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Using Digital Health Technologies to Improve Healthcare Quality

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (23 March 2023) | Viewed by 42145

Special Issue Editors


E-Mail Website
Guest Editor
School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
Interests: using electronic health data to improve the qualty of healthcare

E-Mail Website
Guest Editor
School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
Interests: communication; rehabilitation; digital health / ehealth; social media; speech pathology; traumatic brain injury (tbi); twitter

Special Issue Information

Dear Colleagues,

Digital health describes the use of technologies to support our health and the delivery of healthcare. It is a diverse field of research which includes everything from wearable devices for self-monitoring of activity to the design and implementation of electronic health records, to harnessing technology to strengthen communication pathways between health professionals and the community. The COVID-19 pandemic has accelerated the adoption of technology in healthcare, with digital health being used in an emergency context, and moving forward, we need to better understand how to use these technologies to ensure healthcare is accessible and of high quality for everyone. 

This Special Issue will explore how technology can be used effectively as a support tool across the healthcare system and in the community for health and wellbeing. Coupled with this, articles will also discuss the disconnect between how digital technology could be used to support healthcare and our health and the reality of how it is used in practice. We want to explore the mismatch between real life and the potential of technology to support health and wellbeing. Our vision is to have diverse speakers who challenge us and spark discussions that might help us all to harness technology in different ways for more inclusive healthcare and support.

Dr. Anna Janssen
Dr. Melissa Brunner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital health
  • health services
  • community health
  • digital technology
  • e-health
  • implementation science
  • system transformation
  • virtual care
  • telehealth
  • m-health

Published Papers (14 papers)

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Research

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10 pages, 462 KiB  
Article
Increasing Access to Mental Health Services: Videogame Players’ Perspectives
by Emma L. van der Schyff, Rowena Forsyth, Krestina L. Amon, Brad Ridout and Andrew J. Campbell
Int. J. Environ. Res. Public Health 2023, 20(6), 4772; https://doi.org/10.3390/ijerph20064772 - 8 Mar 2023
Cited by 1 | Viewed by 1886
Abstract
Young men’s mental health is at the forefront of global public health concerns. Young males, who have a high incidence of mental health disorders, are a population that accesses services at lower rates than females and makes up the majority of videogame players. [...] Read more.
Young men’s mental health is at the forefront of global public health concerns. Young males, who have a high incidence of mental health disorders, are a population that accesses services at lower rates than females and makes up the majority of videogame players. By considering the unique perspectives of digitally connected individuals on mental health service delivery, interventions may be designed to address their needs with a higher likelihood of success. This study investigated international male videogamers’ perspectives on how their access to mental health services could be improved via an open-ended survey question. From a total of 2515 completed surveys, 761 responded to the qualitative question. Of these, the 71 responses that discussed access to and provision of mental healthcare services are reported in this article. Results suggest that digital mental health services were a promising way to reach this group. Anonymity and confidentiality were found to be important factors when considering online mental health services. Male videogame players identified a preference for both online and in-person services that are delivered synchronously, one-on-one with an expert practitioner, and readily available in settings that individuals find comfortable. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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17 pages, 2415 KiB  
Article
Designing Digital COVID-19 Screening: Insights and Deliberations
by Soojeong Yoo, Natalia Gulbransen-Diaz, Callum Parker and Audrey P. Wang
Int. J. Environ. Res. Public Health 2023, 20(5), 3899; https://doi.org/10.3390/ijerph20053899 - 22 Feb 2023
Viewed by 1418
Abstract
Due to the global COVID-19 pandemic, public health control and screening measures have been introduced at healthcare facilities, including those housing our most vulnerable populations. These warning measures situated at hospital entrances are presently labour-intensive, requiring additional staff to conduct manual temperature checks [...] Read more.
Due to the global COVID-19 pandemic, public health control and screening measures have been introduced at healthcare facilities, including those housing our most vulnerable populations. These warning measures situated at hospital entrances are presently labour-intensive, requiring additional staff to conduct manual temperature checks and risk-assessment questionnaires of every individual entering the premises. To make this process more efficient, we present eGate, a digital COVID-19 health-screening smart Internet of Things system deployed at multiple entry points around a children’s hospital. This paper reports on design insights based on the experiences of concierge screening staff stationed alongside the eGate system. Our work contributes towards social–technical deliberations on how to improve design and deploy of digital health-screening systems in hospitals. It specifically outlines a series of design recommendations for future health screening interventions, key considerations relevant to digital screening control systems and their implementation, and the plausible effects on the staff who work alongside them. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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12 pages, 1121 KiB  
Article
Online Health Information-Seeking Behaviours and eHealth Literacy among First-Generation Chinese Immigrants
by Ling Zhang, Sherrie Chung, Wendan Shi, Dion Candelaria and Robyn Gallagher
Int. J. Environ. Res. Public Health 2023, 20(4), 3474; https://doi.org/10.3390/ijerph20043474 - 16 Feb 2023
Cited by 3 | Viewed by 2765
Abstract
Due to linguistic and cultural barriers, immigrants often have limited access to health information. Online health information is popular and accessible, but quality is questionable and its benefits dependent on an individual’s eHealth literacy. This study examined online health information-seeking behaviours, eHealth literacy [...] Read more.
Due to linguistic and cultural barriers, immigrants often have limited access to health information. Online health information is popular and accessible, but quality is questionable and its benefits dependent on an individual’s eHealth literacy. This study examined online health information-seeking behaviours, eHealth literacy and its predictors among first-generation Chinese immigrants. A sample of 356 Chinese immigrants living in Australia completed an anonymous paper-based survey, including sociodemographic, clinical data, English proficiency, health literacy, online health information-seeking behaviours, and eHealth literacy. Linear regression models analyzed predictive factors of eHealth literacy. Participants were aged mean 59.3 years, female (68.3%), 53.1% completed university, and their English proficiency was rated fair/poor by 75.1%. Participants perceived online health information as useful (61.6%) and important (56.2%) to their health. Health information accessed was often related to lifestyle (61.2%), health resources (44.9%), diseases (36.0%), and medications (30.9%). Inadequate health literacy and eHealth literacy occurred in 48.3% and 44.9%, respectively. Age, number of technological devices used, education, and health status were independently associated with eHealth literacy. While most Chinese immigrants used online health information, many had inadequate eHealth literacy. Healthcare authorities and providers should support older immigrants, those with lower education and poorer health, and those less engaged with technology in online health information use by providing culturally and linguistically appropriate information, directing immigrants to credible websites, and involving them in health material development processes. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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19 pages, 2814 KiB  
Article
Cancer Care Team’s Management of Clinical Alerts Generated by Electronically Collected Patient Reported Outcomes: We Could Do Better
by Orlando Rincones, Adeola Bamgboje-Ayodele, Anthony Arnold, Geoff P. Delaney, Ivana Durcinoska, Sandra Avery, Tiffany Sandell, Stephen A. Della-Fiorentina, Joanne Pearson, The PROMPT-Care Co-Authorship Group and Afaf Girgis
Int. J. Environ. Res. Public Health 2023, 20(3), 2001; https://doi.org/10.3390/ijerph20032001 - 21 Jan 2023
Viewed by 2137
Abstract
Electronically administered patient-reported outcome measures (ePROMs) are effective digital health tools for informing clinicians about cancer patients’ symptoms and facilitating timely patient-centred care. This paper describes the delivery of healthcare activities supported by the PROMPT-Care model, including ePROMs generated clinical alerts, cancer care [...] Read more.
Electronically administered patient-reported outcome measures (ePROMs) are effective digital health tools for informing clinicians about cancer patients’ symptoms and facilitating timely patient-centred care. This paper describes the delivery of healthcare activities supported by the PROMPT-Care model, including ePROMs generated clinical alerts, cancer care team (CCT) response to alerts, and patients’ perceptions of the CCT response and ePROMs system. This mixed-methods study includes cancer patients from four cancer therapy centres in New South Wales, Australia. Quantitative and qualitative data were collected regarding clinical alert activity, CCT response, and patient perceptions of the CCT responses and ePROMs system. Qualitative data were thematically analysed. Of the 328 participants whose care was informed by the digital health tool, 70.8% (n = 233) generated at least one alert during the trial period, with 877 alerts generated in total. Although 43.7% (n = 383) were actioned by the CCT, at least 80% of participants found follow-up CCT phone calls beneficial, with multiple benefits confirmed in interviews. The cancer care delivery arm of the PROMPT-Care trial involving clinical alerts to the CCT was positively perceived by most participants, resulting in a diverse range of benefits. However, further work is required, informed by implementation science, to improve the percentage of actioned clinical alerts. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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8 pages, 570 KiB  
Article
The Impact of an Electronic Medication Management System on Medication Deviations on Admission and Discharge from Hospital
by Milan R. Vaghasiya, Simon K. Poon, Naren Gunja and Jonathan Penm
Int. J. Environ. Res. Public Health 2023, 20(3), 1879; https://doi.org/10.3390/ijerph20031879 - 19 Jan 2023
Cited by 2 | Viewed by 4455
Abstract
Medication errors at transition of care remain a concerning issue. In recent times, the use of integrated electronic medication management systems (EMMS) has caused a reduction in medication errors, but its effectiveness in reducing medication deviations at transition of care has not been [...] Read more.
Medication errors at transition of care remain a concerning issue. In recent times, the use of integrated electronic medication management systems (EMMS) has caused a reduction in medication errors, but its effectiveness in reducing medication deviations at transition of care has not been studied in hospital-wide settings in Australia. The aim of this study is to assess medication deviations, such as omissions and mismatches, pre-EMMS and post-EMMS implementation at transition of care across a hospital. In this study, patient records were reviewed retrospectively to identify medication deviations (medication omissions and medication mismatches) at admission and discharge from hospital. A total of 400 patient records were reviewed (200 patients in the pre-EMMS and 200 patients in the post-EMMS group). Out of 400 patients, 112 in the pre-EMMS group and 134 patients in post-EMMS group met the inclusion criteria and were included in the analysis. A total of 105 out of 246 patients (42.7%) had any medication deviations on their medications. In the pre-EMMS group, 59 out of 112 (52.7%) patients had any deviations on their medications compared to 46 out of 134 patients (34.3%) from the post-EMMS group (p = 0.004). The proportion of patients with medication omitted from inpatient orders was 36.6% in the pre-EMMS cohort vs. 22.4% in the post-EMMS cohort (p = 0.014). Additionally, the proportion of patients with mismatches in medications on the inpatient charts compared to their medication history was 4.5% in the pre-EMMS group compared to 0% in the post-EMMS group (p = 0.019). Similarly, the proportion of patients with medications omitted from their discharge summary was 23.2% in the pre-EMMS group vs. 12.7% in the post-EMMS group (p = 0.03). Our study demonstrates a reduction in medication deviations after the implementation of the EMMS in hospital settings. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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27 pages, 2997 KiB  
Article
Differentiating Use of Facial Expression between Individuals with and without Traumatic Brain Injury Using Affectiva Software: A Pilot Study
by Kelly Yiew, Leanne Togher, Emma Power, Melissa Brunner and Rachael Rietdijk
Int. J. Environ. Res. Public Health 2023, 20(2), 1169; https://doi.org/10.3390/ijerph20021169 - 9 Jan 2023
Cited by 2 | Viewed by 1497
Abstract
This study investigated the feasibility of using an automated facial coding engine, Affectiva (integrated in iMotions, version 8.2), for evaluating facial expression after traumatic brain injury (TBI). An observational cross-sectional study was conducted based on facial expression data from videos of participants with [...] Read more.
This study investigated the feasibility of using an automated facial coding engine, Affectiva (integrated in iMotions, version 8.2), for evaluating facial expression after traumatic brain injury (TBI). An observational cross-sectional study was conducted based on facial expression data from videos of participants with TBI and control participants. The aims were to compare TBI and control groups, and identify confounding factors affecting the data analysis. Video samples of two narrative tasks (personal event and story retell) from ten participants with severe TBI and ten control participants without TBI were analyzed using Affectiva. Automated data on participants’ engagement, smile and brow furrow were compared statistically between and within groups. Qualitative notes for each sample were also recorded. Affectiva detected a higher percentage of time of engagement for TBI participants than for control participants on both tasks. There was also a higher percentage of time of smiling for TBI participants in one task. Within groups, there were no significant differences between the two narrative tasks. Affectiva provides standardized data about facial expression and may be sensitive to detecting change in the use of facial expression after TBI. This study also identified factors to avoid during videorecording to ensure high quality samples for future research. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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18 pages, 3222 KiB  
Article
Nurse, Give Me the News! Understanding Support for and Opposition to a COVID-19 Health Screening System
by Natalia Gulbransen-Diaz, Soojeong Yoo and Audrey P. Wang
Int. J. Environ. Res. Public Health 2023, 20(2), 1164; https://doi.org/10.3390/ijerph20021164 - 9 Jan 2023
Cited by 1 | Viewed by 2156
Abstract
Helping the sick and protecting the vulnerable has long been the credo of the health profession. In response to the coronavirus-disease-2019 (COVID-19 pandemic), hospitals and healthcare institutions have rapidly employed public health measures to mitigate patient and staff infection. This paper investigates staff [...] Read more.
Helping the sick and protecting the vulnerable has long been the credo of the health profession. In response to the coronavirus-disease-2019 (COVID-19 pandemic), hospitals and healthcare institutions have rapidly employed public health measures to mitigate patient and staff infection. This paper investigates staff and visitor responses to the COVID-19 eGate health screening system; a self-service technology (SST) which aims to protect health care workers and facilities from COVID-19. Our study evaluates the in situ deployment of the eGate, and employs a System Usability Scale (SUS) and questionnaire (n = 220) to understand staff and visitor’s acceptance of the eGate. In detailing the themes relevant to those who advocate for the system and those who oppose it, we contribute towards a more detailed understanding of the use and non-use of health-screening SSTs. We conclude with a series of considerations for the design of future interactive screening systems within hospitals. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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12 pages, 624 KiB  
Article
Lung Support Service: Implementation of a Nationwide Text Message Support Program for People with Chronic Respiratory Disease during the COVID-19 Pandemic
by Rebecca Raeside, Anna C. Singleton, Allyson Todd, Stephanie R. Partridge, Karice K. Hyun, Helen Kulas, Sally L. Wootton, Marita T. Dale, Jennifer A. Alison, Zoe McKeough, Renae J. McNamara, Lissa Spencer, Christine Jenkins and Julie Redfern
Int. J. Environ. Res. Public Health 2022, 19(24), 17073; https://doi.org/10.3390/ijerph192417073 - 19 Dec 2022
Cited by 2 | Viewed by 2669
Abstract
Background: COVID-19 pandemic lockdowns led to the closure of most in-person pulmonary rehabilitation programs in Australia. Text message programs are effective for delivering health support to aid the self-management of people with chronic diseases. This study aimed to evaluate the implementation of a [...] Read more.
Background: COVID-19 pandemic lockdowns led to the closure of most in-person pulmonary rehabilitation programs in Australia. Text message programs are effective for delivering health support to aid the self-management of people with chronic diseases. This study aimed to evaluate the implementation of a six-month pre-post text message support program (Texting for Wellness: Lung Support Service), and the enablers and barriers to its adoption and implementation. Methods: This mixed-methods pre-post study used the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate the Texting for Wellness: Lung Support Service, which is an automated six-month text message support program that included evidence-based lifestyle, disease-self management and COVID-19-related information. Reach was measured by the proportion of participant enrolments and demographic characteristics. Adoption enablers and barriers were measured using text message response data and a user feedback survey (five-point Likert scale questions and free-text responses). Implementation was evaluated to determine fidelity including text message delivery data, opt-outs, and intervention costs to promote and deliver the program. Results: In total, 707/1940 (36.4%) participants enrolled and provided e-consent, with a mean age (±standard deviation) of 67.9 (±9.2) years old (range: 23–87 years). Of participants who provided feedback, (326/707) most ‘agreed’ or ‘strongly agreed’ that the text messages were easy to understand (98.5%), helpful them to feel supported (92.3%) and helped them to manage their health (88.0%). Factors influencing engagement included a feeling of support and reducing loneliness, and its usefulness for health self-management. Messages were delivered as planned (93.7% successfully delivered) with minimal participant dropouts (92.2% retention rate) and low cost ($AUD24.48/participant for six months). A total of 2263 text message replies were received from 496 unique participants. There were no reported adverse events. Conclusion: Texting for Wellness: Lung Support Service was implemented quickly, had a broad reach, with high retention and acceptability among participants. The program was low cost and required minimal staff oversight, which may facilitate future implementation. Further research is needed to evaluate the efficacy of text messaging for the improvement of lung health outcomes and strategies for long-term pulmonary rehabilitation program maintenance. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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11 pages, 306 KiB  
Article
Digital Health to Strengthen District-Based Public–Private Mix Tuberculosis Control in Purwakarta District, Indonesia: A Qualitative Research
by Cindra Paskaria, Deni Kurniadi Sunjaya, Ida Parwati and Muhammad Begawan Bestari
Int. J. Environ. Res. Public Health 2022, 19(19), 12097; https://doi.org/10.3390/ijerph191912097 - 24 Sep 2022
Cited by 1 | Viewed by 1529
Abstract
This study aimed to explore the problem that occurs in district-based public–private mix tuberculosis (DPPM TB) in the Purwakarta district, and how digital health can help overcome this problem. This study used a qualitative research design. By purposive sampling, 46 informants were selected [...] Read more.
This study aimed to explore the problem that occurs in district-based public–private mix tuberculosis (DPPM TB) in the Purwakarta district, and how digital health can help overcome this problem. This study used a qualitative research design. By purposive sampling, 46 informants were selected to be interviewed and 9 informants participated in focus group discussion. Data were collected during January to November 2020 and analyzed using the content analysis technique. Trustworthiness is obtained through the triangulation method and peer debriefing. The problems identified in public and private partnership were the lack of communication and awareness, the under-reporting of TB cases in the private health sector, and the limitation of the existing information system. Communication is important in delivering information about a tuberculosis program, patient referrals, and contact investigation; therefore, digital health is considered as a potential strategy to facilitate that. Digital health must consider ethical issues, avoid redundancy, be user-friendly, and include intervention packages. We conclude that the lack of communication between the public and the private health sectors in TB control was a major problem in DPPM TB. Digital health is needed to ensure the flow of information and communication between the public and the private health sectors. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
13 pages, 372 KiB  
Article
Acceptability of a Smartphone Application to Enhance Healthcare to Female Genital Mutilation Survivors in Liberia: A Qualitative Study
by Kim Nordmann, Guillermo Z. Martínez-Pérez, Mandella King, Thomas Küpper and Ana Belén Subirón-Valera
Int. J. Environ. Res. Public Health 2022, 19(17), 10855; https://doi.org/10.3390/ijerph191710855 - 31 Aug 2022
Viewed by 1399
Abstract
In Liberia, female genital mutilation/cutting (FGM/C) is a legally allowed initiation ritual in the secret Sande society. Due to the secrecy, Liberian healthcare providers receive little education on FGM/C and its health consequences. As mobile learning approaches proved to efficiently increase providers’ knowledge [...] Read more.
In Liberia, female genital mutilation/cutting (FGM/C) is a legally allowed initiation ritual in the secret Sande society. Due to the secrecy, Liberian healthcare providers receive little education on FGM/C and its health consequences. As mobile learning approaches proved to efficiently increase providers’ knowledge and skills, a mobile application (‘app’) was designed to support self-learning, decision-making, and the follow-up of FGM/C survivors’ health. The ‘app’ was introduced in a capacity-building project in 2019 and evaluated through this qualitative study to assess healthcare provider’s needs and acceptance. We conducted 22 semi-structured interviews and eight focus group discussions with 42 adult healthcare providers in three Liberian counties. A thematic approach grounded in descriptive phenomenology guided data analysis and led to three main themes: the ‘app’, mobile learning and health education, and personal impression. Healthcare providers judge the ‘app’ useful to broaden their knowledge and skills, which might lead to better FGM/C detection and management. The ‘app’ might further facilitate patient and community education about the negative health consequences of FMG/C, possibly contributing to a reduction of FGM/C prevalence. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)

Review

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28 pages, 805 KiB  
Review
Lessons Learned from Natural Disasters around Digital Health Technologies and Delivering Quality Healthcare
by Zerina Lokmic-Tomkins, Dinesh Bhandari, Chris Bain, Ann Borda, Timothy Charles Kariotis and David Reser
Int. J. Environ. Res. Public Health 2023, 20(5), 4542; https://doi.org/10.3390/ijerph20054542 - 3 Mar 2023
Cited by 16 | Viewed by 5229
Abstract
As climate change drives increased intensity, duration and severity of weather-related events that can lead to natural disasters and mass casualties, innovative approaches are needed to develop climate-resilient healthcare systems that can deliver safe, quality healthcare under non-optimal conditions, especially in remote or [...] Read more.
As climate change drives increased intensity, duration and severity of weather-related events that can lead to natural disasters and mass casualties, innovative approaches are needed to develop climate-resilient healthcare systems that can deliver safe, quality healthcare under non-optimal conditions, especially in remote or underserved areas. Digital health technologies are touted as a potential contributor to healthcare climate change adaptation and mitigation, through improved access to healthcare, reduced inefficiencies, reduced costs, and increased portability of patient information. Under normal operating conditions, these systems are employed to deliver personalised healthcare and better patient and consumer involvement in their health and well-being. During the COVID-19 pandemic, digital health technologies were rapidly implemented on a mass scale in many settings to deliver healthcare in compliance with public health interventions, including lockdowns. However, the resilience and effectiveness of digital health technologies in the face of the increasing frequency and severity of natural disasters remain to be determined. In this review, using the mixed-methods review methodology, we seek to map what is known about digital health resilience in the context of natural disasters using case studies to demonstrate what works and what does not and to propose future directions to build climate-resilient digital health interventions. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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17 pages, 2394 KiB  
Review
Pregnancy Apps for Self-Monitoring: Scoping Review of the Most Popular Global Apps Available in Australia
by Natasa Lazarevic, Marie Lecoq, Céline Bœhm and Corinne Caillaud
Int. J. Environ. Res. Public Health 2023, 20(2), 1012; https://doi.org/10.3390/ijerph20021012 - 5 Jan 2023
Cited by 6 | Viewed by 3964
Abstract
Digital health tools, such as apps, have the potential to promote healthy behaviours, especially self-monitoring, which can facilitate pregnancy management and reduce the risk of associated pregnancy health conditions. While pregnancy apps are popular amongst pregnant women, there is limited information about the [...] Read more.
Digital health tools, such as apps, have the potential to promote healthy behaviours, especially self-monitoring, which can facilitate pregnancy management and reduce the risk of associated pregnancy health conditions. While pregnancy apps are popular amongst pregnant women, there is limited information about the overall quality of their content or self-monitoring tools and the number of behaviour change techniques (BCTs) that they include. The aim of this study was thus to assess the quality of pregnancy apps for self-monitoring, and their usage of BCTs. We identified pregnancy apps by web scraping the most popular global apps for self-monitoring in the Apple App Store and Google Play Store available in Australia. The app quality was evaluated using the scorecard approach and the inclusion of BCTs was evaluated using the ABACUS tool. We identified 31 pregnancy apps that met our eligibility criteria. We found that pregnancy apps tended to score the highest in the domains of ‘cost and time’, ‘usability’, and ‘technical’, and lowest on ‘clinical’ and ‘end-user requirements’. Additionally, the majority of apps contained minimal BCTs. Based on our findings, we propose a digital health scorecard visualisation that would break down app quality criteria and present them in a more accessible way to clinicians and pregnant users. We conclude that these findings highlight the shortcomings of available commercial pregnancy apps and the utility of a digital health scorecard visualisation that would empower users to make more informed decisions about which apps are the most appropriate for their needs. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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29 pages, 1134 KiB  
Review
The Experiences of Stakeholders Using Social Media as a Tool for Health Service Design and Quality Improvement: A Scoping Review
by Louisa Walsh, Nerida Hyett, Nicole Juniper, Chi Li and Sophie Hill
Int. J. Environ. Res. Public Health 2022, 19(22), 14851; https://doi.org/10.3390/ijerph192214851 - 11 Nov 2022
Cited by 1 | Viewed by 2371
Abstract
Background: Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. This scoping review explores [...] Read more.
Background: Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. This scoping review explores the benefits, risks, barriers and enablers for using social media as a tool for stakeholder engagement in health service design and QI. Methods: The searches were conducted on 16 August 2022. Inclusion criteria were: studies of any health service stakeholders, in any health setting, where social media was used as a tool for service design or QI. Data was analysed using deductive content analysis. A committee of stakeholders provided input on research questions, data analysis and key findings. Results: 61 studies were included. Benefits included improved organisational communication and relationship building. Risks/limitations included low quality of engagement and harms to users. Limited access and familiarity with social media were frequently reported barriers. Making discussions safe and facilitating access were common enablers. Conclusion: The benefits, risks, barriers and enablers identified highlight the complexity of social media as an engagement tool for health service design and QI. Understanding these experiences may help implementers design more effective social media-based engagement activities. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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Other

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17 pages, 691 KiB  
Systematic Review
A Systematic Review of Electronic Medical Record Driven Quality Measurement and Feedback Systems
by Candice Donnelly, Anna Janssen, Shalini Vinod, Emily Stone, Paul Harnett and Tim Shaw
Int. J. Environ. Res. Public Health 2023, 20(1), 200; https://doi.org/10.3390/ijerph20010200 - 23 Dec 2022
Cited by 6 | Viewed by 4657
Abstract
Historically, quality measurement analyses utilize manual chart abstraction from data collected primarily for administrative purposes. These methods are resource-intensive, time-delayed, and often lack clinical relevance. Electronic Medical Records (EMRs) have increased data availability and opportunities for quality measurement. However, little is known about [...] Read more.
Historically, quality measurement analyses utilize manual chart abstraction from data collected primarily for administrative purposes. These methods are resource-intensive, time-delayed, and often lack clinical relevance. Electronic Medical Records (EMRs) have increased data availability and opportunities for quality measurement. However, little is known about the effectiveness of Measurement Feedback Systems (MFSs) in utilizing EMR data. This study explores the effectiveness and characteristics of EMR-enabled MFSs in tertiary care. The search strategy guided by the PICO Framework was executed in four databases. Two reviewers screened abstracts and manuscripts. Data on effect and intervention characteristics were extracted using a tailored version of the Cochrane EPOC abstraction tool. Due to study heterogeneity, a narrative synthesis was conducted and reported according to PRISMA guidelines. A total of 14 unique MFS studies were extracted and synthesized, of which 12 had positive effects on outcomes. Findings indicate that quality measurement using EMR data is feasible in certain contexts and successful MFSs often incorporated electronic feedback methods, supported by clinical leadership and action planning. EMR-enabled MFSs have the potential to reduce the burden of data collection for quality measurement but further research is needed to evaluate EMR-enabled MFSs to translate and scale findings to broader implementation contexts. Full article
(This article belongs to the Special Issue Using Digital Health Technologies to Improve Healthcare Quality)
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