Health specialists’ views on the needs for developing a digital gaming solution for paediatric day surgery

Abstract Aims and objectives: To describe the views on the needs of health specialists to consider when developing a digital gaming solution for children and families in a paediatric day surgery. Background: Children’s day surgery treatment is often cancelled at the last minute for various reasons, for example due to the lack of information. Digital gaming solutions could help families to be better oriented to the coming treatment. Despite the increasing demands for mHealth systems, there is not enough evidence‐based information from the health specialist perspective for developing a digital gaming solution. Design: A qualitative descriptive study was conducted. Methods: Health specialists (N = 15) including 11 nurses, one physiotherapist and four doctors from different areas from one university hospital in Finland were recruited using a snowball sampling method. Semi‐structured, face‐to‐face interviews were conducted in March and April 2019. The data were analysed using inductive conduct analyses. The COREQ checklist was used to report the data collection, analysis and the results. Results: The data yielded 469 open codes, 21 sub‐categories, three upper categories and one main category. The main category the digital gaming solution to support knowledge, care and guidance in children’s day surgery included three upper categories: (a) support for preoperative information and guidance, (b) support for intra‐operative information and care, and (c) support for postoperative information, care and guidance. Conclusion: Digital gaming solutions could be used to help children and families to be better prepared for upcoming treatments, to support communication in different languages and to improve children’s pain management after operations. Relevance to clinical practice: Evidence‐based information is important to ensure that future digital solutions answer the real needs of the staff and patients. There is a need for families and children’s views to be taken into consideration when developing digital gaming solutions in the hospital context

Emerging revenue models for personal data platform operators:when individuals are in control of their data

Abstract Purpose: This paper identifies emerging revenue models for personal data platform operators that facilitate the exchange of resources between an individual and a service provider for their mutual benefit. Context of this study is human-centered personal data management, which refers to individuals being able to control the use and access of their personal data for third-party services. Design: This research is conducted by analysing qualitative questionnaire data from 27 organizations from 12 different countries that are considered as forerunners in creating services in this context. Findings: Our study shows that personal data platform operators can generate revenue by combining transaction-, service-, connection- and membership fees. The study also reveals context-specific propositions for the foundation of revenue model creation. Monetising personal data in the form of advertising like we know it today is explicitly avoided among personal data platform operators. Research limitations/implications: This study calls for further research about how does providing control over personal data to individuals influence on business models of platform operators and other service providers in the market. Practical implications: For practitioners, this research offers new insights on revenue models that are being developed by the forerunners of human-centered personal data management approach in the European market. Originality/value: Revenue models for personal data platform operators when taking a human-centered approach to personal data management. Propositions to consider when creating revenue models in this context

Healthcare professionals’ proposed eHealth needs in elective primary fast-track hip and knee arthroplasty journey:a qualitative interview study

Abstract Aims and objectives: This study examined the lived experience of healthcare professionals providing care for patients with total hip and knee arthroplasty. The aim of this study is to understand healthcare professionals’ proposed eHealth needs in elective primary fast‐track hip and knee arthroplasty journey. Background: There is little evidence in nursing literature to indicate how to develop new eHealth services to support surgical care journeys. Evidence is particularly lacking regarding the development of eHealth solutions. Design: This was a qualitative interview study. Methods: Semi‐structured interviews were conducted with four surgeons, two anaesthesiologists, ten nurses, and four physiotherapists in a single joint replacement centre during autumn 2018. The data were analysed using an inductive content analysis method. NVivo qualitative data analysis software was used. The COREQ checklist for qualitative studies was followed. Results: Our research addressed the gap in evidence by focusing on the four main parts of the patient journey in the selected context. Analysis of the data revealed nine main categories for the proposed eHealth needs: eligibility criteria, referrals, meeting the Health Care Guarantee, patient flow, post‐discharge care, patient counselling, communication, transparency of the journey, and receiving feedback. In addition, the requirements and further development needs for eHealth solutions were generally identified. Conclusions: From the point of view of healthcare professionals, eHealth solutions have huge potential in supporting the elective primary fast‐track hip and knee arthroplasty journey. However, it is important to acknowledge that these needs may be very different depending on the technological and organisational environment in question. Relevance to clinical practice: More effective use of information and communication technologies is needed for organisational optimisation resulting in a streamlined pathway, better access to healthcare services, improved outcomes, and an improved patient experience. These results can be used in the development of new eHealth solutions to support surgical care journeys and patient education

Healthcare professionals’ perceived problems in fast-track hip and knee arthroplasty:results of a qualitative interview study

Abstract Background: Fast-track and outpatient arthroplasty methodologies combine evidence-based clinical features with organizational optimization resulting in a streamlined pathway from admission to discharge and beyond. This qualitative study explored perceived problems of healthcare professionals during fast-track hip and knee arthroplasty. Methods: Semi-structured interviews were conducted with four surgeons, two anesthesiologists, ten nurses, and four physiotherapists. An inductive content analysis was used to analyze the data. NVivo qualitative data analysis software was used. Results: Analysis of the data revealed eight main categories of problems: patient selection, referrals, meeting the Health Care Guarantee, patient flow, homecare, patient counseling, transparency of the journey, and receiving feedback. In addition, problems related to information flows and communication, responsibilities between different stakeholders, and existing information systems were identified. Conclusions: The study revealed that healthcare professionals perceived several problems during the fast-track journey that reduce its effectiveness and make it more difficult to meet the Health Care Guarantee. Problems could be alleviated by changing internal and external organizational practices, as well as by developing new information and communication technologies that would provide up-to-date communication channels for healthcare professionals and patients. In addition, new collaboration mechanisms should be developed in order to solve the problems that occur across different organizations

Data as a driver for shaping the practices of a preventive healthcare service delivery network

Abstract Though data is largely recognized as a new form of capital in the digital era, little research has been done on how innovations related to finding health professionals and using health services are evolving in smart-city-based, preventive healthcare service delivery networks. How does digital data affect preventive healthcare practices in service delivery networks? Evidence is provided from a smart city service delivery network on how data and ICT usage impact preventive healthcare innovations. The research is based on a case study highlighting the transformations continuously occurring in such a network. The results suggest that using data from different sectors will enable individuals and health professionals to communicate via intelligent personalized services, which will act as agents, guiding and coaching individuals to change their lifestyles to avoid chronic diseases. This study provides new knowledge on how continuously using health data can produce novel routines and innovations in healthcare networks over time

Patients’ satisfaction and experiences during elective primary fast‐track total hip and knee arthroplasty journey:a qualitative study

Abstract Aims and objectives: To explore how satisfied patients are with the process of treatment and care, and to identify the experiences that patients perceive during elective primary fast‐track total hip and knee arthroplasty journey. Background: Greater satisfaction with care has predicted better quality of recovery, and patient experience has been positively associated with patient safety and clinical effectiveness. However, little is still known about how patients experience their treatment and care. Design: A qualitative interview study. Methods: The study was conducted among 20 patients in a single joint replacement centre during 2018. Patient satisfaction was measured using a numerical rating scale. Patients’ experiences were identified through qualitative semi‐structured interviews which were analysed using an inductive content analysis method. The COREQ checklist was used (Supplementary File 1). Results: The mean numerical rating scale score for overall satisfaction was 9.0 (SD 1.1) on a scale from 0 to 10. The patients’ experiences were grouped under eight main categories that were derived from the qualitative data in the analysis: 1) patient selection, 2) meeting the Health Care Guarantee, 3) patient flow, 4) post‐discharge care, 5) patient counselling, 6) transparency of the journey, 7) communication and 8) feedback. Conclusions: The findings suggest that patients are highly satisfied after an elective primary fast‐track total hip and knee arthroplasty. However, closer analysis of the patients’ experiences reveals challenges and suggestions on how they could be solved, often involving digital technologies. Relevance to clinical practice: As the number of total joint arthroplasties grows, patients and their families need to take ever greater responsibility, for their own care from advance preparation to rehabilitation. The findings of the study can be used to organise work, improving patient‐clinical communication, fostering engagement, and improving patient centredness. In addition, the results pinpoint the issues on how the patient experience could be improved

The effects and safety of telerehabilitation in patients with lower-limb joint replacement:a systematic review and narrative synthesis

Abstract Introduction: As the number of patients undergoing primary lower-limb joint replacement has risen continuously, hospital-based healthcare resources have become limited. Delivery of any ongoing rehabilitation needs to adapt to this trend. This systematic literature aimed to examine the effects and safety of telerehabilitation in patients with lower-limb joint replacement. Methods: A systematic review of randomized controlled trials was conducted according to procedures by the Joanna Briggs Institute. Studies published prior to February 2020 were identified from Medline Ovid, Scopus, Ebsco Databases and Web of Science. Reference lists of relevant studies were also manually checked to find additional studies. Two researchers conducted study selection separately. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials was used to evaluate the quality of the relevant studies published. A narrative synthesis was used to report the results whereas effect sizes were estimated for different outcomes. Results: Nine studies with 1266 patients were included. Study quality was predominantly affected by the lack of blinding. The patients who completed telerehabilitation showed an improvement in physical functioning that was similar to that of patients completing conventional in-person outpatient physical therapy without an increase in adverse events or resource utilization. The effect of telerehabilitation on physical functioning, however, was assessed as heterogeneous and moderate- to low-quality evidence. Discussion: Telerehabilitation is a practical alternative to conventional in-person outpatient physical therapy in patients with lower-limb joint replacement. However, more robust studies are needed to build evidence about telerehabilitation

Registered nurses’ and medical doctors’ experiences of patient safety in health information exchange during interorganizational care transitions:a qualitative review

Abstract Objective: This systematic review aimed to identify, critically appraise, and synthesize the best available literature on registered nurses’ and medical doctors’ experiences of patient safety in health information exchange (HIE) during interorganizational care transitions. Methods: The review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A total of 5 multidisciplinary databases were searched from January 2010 to September 2020 to identify qualitative or mixed methods studies. The qualitative findings were pooled using JBI SUMARI with the meta-aggregation approach. Results: The final review included 6 original studies. The 53 distinct findings were aggregated into 9 categories, which were further merged into 3 synthesized findings: (1) HIE efficiency and accuracy support patient safety during interorganizational care transitions; (2) inaccuracies in content and structure, along with poor HIE usability, jeopardize patient safety during interorganizational care transitions; and (3) health care professionals’ (HCP) actions in HIE are associated with patient safety during interorganizational care transitions. Conclusions: The results of this review identified several advantages of HIE, namely, improvements in patient safety based on reduced human error. Nevertheless, a lack of usability and functionality can amplify the effects of human error and increase the risk of adverse events. In addition, HCPs’ individual actions in HIE were found to influence patient safety. Hence, the cognitive and sociotechnical perspectives of work related to HIE should be studied. In addition, HCPs’ experiences of each stage of HIE deployment should be clarified to ensure a high standard of patient safety. Registration: PROSPERO CRD42020220631, registered on November 13, 2020

Parental experiences of the pediatric day surgery pathway and the needs for a digital gaming solution:qualitative study

Abstract Background: The parents of hospitalized children are often dissatisfied with waiting times, fasting, discharge criteria, postoperative pain relief, and postoperative guidance. Parents’ experiences help care providers to provide effective, family-centered care that responds to parents’ needs throughout the day surgery pathway. Objective: The objective of our study was to describe parental experiences of the pediatric day surgery pathway and the needs for a digital gaming solution in order to facilitate the digitalization of these pathways. Methods: This was a descriptive qualitative study. The participants (N=31) were parents whose children were admitted to the hospital for the day surgical treatments or magnetic resonance imaging. The data were collected through an unstructured, open-ended questionnaire; an inductive content analysis was conducted to analyze the qualitative data. Reporting of the study findings adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Parental experiences of the children’s day surgery pathway included 3 main categories: (1) needs for parental guidance, (2) needs for support, and (3) child involved in his or her own pathway (eg, consideration of an individual child and preparation of child for treatment). The needs for a digital gaming solution were identified as 1 main category—the digital gaming solution for children and families to support care. This main category included 3 upper categories: (1) preparing children and families for the day surgery via the solution, (2) gamification in the solution, and (3) connecting people through the solution. Conclusions: Parents need guidance and support for their children’s day surgery care pathways. A digital gaming solution may be a relevant tool to support communication and to provide information on day surgeries. Families are ready for and are open to digital gaming solutions that provide support and guidance and engage children in the day surgery pathways

A gamified mobile health intervention for children in day surgery care:protocol for a randomized controlled trial

Abstract Aims: To describe a study protocol for a randomized controlled trial which will evaluate the effectiveness of a gamified mobile health intervention for children in whole day surgery care. Design: A study protocol for a two-arm randomized controlled trial. Methods: Participants will be randomly assigned to the intervention group (N = 62), in which patients receive routine care and play a mobile game designed for children or the control group (N = 62), in which patients receive routine care, including a mobile phone application that supports parents during the care path. The primary outcome is children’s pre-operative anxiety, while the secondary outcome measures included fear and postoperative pain, along with parental satisfaction and anxiety. Data collection started in August 2020. Results: The results of the ongoing randomized controlled trial will determine whether the developed gamified mobile health intervention can be recommended for hospital use, and whether it could be used to educate children about their surgical treatment to decrease anxiety