E-Health Practices and Technologies: A Systematic Review from 2014 to 2019

da Fonseca, Maria Helena; Kovaleski, Fanny; Picinin, Claudia Tania; Pedroso, Bruno; Rubbo, Priscila

doi:10.3390/healthcare9091192

Open AccessReview

E-Health Practices and Technologies: A Systematic Review from 2014 to 2019

by

Maria Helena da Fonseca

^1,*

,

Fanny Kovaleski

¹,

Claudia Tania Picinin

¹

,

Bruno Pedroso

²

and

Priscila Rubbo

³

¹

Department of Production Engineering, Federal University of Technology—Paraná (UTFPR), Ponta Grossa 84017-220, Brazil

²

Division of Physical Education, State University of Ponta Grossa—Paraná (UEPG), Ponta Grossa 84030-900, Brazil

³

Department of Accounting Sciences, Federal University of Technology—Paraná (UTFPR), Pato Branco 85503-390, Brazil

^*

Author to whom correspondence should be addressed.

Healthcare 2021, 9(9), 1192; https://doi.org/10.3390/healthcare9091192

Submission received: 16 July 2021 / Revised: 17 August 2021 / Accepted: 26 August 2021 / Published: 10 September 2021

(This article belongs to the Special Issue Telehealth: How Technology Is Evolving Healthcare Training and Patient Education)

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Abstract

:

E-health can be defined as a set of technologies applied with the help of the internet, in which healthcare services are provided to improve quality of life and facilitate healthcare delivery. As there is a lack of similar studies on the topic, this analysis uses a systematic literature review of articles published from 2014 to 2019 to identify the most common e-health practices used worldwide, as well as the main services provided, diseases treated, and the associated technologies that assist in e-health practices. Some of the key results were the identification of the four most common practices used (mhealth or mobile health; telehealth or telemedicine; technology; and others) and the most widely used technologies associated with e-health (IoT, cloud computing, Big Data, security, and systems).

Keywords:

e-health; ehealth; practices; technologies

1. Introduction

Digital change has been particularly challenging in healthcare, as there is growing demand for services due to the aging population and the emergence of new diseases. Thus, investment in new treatments is necessary so that everyone has equal access to the healthcare system [1,2,3]. E-health involves practices such as mhealth and telehealth that employ electronic technologies to provide healthcare resources, services, and information [4].

Mobile health or mhealth consists of the use of mobile devices so that patients can solicit services electronically, use apps to verify information, and manage or monitor treatment or problems or other health-related issues [5]. Telehealth can be defined as the use of telecommunication technologies to promote the care and education of patients and professionals working in the area [6].

E-health has become an integral part of the healthcare system as it addresses a range of difficulties in medicine, including reducing errors and providing more efficient services with more accurate results [7]. Such is the case with the use of electronic medical records, in which all information about a patient is stored, thus preventing inappropriate administration of medication during medical care and ensuring that the patient is treated quickly and comfortably [8]. However, its implementation depends on adequate planning and strategies so that virtual medical care can be performed [3].

The success of e-health in a country is related to several factors, including user acceptance and the types of infrastructure, systems, and management used [6,9]. Meanwhile, there are four stakeholders involved in the outcomes: entrepreneurs, healthcare professionals, patients, and those responsible for health insurance and assistance policies [10]. To effectively implement the use of information technologies in healthcare, e-health strategies must occur in an integrated manner, including the development of norms, laws, or regulations. This situation is valid whether in the fields of telehealth and mhealth, or specific categories such as electronic medical records or health literacy—eLearning (learning in health) [5,11,12].

The e-health strategy has three main components: (i) knowledge management; (ii) tools and methods; and (iii) policies. These components work to consolidate healthcare systems with support networks and scientific and technological production, manage infrastructure and human resources, reduce barriers to accessing health services, and promote community inclusion [13]. Some barriers to e-health include the difficulties faced when using systems and applications, both by healthcare professionals and patients, as well as ensuring the security and privacy of user data transmitted throughout these systems [12].

Another challenge in e-health is interoperability across systems. That is, new e-health systems must interact with existing ones, and there should be a standard electronic language between hospitals (or clinics) to facilitate communication and data exchange, as well as formal agreements on how the system should work in a standardized way [14,15]. Further, the cost of implementing e-health also presents challenges, which may make the implementation of such systems unfeasible. This is related to the high levels of investment required to purchase equipment to implement more sustainable practices [3,16] than traditional systems that store paper records, alongside the costs of hiring specialized support personnel in information technology (IT) to keep the systems running and software acquisition [8,17].

There are several studies on the topic of e-health, but they generally address a specific practice. One example is [18], in which the authors analyze studies of interventions via e-health using websites and social media in the treatment of patients with mood disorders. Two e-health-related studies with a general approach were found [19,20]. However, such studies do not fully address all e-health practices, which differentiates the present study from previous work on the topic. Although scientific publication databases have a vast range of studies on e-health [21], there are gaps in knowledge related to this topic, which justifies the need for the present review. Herein, we update data related to practices in the field of e-health and provide an overview of the information present in selected articles within a five-year time frame (2014 to 2019), demonstrating what has been published on the topic both in practical studies and literature reviews.

Therefore, the objective of this analysis is to identify, through a systematic literature review, the most commonly used e-health practices worldwide, as well as the key services provided, diseases treated, and the associated technologies that assist in providing e-health practices. This study aims to answer the following questions:

In which countries and journals are studies published on e-health practices?
What are the main e-health practices used worldwide?
What are the main service delivery types and medical fields addressed using e-health?
What are the main barriers to e-health service delivery?
What are the most common diseases treated, and in which countries have e-health practices been applied?
What are the most common technologies used in e-health?

2. Materials and Methods

The identification of the study portfolio was carried out using the Methodi Ordinatio process developed [22] and based on the Cochrane model and ProKnow-C for research studies that use Information and Communication Technologies—ICTs, such as spreadsheets, word processors, and reference managers. The following software programs were employed to conduct the analyses: Mendeley version 1.19.3; JabRef version 3.3; Microsoft Office 365 (Excel and Word); and NVivo trial version 11 for initial article analysis. The Methodi Ordinatio includes nine steps and is used to conduct systematic literature reviews, build bibliographic portfolios, and map the literature on a specific topic. One advantage of the methodology is its multi-criteria decision-making model that considers the impact factor of the journal, the number of citations, and the year of publication. From this, the InOrdinatio index is calculated, and the researcher obtains a bibliographic portfolio [23]. This methodology has been used by authors such as [24,25,26].

The Methodi Ordinatio is shown in Figure 1 and is composed of the following steps:

Step 1—Establish the research objective;
Step 2—Define the keywords;
Step 3—Select the databases to be searched;
Step 4—Search for and register the results obtained;
Step 5—Define search filters such as publication period and type of study (articles, books, etc.), excluding duplicate articles and those unrelated to the selected research topic;
Step 6—Identify the impact factor, year of publication, and number of citations of the articles from Google Scholar for the selected portfolio;
Step 7—Apply the InOrdinatio equation [22] in a spreadsheet to classify the identified articles;

$InOrdinatio = (I F \div 1000) + α \times [10 - (ResearchYear - PublishYear)] + (\sum C i)$

(1)

The equation is composed of the following variables: IF is the impact factor; α is the value defined by the researchers considering the current relevance of the articles, which may vary from 1 to 10 (for this study, we defined α as 10); ResearchYear is the year the research was conducted; PublishYear is the year the article was published; and ∑Ci is the number of citations of the article according to data from Google Scholar.
Step 8—Select the articles for the final portfolio considering the highest InOrdinatio classification; and
Step 9—Read and analyze the final portfolio articles.

First, the search objective was defined, and the keywords were searched using Boolean operators (“E-Health” OR “EHealth” AND “Practice *”). The keyword “Technology” was not used to search the databases so as not to excessively limit the search. The analysis of e-health-related technologies took place after the portfolio was defined.

The search was carried out using seven electronic databases: Lilacs, MedLine, PubMed, SciELO, Scopus, Science Direct, and Web of Science. These databases were chosen due to the multidisciplinary character of this study and the fact that the information concerning medicine and health is vast. Thus, to conduct a careful analysis, well-known and key sources in the field should be used, such as MedLine, PubMed, Lilacs, SciELO, the Cochrane Library, and the Virtual Health Library (VHL).

MedLine is a database containing supplementary materials and offers a good basis for research as it indexes other databases and aggregates complementary materials. It has been employed in research on e-health, health, and medical technology [6].

Scopus is the largest research database for the fields of technology, medicine, science, social sciences, and the arts and humanities, while Science Direct contains technical publications in the fields of science and health [27]. The Web of Science is an independent global citation database that offers reliable multidisciplinary data for academic research [28].

The time frame for the published research was five years, from 2014 to 2019. According to [29], a five-year period is the half-life for article citations. In addition, the following filtering procedures were applied to the databases to obtain the results: selection of types of articles published (review, research, and journal-published), exclusion of duplicate articles. Thus, 3136 articles were obtained, whose titles, abstracts and keywords were read to exclude studies that dealt with areas unrelated to e-health practices and are beyond the scope of this analysis.

Finally, the Methodi Ordinatio equation was applied to obtain the most currently relevant articles. Articles with an index greater than 100 were considered, and one study was excluded as it was not found, resulting in a final portfolio of 446 articles, as listed in Appendix A—Table A1. Final portfolio.

The database search did not exclude any publication language, aiming to obtain a broad range of results and not limit the present analyses. Table 1 shows how the studies were analyzed to answer the research questions.

The questions referring to countries that are publishing studies on e-health and countries that use these practices were answered, respectively, by identifying the country of the first author and where the studies took place. Thus, the results and discussions of the research were organized in a bibliometric and content analysis carried out on the 446 articles from the final portfolio. For the content analysis of the technologies associated with e-health, 57 articles from the final portfolio (446 articles) were analyzed as they specifically address this topic.

3. Results and Discussion

3.1. Bibliometric Analysis

Figure 2 shows the number of publications per year from 2014 to 2019.

We can see that 2014 had the lowest number of publications on the topic and 2019 the highest. There was fluctuation in the number of publications, particularly between 2018 and 2019, when a marked increase in the number of studies related to the theme of e-health occurred. This increase is related to several factors. The area of mhealth has been growing, as has the number of chronic diseases and other health problems, while the advance of mobile technology has enabled greater access to e-health through devices, enabling an increase in research [30]. An increase in publication on the topic is also due to researcher interest, as it is current and still novel, allowing for greater numbers of studies on topics within the field, as is the case with reports published about e-health indicators, such as those from the Global Health Observatory of the World Health Organization (WHO) and the Nordic e-Health Research Network [31].

Although authors from 58 countries contributed to studies, the geographical distribution was uneven, as shown in Figure 3.

The leading countries in developing research related to e-health are United States (109), Australia (41), United Kingdom (32), China (23), Italy (19), Germany (18), Norway (14), and France (10). The countries with the fewest publication include Egypt (1), Mexico (2), and Brazil (3). In the study by [32] on e-health and health informatics skills, the authors found that the countries with the most authors who published on the topic were United States, Canada, United Kingdom, and Australia, and those with the least were Denmark and Norway.

Norway, Australia, Germany, the United Kingdom, United States, France, and Italy are countries with a remarkably high Human Development Index—HDI (which is based on the health, life expectancy, education, and income of a country’s population), while Egypt, Brazil, Mexico, and China are countries with high HDI. The wealthier a country is, the better its economic, political, and healthcare infrastructure, enabling more initiatives for e-health development, as has occurred in many European countries [33,34]. Each country has a different level of e-health development, and consequently, countries with more advanced e-health systems have a higher incidence of scientific production on the topic, such as European countries and the United States, as verified by [35]. Moreover, [36] state that although countries on the African continent and Latin America are publishing on the topic, the number of studies is still low as the countries have less developed e-health systems. Such is the case with Brazil and Mexico, which are still at the stage of telehealth improvement and consolidation.

The 446 articles in the portfolio were published across 253 academic journals. However, some journals among those identified stand out for having very few publications on the topic but a high impact factor, such as The Lancet (1 publication—60.392 JCR); British Medical Journal—BMJ (1 publication—30.223 JCR); IEEE Communications Surveys & Tutorials (1 publication—23.700 JCR); IEEE Internet of Things Journal (2 publications—9.936 JCR); Schizophrenia Bulletin (2 publications—7.958 JCR); Information Sciences (2 publications—5.910 JCR); AIDS and Behavior (3 publications—3.147 JCR); Social Science & Medicine (3 publications—3.616 JCR); International Journal of Environmental Research and Public Health (3 publications—2.849 JCR); Journal of the American Medical Informatics Association—JAMIA (4 publications—4.112 JCR); Frontiers in Psychiatry (4 publications—2.849 JCR); PLoS One (4 publications—2.740 JCR).

In the analysis by [19], who conducted a literature review on e-health, and [32], who did a bibliometric study, the journals that had the most publications were Journal of Medical Internet Research and Telemedicine and e-Health.

Therefore, for the research question “In which country and journals are studies on e-health practices published worldwide?” we can see that the United States stands out as it has the greatest number of authors who published on this topic, with 109 studies. Moreover, the Journal of Medical Internet Research is the most prominent scientific outlet for research on e-health, with 47 publications.

3.2. Content Analysis

3.2.1. Main E-Health Service Delivery Types and Fields

Based on the survey of studies from the final portfolio, Table 2 presents the categories of practices and services provided in e-health as described in the analyzed studies.

When answering the research question “What are the most common e-health practices used around the world?” four categories of e-health practices became evident: (i) mhealth or mobile health; (ii) telehealth or telemedicine; (iii) technology; and (iv) others, which include combinations of different practices.

E-health can be defined as healthcare services and health information provided and/or obtained using the internet, mobile devices, computers, and information technology [64]. It involves the application of digital solutions for healthcare, thus facilitating patient care in a more comfortable way [62]. The practice areas are described below.

Mhealth or mobile health enables persons who use mobile devices, such as smartphones, to access systems, data, and apps to monitor and manage their health status [38]. Telehealth or telemedicine includes remote consultations via videoconference/call using desktop computers, smartphones, or tablets with internet access [44,67,68].

The technology applied in e-health helps healthcare professionals, patients, and the lay population to obtain information or access learning, treatment, and resources that are available online [69].

Through e-health, digital health interventions (DHIs), such as assisted therapy, have been shown as effective among children and young people undergoing mental health treatment, as discussed in the systematic review by [64] on randomized clinical trials of DHIs performed with children and young people up to 25 years of age. However, further data are required to offer satisfactory conclusions about the benefits; despite the potential that the intervention can offer, few studies have been carried out on the subject and with small sample sizes, making this assessment difficult.

In an analysis by [62], the authors evaluated the effectiveness of an electronic health project model for people with severe mental illness (SMI), called the Flat Explicit Design Model (FEDM). The study was carried out via a website with 38 people aged 31 to 59 years who have some degree of severe mental illness and involved online tests.

We also identified a study that sought to conduct a theoretical review on the services and applications offered in the practice of mhealth and their use for therapy in the areas of mental health and behavioral disorders, musculoskeletal and connective tissue systems, oncology, and the nervous system [38]. Another study assessed the skills of medical residents, doctors, and clinics working with telepsychiatry, with a focus on e-mental health (e-MH) care [44].

In the “other” category, articles describing a combination of past practices and other areas, such as costs, were included. The study by [56] assessed the current literature to verify whether specialization in telehealth offset the effective cost. The authors found specializations such as teledermatology, teleophthalmology, and telecardiology offset the amount invested in that healthcare service.

Some of the service delivery types and other themes combined with the most representative e-health practices in the literature are discussed below.

Health literacy is knowledge and skills related to health, and it can be obtained through in-person and/or online environments [70]. The latter includes websites, social media, and the use of health data systems [71]. An aspect related to this area in the analyzed studies is low health literacy, as seen in the studies by [72,73]; when searching for health information, internet users must use a critical approach to determine if the information obtained is correct. Often, the information posted online is presented erroneously, which may misguide or misinform the user about the content.

Mhealth or mobile health and monitoring consists of using smartphone applications to help in disease treatment, identification, and support [74]. It also encompasses health exam scheduling and patient monitoring performed via devices with wireless sensors that check essential vital signs, such as blood glucose level and blood pressure [38]. The results of these exams are stored on the device, thus allowing for the transmission of data from exams done at home [75].

In telehealth, when an intervention is combined with interaction with a healthcare professional, it can be defined as telemonitoring of patients with diseases that need follow-up [43]. This enables doctors to see patients without having to go to the hospital or doctor’s office [45]. Such a service delivery can be employed with mental health patients who require therapy [44], enabling them to participate in sessions at home at more flexible times [76]. It can also be used to monitor the symptoms of cancer patients undergoing treatment [77].

The systems related to the category “technology” entail the creation of encryptions to protect the data of patients who access their medical records online, as well as data protection in the systems of hospitals, pharmacies, and clinics [52,53] so that data remain confidential and secure [54]. Technology also involves creating support for the systems [78] and developing mobile devices that can be used in the healthcare sector, such as wearable sensors [79]. Further, it includes the use of Internet of Things (IoT) [80], cloud storage [81], and Big Data [82] in the areas of e-health.

Regarding the research question “What are the main service delivery types and medical fields served in e-health?” we found that the main areas of service provision are health literacy, mhealth and monitoring, telehealth, and systems combined with technology. In turn, the main medical fields served that are highlighted in the literature are telepsychiatry, teledermatology, telerehabilitation, teleophthalmology, telecardiology, and teledentistry.

As for the research question “What are the main barriers to e-health service delivery?” we found that costs, laws, and system data security of are the main barriers to be overcome. We identified studies related to e-health practices experiencing barriers in terms of costs related to the use of telemedicine [83], regulation and legislation [38], security in the use of cloud computing [84], limitations in clinical trials of existing digital interventions [64], and limitations in databases [58]. In mHealth, a limiting factor is mobile device battery life [85], as the devices with applications or monitoring equipment must have the battery charged to avoid any problems during use [86]. Further, geographic distance is a primary limiting factor, as each country has different health-related applications available to the population [87] and barriers between patient and physician [38].

3.2.2. Main Diseases Treated

Figure 4 shows the main diseases treated in e-health (total and percentage), addressing the research question “What are the most commonly treated diseases and in which countries have e-health services been used?” The most commonly treated diseases are mental illnesses, multiple diseases (diabetes mellitus 1 and 2, stress, depression, and anxiety), cancer, eating disorders, chronic illness, cardiovascular diseases, and sexually transmitted diseases (STDs). Regarding the countries that currently use e-health, we identified the following countries where studies have been conducted: United States, Canada, Australia, Germany, Sub-Saharan Africa, Africa, Netherlands, Sweden, Switzerland, China, Italy, Greece, Finland, Iran, Iraq, Bangladesh, Pakistan, Saudi Arabia, United Kingdom, Spain, France, Italy, and Portugal.

Some of the studies evaluate more than one type of issue, for instance, diabetes mellitus (DM), cardiovascular diseases, and chronic lung diseases [39]; mental illnesses such as depression, anxiety, dementia [76]; others, such as the oral health of pregnant women in prenatal care, anti-smoking, organ transplants [88]; cancer, such as breast cancer, skin cancer, and lung cancer [77]; eating disorders, including care regarding infant nutrition, diabetes, and obesity in adults [75]; chronic illness, such as chronic inflammatory rheumatic diseases (CIRDs), asthma, and chronic pain [10]; cardiovascular diseases [89]; cerebrovascular accident (CVA), coronary artery disease, and atrial fibrillation (AF) [90]; sexually transmitted diseases (STDs), such as HIV and/or sexually transmitted infections (STIs) [50]; human papillomavirus (HPV) and child sexual abuse [91].

Mental illnesses and the studies combining more than one type of disease represented 40% of diseases treated with e-health addressed in the literature. The studies deal mainly with randomized clinical trials applied to groups of people. For example, in the study conducted by [92], the authors verified how a telerehabilitation program works to help control type 2 DM. In the study by [93], a randomized clinical trial (RCT) was carried out with 13 primary brain tumor patients. Using the ReMind App, the pilot study obtained favorable results from patients but still required improvement. On the other hand, [94] observed 66 stroke (CVA) patients and their caregivers for eight weeks, using an e-health system as a treatment aid to do physical exercise. They found no significant effect on patient improvement during that period.

Other authors have chosen to review randomized studies, such as the study by [95], who compared the estimated sizes of combined effects through meta-analyses of analysis of covariance (ANCOVA), simple analysis of change score (SACS), and simple analysis of final values (SAFV), using RCTs of digital interventions with glycated hemoglobin HbA1c as the main result or intervention for disease treatment using e-health practices. Finally, in the study by [96], the use of mhealth for intervention as a form of treatment for patients with hallucinations was investigated.

3.2.3. Technologies Associated with E-Health

From the final portfolio (446 articles), 57 publications were selected that address topics related to technology applied in healthcare. When answering the question “What are the most used technologies in e-health?” we identified IoT, cloud computing, Big Data, security, cryptography, algorithms, among others, as shown in Figure 5.

The technology applied to healthcare includes IoT to integrate medical sensors [80], authenticate, encrypt [97], and maintain security and confidentiality during data exchanges [98] and between physicians and patients [99]. It is vital that users are confident that the systems used are protected [100] and authenticated to ensure the privacy of stored data [51,101]. The cloud system facilitates data storage at a low cost while also being secure and private [42,81,84].

The use of Big Data entails the analysis, diagnosis, and treatment of diseases [82,102]. There is also the use of wireless sensors applied to clothing, which can be used to monitor a patient when performing physical exercise [103,104,105].

The first authors of each of the 57 articles addressing technology in e-health are from 35 different countries, principally China (with 10 articles); India (6 articles); the United States, Australia, and Italy (3 articles each); and Greece, Algeria, Pakistan, and Saudi Arabia (2 articles each). Other countries, such as Spain, South Africa, and Mexico, had only one study. Articles related to technology were published in 38 journals, mainly Future Generation Computer Systems (7 articles); IEEE Access (4); International Journal of Information Management (4); Journal of Medical Systems (3); Computers & Electrical Engineering (2); Health and Technology (2); Information Sciences (1); and Telematics and Informatics (1). In the literature review by [106] on the application of cloud computing in e-health, 44 studies published between 2010 and 2013 were analyzed. The authors were from countries including the United States (11), Australia (4), China (3), India (2), and Spain (1). As we can see, the results found by [106] are similar to those reported herein.

Through an analysis of the literature, we found that technology can provide benefits across healthcare practices, such as the development of products, processes, and systems, as well as support decision-making. Nonetheless, data security and privacy remain a concern, both for developers and users; regardless of how efficient technologies are becoming, there can always be failures. Thus, there is room for in-depth studies and the development of technologies with more secure systems.

4. Conclusions

To achieve its proposed objective, the present study used a systematic literature review of articles published from 2014 to 2019, resulting in the analysis of 446 articles. Six research questions were defined to analyze the literature on e-health practices. Through the analysis, four categories of the most common practices in the field were identified: “mhealth or mobile health”; “telehealth or telemedicine”; “technology”; and “others.” The main services provided with e-health practices are health literacy, mhealth and monitoring, telehealth, and systems combined with technology. Regarding the fields of medical specialties that offer consultations via telehealth, the following were identified: telepsychiatry, teledermatology, telerehabilitation, teleophthalmology, telecardiology, and teledentistry. Other fields were also found that offer services in e-health, such as geriatrics, general medicine, endocrinology, pediatrics, gynecology, and oncology.

Furthermore, 146 of the 446 studies analyzed use one of the common practices for disease diagnosis/treatment/monitoring, with mental illnesses and studies combining the treatment of multiple disease corresponding to 40%. Among the most frequently treated diseases are diabetes mellitus, cardiovascular diseases, chronic lung diseases, and mental illnesses (depression, anxiety, dementia). In terms of the countries that current use e-health, countries in Europe (Austria and Germany), Africa (Sub-Saharan countries), Asia (China), and North America (United States and Canada) stand out.

In relation to the technologies adopted in e-health practices, IoT, cloud computing, Big Data, security, and systems are among the most common.

Systemic reviews such as the one presented herein are important to provide more precise targeting of the practices and technologies that can be adopted in different procedures and processes, considering the context of each country. In general, such analyses can offer information and guide physicians and patients in the use of “new” services.

A study can always be improved, and the present one is no exception. Although the methodology applied followed careful steps and well-defined filters, the choice of only three keywords (considered comprehensive) may have resulted in the exclusion of some relevant studies in the analysis.

The present study was completed at the beginning of the global COVID-19 pandemic, during which physicians and patients began to use considerably more e-health practices and services due to the restrictions imposed by social isolation. Further studies are needed to address the growth in e-health practices, including services, diseases, and new approaches that are in greater demand, and the breakdown of government-imposed restrictions on expanding the use of e-health.

Author Contributions

All authors contributed in some way to the study design. M.H.d.F. wrote the article and had the help of F.K., C.T.P. guided and corrected the manuscript. B.P. made the final correction of the manuscript. P.R. helped in the correction of the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and Fundação Araucária.

Informed Consent Statement

Not applicable.

Acknowledgments

The authors would like to thank the Organizations and Society Research Laboratory, Federal University of Technology—Paraná, Brazil.

Conflicts of Interest

The authors declare no conflict of interest.

Appendix A

Table A1. Final portfolio.

Author	Title	Journal	Impact Factor	Year	Citations	InOrdinatio 10
Stoyanov, S.R.; Hides, L.; Kavanagh, D.J.; Zelenko, O.; Tjondronegoro, D.; Mani, M.	Mobile app rating scale: A new tool for assessing the quality of health mobile apps	JMIR mHealth and uHealth	4.301	2015	550	550.00
[38] Silva, B.M.C.; Rodrigues, J.J.P.C.; Torre-Díez, I.D.L.; Lopez-Coronado, M.; Saleem, K.	Mobile-health: A review of current state in 2015	J. Biomed. Inf.	2.950	2015	454	514.00
[83] Flodgren, G.; Rachas, A.; Farmer, A.J.; Inzitari, M.; Shepperd, S.	Interactive telemedicine: Effects on professional practice and health care outcomes	Cochrane Database Syst. Rev.	7.755	2015	245	305.01
[39] Whitehead, L.; Seaton, P.	The effectiveness of self-management mobile phone and tablet apps in long-term condition management: A systematic review	J. Med. Internet. Res.	4.945	2016	206	276.00
Sultan, N.	Making use of cloud computing for healthcare provision: Opportunities and challenges	International Journal of Information Management	5.063	2014	202	252.01
[105] Wang, J.B.; Cadmus-Bertram, L.A.; Natarajan, L.; White, M.M.; Madanat, H.; Nichols, J.F.; Ayala, G.X.; Pierce, J.P.	Wearable sensor/device (Fitbit One) and SMS text-messaging prompts to increase physical activity in overweight and obese adults: A randomized controlled trial	Telemed. e-Health	1.996	2015	173	233.00
Fortino, G.; Galzarano, S.; Gravina, R.; Li, W.	A framework for collaborative computing and multi-sensor data fusion in body sensor networks	Information Fusion	10.716	2015	167	227.01
Boudreaux, E.; Waring, M.; Hayes, R.; Sadasivam, R.; Mullen, S.; Pagoto, S.	Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations	Transl. Behav. Med.	2.237	2014	173	223.00
[3] Ross, J.; Stevenson, F.; Lau, R.; Murray, E.	Factors that influence the implementation of e-health: A systematic review of systematic reviews (an update)	Implement Sci.	0	2016	149	219.00
Naslund, J.; Marsch, L.; McHugo, G.; Bartels, S.	Emerging mHealth and eHealth interventions for serious mental illness: A review of the literature	J. Ment. Health	2.604	2015	156	216.00
[56] Torre-Díez, I.D.L.; Lopez-Coronado, M.; Vaca, C.; Saez Aguado, J.; De Castro, C.	Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: A Systematic review	Telemedicine and e-Health	1.996	2015	150	210.00
Firth, J.; Torous, J.; Nicholas, J.; Carney, R.; Rosenbaum, S.; Sarris, J.	Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials	J. Affect Disord.	4.084	2017	123	203.00
Riley, R.D.; Ensor, J.; Snell, K.I.E.; Debray, T.P.A.; Altman, D.G., Moons, K.G.M.; Collins, G.S.	External validation of clinical prediction models using big datasets from e-health records or IPD meta-analysis: Opportunities and challenges	BMJ—British Medical Journal	27.604	2016	121	191.03
Poria, S.; Cambria, E.; Hussain, A.; Huang, G.B.	Towards an intelligent framework for multimodal affective data analysis	Neural Networks	5.785	2015	131	191.01
[74] Larsen, M.E.; Nicholas, J.; Christensen, H.	A systematic assessment of smartphone tools for suicide prevention	Plos One	2.776	2016	121	191.00
[64] Hollis, C.; Falconer, C.; Martin, J.; Whittington, C.; Stockton, S.; Glazebrook, C.; Davies, E.	Annual research review: digital health interventions for children and young people with mental health problems—a systematic and meta-review	J. Child. Psychol. Psychiatry	6.129	2017	109	189.01
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Chouvarda, I.G.; Goulis, D.G.; Lambrinoudaki, I.; Maglaveras, N.	Connected health and integrated care: Toward new models for chronic disease management	Maturitas	3.654	2015	50	110.00
Ferreri, F.; Bourla, A.; Mouchabac, S.; Karila, L.	e-Addictology: An overview of new technologies for assessing and intervening in addictive behaviors	Front. Psychiatry	3.162	2018	20	110.00
Lee, E.W.; Denison, F.C.; Hor, K.; Reynolds, R.M.	Web-based interventions for prevention and treatment of perinatal mood disorders: A systematic review	BMC Pregnancy and Childbirth	2.413	2016	40	110.00
Pietro, C.D.; Francetic, I.	E-health in Switzerland: the laborious adoption of the federal law on electronic health records (EHR) and health information exchange (HIE) networks	Health Policy	2.075	2018	20	110.00
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Pussewalage, H.S.G.; Oleshchuk, V.A.	Privacy preserving mechanisms for enforcing security and privacy requirements in e-health solutions	International Journal of Information Management	5.063	2016	39	109.01
Dimidjian, S.; Beck, A.; Felder, J.N.; Boggs, J.M.; Gallop, R.; Segal, Z.V.	Web-based mindfulness-based cognitive therapy for reducing residual depressive symptoms: An open trial and quasi-experimental comparison to propensity score matched controls	Behaviour Research and Therapy	4.309	2014	59	109.00
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Aardoom, J.J.; Dingemans, A.E.; Van Furth, E.F.	E-health interventions for eating disorders: Emerging findings, issues, and opportunities	Curr. Psychiatry Rep.	3.816	2016	39	109.00
Machado, G.; Pinheiro, M.; Lee, H.; Ahmed, O.; Hendrick, P., Williams, C.; Kamper, S.	Smartphone apps for the self-management of low back pain: A systematic review	Best Practice & Research Clinical Rheumatology	3.016	2016	39	109.00
Slev, V.N.; Mistiaen, P.; Pasman, H.R.W.; Verdonck-de Leeuw, I.M.; van Uden-Kraan, C.F.; Francke, A.L.	Effects of eHealth for patients and informal caregivers confronted with cancer: A meta-review	International Journal of Medical Informatics	2.721	2016	39	109.00
Hossain, N.; Yokota, F.; Sultana, N.; Ahmed, A.	Factors influencing rural end-users’ acceptance of e-health in developing countries: A study on portable health clinic in Bangladesh	Telemedicine and e-Health	1.996	2019	9	109.00
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Aghili, S.F.; Mala, H.; Shojafar, M.; Peris-Lopez, P.	LACO: Lightweight three-factor authentication, access control and ownership transfer scheme for e-health systems in IoT	Future Generation Computer Systems	5.768	2019	8	108.01
Yang, Y.; Zheng, X.; Liu, X.; Zhong, S.; Chang, V.	Cross-domain dynamic anonymous authenticated group key management with symptom-matching for e-health social system	Future Generation Computer Systems	5.768	2018	18	108.01
Vitacca, M.; Montini, A.; Comini, L.	How will telemedicine change clinical practice in chronic obstructive pulmonary disease?	Ther. Adv. Respir. Dis.	3.286	2018	18	108.00
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Zhao, X.; Yang, B.; Wong, C.-W.	Analyzing trend for U.S. Immigrants’ e-health engagement from 2008 to 2013	Health Communication	1.846	2019	5	105.00
Keasberry, J.; Scott, I.A.; Sullivan, C.; Staib, A.; Ashby, R.	Going digital: A narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice	Australian Health Review	1.228	2017	25	105.00
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Hammersley, M.; Okely, A.; Batterham, M.; Jones, R.	An internet-based childhood obesity prevention program (TIMe2bhealthy) for parents of preschool-aged children: randomized controlled trial	J. Med. Internet Res.	4.945	2019	4	104.00
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Orchard, J.; Neubeck, L.; Freedman, B.; Li, J.; Webster, R.; Zwar, N.; Gallagher, R.; Ferguson, C.; Lowres, N.	eHealth tools to provide structured assistance for atrial fibrillation screening, management, and guideline-recommended therapy in metropolitan general practice: The AF-SMART study	J. Am. Heart Assoc.	4.660	2019	4	104.00
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Warrington, L.; Absolom, K.; Velikova, G.	Integrated care pathways for cancer survivors—a role for patient-reported outcome measures and health informatics	Acta Oncologica	3.298	2015	44	104.00
Gossec, L.; Molto, A.; Romand, X.; Puyraimond-Zemmour, D.; Lavielle, M.; Beauvais, C.; Senbel, E.; Flipo, R.M.; Pouplin, S.; Richez, C.; Saraux, A.; Mézières, M.; Gutermann, L., Gaudin, P.; Wendling, D.; Dougados, M.	Recommendations for the assessment and optimization of adherence to disease-modifying drugs in chronic inflammatory rheumatic diseases: A process based on literature reviews and expert consensus	Joint Bone Spine	3.278	2019	4	104.00
Kitsios, F.; Stefanakakis, S.; Kamariotou, M.; Dermentzoglou, L.	E-service evaluation: User satisfaction measurement and implications in health sector	Computer Standards & Interfaces	2.441	2019	4	104.00
Lindner, P.; Miloff, A.; Zetterlund, E.; Reuterskiold, L.; Andersson, G.; Carlbring, P.	Attitudes toward and familiarity with virtual reality therapy among practicing cognitive behavior therapists: A cross-sectional survey study in the era of consumer VR platforms	Frontiers in Psychology	2.129	2019	4	104.00
Cho, Y.M.; Lee, S.; Islam, S.; Kim, S.Y.	Theories applied to m-health interventions for behavior change in low- and middle-income countries: A systematic review	Telemedicine and e-Health	1.996	2018	14	104.00
Terrasse, M., Gorin, M.; Sisti, D.	Social media, e-health, and medical ethics	Hastings Center Report	1.728	2019	4	104.00
Öberg, U.; Orre, C.; Isaksson, U.; Schimmer, R.; Larsson, H.; Hörnsten, Å.	Swedish primary healthcare nurses’ perceptions of using digital eHealth services in support of patient self-management	Scand. J. Caring Sci.	1.642	2018	14	104.00
Razmak, J.; Belanger, C.	Using the technology acceptance model to predict patient attitude toward personal health records in regional communities	Information Technology & People	1.263	2018	14	104.00
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Willmott, T.; Pang, B.; Rundle-Thiele, S.; Badejo, A.	Weight management in young adults: Systematic review of electronic health intervention components and outcomes	J. Med. Internet Res.	4.945	2019	3	103.00
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Chenthara, S.; Ahmed, K.; Wang, H.; Whittaker, F.	Security and privacy-preserving challenges of e-health solutions in cloud computing	Access, IEEE	4.098	2019	3	103.00
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Karekla, M.; Kasinopoulos, O.; Neto, D.; Ebert, D.; Van Daele, T.; Nordgreen, T.; Höfer, S.; Oeverland, S.; Jensen, K.	Best practices and recommendations for digital interventions to improve engagement and adherence in chronic illness sufferers	European Psychologist	2.167	2019	3	103.00
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Leung, L.; Chen, C.	E-health/m-health adoption and lifestyle improvements: Exploring the roles of technology readiness, the expectation-confirmation model, and health-related information activities	Telecomm Policy	2.000	2019	3	103.00
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Kubendiran, M.; Singh, S.; Sangaiah, A.K.	Enhanced security framework for e-health systems using blockchain	Journal of Information Processing Systems	0	2019	3	103.00
Celesti, A.; Fazio, M.; Márquez, F.; Glikson, A.; Mauwa, H.; Bagula, A., Celesti, F.; Villari, M.	How to develop IoT cloud e-health systems based on fiware: A lesson learnt	Journal of Sensor and Actuator Networks	0	2019	3	103.00
Alvarez, C.; Fedock, G.	Addressing intimate partner violence with Latina women: A call for research	Trauma Violence Abuse	0	2018	13	103.00
Van Der Meij, E.; Anema, J.R.; Leclercq, W.K.G.; Bongers, M.Y.; Consten, E.C.J.; Koops, S.E.S.; Van De Ven, P.M.; Terwee, C.B.; Van Dongen, J.M.; Schaafsma, F.G.; Meijerink, W.J.H.J.; Bonjer, H.J.; Huirne, J.A.F.	Personalised perioperative care by e-health after intermediate-grade abdominal surgery: A multicentre, single-blind, randomised, placebo-controlled trial	Lancet	59.102	2018	12	102.06
Islam, N.; Faheem, Y.; Din, I.U.; Talha, M.; Guizani, M.; Khalil, M.	A blockchain-based fog computing framework for activity recognition as an application to e-healthcare services	Future Generation Computer Systems	5.768	2019	2	102.01
Peddi, V.B.; Kuhad, P.; Yassine, A.; Pouladzadeh, P.; Shirmohammadi, S.; Shirehjini, A.A.N.	An intelligent cloud-based data processing broker for mobile e-health multimedia applications	Future Generation Computer Systems	5.768	2017	22	102.01
Chen, Y.; Crespi, N.; Ortiz, A.M.; Shu, L.	Reality mining: A prediction algorithm for disease dynamics based on mobile Big Data	Information Sciences	5.524	2017	22	102.01
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Vis, C.; Ruwaard, J.; Finch, T.; Rapley, T.; De Beurs, D.; Van Stel, H.; Van Lettow, B.; Mol, M.; Kleiboer, A.; Riper, H.; Smit, J.	Toward an objective assessment of implementation processes for innovations in health care: Psychometric evaluation of the normalization Measure Development (NOMAD) questionnaire among mental health care professionals	J. Med. Internet Res.	4.945	2019	2	102.00
Wu, B.	Patient continued use of online health care communities: Web mining of patient-doctor communication	J. Med. Internet Res.	4.945	2018	12	102.00
Hossain, M.; Poon, C.; Dong, Y.; Lo, I.; Cheng, J.	Development of social sustainability assessment method and a comparative case study on assessing recycled construction materials	International Journal of Life Cycle Assessment	4.868	2018	12	102.00
Barteit, S.; Neuhann, F.; Barnighausen, T.; Luders, S.; Malunga, G.; Chileshe, G.; Marimo, C.; Jahn, A.	Perspectives of nonphysician clinical students and medical lecturers on tablet-based health care practice support for medical education in Zambia, Africa: Qualitative study	JMIR mHealth and uHealth	4.301	2019	2	102.00
Antonio, M.; Petrovskaya, O.; Lau, F.	Is research on patient portals attuned to health equity? A scoping review	J. Am. Med. Inform. Assoc.	4.292	2019	2	102.00
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Odelu, V.; Saha, S.; Prasath, R.; Sadineni, L.; Conti, M.; Jo, M.	Efficient privacy preserving device authentication in WBANs for industrial e-health applications	Computers & Security	3.062	2019	2	102.00
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Azeez, N.A.; Der Vyver, C.	Security and privacy issues in e-health cloud-based system: A comprehensive content analysis	Egyptian Informatics Journal	2.306	2019	2	102.00
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Possemato, K.; Johnson, E.M.; Emery, J.B.; Wade, M.; Acosta, M.C.; Marsch, L.A.; Rosenblum, A.; Maisto, S.A.	A pilot study comparing peer supported web-based CBT to self-managed web CBT for primary care veterans with PTSD and hazardous alcohol use	Psychiatric Rehabilitation Journal	2.270	2019	2	102.00
Hossain, N.; Sampa, M.B.; Yokota, F.; Fukuda, A.; Ahmed, A.	Factors affecting rural patients’ primary compliance with e-prescription: A developing country perspective	Telemedicine and e-Health	1.996	2019	2	102.00
AlBar, A.M.; Hoque, M.R.	Patient acceptance of e-health services in Saudi Arabia: An integrative perspective	Telemedicine and e-Health	1.996	2019	2	102.00
Treskes, R.; Wildbergh, T.; Schalij, M.; Scherptong, R.	Expectations and perceived barriers to widespread implementation of e-health in cardiology practice: Results from a national survey in the Netherlands	Neth. Heart J.	1.972	2019	2	102.00
Koole, M.A.C.; Kauw, D.; Winter, M.M.; Dohmen, D.A.J.; Tulevski, I.I.; de Haan, R.; Somsen, G.A.; Schijven, M.P.; Robbers-Visser, D.; Mulder, B.J.M.; Bouma, B.J.; Schuuring, M.J.	First real-world experience with mobile health telemonitoring in adult patients with congenital heart disease	Neth. Heart J.	1.972	2019	2	102.00
Kim, S.C.; Shaw, B.R.; Shah, D.V.; Hawkins, R.P.; Pingree, S.; McTavish, F.M.; Gustafson, D.H.	Interactivity, presence, and targeted patient care: Mapping e-health intervention effects over time for cancer patients with depression	Health Communication	1.846	2019	2	102.00
Hang, L.; Choi, E.; Kim, D.H.	A novel EMR integrity management based on a medical blockchain platform in hospital	Electronics	1.764	2019	2	102.00
Dao, J.; Spooner, C.; Lo, W.; Harris, M.	Factors influencing self-management in patients with type 2 diabetes in general practice: A qualitative study	Australian Journal of Primary Health	1.024	2019	2	102.00
Lee, H.; Sullivan, S.J.; Schneiders, A.G.; Ahmed, O.H.; Balasundaram, A.P.; Williams, D.; Meeuwisse, W.H.; McCrory, P.	Smartphone and tablet apps for concussion road warriors (team clinicians): A systematic review for practical users	Br. J. Sports Med.	0	2015	42	102.00
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Kooistra, L.; Ruwaard, J.; Wiersma, J.; Van Oppen, P.; Van Der Vaart, R.; Van Gemert-Pijnen, J.; Riper, H.	Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care	Internet Interv.	0	2016	32	102.00
Petrakis, E.G.; Sotiriadis, S.; Soultanopoulos, T.; Renta, P.T.; Buyya, R.; Bessis, N.	Internet of Things as a Service (iTaaS): Challenges and solutions for management of sensor data on the cloud and the fog	Internet of Things	0	2018	12	102.00
Rajan, S.P.	Review and investigations on future research directions of mobile based telecare system for cardiac surveillance	J. Appl. Res. Technol.	0	2015	42	102.00
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Van Den Berg, M.; Crotty, M.; Liu, E.; Killington, M.; Kwakkel, G.; Van Wegen, E.	Early supported discharge by caregiver-mediated exercises and e-health support after stroke: A proof-of-concept trial	Stroke	6.046	2016	31	101.01
Al-Sharhan, S.; Omran, E.; Lari, K.	An integrated holistic model for an eHealth system: A national implementation approach and a new cloud-based security model	International Journal of Information Management	5.063	2019	1	101.01
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Danaher, B.; Tyler, M.; Crowley, R.; Brendryen, H.; Seeley, J.	Outcomes and device usage for fully automated internet interventions designed for a smartphone or personal computer: The MobileQuit smoking cessation randomized controlled trial	J. Med. Internet Res.	4.945	2019	1	101.00
Din, H.; Mcdaniels-Davidson, C.; Nodora, J.; Madanat, H.	Profiles of a health information-seeking population and the current digital divide: Cross-sectional analysis of the 2015–2016 California health interview survey	J. Med. Internet Res.	4.945	2019	1	101.00
Holter, M.; Johansen, A.; Ness, O.; Brinkmann, S.; Hoybye, M.; Brendryen, H.	Qualitative interview studies of working mechanisms in electronic health: tools to enhance study quality	J. Med. Internet Res.	4.945	2019	1	101.00
Kuipers, E.; Poot, C.C.; Wensing, M.; Chavannes, N.H.; de Smet, P.A.G.M.; Teichert, M.	Self-Management Maintenance Inhalation Therapy with eHealth (SELFIE): Observational study on the use of an electronic monitoring device in respiratory patient care and research	J. Med. Internet Res.	4.945	2019	1	101.00
Hsia, T.-L.; Chiang, A.-J.; Wu, J.-H.; Teng, N.N.; Rubin, A.D.	What drives e-health usage? Integrated institutional forces and top management perspectives	Computers in Human Behavior	4.306	2019	1	101.00
Klaib, A.F.; Nuser, M.S.	Evaluating EHR and health care in Jordan according to the international Health Metrics Network (HMN) framework and standards: A case study of Hakeem	Access, IEEE	4.098	2019	1	101.00
Menon, A.; Gray, L.; Fatehi, F.; Bird, D.; Darssan, D.; Karunanithi, M.; Russell, A.	Mobile-based insulin dose adjustment for type 2 diabetes in community and rural populations: Study protocol for a pilot randomized controlled trial	Ther. Adv. Endocrinol. Metab.	3.543	2019	1	101.00
Smith, B.; Magnani, J.	New technologies, new disparities: The intersection of electronic health and digital health literacy	International Journal of Cardiology	3.471	2019	1	101.00
Gibbs, J.; Gkatzidou, V.; Tickle, L.; Manning, S.; Tilakkumar, T.; Hone, K.; Ashcroft, R.; Sonnenberg, P.; Sadiq, S.; Estcourt, C.	“Can you recommend any good STI apps?” A review of content, accuracy and comprehensiveness of current mobile medical applications for STIs and related genital infections	Sex Transm Infect	3.365	2017	21	101.00
Heard, K.; Hughes, S.; Mughal, N.; Azadian, B.; Moore, L.	Evaluating the impact of the ICNET^® clinical decision support system for antimicrobial stewardship	Antimicrobial Resistance and Infection Control	3.224	2019	1	101.00
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Miramontes, R.; Aquino, R.; Flores, A.; Rodríguez, G.; Anguiano, R., Ríos, A.; Edwards, A.	PlaIMoS: A remote mobile healthcare platform to monitor cardiovascular and respiratory variables	Sensors	3.031	2017	21	101.00
Woods, S.; Sullivan, K.	Lower neurocognitive functioning disrupts the effective use of internet-based health resources in HIV disease: the mediating effects of general health literacy capacity	AIDS Behav.	2.908	2019	1	101.00
Young, C.; Campolonghi, S.; Ponsonby, S.; Dawson, S.L.; O’Neil, A.; Kay-Lambkin, F.; McNaughton, S.A.; Berk, M.; Jacka, F.N.	Supporting engagement, adherence, and behavior change in online dietary interventions	Journal of Nutrition Education and Behavior	2.869	2019	1	101.00
Walsh, K; Pryor, T.; Reynolds, K.; Walker, J.	Searching for answers: How well do depression websites answer the public’s questions about treatment choices?	Patient Educ. Couns.	2.821	2019	1	101.00
Cipolletta, S.; Mocellin, D.	Online counseling: An exploratory survey of Italian psychologists’ attitudes towards new ways of interaction	Psychother. Res.	2.788	2018	11	101.00
Olivero, E.; Bert, F.; Thomas, R.; Scarmozzino, A.; Raciti, I.; Gualano, M.; Siliquini, R.	E-tools for hospital management: An overview of smartphone applications for health professionals	International Journal of Medical Informatics	2.721	2019	1	101.00
Calvillo-Arbizu, J.; Roa-Romero, L.M.; Estudillo-Valderrama, M.A.; Salgueira-Lazo, M.; Aresté-Fosalba, N.; Del Castillo-Rodríguez, N.L.; González-Cabrera, F.; Marrero-Robayna, S.; De-La Manzana, V.L.; Román-Martínez, I.	User-centred design for developing e-health system for renal patients at home (AppNephro)	International Journal of Medical Informatics	2.721	2019	1	101.00
Haddad, S.; Souza, R.; Cecatti, J.	Mobile technology in health (mHealth) and antenatal care—searching for apps and available solutions: A systematic review	International Journal of Medical Informatics	2.721	2019	1	101.00
Miñarro-Giménez, J.; Cornet, R.; Jaulent, M.; Dewenter, H.; Thun, S., Gøeg, K.; Karlsson, D.; Schulz, S.	Quantitative analysis of manual annotation of clinical text samples	International Journal of Medical Informatics	2.721	2019	1	101.00
Lauridsen, S.; Braae, U.C.; Ngowi, H.A.; Johansen, M.V.	Impacts of using the electronic-health education program “The Vicious Worm” for prevention of Taenia solium	Acta Tropica	2.629	2019	1	101.00
Heger, I; Deckers, K.; Van Boxtel, M.; De Vugt, M.; Hajema, K., Verhey, F.; Köhler, S.	Dementia awareness and risk perception in middle-aged and older individuals: Baseline results of the MijnBreincoach survey on the association between lifestyle and brain health	BMC Public Health	2.567	2019	1	101.00
Kloek, C.; Van Tilburg, M.; Staal, J.; Veenhof, C.; Bossen, D.	Development and proof of concept of a blended physiotherapeutic intervention for patients with non-specific low back pain	Physiotherapy (United Kingdom)	2.534	2019	1	101.00
Novak, S.; Djordjevic, N.	Information system for evaluation of healthcare expenditure and health monitoring	Physica A	2.500	2019	1	101.00
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Wiljer, D.; Charow, R.; Costin, H.; Sequeira, L.; Anderson, M., Strudwick, G.; Tripp, T.; Crawford, A.	Defining compassion in the digital health age: Protocol for a scoping review	BMJ Open	2.376	2019	1	101.00
Mangin, D.; Parascandalo, J., Khudoyarova, O., Agarwal, G., Bismah, V.; Orr, S.	Multimorbidity, eHealth and implications for equity: A cross-sectional survey of patient perspectives on eHealth	BMJ Open	2.376	2019	1	101.00
Krusche, A.; Bradbury, K.; Corbett, T.; Barnett, J.; Stuart, B.; Yao, G.L.; Bacon, R.; Böhning, D.; Cheetham-Blake, T.; Eccles, D.; Foster, C.; Geraghty, A.W.A.; Leydon, G.; Müller, A.; Neal, R.D.; Osborne, R.; Rathod, S.; Richardson, A.; Sharman, G.; Summers, K.; Watson, E.; Wilde, L.; Wilkinson, C.; Yardley, L.; Little, P.	Renewed: Protocol for a randomised controlled trial of a digital intervention to support quality of life in cancer survivors	BMJ Open	2.376	2019	1	101.00
Zayyad, M.A.; Toycan, M.	Factors affecting sustainable adoption of e-health technology in developing countries: An exploratory survey of Nigerian hospitals from the perspective of healthcare professionals	PEERJ	2.353	2018	11	101.00
Zanutto, A.	“Two clicks and I’m in!” Patients as co-actors in managing health data through a personal health record infrastructure	Health Informatics J.	2.297	2019	1	101.00
Mauco, K.L.; Scott, R.E.; Mars, M.	Critical analysis of e-health readiness assessment frameworks: Suitability for application in developing countries	J. Telemed. Telecare	2.229	2018	11	101.00
Olayiwola, J.N.; Potapov, A.; Gordon, A.; Jurado, J.; Magana, C.; Knox, M.; Tuot, D.	Electronic consultation impact from the primary care clinician perspective: Outcomes from a national sample	J. Telemed. Telecare	2.229	2019	1	101.00
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Nymberg, V.M.; Bolmsjo, B.B.; Wolff, M.; Calling, S.; Gerward, S.; Sandberg, M.	“Having to learn this so late in our lives horizontal…” Swedish elderly patients’ beliefs, experiences, attitudes and expectations of e-health in primary health care	Scand J Prim Health Care	2.095	2019	1	101.00
Gupta, S.; Cheung, V.L.S.; Kastner, M.; Straus, S.; Kaplan, A.; Boulet, L.-P.; Sale, J.E.M.	Patient preferences for a touch screen tablet-based asthma questionnaire	Journal of Asthma	2.081	2019	1	101.00
James, N.; Power, E.; Hogden, A.; Vucic, S.	Patients’ perspectives of multidisciplinary home-based e-health service delivery for motor neurone disease	Disability and rehabilitation	2.054	2019	1	101.00
Dang, S.; Ruiz, D.; Klepac, L.; Morse, S.; Becker, P.; Levy, C.; Kinosian, B.; Edes, T.	Key characteristics for successful adoption and implementation of home telehealth technology in Veterans Affairs home-based primary care: An exploratory study	Telemedicine and e-Health	1.996	2019	1	101.00
Botrugno, C.	Towards an ethics for telehealth	Nurs Ethics	1.957	2019	1	101.00
Petrellis, N.; Birbas, M.; Gioulekas, F.	On the design of low-cost IoT sensor node for e-health environments	Electronics	1.764	2019	1	101.00
Shin, S.Y.	Current status and future direction of digital health in Korea	Korean J. Physiol. Pharmacol	1.654	2019	1	101.00
Van Dooren, M.M.; Siriaraya, P.; Visch, V.; Spijkerman, R.; Bijkerk, L.	Reflections on the design, implementation, and adoption of a gamified eHealth application in youth mental healthcare	Entertainment Computing	1.297	2019	1	101.00
Kinnunen, U.-M.; Heponiemi, T.; Rajalahti, E.; Ahonen, O.; Korhonen, T.; Hyppönen, H.	Factors related to health informatics competencies for nurses—results of a national electronic health record survey	CIN—Computers Informatics Nursing	1.029	2019	1	101.00
Del Río Carral, M.; Schweizer, A.; Papon, A.; Santiago-Delefosse, M.	Connected objects and health applications: Exploratory study on attitudes, use (or non-use) and contexts of use [Les objets connectés et applications de santé: étude exploratoire des perceptions, usages (ou non) et contextes d’usage]	Pratiques Psychologiques	0.196	2019	1	101.00
Kiberu, V.M.; Mars, M.; Scott, R.E.	Barriers and opportunities to implementation of sustainable e-health programmes in Uganda: A literature review	AFR. J. Prim. Health Care Fam. Med.	0	2017	21	101.00
Delgado, J.A.M.; Alonso, F.J.M.; Boquet, E.M.; de Tomás, J.F.Á.; Díez, J.M.C.	Competencias digitales clave de los profesionales sanitarios	Educación Médica	0	2019	1	101.00
Dai, J.; Granikov, V.; El Sherif, R.; Grguric, E.; Turcotte, E.; Pluye, P.	Patient Information Aid: An innovative educational program to improve outcomes of online consumer health information	Education For Information	0	2019	1	101.00
Kose, T.; Oymak, C.	E-health in Turkey: An analysis of consumer activities	Health and Technology	0	2019	1	101.00
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Merlo, C.; Akle, A.A.; Llaria, A.; Terrasson, G.; Villeneuve, E.; Pilnière, V.	Proposal of a user-centred approach for CPS design: Pillbox case study	IFAC- PapersOnLine	0	2019	1	101.00
Omotosho, A.; Ayegba, P.; Emuoyibofarhe, J.; Meinel, C.	Current state of ICT in healthcare delivery in developing countries	International Journal of Online and Biomedical Engineering	0	2019	1	101.00
Van Der Meulen, H.; Mccashin, D.; O’Reilly, G.; Coyle, D.	Using computer games to support mental health interventions: Naturalistic deployment study	JMIR Mental Health	0	2019	1	101.00
Moor, C.; Gür-Demirel, Y.; Wijsenbeek, M.	Feasibility of a comprehensive home monitoring program for sarcoidosis	J. Pers. Med.	0	2019	1	101.00
Maunder, K.; Walton, K.; Williams, P.; Ferguson, M.; Beck, E.	Strategic leadership will be essential for dietitian eHealth readiness: A qualitative study exploring dietitian perspectives of eHealth readiness	Nutrition & Dietetics: The Journal of The Dietitians Association of Australia	0	2019	1	101.00
Naarding, P.; Marijnissen, R.; Westerhof, G.	Digital psychiatry [Digitale psychiatrie]	Tijdschr. Psychiatr.	0	2019	1	101.00
Licari, A.; Ferrante, G.; Gian Luigi Marseglia, M.D.; Giovanni Corsello, M.D.; Grutta, S.L.	What is the impact of innovative electronic health interventions in improving treatment adherence in asthma? The pediatric perspective	J. Allergy Clin. Immunol. Pract.	7.550	2019	0	100.01
Garcia, S.; Wortman, K.; Cella, D.; Wagner, L.; Bass, M.; Kircher, S.; Pearman, T.; Penedo, F.	Implementing electronic health record–integrated screening of patient-reported symptoms and supportive care needs in a comprehensive cancer center	Cancer	6.164	2019	0	100.01
Carter, J.; Seed, P.T.; Watson, H.A.; David, A.L.; Sandall, J.; Shennan, A.H.; Tribe, R.M.	Development and validation of prediction models for the QUiPP App v.2: A tool for predicting preterm birth in women with symptoms of threatened preterm labor	Ultrasound in obstetrics & gynecology	5.595	2019	0	100.01
Delanty, N.; White, M.; Benson, K.; McCormack, M.; Heavin, S.; Comerford, E.; Gangadharan, N.; Power, K.; Dunleavey, B.; El-Naggar, H.; Doherty, C.; Greally, M.; Cavalleri, G.; Fitzsimons, M.	Development of a genomics module within an epilepsy-specific electronic health record: Toward genomic medicine in epilepsy care	Epilepsia	5.562	2019	0	100.01
Webber, E.; Brick, D.; Scibilia, J.; Dehnel, P.; Weinberg, S.; Alexander, G.; Beyer, E.; Hamling, A.; Kirkendall, E.; Lighter, D.; Mann, A.; Morgan, S.; Shelov, E.; Wright, J.; Alverson, D.; Chan, F.; Van Cain, M.; Krams, L.; Altman, R.; Bondi, S.; Fanaroff, J.; Narang, S.; Oken, R.; Rusher, J.; Santucci, K.; Scott, S.; Ake, J.; Alexander, J.; Bodnar, C.; Curfman, A., Herendeen, N.; Kahn, J.; McSwain, S.; Garber, K.; Calabrese, T., Council On Clinical Information Technology; Committee On Medical Liability And Risk Management; Section On Telehealth Care.	Electronic communication of the health record and information with pediatric patients and their guardians	Pediatrics	5.401	2019	0	100.01
Yi, C.; Cai, J.	Delay-dependent priority-aware transmission scheduling for e-health networks: A mechanism design approach	IEEE Trans. Veh. Technol.	5.339	2019	0	100.01
Fang, S.H.; Li, C.C.; Lu, W.C.; Xu, Z.; Chien, Y.R.	Enhanced device-free human detection: Efficient learning from phase and amplitude of channel state information	IEEE Trans. Veh. Technol.	5.339	2019	0	100.01
Elfstrom, K.M.; Sundstrom, K.; Andersson, S.; Bzhalava, Z.; Carlsten Thor, A.; Gzoul, Z.; Ohman, D.; Lamin, H.; Eklund, C.; Dillner, J.; Tornberg, S.	Increasing participation in cervical screening by targeting long-term nonattenders: Randomized health services study	International Journal of Cancer	4.982	2019	0	100.00
Cullinan, N.; Villani, A.; Mourad, S.; Somers, G.; Reichman, L.; Van Engelen, K.; Stephens, D.; Weksberg, R.; Foulkes, W.; Malkin, D.; Grant, R; Goudie, C.	An eHealth decision-support tool to prioritize referral practices for genetic evaluation of patients with Wilms tumor	International Journal of Cancer	4.982	2019	0	100.00
Den Bakker, C.M.; Huirne, J.A.; Schaafsma, F.G.; De Geus, C., Bonjer, H.J.; Anema, J.R.	Electronic health program to empower patients in returning to normal activities after colorectal surgical procedures: Mixed-methods process evaluation alongside a randomized controlled trial	J. Med. Internet Res.	4.945	2019	0	100.00
Paulsen, M.; Varsi, C.; Paur, I.; Tangvik, R.; Andersen, L.	Barriers and facilitators for implementing a decision support system to prevent and treat disease-related malnutrition in a hospital setting: Qualitative study	J. Med. Internet Res.	4.945	2019	0	100.00
Ariens, L.F.M.; Schussler-Raymakers, F.M.L.; Frima, C.; Flinterman, A.; Hamminga, E.; Arents, B.W.M.; Bruijnzeel-Koomen, C.A.F.M.; De Bruin-Weller, M.S.; Van Os-Medendorp, H.	Barriers and facilitators to eHealth use in daily practice: Perspectives of patients and professionals in dermatology	J. Med. Internet Res.	4.945	2017	20	100.00
Ijzerman, R.V.H.; Van Der Vaart, R.; Evers, A.W.M.	Internet-based cognitive behavioral therapy among psychologists in a medical setting: A survey on implementation	J. Med. Internet Res.	4.945	2019	0	100.00
Moore, G.; Wilding, H.; Gray, K.; Castle, D.	Participatory methods to engage health service users in the development of electronic health resources: Systematic review	J Med. Internet Res.	4.945	2019	0	100.00
Feijt, M.; De Kort, Y.; Bongers, I.; IJsselsteijn, W.	Perceived drivers and barriers to the adoption of eMental health by psychologists: The construction of the levels of adoption of eMental health model	J. Med. Internet Res.	4.945	2018	10	100.00
Sjöström, A.; Hörnsten, A.; Hajdarevic, S.; Emmoth, A.; Isaksson, U.	Primary health care nurses’ experiences of consultations with internet-informed patients: qualitative study	J. Med. Internet Res.	4.945	2019	0	100.00
Abbott-Garner, P.; Richardson, J.; Jones, R.	The impact of superfast broadband, tailored booklets for households, and discussions with general practitioners on personal electronic health readiness: Cluster factorial quasi-randomized control trial	J Med. Internet Res.	4.945	2019	0	100.00
Kip, H.; Kelders, S.M.; Bouman, Y.H.A.; Van Gemert-Pijnen, L.J.E.W.C.	The importance of systematically reporting and reflecting on eHealth development: Participatory development process of a virtual reality application for forensic mental health care	J. Med. Internet Res.	4.945	2019	0	100.00
Schofield, P.; Shaw, T.; Pascoe, M.	Toward comprehensive patient-centric care by integrating digital health technology with direct clinical contact in Australia	J. Med. Internet Res.	4.945	2019	0	100.00
Neijenhuijs, K.I.; Van Der Hout, A.; Veldhuijzen, E.; Scholten-Peeters, G.G.M.; Van Uden-Kraan, C.F.; Cuijpers, P.; Verdonck-De Leeuw, I.M.	Translation of the eHealth Impact Questionnaire for a population of Dutch electronic health users: Validation study	J. Med. Internet Res.	4.945	2019	0	100.00
Gray, C.; Gravesande, J.; Hans, P.; Nie, J.; Sharpe, S.; Loganathan, M.; Lyons, R.; Cott, C.	Using exploratory trials to identify relevant contexts and mechanisms in complex electronic health interventions: Evaluating the electronic patient-reported outcome tool	J. Med. Internet Res.	4.945	2019	0	100.00
Ospina-Pinillos, L.; Davenport, T.; Diaz, A.; Navarro-Mancilla, A.; Scott, E.; Hickie, I.	Using participatory design methodologies to co-design and culturally adapt the Spanish version of the mental health eClinic: Qualitative study	J. Med. Internet Res.	4.945	2019	0	100.00
Carroll, J.; Tobin, J.; Luque, A.; Farah, S.; Sanders, M.; Cassells, A.; Fine, S.; Cross, W.; Boyd, M.; Holder, T.; Thomas, M.; Overa, C.; Fiscella, K.	“Get Ready and Empowered About Treatment” (GREAT) Study: A pragmatic randomized controlled trial of activation in persons living with HIV	J. Gen. Intern. Med.	4.606	2019	0	100.00
Mapar, M.; Jafari, M.; Mansouri, N.; Arjmandi, R.; Azizinejad, R.; Ramos, T.	Sustainability indicators for municipalities of megacities: Integrating health, safety and environmental performance	Ecological Indicators	4.49	2017	20	100.00
Maillart, E.; Labauge, P.; Cohen, M.; Maarouf, A.; Vukusic, S.; Donze, C.; Gallien, P.; De Seze, J.; Bourre, B.; Moreau, T.; Louapre, C.; Mayran, P.; Bieuvelet, S.; Vallee, M.; Bertillot, F.; Klaeyle, L.; Argoud, A.-L.; Zinai, S.; Tourbah, A.	MSCopilot, a new multiple sclerosis self-assessment digital solution: Results of a comparative study versus standard tests	Eur. J. Neurol.	4.387	2019	0	100.00
Li, D.; Brown, C.; Gallo, C.; Morgan, E.; Sullivan, P.; Young, S.; Mustanski, B.	Design considerations for implementing eHealth behavioral interventions for HIV prevention in evolving sociotechnical landscapes	Curr. HIV/AIDS Rep.	4.382	2019	0	100.00
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Knitza, J.; Tascilar, K.; Messner, E.-M.; Meyer, M.; Vossen, D.; Pulla, A.; Bosch, P.; Kittler, J.; Kleyer, A.; Sewerin, P.; Mucke, J.; Haase, I., Simon, D.; Krusche, M.	German mobile apps in rheumatology: Review and analysis using the Mobile Application Rating Scale (MARS)	JMIR mHealth and uHealth	4.301	2019	0	100.00
Mountford, N.	Managing by proxy: Organizational networks as institutional levers in evolving public good markets	J. Bus. Res.	4.028	2019	0	100.00
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Niemelä, R.; Pikkarainen, M.; Ervasti, M.; Reponen, J.	The change of pediatric surgery practice due to the emergence of connected health technologies	Technol. Forecast. Soc. Change	3.815	2019	0	100.00
Canonica, G.; Bachert, C.; Hellings, P.; Ryan, D.; Valovirta, E.; Wickman, M.; De Beaumont, O.; Bousquet, J.	Allergen Immunotherapy (AIT): A prototype of Precision Medicine	World Allergy Organization Journal	3.684	2015	40	100.00
Peeters, J.M.; Krijgsman, J.W.; Brabers, A.E.; De Jong, J.D.; Friele, R.D.	Use and uptake of eHealth in general practice: A cross-sectional survey and focus group study among health care users and general practitioners	JMIR Medical Informatics	3.188	2016	30	100.00
[93] Van Der Linden, S.; Sitskoorn, M.; Rutten, G.J.; Gehring, K.	Feasibility of the evidence-based cognitive telerehabilitation program Remind for patients with primary brain tumors	J. Neurooncol.	3.129	2018	10	100.00
Bervell, B.; Al-Samarraie, H.	A comparative review of mobile health and electronic health utilization in sub-Saharan African countries	Soc. Sci. Med.	3.087	2019	0	100.00
[98] Boussada, R.; Hamdane, B.; Elhdhili, M.E.; Saidane, L.A.	Privacy-preserving aware data transmission for IoT-based e-health	Computer Networks	3.03	2019	0	100.00
Mondal, S.; Mukherjee, N.	An efficient reachability query based pruning algorithm in e-health scenario	J. Biomed. Inf.	2.95	2019	0	100.00
Perazzo, J.; Reyes, D.; Webel, A.	A systematic review of health literacy interventions for people living with HIV	AIDS Behav.	2.908	2017	20	100.00
Carmel, A.; Cornelius-Schecter, A.; Frankel, B.; Jannat-Khah, D.; Sinha, S.; Pelzman, F.; Safford, M.	Evaluation of the Patient Activated Learning System (PALS) to improve knowledge acquisition, retention, and medication decision making among hypertensive adults: Results of a pilot randomized controlled trial	Patient Educ. Couns.	2.821	2019	0	100.00
Chang, Y.W.; Hsu, P.Y.; Wang, Y.; Chang, P.Y.	Integration of online and offline health services: The role of doctor-patient online interaction	Patient Educ. Couns.	2.821	2019	0	100.00
Fang, S.Y.; Wang, Y.L.; Lu, W.H.; Lee, K.T.; Kuo, Y.L.; Fetzer, S.J.	Long-term effectiveness of an E-based survivorship care plan for breast cancer survivors: A quasi-experimental study	Patient Educ. Couns.	2.821	2019	0	100.00
Helle, C.; Hillesund, E.; Wills, A.; Øverby, N.	Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health	Plos One	2.776	2019	0	100.00
Denis, F.; Voog, E.; Pointreau, Y.; Bourgeois, H.; Seegers, V.; Le Du, K.	Prospective study of a web-mediated management of febrile neutropenia related to chemotherapy (Bioconnect)	Support Care Cancer	2.754	2019	0	100.00
Sadegh, S.S.; Saadat, P.K.; Sepehri, M.M.; Assadi, V.	A framework for m-health service development and success evaluation	International Journal of Medical Informatics	2.721	2018	10	100.00
Frontoni, E.; Mancini, A.; Baldi, M.; Paolanti, M.; Moccia, S.; Zingaretti, P.; Landro, V.;Misericordia, P.	Sharing health data among general practitioners: The Nu.Sa. project	International Journal of Medical Informatics	2.721	2019	0	100.00
Gu, D.; Li, T.; Wang, X.; Yang, X.; Yu, Z.	Visualizing the intellectual structure and evolution of electronic health and telemedicine research	International Journal of Medical Informatics	2.721	2019	0	100.00
Kagawa, R.; Shinohara, E.; Imai, T.; Kawazoe, Y.; Ohe, K.	Bias of inaccurate disease mentions in electronic health record-based phenotyping	International Journal of Medical Informatics	2.721	2019	0	100.00
Parks, R.; Wigand, R.; Othmani, M.; Serhier, Z.; Bouhaddou, O.	Electronic health records implementation in Morocco: Challenges of silo efforts and recommendations for improvements	International Journal of Medical Informatics	2.721	2019	0	100.00
Krijnen-De Bruin, E.; Muntingh, A.; Hoogendoorn, A.; Van Straten, A.; Batelaan, N.; Maarsingh, O.; Van Balkom, A.; Van Meijel, B.	The GET READY relapse prevention programme for anxiety and depression: A mixed-methods study protocol	BMC Psychiatry	2.666	2019	0	100.00
Habboushe, J.; Altman, C.; Lip, G.	Time trends in use of the CHADS 2 and CHA 2 DS 2 VASc scores, and the geographical and specialty uptake of these scores from a popular online clinical decision tool and medical reference	International Journal of Clinical Practice	2.613	2019	0	100.00
Droes, R.M.; Van Rijn, A.;Rus, E.; Dacier, S.; Meiland, F.	Utilization, effect, and benefit of the individualized Meeting Centers Support Program for people with dementia and caregivers	Clin. Interv. Aging.	2.585	2019	0	100.00
Berger, M.; Steinberg, D.; Askew, S.; Gallis, J.; Treadway, C.; Egger, J.; Kay, M.; Batch, B.; Finkelstein, E.; Devries, A.; Brewer, A.; Bennett, G.	The Balance protocol: A pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care	BMC Public Health	2.567	2019	0	100.00
Ohana, S.; Barnoy, S.	Israeli e-patients’ Informational Needs	Nurs. Outlook	2.54	2019	0	100.00
Albarrak, A.I.; Mohammed, R.; Almarshoud, N.; Almujalli, L.; Aljaeed, R.; Altuwaijiri, S.; Albohairy, T.	Assessment of physician’s knowledge, perception and willingness of telemedicine in Riyadh region, Saudi Arabia	J. Infect. Public Health	2.487	2019	0	100.00
Zhou, J.; Fan, T.	Understanding the factors influencing patient e-health literacy in online health communities (OHCs): A social cognitive theory perspective	Int. J. Environ. Res Public Health	2.468	2019	0	100.00
Rathnayake, S.; Senevirathna, A.	Self-reported eHealth literacy skills among nursing students in Sri Lanka: A cross-sectional study	Nurse Educ Today	2.442	2019	0	100.00
[102] Waschkau, A.; Wilfling, D.; Steinhaeuser, J.	Are Big Data analytics helpful in caring for multimorbid patients in general practice?—a scoping review	BMC Fam. Pract.	2.431	2019	0	100.00
Firet, L.; De Bree, C.; Verhoeks, C.; Teunissen, D.; Lagro-Janssen, A.	Mixed feelings: General practitioners’ attitudes towards eHealth for stress urinary incontinence—a qualitative study	BMC Fam. Pract.	2.431	2019	0	100.00
Gagnon, M.-P.;Ndiaye, M.A.; Larouche, A.; Chabot, G.; Chabot, C., Buyl, R.; Fortin, J.-P.; Giguere, A.; Leblanc, A.; Legare, F.; Motulsky, A.;Sicotte, C.; Witteman, H.O.; Kavanagh, E.; Lepinay, F.; Roberge, J.; Deletroz, C.; Abbasgholizadeh-Rahimi, S.	Optimising patient active role with a user-centred eHealth platform (CONCERTO plus) in chronic diseases management: A study protocol for a pilot cluster randomised controlled trial	BMJ Open	2.376	2019	0	100.00
Beishuizen, C.; Akenine, U.; Barbera, M.; Rosenberg, A.; Fallah Pour, M.; Richard, E.; Soininen, H.; Mangialasche, F.; Kivipelto, M.; Pols, A.; Moll Van Charante, E.	Integrating nurses’ experiences with supporting behaviour change for cardiovascular prevention into a self-management internet platform in Finland and the Netherlands: A qualitative study	BMJ Open	2.376	2019	0	100.00
Kocher, A.; Simon, M.; Dwyer, A.A.; Villiger, P.M.; Kunzler-Heule, P.; De Geest, S.; Berben, L.; Nicca, D.	Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol	Journal of Advanced Nursing	2.376	2019	0	100.00
Ladan, M.A.; Wharrad, H.; Windle, R.	eHealth adoption and use among healthcare professionals in a tertiary hospital in Sub-Saharan Africa: A Qmethodology study	PEERJ	2.353	2019	0	100.00
Huang, R.-C.; Silva, D.; Beilin, L.; Neppe, C.; Mackie, K.; Roffey, E.; Gibson, L.; D’vaz, N.;Christian, H.;Reid, C.; Prescott, S.	Feasibility of conducting an early pregnancy diet and lifestyle e-health intervention: The Pregnancy Lifestyle Activity Nutrition (PLAN) project	J. Dev. Orig. Health Dis.	2.34	2019	0	100.00
Vamos, C.A.; Griner, S.B.; Kirchharr, C.; Green, S.M.; Debate, R.; Daley, E.M.; Quinonez, R.B.; Boggess, K.A; Jacobs, T.; Christiansen, S.	The development of a theory-based eHealth app prototype to promote oral health during prenatal care visits	Transl. Behav. Med.	2.237	2019	0	100.00
[59] Devan, H.; Godfrey, H.K.; Perry, M.A.; Hempel, D.; Saipe, B.; Hale, L.; Grainger, R.	Current practices of health care providers in recommending online resources for chronic pain self-management	J. Pain Res.	2.236	2019	0	100.00
Vehko, T.; Hyppönen, H.; Puttonen, S.; Kujala, S.; Ketola, E.; Tuukkanen, J.; Aalto, A.-M.; Heponiemi, T.	Experienced time pressure and stress: electronic health records usability and information technology competence play a role	BMC Med. Inform. Decis. Mak.	2.067	2019	0	100.00
[92] Duruturk, N.; Özköslü, M.A.	Effect of tele-rehabilitation on glucose control, exercise capacity, physical fitness, muscle strength and psychosocial status in patients with type 2 diabetes: A double blind randomized controlled trial	Prim. Care Diabetes	2.008	2019	0	100.00
Van Schaik, P.; Thornhill, E.; Davies, M.; Flynn, D.; Kusev, P.	The use of information in online healthcare provider choice	Int. J. Hum. Comput. Stud.	2.006	2019	0	100.00
Arduini, D.; Zanfei, A.	An overview of scholarly research on public e-services? A meta-analysis of the literature	Telecomm Policy	2.000	2014	50	100.00
Doarn, C.; Zacharias, S.; Keck, C.; Tabangin, M.; Dealarcon, A.; Kelchner, L.	Design and implementation of an interactive website for pediatric voice therapy—the concept of in-between care: A telehealth model	Telemedicine and e-Health	1.996	2019	0	100.00
Doarn, C.R.; Dorogi, A.; Tikhtman, R.; Pallerla, H.; Vonder Meulen, M.B.	Opinions on the role of telehealth in a large Midwest academic health center: A case study	Telemedicine and e-Health	1.996	2019	0	100.00
Rebchuk, A.; Deptuck, H.; O’Neill, Z.; Fawcett, D.; Silverberg, N.; Field, T.	Validation of a novel telehealth administration protocol for the NIH toolbox-cognition battery	Telemedicine and e-Health	1.996	2019	0	100.00
Murchie, P.; Masthoff, J.; Walter, F.; Rahman, K.; Allan, J.; Burrows, N.; Proby, C.; Lee, A.; Johnston, M.; Durrani, A.; Depasquale, I.; Brant, B.; Neilson, A.; Meredith, F.; Treweek, S.; Hall, S.; McDonald, A.	Achieving Self-Directed Integrated Cancer Aftercare (ASICA) in melanoma: Protocol for a randomised patient-focused pilot trial of delivering the ASICA intervention as a means to earlier detection of recurrent and second primary melanoma	Trials	1.975	2019	0	100.00
Gerrits, O.	The future of healthcare has arrived: Who dares take up the challenge?	Neth. Heart J.	1.972	2019	0	100.00
Van Den Bosch, S.; Van De Voort, N.; Xi, T.; Kool, R.; Bergé, S.; Faber, M.	Oral and maxillofacial surgery is ready for patient-centred eHealth interventions—the outcomes of a scoping review	International Journal of Oral and Maxillofacial Surgery	1.961	2019	0	100.00
Warth, L.L.; Dyb, K.	eHealth initiatives; the relationship between project work and institutional practice	BMC Health Serv, Res,	1.932	2019	0	100.00
Heisler, M.; Choi, H.; Mase, R.; Long, J.A.; Reeves, P.J.	Effectiveness of technologically enhanced peer support in improving glycemic management among predominantly African American, low-income adults with diabetes	Diabetes Educator	1.910	2019	0	100.00
Ferguson, M.; Leighton, P.; Brandreth, M.; Wharrad, H.	Development of a multimedia educational programme for first-time hearing aid users: A participatory design	International Journal of Audiology	1.821	2018	10	100.00
Leung, C.; Shaipanich, T.	Current practice in the management of pulmonary nodules detected on computed tomography chest scans	Can. Respir. J.	1.803	2019	0	100.00
Shin, E.; Shim, J.-M.	Listen to doctors, friends, or both? Embedded they produce thick knowledge and promote health	J. Health Commun.	1.773	2019	0	100.00
[66] Jansson, M.M.; Harjumaa, M.; Puhto, A.-P.; Pikkarainen, M.	Healthcare professionals’ proposed eHealth needs in elective primary fast-track hip and knee arthroplasty journey: A qualitative interview study	J. Clin. Nurs.	1.757	2019	0	100.00
Kiberu, V.; Mars, M.; Scott, R.	Development of an evidence-based e-health readiness assessment framework for Uganda	Health Information Management Journal	1.742	2019	0	100.00
Aromatario, O.; Hoye, A.V.; Vuillemin, A.; Foucaut, A.-M.; Crozet, C.; Pommier, J.; Cambon, L.	How do mobile health applications support behaviour changes? A scoping review of mobile health applications relating to physical activity and eating behaviours	Public Health	1.696	2019	0	100.00
Lie, S., Karlsen, B., Graue, M. and Oftedal, B.	The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: A qualitative study	Scand. J. Caring Sci.	1.642	2019	0	100.00
Momenipour, A.; Pennathur, P.	Balancing documentation and direct patient care activities: A study of a mature electronic health record system	Int. J. Ind. Ergon.	1.571	2019	0	100.00
[60] Zitkus, V.; Butkiene, R.; Butleris, R.; Maskeliunas, R.; Damasevicius, R.; Wozniak, M.	Minimalistic approach to coreference resolution in Lithuanian medical records	Comput. Math. Methods Med.	1.563	2019	0	100.00
Wingo, B.C.; Yang, D.; Davis, D.; Padalabalanarayanan, S.; Hopson, B.; Thirumalai, M.; Rimmer, J.H.	Lessons learned from a blended telephone/e-health platform for caregivers in promoting physical activity and nutrition in children with a mobility disability	Disabil. Health J.	1.471	2019	0	100.00
[46] Vyas, K.S.; Hambrick, H.R.; Shakir, A.; Morrison, S.D.; Tran, D.C.; Pearson, K.; Vasconez, H.C.; Mardini, S.; Gosman, A.A.; Dobke, M.; Granick, M.S.	A systematic review of the use of telemedicine in plastic and reconstructive surgery and dermatology	Annals of Plastic Sugery	1.448	2017	20	100.00
Brignone, L.; Edleson, J.	The dating and domestic violence app Rubric: Synthesizing clinical best practices and digital health app standards for relationship violence prevention smartphone apps	Int. J. Hum. Comput. Interact.	1.354	2019	0	100.00
[88] Triplett, K.; El-Behadli, A.; Masood, S.; Sullivan, S.; Desai, D.	Digital medicine program with pediatric solid organ transplant patients: Perceived benefits and challenges	Pediatr. Transplant.	1.326	2019	0	100.00
Garai, A.; Pentek, I.; Adamko, A.	Revolutionizing healthcare with IoT and cognitive, cloud-based telemedicine	Acta Polytechnica Hungarica	1.286	2019	0	100.00
Eden, R.; Burton-Jones, A.; Grant, J.; Collins, R.; Staib, A; Sullivan, C.	Digitising an Australian university hospital: Qualitative analysis of staff-reported impacts	Australian Health Review	1.228	2019	0	100.00
Ross, P.; Cross, R.	Rise of the e-nurse: The power of social media in nursing	Contemp. Nurse	1.216	2019	0	100.00
Castaneda, P.; Sales, A., Osborne, N. and Corriere, M.	Scope, themes, and medical accuracy of eHealth peripheral artery disease community forums	Annals of Vascular Surgery	1.179	2019	0	100.00
Charnock, V.	Electronic healthcare records and data quality	Health Info. Libr. J.	1.179	2019	0	100.00
Peterson, S.; Kuntz, C.; Roush, J.	Use of a modified treatment-based classification system for subgrouping patients with low back pain: Agreement between telerehabilitation and face-to-face assessments	Physiother. Theory Pract.	1.158	2019	0	100.00
Veldhuijzen, G.; Van Esch, A.; Klemt-Kropp, M.; Terhaar Sive Droste, J.; Drenth, J.	E-patient counseling trial (E-PACO): Computer based education versus nurse counseling for patients to prepare for colonoscopy	JOVE—Journal of Visualized Experiments	1.108	2019	0	100.00
Kerdjidj, O.; Amira, A.; Ghanem, K.; Ramzan, N.; Katsigiannis, S.; Chouireb, F.	An FPGA implementation of the matching pursuit algorithm for a compressed sensing enabled e-health monitoring platform	Microprocessors and Microsystems	1.045	2019	0	100.00
Serafica, R.; Inouye, J.; Lukkahatai, N.; Braginsky, N.; Pacheco, M.; Daub, K.	The use of mobile health to assist self-management and access to services in a rural community	CIN—Computers Informatics Nursing	1.029	2019	0	100.00
Abaza, H.; Marschollek, M.	mHealth application areas and technology combinations*. A comparison of literature from high and low/middle income countries	Methods Inf. Med.	1.024	2017	20	100.00
Souza, T.; Lobão, W.; Santos, C.; Almeida, M.; Moreira Júnior, E.	Factors associated with the acceptance of the influenza vaccine among health workers: Knowledge, attitude and practice [Fatores associados à aceitação da vacina influenza entre trabalhadores de saúde: conhecimento, atitude e prática]	Cien. Saude. Colet.	1.008	2019	0	100.00
Brown, L.J.; Jones, G.M.; Bond, M.J.	E-health: Psychosocial challenges for South Australian rural mental health consumers	Rural Remote Health	0.985	2019	0	100.00
Kips, J.; Lambert, J.; Ongenae, K.; De Sutter, A.; Verhaeghe, E.	Teledermatology in Belgium: A pilot study	Acta Clinica Belgica	0.960	2019	0	100.00
Clanchy, K.; Tweedy, S.; Trost, S.	The Adapted Physical Activity Program: A theory-driven, evidence-based physical activity intervention for people with brain impairment	Brain Impairment	0.958	2019	0	100.00
Berndt, R.-D.; Preik, P.; Takenga, C.	TeleDermatology: the teledermatological solution mSkin^® for daily practice	Hautarzt	0.828	2019	0	100.00
Jedamzik, S.	Digital health and nursing: the future is now [Digitale Gesundheit und Pflege: Die Zukunft ist jetzt]	Unfallchirurg	0.716	2019	0	100.00
Khan, I.; Xitong, G.; Ahmad, Z.; Shahzad, F.	Investigating factors impelling the adoption of e-health: A perspective of African expats in China	Sage Open	0.675	2019	0	100.00
Alghazo, J.M.	Intelligent security and privacy of electronic health records using biometric images	Current Medical Imaging Reviews	0.533	2019	0	100.00
De Leon-Castaneda, C.	Electronic health (e-health): A conceptual framework for implementation in health services	Gac. Med. Mex.	0.283	2019	0	100.00
Chadi, N.; Weisbaum, E.; Malboeuf-Hurtubise, C.; Kohut, S.A.; Viner, C.; Palaniyar, N.; Kaufman, M.; Locke, J.; Vo, D.X.	In-person vs. eHealth mindfulness-based intervention for adolescents with chronic illnesses: A pilot randomized trial	Adolescent Psychiatry	0	2019	0	100.00
Voutsidou, S.; Moraitis, E.; Jelastopoulou, E.; Sissouras, A.; Charalampous, G.	Electronic health applications in primary medical health care: Advantages and expectations	Archives of Hellenic Medicine	0	2019	0	100.00
Spyridaki, A.; Antonakos, I.; Apostolakis, I.; Tountas, I.	Investigation of the effectiveness of mobile health applications for chronic diseases	Archives of Hellenic Medicine	0	2019	0	100.00
Ramos, A.C.; Bouzas-Lorenzo, R.; del Olmo, A.M.; Buceta, B.B.	Opinión de los facultativos y usuarios sobre avances de la e-salud en atención primaria	Aten. Prim.	0	2019	0	100.00
Guarda, P.	“OK Google, am I sick?’’: Artificial intelligence, e-health, and data protection regulation	Biolaw Journal-Rivista Di Biodiritto	0	2019	0	100.00
Klocek, A.; Smahelova, M.; Knapova, L.; Elavsky, S.	GPs’ perspectives on eHealth use in the Czech Republic: A cross-sectional mixed-design survey study	BJGP Open	0	2019	0	100.00
Reddeman, L.; Bourgeois, N.; Angl, E.N.; Heinrich, M.; Hillier, L.; Finn, H.; Bosiak, B.; Agarwal, P.; Mawson, R.; Propp, R.; Ivers, N.M.	How should family physicians provide physical activity advice? Qualitative study to inform the design of an e-health intervention	Can. Fam. Physician	0	2019	0	100.00
Borries, T.M.; Dunbar, A.; Bhukhen, A.; Rismany, J.; Kilham, J., Feinn, R.; Meehan Sr., T.P.	The impact of telemedicine on patient self-management processes and clinical outcomes for patients with types I or II diabetes mellitus in the United States: A scoping review	Diabetes & Metabolic Syndrome-Clinical Research & Reviews	0	2019	0	100.00
Howarth, A.; Quesada, J.; Donnelly, T.; Mills, P.R.	The development of “Make One Small Change”: An e-health intervention for the workplace developed using the Person-Based Approach	Digital Health	0	2019	0	100.00
Krivenko V, N.; Elishev, V.G.; Kriventsova, L.A.	The impact of innovation on the performance of health care in the economic security system of the region	Ekonomika Regiona-Economy of Region	0	2019	0	100.00
Seckin, G.; Hughes, S.; Yeatts, D.; Degreve, T.	Digital pathways to positive health perceptions: Does age moderate the relationship between medical satisfaction and positive health perceptions among middle-aged and older internet users?	Innov. Aging	0	2019	0	100.00
Al-Sharekh, S.I.; Al-Shqeerat, K.H.A.	Security challenges and limitations in IoT environments	IJCSNS	0	2019	0	100.00
Azcarraga, J.; Raduban, J.; Christine Gendrano, M.; Azcarraga, A.	Identity concealment when uploading pictures of patients in a tele-medicine system	International Journal of E-Health and Medical Communications	0	2019	0	100.00
Khennou, F.; Chaoui, N.E.H.; Khamlichi, Y.I.	A migration methodology from legacy to new electronic health record based OpenEHR	International Journal of E-Health and Medical Communications	0	2019	0	100.00
Christie, H.L.; Martin, J.L.; Connor, J.; Tange, H.J.; Verhey, F.R., de; Vugt, M.E.; Orrell, M.	eHealth interventions to support caregivers of people with dementia may be proven effective, but are they implementation-ready?	Internet Interv.	0	2019	0	100.00
De Cicco, L.; Mascolo, S.; Palmisano, V.; Ribezzo, G.	Reducing the network bandwidth requirements for 360 degrees immersive video streaming	Internet Technology Letters	0	2019	0	100.00
[78] Schimmer, R.; Orre, C.; Oberg, U.; Danielsson, K.; Hornsten, A.	Digital person-centered self-management support for people with type 2 diabetes: Qualitative study exploring design challenges	JMIR Diabetes	0	2019	0	100.00
Goodall, G.; Ciobanu, I.; Taraldsen, K.; Sorgaard, J.; Marin, A., Draghici, R.; Zamfir, M.-V.; Berteanu, M.; Maetzler, W.; Serrano, J.A.	The use of virtual and immersive technology in creating personalized multisensory spaces for people living with dementia (SENSE-GARDEN): Protocol for a multisite before-after trial	JMIR Res. Protoc.	0	2019	0	100.00
Prasad, M.; Manjunath, C.; Murthy, A.K.; Sampath, A.; Jaiswal, S.; Mohapatra, A.	Integration of oral health into primary health care: A systematic review	J. Family Med. Prim. Care	0	2019	0	100.00
Bhatia, R.; Taneja, U.	Factors affecting indian consumers’ intention to use eHealth services	Journal of Health Management	0	2019	0	100.00
Farzana, S.; Islam, S.	Symmetric key-based patient controlled secured electronic health record management protocol	Journal of High Speed Networks	0	2019	0	100.00
Øvrelid, E; Halvorsen, M.	Supporting process innovation with lightweight IT at an emergency unit	Journal of Integrated Design and Process Science	0	2019	0	100.00
Eke, E.; Kisi, M.; Ugurluoglu, D.	A research on awareness of e-health practices	Journal of Mehmet Akif Ersoy University Economics and Administrative Sciences Faculty	0	2019	0	100.00
Anya, O.; Tawfik, H.; Alani, M.; Hu, J.	Cybersecurity design considerations for cross-boundary clinical decision support	J Reliab. Intell. Environ.	0	2019	0	100.00
Kruczek, A.	e-health—modern technologies in mental health care	Postepy. Psychiatrii. I. Neurologii.	0	2019	0	100.00
Costa, W.L.G.; Pereira, E.; Kontonatsios, G.	Use of smartphones for hypoglycaemia prediction—A feasibility study	Procedia Comput Sci	0	2019	0	100.00
Senges, E.; Guiot, D.; Chandon, J.-L.	Desired ageing well: Predictive validity for consumers aged 50–80	Recherche Et Applications En Marketing-English Edition	0	2019	0	100.00
Webers, C.; Beckers, E.; Boonen, A.; Van Eijk-Hustings, Y.; Vonkeman, H.; Van De Laar, M.; Van Tubergen, A.	Development, usability and acceptability of an integrated eHealth system for spondyloarthritis in the Netherlands (SpA-Net)	RMD Open	0	2019	0	100.00
Vesnic-Alujevic, L.; Pereira, A.G.; Breitegger, M.	Wearable sensors exploring EU policy narratives by engaging the extended peer community	Tecnoscienza	0	2019	0	100.00
Metz, M.J.; Veerbeek, M.A.; Elfeddali, I.; De Beurs, E.; Van Der Feltz-Cornelis, C.M.; Beekman, A.T.F.	Shared decision making in mental health care; evaluation of the added value for patients and clinicians	Tijdschr. Psychiatr.	0	2019	0	100.00
Allner, R.; Wilfling, D.; Kidholm, K.; Steinhäuser, J.	Telemedizinprojekte im ländlichen Raum Deutschlands. Eine systematische Bewertung mit dem “Modell zur Evaluation von telemedizinischen Anwendungen”. TT—[Telemedicine projects in rural areas of Germany. A systematic evaluation with the “M”	Z. Evid. Fortbild. Qual. Gesundhwes	0	2019	0	100.00
Scherer, M.; Szecsenyi, J.; Gerlach, F.	Digitalisation in medicine—Who proceeds and who looks behind a plea for a DEGAM digital strategy [Digitalisierung in der medizin—Wer schreitet voran, wer schaut hinterher? Ein plädoyer für eine DEGAM-digitalstrategie]	Z. Allgemeinmed.	0	2019	0	100.00
Gebre-Mariam, M.; Bygstad, B.	What can enterprise architecture do for healthcare? A framework of antecedents and benefits	Electronic Government	0	2019	0	100.00
Ivanova, O.; Wambua, S.; Mwaisaka, J.; Bossier, T.; Thiongo, M.; Michielsen, K.; Gichangi, P.	Evaluation of the ELIMIKA Pilot Project: Improving ART adherence among HIV positive youth using an eHealth intervention in Mombasa, Kenya	African Journal of Reproductive Health	0.547	2019	0	100.00

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Figure 1. Research method.

Figure 2. Number of publications per year.

Figure 3. Distribution of articles by country and number of articles published by journal.

Figure 4. Diseases treated with e-health.

Figure 5. Number of publications in articles combining technology and e-health.

Table 1. Type of analysis used to address the research questions.

Type of Analysis	Research Question
Bibliometric analysis	In which countries and journals are studies on e-health practices published?
Content analysis	What are the main e-health practices used worldwide? What are the main service delivery types and medical fields served with e-health? What are the main barriers to e-health service delivery? What are the most commonly treated diseases, and in which countries has e-health been applied? What are the most common technologies in e-health?

Table 2. E-health practices and fields.

E-Health Practices	Specification of Service Delivery Types and Other E-Health-Related Topics Found in the Articles	Medical Fields Identified in the Articles	Authors
Mhealth or Mobile Health	Mhealth; assessment; systems assessment; information; telehealth; monitoring; health literacy.	General medicine; emergency; pediatrics; cardiology; oncology; psychiatry; neurology; dermatology; gynecology; hematology; infectiology/infectious diseases; radiotherapy/radiology; diagnostic imaging; gastroenterology; anesthesiology; nutrition; orthopedics; respiratory system/otorhinolaryngology; general surgery; urology; geriatrics; endocrinology; nephrology; ophthalmology.	[37,38,39,40,41,42]
Telehealth or Telemedicine	Telehealth; intervention; interaction; mhealth; systems; technology.	Telepsychiatry; teledermatology; teledentistry; telerehabilitation; teleophthalmology; telecardiology.	[43,44,45,46,47,48]
Technology	Technology; others; mhealth; patient monitoring; support; systems; telehealth; knowledge level; health literacy; systems assessment; program.		[49,50,51,52,53,54]
Others	Others; diagnosis; telehealth; mhealth; costs; programs; problems; project; quality of services; general e-health; care; project assessment; benefits; development; diagnosis; evaluation system; impact x cost-benefit; use and acceptance/barriers; knowledge level; mhealth; treatments; professionals’ views; study groups; intervention assessment; health literacy; technology; telehealth; randomized controlled trial—RCT; standardized service.	Nursing; oncology; gynecology; psychology; neurology; cardiology; psychiatry.	[55,56,57,58,59,60,61,62,63,64,65,66]

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da Fonseca, M.H.; Kovaleski, F.; Picinin, C.T.; Pedroso, B.; Rubbo, P. E-Health Practices and Technologies: A Systematic Review from 2014 to 2019. Healthcare 2021, 9, 1192. https://doi.org/10.3390/healthcare9091192

AMA Style

da Fonseca MH, Kovaleski F, Picinin CT, Pedroso B, Rubbo P. E-Health Practices and Technologies: A Systematic Review from 2014 to 2019. Healthcare. 2021; 9(9):1192. https://doi.org/10.3390/healthcare9091192

Chicago/Turabian Style

da Fonseca, Maria Helena, Fanny Kovaleski, Claudia Tania Picinin, Bruno Pedroso, and Priscila Rubbo. 2021. "E-Health Practices and Technologies: A Systematic Review from 2014 to 2019" Healthcare 9, no. 9: 1192. https://doi.org/10.3390/healthcare9091192

APA Style

da Fonseca, M. H., Kovaleski, F., Picinin, C. T., Pedroso, B., & Rubbo, P. (2021). E-Health Practices and Technologies: A Systematic Review from 2014 to 2019. Healthcare, 9(9), 1192. https://doi.org/10.3390/healthcare9091192

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E-Health Practices and Technologies: A Systematic Review from 2014 to 2019

Abstract

1. Introduction

2. Materials and Methods

3. Results and Discussion

3.1. Bibliometric Analysis

3.2. Content Analysis

3.2.1. Main E-Health Service Delivery Types and Fields

3.2.2. Main Diseases Treated

3.2.3. Technologies Associated with E-Health

4. Conclusions

Author Contributions

Funding

Informed Consent Statement

Acknowledgments

Conflicts of Interest

Appendix A

References

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