An Investigation of Social Support Features of Digital Health Applications

Using digital health applications for health behaviour intervention is becoming popular. Among all application features designed for nudging users\u27 behaviour changes, social support features have received great attention, as social support is shown to reduce patients\u27 uncertainty and improve health behaviour engagement. A variety of social support features have been implemented, but how they are related to app performance, such as app ratings, downloads and review numbers, is unknown. This paper aims to understand the relationship between social support features and these app performance indicators, and identify common ways of providing social support. Three types of social support features have been identified through a review of selected health apps: the support from social networks, from in-app communities, and from health professionals. Apps with social support features are found to have higher review numbers, although not correlate with ratings or download numbers. Potential theoretical and practical implications are discussed, together with the future research plan

Postmarketing Follow-Up of a Digital Home Exercise Program for Back, Hip, and Knee Pain: Retrospective Observational Study With a Time-Series and Matched-Pair Analysis

Background: Musculoskeletal conditions are the main drivers of global disease burden and cause significant direct and indirect health care costs. Digital health applications improve the availability of and access to adequate care. The German health care system established a pathway for the approval of “Digitale Gesundheitsanwendungen” (DiGAs; Digital Health Applications) as collectively funded medical services through the “Digitale-Versorgung-Gesetz” (Digital Health Care Act) in 2019. Objective: This article presents real-world prescription data collected through the smartphone-based home exercise program “Vivira,” a fully approved DiGA, regarding its effect on self-reported pain intensity and physical inability in patients with unspecific and degenerative pain in the back, hip, and knee. Methods: This study included 3629 patients (71.8% [2607/3629] female; mean age 47 years, SD 14.2 years). The primary outcome was the self-reported pain score, which was assessed with a verbal numerical rating scale. The secondary outcomes were self-reported function scores. To analyze the primary outcome, we used a 2-sided Skillings-Mack test. For function scores, a time analysis was not feasible; therefore, we calculated matched pairs using the Wilcoxon signed-rank test. Results: Our results showed significant reductions in self-reported pain intensity after 2, 4, 8, and 12 weeks in the Skillings-Mack test (T3628=5308; P<.001). The changes were within the range of a clinically relevant improvement. Function scores showed a generally positive yet more variable response across the pain areas (back, hip, and knee). Conclusions: This study presents postmarketing observational data from one of the first DiGAs for unspecific and degenerative musculoskeletal pain. We noted significant improvements in self-reported pain intensity throughout the observation period of 12 weeks, which reached clinical relevance. Additionally, we identified a complex response pattern of the function scores assessed. Lastly, we highlighted the challenges of relevant attrition at follow-up and the potential opportunities for evaluating digital health applications. Although our findings do not have confirmatory power, they illustrate the potential benefits of digital health applications to improve the availability of and access to medical care

Utilization of Digital Health Applications in Implementing the Dengue Vector Control Program

One House One Larva Monitor Movement is a dengue vector control program of the Ministry of Health which has been promoted since 2016. However, there are still several areas that have not been successful in implementing this movement, one of which includes the City of Padang. The purpose of this study was to examine the importance of using digital applications in implementing dengue vector control programs. This research is a research with qualitative methods using the case study genre through a constructivist approach. The location of the qualitative research was carried out at the Padang City Health Office, in the working areas of the Nanggalo Health Center, Pagambiran Health Center, and Rawang Health Center which were designated as research areas. This research was conducted in 2023 with informants including the person in charge of the dengue fever program at the Padang City Health Service, the person in charge of the dengue fever program at the Community Health Center, and the larva monitoring coordinator. The results of the study indicate that efforts to control dengue vectors through the One House One larva monitor Movement are still not running as they should. This movement can only run when larva monitor performs its main tasks and functions in accordance with the provisions. For this reason, it is necessary to carry out coaching and supervision efforts. However, there are several obstacles that require the design of a comprehensive and integrated digital health application to improve the health information system to improve the performance of larva monitors. Keyword: DHF, Digital Health, Vector Dengu

The importance of physiological data variability in wearable devices for digital health applications

This paper aims at characterizing the variability of physiological data collected through a wearable device (Empatica E4), given that both intra- and inter-subject variability play a pivotal role in digital health applications, where Artificial Intelligence (AI) techniques have become popular. Inter-beat intervals (IBIs), ElectroDermal Activity (EDA) and Skin Temperature (SKT) signals have been considered and variability has been evaluated in terms of general statistics (mean and standard deviation) and coefficient of variation. Results show that both intra- and inter-subject variability values are significant, especially when considering those parameters describing how the signals vary over time. Moreover, EDA seems to be the signal characterized by the highest variability, followed by IBIs, contrary to SKT that results more stable. This variability could affect AI algorithms in classifying signals according to particular discriminants (e.g. emotions, daily activities, etc.), taking into account the dual role of variability: hindering a net distinction between classes, but also making algorithms more robust for deep learning purposes thanks to the consideration of a wide test population. Indeed, it is worthy to note that variability plays a fundamental role in the whole measurement chain, characterizing data reliability and impacting on the final results accuracy and consequently on decision-making processes

Proposal of a New Rating Concept for Digital Health Applications in Orthopedics and Traumatology

BACKGROUND Health-related mobile applications (apps) are rapidly increasing in number. There is an urgent need for assessment tools and algorithms that allow the usability and content criteria of these applications to be objectively assessed. The aim of this work was to establish and validate a concept for orthopedic societies to rate health apps to set a quality standard for their safe use. METHODS An objective rating concept was created, consisting of nine quality criteria. A self-declaration sheet for app manufacturers was designed. Manufacturers completed the self-declaration, and the app was examined by independent internal reviewers. The pilot validation and analysis were performed on two independent health applications. An algorithm for orthopedic societies was created based on the experiences in this study flow. RESULTS "Sprunggelenks-App" was approved by the reviewers with 45 (98%) fulfilled criteria and one (2%) unfulfilled criterion. "Therapie-App" was approved, with 28 (61%) met criteria, 6 (13%) unfulfilled criteria and 12 (26%) criteria that could not be assessed. The self-declaration completed by the app manufacturer is recommended, followed by a legal and technical rating performed by an external institution. When rated positive, the societies' internal review using independent raters can be performed. In case of a positive rating, a visual certification can be granted to the manufacturer for a certain time frame. CONCLUSION An objective rating algorithm is proposed for the assessment of digital health applications. This can help societies to improve the quality assessment, quality assurance and patient safety of those apps. The proposed concept must be further validated for inter-rater consistency and reliability

Proposal of a New Rating Concept for Digital Health Applications in Orthopedics and Traumatology

Background: Health-related mobile applications (apps) are rapidly increasing in number. There is an urgent need for assessment tools and algorithms that allow the usability and content criteria of these applications to be objectively assessed. The aim of this work was to establish and validate a concept for orthopedic societies to rate health apps to set a quality standard for their safe use. Methods: An objective rating concept was created, consisting of nine quality criteria. A selfdeclaration sheet for app manufacturers was designed. Manufacturers completed the self-declaration, and the app was examined by independent internal reviewers. The pilot validation and analysis were performed on two independent health applications. An algorithm for orthopedic societies was created based on the experiences in this study flow. Results: “Sprunggelenks-App“ was approved by the reviewers with 45 (98%) fulfilled criteria and one (2%) unfulfilled criterion. “Therapie-App” was approved, with 28 (61%) met criteria, 6 (13%) unfulfilled criteria and 12 (26%) criteria that could not be assessed. The self-declaration completed by the app manufacturer is recommended, followed by a legal and technical rating performed by an external institution. When rated positive, the societies’ internal review using independent raters can be performed. In case of a positive rating, a visual certification can be granted to the manufacturer for a certain time frame. Conclusion: An objective rating algorithm is proposed for the assessment of digital health applications. This can help societies to improve the quality assessment, quality assurance and patient safety of those apps. The proposed concept must be further validated for inter-rater consistency and reliability

Use of digital healthcare solutions for care delivery during a pandemic-chances and (cyber) risks referring to the example of the COVID-19 pandemic

During pandemics, regular service provisioning processes in medical care may be disrupted. Digital health promises many opportunities for service provisioning during a pandemic. However, a broad penetration of medical processes with information technology also has drawbacks. Within this work, the authors use the COVID-19 pandemic to analyze the chances and the risks that may come with using digital health solutions for medical care during a pandemic. Therefore, a multi-methods approach is used. First we use a systematic literature review for reviewing the state of the art of digital health applications in healthcare. Furthermore, the usage of digital health applications is mapped to the different processes in care delivery. Here we provide an exemplary process model of oncological care delivery. The analysis shows that including digital health solutions may be helpful for care delivery in most processes of medical care provisioning. However, research on digital health solutions focuses strongly on some few processes and specific disciplines while other processes and medical disciplines are underrepresented in literature. Last, we highlight the necessity of a comprehensive risk-related debate around the effects that come with the use of digital healthcare solutions

How to turn the Fast-Track into a Fast-Track: Process integration for evaluation of the quality of Digital Health Applications (DiGAs) on the example of the German Fast-Track Process

In this paper, we address the research question of which integration points in the \textit{German Fast-Track process} are particularly well suited for the integration of evaluation platforms for digital health applications. For this purpose, possible integration points are first identified and then analyzed with the help of a utility analysis with regard to the posed research question. Finally, a recommendation for action is made based on the results of the conducted utility analysis

Review of innovative immersive technologies for healthcare applications

Immersive technologies, including virtual reality (VR), augmented reality (AR), and mixed reality (MR), can connect people using enhanced data visualizations to better involve stakeholders as integral members of the process. Immersive technologies have started to change the research on multidimensional genomic data analysis for disease diagnostics and treatments. Immersive technologies are highlighted in some research for health and clinical needs, especially for precision medicine innovation. The use of immersive technology for genomic data analysis has recently received attention from the research community. Genomic data analytics research seeks to integrate immersive technologies to build more natural human-computer interactions that allow better perception engagements. Immersive technologies, especially VR, help humans perceive the digital world as real and give learning output with lower performance errors and higher accuracy. However, there are limited reviews about immersive technologies used in healthcare and genomic data analysis with specific digital health applications. This paper contributes a comprehensive review of using immersive technologies for digital health applications, including patient-centric applications, medical domain education, and data analysis, especially genomic data visual analytics. We highlight the evolution of a visual analysis using VR as a case study for how immersive technologies step, can by step, move into the genomic data analysis domain. The discussion and conclusion summarize the current immersive technology applications’ usability, innovation, and future work in the healthcare domain, and digital health data visual analytics