An e-health driven national healthcare ecosystem

Informatie- en communicatietechnologieën in de gezondheidszorg zijn niet langer beperkt tot gegevensoverdracht en eenvoudige gegevensverwerking. Gezondheidsinformatiesystemen worden tegenwoordig ontwikkeld om effectieve, efficiënte en rechtvaardige gezondheidsstelsels te ondersteunen, beleidsmakers en het publiek te adviseren over dreigende gevaren, evenals over gezondheidsrisico's op langere termijn. Gezondheidszorgsystemen zijn complex, hebben meer veiligheid nodig en moeten rekening houden met de heterogeniteit van gebruikers. De eerste doelstelling van deze studie was om een landgerichte methodologie voor te stellen. De tweede doelstelling was om aan te tonen waarom het ontwerp en de implementatie van een gezondheidszorgsysteem een landspecifieke benadering moeten volgen die wordt bepaald door het niveau van eHealth-volwassenheid van een land en zijn burgers. De derde doelstelling was om een eHealth-strategie voor te stellen die geïntegreerd is in een pan-Europees eHealth-ecosysteem. Het uiteindelijke doel was hoe via eLearning een voortdurende bijwerking van de noodzakelijke kennis in de eHealth-omgeving kan worden bereikt. We hebben een kader voorgesteld voor de implementatie van een nationaal gezondheidszorgsysteem op basis van een interoperabel elektronisch patiëntendossier dat is aangemerkt als het noodzakelijke element van een modern gezondheidszorgsysteem. We hebben de voorgestelde methodologie toegepast binnen verschillende door de EU gefinancierde projecten en we hebben technische oplossingen ontwikkeld voor het bouwen van geschikte pilotsystemen voor het verifiëren van het concept. Met de hulp van alle belanghebbenden slaagden we erin het relevante juridische systeem in Cyprus te hervormen voor het accommoderen van eHealth. Verder hebben we een educatief model ontwikkeld voor het voorbereiden van geneeskunde- en informaticastudenten op eHealth-technologieën en de on-the-job nascholing van medische professionals op dit gebied

Proposal for an eHealth Based Ecosystem Serving National Healthcare

The European Union (EU)'s keen concern about citizens' health and well-being advancement has been expressed at all levels. It has been understood that at present, these can only be achieved through coordinated actions at the individual member states' level based on EU directives, as well as through promoting and funding R&D and expanding the use of eHealth technologies. Despite the diversities and particularities among member states, common values such as universal access to good quality healthcare, equity, and solidarity have been widely accepted across EU. That demanded the adoption of policies and follow directives, which streamlined actions to bridge healthcare gaps, and facilitate cross-border healthcare. This paper articulates a framework for deriving a national healthcare system, based on interoperable Electronic Health Record (EHR) with safeguarding healthcare quality, enabling quadruple helix (Public, Academia, Industry, NGOs) driven R&D and guided by a patient-centered approach. A methodology to develop an integrated EHR at National level is proposed as a prerequisite for eHealth and put into perspective. Recommendations are given for the steps needed, from the managerial, legal, technical, and financial concerns in developing an open access, patient-centered national healthcare system based on the context and constraints of a country. The example of a small country to apply the proposed methodology is demonstrated. Stakeholders, including citizens, healthcare professionals, academia, and the industry are mobilized, enabled, and incentivized for implementing the methodology. Experiences are aspired to be offered as lessons learned for other countries to adapt on their environment

Eliciting Co-Creation Best Practices of Virtual Reality Reusable e-Resources

Immersive experiential technologies find fertile grounds to grow and support healthcare education. Virtual, Augmented, or Mixed reality (VR/AR/MR) have proven to be impactful in both the educational and the affective state of the healthcare student’s increasing engagement. However, there is a lack of guidance for healthcare stakeholders on developing and integrating virtual reality resources into healthcare training. Thus, the authors applied Bardach’s Eightfold Policy Analysis Framework to critically evaluate existing protocols to determine if they are inconsistent, ineffective, or result in uncertain outcomes, following systematic pathways from concepts to decision-making. Co-creative VR resource development resulted as the preferred method. Best practices for co-creating VR Reusable e-Resources identified co-creation as an effective pathway to the prolific use of immersive media in healthcare education. Co-creation should be considered in conjunction with a training framework to enhance educational quality. Iterative cycles engaging all stakeholders enhance educational quality, while co-creation is central to the quality assurance process both for technical and topical fidelity, and tailoring resources to learners’ needs. Co-creation itself is seen as a bespoke learning modality. This paper provides the first body of evidence for co-creative VR resource development as a valid and strengthening method for healthcare immersive content development. Despite prior research supporting co-creation in immersive resource development, there were no established guidelines for best practices

Virtual reality reusable e-resources for clinical skills training: a mixed-methods evaluation

Virtual reality has long existed, but its wider adoption in education is recent. Studies informed by theoretical underpinned co-creation frameworks and utilization of theoretical informed evaluations are scarce in literature. Thus, this study internationally evaluated the efficacy of three virtual reality reusable e-resources (VRReRs), co-created based on the ASPIRE framework, for teaching clinical skills to university students. The study followed a mixed-methods approach, combining SUS, SUS Presence Questionnaire, TAM, and UTAUT2 with a focus group discussion. Additionally, for one VRReR, a quantitative pre/post evaluation of knowledge and comparison with lecture notes followed. Results demonstrated moderately to highly usability, effectively facilitated a strong sense of presence, confidence while using them, and willingness to continue using VRReRs in the future, while increased knowledge of the learners, highlighted their effectiveness. Although some usability issues were identified, these were considered easy to address. This work evidence, in an international context, that co-created VR resources are highly acceptable and effective, similar to other types of digital or traditional resources developed through participatory inquiry paradigm. By leveraging the benefits of VR technology, VRReRs have the potential to transform and enhance the learning experience in the field of clinical skills, ultimately advancing the digitalization of higher education

Effect of mode of delivery of patient reported outcomes in patients with breast disease : a randomised controlled trial

Background: Patient reported outcomes (PROs) have an integral role on how to improve patients' overall experience. The optimal PROs delivery in patients with breast disease is an important issue since PROs are steadily integrated in routine care. Methods: An institutional phase 3 randomised controlled, open-label trial. Eligible candidates were adult women with perceived or confirmed breast disease. Computer generated randomization was used to allocate interventions: collection of PROs in electronic or paper form. Our objective was the effectiveness of electronic versus paper form of PROs. The main outcome measures were: response rate, reported experience, administrative resources, and carbon dioxide emissions. Results: Two hundred thirty-eight patients were randomised. After loss-to-follow-up and consent withdrawals, 218 participants (median age, IQR=55, 21; n=110/n=108) were included in the per-intention-to-treat analysis. Response rate was 61.8% for electronic patient reported outcomes (ePROs) and 63.9% for paper patient reported outcomes (pPROs) (difference=-2.1%, 95% CI: -15.8-11.7%). Only known breast cancer at recruitment was predictive for response in multivariable analysis. ePROs were associated with a 57% reduction in administrative time required, a 95% reduction in incremental costs, and 84% reduction in carbon dioxide emissions, all differences being significant. No difference was detected in perception of PRO significance or ease of completion, but participants experienced that they needed less time to complete ePROs [median, (IQR) 10 (9) respectively 15(10)]. Finally, respondents would prefer ePROs over pPROs (difference 48.1%, 95% CI: 32.8-63.4%). Conclusion: ePROs do not increase the response rate in patients with perceived or confirmed breast disease. However, they can enhance patient experience, reduce incremental costs, facilitate administrative logistics, and are more sustainable. On the basis of these findings, both modalities should continue to be available.De två första författarna delar förstaförfattarskapet.De två sista författarna delar sistaförfattarskapet.</p