Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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Implementation strategies to enhance the implementation of eHealth programs for patients with chronic illnesses: realist systematic review

Background: There is growing evidence of the positive effects of electronic health (eHealth) interventions for patients with chronic illness, but implementation of such interventions into practice is challenging. Implementation strategies that potentially impact implementation outcomes and implementation success have been identified. Which strategies are actually used in the implementation of eHealth interventions for patients with chronic illness and which ones are the most effective is unclear. Objective: This systematic realist review aimed to summarize evidence from empirical studies regarding (1) which implementation strategies are used when implementing eHealth interventions for patients with chronic illnesses living at home, (2) implementation outcomes, and (3) the relationship between implementation strategies, implementation outcomes, and degree of implementation success. Methods: A systematic literature search was performed in the electronic databases MEDLINE, Embase, PsycINFO, Scopus, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Studies were included if they described implementation strategies used to support the integration of eHealth interventions into practice. Implementation strategies were categorized according to 9 categories defined by the Expert Recommendations for Implementing Change project: (1) engage consumers, (2) use evaluative and iterative strategies, (3) change infrastructure, (4) adapt and tailor to the context, (5) develop stakeholder interrelationships, (6) use financial strategies, (7) support clinicians, (8) provide interactive assistance, and (9) train and educate stakeholders. Implementation outcomes were extracted according to the implementation outcome framework by Proctor and colleagues: (1) acceptability, (2) adoption, (3) appropriateness, (4) cost, (5) feasibility, (6) fidelity, (7) penetration, and (8) sustainability. Implementation success was extracted according to the study authors’ own evaluation of implementation success in relation to the used implementation strategies. Results: The implementation strategies management support and engagement, internal and external facilitation, training, and audit and feedback were directly related to implementation success in several studies. No clear relationship was found between the number of implementation strategies used and implementation success. Conclusions: This is the first review examining implementation strategies, implementation outcomes, and implementation success of studies reporting the implementation of eHealth programs for patients with chronic illnesses living at home. The review indicates that internal and external facilitation, audit and feedback, management support, and training of clinicians are of importance for eHealth implementation. The review also points to the lack of eHealth studies that report implementation strategies in a comprehensive way and highlights the need to design robust studies focusing on implementation strategies in the future.publishedVersio

Gamifying self-management of chronic illnesses: amixed-methods study

Background: Self-management of chronic illnesses is an ongoing issue in health care research. Gamification is a concept that arose in the field of computer science and has been borrowed by many other disciplines. It is perceived by many that gamification can improve the self-management experience of people with chronic illnesses. This paper discusses the validation of a framework (called The Wheel of Sukr) that was introduced to achieve this goal.Objective: This research aims to (1) discuss a gamification framework targeting the self-management of chronic illnesses and (2) validate the framework by diabetic patients, medical professionals, and game experts.Methods: A mixed-method approach was used to validate the framework. Expert interviews (N=8) were conducted in order to validate the themes of the framework. Additionally, diabetic participants completed a questionnaire (N=42) in order to measure their attitudes toward the themes of the framework.Results: The results provide a validation of the framework. This indicates that gamification might improve the self-management of chronic illnesses, such as diabetes. Namely, the eight themes in the Wheel of Sukr (fun, esteem, socializing, self-management, self-representation, motivation, growth, sustainability) were perceived positively by 71% (30/42) of the participants with P value <.001.Conclusions: In this research, both the interviews and the questionnaire yielded positive results that validate the framework (The Wheel of Sukr). Generally, this study indicates an overall acceptance of the notion of gamification in the self-management of diabete

The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida

SHARPP Games for the Education Prevention and Reversion of Chronic Diseases

Prevalence of chronic diseases has become a serious problem in our society. These illnesses are commonly caused by dietary and lifestyle risk factors and are hard to cure completely. However, behavioral changes such as adopting a healthy diet and lifestyle are effective in reducing chronic conditions. In this research, we propose to build games that could support the Sustainable transformation of chronic patients in a Holistic and Adaptable manner using Real-time, Precise, and Persuasive (SHARPP) principles, processes, systems, and technologies. This research leverages wearable information technologies and chronic disease studies to design games that interweave virtual worlds with the real world. It not only supports patients to form healthy habits that prevent and revert chronic diseases but also helps individuals to balance various life dimensions

Building Medical Homes in State Medicaid and CHIP Programs

Presents strategies, best practices, and lessons learned from ten states' efforts to advance the medical home model of comprehensive and coordinated care in Medicaid and Children's Health Insurance Programs in order to improve quality and contain costs

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - TDP (United Kingdom) Case Study Report

The Telecare Development Programme (TDP) case in Scotland (UK) is a patient-centred Integrated Care management process targeting the 65+ population in the country. It particularly addresses vulnerable subgroups of patients and patients with complex illnesses within the 32 communities across Scotland. The TDP case is a funding initiative developed between 2006 and 2011 by the Scottish Government in order to encourage the adoption of the telecare by health and social care services. It sought to demonstrate how telecare could contribute to support the safety and quality of life of older people and enable them to live at home longer, while significantly reducing the cost of health and social care services provisioning. During the period of 2006-2011, no less than 51 telecare projects were operating within all 32 Communities, covering the whole population of Scotland. The starting point of the TDP case was a change in the policy context that required a shift from a healthcare system oriented towards hospital-based treatment to a system based on preventive care to manage long-term conditions. TDP enables vertical integration within the Communities of Health Partnerships (CHPs), but should also promote full integration in a short to medium-term perspective, especially as the new legislative framework coming into force in March-April 2015 aims to integrate health and social care units, as a consequence of a recent health care spending review.JRC.J.3-Information Societ

State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform

Examines ten states' initiatives to address key components of quality and efficiency improvement, including data collection, aggregation, and standardization; public reporting; payment reform; consumer engagement; and provider engagement