International Journal of Environmental Research and Public Health

Research

8 pages, 322 KiB

Open AccessArticle

Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

by Ik-Whan G. Kwon, Sung-Ho Kim and David Martin

Int. J. Environ. Res. Public Health 2021, 18(9), 5018; https://doi.org/10.3390/ijerph18095018 - 10 May 2021

Cited by 13 | Viewed by 5071

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while [...] Read more.

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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21 pages, 21307 KiB

Open AccessArticle

Statewide Ambulance Coverage of a Mixed Region of Urban, Rural and Frontier under Travel Time Catchment Areas

by EunSu Lee, Melanie McDonald, Erin O’Neill and William Montgomery

Int. J. Environ. Res. Public Health 2021, 18(5), 2638; https://doi.org/10.3390/ijerph18052638 - 5 Mar 2021

Cited by 8 | Viewed by 4233

Abstract

This study examines the statewide service coverage of emergency medical services (EMS) in view of public health planners, policy makers, and ambulance service managers. The study investigates the statewide service coverage in a mixed region of urban, rural, and frontier regions to address [...] Read more.

This study examines the statewide service coverage of emergency medical services (EMS) in view of public health planners, policy makers, and ambulance service managers. The study investigates the statewide service coverage in a mixed region of urban, rural, and frontier regions to address the importance of ambulance service coverage at a large scale. The study incorporated statewide road networks for ambulance travel time, census blocks for population, and backup service coverage using geographic information systems (GIS). The catchment areas were delineated by the travel time after subtracting chute time for each Census Block as an analysis zone. Using the catchment areas from the ambulance base to the centroid of Census Block, the population and land coverage were calculated. The service shortage and multiple coverage areas were identified by the catchment areas. The study found that both reducing chute time and increasing the speed of emergency vehicles at the same time was significantly more effective than improving only one of two factors. The study shows that the service is improved significantly in frontier and urban areas by increasing driving time and chute time. However, in rural areas, the improvement is marginal owing to wider distribution than urban areas and shorter threshold response time than frontier areas. The public health planners and EMS managers benefit from the study to identify underserved areas and redistribute limited public resources. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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13 pages, 542 KiB

Open AccessArticle

Mental Health Outreach via Supportive Text Messages during the COVID-19 Pandemic: Improved Mental Health and Reduced Suicidal Ideation after Six Weeks in Subscribers of Text4Hope Compared to a Control Population

by Vincent I. O. Agyapong, Reham Shalaby, Marianne Hrabok, Wesley Vuong, Jasmine M. Noble, April Gusnowski, Kelly Mrklas, Daniel Li, Mark Snaterse, Shireen Surood, Bo Cao, Xin-Min Li, Russell Greiner and Andrew J. Greenshaw

Int. J. Environ. Res. Public Health 2021, 18(4), 2157; https://doi.org/10.3390/ijerph18042157 - 23 Feb 2021

Cited by 41 | Viewed by 5453

Abstract

Background: In March 2020, Alberta Health Services launched Text4Hope, a free mental health text-message service. The service aimed to alleviate pandemic-associated stress, generalized anxiety disorder (GAD), major depressive disorder (MDD), and suicidal propensity. The effectiveness of Text4Hope was evaluated by comparing psychiatric parameters [...] Read more.

Background: In March 2020, Alberta Health Services launched Text4Hope, a free mental health text-message service. The service aimed to alleviate pandemic-associated stress, generalized anxiety disorder (GAD), major depressive disorder (MDD), and suicidal propensity. The effectiveness of Text4Hope was evaluated by comparing psychiatric parameters between two subscriber groups. Methods: A comparative cross-sectional study with two arms: Text4Hope subscribers who received daily texts for six weeks, the intervention group (IG); and new Text4Hope subscribers who were yet to receive messages, the control group (CG). Logistic regression models were used in the analysis. Results: Participants in the IG had lower prevalence rates for moderate/high stress (78.8% vs. 88.0%), likely GAD (31.4% vs. 46.5%), and likely MDD (36.8% vs. 52.1%), respectively, compared to respondents in the CG. After controlling for demographic variables, the IG remained less likely to self-report symptoms of moderate/high stress (OR = 0.56; 95% CI = 0.41–0.75), likely GAD (OR = 0.55; 95% CI = 0.44–0.68), and likely MDD (OR = 0.50; 95% CI = 0.47–0.73). The mean Composite Mental Health score, the sum of mean scores on the PSS, GAD-7, and PHQ-9 was 20.9% higher in the CG. Conclusions: Text4Hope is an effective population-level intervention that helps reduce stress, anxiety, depression, and suicidal thoughts during the COVID-19 pandemic. Similar texting services should be implemented during global crises. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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14 pages, 3567 KiB

Open AccessArticle

Factors That Impact the Adoption of Clinical Decision Support Systems (CDSS) for Antibiotic Management

by Mah Laka, Adriana Milazzo and Tracy Merlin

Int. J. Environ. Res. Public Health 2021, 18(4), 1901; https://doi.org/10.3390/ijerph18041901 - 16 Feb 2021

Cited by 39 | Viewed by 7359

Abstract

The study evaluated individual and setting-specific factors that moderate clinicians’ perception regarding use of clinical decision support systems (CDSS) for antibiotic management. A cross-sectional online survey examined clinicians’ perceptions about CDSS implementation for antibiotic management in Australia. Multivariable logistic regression determined the association [...] Read more.

The study evaluated individual and setting-specific factors that moderate clinicians’ perception regarding use of clinical decision support systems (CDSS) for antibiotic management. A cross-sectional online survey examined clinicians’ perceptions about CDSS implementation for antibiotic management in Australia. Multivariable logistic regression determined the association between drivers of CDSS adoption and different moderators. Clinical experience, CDSS use and care setting were important predictors of clinicians’ perception concerning CDSS adoption. Compared to nonusers, CDSS users were less likely to lack confidence in CDSS (OR = 0.63, 95%, CI = 0.32, 0.94) and consider it a threat to professional autonomy (OR = 0.47, 95%, CI = 0.08, 0.83). Conversely, there was higher likelihood in experienced clinicians (>20 years) to distrust CDSS (OR = 1.58, 95%, CI = 1.08, 2.23) due to fear of comprising their clinical judgement (OR = 1.68, 95%, CI = 1.27, 2.85). In primary care, clinicians were more likely to perceive time constraints (OR = 1.96, 95%, CI = 1.04, 3.70) and patient preference (OR = 1.84, 95%, CI = 1.19, 2.78) as barriers to CDSS adoption for antibiotic prescribing. Our findings provide differentiated understanding of the CDSS implementation landscape by identifying different individual, organisational and system-level factors that influence system adoption. The individual and setting characteristics can help understand the variability in CDSS adoption for antibiotic management in different clinicians. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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13 pages, 1180 KiB

Open AccessArticle

Relationships among Healthcare Digitalization, Social Capital, and Supply Chain Performance in the Healthcare Manufacturing Industry

by Hee Kyung Kim and Chang Won Lee

Int. J. Environ. Res. Public Health 2021, 18(4), 1417; https://doi.org/10.3390/ijerph18041417 - 3 Feb 2021

Cited by 52 | Viewed by 8522

Abstract

Due to the impact of coronavirus disease 2019 (COVID-19), automation and artificial intelligence (AI) have attracted renewed interest in multiple industrial fields. Global manufacturing bases were affected strongly by workforce shortages associated with the spread of COVID-19, and are working to increase productivity [...] Read more.

Due to the impact of coronavirus disease 2019 (COVID-19), automation and artificial intelligence (AI) have attracted renewed interest in multiple industrial fields. Global manufacturing bases were affected strongly by workforce shortages associated with the spread of COVID-19, and are working to increase productivity by embracing digital manufacturing technologies that take advantage of artificial intelligence and the Internet of Things (IoT) that offer the promise of improved connectivity among supply chains. This trend can increase and smooth the flow of social capital, which is a potential resource in supply chains and can affect supply chain performance in healthcare industry. However, such an issue has not been properly recognized as the best practice in healthcare industry. Thus, this study investigates empirically the relationship between digitalization and supply chain performance in healthcare manufacturing companies based on previous research that proposed a role for social capital. We surveyed the staff of domestic small and medium-sized healthcare manufacturing companies in South Korea currently operating or planning to deploy digital manufacturing technologies. Online and email surveys were utilized to collect the data. Invalid responses were excluded and the remaining 130 responses were analyzed using a structural equation model in SPSS with the AMOS module. We found that digitalization has a positive effect on the formation of social capital, which in turn has a positive effect on supply chain performance. The direct effect of digitalization on supply chain performance is small, and relatively large portions are mediated and influenced by social capital. The establishment of strategic relationships in the healthcare manufacturing industry is significant, as supply chain networks and production processes can influence the intended use of factory output. Companies should, therefore, secure timely and accurate information to manage the flow of products and services. The formation of social capital in the supply chain can help visualize entire supply chains and has a positive effect on real-time information-sharing among key elements of those chains. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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30 pages, 1165 KiB

Open AccessArticle

Public Health Innovation through Cloud Adoption: A Comparative Analysis of Drivers and Barriers in Japan, South Korea, and Singapore

by Aarthi Raghavan, Mehmet Akif Demircioglu and Araz Taeihagh

Int. J. Environ. Res. Public Health 2021, 18(1), 334; https://doi.org/10.3390/ijerph18010334 - 5 Jan 2021

Cited by 32 | Viewed by 12324

Abstract

Governments are increasingly using cloud computing to reduce cost, increase access, improve quality, and create innovations in healthcare. Existing literature is primarily based on successful examples from developed western countries, and there is a lack of similar evidence from Asia. With a population [...] Read more.

Governments are increasingly using cloud computing to reduce cost, increase access, improve quality, and create innovations in healthcare. Existing literature is primarily based on successful examples from developed western countries, and there is a lack of similar evidence from Asia. With a population close to 4.5 billion people, Asia faces healthcare challenges that pose an immense burden on economic growth and policymaking. Cloud computing in healthcare can potentially help increase the quality of healthcare delivery and reduce the economic burden, enabling governments to address healthcare challenges effectively and within a short timeframe. Advanced Asian countries such as Japan, South Korea, and Singapore provide successful examples of how cloud computing can be used to develop nationwide databases of electronic health records; real-time health monitoring for the elderly population; genetic database to support advanced research and cancer treatment; telemedicine; and health cities that drive the economy through medical industry, tourism, and research. This article examines these countries and identifies the drivers and barriers of cloud adoption in healthcare and makes policy recommendations to enable successful public health innovations through cloud adoption. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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18 pages, 501 KiB

Open AccessArticle

Application of Artificial Intelligence-Based Technologies in the Healthcare Industry: Opportunities and Challenges

by DonHee Lee and Seong No Yoon

Int. J. Environ. Res. Public Health 2021, 18(1), 271; https://doi.org/10.3390/ijerph18010271 - 1 Jan 2021

Cited by 375 | Viewed by 89998

Abstract

This study examines the current state of artificial intelligence (AI)-based technology applications and their impact on the healthcare industry. In addition to a thorough review of the literature, this study analyzed several real-world examples of AI applications in healthcare. The results indicate that [...] Read more.

This study examines the current state of artificial intelligence (AI)-based technology applications and their impact on the healthcare industry. In addition to a thorough review of the literature, this study analyzed several real-world examples of AI applications in healthcare. The results indicate that major hospitals are, at present, using AI-enabled systems to augment medical staff in patient diagnosis and treatment activities for a wide range of diseases. In addition, AI systems are making an impact on improving the efficiency of nursing and managerial activities of hospitals. While AI is being embraced positively by healthcare providers, its applications provide both the utopian perspective (new opportunities) and the dystopian view (challenges to overcome). We discuss the details of those opportunities and challenges to provide a balanced view of the value of AI applications in healthcare. It is clear that rapid advances of AI and related technologies will help care providers create new value for their patients and improve the efficiency of their operational processes. Nevertheless, effective applications of AI will require effective planning and strategies to transform the entire care service and operations to reap the benefits of what technologies offer. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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13 pages, 909 KiB

Open AccessArticle

A Health Guidance App to Improve Motivation, Adherence to Lifestyle Changes and Indicators of Metabolic Disturbances among Japanese Civil Servants

by Naoko Takeyama, Michiko Moriyama, Kana Kazawa, Malinda Steenkamp and Md Moshiur Rahman

Int. J. Environ. Res. Public Health 2020, 17(21), 8147; https://doi.org/10.3390/ijerph17218147 - 4 Nov 2020

Cited by 5 | Viewed by 2457

Abstract

We investigated whether an Information and Communication Technology (ICT) application (app) motivated to increase adherence to lifestyle changes, and to improve indicators of metabolic disturbances among Japanese civil servants. A non-randomized, open-label, parallel-group study was conducted with 102 participants aged 20–65 years undergoing [...] Read more.

We investigated whether an Information and Communication Technology (ICT) application (app) motivated to increase adherence to lifestyle changes, and to improve indicators of metabolic disturbances among Japanese civil servants. A non-randomized, open-label, parallel-group study was conducted with 102 participants aged 20–65 years undergoing a health check during 2016–2017, having overweight and/or elevated glucose concentration. Among them, 63 participants chose Specific Health Guidance (SHG) and ongoing support incorporating the use of an app (ICT group) and 39 individuals chose only SHG (control group). Fifty from the ICT group and 38 from the control group completed the study. After completing the 6-month program, the control group showed a significant decrease in body mass index (p = 0.008), male waist circumference (p < 0.001), systolic blood pressure (BP) (p = 0.005), diastolic BP (p < 0.001), and glycated hemoglobin (HbA1c) (p < 0.001), and increase in high-density lipoprotein (HDL) cholesterol (p = 0.008). However, the ICT group showed a significant decrease in male waist circumference (p < 0.001), diastolic BP (p = 0.003), and HbA1c (p < 0.001), and increase in HDL cholesterol (p = 0.032). The magnitude of change for most indicators tended to be highest for ICT participants (used the app ≥5 times/month). Both groups reported raised awareness on BP and weight. The app use program did not have a major impact after the observation period. Proper action requires frequent use of the app to enhance best results. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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21 pages, 8345 KiB

Open AccessArticle

Robotics Utilization for Healthcare Digitization in Global COVID-19 Management

by Zeashan Hameed Khan, Afifa Siddique and Chang Won Lee

Int. J. Environ. Res. Public Health 2020, 17(11), 3819; https://doi.org/10.3390/ijerph17113819 - 28 May 2020

Cited by 208 | Viewed by 25976

Abstract

This paper describes the evolving role of robotics in healthcare and allied areas with special concerns relating to the management and control of the spread of the novel coronavirus disease 2019 (COVID-19). The prime utilization of such robots is to minimize person-to-person contact [...] Read more.

This paper describes the evolving role of robotics in healthcare and allied areas with special concerns relating to the management and control of the spread of the novel coronavirus disease 2019 (COVID-19). The prime utilization of such robots is to minimize person-to-person contact and to ensure cleaning, sterilization and support in hospitals and similar facilities such as quarantine. This will result in minimizing the life threat to medical staff and doctors taking an active role in the management of theCOVID-19 pandemic. The intention of the present research is to highlight the importance of medical robotics in general and then to connect its utilization with the perspective of COVID-19 management so that the hospital management can direct themselves to maximize the use of medical robots for various medical procedures. This is despite the popularity of telemedicine, which is also effective in similar situations. In essence, the recent achievement of the Korean and Chinese health sectors in obtaining active control of the COVID-19 pandemic was not possible without the use of state of the art medical technology. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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25 pages, 964 KiB

Open AccessArticle

Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing

by Roberto Moro Visconti and Donato Morea

Int. J. Environ. Res. Public Health 2020, 17(7), 2318; https://doi.org/10.3390/ijerph17072318 - 30 Mar 2020

Cited by 81 | Viewed by 19097

Abstract

This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving [...] Read more.

This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public–private partnerships (PPPs) is significant due to the consistency of digital platforms with health issues and the complexity of the stakeholder’s interaction. In infrastructural PPPs, public and private players cooperate, usually following PF patterns. This relationship is complemented by digitized supply chains and is increasingly patient-centric. This paper reviews the literature, analyzes some supply chain bottlenecks, addresses solutions concerning the networking effects of platforms to improve PPP interactions, and investigates the cost–benefit analysis of digital health with an empirical case. Whereas diagnostic or infrastructural technology is an expensive investment with long-term payback, leapfrogging digital applications reduce contingent costs. “Digital” savings can be shared by key stakeholders with P4P schemes, incentivizing value co-creation patterns. Efficient sharing may apply network theory to a comprehensive PPP ecosystem where stakeholding nodes are digitally connected. This innovative approach improves stakeholder relationships, which are re-engineered around digital platforms that enhance patient-centered satisfaction and sustainability. Digital technologies are useful even for infectious disease surveillance, like that of the coronavirus pandemic, for supporting massive healthcare intervention, decongesting hospitals, and providing timely big data. Full article

(This article belongs to the Special Issue Digital Healthcare Innovation)

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