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

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 45689

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Special Issue Editors

Dipl.-Inform. Med. Martin Wiesner

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Guest Editor

Department for Medical Informatics, Heilbronn University, Max-Planck-Str. 39, 74081 Heilbronn, Germany
Interests: health informatics; consumer health informatics; information technology; information retrieval; machine-learning; recommender systems; and human-computer interaction

Prof. Dr. Björn Schreiweis

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Guest Editor

Institute for Medical Informatics and Statistics, Kiel University and University Hospital Schleswig-Holstein, Kaistraße 101, 24114 Kiel, Germany
Interests: health informatics; consumer health informatics; personal health records; health standards; interoperability; and secondary use of clinical data

Special Issue Information

Dear Colleagues,

Over the past few decades, modern information technology has made a significant impact on people’s daily life worldwide. In the field of health care and prevention, too, a progressing penetration of assistive health services such as personal health records, supporting apps for chronic diseases, or preventive cardiological monitoring could be observed.

In 2020, the range of personal health services appears to be almost unmanageable, accompanied by a multitude of different data formats and technical interfaces. The exchange of health-related data between different healthcare providers or platforms may therefore be difficult or even impossible. In addition, health professionals are increasingly confronted with medical data that were not acquired by themselves, but by an algorithmic “black box”. Even further, externally recorded data tend to be incompatible with the data models of classical healthcare information systems.

From the individuals’ perspective, digital services allow for a monitoring of their own health status. However, such services can also overwhelm their users, especially elderly people, with too many features or hardly comprehensible information. It therefore seems highly relevant to examine whether such “always at hand” services exceed the digital literacy levels of average citizens.

In this context, this Call for Papers seeks contributions that present innovative, health-related applications or services emphasizing the role of user-centered information technology, with a special focus on one of the aforementioned aspects.

Dipl.-Inform. Med. Martin Wiesner
Prof. Dr. Björn Schreiweis
Guest Editors

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Keywords

health informatics
consumer health informatics
information technology
digital health
machine learning
personal health records
human–computer interaction

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Published Papers (11 papers)

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Research

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10 pages, 300 KiB

Open AccessArticle

Do Market Characteristics Matter? Factors Associated with Health Information Exchange

by Na-Eun Cho, KiHoon Hong and Jongwha Chang

Int. J. Environ. Res. Public Health 2021, 18(22), 11976; https://doi.org/10.3390/ijerph182211976 - 15 Nov 2021

Cited by 2 | Viewed by 2167

Abstract

This study explores factors associated with the breadth (extent) and depth (level of detail) of digital information exchange among stakeholders in health information technology (IT) systems. Annual and IT surveys of the American Hospital Association and the U.S. Census Bureau’s small-area income and poverty estimates from 2014–2016 were analyzed for associations between key factors and breadth and depth of information exchange. OLS Regression was used with a sample consisting of 10,040 year-hospital observations. We found that hospital-level variables such as size, ownership type, system affiliation, physician-hospital arrangement, and revenue model affect information exchange. We further found that market-level variables such as concentration ratio, urbanness, and median household income, although they directly affect information exchange, do not moderate the relationship between hospital-level variables and information exchange. Our study fills a gap in the previous literature arising from the lack of research on the determinants of health information exchange. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

21 pages, 1350 KiB

Open AccessArticle

Exploring the Impact of Linguistic Signals Transmission on Patients’ Health Consultation Choice: Web Mining of Online Reviews

by Adnan Muhammad Shah, Mudassar Ali, Abdul Qayyum, Abida Begum, Heesup Han, Antonio Ariza-Montes and Luis Araya-Castillo

Int. J. Environ. Res. Public Health 2021, 18(19), 9969; https://doi.org/10.3390/ijerph18199969 - 22 Sep 2021

Cited by 9 | Viewed by 3297

Abstract

Background: Patients face difficulties identifying appropriate physicians owing to the sizeable quantity and uneven quality of information in physician rating websites. Therefore, an increasing dependence of consumers on online platforms as a source of information for decision-making has given rise to the need for further research into the quality of information in the form of online physician reviews (OPRs). Methods: Drawing on the signaling theory, this study develops a theoretical model to examine how linguistic signals (affective signals and informative signals) in physician rating websites affect consumers’ decision making. The hypotheses are tested using 5521 physicians’ six-month data drawn from two leading health rating platforms in the U.S (i.e., Healthgrades.com and Vitals.com) during the COVID-19 pandemic. A sentic computing-based sentiment analysis framework is used to implicitly analyze patients’ opinions regarding their treatment choice. Results: The results indicate that negative sentiment, review readability, review depth, review spelling, and information helpfulness play a significant role in inducing patients’ decision-making. The influence of negative sentiment, review depth on patients’ treatment choice was indirectly mediated by information helpfulness. Conclusions: This paper is a first step toward the understanding of the linguistic characteristics of information relating to the patient experience, particularly the emerging field of online health behavior and signaling theory. It is also the first effort to our knowledge that employs sentic computing-based sentiment analysis in this context and provides implications for practice. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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31 pages, 3975 KiB

Open AccessArticle

Role of Individual Motivations and Privacy Concerns in the Adoption of German Electronic Patient Record Apps—A Mixed-Methods Study

by Richard Henkenjohann

Int. J. Environ. Res. Public Health 2021, 18(18), 9553; https://doi.org/10.3390/ijerph18189553 - 10 Sep 2021

Cited by 10 | Viewed by 3481

Abstract

Germany’s electronic patient record (“ePA”) launched in 2021 with several attempts and years of delay. The development of such a large-scale project is a complex task, and so is its adoption. Individual attitudes towards an electronic health record are crucial, as individuals can reject opting-in to it and making any national efforts unachievable. Although the integration of an electronic health record serves potential benefits, it also constitutes risks for an individual’s privacy. With a mixed-methods study design, this work provides evidence that different types of motivations and contextual privacy antecedents affect usage intentions towards the ePA. Most significantly, individual motivations stemming from feelings of volition or external mandates positively affect ePA adoption, although internal incentives are more powerful. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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18 pages, 2340 KiB

Open AccessArticle

Does Being Ill Improve Acceptance of Medical Technology?—A Patient Survey with the Technology Usage Inventory

by Sabur Safi, Gerhard Danzer, Solaiman Raha, Eyyad Nassar, Frank T. Hufert and Kurt J. G. Schmailzl

Int. J. Environ. Res. Public Health 2021, 18(17), 9367; https://doi.org/10.3390/ijerph18179367 - 5 Sep 2021

Viewed by 2304

Abstract

Acceptance of new medical technology may be influenced by social conditions and an individual’s background and particular situation. We studied this acceptance by hypothesizing that current and former COVID-19 patients would be more likely to accept an electrocardiogram (ECG) “patch” (attached to the chest) that allows continuous monitoring of the heart than individuals who did not have the disease and thus the respective experience. Currently infected COVID-19 patients, individuals who had recovered from COVID-19, and a control group were recruited online through Facebook (and Instagram) and through general practitioners (GPs). Demographic information and questions tailored to the problem were collected via an online questionnaire. An online survey was chosen in part because of the pandemic conditions, and Facebook was chosen because of the widespread discussions of health topics on that platform. The results confirmed the central hypothesis that people who had experienced a disease are more willing to accept new medical technologies and showed that curiosity about new technologies and willingness to use them were significantly higher in the two groups currently or previously affected by COVID-19, whereas fears of being “monitored” (in the sense of surveillance) were significantly higher among people who had not experienced the disease and threat. Experiencing a serious disease (“patient experience”) promotes acceptance of new medical technologies. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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10 pages, 549 KiB

Open AccessArticle

Patients’ Access to Their Psychiatric Notes: Current Policies and Practices in Sweden

by Annika Bärkås, Isabella Scandurra, Hanife Rexhepi, Charlotte Blease, Åsa Cajander and Maria Hägglund

Int. J. Environ. Res. Public Health 2021, 18(17), 9140; https://doi.org/10.3390/ijerph18179140 - 30 Aug 2021

Cited by 15 | Viewed by 3914

Abstract

Patients’ access to electronic health records (EHRs) is debated worldwide, and access to psychiatry records is even more criticized. There is a nationwide service in Sweden which offers all citizens the opportunity to read their EHR, including clinical notes. This study aims to explore Swedish national and local policy regulations regarding patients’ access to their psychiatric notes and describe to what extent patients currently are offered access to them. The rationale behind the study is that current policies and current practices may differ between the 21 self-governing regions, although there is a national regulation. We gathered web-based information from policy documents and regulations from each region’s website. We also conducted key stakeholder interviews with respondents from the regions and cross-regional private care providers, using a qualitative approach. The results show that 17 of 21 regions share psychiatric notes with patients, where forensic psychiatric care was the most excluded psychiatric care setting. All private care providers reported that they mainly follow the regions’ guidelines. Our findings show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone. The differences, however, appear to have decreased over time, and we report evidence that the regions are moving toward increased transparency for psychiatry patients. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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16 pages, 1400 KiB

Open AccessArticle

Usage of eHealth/mHealth Services among Young Czech Adults and the Impact of COVID-19: An Explorative Survey

by Michal Dolezel and Zdenek Smutny

Int. J. Environ. Res. Public Health 2021, 18(13), 7147; https://doi.org/10.3390/ijerph18137147 - 3 Jul 2021

Cited by 7 | Viewed by 3800

Abstract

Various mHealth/eHealth services play an increasingly important role in healthcare systems and personal lifestyle management. Yet, the relative popularity of these services among the young population of the Czech Republic was not known. Therefore, we carried out an on-line survey with a convenience sample (n = 299) of young adults aged 18–29 and living in the Czech Republic. To this end, we adapted the survey instrument which was previously used in a similar study conducted in a different cultural context (Hong Kong). In our study, we found out that health tutorial activities (i.e., acquiring information on diet, exercise, fitness) were the most common among our respondents (M = 2.81, SD = 1.14). These were followed by health information seeking activities (i.e., acquiring information on medical problems) (M = 2.63, SD = 0.89) and medical services (i.e., the eHealth/mHealth services that provide infrastructural support, such as ePrescription and doctor appointment organizers) (M = 2.18, SD = 0.97). Based on the grouping according to gender and existing health condition, pairwise comparisons showed statistically significant differences. We also briefly analyzed the influence of the COVID-19 pandemic on the examined activities. Based on their relative popularity, we suggest leveraging the potential of health tutorial activities to improve public health. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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36 pages, 1947 KiB

Open AccessArticle

Searching for New Model of Digital Informatics for Human–Computer Interaction: Testing the Institution-Based Technology Acceptance Model (ITAM)

by Youngcheoul Kang, Nakbum Choi and Seoyong Kim

Int. J. Environ. Res. Public Health 2021, 18(11), 5593; https://doi.org/10.3390/ijerph18115593 - 24 May 2021

Cited by 20 | Viewed by 5499

Abstract

The fourth industrial revolution has produced new information technology (IT) that is widely used in the healthcare industry. Although the nature of the institution affects IT adoption, the Technology Acceptance Model (TAM), a dominant theory, has dismissed its role and influence. Our research investigates how institutions influence the adoption of new IT by using the Institution-based Technology Acceptance Model (ITAM). We conducted an empirical test by using survey data collected from 300 employees in the public sector. Structural equation modeling was applied to test the proposed hypotheses. The results showed the total effect of institutions on the intention to use new IT is positive and significant. Second, IT adoption is not only affected by external institutions but also by type of institution; the external institution takes a greater role in inducing perceived usefulness, perceived ease of use, and intention to use than does the internal. Third, perceived ease of use and perceived usefulness play mediating roles between institution and IT adoption. Fourth, an alternative expanded model to which more individual and organizational factors were added confirmed the results of the base model. We concluded that institutions have a strong impact on the level of intention for IT use through perceived ease of use and perceived usefulness. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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14 pages, 5131 KiB

Open AccessArticle

Rise of Clinical Studies in the Field of Machine Learning: A Review of Data Registered in ClinicalTrials.gov

by Claus Zippel and Sabine Bohnet-Joschko

Int. J. Environ. Res. Public Health 2021, 18(10), 5072; https://doi.org/10.3390/ijerph18105072 - 11 May 2021

Cited by 15 | Viewed by 5263

Abstract

Although advances in machine-learning healthcare applications promise great potential for innovative medical care, few data are available on the translational status of these new technologies. We aimed to provide a comprehensive characterization of the development and status quo of clinical studies in the field of machine learning. For this purpose, we performed a registry-based analysis of machine-learning-related studies that were published and first available in the ClinicalTrials.gov database until 2020, using the database’s study classification. In total, n = 358 eligible studies could be included in the analysis. Of these, 82% were initiated by academic institutions/university (hospitals) and 18% by industry sponsors. A total of 96% were national and 4% international. About half of the studies (47%) had at least one recruiting location in a country in North America, followed by Europe (37%) and Asia (15%). Most of the studies reported were initiated in the medical field of imaging (12%), followed by cardiology, psychiatry, anesthesia/intensive care medicine (all 11%) and neurology (10%). Although the majority of the clinical studies were still initiated in an academic research context, the first industry-financed projects on machine-learning-based algorithms are becoming visible. The number of clinical studies with machine-learning-related applications and the variety of medical challenges addressed serve to indicate their increasing importance in future clinical care. Finally, they also set a time frame for the adjustment of medical device-related regulation and governance. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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13 pages, 794 KiB

Open AccessArticle

Sociodemographic Characteristics and Interests of FeverApp Users

by Silke Schwarz, David D. Martin, Arndt Büssing, Olga Kulikova, Hanno Krafft, Moritz Gwiasda, Sara Hamideh Kerdar, Ingo Fingerhut and Ekkehart Jenetzky

Int. J. Environ. Res. Public Health 2021, 18(6), 3121; https://doi.org/10.3390/ijerph18063121 - 18 Mar 2021

Cited by 7 | Viewed by 2712

Abstract

The FeverApp Registry is a model registry focusing on pediatric fever using a mobile app to collect data and present recommendations. The recorded interactions can clarify the relationship between user documentation and user information. This initial evaluation regarding features of participants and usage intensity of educational video, information library, and documentation of fever events covers the runtime of FeverApp for the first 14 months. Of the 1592 users, the educational opening video was viewed by 41.5%, the Info Library was viewed by 37.5%, and fever events were documented by 55.5%. In the current sample, the role of a mother (p < 0.0090), having a higher level of education (p = 0.0013), or being registered at an earlier date appear to be cues to take note of the training video, Info Library, and to document. The FeverApp was used slightly less by people with a lower level of education or who had a migration background, but at the current stage of recruitment no conclusion can be made. The user analyses presented here are plausible and should be verified with further dissemination of the registry. Ecological momentary assessment is used more than the information option, in line with the task of a registry. Data collection via app seems feasible. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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Review

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13 pages, 766 KiB

Open AccessReview

Telemonitoring of Real-World Health Data in Cardiology: A Systematic Review

by Benjamin Kinast, Matthias Lutz and Björn Schreiweis

Int. J. Environ. Res. Public Health 2021, 18(17), 9070; https://doi.org/10.3390/ijerph18179070 - 27 Aug 2021

Cited by 10 | Viewed by 3913

Abstract

Background: New sensor technologies in wearables and other consumer health devices open up promising opportunities to collect real-world data. As cardiovascular diseases remain the number one reason for disease and mortality worldwide, cardiology offers potent monitoring use cases with patients in their out-of-hospital daily routines. Therefore, the aim of this systematic review is to investigate the status quo of studies monitoring patients with cardiovascular risks and patients suffering from cardiovascular diseases in a telemedical setting using not only a smartphone-based app, but also consumer health devices such as wearables and other sensor-based devices. Methods: A literature search was conducted across five databases, and the results were examined according to the study protocols, technical approaches, and qualitative and quantitative parameters measured. Results: Out of 166 articles, 8 studies were included in this systematic review; these cover interventional and observational monitoring approaches in the area of cardiovascular diseases, heart failure, and atrial fibrillation using various app, wearable, and health device combinations. Conclusions: Depending on the researcher’s motivation, a fusion of apps, patient-reported outcome measures, and non-invasive sensors can be orchestrated in a meaningful way, adding major contributions to monitoring concepts for both individual patients and larger cohorts. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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26 pages, 593 KiB

Open AccessReview

Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews

by Francesc Saigí-Rubió, José Juan Pereyra-Rodríguez, Joan Torrent-Sellens, Hans Eguia, Natasha Azzopardi-Muscat and David Novillo-Ortiz

Int. J. Environ. Res. Public Health 2021, 18(9), 4622; https://doi.org/10.3390/ijerph18094622 - 27 Apr 2021

Cited by 16 | Viewed by 7181

Abstract

(1) Background: The aim of this study is to provide a better understanding of the requirements to improve routine health information systems (RHISs) for the management of health systems, including the identification of best practices, opportunities, and challenges in the 53 countries and territories of the WHO European region. (2) Methods: We conducted an overview of systematics reviews and searched the literature in the databases MEDLINE/PubMed, Cochrane, EMBASE, and Web of Science electronic databases. After a meticulous screening, we identified 20 that met the inclusion criteria, and RHIS evaluation results were presented according to the Performance of Routine Information System Management (PRISM) framework. (3) Results: The reviews were published between 2007 and 2020, focusing on the use of different systems or technologies and aimed to analyze interventions on professionals, centers, or patients’ outcomes. All reviews examined showed variability in results in accordance with the variability of interventions and target populations. We have found different areas for improvement for RHISs according to the three determinants of the PRISM framework that influence the configuration of RHISs: technical, organizational, or behavioral elements. (4) Conclusions: RHIS interventions in the European region are promising. However, new global and international strategies and the development of tools and mechanisms should be promoted to highly integrate platforms among European countries. Full article

(This article belongs to the Special Issue Information Technology's Role in Global Healthcare Systems)

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