Smart Healthcare solutions in China and Europe, an international business perspective

The thesis is part of the Marie Curie Fellowship project addressing health related challenges with IoT solutions. The author tries to address the challenge for the implementation of telehealth solutions by finding out the demand of the telehealth solution in selected European economies and in China (chapter 1), analyzing the emerging business models for telehealth solution ecosystems in China (chapter 2), how to integrate telehealth solutions with institutional stakeholders (chapter 3) and why are elderly users willing to use telehealth solutions in China. Chapter 1 and chapter 2 form the theoretical background for empirical work in chapter 3 and chapter 4. The thesis addressed four research questions, namely “Which societal and social-economics unmet needs that Internet of Healthcare Things can help to resolve?”, “What are the business model innovation for tech companies in China for the smart health industry?”, “What are the facilitators and hurdles for implementing telehealth solutions”, “Are elderly users willing to use telehealth solutions in China?”. Both qualitative study and quantitative analysis has been made based on data collected by in depth interviews with stakeholders, focus group study work with urban and rural residents in China. The digital platform framework was used in chapter 2 as the theoretical framework where as the stakeholder power mapping framework was used in chapter 3. The discretion choice experiment was used in chapter 4 to design questionnaire study while ordered logit regression was used to analyze the data. Telehealth solutions have great potential to fill in the gap for lack of community healthcare and ensuring health continuity between home care setting, community healthcare and hospitals. There is strong demand for such solutions if they can prove the medical value in managing chronic disease by raising health awareness and lowering health risks by changing the patients’ lifestyle. Analyzing how to realize the value for preventive healthcare by proving the health-economic value of digital health solutions (telehealth solutions) is the focus of research. There remain hurdles to build trust for telehealth solutions and the use of AI in healthcare. Next step of research can also be extended to addressing such challenges by analyzing how to improve the transparency of algorithms by disclosing the data source, and how the algorithms were built. Further research can be done on data interoperability between the EHR systems and telehealth solutions. The medical value of telehealth solutions can improve if doctors could interpret data collected from telehealth solutions; furthermore, if doctors could make diagnosis and provide treatment, adjust healthcare management plans based on such data, telehealth solutions then can be included in insurance packages, making them more accessible

Toward Universal Broadband in Rural Alaska

The TERRA-Southwest project is extending broadband service to 65 communities in the Bristol Bay, Bethel and Yukon-Kuskokwim regions. A stimulus project funded by a combination of grants and loans from the Rural Utilities Service (RUS), TERRA-Southwest has installed a middle-mile network using optical fiber and terrestrial microwave. Last-mile service will be through fixed wireless or interconnection with local telephone networks. The State of Alaska, through its designee Connect Alaska, also received federal stimulus funding from the National Telecommunications and Information Administration (NTIA) for tasks that include support for an Alaska Broadband Task Force “to both formalize a strategic broadband plan for the state of Alaska and coordinate broadband activities across relevant agencies and organizations.” Thus, a study of the impact of the TERRA project in southwest Alaska is both relevant and timely. This first phase provides baseline data on current access to and use of ICTs and Internet connectivity in rural Alaska, and some insights about perceived benefits and potential barriers to adoption of broadband. It is also intended to provide guidance to the State Broadband Task Force in determining how the extension of broadband throughout the state could contribute to education, social services, and economic activities that would enhance Alaska’s future. Results of the research could also be used proactively to develop strategies to encourage broadband adoption, and to identify applications and support needed by users with limited ICT skills.Connect Alaska. The National Telecommunications and Information Administration. General Communications Incorporated.Part 1: An Analysis of Internet Use in Southwest Alaska / Introduction / Previous Studies / Current Connectivity / Analytical Framework and Research Methodology / Demographics / Mobile Phones: Access and Use / Access to the Internet / Internet Useage / Considerations about Internet Service / Interest in Broadband / Sources of News / Comparison with National Data / Internet Use by Businesses and Organizations / What Difference may Broadband make in the Region? / Conclusiongs / Part 2 Literature Review / Reference

Digital health reimbursement strategies of 8 European countries and Israel: scoping review and policy mapping

Background: The adoption of digital health care within health systems is determined by various factors, including pricing and reimbursement. The reimbursement landscape for digital health in Europe remains underresearched. Although various emergency reimbursement decisions were made during the COVID-19 pandemic to enable health care delivery through videoconferencing and asynchronous care (eg, digital apps), research so far has primarily focused on the policy innovations that facilitated this outside of Europe. Objective: This study examines the digital health reimbursement strategies in 8 European countries (Belgium, France, Germany, Italy, the Netherlands, Poland, Sweden, and the United Kingdom) and Israel. Methods: We mapped available digital health reimbursement strategies using a scoping review and policy mapping framework. We reviewed the literature on the MEDLINE, Embase, Global Health, and Web of Science databases. Supplementary records were identified through Google Scholar and country experts. Results: Our search strategy yielded a total of 1559 records, of which 40 (2.57%) were ultimately included in this study. As of August 2023, digital health solutions are reimbursable to some extent in all studied countries except Poland, although the mechanism of reimbursement differs significantly across countries. At the time of writing, the pricing of digital health solutions was mostly determined through discussions between national or regional committees and the manufacturers of digital health solutions in the absence of value-based assessment mechanisms. Financing digital health solutions outside traditional reimbursement schemes was possible in all studied countries except Poland and typically occurs via health innovation or digital health-specific funding schemes. European countries have value-based pricing frameworks that range from nonexistent to embryonic. Conclusions: Studied countries show divergent approaches to the reimbursement of digital health solutions. These differences may complicate the ability of patients to seek cross-country health care in another country, even if a digital health app is available in both countries. Furthermore, the fragmented environment will present challenges for developers of such solutions, as they look to expand their impact across countries and health systems. An increased emphasis on developing a clear conceptualization of digital health, as well as value-based pricing and reimbursement mechanisms, is needed for the sustainable integration of digital health. This study can therein serve as a basis for further, more detailed research as the field of digital health reimbursement evolves

Guidelines for TMS/tES Clinical Services and Research through the COVID-19 Pandemic

BACKGROUND: The COVID-19 pandemic has broadly disrupted biomedical treatment and research including non-invasive brain stimulation (NIBS). Moreover, the rapid onset of societal disruption and evolving regulatory restrictions may not have allowed for systematic planning of how clinical and research work may continue throughout the pandemic or be restarted as restrictions are abated. The urgency to provide and develop NIBS as an intervention for diverse neurological and mental health indications, and as a catalyst of fundamental brain research, is not dampened by the parallel efforts to address the most life-threatening aspects of COVID-19; rather in many cases the need for NIBS is heightened including the potential to mitigate mental health consequences related to COVID-19. OBJECTIVE: To facilitate the re-establishment of access to NIBS clinical services and research operations during the current COVID-19 pandemic and possible future outbreaks, we develop and discuss a framework for balancing the importance of NIBS operations with safety considerations, while addressing the needs of all stakeholders. We focus on Transcranial Magnetic Stimulation (TMS) and low intensity transcranial Electrical Stimulation (tES) - including transcranial Direct Current Stimulation (tDCS) and transcranial Alternating Current Stimulation (tACS). METHODS: The present consensus paper provides guidelines and good practices for managing and reopening NIBS clinics and laboratories through the immediate and ongoing stages of COVID-19. The document reflects the analysis of experts with domain relevant expertise spanning NIBS technology, clinical services, and basic and clinical research - with an international perspective. We outline regulatory aspects, human resources, NIBS optimization, as well as accommodations for specific demographics. RESULTS: A model based on three phases (early COVID-19 impact, current practices, and future preparation) with an 11-step checklist (spanning removing or streamlining in-person protocols, incorporating telemedicine, and addressing COVID-19-associated adverse events) is proposed. Recommendations on implementing social distancing and sterilization of NIBS related equipment, specific considerations of COVID-19 positive populations including mental health comorbidities, as well as considerations regarding regulatory and human resource in the era of COVID-19 are outlined. We discuss COVID-19 considerations specifically for clinical (sub-)populations including pediatric, stroke, addiction, and the elderly. Numerous case-examples across the world are described. CONCLUSION: There is an evident, and in cases urgent, need to maintain NIBS operations through the COVID-19 pandemic, including anticipating future pandemic waves and addressing effects of COVID-19 on brain and mind. The proposed robust and structured strategy aims to address the current and anticipated future challenges while maintaining scientific rigor and managing risk

Citizen-Patient Involvement in the Development of mHealth Technology:Protocol for a Systematic Scoping Review

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European Arctic Initiatives Compendium

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COVID-19 Pandemic and Remote Consultations in Children: A Bibliometric Analysis.

Telemedicine is becoming a standard method of consultation, and the COVID-19 pandemic has increased its need. Telemedicine is suitable for non-communicable diseases (NCDs) in the pediatric population, as these are chronic conditions that affect many children worldwide. The aim of this study was to analyze the bibliometric parameters of publications on the use of telemedicine for the most common NCDs in children before and after the COVID-19 pandemic. Following the electronic search, 585 records were selected. "Metabolic diseases" was the most frequent topic before and after the pandemic, accounting for 34.76% in 2017-2019 and 33.97% in 2020-2022. The average IF of the journals from which records were retrieved was 5.46 ± 4.62 before and 4.58 ± 2.82 after the pandemic, with no significant variation. The number of citations per reference averaged 14.71 ± 17.16 in 2017-2019 (95% CI: 12.07; 17.36) and 5.54 ± 13.71 in 2020-2022 (95% CI: 4.23; 6.86). Asthma, metabolic diseases, and neurodevelopmental disorders were the most explored topics. A relevant finding concerns the increasing number of observational studies after the pandemic, with a reduction of the interventional studies. The latter type of study should be recommended as it can increase the evaluation of new strategies for the management of NCDs

ICT-Enabled Social Innovation to support the Implementation of the Social Investment Package: Mapping and Analysis of ICT-enabled Social Innovation initiatives promoting social investment in integrated approaches to the provision of social services: IESI Knowledge Map 2015

This report presents the analysis of the Mapping 2015 of the project 'ICT-enabled Social Innovation to support the Implementation of the Social Investment Package' (IESI). It provides an enriched picture of the existing knowledge base and evidence of how ICT-enabled social innovation initiatives that promote social investment through integrated approaches to social services delivery can contribute to the policy objectives of the EU Social Investment Package (SIP) to support the achievement of the goals of the EU 2020 strategy in terms of inclusive growth and employment. After having introduced the policy and research background outlining the overall objectives and scope of the IESI research and the aim of the mapping 2015, the report provides an overview of the methodology followed for enriching the IESI inventory of ICT-enabled social innovation initiatives through a structured dynamic database and by conducting the mapping and analysis of a selected sample of 210 initiatives. The report then updates the review of the literature and practice in domains related to the role and impact of ICT-enabled social innovation promoting social investment, with a specific focus on the area of active and healthy ageing and long-term care for older people, particularly the theme: prevention, health promotion and rehabilitation. In reviewing the state of the art the report discusses the degree of deployment of ICT-enabled social innovations that promote social investment through integrated approaches to social services provision in terms of geographical spread and different areas of social services covered, providing insight into the levels and types of deployment achieved. Further, the IESI conceptual framework which underpins the research and which has been used to guide the mapping and analysis of initiatives is discussed, proposing additional dimensions in order to enrich the framework of analysis itself. Evolving theoretical approaches are taken into account, the aim being to better explain the implications ICT-enabled social innovation initiatives have or may have for social policy reforms. This is followed by an overview of the consolidated results of the analysis of the initiatives collected as part of the IESI mapping exercise in 2014 and 2015. The analysis presents the IESI Knowledge Map 2015, which aims to provide a better understanding of the main characteristics and patterns of the initiatives identified, according to the IESI conceptual framework. Reference is also made to the different welfare systems and social services delivery models which characterise various EU countries in order to contextualise the potential role played by ICT-enabled social innovation to promote social investment through integrated approaches to social services delivery. The findings of specific thematic analyses conducted on a set of selected topics: 1) the role of social enterprise-driven ICT-enabled social innovation initiatives in support of social services delivery; and the implications of ICT-enabled social innovation that promote social investment through integrated approaches to social services delivery in support of: 2) active inclusion of young people; and 3) active and healthy ageing and long-term care for older people, particularly as regards prevention, health promotion and rehabilitation are then presented. Finally, the main conclusions deriving from the analysis of the mapping in terms of the contribution made by ICT-enabled social innovation promoting social investment through integrated approaches to social services delivery to the implementation of the SIP are outlined. This is complemented by an analysis of the gaps identified; the limitations of the current mapping exercise and recommendations for future research, as well as implications and possible directions for policy.JRC.J.3-Information Societ

Report of Senior Arctic Officials to Ministers at the 5th Arctic Council Ministerial Meeting October 2006

Report of Senior Arctic Official to Arctic Council Ministers, Salekhard, Russian Federation, October 2006. Reviews the progress reports of the Working Groups and priorities of the Arctic Council moving forward into the next interministerial period