The Trajectory of IT in Healthcare at HICSS: A Literature Review, Analysis, and Future Directions

Research has extensively demonstrated that healthcare industry has rapidly implemented and adopted information technology in recent years. Research in health information technology (HIT), which represents a major component of the Hawaii International Conference on System Sciences, demonstrates similar findings. In this paper, review the literature to better understand the work on HIT that researchers have conducted in HICSS from 2008 to 2017. In doing so, we identify themes, methods, technology types, research populations, context, and emerged research gaps from the reviewed literature. With much change and development in the HIT field and varying levels of adoption, this review uncovers, catalogs, and analyzes the research in HIT at HICSS in this ten-year period and provides future directions for research in the field

Patient Generated Health Data: Framework for Decision Making

Patient information is a major part of healthcare decision making. Although currently scattered due to multiple sources and diverse formats, decision making can be improved if the patient information is readily available in a unified manner. Mobile technologies can improve decision making by integrating patient information from multiple sources. This study explores how patient generated health data (PGHD) from multiple sources can lead to improved healthcare decision making. A semi-systematic review is conducted to analyze research articles for transparency, clarity, and complete reporting. We conceptualize the data generated by healthcare professional as primarily from EHR/EMR and the data generated by patient as primarily from mobile apps and wearables. Eight themes led to the development of Convergence Model for Patient Data (CMPD). A framework was developed to illustrate several scenarios, to identify quality and timeliness requirements in mobile healthcare environment, and to provide necessary decision support

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution