Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012.

PubMed

Kontos, Emily; Blake, Kelly D; Chou, Wen-Ying Sylvia; Prestin, Abby

2014-07-16

Recent eHealth developments have elevated the importance of assessing the extent to which technology has empowered patients and improved health, particularly among the most vulnerable populations. With noted disparities across racial and social groups in chronic health outcomes, such as cancer, obesity, and diabetes, it is essential that researchers examine any differences in the implementation, uptake, and impact of eHealth strategies across groups that bear a disproportionate burden of disease. The goal was to examine eHealth use by sociodemographic factors, such as race/ethnicity, socioeconomic status (SES), age, and sex. We drew data from National Cancer Institute's 2012 Health Information National Trends Survey (HINTS) (N=3959) which is publicly available online. We estimated multivariable logistic regression models to assess sociodemographic predictors of eHealth use among adult Internet users (N=2358) across 3 health communication domains (health care, health information-seeking, and user-generated content/sharing). Among online adults, we saw no evidence of a digital use divide by race/ethnicity. However, there were significant differences in use by SES, particularly for health care and health information-seeking items. Patients with lower levels of education had significantly lower odds of going online to look for a health care provider (high school or less: OR 0.50, 95% CI 0.33-0.76) using email or the Internet to communicate with a doctor (high school or less: OR 0.46, 95% CI 0.29-0.72), tracking their personal health information online (high school or less: OR 0.53, 95% CI 0.32-0.84), using a website to help track diet, weight, and physical activity (high school or less: OR 0.64, 95% CI 0.42-0.98; some college: OR 0.67, 95% CI 0.49-0.93), or downloading health information to a mobile device (some college: OR 0.54, 95% CI 0.33-0.89). Being female was a consistent predictor of eHealth use across health care and user-generated content/sharing domains

National Health Models and the Adoption of E-Health and E-Prescribing in Primary Care - New Evidence from Europe.

PubMed

Brennan, James; McElligott, Annette; Power, Norah

2015-11-25

Recent research from the European Commission (EC) suggests that the development and adoption of eHealth in primary care is significantly influenced by the context of the national health model in operation. This research identified three national health models in Europe at this time - the National Health Service (NHS) model, the social insurance system (SIS) model and the transition country (TC) model, and found a strong correlation between the NHS model and high adoption rates for eHealth. The objective of this study is to establish if there is a similar correlation in one specific application area - electronic prescribing (ePrescribing) in primary care. A review of published literature from 2000 to 2014 was undertaken covering the relevant official publications of the European Union and national government as well as the academic literature. An analysis of the development and adoption of ePrescribing in Europe was extracted from these data. The adoption of ePrescribing in primary care has increased significantly in recent years and is now practised by approximately 32% of European general practitioners. National ePrescribing services are now firmly established in 11 countries, with pilot projects underway in most others. The highest adoption rates are in countries with the NHS model, concentrated in the Nordic area. The electronic transmission of prescriptions continues to pose a significant challenge, especially in SIS countries and TCs. There is a strong correlation between the NHS model and high adoption rates for ePrescribing similar to the EC findings on the adoption of eHealth. It may be some time before many SIS countries and TCs reach the same adoption levels for ePrescribing and eHealth in primary care as most NHS countries.

Information and communication technology (ICT) and eHealth policy in Latin America and the Caribbean: a review of national policies and assessment of socioeconomic context.

PubMed

Jimenez-Marroquin, Maria Carolina; Deber, Raisa; Jadad, Alejandro R

2014-01-01

To examine the availability of national information and communication technology (ICT) or eHealth policies produced by countries in Latin America and the Caribbean (LAC), and to determine the influence of a country's socioeconomic context on the existence of these policies. Documents describing a national ICT or eHealth policy in any of the 33 countries belonging to the LAC region as listed by the United Nations were identified from three data sources: academic databases; the Google search engine; and government agencies and representatives. The relationship between the existence of a policy and national socioeconomic indicators was also investigated. There has been some progress in the establishment of ICT and eHealth policies in the LAC region. The most useful methods for identifying the policies were 1) use of the Google search engine and 2) contact with Pan American Health Organization (PAHO) country representatives. The countries that have developed a national ICT policy seem to be more likely to have a national eHealth policy in place. There was no statistical significant association between the existence of a policy and a country's socioeconomic context. Governments need to make stronger efforts to raise awareness about existing and planned ICT and eHealth policies, not only to facilitate ease of use and communication with their stakeholders, but also to promote collaborative international efforts. In addition, a better understanding of the effect of economic variables on the role that ICTs play in health sector reform efforts will help shape the vision of what can be achieved.

Monitoring and Benchmarking eHealth in the Nordic Countries.

PubMed

Nøhr, Christian; Koch, Sabine; Vimarlund, Vivian; Gilstad, Heidi; Faxvaag, Arild; Hardardottir, Gudrun Audur; Andreassen, Hege K; Kangas, Maarit; Reponen, Jarmo; Bertelsen, Pernille; Villumsen, Sidsel; Hyppönen, Hannele

2018-01-01

The Nordic eHealth Research Network, a subgroup of the Nordic Council of Ministers eHealth group, is working on developing indicators to monitor progress in availability, use and outcome of eHealth applications in the Nordic countries. This paper reports on the consecutive analysis of National eHealth policies in the Nordic countries from 2012 to 2016. Furthermore, it discusses the consequences for the development of indicators that can measure changes in the eHealth environment arising from the policies. The main change in policies is reflected in a shift towards more stakeholder involvement and intensified focus on clinical infrastructure. This change suggests developing indicators that can monitor understandability and usability of eHealth systems, and the use and utility of shared information infrastructure from the perspective of the end-users - citizens/patients and clinicians in particular.

Fifteen Challenges in Establishing a Multidisciplinary Research Program on eHealth Research in a University Setting: A Case Study

PubMed Central

Johansson, Birgitta; Held, Claes; Sjöström, Jonas; Lindahl Norberg, Annika; Hovén, Emma; Sanderman, Robbert; van Achterberg, Theo; von Essen, Louise

2017-01-01

Background U-CARE is a multidisciplinary eHealth research program that involves the disciplines of caring science, clinical psychology, health economics, information systems, and medical science. It was set up from scratch in a university setting in 2010, funded by a governmental initiative. While establishing the research program, many challenges were faced. Systematic documentation of experiences from establishing new research environments is scarce. Objective The aim of this paper was to describe the challenges of establishing a publicly funded multidisciplinary eHealth research environment. Methods Researchers involved in developing the research program U-CARE identified challenges in the formal documentation and by reflecting on their experience of developing the program. The authors discussed the content and organization of challenges into themes until consensus was reached. Results The authors identified 15 major challenges, some general to establishing a new research environment and some specific for multidisciplinary eHealth programs. The challenges were organized into 6 themes: Organization, Communication, Implementation, Legislation, Software development, and Multidisciplinarity. Conclusions Several challenges were faced during the development of the program and several accomplishments were made. By sharing our experience, we hope to help other research groups embarking on a similar journey to be prepared for some of the challenges they are likely to face on their way. PMID:28536090

E-health blood pressure control program.

PubMed

Ahern, David K; Stinson, Lynda J; Uebelacker, Lisa A; Wroblewski, Joseph P; McMurray, Jerome H; Eaton, Charles B

2012-01-01

Both technological and human factors design requirements for integration of home blood pressure monitoring (HBPM) into a patient centered medical home (PCMH) model primary care practice are described. Patients with uncontrolled hypertension were given home blood pressure (BP) monitors, and after a three-month run-in period introduced to either a high-tech only (HBPM connectivity to personal health record and tailored Web portal access) or a high-tech/"high-touch" (high-tech solution plus patient navigator [PN]) solution. Features of the Web portal included: BP graphing function, traffic-light feedback system of BP goal attainment, economic incentives for self-monitoring, and dual patient-facing and care-team-facing dashboard functions. The e-health BP control system with PN support was well received by patients, providers, and the healthcare team. Current e-health technology and limited technological literacy of many patients suggest that a PN or some other personnel resource may be required for the adoption of patient-facing technology in primary care.

eHealth in Saudi Arabia: Current Trends, Challenges and Recommendations.

PubMed

Alsulame, Khaled; Khalifa, Mohamed; Househ, Mowafa

2015-01-01

The purpose of this study is to explore the current status of eHealth in Saudi Arabia from the perspective of health informatics professionals. We used a case study approach and analyzed participant data using thematic analysis. The study took place between July and August 2013. Data collection included interviews with nine senior health information professionals in Saudi Arabia. The findings describe participant views on current eHealth trends in Saudi Arabia and show differences among Saudi healthcare organizations in terms of eHealth adoption. Participants also describe the challenges relating to organizational and cultural issues, end user attitudes towards eHealth projects, and the lack of specialized human resources to implement eHealth systems. Two main recommendations made by the participants were to form a new national body for eHealth and to develop a unified plan for the implementation of Saudi eHealth initiatives.

Can eHealth Reduce Medical Expenditures of Chronic Diseases?

PubMed

Tsuji, Masatsugu; Taher, Sheikh Abu; Kinai, Yusuke

2015-01-01

The objective of this research is to evaluate empirically the effectiveness of eHealth in Nishi-aizu Town, Fukushima Prefecture, based on a mail survey to the residents and their receipt data of National Health Insurance from November 2006 to February 2007. The residents were divided into two groups, users and non-users, and sent questionnaires to ask their characteristics or usage of the system. Their medical expenditures paid by National Health Insurance for five years from 2002 to 2006 are examined. The effects were analyzed by comparison of medical expenditures between users and non-users. The interests are focused on four chronic diseases namely heart diseases, high blood pressure, diabetes, and strokes. A regression analysis is employed to estimate the effect of eHealth to users who have these diseases and then calculate the monetary effect of eHealth on reduction of medical expenditures. The results are expected to be valid for establishment of evidence-based policy such as reimbursement from medical insurance to eHealth.

Developing internet-based eHealth promotion programs: the Spiral Technology Action Research (STAR) model.

PubMed

Skinner, Harvey A; Maley, Oonagh; Norman, Cameron D

2006-10-01

Health education and health promotion have a tradition of using information and communication technology (ICT). In recent years, the rapid growth of the Internet has created innovative opportunities for Web-based health education and behavior change applications-termed eHealth promotion. However, many eHealth promotion applications are developed without an explicit model to guide the design, evaluation, and ongoing improvement of the program. The spiral technology action research (STAR) model was developed to address this need. The model comprises five cycles (listen, plan, do, study, act) that weave together technological development, community involvement, and continuous improvement. The model is illustrated by a case study describing the development of the Smoking Zine (www.SmokingZine.org), a youth smoking prevention and cessation Web site.

From Entry to Practice to Advanced Nurse Practitioner - The Progression of Competencies and How They Assist in Delivery of eHealth Programs for Healthy Ageing.

PubMed

Rodger, Daragh; Hussey, Pamela

2017-01-01

Most of the health issues encountered in persons of older age are the result of one or more chronic diseases. The evidence base reports that chronic diseases can be prevented or delayed by engaging in healthy behaviors. Education provides a cost effective intervention on both economic grounds in addition to delivery of optimal patient outcomes. Information and Communication Technology (ICT) increasingly is viewed as a critical utility in eHealth delivery, providing scope for expanding online education facilities for older persons. Developing nursing competencies in the delivery of eHealth solutions to deliver user education programs therefore makes sense. This chapter discusses nursing competencies on the development of targeted eHealth programs for healthy ageing. The role of Advanced Nurse Practitioner in Ireland and its associated competency set identifies how a strong action learning model can be designed to deliver eHealth educational programs for effective delivery of healthy ageing in place.

Access and authorisation in a Glocal e-Health Policy context.

PubMed

Scott, Richard E; Jennett, Penny; Yeo, Maryann

2004-03-31

Challenges to the development of appropriate yet adaptable policy and tools for security of the individual patient electronic health record (EHR) are proving to be significant. Compounding this is the unique capability of e-health to transgress all existing geo-political and other barriers. Initiatives to develop and advance policy, standards, and tools in relation to EHR access control and authorisation management must address this capability. Currently policy development initiatives take place largely in an isolated manner. This jeopardises the potential of e-health because decisions made in one jurisdiction might hamper, even prevent, an e-health opportunity in another. This paper places access and authorisation issues in an overall policy context through describing current Canadian initiatives. The National Initiative for Telehealth (NIFTE) Guidelines project is developing a framework of national guidelines for telehealth. The Policy and Peer Permission (PPP) project is developing a unique tool that provides persistent protection of data. The new corporate body 'Infoway' is developing a pan-Canadian electronic health record solution. Finally, the Glocal e-Health Policy initiative is developing a tool with which to identify and describe the inter-relationships of e-health issues amongst policy levels, themes, and actors.

The e-health landscape: current status and future prospects in Korea.

PubMed

Lee, Myoungho; Min, Se Dong; Shin, Hang Sik; Lee, Byung Woo; Kim, Jin Kwon

2009-05-01

The e-health infrastructure in Korea has come a long way within a short period since the establishment of the Korea e-Health Association in 2003 by the Korean Ministry of Commerce, Industry and Energy. Since then, four related government departments in the Ministry of Health and Welfare, Ministry of Information and Communication, Ministry of National Defense, and the Ministry of Science and Technology have also started planning and promoting their own strategies for e-Health applications. We have defined standardization, law and policy planning, human resources development, research and development for e-health products, and international collaboration as the five core pillars for the development of a successful e-health industry. In 2008, through the reorganization of government ministries, e-health has become an even more important growth industry for the Korean economy. Consequently, relevant government ministries have more concrete and robust action plans for realization of e-health in effect.

Emerging eHealth Directions in the Philippines.

PubMed

Fernandez-Marcelo, P G; Ho, B L; Faustorilla, J F; Evangelista, A L; Pedrena, M; Marcelo, A

2012-01-01

This paper aims to provide an overview of research and education initiatives in the Philippines. Moreover, it outlines the various agencies and organizations that spearhead the eHealth projects. The researchers utilized internet-based review of literature, key informant interviews and proceedings from two eHealth conferences among Filipino researchers in 2011 organized by the authors. eHealth capacities in the areas of research, education and service have progressed dramatically in the last four decades as a result of improved access to information and communication technology. The National Unified Health Research Agenda initiatives have been led largely by higher educational institutions and organizations specializing in eHealth. Educational reforms have been seen with the establishment of the Masters of Science in Health Informatics, infusion of Nursing Informatics into the nursing undergraduate curriculum and offering of short courses on eHealth. Service- oriented organizations and innovations have also been formulated to meet the needs of the practitioners as information and communication technologies are embedded into the healthcare delivery system. Experts, researchers, practitioners and enthusiasts have successfully promoted awareness and uplifted the standards in the practice of eHealth in research, education and service. However, three main areas of improvement need to be given priority: (1) Policy and standards creation, (2) capability building and (3) multi-sectoral collaborations.

Government capacities and stakeholders: what facilitates ehealth legislation?

PubMed Central

2014-01-01

Background Newly established high-technology areas such as eHealth require regulations regarding the interoperability of health information infrastructures and data protection. It is argued that government capacities as well as the extent to which public and private organizations participate in policy-making determine the level of eHealth legislation. Both explanatory factors are influenced by international organizations that provide knowledge transfer and encourage private actor participation. Methods Data analysis is based on the Global Observatory for eHealth - ATLAS eHealth country profiles which summarizes eHealth policies in 114 countries. Data analysis was carried out using two-component hurdle models with a truncated Poisson model for positive counts and a hurdle component model with a binomial distribution for zero or greater counts. Results The analysis reveals that the participation of private organizations such as donors has negative effects on the level of eHealth legislation. The impact of public-private partnerships (PPPs) depends on the degree of government capacities already available and on democratic regimes. Democracies are more responsive to these new regulatory demands than autocracies. Democracies find it easier to transfer knowledge out of PPPs than autocracies. Government capacities increase the knowledge transfer effect of PPPs, thus leading to more eHealth legislation. Conclusions All international regimes – the WHO, the EU, and the OECD – promote PPPs in order to ensure the construction of a national eHealth infrastructure. This paper shows that the development of government capacities in the eHealth domain has to be given a higher priority than the establishment of PPPs, since the existence of some (initial) capacities is the sine qua non of further capacity building. PMID:24410989

Fifteen Challenges in Establishing a Multidisciplinary Research Program on eHealth Research in a University Setting: A Case Study.

PubMed

Grönqvist, Helena; Olsson, Erik Martin Gustaf; Johansson, Birgitta; Held, Claes; Sjöström, Jonas; Lindahl Norberg, Annika; Hovén, Emma; Sanderman, Robbert; van Achterberg, Theo; von Essen, Louise

2017-05-23

U-CARE is a multidisciplinary eHealth research program that involves the disciplines of caring science, clinical psychology, health economics, information systems, and medical science. It was set up from scratch in a university setting in 2010, funded by a governmental initiative. While establishing the research program, many challenges were faced. Systematic documentation of experiences from establishing new research environments is scarce. The aim of this paper was to describe the challenges of establishing a publicly funded multidisciplinary eHealth research environment. Researchers involved in developing the research program U-CARE identified challenges in the formal documentation and by reflecting on their experience of developing the program. The authors discussed the content and organization of challenges into themes until consensus was reached. The authors identified 15 major challenges, some general to establishing a new research environment and some specific for multidisciplinary eHealth programs. The challenges were organized into 6 themes: Organization, Communication, Implementation, Legislation, Software development, and Multidisciplinarity. Several challenges were faced during the development of the program and several accomplishments were made. By sharing our experience, we hope to help other research groups embarking on a similar journey to be prepared for some of the challenges they are likely to face on their way. ©Helena Grönqvist, Erik Martin Gustaf Olsson, Birgitta Johansson, Claes Held, Jonas Sjöström, Annika Lindahl Norberg, Emma Hovén, Robbert Sanderman, Theo van Achterberg, Louise von Essen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.05.2017.

Commentary: Pediatric eHealth Interventions: Common Challenges During Development, Implementation, and Dissemination

PubMed Central

Steele, Ric G.; Connelly, Mark A.; Palermo, Tonya M.; Ritterband, Lee M.

2014-01-01

Objective To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. Methods The article draws on the existing eHealth literature and the authors’ collective experience in pediatric eHealth research. Results and conclusions The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. PMID:24816766

The Development Process of eHealth Strategy for Nurses in Finland.

PubMed

Ahonen, Outi; Kouri, Pirkko; Kinnunen, Ulla-Mari; Junttila, Kristiina; Liljamo, Pia; Arifulla, Dinah; Saranto, Kaija

2016-01-01

Growing use of information and communication technology (ICT) demands have caused a need for nursing to strengthen the knowledge, skills and competences related to ICT in health (eHealth) and define its versatile roles. The Finnish Nurses Association (FNA) named a group of eHealth experts from various professional fields that are closely connected to nursing e.g. nursing practice, higher education, nursing research and administration. The main purpose was to describe nurses' contribution to the national strategy concerning eHealth development and implementation in health and social care. The group searched for answers, discussed strategic issues, wrote drafts, and sent texts for open commentary circles. The chosen themes of the eHealth strategies deal with the role of the client, nursing practice, ethical aspects education and eHealth competences, nursing leadership, knowledge management and research and development. The article describes the strategic work and the structure of eHealth strategy of nurses in Finland.

Determinants of Consumer eHealth Information Seeking Behavior.

PubMed

Sandefer, Ryan H; Westra, Bonnie L; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

2015-01-01

Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access.

I Got 99 Problems, and eHealth Is One.

PubMed

Wass, Sofie; Vimarlund, Vivian

2017-01-01

Many eHealth initiatives are never implemented or merely end as pilot projects. Previous studies report that organisational, technical and human issues need to be properly taken into consideration if such initiatives are to be successful. The aim of this paper is to explore whether previously identified challenges within the area have remained in the Swedish eHealth setting or whether they have changed. After interviewing experts in eHealth, we present a classification of areas of concern. Recurrence of previously identified challenges was found, but also new issues were identified. The results of the study indicate that there is a need to consider organisational and semantic issues on both national and international levels. Legal and technical challenges still exist but it seems even more important to support eHealth initiatives financially, increase practitioners' knowledge in health informatics and manage new expectations from patients.

[E-health within the Dutch mental health services: what is the current situation?].

PubMed

Smeets, Odile; Martin Abello, Katherina; Zijlstra-Vlasveld, Moniek; Boon, Brigitte

2014-01-01

The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.

Education-Based Gaps in eHealth: A Weighted Logistic Regression Approach.

PubMed

Amo, Laura

2016-10-12

Persons with a college degree are more likely to engage in eHealth behaviors than persons without a college degree, compounding the health disadvantages of undereducated groups in the United States. However, the extent to which quality of recent eHealth experience reduces the education-based eHealth gap is unexplored. The goal of this study was to examine how eHealth information search experience moderates the relationship between college education and eHealth behaviors. Based on a nationally representative sample of adults who reported using the Internet to conduct the most recent health information search (n=1458), I evaluated eHealth search experience in relation to the likelihood of engaging in different eHealth behaviors. I examined whether Internet health information search experience reduces the eHealth behavior gaps among college-educated and noncollege-educated adults. Weighted logistic regression models were used to estimate the probability of different eHealth behaviors. College education was significantly positively related to the likelihood of 4 eHealth behaviors. In general, eHealth search experience was negatively associated with health care behaviors, health information-seeking behaviors, and user-generated or content sharing behaviors after accounting for other covariates. Whereas Internet health information search experience has narrowed the education gap in terms of likelihood of using email or Internet to communicate with a doctor or health care provider and likelihood of using a website to manage diet, weight, or health, it has widened the education gap in the instances of searching for health information for oneself, searching for health information for someone else, and downloading health information on a mobile device. The relationship between college education and eHealth behaviors is moderated by Internet health information search experience in different ways depending on the type of eHealth behavior. After controlling for college

Including men in prenatal health: the potential of e-health to improve birth outcomes.

PubMed

Mackert, Michael; Guadagno, Marie; Donovan, Erin; Whitten, Pamela

2015-03-01

The U.S. infant mortality rate is the highest in the developed world, and disparity impacts underserved populations. Traditional maternal health focuses on women, excluding men from information affecting family health. Scholars advocate including men in prenatal health to reduce infant mortality, a proven strategy in developing nations. This study explored the role of U.S. men in prenatal health, barriers to involvement, and the use of e-health. Special attention was given to health literacy; research indicates e-health is effective in educating low health-literate audiences. This study interviewed men with an average age of 33 years (n=32). The sample was 38% Hispanic, 28% African American, 28% white, and 6% multiracial. Participants were asked about pregnancy health and used a pregnancy-related e-health application on a tablet computer. Participants provided opinions on content, ease of use of the tablet, and willingness to use similar applications. Men believe it is important to be involved in pregnancy to help ensure healthy births. Most use mobile devices and computers for health information and found the application to be useful and interesting. Most concluded they would use a similar application to learn about pregnancy. Health literacy had minimal impact on participants' use of the tablet and information. This study explored the role men play in prenatal health, a promising avenue toward better birth outcomes. Using e-health is an opportune approach-it can reach men unavailable to attend prenatal programs because of work or feeling unwelcome at programs deemed "only for women."

E-health: how to make the right choice.

PubMed

Perez, Elizabeth

2009-01-01

TOPIC. The online health promotion phenomenon is a pivotal movement toward consumer empowerment. The challenges for the 21st century are to create meaningful, accurate online health communication interventions that successfully change behavior and improve health. PURPOSE. The Internet is a valuable tool for health promotion, self-care tools, and decision aids components for a high-quality care. The nurse educator ensures e-health sites used meet the criteria for achieving optimal wellness for the consumer. SOURCES. Published literature. CONCLUSIONS. It is crucial for nurses to use reputable e-health sites for consumer engagement and education. Researchers and practitioners are exploring the phenomenon of e-health to gain a better understanding of how to engage these consumers in health behavioral change programs.

A patient centered electronic health: eHealth system development.

PubMed

Schiza, Eirini C; Neokleous, Kleanthis C; Petkov, Nikolai; Schizas, Christos N

2015-01-01

Medical practice and patient-doctor relationship will continue improving while technology is integrated in our everyday life. In recent years the term eHealth landmarked a new era with improved health provider's skills and knowledge, and increased patient participation in medical care activities. To show why the design and implementation of a healthcare system needs to follow a specific philosophy dictated by the level of eHealth maturity of a country and its citizens. Based on the maturity level, an adaptable framework for implementing an Electronic Health System at national level is derived, guided by the Patient Centered Philosophy as defined and introduced by the EU directives. Implementation prerequisites are analyzed together with guiding principles for identifying the maturity level of an organization or country. Cyprus being a small EU country, it can be used as pilot site for the whole Europe, was chosen for this study and its maturity level analysis is presented. Recommendations that determine general steps needed to prepare the ground for an adequate patient-centered national healthcare system are accompanied. The implementation of an integrated Electronic Health Record at National level, as a prerequisite for a patient-centered eHealth environment is evidently demonstrated.

Commentary: pediatric eHealth interventions: common challenges during development, implementation, and dissemination.

PubMed

Wu, Yelena P; Steele, Ric G; Connelly, Mark A; Palermo, Tonya M; Ritterband, Lee M

2014-07-01

To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. The article draws on the existing eHealth literature and the authors' collective experience in pediatric eHealth research. The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

eHealth research from the user's perspective.

PubMed

Hesse, Bradford W; Shneiderman, Ben

2007-05-01

The application of information technology (IT) to issues of healthcare delivery has had a long and tortuous history in the United States. Within the field of eHealth, vanguard applications of advanced computing techniques, such as applications in artificial intelligence or expert systems, have languished in spite of a track record of scholarly publication and decisional accuracy. The problem is one of purpose, of asking the right questions for the science to solve. Historically, many computer science pioneers have been tempted to ask "what can the computer do?" New advances in eHealth are prompting developers to ask "what can people do?" How can eHealth take part in national goals for healthcare reform to empower relationships between healthcare professionals and patients, healthcare teams and families, and hospitals and communities to improve health equitably throughout the population? To do this, eHealth researchers must combine best evidence from the user sciences (human factors engineering, human-computer interaction, psychology, and usability) with best evidence in medicine to create transformational improvements in the quality of care that medicine offers. These improvements should follow recommendations from the Institute of Medicine to create a healthcare system that is (1) safe, (2) effective (evidence based), (3) patient centered, and (4) timely. Relying on the eHealth researcher's intuitive grasp of systems issues, improvements should be made with considerations of users and beneficiaries at the individual (patient-physician), group (family-staff), community, and broad environmental levels.

Barriers to e-health business processes.

PubMed

Mieczkowska, Suzanne; Hinton, Matthew; Barnes, David

2004-01-01

This paper builds from recent case study research in commercial organisations to develop the hypothesis that many of the barriers to e-health processes are similar to those encountered by commercial businesses. The paper reports findings from a case study within the pathology department of a UK National Health Service (NHS) Trust. The NHS has a risk-averse culture where many individuals practice defensive behaviour and there are deeply embedded working practices. The paper suggests that if the NHS is to seize the opportunities offered by substantial new investments in e-health systems that utilise internet-based ICTs, greater effort needs to be made to understand and address the socio-cultural factors affecting the UK healthcare system.

Global eHealth, Social Business and Citizen Engagement.

PubMed

Liaw, Siaw-Teng; Ashraf, Mahfuz; Ray, Pradeep

2017-01-01

The UNSW WHO Collaborating Centre (WHOCC) in eHealth was established in 2013. Its designated activities are: mHealth and evidence-based evaluation, including use case analyses. The UNSW Yunus Social Business Health Hub (YSBHH), established in 2015 to build on the Yunus Centre/Grameen Bank eHealth initiatives, added social business and community participation dimensions to the UNSW global eHealth program. The Grameen Bank is a social business built around microcredit, which are small loans to poor people to enable them to "produce something, sell something, earn something to develop self-reliance and a life of dignity". The vision revolves around global partnerships for development, Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). The scope includes mHealth implementation and evaluation in the context of the Internet of Things (IoT), with a growing focus on social business and citizen engagement approaches. This paper summarises a critical case study of the UNSW WHOCC (eHealth) designated activities in collaboration with Bangladesh institutions (International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) and Yunus Centre). Issues and challenges are highlighted.

eHealth literacy and preferences for eHealth resources in parents of children with complex CHD.

PubMed

Kasparian, Nadine A; Lieu, Nathan; Winlaw, David S; Cole, Andrew; Kirk, Edwin; Sholler, Gary F

2017-05-01

Introduction This study aimed to (a) examine eHealth literacy, beliefs, and behaviours in parents of children with complex CHD, and (b) identify parents' preferences for the content, format, features, and functions of eHealth resources for CHD. Materials and methods Families (n=198) of children born between 2008 and 2011 and diagnosed with CHD requiring surgery were mailed a survey assessing a range of variables including eHealth literacy, beliefs, and behaviours as well as preferences for the format, functions, features, and content of eHealth resources for CHD. A total of 132 parents (83 mothers, 49 fathers) completed the survey (response rate: 50%). Mothers (96%) were more likely to access eHealth resources than fathers (83%, χ2=6.74, p=0.009). Despite high eHealth resource use, eHealth literacy was relatively low, with results demonstrating considerable and widespread gaps in awareness of, access to, and communication about eHealth resources. Over 50% of parents reported that decisions regarding their child's healthcare were influenced, to some extent, by web-based resources. Barriers to doctor-patient communication about eHealth included limited consultation time and concern about doctors' disapproval. Participants demonstrated a strong desire for "eHealth prescriptions" from their child's healthcare team, and perceived a wide range of eHealth topics as highly important, including treatment-related complications as well as physical, cognitive, and emotional development in children with CHD. Discussion Results suggest a need for stronger, more proactive partnerships between clinicians, researchers, educators, technologists, and patients and families to bring about meaningful innovations in the development and implementation of eHealth interventions in paediatric cardiology.

Legal aspects of E-HEALTH.

PubMed

Callens, Stefaan; Cierkens, Kim

2008-01-01

Cross-border activities in health care in the European single market are increasing. Many of these cross-border developments are related to e-Health. E-Health describes the application of information and communication technologies across the whole range of functions that affect the health care sector. E-health attracts a growing interest on the European level that highlights the sharp need of appropriate regulatory framework able to ensure its promotion in the European Union. Some Directives constitute a step in this direction. Both the Data Protection Directive, the E-Commerce Directive, the Medical Device Directive and the Directive on Distance Contracting are some of the most important European legal achievements related to e-Health. Although the directives are not adopted especially for e-health applications, they are indirectly very important for e-Health. Firstly, the Data Protection Directive applies to personal data which form part of a filing system and contains several important principles that have to be complied with by e-Health actors processing personal data concerning health. Secondly, the E-commerce Directive applies to services provided at a distance by electronic means. Many e-Health applications fall within this scope. Thirdly, the Medical Devices Directive is of importance for the e-Health sector, especially with regard to e.g. the medical software that is used in many e-health applications. Finally, the Directive on Distance Contracting applies to contracts for goods or services which make use of one or more means of distance communication; E-Health business may involve the conclusion of contracts. Despite these Directives more developments are needed at the European level in order to make sure that e-Health will play an even more important role in health care systems than is the case today. The new e-Health applications like electronic health records, e-health platforms, health grids and the further use of genetic data and tissue involve new

What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants

PubMed Central

Janssen, Anna; Barnet, Stewart

2017-01-01

Background Despite rapid growth in eHealth research, there remains a lack of consistency in defining and using terms related to eHealth. More widely cited definitions provide broad understanding of eHealth but lack sufficient conceptual clarity to operationalize eHealth and enable its implementation in health care practice, research, education, and policy. Definitions that are more detailed are often context or discipline specific, limiting ease of translation of these definitions across the breadth of eHealth perspectives and situations. A conceptual model of eHealth that adequately captures its complexity and potential overlaps is required. This model must also be sufficiently detailed to enable eHealth operationalization and hypothesis testing. Objective This study aimed to develop a conceptual practice-based model of eHealth to support health professionals in applying eHealth to their particular professional or discipline contexts. Methods We conducted semistructured interviews with key informants (N=25) from organizations involved in health care delivery, research, education, practice, governance, and policy to explore their perspectives on and experiences with eHealth. We used purposeful sampling for maximum diversity. Interviews were coded and thematically analyzed for emergent domains. Results Thematic analyses revealed 3 prominent but overlapping domains of eHealth: (1) health in our hands (using eHealth technologies to monitor, track, and inform health), (2) interacting for health (using digital technologies to enable health communication among practitioners and between health professionals and clients or patients), and (3) data enabling health (collecting, managing, and using health data). These domains formed a model of eHealth that addresses the need for clear definitions and a taxonomy of eHealth while acknowledging the fluidity of this area and the strengths of initiatives that span multiple eHealth domains. Conclusions This model extends current

What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants.

PubMed

Shaw, Tim; McGregor, Deborah; Brunner, Melissa; Keep, Melanie; Janssen, Anna; Barnet, Stewart

2017-10-24

Despite rapid growth in eHealth research, there remains a lack of consistency in defining and using terms related to eHealth. More widely cited definitions provide broad understanding of eHealth but lack sufficient conceptual clarity to operationalize eHealth and enable its implementation in health care practice, research, education, and policy. Definitions that are more detailed are often context or discipline specific, limiting ease of translation of these definitions across the breadth of eHealth perspectives and situations. A conceptual model of eHealth that adequately captures its complexity and potential overlaps is required. This model must also be sufficiently detailed to enable eHealth operationalization and hypothesis testing. This study aimed to develop a conceptual practice-based model of eHealth to support health professionals in applying eHealth to their particular professional or discipline contexts. We conducted semistructured interviews with key informants (N=25) from organizations involved in health care delivery, research, education, practice, governance, and policy to explore their perspectives on and experiences with eHealth. We used purposeful sampling for maximum diversity. Interviews were coded and thematically analyzed for emergent domains. Thematic analyses revealed 3 prominent but overlapping domains of eHealth: (1) health in our hands (using eHealth technologies to monitor, track, and inform health), (2) interacting for health (using digital technologies to enable health communication among practitioners and between health professionals and clients or patients), and (3) data enabling health (collecting, managing, and using health data). These domains formed a model of eHealth that addresses the need for clear definitions and a taxonomy of eHealth while acknowledging the fluidity of this area and the strengths of initiatives that span multiple eHealth domains. This model extends current understanding of eHealth by providing clearly

Exploration of patients' readiness for an eHealth management program for chronic heart failure: a preliminary study.

PubMed

Nahm, Eun-Shim; Blum, Kay; Scharf, Barbara; Friedmann, Erika; Thomas, Sue; Jones, Deborah; Gottlieb, Stephen S

2008-01-01

Heart failure (HF) is a major public health problem in the United States. Approximately 5 million Americans are living with HF, and each year, 550,000 more are newly diagnosed. With recent, rapidly advancing technologies, many studies have examined the effects of technology-based HF management programs. Most of these studies focused on telemonitoring devices, lacking an aspect to motivate individuals to manage their own illnesses. This exploratory study was conducted to (1) examine the readiness of patients with HF in using an eHealth program that includes both telemonitoring and motivational components (ie, Web learning modules, eCommunication) and (2) assess the specific needs of patients with HF that can be addressed by a future eHealth program. This was a single group descriptive study using a convenience sample. A total of 44 patients with HF (mean age, 72.8 years; range, 55-85 years) were recruited from the pool of enrollees of the Medicare Coordinated Care Demonstration project for HF management that used only a telemonitoring component. Although only 10 participants were users, among 34 nonusers, 17 reported availability of Web access, and 15 reported that they would use the Internet if access and training were available. Overall, confidence for using telemonitoring devices and Web-based health modules was high, with means of 27 (range, 3-30) and 7.6 (range, 1-10), respectively. Confidence for learning health information using Web modules, however, was lower with a mean of 41.5 (range, 8-80). The 2 most highly rated health information needs were research findings (n = 41, 93.2%) and medication (n = 39, 88.6%). Most participants would like to have e-mail communication with healthcare providers. The findings showed the participants' high readiness to use the proposed eHealth program if access and training were provided. This study used a small convenience sample. Further studies are needed with larger, diverse samples.

Relationship Between Parental and Adolescent eHealth Literacy and Online Health Information Seeking in Taiwan.

PubMed

Chang, Fong-Ching; Chiu, Chiung-Hui; Chen, Ping-Hung; Miao, Nae-Fang; Lee, Ching-Mei; Chiang, Jeng-Tung; Pan, Ying-Chun

2015-10-01

This study examined the relationship between parental and adolescent eHealth literacy and its impact on online health information seeking. Data were obtained from 1,869 junior high school students and 1,365 parents in Taiwan in 2013. Multivariate analysis results showed that higher levels of parental Internet skill and eHealth literacy were associated with an increase in parental online health information seeking. Parental eHealth literacy, parental active use Internet mediation, adolescent Internet literacy, and health information literacy were all related to adolescent eHealth literacy. Similarly, adolescent Internet/health information literacy, eHealth literacy, and parental active use Internet mediation, and parental online health information seeking were associated with an increase in adolescent online health information seeking. The incorporation of eHealth literacy courses into parenting programs and school education curricula is crucial to promote the eHealth literacy of parents and adolescents.

Development and Implementation of the DHAPP Military eHealth Information Network System.

PubMed

Kratz, Mary; Thomas, Anne; Hora, Ricardo; Vera, Delphis; Lutz, Mickey; Johnson, Mark D

2017-01-01

As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study

PubMed Central

Schrader, Geoffrey; Harris, Melanie; Newman, Lareen; Lynn, Sarah; Peterson, Leigh; Battersby, Malcolm

2014-01-01

Background eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. Objective The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. Methods We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. Results The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. Conclusions The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement. PMID:24927511

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study.

PubMed

Schrader, Geoffrey; Bidargaddi, Niranjan; Harris, Melanie; Newman, Lareen; Lynn, Sarah; Peterson, Leigh; Battersby, Malcolm

2014-06-12

eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement.

Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

PubMed

Park, Hyejin; Cormier, Eileen; Gordon, Glenna; Baeg, Jung Hoon

2016-02-01

The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

Lifestyle interventions based on the diabetes prevention program delivered via eHealth: A systematic review and meta-analysis.

PubMed

Joiner, Kevin L; Nam, Soohyun; Whittemore, Robin

2017-07-01

The objective was to describe Diabetes Prevention Program (DPP)-based lifestyle interventions delivered via electronic, mobile, and certain types of telehealth (eHealth) and estimate the magnitude of the effect on weight loss. A systematic review was conducted. PubMed and EMBASE were searched for studies published between January 2003 and February 2016 that met inclusion and exclusion criteria. An overall estimate of the effect on mean percentage weight loss across all the interventions was initially conducted. A stratified meta-analysis was also conducted to determine estimates of the effect across the interventions classified according to whether behavioral support by counselors post-baseline was not provided, provided remotely with communication technology, or face-to-face. Twenty-two studies met the inclusion/exclusion criteria, in which 26 interventions were evaluated. Samples were primarily white and college educated. Interventions included Web-based applications, mobile phone applications, text messages, DVDs, interactive voice response telephone calls, telehealth video conferencing, and video on-demand programing. Nine interventions were stand-alone, delivered post-baseline exclusively via eHealth. Seventeen interventions included additional behavioral support provided by counselors post-baseline remotely with communication technology or face-to-face. The estimated overall effect on mean percentage weight loss from baseline to up to 15months of follow-up across all the interventions was -3.98%. The subtotal estimate across the stand-alone eHealth interventions (-3.34%) was less than the estimate across interventions with behavioral support given by a counselor remotely (-4.31%), and the estimate across interventions with behavioral support given by a counselor in-person (-4.65%). There is promising evidence of the efficacy of DPP-based eHealth interventions on weight loss. Further studies are needed particularly in racially and ethnically diverse

eHealth literacy, Internet and eHealth service usage: a survey among cancer patients and their relatives.

PubMed

Halwas, Nikolaus; Griebel, Lena; Huebner, Jutta

2017-11-01

The aim of our study was to investigate Internet and eHealth usage, with respect to eHealth literacy, by cancer patients and their relatives. Using a standardized questionnaire we asked patients who attended lectures on complementary medicine in 2016. We received 142 questionnaires. The frequency of general Internet usage was directly associated with younger age and better Internet connection. Younger participants were not only more confident in allocating health-related Internet information into reliable or unreliable facts, but also more confident and capable of gaining medical knowledge through eHealth services. A regular use of eHealth services facilitated the decision-making process. Reading ability was associated with a better understanding regarding eHealth offers. In a modern health care system, emphasis should be on skills contributing to eHealth literacy among patients to improve their ability to profit from eHealth offers and improve health care.

eHealth literacy research-Quo vadis?

PubMed

Griebel, Lena; Enwald, Heidi; Gilstad, Heidi; Pohl, Anna-Lena; Moreland, Julia; Sedlmayr, Martin

2017-10-18

The concept of electronic health (eHealth) literacy evolved from the social and information sciences and describes competencies necessary to use electronic health services. As it is a rather new topic, and as there is no current overview of the state of the art in research, it is not possible to identify research gaps. Therefore, the objective of this viewpoint article is to increase knowledge on the current state of the art of research in eHealth literacy and to identify gaps in scientific research which should be focused on by the research community in the future. The article provides a current viewpoint of the concept of eHealth literacy and related research. Gaps can be found in terms of a missing "gold standard" regarding both the definition and the measurement of eHealth literacy. Furthermore, there is a need for identifying the implications on eHealth developers, which evolve from the measurement of eHealth literacy in eHealth users. Finally, a stronger inclusion of health professionals, both in the evolving concept and in the measurement of eHealth literacy, is needed in the future.

Development of an eHealth Program for Parents of Adolescents With Type 1 Diabetes.

PubMed

Whittemore, Robin; Zincavage, Rebekah M; Jaser, Sarah S; Grey, Margaret; Coleman, Julia L; Collett, David; Delvy, Roberta; Basile Ibrahim, Bridget; Marceau, Lisa D

2018-02-01

Purpose The purpose of this study was to understand the experience of parenting an adolescent with type 1 diabetes (T1DM), to develop a prototype of an eHealth program for parents of adolescents with T1DM, and to evaluate the prototype content and acceptability from the perspective of parents and health care providers. Methods A multiphase method was used generating both qualitative and quantitative data at multiple time points. There were 27 parents of adolescents aged 12 to 18 years with T1DM and 16 health care providers who participated in semistructured interviews to identify parental challenges; 53 parents and 27 providers evaluated the prototype. Thematic content analysis was used to analyze interview transcripts, and descriptive statistics were used to summarize survey data. Results Challenges experienced by parents of adolescents with T1DM included understanding the developmental and hormonal changes of adolescence that affect diabetes care, feeling tension between adolescent independence and parent control, communicating without nagging or conflict, transferring diabetes care responsibility safely, dealing with feelings of stress and distress, and perceiving a lack of resources for T1DM care and insufficient personal time for self-care. In the prototype evaluation, both parents and providers found content to be relevant and provided feedback to guide the development of the full program. Conclusions Parents of adolescents with T1DM and providers expressed a need for parents to have more support in transitioning diabetes care from parent to adolescent. eHealth programs offer an ideal way to address these needs and ultimately can be linked to electronic medical records improving quality and efficiency of health care in this population.

What Is eHealth (4): A Scoping Exercise to Map the Field

PubMed Central

Sloan, David; Gregor, Peter; Sullivan, Frank; Detmer, Don; Kahan, James P; Oortwijn, Wija; MacGillivray, Steve

2005-01-01

Background Lack of consensus on the meaning of eHealth has led to uncertainty among academics, policymakers, providers and consumers. This project was commissioned in light of the rising profile of eHealth on the international policy agenda and the emerging UK National Programme for Information Technology (now called Connecting for Health) and related developments in the UK National Health Service. Objectives To map the emergence and scope of eHealth as a topic and to identify its place within the wider health informatics field, as part of a larger review of research and expert analysis pertaining to current evidence, best practice and future trends. Methods Multiple databases of scientific abstracts were explored in a nonsystematic fashion to assess the presence of eHealth or conceptually related terms within their taxonomies, to identify journals in which articles explicitly referring to eHealth are contained and the topics covered, and to identify published definitions of the concept. The databases were Medline (PubMed), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Science Citation Index (SCI), the Social Science Citation Index (SSCI), the Cochrane Database (including Dare, Central, NHS Economic Evaluation Database [NHS EED], Health Technology Assessment [HTA] database, NHS EED bibliographic) and ISTP (now known as ISI proceedings).We used the search query, “Ehealth OR e-health OR e*health”. The timeframe searched was 1997-2003, although some analyses contain data emerging subsequent to this period. This was supplemented by iterative searches of Web-based sources, such as commercial and policy reports, research commissioning programmes and electronic news pages. Definitions extracted from both searches were thematically analyzed and compared in order to assess conceptual heterogeneity. Results The term eHealth only came into use in the year 2000, but has since become widely prevalent. The scope of the topic was not immediately

eHealth in Denmark: a case study.

PubMed

Kierkegaard, Patrick

2013-12-01

Denmark is widely regarded as a leading country in terms of eHealth integration and healthcare delivery services. The push for eHealth adoption over that past 20 years in the Danish health sector has led to the deployment of multiple eHealth technologies. However, in reality the Danish healthcare suffers from eHealth system fragmentation which has led to eHealth's inability to reach full potential in delivering quality healthcare service. This paper will presents a case study of the current state of eHealth in the Danish healthcare system and discuss the current challenges the country is facing today.

Making Behavior Change Interventions Available to Young African American Women: Development and Feasibility of an eHealth Lifestyle Program.

PubMed

Staffileno, Beth A; Tangney, Christy C; Fogg, Louis; Darmoc, Rebecca

2015-01-01

Less is known about young African American (AA) women, largely because the young are hard to reach. Traditional approaches to behavior changes interventions impose several challenges, especially for AA women at risk for developing hypertension. This feasibility study describes the process of transforming a face-to-face lifestyle change intervention into a Web-based platform (eHealth) accessible by iPads, iPhones, smartphones, and personal computers. Four sequential phases were conducted using elements of formative evaluation and quantitative analysis. A convenience sample of AA women, aged 18 to 45 years, with self-reported prehypertension and regular access to the Internet were eligible to participate. Eleven women involved in phase 1 expressed that they (1) currently use the Internet to retrieve health-related information, (2) prefer to use the Internet rather than face-to-face contact for nonserious conditions, (3) need convenience and easily accessible health-related interventions, and (4) are amenable to the idea of an eHealth lifestyle modification program. During phase 2, learning modules derived from printed manuals were adapted and compressed for a Web audience. The modules were designed to present evidence-based content but allowed for tailoring and individualization according to the needs of the target population. During phase 3, 8 women provided formative information concerning appeal and usability of the eHealth program in relation to delivery, visual quality, interactivity, and engagement. Phase 4 involved 8 women beta testing the 12-week program, with a 63% completion rate. Most of the women agreed that the program and screens opened with ease, the functions on the screens did what they were supposed to do, and the discussion board was easy to access. Program completion was greater for physical activity compared with dietary content. This study outlines a step-by-step process for transforming face-to-face content into a Web-based platform, which

How do physicians discuss e-health with patients? the relationship of physicians' e-health beliefs to physician mediation styles.

PubMed

Fujioka, Yuki; Stewart, Erin

2013-01-01

A survey of 104 physicians examined the role of physicians' evaluation of the quality of e-health and beliefs about the influence of patients' use of e-health in how physicians discuss e-health materials with patients. Physicians' lower (poor) evaluation of the quality of e-health content predicted more negative mediation (counter-reinforcement of e-health content). Perceived benefits of patients' e-health use predicted more positive (endorsement of e-health content). Physician's perceived concerns (negative influence) regarding patients' e-health use were not a significant predictor for their mediation styles. Results, challenging the utility of restrictive mediation, suggested reconceptualizing it as redirective mediation in a medical interaction. The study suggested that patient-generated e-health-related inquiries invite physician mediation in medical consultations. Findings and implications are discussed in light of the literature of physician-patient interaction, incorporating the theory of parental mediation of media into a medical context.

eHealth Research from the User’s Perspective

PubMed Central

Hesse, Bradford W.; Shneiderman, Ben

2007-01-01

The application of Information Technology (IT) to issues of healthcare delivery has had a long and tortuous history in the U.S. Within the field of eHealth, vanguard applications of advanced computing techniques, such as applications in artificial intelligence or expert systems, have languished in spite of a track record of scholarly publication and decisional accuracy. The problem is one of purpose, of asking the right questions for the science to solve. Historically, many computer science pioneers have been tempted to ask “what can the computer do?” New advances in eHealth are prompting developers to ask “what can people do?” How can eHealth take part in national goals for healthcare reform to empower relationships between healthcare professionals and patients, healthcare teams and families, and hospitals and communities to improve health equitably throughout the population? To do this, eHealth researchers must combine best evidence from the user sciences (human factors engineering, human-computer interaction, psychology, and usability) with best evidence in medicine to create transformational improvements in the quality of care that medicine offers. These improvements should follow recommendations from the Institute of Medicine to create a health care system that is (a) safe, (b) effective (evidence-based), (c) patient-centered, and (d) timely. Relying on the eHealth researcher’s intuitive grasp of systems issues, improvements should be made with considerations of users and beneficiaries at the individual (patient/physician), group (family/staff), community, and broad environmental levels. PMID:17466825

Acceptance of Swedish e-health services.

PubMed

Jung, Mary-Louise; Loria, Karla

2010-11-16

To investigate older people's acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people's intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens' needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.

E-health internationalization requirements for audit purposes.

PubMed

Ouhbi, Sofia; Fernández-Alemán, José Luis; Carrillo-de-Gea, Juan Manuel; Toval, Ambrosio; Idri, Ali

2017-06-01

In the 21st century, e-health is proving to be one of the strongest drivers for the global transformation of the health care industry. Health information is currently truly ubiquitous and widespread, but in order to guarantee that everyone can appropriately access and understand this information, regardless of their origin, it is essential to bridge the international gap. The diversity of health information seekers languages and cultures signifies that e-health applications must be adapted to satisfy their needs. In order to achieve this objective, current and future e-health programs should take into account the internationalization aspects. This paper presents an internationalization requirements specification in the form of a reusable requirements catalog, obtained from the principal related standards, and describes the key methodological elements needed to perform an e-health software audit by using the internationalization knowledge previously gathered. S Health, a relevant, well-known Android application that has more than 150 million users in over 130 countries, was selected as a target for the e-health internationalization audit method and requirements specification presented above. This application example helped us to put into practice the proposal and show that the procedure is realistic and effective. The approach presented in this study is subject to continuous improvement through the incorporation of new knowledge originating from additional information sources, such as other standards or stakeholders. The application example is useful for early evaluation and serves to assess the applicability of the internationalization catalog and audit methodology, and to improve them. It would be advisable to develop of an automated tool with which to carry out the audit method. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of the Introduction of an e-Health Skills Component for Dietetics Students.

PubMed

Rollo, Megan E; Collins, Clare E; MacDonald-Wicks, Lesley

2017-11-01

Appropriate and effective use of technology within practice is a key competency outlined in Australian dietetics training standards. An e-health skills component (lecture and workshop) was introduced to undergraduate students enrolled in an Australian nutrition and dietetics program. The lecture orientated students to key e-health terms and concepts relating to telehealth and m-health technologies, while the workshop provided an opportunity to apply knowledge. The workshop consisted of four stations with activities relating to (1) orientation to telehealth equipment; (2) comparison of dietetic consultation components completed in person versus remotely via video call; (3) quality assessment of mobile apps; and (4) exploration of advantages and disadvantages, and the ethical, security, and privacy issues relating to use of e-health technologies in dietetic practice. Student experience of the training was evaluated via questionnaire. Forty-five students (62.2% aged ≤19-24 years, 86.7% female) completed the survey. Following the workshop, the level of understanding relating to each key e-health concept improved significantly (p < 0.001). The aspects relating to the impact and need for initial training and ongoing professional education to support the use of e-health technologies within dietetic practice were rated a high level of importance by most students (78-80%). The majority of students (93.3% to 97.8%) reported a positive experience at each of the four workshop stations, with "informative" the most common word selected to rate each station (37.8% to 44.4% of students across the four stations). The introduction of an e-health skills component resulted in an improved understanding of concepts for using these technologies. These findings provide preliminary support for integration of further e-health training within the dietetics program.

Visualization of e-Health Research Topics and Current Trends Using Social Network Analysis.

PubMed

Son, Youn-Jung; Jeong, Senator; Kang, Byeong-Gwon; Kim, Sun-Hyung; Lee, Soo-Kyoung

2015-05-01

E-health has been grown rapidly with significant impact on quality and safety of healthcare. However, there is a large gap between the postulated and empirically demonstrated benefits of e-health technologies and a need for a clearer mapping of its conceptual domains. Therefore, this study aimed to critically review the main research topics and trends of international e-health through social network analysis. Medical subject heading terms were used to retrieve 3,023 research articles published from 1979 through 2014 in the PubMed database. We extracted n-grams from the corpus using a text analysis program, generated co-occurrence networks, and then analyzed and visualized the networks using Pajek software. The hub and authority measures identified the most important research topics in e-health. Newly emerging topics by 4-year period units were identified as research trends. The most important research topics in e-health are personal health records (PHR), health information technology, primary care, mobile health, clinical decision support systems (CDSS), and so on. The eight groups obtained through ego network analysis can be divided into four semantically different areas, as follows: information technology, infrastructure, services, and subjects. Also, four historical trends in e-health research are identified: the first focusing on e-health and telemedicine; the second, PHR and monitoring; the third, CDSS and alert; and the fourth, mobile health and health literacy. This study promotes a systematic understanding of e-health by identifying topic networks, thereby contributing to the future direction of e-health research and education.

Acceptance of Swedish e-health services

PubMed Central

Jung, Mary-Louise; Loria, Karla

2010-01-01

Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860

Design and Implementation of e-Health System Based on Semantic Sensor Network Using IETF YANG.

PubMed

Jin, Wenquan; Kim, Do Hyeun

2018-02-20

Recently, healthcare services can be delivered effectively to patients anytime and anywhere using e-Health systems. e-Health systems are developed through Information and Communication Technologies (ICT) that involve sensors, mobiles, and web-based applications for the delivery of healthcare services and information. Remote healthcare is an important purpose of the e-Health system. Usually, the eHealth system includes heterogeneous sensors from diverse manufacturers producing data in different formats. Device interoperability and data normalization is a challenging task that needs research attention. Several solutions are proposed in the literature based on manual interpretation through explicit programming. However, programmatically implementing the interpretation of the data sender and data receiver in the e-Health system for the data transmission is counterproductive as modification will be required for each new device added into the system. In this paper, an e-Health system with the Semantic Sensor Network (SSN) is proposed to address the device interoperability issue. In the proposed system, we have used IETF YANG for modeling the semantic e-Health data to represent the information of e-Health sensors. This modeling scheme helps in provisioning semantic interoperability between devices and expressing the sensing data in a user-friendly manner. For this purpose, we have developed an ontology for e-Health data that supports different styles of data formats. The ontology is defined in YANG for provisioning semantic interpretation of sensing data in the system by constructing meta-models of e-Health sensors. The proposed approach assists in the auto-configuration of eHealth sensors and querying the sensor network with semantic interoperability support for the e-Health system.

Design and Implementation of e-Health System Based on Semantic Sensor Network Using IETF YANG

PubMed Central

Kim, Do Hyeun

2018-01-01

Recently, healthcare services can be delivered effectively to patients anytime and anywhere using e-Health systems. e-Health systems are developed through Information and Communication Technologies (ICT) that involve sensors, mobiles, and web-based applications for the delivery of healthcare services and information. Remote healthcare is an important purpose of the e-Health system. Usually, the eHealth system includes heterogeneous sensors from diverse manufacturers producing data in different formats. Device interoperability and data normalization is a challenging task that needs research attention. Several solutions are proposed in the literature based on manual interpretation through explicit programming. However, programmatically implementing the interpretation of the data sender and data receiver in the e-Health system for the data transmission is counterproductive as modification will be required for each new device added into the system. In this paper, an e-Health system with the Semantic Sensor Network (SSN) is proposed to address the device interoperability issue. In the proposed system, we have used IETF YANG for modeling the semantic e-Health data to represent the information of e-Health sensors. This modeling scheme helps in provisioning semantic interoperability between devices and expressing the sensing data in a user-friendly manner. For this purpose, we have developed an ontology for e-Health data that supports different styles of data formats. The ontology is defined in YANG for provisioning semantic interpretation of sensing data in the system by constructing meta-models of e-Health sensors. The proposed approach assists in the auto-configuration of eHealth sensors and querying the sensor network with semantic interoperability support for the e-Health system. PMID:29461493

Student Perceptions of a Hands-on Practicum to Supplement an Online eHealth Course

PubMed Central

2012-01-01

Background Since 2000, the Centre for Online Health (COH) at The University of Queensland has offered a range of online eHealth courses at the undergraduate and postgraduate level. While online learning has a number of advantages, in some domains, it can present some challenges to the development of practical skills and experience. Objective To assess students’ perceptions of the value of an eHealth practicum. Methods To supplement our online learning program, we introduced an eHealth practicum component that aimed to expose students to a range of clinically relevant learning experiences. Subsequently, by means of a questionnaire, student perceptions of the practicum were assessed. Results Over two semesters, a total of 66 students participated in the eHealth practicum, and questionnaire responses were very positive. The majority of students agreed that the practicum allowed them to gain necessary skills in eHealth applications (59%) and provided them with an opportunity to explore ways of using different eHealth tools for the delivery of health care at a distance (62%). Conclusions The study shows that a practical component in eHealth teaching was well received by students. While online teaching is appropriate for providing knowledge, the opportunity to develop practical skills may encourage students to use eHealth techniques in their future practices. PMID:23246840

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study

PubMed Central

McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-01-01

Background The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. Objective This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. Methods A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Results Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. Conclusions The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development

Effect of e-health on medical expenditures of outpatients with lifestyle-related diseases.

PubMed

Minetaki, Kazunori; Akematsu, Yuji; Tsuji, Masatsugu

2011-10-01

We analyzed the effect of e-health on medical expenditures in Nishi-aizu Town, Fukushima Prefecture, Japan, using panel data of medical expenditures for about 400 residents from 2002 to 2006. The Nishi-aizu Town system was introduced in 1994 and is still successfully operating as one of the longest running implementations of e-health in Japan. The town office maintains a register of receipts for medical expenditures paid by the National Health Insurance system and provides data on e-health users, allowing users and nonusers of e-health and their respective costs to be distinguished. Here, we focus on patients with lifestyle-related diseases such as high blood pressure, diabetes, stroke, heart failure, etc. This article postulates that e-health reduces medical expenditures via two mechanisms, decreasing travel expenses and preventing symptoms from worsening. The former implies that e-health monitoring allows patients at home to visit medical institutions less frequently, and the latter that the symptoms experienced by e-health users are less severe than those experienced by nonusers. We termed these the travel cost effect and opportunity cost effect, respectively. Chronic conditions tend not to occur singly, and many patients have more than one; for example, patients with high blood pressure or diabetes also likely have heart disease at the same time. This multiplicity of conditions hampers cost analysis. Among methodological issues, a number of recent empirical health analyses have focused on the endogenous problem of explanatory variables. Here, we solved this problem using the generalized method moments (GMM) system, which allows treatment of not only the endogenous problem of explanatory variables but also the dynamic relationship among variables, which arise due to the chronic time-lagged effect of lifestyle-related diseases on patients. We also examined a second important methodological problem related to reverse correlation between the medical expenditures of

Principles and Framework for eHealth Strategy Development

PubMed Central

Mars, Maurice

2013-01-01

Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs- and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth. PMID:23900066

Principles and framework for eHealth strategy development.

PubMed

Scott, Richard E; Mars, Maurice

2013-07-30

Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs- and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth.

[E-health developments in the system of health services in Hungary and the European Union].

PubMed

Váradi, Ágnes

2014-05-25

The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which - if accepted - would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems.

The e-health implementation toolkit: qualitative evaluation across four European countries

PubMed Central

2011-01-01

Background Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. Methods We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. Results e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. Conclusion The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems. PMID:22098945

The e-Health Implementation Toolkit: qualitative evaluation across four European countries.

PubMed

MacFarlane, Anne; Clerkin, Pauline; Murray, Elizabeth; Heaney, David J; Wakeling, Mary; Pesola, Ulla-Maija; Waterworth, Eva Lindh; Larsen, Frank; Makiniemi, Minna; Winblad, Ilkka

2011-11-19

Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems.

Health literacy in the eHealth era: A systematic review of the literature.

PubMed

Kim, Henna; Xie, Bo

2017-06-01

This study aimed to identify studies on online health service use by people with limited health literacy, as the findings could provide insights into how health literacy has been, and should be, addressed in the eHealth era. To identify the relevant literature published since 2010, we performed four rounds of selection-database selection, keyword search, screening of the titles and abstracts, and screening of full texts. This process produced a final of 74 publications. The themes addressed in the 74 publications fell into five categories: evaluation of health-related content, development and evaluation of eHealth services, development and evaluation of health literacy measurement tools, interventions to improve health literacy, and online health information seeking behavior. Barriers to access to and use of online health information can result from the readability of content and poor usability of eHealth services. We need new health literacy screening tools to identify skills for adequate use of eHealth services. Mobile apps hold great potential for eHealth and mHealth services tailored to people with low health literacy. Efforts should be made to make eHealth services easily accessible to low-literacy individuals and to enhance individual health literacy through educational programs. Copyright © 2017 Elsevier B.V. All rights reserved.

Development of Knowledge Profiles for International eHealth eLearning Courses.

PubMed

Herzog, Juliane; Sauermann, Stefan; Mense, Alexander; Forjan, Mathias; Urbauer, Philipp

2015-01-01

Professionals working in the multidisciplinary field of eHealth vary in their educational background. However, knowledge in the areas of medicine, engineering and management is required to fulfil the tasks associated with eHealth sufficiently. Based on the results of an analysis of national and international educational offers a survey gathering user requirements for the development of knowledge profiles in eHealth was conducted (n=75) by professionals and students. During a workshop the first results were presented and discussed together with the network partners and the attendees. The resulting knowledge profiles contain knowledge areas of all three thematic content categories including fundamentals of medical terminology, standards and interoperability and usability as well as basics of all three content categories. The knowledge profiles are currently applied in a master's degree programme at the UAS Technikum Wien and will be developed further.

Web-based Health Information Seeking and eHealth Literacy among Patients Living with Chronic Obstructive Pulmonary Disease (COPD).

PubMed

Stellefson, Michael L; Shuster, Jonathan J; Chaney, Beth H; Paige, Samantha R; Alber, Julia M; Chaney, J Don; Sriram, P S

2017-09-05

Many people living with Chronic Obstructive Pulmonary Disease (COPD) have low general health literacy; however, there is little information available on these patients' eHealth literacy, or their ability to seek, find, understand, and appraise online health information and apply this knowledge to address or solve disease-related health concerns. A nationally representative sample of patients registered in the COPD Foundation's National Research Registry (N = 1,270) was invited to complete a web-based survey to assess socio-demographic (age, gender, marital status, education), health status (generic and lung-specific health-related quality of life), and socio-cognitive (social support, self-efficacy, COPD knowledge) predictors of eHealth literacy, measured using the 8-item eHealth literacy scale (eHEALS). Over 50% of the respondents (n = 176) were female (n = 89), with a mean age of 66.19 (SD = 9.47). Overall, participants reported moderate levels of eHealth literacy, with more than 70% feeling confident in their ability to find helpful health resources on the Internet. However, respondents were much less confident in their ability to distinguish between high- and low-quality sources of web-based health information. Very severe versus less severe COPD (β = 4.15), lower lung-specific health-related quality of life (β = -0.19), and greater COPD knowledge (β = 0.62) were significantly associated with higher eHealth literacy. Higher COPD knowledge was also significantly associated with greater knowledge (ρ = 0.24, p = .001) and use (ρ = 0.24, p = .001) of web-based health resources. Findings emphasize the importance of integrating skill-building activities into comprehensive patient education programs that enable patients with severe cases of COPD to identify high-quality sources of web-based health information. Additional research is needed to understand how new social technologies can be used to help medically underserved COPD patients

E-health readiness assessment framework in iran.

PubMed

Rezai-Rad, M; Vaezi, R; Nattagh, F

2012-01-01

Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well.

E-Health Readiness Assessment Framework in Iran

PubMed Central

Rezai-Rad, M; Vaezi, R; Nattagh, F

2012-01-01

Background: Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. Methods: The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. Results: The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). Conclusion: The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well. PMID:23304661

eHealth literacy among undergraduate nursing students.

PubMed

Tubaishat, Ahmad; Habiballah, Laila

2016-07-01

The Internet has become a major source of health related information. Nursing students, as future healthcare providers, should be skilled in locating, using and evaluating online health information. The main purpose of this study was to assess eHealth literacy among nursing students in Jordan, as well as to explore factors associated with eHealth literacy. A descriptive cross sectional survey was conducted in two universities in Jordan, one public and one private. A total of 541 students completed the eHealth literacy scale (eHEALS). Some additional personal and demographical variables were collected to explore their relation to eHealth literacy. Students have a moderate self-perceived level of eHealth literacy (M=3.62, SD=0.58). They are aware of the available online health resources and know how to search, locate, and use these resources. Yet, they lack skills to evaluate them and cannot differentiate between high and low quality resources. Factors that are related to eHealth literacy include type of university, type of student admission, academic level, students' internet skills, and their perception of the usefulness and importance of the internet. On the other hand, age, gender, grade point average (GPA), and frequency of internet use were found not to significantly affect eHealth literacy. This study represents a baseline reference for eHealth literacy in Jordan. Students have some of the necessary skills, while others still need to be improved. Nursing educators and administrators should incorporate eHealth literacy skills into the curriculum. Copyright © 2016 Elsevier Ltd. All rights reserved.

ICW eHealth Framework.

PubMed

Klein, Karsten; Wolff, Astrid C; Ziebold, Oliver; Liebscher, Thomas

2008-01-01

The ICW eHealth Framework (eHF) is a powerful infrastructure and platform for the development of service-oriented solutions in the health care business. It is the culmination of many years of experience of ICW in the development and use of in-house health care solutions and represents the foundation of ICW product developments based on the Java Enterprise Edition (Java EE). The ICW eHealth Framework has been leveraged to allow development by external partners - enabling adopters a straightforward integration into ICW solutions. The ICW eHealth Framework consists of reusable software components, development tools, architectural guidelines and conventions defining a full software-development and product lifecycle. From the perspective of a partner, the framework provides services and infrastructure capabilities for integrating applications within an eHF-based solution. This article introduces the ICW eHealth Framework's basic architectural concepts and technologies. It provides an overview of its module and component model, describes the development platform that supports the complete software development lifecycle of health care applications and outlines technological aspects, mainly focusing on application development frameworks and open standards.

What Is eHealth (6): Perspectives on the Evolution of eHealth Research

PubMed Central

Kreslake, Jennifer M; Phalen, Judith M

2006-01-01

Background The field of eHealth holds promise for supporting and enabling health behavior change and the prevention and management of chronic disease. Objective In order to establish areas of congruence and controversy among contributors to the early development, evaluation, and dissemination of eHealth applications, as well as the desire to inform an evaluation research funding agenda, 38 semistructured, qualitative interviews were conducted among stakeholders in eHealth between May 2002 and September 2003. Methods Participants were asked about their perspectives on the credibility, value, and future potential of information technology for health behavior change and chronic disease management. Interviews were coded and analyzed for emergent themes using qualitative methods. Results Consistent themes were identified across stakeholder groups, with slight differences in emphasis. These topics included the following: (1) consensus and standardization—most stakeholders expressed a strong desire for a more coordinated, rigorous effort to define and integrate the field; (2) evaluation methods and challenges—demonstrating outcomes is required to establish eHealth quality and efficacy, but stakeholders were not satisfied with the sensitivity, validity, and reliability of existing outcome measures; (3) quality, value, and future potential—the intersection between eHealth’s potential cost-effectiveness, efficiency, and improved clinical status among users generated a high degree of interest; and (4) health disparities—many stakeholders contended that traditionally underserved populations will particularly benefit from eHealth applications, although others argued that the underserved are also disadvantaged in terms of access to technology. Conclusions Recommendations included the need for improvement and formalization of development and evaluation standards across private and public sectors, additional research on the technology needs and preferences of

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study.

PubMed

Brunner, Melissa; McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-05-15

The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. ©Melissa Brunner, Deborah Mc

Align, share responsibility and collaborate: potential considerations to aid in e-health policy development.

PubMed

Ragaban, Nouran; Day, Karen; Orr, Martin

2012-01-01

Policies that support strategic development and implementation are related to health ICT implementation successes. This research aimed to explore the question, 'Why have we not seen more successful ICT implementation in healthcare, and what does policy have to do with success?' Healthcare systems are faced with rising costs, increased prevalence of chronic diseases and diminishing resources. E-health initiatives have gained acceptance in addressing these crucial health sector issues. National governments and healthcare organisations are finding it necessary to have health Information and Communications Technology (ICT) systems in place. However, poorly developed health information policies, lack of a clear business plan and ineffective leadership contribute to failure of ICT implementation in healthcare. This study uses a Grounded Theory approach, in which a series of data gathering activities will be completed. The first author attended the Health Information Management & Systems Society (HIMSS) Policy Summit in the USA in 2011. Five Summit participants were approached individually and informally discussed the 'meaningful use' policy and how it influences ICT implementation in healthcare. Field notes were made and analysed for themes relating to the research question. There were three overlapping concepts that all of the participants indicated as primary considerations for policymakers. The alignment aspect stresses the need to align e-health initiatives with overall health policy, ensuring that e-health is incorporated with other healthcare investments. The shared responsibility theme involves the need for e-health initiatives to be recognised as a priority along all levels of government, i.e. local, state, federal, and national. This stresses the importance of health ICT development and implementation in a joint government direction. The last theme is collaboration with stakeholders, including clear division of tasks and clarity about technical and non

Applying Use Cases to Describe the Role of Standards in e-Health Information Systems

NASA Astrophysics Data System (ADS)

Chávez, Emma; Finnie, Gavin; Krishnan, Padmanabhan

Individual health records (IHRs) contain a person's lifetime records of their key health history and care within a health system (National E-Health Transition Authority, Retrieved Jan 12, 2009 from http://www.nehta.gov.au/coordinated-care/whats-in-iehr, 2004). This information can be processed and stored in different ways. The record should be available electronically to authorized health care providers and the individual anywhere, anytime, to support high-quality care. Many organizations provide a diversity of solutions for e-health and its services. Standards play an important role to enable these organizations to support information interchange and improve efficiency of health care delivery. However, there are numerous standards to choose from and not all of them are accessible to the software developer. This chapter proposes a framework to describe the e-health standards that can be used by software engineers to implement e-health information systems.

Applying e-health to case management.

PubMed

Adams, J M

2000-01-01

The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.

Ten Demands of Improved Usability in eHealth and Some Progress - Co-Creation by Health and Social Care Professionals.

PubMed

Scandurra, Isabella; Liljequist, David

2016-01-01

Current healthcare organizations often do not accomplish the intended effects of their eHealth systems due to inadequate usability. Commissioned by the Swedish Ministry of Health and Social Affairs, the usability of current eHealth systems in Swedish health and social care has been analysed from the perspective of their professionals. The objective of the study was to report on current problems, potential solutions as well as to relate these to research in relevant areas. Using a participatory approach, nine workshops were held where health informatics researchers guided staff from different care organizations, representatives of the national associations of health and social care professionals and the national eHealth system vendor organization. This paper presents ten demands that Swedish health and social care professionals find imperative to prioritize. The study emphasizes that development of eHealth systems must be integrated into the care practice improvement process and iteratively evaluated regarding usability.

Cancer survivors' perceived need for supportive care and their attitude towards self-management and eHealth.

PubMed

Jansen, Femke; van Uden-Kraan, Cornelia F; van Zwieten, Valesca; Witte, Birgit I; Verdonck-de Leeuw, Irma M

2015-06-01

The aim of this study was to explore the perceived need for supportive care including healthy lifestyle programs among cancer survivors, their attitude towards self-management and eHealth, and its association with several sociodemographic and clinical variables and quality of life. A questionnaire on the perceived need for supportive care and attitude towards self-management and eHealth was completed by 212 cancer survivors from an online panel. Highest needs were reported regarding physical care (66 %), followed by healthy lifestyle programs (54 %), social care (43 %), psychological care (38 %), and life question-related programs (24 %). In general, cancer survivors had a positive attitude towards self-management and eHealth. Supportive care needs were associated with male gender, lower age, treatment with chemotherapy or (chemo)radiation (versus surgery alone), hematological cancer (versus skin cancer, breast cancer, and other types of cancer), and lower quality of life. A positive attitude towards self-management was associated with lower age. A more positive attitude towards eHealth was associated with lower age, higher education, higher income, currently being under treatment (versus treatment in the last year), treatment with chemotherapy or (chemo)radiation (versus surgery alone), prostate and testicular cancer (versus hematological, skin, gynecological, and breast cancer and other types of cancer), and lower quality of life. The perceived need for supportive care including healthy lifestyle programs was high, and in general, cancer survivors had a positive attitude towards self-management and eHealth. Need and attitude were associated with sociodemographic and clinical variables and quality of life. Therefore, a tailored approach seems to be warranted to improve and innovate supportive care targeting cancer survivors.

Individualized Infliximab Treatment Guided by Patient-managed eHealth in Children and Adolescents with Inflammatory Bowel Disease.

PubMed

Carlsen, Katrine; Houen, Gunnar; Jakobsen, Christian; Kallemose, Thomas; Paerregaard, Anders; Riis, Lene B; Munkholm, Pia; Wewer, Vibeke

2017-09-01

To individualize timing of infliximab (IFX) treatment in children and adolescents with inflammatory bowel disease (IBD) using a patient-managed eHealth program. Patients with IBD, 10 to 17 years old, treated with IFX were prospectively included. Starting 4 weeks after their last infusion, patients reported a weekly symptom score and provided a stool sample for fecal calprotectin analysis. Based on symptom scores and fecal calprotectin results, the eHealth program calculated a total inflammation burden score that determined the timing of the next IFX infusion (4-12 wk after the previous infusion). Quality of Life was scored by IMPACT III. A control group was included to compare trough levels of IFX antibodies and concentrations and treatment intervals. Patients and their parents evaluated the eHealth program. There were 29 patients with IBD in the eHealth group and 21 patients with IBD in the control group. During the control period, 94 infusions were provided in the eHealth group (mean interval 9.5 wk; SD 2.3) versus 105 infusions in the control group (mean interval 6.9 wk; SD 1.4). Treatment intervals were longer in the eHealth group (P < 0.001). Quality of Life did not change during the study. Appearance of IFX antibodies did not differ between the 2 groups. Eighty percent of patients reported increased disease control and 63% (86% of parents) reported an improved knowledge of the disease. Self-managed, eHealth-individualized timing of IFX treatments, with treatment intervals of 4 to 12 weeks, was accompanied by no significant development of IFX antibodies. Patients reported better control and improved knowledge of their IBD.

Increasing the cost-effectiveness of telemedicine by embracing e-health.

PubMed

Mitchell, J

2000-01-01

In 1999 a national study of telemedicine in Australia led to the promotion of the concept of 'e-health', the health sector's equivalent of 'e-commerce'. A new study explored the view that, with the convergence of technologies and the consequent increase in ability to perform multiple functions with those technologies, it is unwise to promote telemedicine in isolation from other uses of technologies in health-care. The major sources of information for the study were the presentations and discussions at five national workshops held to discuss the findings of the original report on telemedicine. Nineteen case studies were identified. The case studies showed that with the convergence of technologies telehealth is becoming part of e-health. The cost-effectiveness of both telehealth and telemedicine improves considerably when they are part of an integrated use of telecommunications and information technology in the health sector.

The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting.

PubMed

Carey, Mariko; Noble, Natasha; Mansfield, Elise; Waller, Amy; Henskens, Frans; Sanson-Fisher, Rob

2015-05-22

Modifiable health risk behaviors such as smoking, overweight and obesity, risky alcohol consumption, physical inactivity, and poor nutrition contribute to a substantial proportion of the world's morbidity and mortality burden. General practitioners (GPs) play a key role in identifying and managing modifiable health risk behaviors. However, these are often underdetected and undermanaged in the primary care setting. We describe the potential of eHealth to help patients and GPs to overcome some of the barriers to managing health risk behaviors. In particular, we discuss (1) the role of eHealth in facilitating routine collection of patient-reported data on lifestyle risk factors, and (2) the role of eHealth in improving clinical management of identified risk factors through provision of tailored feedback, point-of-care reminders, tailored educational materials, and referral to online self-management programs. Strategies to harness the capacity of the eHealth medium, including the use of dynamic features and tailoring to help end users engage with, understand, and apply information need to be considered and maximized. Finally, the potential challenges in implementing eHealth solutions in the primary care setting are discussed. In conclusion, there is significant potential for innovative eHealth solutions to make a contribution to improving preventive care in the primary care setting. However, attention to issues such as data security and designing eHealth interfaces that maximize engagement from end users will be important to moving this field forward.

With Some Help From My Network: Supplementing eHealth Literacy With Social Ties

PubMed Central

Brainin, Esther; Neter, Efrat

2017-01-01

Background eHealth literacy is defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem. Previous research has shown high reliance on both online and face-to-face interpersonal sources when sharing and receiving health information. Objective In this paper, we examine these interpersonal sources and their interplay with respondents’ eHealth literacy and perceived health outcomes. Specifically, we look at how the relationship between eHealth literacy and health outcomes is moderated by (1) finding help while performing online activities, (2) finding others with similar health concerns online, and (3) the importance of finding others with similar health concerns for people from ethnic minorities, specifically Palestinian citizens of Israel versus Israeli Jews. Methods We used a nationally representative random-digit dial telephone household survey of an Israeli adult population (age ≥21 years, N=819). The collected data were analyzed using two regression models. The first examined how the correlation between eHealth literacy and perceived outcomes was moderated by the availability of help. The second examined how the correlation between eHealth literacy and perceived outcomes was moderated by finding others with similar health concerns and by ethnicity. Results Respondents with low eHealth literacy who were able to recruit help when performing online activities demonstrated higher perceived health outcomes compared to similar respondents who did not find help. Respondents with low eHealth literacy, who were able to find others with similar health concerns (online), demonstrated higher perceived health outcomes when compared to similar respondents who did not find others with similar health concerns. Finally, finding similar others online was more helpful in enhancing health outcomes for ethnic minorities; Palestinian citizens of Israel gained more

Utilization and efficacy of internet-based eHealth technology in gastroenterology: a systematic review.

PubMed

Knowles, Simon R; Mikocka-Walus, Antonina

2014-04-01

While there have been several reviews exploring the outcomes of various eHealth studies, none have been gastroenterology-specific. This paper aims to evaluate the research conducted within gastroenterology which utilizes internet-based eHealth technology to promote physical and psychological well-being. A systematic literature review of internet-based eHealth interventions involving gastroenterological cohorts was conducted. Searched databases included: EbSCOhost Medline, CINAHL, and PsycINFO. Inclusion criteria were studies reporting on eHealth interventions (both to manage mental health problems and somatic symptoms) in gastroenterology, with no time restrictions. Exclusion criteria were non-experimental studies, or studies using only email as primary eHealth method, and studies in language other than English. A total of 17 papers were identified; seven studies evaluated the efficacy of a psychologically oriented intervention (additional two provided follow-up analyses exploring the original published data) and eight studies evaluated disease management programs for patients with either irritable bowel syndrome, inflammatory bowel disease (IBD) or celiac disease. Overall, psychological eHealth interventions were associated with significant reductions in bowel symptoms and improvement in quality of life (QoL) that tended to continue up to 12 months follow up. The eHealth disease management was shown to generally improve QoL, adherence, knowledge about the disease, and reduce healthcare costs in IBD, although the studies were associated with various methodological problems, and thus, this observation should be confirmed in well-designed interventional studies. Based on the evidence to date, eHealth internet-based technology is a promising tool that can be utilized to both promote and enhance gastrointestinal disease management and mental health.

Ready for eHealth? Health Professionals' Acceptance and Adoption of eHealth Interventions in Inpatient Routine Care.

PubMed

Hennemann, Severin; Beutel, Manfred E; Zwerenz, Rüdiger

2017-03-01

eHealth interventions can be effective in treating health problems. However, adoption in inpatient routine care seems limited. The present study therefore aimed to investigate barriers and facilitators to acceptance of eHealth interventions and of online aftercare in particular in health professionals of inpatient treatment. A total of 152 out of 287 health professionals of various professional groups in four inpatient rehabilitation facilities filled out a self-administered web-based questionnaire (response rate: 53%); 128 individuals were eligible for further data analysis. Acceptance and possible predictors were investigated with a complex research model based on the Unified Theory of Acceptance and Use of Technology. Acceptance of eHealth interventions was rather low (M = 2.47, SD = 0.98); however, acceptance of online aftercare was moderate (M = 3.08, SD = 0.96, t(127) = 8.22, p < .001), and eHealth literacy was elevated. Social influence, performance expectancy, and treatment-related internet and mobile use significantly predicted overall acceptance. No differences were found between professional and age groups. Although acceptance of eHealth interventions was limited in health professionals of inpatient treatment, moderate acceptance of online aftercare for work-related stress implies a basis for future implementation. Tailored eHealth education addressing misconceptions about inferiority and incongruity with conventional treatment considering the systemic aspect of acceptance formation are needed.

A Systematic Review and Taxonomy of Published Quality Criteria Related to the Evaluation of User-Facing eHealth Programs.

PubMed

Baumel, Amit; Birnbaum, Michael L; Sucala, Madalina

2017-08-01

The purpose of this review was to identify and classify key criteria concepts related to the evaluation of user-facing eHealth programs. In line with the PRISMA statement methodology, computer searches of relevant databases were conducted for studies published between January 1, 2000 and March 1, 2016 that contained explicit quality criteria related to mHealth and eHealth products. Reference lists of included articles, review articles, and grey literature (e.g., books, websites) were searched for additional sources. A team of nine experts led by the first author was gathered to support the classification of these criteria. Identified criteria were extracted, grouped and organized using an inductive thematic analysis. Eighty-four sources - emanating from 26 different courtiers - were included in this review. The team extracted 454 criteria that were grouped into 11 quality domains, 58 criteria concepts and 134 concepts' sub-groups. Quality domains were: Usability, Visual Design, User Engagement, Content, Behavior Change/Persuasive Design, Influence of Social Presence, Therapeutic Alliance, Classification, Credibility/Accountability, and Privacy/Security. Findings suggest that authors around the globe agree on key criteria concepts when evaluating user-facing eHealth products. The high proportion of new published criteria in the second half of this review time-frame (2008-2016), and more specifically, the high proportion of criteria relating to persuasive design, therapeutic alliance and privacy/security within this time-frame, points to the advancements made in recent years within this field.

Be Positive Be Healthe: Development and Implementation of a Targeted e-Health Weight Loss Program for Young Women.

PubMed

Hutchesson, Melinda J; Morgan, Philip J; Callister, Robin; Pranata, Ilung; Skinner, Geoff; Collins, Clare E

2016-06-01

Greater numbers of women are entering young adulthood overweight, but traditional weight loss programs do not appeal to them. This article describes the development and evaluation of an e-health weight loss intervention for young women (18-30 years of age). Young women's preferences for a targeted weight loss program were investigated via a cross-sectional online survey. A 3-month targeted weight loss program for young women was developed based on the formative research. A single-arm pre-post study was conducted to evaluate the acceptability of the intervention (process evaluation survey and objective usage data) and to estimate the treatments' effects on weight-related outcomes from baseline to 3 months. Online survey respondents (n = 274) indicated preferences for various technologies (Web site, online quizzes with e-mail feedback and goal setting, an online discussion forum, smartphone application, e-mail newsletters, and text messages). Eighteen (mean ± standard deviation [SD] age, 22.8 ± 3.2 years; body mass index, 27.3 ± 1.6 kg/m(2)) women entered the pre-post study. Mean satisfaction was 3.4 ± 1.0 (maximum of 5), and 66.7% of participants completed the study. Significant reductions in mean ± SD weight (-1.5 ± 2.4 kg; p = 0.02) and waist circumference (-0.7 ± 1.4 cm; p = 0.04) were observed. Due to lower than anticipated participant satisfaction, modifications to the program content and modes of delivery are required to ensure a higher proportion of young women complete and actively engage with the program. The positive effects of treatment on weight-related outcomes supports further refinement and evaluation of targeted, e-health weight loss interventions for young women.

Special Topic Interoperability and EHR: Combining openEHR, SNOMED, IHE, and Continua as approaches to interoperability on national eHealth.

PubMed

Beštek, Mate; Stanimirović, Dalibor

2017-08-09

The main aims of the paper comprise the characterization and examination of the potential approaches regarding interoperability. This includes openEHR, SNOMED, IHE, and Continua as combined interoperability approaches, possibilities for their incorporation into the eHealth environment, and identification of the main success factors in the field, which are necessary for achieving required interoperability, and consequently, for the successful implementation of eHealth projects in general. The paper represents an in-depth analysis regarding the potential application of openEHR, SNOMED, IHE and Continua approaches in the development and implementation process of eHealth in Slovenia. The research method used is both exploratory and deductive in nature. The methodological framework is grounded on information retrieval with a special focus on research and charting of existing experience in the field, and sources, both electronic and written, which include interoperability concepts and related implementation issues. The paper will try to answer the following inquiries that are complementing each other: 1. Scrutiny of the potential approaches, which could alleviate the pertinent interoperability issues in the Slovenian eHealth context. 2. Analyzing the possibilities (requirements) for their inclusion in the construction process for individual eHealth solutions. 3. Identification and charting the main success factors in the interoperability field that critically influence development and implementation of eHealth projects in an efficient manner. Provided insights and identified success factors could serve as a constituent of the strategic starting points for continuous integration of interoperability principles into the healthcare domain. Moreover, the general implementation of the identified success factors could facilitate better penetration of ICT into the healthcare environment and enable the eHealth-based transformation of the health system especially in the countries

Last Mile Towards Efficient Healthcare Delivery in Switzerland: eHealth Enabled Applications Could Speed Up the Care Process.

PubMed

Deng, Yihan; Bürkle, Thomas; Holm, Jürgen; Zetz, Erwin; Denecke, Kerstin

2018-01-01

A precise and timely care delivery depends on an efficient triage performed by primary care providers and smooth collaboration with other medical specialities. In recent years telemedicine gained increasing importance for efficient care delivery. It's use, however, has been limited by legal issues, missing digital infrastructures, restricted support from health insurances and the digital divide in the population. A new era towards eHealth and telemedicine starts with the establishment of national eHealth regulations and laws. In Switzerland, a nation-wide digital infrastructure and electronic health record will be established. But appropriate healthcare apps to improve patient care based on this infrastructure remain rare. In this paper, we present two applications (self-anamnesis and eMedication assistant) for eHealth enabled care delivery which have the potential to speed up diagnosis and treatment.

Health Consumers eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

PubMed

Park, Hyejin; Cormier, Eileen; Glenna, Gordon

2016-01-01

The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that health care professionals can effectively address skills gaps in health consumers' ability to access and use high quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth literacy scale (eHEALS) was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high from low quality information was considerably less. The findings suggest the need for eHealth education and support to health consumers from health care professionals, in particular, how to access and evaluate the quality of health information.

Modeling patients' acceptance of provider-delivered e-health.

PubMed

Wilson, E Vance; Lankton, Nancy K

2004-01-01

Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

With Some Help From My Network: Supplementing eHealth Literacy With Social Ties.

PubMed

Hayat, Tsahi Zack; Brainin, Esther; Neter, Efrat

2017-03-30

eHealth literacy is defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem. Previous research has shown high reliance on both online and face-to-face interpersonal sources when sharing and receiving health information. In this paper, we examine these interpersonal sources and their interplay with respondents' eHealth literacy and perceived health outcomes. Specifically, we look at how the relationship between eHealth literacy and health outcomes is moderated by (1) finding help while performing online activities, (2) finding others with similar health concerns online, and (3) the importance of finding others with similar health concerns for people from ethnic minorities, specifically Palestinian citizens of Israel versus Israeli Jews. We used a nationally representative random-digit dial telephone household survey of an Israeli adult population (age ≥21 years, N=819). The collected data were analyzed using two regression models. The first examined how the correlation between eHealth literacy and perceived outcomes was moderated by the availability of help. The second examined how the correlation between eHealth literacy and perceived outcomes was moderated by finding others with similar health concerns and by ethnicity. Respondents with low eHealth literacy who were able to recruit help when performing online activities demonstrated higher perceived health outcomes compared to similar respondents who did not find help. Respondents with low eHealth literacy, who were able to find others with similar health concerns (online), demonstrated higher perceived health outcomes when compared to similar respondents who did not find others with similar health concerns. Finally, finding similar others online was more helpful in enhancing health outcomes for ethnic minorities; Palestinian citizens of Israel gained more health benefits by finding similar

Physician leadership in e-health? A systematic literature review.

PubMed

Keijser, Wouter; Smits, Jacco; Penterman, Lisanne; Wilderom, Celeste

2016-07-04

Purpose This paper aims to systematically review the literature on roles of physicians in virtual teams (VTs) delivering healthcare for effective "physician e-leadership" (PeL) and implementation of e-health. Design/methodology/approach The analyzed studies were retrieved with explicit keywords and criteria, including snowball sampling. They were synthesized with existing theoretical models on VT research, healthcare team competencies and medical leadership. Findings Six domains for further PeL inquiry are delineated: resources, task processes, socio-emotional processes, leadership in VTs, virtual physician-patient relationship and change management. We show that, to date, PeL studies on socio-technical dynamics and their consequences on e-health are found underrepresented in the health literature; i.e. no single empirical, theoretic or conceptual study with a focus on PeL in virtual healthcare work was identified. Research limitations/implications E-health practices could benefit from organization-behavioral type of research for discerning effective physicians' roles and inter-professional relations and their (so far) seemingly modest but potent impact on e-health developments. Practical implications Although best practices in e-health care have already been identified, this paper shows that physicians' roles in e-health initiatives have not yet received any in-depth study. This raises questions such as are physicians not yet sufficiently involved in e-health? If so, what (dis)advantages may this have for current e-health investments and how can they best become involved in (leading) e-health applications' design and implementation in the field? Originality/value If effective medical leadership is being deployed, e-health effectiveness may be enhanced; this new proposition needs urgent empirical scrutiny.

eHealth for Patient Engagement: A Systematic Review.

PubMed

Barello, Serena; Triberti, Stefano; Graffigna, Guendalina; Libreri, Chiara; Serino, Silvia; Hibbard, Judith; Riva, Giuseppe

2015-01-01

eHealth interventions are recognized to have a tremendous potential to promote patient engagement. To date, the majority of studies examine the efficacy of eHealth in enhancing clinical outcomes without focusing on patient engagement in its specificity. This paper aimed at reviewing findings from the literature about the use of eHealth in engaging patients in their own care process. We undertook a comprehensive literature search within the peer-reviewed international literature. Eleven studies met the inclusion criteria. eHealth interventions reviewed were mainly devoted to foster only partial dimensions of patient engagement (i.e., alternatively cognitive, emotional or behavioral domains related to healthcare management), thus failing to consider the complexity of such an experience. This also led to a great heterogeneity of technologies, assessed variables and achieved outcomes. This systematic review underlines the need for a more holistic view of patient needs to actually engage them in eHealth interventions and obtaining positive outcomes. In this sense, patient engagement constitute a new frontiers for healthcare models where eHealth could maximize its potentialities.

eHealth for Patient Engagement: A Systematic Review

PubMed Central

Barello, Serena; Triberti, Stefano; Graffigna, Guendalina; Libreri, Chiara; Serino, Silvia; Hibbard, Judith; Riva, Giuseppe

2016-01-01

eHealth interventions are recognized to have a tremendous potential to promote patient engagement. To date, the majority of studies examine the efficacy of eHealth in enhancing clinical outcomes without focusing on patient engagement in its specificity. This paper aimed at reviewing findings from the literature about the use of eHealth in engaging patients in their own care process. We undertook a comprehensive literature search within the peer-reviewed international literature. Eleven studies met the inclusion criteria. eHealth interventions reviewed were mainly devoted to foster only partial dimensions of patient engagement (i.e., alternatively cognitive, emotional or behavioral domains related to healthcare management), thus failing to consider the complexity of such an experience. This also led to a great heterogeneity of technologies, assessed variables and achieved outcomes. This systematic review underlines the need for a more holistic view of patient needs to actually engage them in eHealth interventions and obtaining positive outcomes. In this sense, patient engagement constitute a new frontiers for healthcare models where eHealth could maximize its potentialities. PMID:26779108

eHealth interventions for HIV prevention

PubMed Central

Noar, Seth M.; Willoughby, Jessica Fitts

2015-01-01

The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed. PMID:22519523

The Associations Among Individual Factors, eHealth Literacy, and Health-Promoting Lifestyles Among College Students

PubMed Central

Luo, Yi-Fang

2017-01-01

Background eHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students’ college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors. Objective To examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles. Methods The eHealth Literacy Scale is a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students’ self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents’ background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students’ major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles. Results The study found that factors such as medical majors (t550=2.47-7.55, P<.05) and greater concern with health (t550=2.15-9.01, P<.05) predicted college students’ 4-6 health-promoting lifestyle dimensions and the 3 dimensions

The Associations Among Individual Factors, eHealth Literacy, and Health-Promoting Lifestyles Among College Students.

PubMed

Yang, Shu-Ching; Luo, Yi-Fang; Chiang, Chia-Hsun

2017-01-10

eHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students' college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors. To examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students' self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents' background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students' major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles. The study found that factors such as medical majors (t 550 =2.47-7.55, P<.05) and greater concern with health (t 550 =2.15-9.01, P<.05) predicted college students' 4-6 health-promoting lifestyle dimensions and the 3 dimensions of eHealth literacy. Moreover, critical eHealth

eHealth in Switzerland - building consensus, awareness and architecture.

PubMed

Lovis, Christian; Looser, Hansjorg; Schmid, Adrian; Wagner, Judith; Wyss, Stefan

2011-01-01

This paper reports on the process of the Swiss national strategy to define and implement eHealth. Switzerland is a federal political organization with 26 cantons that are autonomous for the health legal framework. Switzerland must also provide support for four national languages. Thus, this experience addresses many challenges that are experienced at the European level in a much larger scale. Also, Switzerland benefits from the major projects ongoing in Europe, such as epSOS, to define its own strategy.

Mapping e-health strategies: thinking outside the traditional healthcare box.

PubMed

Wen, H Joseph; Tan, Joseph

2005-01-01

E-health has evolved and emerged in many forms; for instance, prescription refills, appointment scheduling, online billing, online medical records, and patient provider communications. Among other marketable e-health strategic applications, the use of e-health information has proliferated and has been presented in the form of content-only health gateways, physician directories, physician-only sites, and online pharmacies. The adoption of the web as an e-health medium has caused both traditional and e-healthcare providers to rethink and experiment with innovative ways of providing healthcare services. The e-providers who can effectively market themselves on the web will have a distinct advantage. At this time, a lot of education appears to be needed in this field in order to ensure that key players in this arena are contributing to the growth and success of e-health. In this paper, we present a general framework for mapping e-health strategies based on e-health business structures and their value proposition. Such e-health systems may be designed to meet the needs of e-stakeholders and for gaining competitive advantages. We believe that by opening up this line of discussion, it will provide future-orientated healthcare executives and entrepreneurs with useful insights into feasible e-health strategic solutions and their commercial potentials.

Readiness of healthcare providers for eHealth: the case from primary healthcare centers in Lebanon.

PubMed

Saleh, Shadi; Khodor, Rawya; Alameddine, Mohamad; Baroud, Maysa

2016-11-10

change efficacy; and between frequency of computer use and change efficacy. The implementation of eHealth cannot be achieved without the readiness of healthcare providers. This study demonstrates that the majority of healthcare providers at PHC centers across Lebanon are ready for eHealth implementation. The findings of this study can be considered by decision makers to enhance and scale-up the use of eHealth in PHC centers nationally. Efforts should be directed towards capacity building for healthcare providers.

Analysis of ehealth search perspectives among female college students in the health professions using Q methodology.

PubMed

Stellefson, Michael; Hanik, Bruce; Chaney, J Don; Tennant, Bethany

2012-04-27

The current "Millennial Generation" of college students majoring in the health professions has unprecedented access to the Internet. Although some research has been initiated among medical professionals to investigate the cognitive basis for health information searches on the Internet, little is known about Internet search practices among health and medical professional students. To systematically identify health professional college student perspectives of personal eHealth search practices. Q methodology was used to examine subjective perspectives regarding personal eHealth search practices among allied health students majoring in a health education degree program. Thirteen (n = 13) undergraduate students were interviewed about their attitudes and experiences conducting eHealth searches. From the interviews, 36 statements were used in a structured ranking task to identify clusters and determine which specific perceptions of eHealth search practices discriminated students into different groups. Scores on an objective measure of eHealth literacy were used to help categorize participant perspectives. Q-technique factor analysis of the rankings identified 3 clusters of respondents with differing views on eHealth searches that generally coincided with participants' objective eHealth literacy scores. The proficient resourceful students (pattern/structure coefficient range 0.56-0.80) described themselves as using multiple resources to obtain eHealth information, as opposed to simply relying on Internet search engines. The intermediate reluctant students (pattern/structure coefficient range 0.75-0.90) reported engaging only Internet search engines to locate eHealth information, citing undeveloped evaluation skills when considering sources of information located on the Internet. Both groups of advanced students reported not knowing how to use Boolean operators to conduct Internet health searches. The basic hubristic students (pattern/structure coefficient range 0

Women's expectations and experiences regarding e-health treatment: A systematic review.

PubMed

Verhoeks, Carmen; Teunissen, Doreth; van der Stelt-Steenbergen, Anke; Lagro-Janssen, Antoine

2017-08-01

There is a gap in knowledge of women's perceptions of e-health treatment. This review aims to investigate women's expectations and experiences regarding e-health. A search was conducted in MEDLINE, EMBASE, CINAHL and PsycInfo in March 2016. We included articles published between 2000 and March 2016, reporting on e-health interventions. The initial search yielded 2987 articles. Eventually, 16 articles reporting on 16 studies were included. Barriers to e-health treatment were lower for women than barriers to face-to-face treatment, such as feelings of shame and time constraints. Women were able to develop an online therapeutic relationship. As reduced feelings of obligation and lack of motivation were women's greatest challenges in completing e-health treatment, they expressed a wish for more support during e-health treatment, preferably blended care. e-Health lowers the threshold for women to seek healthcare. Combining e-health interventions with face-to-face sessions may enhance women's motivation to complete treatment.

Social Support for Diabetes Self-Management via eHealth Interventions.

PubMed

Vorderstrasse, Allison; Lewinski, Allison; Melkus, Gail D'Eramo; Johnson, Constance

2016-07-01

eHealth interventions have been increasingly used to provide social support for self-management of type 2 diabetes. In this review, we discuss social support interventions, types of support provided, sources or providers of support, outcomes of the support interventions (clinical, behavioral, psychosocial), and logistical and clinical considerations for support interventions using eHealth technologies. Many types of eHealth interventions demonstrated improvements in self-management behaviors, psychosocial outcomes, and clinical measures, particularly HbA1c. Important factors to consider in clinical application of eHealth support interventions include participant preferences, usability of eHealth technology, and availability of personnel to orient or assist participants. Overall, eHealth is a promising adjunct to clinical care as it addresses the need for ongoing support in chronic disease management.

The eHealth Behavior Management Model: a stage-based approach to behavior change and management.

PubMed

Bensley, Robert J; Mercer, Nelda; Brusk, John J; Underhile, Ric; Rivas, Jason; Anderson, Judith; Kelleher, Deanne; Lupella, Melissa; de Jager, André C

2004-10-01

Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here - at the point of stage-specific information - that behavioral intent in moving toward more active stages of change occurs. The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education among participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children; asthma management among university staff and students; and human immunodeficiency virus prevention among South African women. Preliminary results have found the eHealth Behavior Management Model to be promising as a model for Internet-based behavior change programming. Further application and evaluation among other behavior and disease management issues are needed.

A scoping review of Australian allied health research in ehealth.

PubMed

Iacono, Teresa; Stagg, Kellie; Pearce, Natalie; Hulme Chambers, Alana

2016-10-04

Uptake of e-health, the use of information communication technologies (ICT) for health service delivery, in allied health appears to be lagging behind other health care areas, despite offering the potential to address problems with service access by rural and remote Australians. The aim of the study was to conduct a scoping review of studies into the application of or attitudes towards ehealth amongst allied health professionals conducted in Australia. Studies meeting inclusion criteria published from January 2004 to June 2015 were reviewed. Professions included were audiology, dietetics, exercise physiology, occupational therapy, physiotherapy, podiatry, social work, and speech pathology. Terms for these professions and forms of ehealth were combined in databases of CINAHL (EBSCO), Cochrane Library, PsycINFO (1806 - Ovid), MEDLINE (Ovid) and AMED (Ovid). Forty-four studies meeting inclusion criteria were summarised. They were either trials of aspects of ehealth service delivery, or clinician and/or client use of and attitudes towards ehealth. Trials of ehealth were largely from two research groups located at the Universities of Sydney and Queensland; most involved speech pathology and physiotherapy. Assessments through ehealth and intervention outcomes through ehealth were comparable with face-to-face delivery. Clinicians used ICT mostly for managing their work and for professional development, but were reticent about its use in service delivery, which contrasted with the more positive attitudes and experiences of clients. The potential of ehealth to address allied health needs of Australians living in rural and remote Australia appears unrealised. Clinicians may need to embrace ehealth as a means to radicalise practice, rather than replicate existing practices through a different mode of delivery.

E-health progresses in Romania.

PubMed

Moisil, Ioana; Jitaru, Elena

2006-01-01

The paper is presenting the recent evolution of e-health aspects in Romania. Data presented are based on governmental reports. Surveys organized by the "Lucian Blaga" University of Sibiu and studies carried on by the national Institute for Research and Development in Informatics (I.C.I.) have shown that Romania has important health problems, from cardio vascular diseases (CVD) to cancer and infectious diseases, a high score on mortality and morbidity and a low one on natality. Poor management of the health sector did not help to solve all these problems. In the last 14 years there were several attempts to reform healthcare but none succeeded until now. The health insurance system is operational but needs still to be improved. Acknowledging the deep crisis of the health system the Prime Minister nominated a new minister of health and important changes in the health management approach are to be envisaged. One of this is the introduction of the e-procurement system for all health related goods. In spite of the crisis of the health system, e-health applications are flourishing. We can distinguish applications at national and local level and also punctual applications. The main applications refer to hospital information systems (HIS), electronic health records (EHR), e-procurement, image processing, diagnosis and treatment aids, telediagnosis, teleconsultation, education, research and domain oriented web support services. Most academic clinical hospital is now members of a web community "mednet". Unfortunately a lot of medical web sites have disappeared for lack of funds. As the health sector is in general funded from the public budget and the health crisis is deepened in the last years, the driving force in implementing e-health concepts and technologies is not the Ministry of Health but the Information Technology (IT) community, with a strong support from the Ministry of Information Technology and Communications and also from the Ministry of Education and Research

Policy needs and options for a common transatlantic approach towards measuring adoption, usage and benefits of eHealth.

PubMed

Stroetmann, Karl A; Middleton, Blackford

2011-01-01

The European Union (EU) sponsored ARGOS project analysed current eHealth policy thinking in both the EU and the USA, compared strategic challenges and outcomes in selected fields, and drafted roadmaps towards developing advanced global approaches for these issues. This policy brief focuses on better understanding the benefits and costs of eHealth investments, assessing their overall socio-economic impact, identifying challenges and success factors, as well as measuring and globally benchmarking the concrete usage of eHealth solutions. These are by now key policy priorities not only of national governments and the European Commission, but also of international institutions like WHO or OECD. There is a strong felt transatlantic need for stocktaking, identifying lessons learned, sharing of experience, and working together to advance these issues for the benefit of health systems. A growing number of national and international activities can be taken advantage of. Recommendations on how to proceed with such transatlantic activities are proposed.

Analysis of eHealth Search Perspectives Among Female College Students in the Health Professions Using Q Methodology

PubMed Central

Hanik, Bruce; Chaney, J. Don; Tennant, Bethany

2012-01-01

Background The current “Millennial Generation” of college students majoring in the health professions has unprecedented access to the Internet. Although some research has been initiated among medical professionals to investigate the cognitive basis for health information searches on the Internet, little is known about Internet search practices among health and medical professional students. Objective To systematically identify health professional college student perspectives of personal eHealth search practices. Methods Q methodology was used to examine subjective perspectives regarding personal eHealth search practices among allied health students majoring in a health education degree program. Thirteen (n = 13) undergraduate students were interviewed about their attitudes and experiences conducting eHealth searches. From the interviews, 36 statements were used in a structured ranking task to identify clusters and determine which specific perceptions of eHealth search practices discriminated students into different groups. Scores on an objective measure of eHealth literacy were used to help categorize participant perspectives. Results Q-technique factor analysis of the rankings identified 3 clusters of respondents with differing views on eHealth searches that generally coincided with participants’ objective eHealth literacy scores. The proficient resourceful students (pattern/structure coefficient range 0.56-0.80) described themselves as using multiple resources to obtain eHealth information, as opposed to simply relying on Internet search engines. The intermediate reluctant students (pattern/structure coefficient range 0.75-0.90) reported engaging only Internet search engines to locate eHealth information, citing undeveloped evaluation skills when considering sources of information located on the Internet. Both groups of advanced students reported not knowing how to use Boolean operators to conduct Internet health searches. The basic hubristic students

Assessment of Self-Perceived Knowledge in e-Health Among Undergraduate Students.

PubMed

Edirippulige, Sisira; Samanta, Mayukh; Armfield, Nigel R

2018-02-01

Growing research evidence shows the value of e-health in healthcare delivery. While efforts are made to implement e-health in mainstream healthcare, relatively modest attention has been paid to develop e-health knowledge and skills in health practitioners. Using a pre-post design, in this study, we aimed to examine self-reported knowledge and perception changes associated with an e-health course offered to university undergraduate students in Australia. Pre- and postsurveys were used to examine self-reported knowledge and perception changes relating to e-health among undergraduate students. All students enrolled in an e-health course (n = 165) were asked to complete an identical survey in the first and last week of the semester. The response rates were 53% (n = 87) for the presurvey and 52% (n = 85) for the postsurvey. For all items, changes in self-reported knowledge and perception were statistically significant in pre/post median scores and dichotomized negative/positive proportions. Students believed the course helped them to improve their knowledge regarding key aspects of e-health. It is important to design an e-health curriculum targeting competencies to provide necessary knowledge and skills to help students practice e-health in their professional careers.

Exploring antecedents of consumer satisfaction and repeated search behavior on e-health information.

PubMed

Lee, Yun Jung; Park, Jungkun; Widdows, Richard

2009-03-01

E-health information has become an important resource for people seeking health information. Even though many studies have been conducted to examine the quality of e-health information, only a few studies have explored the effects of the information seekers' motivations on the perceived quality of e-health information. There is even less information about repeated searches for e-health information after the users' initial experience of e-health information use. Using an online survey of information seekers, 252 e-health information users' responses were collected. The research examines the relationship among motivation, perceived quality, satisfaction, and intention to repeat-search e-health information. The results identify motivations to search e-health information and confirm the relationship among motivation, perceived quality dimensions, and satisfaction and intention to repeat searches for e-health information.

An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability: study protocol for a randomized controlled trial.

PubMed

Berglind, Daniel; Nyberg, Gisela; Willmer, Mikaela; Persson, Margareta; Wells, Michael; Forsell, Yvonne

2018-04-27

Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors. The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability. There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1). International Standard Randomised Controlled Trial Number (ISRCTN), reference number ISRCTN22387524 . Prospectively registered February 4, 2018.

What Are Complex eHealth Innovations and How Do You Measure Them? Position Paper.

PubMed

Hübner, U

2015-01-01

eHealth and innovation are often regarded as synonyms - not least because eHealth technologies and applications are new to their users. This position paper challenges this view and aims at exploring the nature of eHealth innovation against the background of common definitions of innovation and facts from the biomedical and health informatics literature. A good understanding of what constitutes innovative eHealth developments allows the degree of innovation to be measured and interpreted. To this end, relevant biomedical and health informatics literature was searched mainly in Medline and ACM digital library. This paper presents seven facts about implementing and applying new eHealth developments hereby drawing on the experience published in the literature. The facts are: 1. eHealth innovation is relative. 2. Advanced clinical practice is the yardstick. 3. Only used and usable eHealth technology can give birth to eHealth innovatio. 4. One new single eHealth function does not make a complex eHealth innovation. 5. eHealth innovation is more evolution than revolution. 6. eHealth innovation is often triggered behind the scenes; and 7. There is no eHealth innovation without sociocultural change. The main conclusion of the seven facts is that eHealth innovations have many ingredients: newness, availability, advanced clinical practice with proven outcomes, use and usability, the supporting environment, other context factors and the stakeholder perspectives. Measuring eHealth innovation is thus a complex matter. To this end we propose the development of a composite score that expresses comprehensively the nature of eHealth innovation and that breaks down its complexity into the three dimensions: i) eHealth adoption, ii) partnership with advanced clinical practice, and iii) use and usability of eHealth. In order to better understand the momentum and mechanisms behind eHealth innovation the fourth dimension, iv) eHealth supporting services and means, needs to be studied

Type 1 Diabetes eHealth Psychoeducation: Youth Recruitment, Participation, and Satisfaction

PubMed Central

Jaser, Sarah S; Faulkner, Melissa S; Murphy, Kathryn; Delamater, Alan; Grey, Margaret

2013-01-01

Background The Internet and other eHealth technologies offer a platform for improving the dissemination and accessibility of psychoeducational programs for youth with chronic illness. However, little is known about the recruitment process and yield of diverse samples in Internet research with youth who have a chronic illness. Objective The purpose of this study was to compare the demographic and clinical characteristics of youth with Type 1 diabetes on recruitment, participation, and satisfaction with 2 eHealth psychoeducational programs. Methods Youth with Type 1 diabetes from 4 sites in the United States were invited to participate (N=510) with 320 eligible youth consenting (mean age=12.3, SD 1.1; 55.3% female; 65.2% white; and mean A1C=8.3, SD 1.5). Data for this secondary analysis included demographic information (age, race/ethnicity, and income), depressive symptoms, and recruitment rates, including those who refused at point of contact (22.0%), passive refusers who consented but did not participate (15.3%), and those who enrolled (62.7%). Participation (80% lessons completed) and a satisfaction survey (ie, how helpful, enjoyable) were also analyzed. Chi-square or analysis of variance (ANOVA) analyses were used. Results There were significant differences in recruitment rates by income and race/ethnicity such that black, Hispanic, or mixed race/ethnicity and low-income youth were more likely to refuse passively compared to white and higher-income youth who were more likely to enroll (P<.001). Participation in program sessions was high, with 78.1% of youth completing at least 4 of 5 sessions. There were no significant differences in participation by program, age, gender, or race/ethnicity. Low-income youth were less likely to participate (P=.002). Satisfaction in both programs was also high (3.9 of 5). There were significant gender, race/ethnicity, and income differences, in that girls (P=.001), black, Hispanic, or mixed race/ethnicity youth (P=.02), and low

Self-reported eHealth literacy among undergraduate nursing students in South Korea: a pilot study.

PubMed

Park, Hyejin; Lee, Eunjoo

2015-02-01

With the Internet being the preferred primary source for information seekers, 9 out of 10 Internet users report that they have looked online for health information in South Korea. Nurses as well as nursing students need to be knowledgeable about online health information resources and able to evaluate relevant information online in order to assist patients and patients' families' access. The purpose of the study was to assess eHealth literacy among undergraduate nursing students in South Korea. The specific aims were to: 1) identify the self-reported eHealth literacy levels, and 2) determine differences in levels of eHealth literacy between pre-nursing and nursing students. This study used a descriptive comparison design. One hundred and seventy-six undergraduate nursing students in South Korea participated. Participants were asked to complete the eHealth Literacy Scale. Collected data were analyzed using a descriptive statistical method and t-tests. Participants responded that the Internet is a useful or very useful tool in helping them make health-related decisions. Furthermore, participants felt that it is important to be able to access health resources on the Internet. The majority of the participants either agreed or strongly agreed that they felt comfortable using the Internet with awareness of what information is available and of their skill to find information. Only a few respondents agreed or strongly agreed that they had the ability to differentiate between a high quality and a low quality health resource on the Internet. Students enrolled in nursing scored higher means in all eHealth literacy items than students enrolled in pre-nursing. Six out of ten eHealth literacy items showed significant differences between two groups. Findings from this study provide fundamental data for education administrators and educators to begin supporting students with appropriate education programs to enhance their eHealth literacy. Copyright © 2014 Elsevier Ltd. All

eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis.

PubMed

Hutchesson, M J; Rollo, M E; Krukowski, R; Ells, L; Harvey, J; Morgan, P J; Callister, R; Plotnikoff, R; Collins, C E

2015-05-01

A systematic review of randomized controlled trials was conducted to evaluate the effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults. Eight databases were searched for studies published in English from 1995 to 17 September 2014. Eighty-four studies were included, with 183 intervention arms, of which 76% (n = 139) included an eHealth component. Sixty-one studies had the primary aim of weight loss, 10 weight loss maintenance, eight weight gain prevention, and five weight loss and maintenance. eHealth interventions were predominantly delivered using the Internet, but also email, text messages, monitoring devices, mobile applications, computer programs, podcasts and personal digital assistants. Forty percent (n = 55) of interventions used more than one type of technology, and 43.2% (n = 60) were delivered solely using eHealth technologies. Meta-analyses demonstrated significantly greater weight loss (kg) in eHealth weight loss interventions compared with control (MD -2.70 [-3.33,-2.08], P < 0.001) or minimal interventions (MD -1.40 [-1.98,-0.82], P < 0.001), and in eHealth weight loss interventions with extra components or technologies (MD 1.46 [0.80, 2.13], P < 0.001) compared with standard eHealth programmes. The findings support the use of eHealth interventions as a treatment option for obesity, but there is insufficient evidence for the effectiveness of eHealth interventions for weight loss maintenance or weight gain prevention. © 2015 World Obesity.

Setting the scene for the future: implications of key legal regulations for the development of e-health interoperability in the EU.

PubMed

Kautsch, Marcin; Lichoń, Mateusz; Matuszak, Natalia

2017-10-01

E-health has experienced a dynamic development across the European Union in the recent years and enjoys support from the European Commission that seeks to achieve interoperability of national healthcare systems in order to facilitate free movement. Differences that can be observed between the member states in legal regulations, cultural approaches and technological solutions may hinder this process. This study compares the legal standing of e-health in Denmark, Poland, Spain and the UK, along with key legal acts and their implications. The academic literature review along with an analysis of materials found through the desk study research (reports, legal acts, press articles, governmental web pages and so on) was performed in order to identify aspects relevant to e-health interoperability. The approach to legal regulation of e-health substantially differs by country. So do the procedures that they have developed regarding the requirement for patient's consent for the processing of their data, their rights to access to the medical data, to change the data, data confidentiality and types of electronic health records. The principles governing the assignment of responsibility for data protection are also different. These legal and technological differences must be reconciled if interoperability of European national e-health systems is to be achieved. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Perceived and Performed eHealth Literacy: Survey and Simulated Performance Test

PubMed Central

2017-01-01

Background Electronic health (eHealth) literacy of consumers is essential in order to improve information and communication technology (ICT) use for health purposes by ordinary citizens. However, performed eHealth literacy is seldom studied. Therefore, the present study assessed perceived and performed eHealth literacy using the recent conceptualization of health literacy skills. Objective The aim of this paper was to examine the association between perceived and performed eHealth literacies. Methods In total, 82 Israeli adults participated in the study, all 50 years and older, with a mean age of 67 (SD 11). Of the participants, 60% (49/82) were women and 72% (59/82) had a post-secondary education. The participants were first surveyed and then tested in a computer simulation of health-related Internet tasks. Performed, perceived (eHealth Literacy Scale, eHEALS), and evaluated eHealth literacy were assessed, and performed eHealth literacy was also recorded and re-evaluated later. Performance was scored for successful completion of tasks, and was also assessed by two researchers for motivation, confidence, and amount of help provided. Results The skills of accessing, understanding, appraising, applying, and generating new information had decreasing successful completion rates. Generating new information was least correlated with other skills. Perceived and performed eHealth literacies were moderately correlated (r=.34, P=.01) while facets of performance (ie, digital literacy and eHealth literacy) were highly correlated (r=.82, P<.001). Participants low and high in performed eHealth literacy were significantly different: low performers were older and had used the Internet for less time, required more assistance, and were less confident in their conduct than high performers. Conclusions The moderate association between perceived and performed eHealth literacy indicates that the latter should be assessed separately. In as much, the assessment of performed eHealth

Perceived and Performed eHealth Literacy: Survey and Simulated Performance Test.

PubMed

Neter, Efrat; Brainin, Esther

2017-01-17

Electronic health (eHealth) literacy of consumers is essential in order to improve information and communication technology (ICT) use for health purposes by ordinary citizens. However, performed eHealth literacy is seldom studied. Therefore, the present study assessed perceived and performed eHealth literacy using the recent conceptualization of health literacy skills. The aim of this paper was to examine the association between perceived and performed eHealth literacies. In total, 82 Israeli adults participated in the study, all 50 years and older, with a mean age of 67 (SD 11). Of the participants, 60% (49/82) were women and 72% (59/82) had a post-secondary education. The participants were first surveyed and then tested in a computer simulation of health-related Internet tasks. Performed, perceived (eHealth Literacy Scale, eHEALS), and evaluated eHealth literacy were assessed, and performed eHealth literacy was also recorded and re-evaluated later. Performance was scored for successful completion of tasks, and was also assessed by two researchers for motivation, confidence, and amount of help provided. The skills of accessing, understanding, appraising, applying, and generating new information had decreasing successful completion rates. Generating new information was least correlated with other skills. Perceived and performed eHealth literacies were moderately correlated (r=.34, P=.01) while facets of performance (ie, digital literacy and eHealth literacy) were highly correlated (r=.82, P<.001). Participants low and high in performed eHealth literacy were significantly different: low performers were older and had used the Internet for less time, required more assistance, and were less confident in their conduct than high performers. The moderate association between perceived and performed eHealth literacy indicates that the latter should be assessed separately. In as much, the assessment of performed eHealth literacy in clinical settings should entail the

The effect of individual factors on health behaviors among college students: the mediating effects of eHealth literacy.

PubMed

Hsu, WanChen; Chiang, ChiaHsun; Yang, ShuChing

2014-12-12

College students' health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual's health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated. This study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU. The Health Behavior Scale is a 12-item instrument developed to measure college students' eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants' health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects. The study found that perceptions of better health status (t520=2.14-6.12, P<.001-.03) and greater concern for health (t520=2.58-6.95, P<.001-.003) influenced college students' development of 3 dimensions of eHealth literacy and adoption of healthy eating, exercise, and sleep behaviors. Moreover, eHealth

eHealth program to empower patients in returning to normal activities and work after gynecological surgery: intervention mapping as a useful method for development.

PubMed

Vonk Noordegraaf, Antonie; Huirne, Judith A F; Pittens, Carina A; van Mechelen, Willem; Broerse, Jacqueline E W; Brölmann, Hans A M; Anema, Johannes R

2012-10-19

Full recovery after gynecological surgery takes much longer than expected regardless of surgical technique or the level of invasiveness. After discharge, detailed convalescence recommendations are not provided to patients typically, and postoperative care is fragmented, poorly coordinated, and given only on demand. For patients, this contributes to irrational beliefs and avoidance of resumption of activities and can result in a prolonged sick leave. To develop an eHealth intervention that empowers gynecological patients during the perioperative period to obtain timely return to work (RTW) and prevent work disability. The intervention mapping (IM) protocol was used to develop the eHealth intervention. A literature search about behavioral and environmental conditions of prolonged sick leave and delayed RTW in patients was performed. Patients' needs, attitudes, and beliefs regarding postoperative recovery and resumption of work were identified through focus group discussions. Additionally, a literature search was performed to obtain determinants, methods, and strategies for the development of a suitable interactive eHealth intervention to empower patients to return to normal activities after gynecological surgery, including work. Finally, the eHealth intervention was evaluated by focus group participants, medical doctors, and eHealth specialists through questionnaires. Twenty-one patients participated in the focus group discussions. Sufficient, uniform, and tailored information regarding surgical procedures, complications, and resumption of activities and work were considered most essential. Knowing who to contact in case of mental or physical complaints, and counseling and tools for work reintegration were also considered important. Finally, opportunities to exchange experiences with other patients were a major issue. Considering the determinants of the Attitude-Social influence-self-Efficacy (ASE) model, various strategies based on a combination of theory and

EHealth Technologies in Inflammatory Bowel Disease: A Systematic Review.

PubMed

Jackson, Belinda D; Gray, Kathleen; Knowles, Simon R; De Cruz, Peter

2016-09-01

Electronic-health technologies (eHealth) such as Web-based interventions, virtual clinics, smart-phone applications, and telemedicine are being used to manage patients with inflammatory bowel disease (IBD). We aimed to: (1) Evaluate the impact of eHealth technologies on conventional clinical indices and patient-reported outcome measures (PROs) in IBD; (2) assess the effectiveness, cost-effectiveness and feasibility of using eHealth technologies to facilitate the self-management of individuals with IBD, and; (3) provide recommendations for their design and optimal use for patient care. Relevant publications were identified via a literature search, and 17 publications were selected based on predefined quality parameters. Six randomized controlled trials and nine observational studies utilizing eHealth technologies in IBD were identified. Compared with standard outpatient-led care, eHealth technologies have led to improvements in: Relapse duration [(n = 1) 18 days vs 77 days, p < 0.001]; disease activity (n = 2); short-term medication adherence (n = 3); quality of life (n = 4); IBD knowledge (n = 2); healthcare costs (n = 4); the number of acute visits to the outpatient clinic due to IBD symptoms (n = 1), and; facilitating the remote management of up to 20% of an IBD cohort (n = 2). Methodological shortcomings of eHealth studies include heterogeneity of outcome measures, lack of clinician/patient input, lack of validation against conventional clinical indices and PROs, and limited cost-benefit analyses. EHealth technologies have the potential for promoting self-management and reducing the impact of the growing burden of IBD on health care resource utilization. A theoretical framework should be applied to the development, implementation, and evaluation of eHealth interventions. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Predictors of High eHealth Literacy in Primary Lung Cancer Survivors.

PubMed

Milne, Robin A; Puts, Martine T E; Papadakos, Janet; Le, Lisa W; Milne, Victoria C; Hope, Andrew J; Catton, Pamela; Giuliani, Meredith E

2015-12-01

Lung cancer survivors are likely to have low health literacy which is an independent risk factor for poorer health outcomes. The eHealth literacy in lung cancer survivors has not been reported. The purposes of this study were to determine self-perceived eHealth literacy levels in lung cancer survivors and to explore predictors of higher eHealth literacy. A cross-sectional study was conducted at the Princess Margaret Cancer Centre in Toronto, Canada. Survivors completed a survey that collected demographic, self-perceived eHealth literacy (using the eHealth Literacy Scale), and quality of life information. Tumor and treatment details were extracted from medical records. Demographic data was summarized using descriptive statistics and compared against those with high and low eHealth literacy using Fisher's exact test. Eighty-three survivors were enrolled over 7 months. Median age was 71 years (range 44-89); 41 survivors (49%) were male. Forty-six (55%) survivors had some college education or higher. Most had access to eResources (78%) via computer, Internet, or smartphone. Fifty-seven (69%) scored 5 or greater (7=excellent) on the overall health scale. Twenty-eight (33.7%) perceived themselves to have high eHealth literacy. There was no statistically significant correlation between eHealth literacy groups and age (p=1.00), gender (p=0.82), living situation (p=1.00), overall health (p=1.00), overall quality of life (QoL) (p=1.00), or histology (p=0.74). High eHealth literacy correlated with the level of education received (p=0.003) and access to eResources (p=0.004). The self-perceived eHealth literacy of lung cancer survivors is generally low.

Health Professionals' Expanding eHealth Competences for Supporting Patients' Self-Management.

PubMed

Kujala, Sari; Rajalahti, Elina; Heponiemi, Tarja; Hilama, Pirjo

2018-01-01

An increasing number of new eHealth services that support patients' self-management has changed health professionals' work and has created a need for a new eHealth competence. In this study, we evaluated the health professionals' eHealth competences and training needs in a public health organization in Finland. The target organization's goal was to increase the number of eHealth services provided to patients, and health professionals and their competences were seen as critical for the adoption of services. Data was collected through an online survey of 701 health professionals working in the target organization. Professionals perceived their basic computer skills as good and they were mostly willing to use eHealth services in patient work. However, health professionals need guidance, especially in their patient work in the new eHealth-enabled environment. They were less confident about their competence to motivate and advise patients to use eHealth services and how to communicate with patients using eHealth solutions. The results also imply that eHealth competence is not merely about an individual's skills but that organizations need to develop new working processes, work practices and distribution of work. We suggest that the training and support needs identified be considered in curricula and lifelong learning.

Relationships Between eHealth Literacy and Health Behaviors in Korean Adults.

PubMed

Kim, Sun-Hee; Son, Youn-Jung

2017-02-01

The Internet is a useful and accessible source for health-related information for modern healthcare consumers. Individuals with adequate eHealth literacy have an incentive to use the Internet to access health-related information, and they consider themselves capable of using Web-based knowledge for health. This cross-sectional study aimed to describe the relationship between eHealth literacy and health behaviors. A total of 230 adults aged 18 to 39 years and residing in South Korea participated in the study. The mean (SD) score for eHealth literacy was 25.52 (4.35) of a total possible score of 40. The main source of health information was the Internet. Using hierarchical linear regression, the results showed that eHealth literacy was the strongest predictor of health behaviors after adjusting for general characteristics. These findings indicate that eHealth literacy can be an important factor in promoting individual health behaviors. Further research on eHealth literacy and actual health behaviors including intention and self-reported health behaviors are required to explain the impact of eHealth literacy on overall health status.

eHealth Literacy: In the Quest of the Contributing Factors.

PubMed

Xesfingi, Sofia; Vozikis, Athanassios

2016-05-25

Understanding the factors that influence eHealth in a country is particularly important for health policy decision makers and the health care market, as it provides critical information to develop targeted and tailored interventions for relevant patient-consumer segments, and further suggests appropriate strategies for training the health illiterate part of the population. The objective of the study is to assess the eHealth literacy level of Greek citizens, using the eHealth Literacy Scale (eHEALS), and further explore the factors that shape it and are associated with it. This empirical study relies on a unique sample of 1064 citizens in Greece in the year 2013. The participants were requested to answer various questions about their ability to solve health-related issues using the Internet, and to provide information about their demographic characteristics and life-style habits. Ordered logit models were used to describe a certain citizen's likelihood of being eHealth literate. The demographic factors show that the probability of an individual being eHealth literate decreases by 23% (P=.001) when the individual ages and increases by 53% (P<.001) when he or she acquires higher level of education. Among the life-style variables, physical exercise appears to be strongly and positively associated with the level of eHealth literacy (P=.001). Additionally, other types of technology literacies, such as computer literacy and information literacy, further enhance the eHealth performance of citizens and have the greatest impact among all factors. The factors influencing eHealth literacy are complex and interdependent. However, the Internet is a disruptive factor in the relationship between health provider and health consumer. Further research is needed to examine how several factors associate with eHealth literacy, since, the latter is not only related to health care outcomes but also can be a tool for disseminating social inequalities.

Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach

PubMed Central

Wentzel, Jobke; Van Gemert-Pijnen, Julia EWC

2013-01-01

Background Requirements development is a crucial part of eHealth design. It entails all the activities devoted to requirements identification, the communication of requirements to other developers, and their evaluation. Currently, a requirements development approach geared towards the specifics of the eHealth domain is lacking. This is likely to result in a mismatch between the developed technology and end user characteristics, physical surroundings, and the organizational context of use. It also makes it hard to judge the quality of eHealth design, since it makes it difficult to gear evaluations of eHealth to the main goals it is supposed to serve. Objective In order to facilitate the creation of eHealth that matters, we present a practical, multidisciplinary requirements development approach which is embedded in a holistic design approach for eHealth (the Center for eHealth Research roadmap) that incorporates both human-centered design and business modeling. Methods Our requirements development approach consists of five phases. In the first, preparatory, phase the project team is composed and the overall goal(s) of the eHealth intervention are decided upon. Second, primary end users and other stakeholders are identified by means of audience segmentation techniques and our stakeholder identification method. Third, the designated context of use is mapped and end users are profiled by means of requirements elicitation methods (eg, interviews, focus groups, or observations). Fourth, stakeholder values and eHealth intervention requirements are distilled from data transcripts, which leads to phase five, in which requirements are communicated to other developers using a requirements notation template we developed specifically for the context of eHealth technologies. Results The end result of our requirements development approach for eHealth interventions is a design document which includes functional and non-functional requirements, a list of stakeholder values, and end

Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach.

PubMed

Van Velsen, Lex; Wentzel, Jobke; Van Gemert-Pijnen, Julia Ewc

2013-06-24

Requirements development is a crucial part of eHealth design. It entails all the activities devoted to requirements identification, the communication of requirements to other developers, and their evaluation. Currently, a requirements development approach geared towards the specifics of the eHealth domain is lacking. This is likely to result in a mismatch between the developed technology and end user characteristics, physical surroundings, and the organizational context of use. It also makes it hard to judge the quality of eHealth design, since it makes it difficult to gear evaluations of eHealth to the main goals it is supposed to serve. In order to facilitate the creation of eHealth that matters, we present a practical, multidisciplinary requirements development approach which is embedded in a holistic design approach for eHealth (the Center for eHealth Research roadmap) that incorporates both human-centered design and business modeling. Our requirements development approach consists of five phases. In the first, preparatory, phase the project team is composed and the overall goal(s) of the eHealth intervention are decided upon. Second, primary end users and other stakeholders are identified by means of audience segmentation techniques and our stakeholder identification method. Third, the designated context of use is mapped and end users are profiled by means of requirements elicitation methods (eg, interviews, focus groups, or observations). Fourth, stakeholder values and eHealth intervention requirements are distilled from data transcripts, which leads to phase five, in which requirements are communicated to other developers using a requirements notation template we developed specifically for the context of eHealth technologies. The end result of our requirements development approach for eHealth interventions is a design document which includes functional and non-functional requirements, a list of stakeholder values, and end user profiles in the form of

Effects of an eHealth Literacy Intervention for Older Adults

PubMed Central

2011-01-01

Background Older adults generally have low health and computer literacies, making it challenging for them to function well in the eHealth era where technology is increasingly being used in health care. Little is known about effective interventions and strategies for improving the eHealth literacy of the older population. Objective The objective of this study was to examine the effects of a theory-driven eHealth literacy intervention for older adults. Methods The experimental design was a 2 × 2 mixed factorial design with learning method (collaborative; individualistic) as the between-participants variable and time of measurement (pre; post) as the within-participants variable. A total of 146 older adults aged 56–91 (mean 69.99, SD 8.12) participated in this study during February to May 2011. The intervention involved 2 weeks of learning about using the National Institutes of Health’s SeniorHealth.gov website to access reliable health information. The intervention took place at public libraries. Participants were randomly assigned to either experimental condition (collaborative: n = 72; individualistic: n = 74). Results Overall, participants’ knowledge, skills, and eHealth literacy efficacy all improved significantly from pre to post intervention (P < .001 in all cases; effect sizes were >0.8 with statistical power of 1.00 even at the .01 level in all cases). When controlling for baseline differences, no significant main effect of the learning method was found on computer/Web knowledge, skills, or eHealth literacy efficacy. Thus, collaborative learning did not differ from individualistic learning in affecting the learning outcomes. No significant interaction effect of learning method and time of measurement was found. Group composition based on gender, familiarity with peers, or prior computer experience had no significant main or interaction effect on the learning outcomes. Regardless of the specific learning method used, participants had overwhelmingly

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management.

PubMed

Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

2016-01-01

Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided.

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

PubMed Central

Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

2016-01-01

Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided. PMID:27853384

Are Health Literacy and eHealth Literacy the Same or Different?

PubMed

Monkman, Helen; Kushniruk, Andre W; Barnett, Jeff; Borycki, Elizabeth M; Greiner, Leigh E; Sheets, Debra

2017-01-01

Many researchers assume that there is a relationship between health literacy and eHealth literacy, yet it is not clear whether the literature supports this assumption. The purpose of this study was to determine if there was a relationship between health and eHealth literacy. To this end, participants' (n = 36) scores on the Newest Vital Sign (NVS, a health literacy measure) were correlated with the eHealth Literacy Scale (eHEALS, an eHealth literacy measure). This analysis revealed no relationship (r = -.041, p = .81) between the two variables. This finding suggests that eHealth Literacy and health literacy are dissimilar. Several possible explanations of the pattern of results are proposed. Currently, it does not seem prudent to use the eHEALS as the sole measure of eHealth literacy, but rather researchers should continue to complement it with a validated health literacy screening tool.

eHealth Program to Empower Patients in Returning to Normal Activities and Work After Gynecological Surgery: Intervention Mapping as a Useful Method for Development

PubMed Central

Huirne, Judith A.F; Pittens, Carina A; van Mechelen, Willem; Broerse, Jacqueline E.W; Brölmann, Hans A.M; Anema, Johannes R

2012-01-01

Background Full recovery after gynecological surgery takes much longer than expected regardless of surgical technique or the level of invasiveness. After discharge, detailed convalescence recommendations are not provided to patients typically, and postoperative care is fragmented, poorly coordinated, and given only on demand. For patients, this contributes to irrational beliefs and avoidance of resumption of activities and can result in a prolonged sick leave. Objective To develop an eHealth intervention that empowers gynecological patients during the perioperative period to obtain timely return to work (RTW) and prevent work disability. Methods The intervention mapping (IM) protocol was used to develop the eHealth intervention. A literature search about behavioral and environmental conditions of prolonged sick leave and delayed RTW in patients was performed. Patients’ needs, attitudes, and beliefs regarding postoperative recovery and resumption of work were identified through focus group discussions. Additionally, a literature search was performed to obtain determinants, methods, and strategies for the development of a suitable interactive eHealth intervention to empower patients to return to normal activities after gynecological surgery, including work. Finally, the eHealth intervention was evaluated by focus group participants, medical doctors, and eHealth specialists through questionnaires. Results Twenty-one patients participated in the focus group discussions. Sufficient, uniform, and tailored information regarding surgical procedures, complications, and resumption of activities and work were considered most essential. Knowing who to contact in case of mental or physical complaints, and counseling and tools for work reintegration were also considered important. Finally, opportunities to exchange experiences with other patients were a major issue. Considering the determinants of the Attitude–Social influence–self-Efficacy (ASE) model, various strategies

Systematic thematic review of e-health research in the Gulf Cooperation Council (Arabian Gulf): Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates.

PubMed

Weber, Alan S; Turjoman, Rebal; Shaheen, Yanal; Al Sayyed, Farah; Hwang, Mu Ji; Malick, Faryal

2017-05-01

Introduction The Gulf Cooperation Council (GCC or 'Arabian Gulf'), comprising Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates, is a political organization sharing a common history and culture. All GCC nations have made substantial investments in telecommunications and electronic health infrastructure since 2000. Methods We conducted a literature search in English and Arabic on peer-reviewed e-health research up to December 2014 originating in the GCC. The objective was to retrieve all research on e-health in the GCC and to categorize and analyse it qualitatively to reveal the current state of e-health research and development in the region. Inclusion criteria included peer-reviewed articles, books, book chapters, conference papers and graduate theses written on e-health in the GCC. Blogs, health websites and non-peer-reviewed literature were excluded. Results Three hundred and six articles were retrieved, categorized and analysed qualitatively to reveal the state of e-health research in the GCC. Both country-specific and GCC-wide major themes were identified using NVivo 10.0 qualitative software and summarized. The most common type of study was an overview (35.0%), with common study designs of case studies (26.8%) and descriptive articles (46.4%). Significant themes were: prospective national benefits from e-health, implementation and satisfaction with electronic health records, online technologies in medical education, innovative systems (case studies), and information security and personal health information. Discussion This is the first comprehensive analytical literature review of e-health in the GCC. Important research gaps were identified: few cost-benefit analyses, controlled interventional studies, or research targeting gender and religious issues were retrieved.

The importance of using open source technologies and common standards for interoperability within eHealth: Perspectives from the Millennium Villages Project

PubMed Central

Borland, Rob; Barasa, Mourice; Iiams-Hauser, Casey; Velez, Olivia; Kaonga, Nadi Nina; Berg, Matt

2013-01-01

The purpose of this paper is to illustrate the importance of using open source technologies and common standards for interoperability when implementing eHealth systems and illustrate this through case studies, where possible. The sources used to inform this paper draw from the implementation and evaluation of the eHealth Program in the context of the Millennium Villages Project (MVP). As the eHealth Team was tasked to deploy an eHealth architecture, the Millennium Villages Global-Network (MVG-Net), across all fourteen of the MVP sites in Sub-Saharan Africa, the team recognized the need for standards and uniformity but also realized that context would be an important factor. Therefore, the team decided to utilize open source solutions. The MVP implementation of MVG-Net provides a model for those looking to implement informatics solutions across disciplines and countries. Furthermore, there are valuable lessons learned that the eHealth community can benefit from. By sharing lessons learned and developing an accessible, open-source eHealth platform, we believe that we can more efficiently and rapidly achieve the health-related and collaborative Millennium Development Goals (MDGs). PMID:22894051

The Effect of Individual Factors on Health Behaviors Among College Students: The Mediating Effects of eHealth Literacy

PubMed Central

Chiang, ChiaHsun

2014-01-01

Background College students’ health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual’s health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated. Objective This study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU. Methods The Health Behavior Scale is a 12-item instrument developed to measure college students’ eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants’ health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects. Results The study found that perceptions of better health status (t520=2.14-6.12, P<.001-.03) and greater concern for health (t520=2.58-6.95, P<.001-.003) influenced college students’ development of 3 dimensions of eHealth literacy and adoption of healthy eating

How should we define eHealth, and does the definition matter?

PubMed

Showell, Chris; Nøhr, Christian

2012-01-01

There is no useful definition for eHealth; we would like to find one. This study will provide a contribution to clarify the discussion on eHealth as a concept to enhance the understanding of the range of meanings which have been ascribed to the term ehealth.

Early experiences with e-health services (1999-2002): promise, reality, and implications.

PubMed

Fung, Vicki; Ortiz, Eduardo; Huang, Jie; Fireman, Bruce; Miller, Robert; Selby, Joseph V; Hsu, John

2006-05-01

E-health services may improve the quality and efficiency of care; however, there is little quantitative data on e-health use. The objective of this study was to examine trends in e-health use and user characteristics. This was a longitudinal study of e-health use (1999-2002) within an integrated delivery system (IDS). We classified 4 e-health services into transactional (drug refills and appointment scheduling) and care-related (medical and medication advice) services. Approximately 3.3 million members of a large, prepaid IDS. Amount and frequency of e-health use over time and characteristics of users. The number of members registered for access to e-health increased from 20,617 (0.7% of all members) in Q1 1999 to 270,987 (8.6%) in Q3 2002. Between Q1 and Q3 2002, 42,845 members (1.3%) used the drug refill service and 55,901 (1.7%) used the appointment scheduling service compared with 10,756 members (0.3%) who used the medical advice service and 3069 (0.1%) who used the medication advice service. Over the same period, transactional service users averaged 3.5 uses/user versus 1.6 uses/user among care-related service users. Members most likely to use e-health services had a high level of clinical need, a regular primary care provider, were 30 to 64 years old, female, white, and lived in a nonlow socioeconomic status neighborhood. These findings were consistent across e-health service types. Although use of all e-health services grew rapidly, use of care-related services lagged significantly behind use of transactional services. Subjects with greater clinical need and better ties to the health system were more likely to use both types of e-health services.

The Impact of an eHealth Portal on Health Care Professionals’ Interaction with Patients: Qualitative Study

PubMed Central

Faxvaag, Arild; Svanæs, Dag

2015-01-01

Background People who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic. Objective The aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals’ interaction with patients in bariatric surgery. Methods This qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis. Results The analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic. Conclusions By providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients�

The Impact of an eHealth Portal on Health Care Professionals' Interaction with Patients: Qualitative Study.

PubMed

Das, Anita; Faxvaag, Arild; Svanæs, Dag

2015-11-24

People who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic. The aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals' interaction with patients in bariatric surgery. This qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis. The analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic. By providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients' writings and revelations thereby capturing patient

Attitudes Toward e-Health: The Otolaryngologists' Point of View.

PubMed

Holderried, Martin; Hoeper, Ansgar; Holderried, Friederike; Blumenstock, Gunnar; Ernst, Christian; Tropitzsch, Anke

2018-06-01

Online communication and the number of e-health applications have noticeably increased. However, little is known about the otolaryngologists' use behavior and their attitudes toward the potential of e-health. The aims of the study were to evaluate the documentation, information, and communication technologies used by otolaryngologists and to get a better understanding of their attitudes toward the potential of e-health for cross-sectoral patient care. A survey was developed and tested by otolaryngologists, healthcare-information technology experts, and health services researchers. A total of 334 otolaryngologists in private practice were asked to participate in this cross-sectional study. In total, 234 of them took part in the study, and 157 returned completed questionnaires. Statistical analysis was performed by using crosstabs, including chi-square tests, and multivariate logistic regressions. Results and Materials: Digital technologies are widely used by otolaryngologists (e.g., 89.6% use an electronic health record). However, the majority of intersectoral communication is still based on analogue techniques (e.g., fax use in 63.7%). From the otolaryngologists' perspectives, the potential of e-health for intersectoral care is mostly in appointment scheduling, further referrals to hospitals, and automated appointment reminders. The physicians' attitudes toward e-health are associated with their Internet use behavior in daily life (odds ratio = 4.30, confidence interval 1.11-16.64, p = 0.035) but not with their demographics. The otolaryngologists are well prepared and have an overall positive attitude toward e-health for deeper use in cross-sectoral care. Therefore, e-health in otolaryngology needs more attention and resources for further studies, especially with a focus on quality and safety of care.

The eHealth Enhanced Chronic Care Model: a theory derivation approach.

PubMed

Gee, Perry M; Greenwood, Deborah A; Paterniti, Debora A; Ward, Deborah; Miller, Lisa M Soederberg

2015-04-01

Chronic illnesses are significant to individuals and costly to society. When systematically implemented, the well-established and tested Chronic Care Model (CCM) is shown to improve health outcomes for people with chronic conditions. Since the development of the original CCM, tremendous information management, communication, and technology advancements have been established. An opportunity exists to improve the time-honored CCM with clinically efficacious eHealth tools. The first goal of this paper was to review research on eHealth tools that support self-management of chronic disease using the CCM. The second goal was to present a revised model, the eHealth Enhanced Chronic Care Model (eCCM), to show how eHealth tools can be used to increase efficiency of how patients manage their own chronic illnesses. Using Theory Derivation processes, we identified a "parent theory", the Chronic Care Model, and conducted a thorough review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct, as well as government reports, industry reports, legislation using search terms "CCM or Chronic Care Model" AND "eHealth" or the specific identified components of eHealth. Additionally, "Chronic Illness Self-management support" AND "Technology" AND several identified eHealth tools were also used as search terms. We then used a review of the literature and specific components of the CCM to create the eCCM. We identified 260 papers at the intersection of technology, chronic disease self-management support, the CCM, and eHealth and organized a high-quality subset (n=95) using the components of CCM, self-management support, delivery system design, clinical decision support, and clinical information systems. In general, results showed that eHealth tools make important contributions to chronic care and the CCM but that the model requires modification in several key areas. Specifically, (1) eHealth education is critical for self-care, (2) eHealth support needs to be

eHealth as the Next-Generation Perinatal Care: An Overview of the Literature.

PubMed

van den Heuvel, Josephus Fm; Groenhof, T Katrien; Veerbeek, Jan Hw; van Solinge, Wouter W; Lely, A Titia; Franx, Arie; Bekker, Mireille N

2018-06-05

Unrestricted by time and place, electronic health (eHealth) provides solutions for patient empowerment and value-based health care. Women in the reproductive age are particularly frequent users of internet, social media, and smartphone apps. Therefore, the pregnant patient seems to be a prime candidate for eHealth-supported health care with telemedicine for fetal and maternal conditions. This study aims to review the current literature on eHealth developments in pregnancy to assess this new generation of perinatal care. We conducted a systematic literature search of studies on eHealth technology in perinatal care in PubMed and EMBASE in June 2017. Studies reporting the use of eHealth during prenatal, perinatal, and postnatal care were included. Given the heterogeneity in study methods, used technologies, and outcome measurements, results were analyzed and presented in a narrative overview of the literature. The literature search provided 71 studies of interest. These studies were categorized in 6 domains: information and eHealth use, lifestyle (gestational weight gain, exercise, and smoking cessation), gestational diabetes, mental health, low- and middle-income countries, and telemonitoring and teleconsulting. Most studies in gestational diabetes and mental health show that eHealth applications are good alternatives to standard practice. Examples are interactive blood glucose management with remote care using smartphones, telephone screening for postnatal depression, and Web-based cognitive behavioral therapy. Apps and exercise programs show a direction toward less gestational weight gain, increase in step count, and increase in smoking abstinence. Multiple studies describe novel systems to enable home fetal monitoring with cardiotocography and uterine activity. However, only few studies assess outcomes in terms of fetal monitoring safety and efficacy in high-risk pregnancy. Patients and clinicians report good overall satisfaction with new strategies that enable

Obstacles to Successful Implementation of eHealth Applications into Clinical Practice.

PubMed

Voogt, Marianne P; Opmeer, Brent C; Kastelein, Arnoud W; Jaspers, Monique W M; Peute, Linda W

2018-01-01

eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.

Building the capacity to build capacity in e-health in sub-Saharan Africa: the KwaZulu-Natal experience.

PubMed

Mars, Maurice

2012-01-01

Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workers. There are already too few doctors to train doctors in specialities and sub-specialties. E-health is seen as a possible solution through distance education, telemedicine, and computerized health information systems but there are few people trained in e-health. We describe 12 years of experience at the University of KwaZulu-Natal (UKZ-N) in education and training in postgraduate medical disciplines, medical informatics, and telemedicine. Videoconferencing of seminars and grand rounds to regional training hospitals commenced in 2001 and has grown to 40 h of interactive conferencing taking place weekly during academic terms involving over 33,000 participants in 2010. Videoconferenced sessions are directly recorded to DVD and DVDs are sent to other medical schools in Africa that do not have the infrastructure to directly connect. E-HEALTH EDUCATION: Students and academic staff were initially sent to the United States for training in medical informatics and workshops were held in South Africa for people from sub-Saharan Africa. This led to the development of postgraduate academic programs in medical informatics and telemedicine at UKZ-N. African students were then brought to UKZ-N for training. The model was changed from UKZ-N to students and staff based at their home universities with the aim of building capacity in the staff at partner institutions so that they can in time offer their own e-health academic programs. The need for capacity development in all aspects of e-health in sub-Saharan Africa is great and innovative solutions are required.

Building the Capacity to Build Capacity in e-Health in Sub-Saharan Africa: The KwaZulu-Natal Experience

PubMed Central

2012-01-01

Abstract Background: Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workers. There are already too few doctors to train doctors in specialities and sub-specialties. E-health is seen as a possible solution through distance education, telemedicine, and computerized health information systems but there are few people trained in e-health. We describe 12 years of experience at the University of KwaZulu-Natal (UKZ-N) in education and training in postgraduate medical disciplines, medical informatics, and telemedicine. Medical Education: Videoconferencing of seminars and grand rounds to regional training hospitals commenced in 2001 and has grown to 40 h of interactive conferencing taking place weekly during academic terms involving over 33,000 participants in 2010. Videoconferenced sessions are directly recorded to DVD and DVDs are sent to other medical schools in Africa that do not have the infrastructure to directly connect. E-health Education: Students and academic staff were initially sent to the United States for training in medical informatics and workshops were held in South Africa for people from sub-Saharan Africa. This led to the development of postgraduate academic programs in medical informatics and telemedicine at UKZ-N. African students were then brought to UKZ-N for training. The model was changed from UKZ-N to students and staff based at their home universities with the aim of building capacity in the staff at partner institutions so that they can in time offer their own e-health academic programs. Conclusions: The need for capacity development in all aspects of e-health in sub-Saharan Africa is great and innovative solutions are required. PMID:22150714

A framework for characterizing eHealth literacy demands and barriers.

PubMed

Chan, Connie V; Kaufman, David R

2011-11-17

Consumer eHealth interventions are of a growing importance in the individual management of health and health behaviors. However, a range of access, resources, and skills barriers prevent health care consumers from fully engaging in and benefiting from the spectrum of eHealth interventions. Consumers may engage in a range of eHealth tasks, such as participating in health discussion forums and entering information into a personal health record. eHealth literacy names a set of skills and knowledge that are essential for productive interactions with technology-based health tools, such as proficiency in information retrieval strategies, and communicating health concepts effectively. We propose a theoretical and methodological framework for characterizing complexity of eHealth tasks, which can be used to diagnose and describe literacy barriers and inform the development of solution strategies. We adapted and integrated two existing theoretical models relevant to the analysis of eHealth literacy into a single framework to systematically categorize and describe task demands and user performance on tasks needed by health care consumers in the information age. The method derived from the framework is applied to (1) code task demands using a cognitive task analysis, and (2) code user performance on tasks. The framework and method are applied to the analysis of a Web-based consumer eHealth task with information-seeking and decision-making demands. We present the results from the in-depth analysis of the task performance of a single user as well as of 20 users on the same task to illustrate both the detailed analysis and the aggregate measures obtained and potential analyses that can be performed using this method. The analysis shows that the framework can be used to classify task demands as well as the barriers encountered in user performance of the tasks. Our approach can be used to (1) characterize the challenges confronted by participants in performing the tasks, (2

A Framework for Characterizing eHealth Literacy Demands and Barriers

PubMed Central

Chan, Connie V

2011-01-01

Background Consumer eHealth interventions are of a growing importance in the individual management of health and health behaviors. However, a range of access, resources, and skills barriers prevent health care consumers from fully engaging in and benefiting from the spectrum of eHealth interventions. Consumers may engage in a range of eHealth tasks, such as participating in health discussion forums and entering information into a personal health record. eHealth literacy names a set of skills and knowledge that are essential for productive interactions with technology-based health tools, such as proficiency in information retrieval strategies, and communicating health concepts effectively. Objective We propose a theoretical and methodological framework for characterizing complexity of eHealth tasks, which can be used to diagnose and describe literacy barriers and inform the development of solution strategies. Methods We adapted and integrated two existing theoretical models relevant to the analysis of eHealth literacy into a single framework to systematically categorize and describe task demands and user performance on tasks needed by health care consumers in the information age. The method derived from the framework is applied to (1) code task demands using a cognitive task analysis, and (2) code user performance on tasks. The framework and method are applied to the analysis of a Web-based consumer eHealth task with information-seeking and decision-making demands. We present the results from the in-depth analysis of the task performance of a single user as well as of 20 users on the same task to illustrate both the detailed analysis and the aggregate measures obtained and potential analyses that can be performed using this method. Results The analysis shows that the framework can be used to classify task demands as well as the barriers encountered in user performance of the tasks. Our approach can be used to (1) characterize the challenges confronted by

eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US.

PubMed

Gray, Carolyn Steele; Mercer, Stewart; Palen, Ted; McKinstry, Brian; Hendry, Anne

2016-01-01

Information technology (IT) in healthcare, also referred to as eHealth technologies, may offer a promising solution to the provision of better care and support for people who have multiple conditions and complex care needs, and their caregivers. eHealth technologies can include electronic medical records, telemonitoring systems and web-based portals, and mobile health (mHealth) technologies that enable information sharing between providers, patients, clients and their families. IT often acts as an enabler of improved care delivery, rather than being an intervention per se. But how are different countries seeking to leverage adoption of these technologies to support people who have chronic conditions and complex care needs? This article presents three case examples from Ontario (Canada), Scotland and Kaiser Permanente Colorado (United States) to identify how these jurisdictions are currently using technology to address multimorbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case and a final discussion addresses the future of eHealth for complex care needs. The case reports presented in this manuscript mark the foundational work of the Multi-National eHealth Research Partnership Supporting Complex Chronic Disease and Disability (the eCCDD Network); a CIHR-funded project intended to support the international development and uptake of eHealth tools for people with complex care needs.

General Practitioners' Perspective on eHealth and Lifestyle Change: Qualitative Interview Study.

PubMed

Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo

2018-04-17

Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to

Toward a Global eHealth Observatory for Nursing.

PubMed

Bartz, Claudia C; Hardiker, Nicholas R; Coenen, Amy

2015-01-01

This poster summarizes a review of existing health observatories and proposes a new entity for nursing. A nursing eHealth observatory would be an authoritative and respected source of eHealth information that would support nursing decision-making and policy development and add to the body of knowledge about professional nursing and client care outcomes.

E-health in the new millennium: a research and practice agenda.

PubMed

Metaxiotis, Kostas; Ptochos, Dimitrios; Psarras, John

2004-01-01

Advances in telecommunications, automated processes, web technologies and wireless computing are already forcing dramatic changes in a variety of sectors, ranging from business and industry to education and health. Yet, the electronic business space, in a broader sense, is still in a relatively early state of evolution, and it is only recently that policy makers have started looking at the potential of applying the tools and techniques of e-commerce to the tasks of other sectors. The use of the internet as a source of health information and connectivity between healthcare providers and consumers has increased interest in e-health. E-health offers the rich potential of supplementing traditional delivery of services and channels of communication in ways that extend the healthcare organisation's ability to meet the needs of its patients. To date, some e-health applications have improved the quality of healthcare, and later they will lead to substantial cost savings. However, e-health is not simply a technology but a complex technological and relational process. In this sense, practitioners and researchers who want to successfully exploit e-health need to pay attention to various pending issues that have to be addressed. The aim of this paper is to propose a novel taxonomy for e-health research in the new millennium by instantaneously presenting the current status with some major themes of e-health research.

The eHealth Enhanced Chronic Care Model: A Theory Derivation Approach

PubMed Central

Greenwood, Deborah A; Paterniti, Debora A; Ward, Deborah; Miller, Lisa M Soederberg

2015-01-01

Background Chronic illnesses are significant to individuals and costly to society. When systematically implemented, the well-established and tested Chronic Care Model (CCM) is shown to improve health outcomes for people with chronic conditions. Since the development of the original CCM, tremendous information management, communication, and technology advancements have been established. An opportunity exists to improve the time-honored CCM with clinically efficacious eHealth tools. Objective The first goal of this paper was to review research on eHealth tools that support self-management of chronic disease using the CCM. The second goal was to present a revised model, the eHealth Enhanced Chronic Care Model (eCCM), to show how eHealth tools can be used to increase efficiency of how patients manage their own chronic illnesses. Methods Using Theory Derivation processes, we identified a “parent theory”, the Chronic Care Model, and conducted a thorough review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct, as well as government reports, industry reports, legislation using search terms “CCM or Chronic Care Model” AND “eHealth” or the specific identified components of eHealth. Additionally, “Chronic Illness Self-management support” AND “Technology” AND several identified eHealth tools were also used as search terms. We then used a review of the literature and specific components of the CCM to create the eCCM. Results We identified 260 papers at the intersection of technology, chronic disease self-management support, the CCM, and eHealth and organized a high-quality subset (n=95) using the components of CCM, self-management support, delivery system design, clinical decision support, and clinical information systems. In general, results showed that eHealth tools make important contributions to chronic care and the CCM but that the model requires modification in several key areas. Specifically, (1) eHealth education is

E-health: transforming the physician/patient relationship.

PubMed

Ball, M J; Lillis, J

2001-04-01

Healthcare delivery is being transformed by advances in e-health and by the empowered, computer-literate public. Ready to become partners in their own health and to take advantage of online processes, health portals, and physician web pages and e-mail, this new breed of consumer is slowly redefining the physician/patient relationship. Such changes can effect positive results like improved clinical decision-making, increased efficiency, and strengthened communication between physicians and patients. First, however, physicians and the organizations that support them must fully understand their role in the e-health revolution. Both must advance their awareness of the new consumers and their needs and define specific action items that will help them realize the benefits of e-health. Through a combination of timely research and advice, this article will aid them in fulfilling both tasks.

Economic evaluations of eHealth technologies: A systematic review.

PubMed

Sanyal, Chiranjeev; Stolee, Paul; Juzwishin, Don; Husereau, Don

2018-01-01

Innovations in eHealth technologies have the potential to help older adults live independently, maintain their quality of life, and to reduce their health system dependency and health care expenditure. The objective of this study was to systematically review and appraise the quality of cost-effectiveness or utility studies assessing eHealth technologies in study populations involving older adults. We systematically searched multiple databases (MEDLINE, EMBASE, CINAHL, NHS EED, and PsycINFO) for peer-reviewed studies published in English from 2000 to 2016 that examined cost-effectiveness (or utility) of eHealth technologies. The reporting quality of included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards statement. Eleven full text articles met the inclusion criteria representing public and private health care systems. eHealth technologies evaluated by these studies includes computerized decision support system, a web-based physical activity intervention, internet-delivered cognitive behavioral therapy, telecare, and telehealth. Overall, the reporting quality of the studies included in the review was varied. Most studies demonstrated efficacy and cost-effectiveness of an intervention using a randomized control trial and statistical modeling, respectively. This review found limited information on the feasibility of adopting these technologies based on economic and organizational factors. This review identified few economic evaluations of eHealth technologies that included older adults. The quality of the current evidence is limited and further research is warranted to clearly demonstrate the long-term cost-effectiveness of eHealth technologies from the health care system and societal perspectives.

The use of e-health and m-health tools in health promotion and primary prevention among older adults: a systematic literature review.

PubMed

Kampmeijer, Ramon; Pavlova, Milena; Tambor, Marzena; Golinowska, Stanisława; Groot, Wim

2016-09-05

The use of e-health and m-health technologies in health promotion and primary prevention among older people is largely unexplored. This study provides a systematic review of the evidence on the scope of the use of e-health and m-health tools in health promotion and primary prevention among older adults (age 50+). A systematic literature review was conducted in October 2015. The search for relevant publications was done in the search engine PubMed. The key inclusion criteria were: e-health and m-health tools used, participants' age 50+ years, focus on health promotion and primary prevention, published in the past 10 years, in English, and full-paper can be obtained. The text of the publications was analyzed based on two themes: the characteristics of e-health and m-health tools and the determinants of the use of these tools by older adults. The quality of the studies reviewed was also assessed. The initial search resulted in 656 publications. After we applied the inclusion and exclusion criteria, 45 publications were selected for the review. In the publications reviewed, various types of e-health/m-health tools were described, namely apps, websites, devices, video consults and webinars. Most of the publications (60 %) reported studies in the US. In 37 % of the publications, the study population was older adults in general, while the rest of the publications studied a specific group of older adults (e.g. women or those with overweight). The publications indicated various facilitators and barriers. The most commonly mentioned facilitator was the support for the use of the e-health/m-health tools that the older adults received. E-health and m-health tools are used by older adults in diverse health promotion programs, but also outside formal programs to monitor and improve their health. The latter is hardly studied. The successful use of e-health/m-health tools in health promotion programs for older adults greatly depends on the older adults' motivation and support

Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT).

PubMed

Murray, Elizabeth; May, Carl; Mair, Frances

2010-10-18

The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice). This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format. The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit--a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls. The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations.

Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT)

PubMed Central

2010-01-01

Background The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice). This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format. Results The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls Conclusions The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations. PMID:20955594

Why Business Modeling is Crucial in the Development of eHealth Technologies

PubMed Central

van Gemert-Pijnen, Julia EWC; Nijland, Nicol; Ossebaard, Hans C; Hendrix, Ron MG; Seydel, Erwin R

2011-01-01

The impact and uptake of information and communication technologies that support health care are rather low. Current frameworks for eHealth development suffer from a lack of fitting infrastructures, inability to find funding, complications with scalability, and uncertainties regarding effectiveness and sustainability. These issues can be addressed by defining a better implementation strategy early in the development of eHealth technologies. A business model, and thus business modeling, help to determine such an implementation strategy by involving all important stakeholders in a value-driven dialogue on what the technology should accomplish. This idea also seems promising to eHealth, as it can contribute to the whole development of eHealth technology. We therefore suggest that business modeling can be used as an effective approach to supporting holistic development of eHealth technologies. The contribution of business modeling is elaborated in this paper through a literature review that covers the latest business model research, concepts from the latest eHealth and persuasive technology research, evaluation and insights from our prior eHealth research, as well as the review conducted in the first paper of this series. Business modeling focuses on generating a collaborative effort of value cocreation in which all stakeholders reflect on the value needs of the others. The resulting business model acts as the basis for implementation. The development of eHealth technology should focus more on the context by emphasizing what this technology should contribute in practice to the needs of all involved stakeholders. Incorporating the idea of business modeling helps to cocreate and formulate a set of critical success factors that will influence the sustainability and effectiveness of eHealth technology. PMID:22204896

Why business modeling is crucial in the development of eHealth technologies.

PubMed

van Limburg, Maarten; van Gemert-Pijnen, Julia E W C; Nijland, Nicol; Ossebaard, Hans C; Hendrix, Ron M G; Seydel, Erwin R

2011-12-28

The impact and uptake of information and communication technologies that support health care are rather low. Current frameworks for eHealth development suffer from a lack of fitting infrastructures, inability to find funding, complications with scalability, and uncertainties regarding effectiveness and sustainability. These issues can be addressed by defining a better implementation strategy early in the development of eHealth technologies. A business model, and thus business modeling, help to determine such an implementation strategy by involving all important stakeholders in a value-driven dialogue on what the technology should accomplish. This idea also seems promising to eHealth, as it can contribute to the whole development of eHealth technology. We therefore suggest that business modeling can be used as an effective approach to supporting holistic development of eHealth technologies. The contribution of business modeling is elaborated in this paper through a literature review that covers the latest business model research, concepts from the latest eHealth and persuasive technology research, evaluation and insights from our prior eHealth research, as well as the review conducted in the first paper of this series. Business modeling focuses on generating a collaborative effort of value cocreation in which all stakeholders reflect on the value needs of the others. The resulting business model acts as the basis for implementation. The development of eHealth technology should focus more on the context by emphasizing what this technology should contribute in practice to the needs of all involved stakeholders. Incorporating the idea of business modeling helps to cocreate and formulate a set of critical success factors that will influence the sustainability and effectiveness of eHealth technology.

Socio-technical and organizational challenges to wider e-Health implementation.

PubMed

Vitacca, M; Mazzù, M; Scalvini, S

2009-01-01

Recent advances in information communication technology allow contact with patients at home through e-Health services (telemedicine, in particular). We provide insights on the state of the art of e-Health and telemedicine for possible wider future clinical use. Telemedicine opportunities are summarized as i) home telenursing, ii) electronic transfer to specialists and hospitals, iii) teleconsulting between general practitioners and specialists and iv) call centres activities and online health. At present, a priority action of the EU is the Initiative on TM for chronic disease management as home health monitoring and the future Vision for Europe 2020 is based on development of Integrated Telemedicine Services. There are pros and cons in e-Health and telemedicine. Benefits can be classified as benefits for i) citizens, patients and caregivers and ii) health care provider organizations. Institutions and individuals that play key roles in the future of e-Health are doctors, patients and hospitals, while the whole system should be improved at three crucial levels: 1) organizational, 2) regulatory and 3) technological. Quality, access and efficiency are the general key issues for the success of e-Health and telemedicine implementation. The real technology is the human resource available into the organizations. For e-Health and telemedicine to grow, it will be necessary to investigate their long-term efficacy, cost effectiveness, possible improvement in quality of life and impact on public health burden.

A systematic review of gamification in e-Health.

PubMed

Sardi, Lamyae; Idri, Ali; Fernández-Alemán, José Luis

2017-07-01

Gamification is a relatively new trend that focuses on applying game mechanics to non-game contexts in order to engage audiences and to inject a little fun into mundane activities besides generating motivational and cognitive benefits. While many fields such as Business, Marketing and e-Learning have taken advantage of the potential of gamification, the digital healthcare domain has also started to exploit this emerging trend. This paper aims to summarize the current knowledge regarding gamified e-Health applications. A systematic literature review was therefore conducted to explore the various gamification strategies employed in e-Health and to address the benefits and the pitfalls of this emerging discipline. A total of 46 studies from multiple sources were then considered and thoroughly investigated. The results show that the majority of the papers selected reported gamification and serious gaming in health and wellness contexts related specifically to chronic disease rehabilitation, physical activity and mental health. Although gamification in e-Health has attracted a great deal of attention during the last few years, there is still a dearth of valid empirical evidence in this field. Moreover, most of the e-Health applications and serious games investigated have been proven to yield solely short-term engagement through extrinsic rewards. For gamification to reach its full potential, it is therefore necessary to build e-Health solutions on well-founded theories that exploit the core experience and psychological effects of game mechanics. Copyright © 2017 Elsevier Inc. All rights reserved.

Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

PubMed Central

Nuti, Sabina

2017-01-01

Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

Beyond privacy: benefits and burdens of e-health technologies in primary care.

PubMed

Aultman, Julie M; Dean, Erin

2014-01-01

In this mixed methods study we identify and assess ethical and pragmatic issues and dilemmas surrounding e-health technologies in the context of primary care, including what is already in the literature. We describe how primary healthcare professionals can access reliable and accurate data, improve the quality of care for patients, and lower costs while following institutional guidelines to protect patients. Using qualitative and quantitative methodologies we identify several underlying ethical and pragmatic burdens and benefits of e-health technologies.The 41 study participants reported more burdens than benefits, and were generally ambivalent about their level of satisfaction with their institutions' e-health technologies, their general knowledge about the technologies, and whether e-health can improve team-based communication and collaboration. Participants provided recommendations to improve e-health technologies in primary care settings.

A holistic framework to improve the uptake and impact of eHealth technologies.

PubMed

van Gemert-Pijnen, Julia E W C; Nijland, Nicol; van Limburg, Maarten; Ossebaard, Hans C; Kelders, Saskia M; Eysenbach, Gunther; Seydel, Erwin R

2011-12-05

Many eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders. The aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector. To identify the potential and limitations of current eHealth frameworks (1999-2009), we carried out a literature search in the following electronic databases: PubMed, ScienceDirect, Web of Knowledge, PiCarta, and Google Scholar. Of the 60 papers that were identified, 44 were selected for full review. We excluded those papers that did not describe hands-on guidelines or quality criteria for the design, implementation, and evaluation of eHealth technologies (28 papers). From the results retrieved, we identified 16 eHealth frameworks that matched the inclusion criteria. The outcomes were used to posit strategies and principles for a holistic approach toward the development of eHealth technologies; these principles underpin our holistic eHealth framework. A total of 16 frameworks qualified for a final analysis, based on their theoretical backgrounds and visions on eHealth, and the strategies and conditions for the research and development of eHealth technologies. Despite their potential, the relationship between the visions on eHealth, proposed strategies, and research methods is obscure, perhaps due to a rather conceptual approach that focuses

A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies

PubMed Central

van Limburg, Maarten; Ossebaard, Hans C; Kelders, Saskia M; Eysenbach, Gunther; Seydel, Erwin R

2011-01-01

Background Many eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders. Objective The aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector. Methods To identify the potential and limitations of current eHealth frameworks (1999–2009), we carried out a literature search in the following electronic databases: PubMed, ScienceDirect, Web of Knowledge, PiCarta, and Google Scholar. Of the 60 papers that were identified, 44 were selected for full review. We excluded those papers that did not describe hands-on guidelines or quality criteria for the design, implementation, and evaluation of eHealth technologies (28 papers). From the results retrieved, we identified 16 eHealth frameworks that matched the inclusion criteria. The outcomes were used to posit strategies and principles for a holistic approach toward the development of eHealth technologies; these principles underpin our holistic eHealth framework. Results A total of 16 frameworks qualified for a final analysis, based on their theoretical backgrounds and visions on eHealth, and the strategies and conditions for the research and development of eHealth technologies. Despite their potential, the relationship between the visions on eHealth, proposed strategies, and research methods is obscure, perhaps due to a

eHealth Literacy: Predictors in a Population With Moderate-to-High Cardiovascular Risk

PubMed Central

Richtering, Sarah S; Hyun, Karice; Neubeck, Lis; Coorey, Genevieve; Chalmers, John; Usherwood, Tim; Peiris, David; Chow, Clara K

2017-01-01

Background Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. Objective The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk. Methods Demographic and socioeconomic data were collected from 453 participants of the CONNECT (Consumer Navigation of Electronic Cardiovascular Tools) study, which included age, gender, education, income, cardiovascular-related polypharmacy, private health care, main electronic device use, and time spent on the Internet. Participants also completed an eHealth Literacy Scale (eHEALS) and a Health Literacy Questionnaire (HLQ). Univariate analyses were performed to compare patient demographic and socioeconomic characteristics between the low (eHEALS<26) and high (eHEALS≥26) eHealth literacy groups. To then determine the predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. This technique was also used to examine the correlation between eHealth literacy and health literacy for 4 predefined literacy themes: navigating resources, skills to use resources, usefulness for oneself, and critical evaluation. Results The univariate analysis showed that patients with lower eHealth literacy were older (68 years vs 66 years, P=.01), had lower level of education (P=.007), and spent less time on the Internet (P<.001). However, multiple-adjusted generalized estimating equation logistic regression model demonstrated that only the time spent on the Internet (P=.01) was associated with the level of eHealth

Security, safety, and related technology - the triangle of eHealth service provision.

PubMed

Savastano, Mario; Hovsto, Asbjorn; Pharow, Peter; Blobel, Bernd

2008-01-01

The developing of innovative solutions in the emerging eHealth market requires strong economic efforts which may be justified only in presence of particularly suitable boundary conditions. Among the factors retained of primary importance for the development of eHealth, a correct approach to id-management is unanimously considered fundamental. Three keywords in the id-management context appear particularly important: standardization, security and safety. Standardization may contribute to increase the size and duration of the eHealth market, while security and safety may encourage all the stakeholders to trust in a appropriate and safe management of all the very sensitive personal data involved in the eHealth applications. The aim of the present paper is analyzing some security and safety issues in eHealth from the particular prospective of the identity management and standardization. The paper highlights the mission of the EU funded "BioHealth" project whose mission is to increase the stakeholders' knowledge about existing and emerging standards in eHealth with particular reference to identity management.

An e-health trend plan for the Jordanian health care system: a review.

PubMed

Rawabdeh, Ali Ahamd Awad

2007-01-01

The purpose of this research is to examine the potential of e-health by focusing explicitly on the delivery of health care products and services. The examination of e-health activity is guided by one broad research question, "What is the potential for constructing e-health strategy as an innovative health technology?". A great amount of attention has been given to e-health activity in the present day. However important this form of e-health is, this type of service simply does not face the same constraints that must be addressed by those actually delivering health care services. The researchers employed a qualitative data collection technique to formulate more examples and cases to derive lessons for Jordan. Phone interviews in a random sample were conducted with corporate officers in Jordan in order to reveal the internal organizational structure and business trends, interface issues, marketing strategies, as well as comparing and contrasting the online health world to the traditional health care realm. Internet-related projects is a top priority for health care information technology executives in the present day, with a cautious approach toward "e-health", as many products have yet to mature, and that the "click and mortar" model may perhaps be the optimal strategy for e-health in Jordan. This paper reviews the e-health trends to demonstrate the tremendous potential for health-related commercial activity on the internet. However, the researcher examining the barriers facing e-health to the Jordanian health system also pointed out almost insurmountable challenges. Despite the apparent promise of e-health, its instability is measured by its failure so far to systematically penetrate the organization of health care. Beyond the pragmatic negotiation of e-health in the immediate context of clinical practice, there are wider issues about how the development/implementation of e-health is funded, about its organization and management at the policy level; and about its

Tying eHealth Tools to Patient Needs: Exploring the Use of eHealth for Community-Dwelling Patients With Complex Chronic Disease and Disability

PubMed Central

Miller, Daniel; Kuluski, Kerry; Cott, Cheryl

2014-01-01

Background Health policy makers have recently shifted attention towards examining high users of health care, in particular patients with complex chronic disease and disability (CCDD) characterized as having multimorbidities and care needs that require ongoing use of services. The adoption of eHealth technologies may be a key strategy in supporting and providing care for these patients; however, these technologies need to address the specific needs of patients with CCDD. This paper describes the first phase of a multiphased patient-centered research project aimed at developing eHealth technology for patients with CCDD. Objective As part of the development of new eHealth technologies to support patients with CCDD in primary care settings, we sought to determine the perceived needs of these patients with respect to (1) the kinds of health and health service issues that are important to them, (2) the information that should be collected and how it could be collected in order to help meet their needs, and (3) their views on the challenges/barriers to using eHealth mobile apps to collect the information. Methods Focus groups were conducted with community-dwelling patients with CCDD and caregivers. An interpretive description research design was used to identify the perceived needs of participants and the information sharing and eHealth technologies that could support those needs. Analysis was conducted concurrently with data collection. Coding of transcripts from four focus groups was conducted by 3 authors. QSR NVivo 10 software was used to manage coding. Results There were 14 total participants in the focus groups. The average age of participants was 64.4 years; 9 participants were female, and 11 were born in Canada. Participants identified a need for open two-way communication and dialogue between themselves and their providers, and better information sharing between providers in order to support continuity and coordination of care. Access issues were mainly around

A qualitative case study of ehealth and digital literacy experiences of pharmacy staff.

PubMed

MacLure, Katie; Stewart, Derek

2018-06-01

eHealth's many forms are benchmarked by the World Health Organization. Scotland is considered an advanced adopter of ehealth. The third global survey on ehealth includes pharmacy-related ehealth indicators. Advances in ehealth place an obligation on pharmacy staff to demonstrate proficiency, or digital literacy, in using ehealth technologies. The aim of this study was to provide an indepth exploration of the ehealth and digital literacy experiences of pharmacy staff in the North East of Scotland. A qualitative local case study approach was adopted for observational and interview activities in community and hospital pharmacies. Interview and observational data were collated and analysed using a framework approach. This study gained management approval from the local health board following ethical review by the sponsor university. Nineteen pharmacies and staff (n = 94) participated including two hospitals. Most participants were female (n = 82), aged 29 years and younger (n = 34) with less than 5 years pharmacy experience (n = 49). Participants identified their own digital literacy as basic. Most of the pharmacies had minimum levels of technology implemented (n = 15). Four themes (technology, training, usability, processes) were inducted from the data, coded and modelled with illustrative quotes. Scotland is aspirational in seeking to support the developing role of pharmacy practice with ehealth, however, evidence to date shows most pharmacy staff work with minimum levels of technology. The self-reported lack of digital literacy and often mentioned lack of confidence in using IT suggest pharmacy staff need support and training. Informal work based digital literacy development of the pharmacy team is self-limiting. Usability of ehealth technology could be a key element of its' acceptability. There is potential to better engage with ehealth process efficiencies in both hospital and community pharmacy. As Scotland increasingly invests in ehealth pharmacy

PORTALS: design of an innovative approach to anticoagulation management through eHealth.

PubMed

Talboom-Kamp, E P W A; Verdijk, N A; Talboom, I J S H; Harmans, L M; Numans, M E; Chavannes, N H

2017-03-16

For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes. Our study, called PORTALS, aims at identifying the optimal implementation strategy of training to improve self-management and explore factors that enhance good self-management skills. In addition, the relationship between the implementation strategy of training, clinical outcomes, and individual characteristics will be investigated. Of the 247 recruited participants, 110 chose to continue with regular care. 137 patients have been randomly divided in subgroups and compared using a parallel cohort design: one group will be trained and educated by e-learning, and the other group will receive face-to-face group training. More insight in factors that enhance good self-management will help to improve clinical outcomes and patient satisfaction on anticoagulation therapy. Our study will provide practical insights and knowledge of eHealth in daily practice and of the importance of education on the adoption of self-management. We expect the self-management program including training to help patients to better manage their own INR values and medication use, thereby increasing health status and diminishing thromboembolic events and hospitalisation. The Netherlands National Trial Register, number NTR3947 .

A Service Design Thinking Approach for Stakeholder-Centred eHealth.

PubMed

Lee, Eunji

2016-01-01

Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

eHealth for inflammatory bowel disease self-management - the patient perspective.

PubMed

Con, Danny; Jackson, Belinda; Gray, Kathleen; De Cruz, Peter

2017-09-01

Electronic health (eHealth) solutions may help address the growing pressure on IBD outpatient services as they encompass a component of self-management. However, information regarding patients' attitudes towards the use of eHealth solutions in IBD is lacking. The aim of this study was to evaluate eHealth technology use and explore the perspectives of IBD patients on what constitutes the ideal eHealth solution to facilitate self-management. A mixed methods qualitative and quantitative analysis of the outcomes of a discussion forum and an online survey conducted at a tertiary hospital in Melbourne, Australia between November 2015 and January 2016 was undertaken. Eighteen IBD patients and parents participated in the discussion forum. IBD patients expressed interest in eHealth tools that are convenient and improve access to care, communication, disease monitoring and adherence. Eighty six patients with IBD responded to the online survey. A majority of patients owned a mobile phone (98.8%), had access to the internet (97.7%), and felt confident entering data onto a phone or computer (73.3%). Most patients (98.8%) were willing to use at least one form of information and communication technology to help manage their IBD. Smartphone apps and internet websites were the two most preferred technologies to facilitate IBD self-management. This study demonstrates the willifngness of patients to engage with eHealth as a potential solution to facilitate IBD self-management. Future development and testing of eHealth solutions should be informed by all major stakeholders including patients to maximise their uptake and efficacy to facilitate IBD self-management.

Public strategies for improving eHealth integration and long-term sustainability in public health care systems: Findings from an Italian case study.

PubMed

De Rosis, Sabina; Nuti, Sabina

2018-01-01

eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. In a public health care system, the public actor is among the main "buyers" eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a "buyer") improve long-term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win-win strategies should be followed. Investments should take into account the need to long-term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the "platform approach" emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. © 2017 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis.

PubMed

Deady, M; Choi, I; Calvo, R A; Glozier, N; Christensen, H; Harvey, S B

2017-08-29

Anxiety and depression are associated with a range of adverse outcomes and represent a large global burden to individuals and health care systems. Prevention programs are an important way to avert a proportion of the burden associated with such conditions both at a clinical and subclinical level. eHealth interventions provide an opportunity to offer accessible, acceptable, easily disseminated globally low-cost interventions on a wide scale. However, the efficacy of these programs remains unclear. The aim of this study is to review and evaluate the effects of eHealth prevention interventions for anxiety and depression. A systematic search was conducted on four relevant databases to identify randomized controlled trials of eHealth interventions aimed at the prevention of anxiety and depression in the general population published between 2000 and January 2016. The quality of studies was assessed and a meta-analysis was performed using pooled effect size estimates obtained from a random effects model. Ten trials were included in the systematic review and meta-analysis. All studies were of sufficient quality and utilized cognitive behavioural techniques. At post-treatment, the overall mean difference between the intervention and control groups was 0.25 (95% confidence internal: 0.09, 0.41; p = 0.003) for depression outcome studies and 0.31 (95% CI: 0.10, 0.52; p = 0.004) for anxiety outcome studies, indicating a small but positive effect of the eHealth interventions. The effect sizes for universal and indicated/selective interventions were similar (0.29 and 0.25 respectively). However, there was inadequate evidence to suggest that such interventions have an effect on long-term disorder incidence rates. Evidence suggests that eHealth prevention interventions for anxiety and depression are associated with small but positive effects on symptom reduction. However, there is inadequate evidence on the medium to long-term effect of such interventions, and importantly, on

Associations of eHealth Literacy With Health Behavior Among Adult Internet Users.

PubMed

Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2016-07-18

In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth

Associations of eHealth Literacy With Health Behavior Among Adult Internet Users

PubMed Central

Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2016-01-01

Background In the rapidly developing use of the Internet in society, eHealth literacy—having the skills to utilize health information on the Internet—has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. Objective The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. Methods The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. Results We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis

eHealth Literacy: Predictors in a Population With Moderate-to-High Cardiovascular Risk.

PubMed

Richtering, Sarah S; Hyun, Karice; Neubeck, Lis; Coorey, Genevieve; Chalmers, John; Usherwood, Tim; Peiris, David; Chow, Clara K; Redfern, Julie

2017-01-27

Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk. Demographic and socioeconomic data were collected from 453 participants of the CONNECT (Consumer Navigation of Electronic Cardiovascular Tools) study, which included age, gender, education, income, cardiovascular-related polypharmacy, private health care, main electronic device use, and time spent on the Internet. Participants also completed an eHealth Literacy Scale (eHEALS) and a Health Literacy Questionnaire (HLQ). Univariate analyses were performed to compare patient demographic and socioeconomic characteristics between the low (eHEALS<26) and high (eHEALS≥26) eHealth literacy groups. To then determine the predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. This technique was also used to examine the correlation between eHealth literacy and health literacy for 4 predefined literacy themes: navigating resources, skills to use resources, usefulness for oneself, and critical evaluation. The univariate analysis showed that patients with lower eHealth literacy were older (68 years vs 66 years, P=.01), had lower level of education (P=.007), and spent less time on the Internet (P<.001). However, multiple-adjusted generalized estimating equation logistic regression model demonstrated that only the time spent on the Internet (P=.01) was associated with the level of eHealth literacy. Regarding the comparison

Association of eHealth literacy with cancer information seeking and prior experience with cancer screening.

PubMed

Park, Hyejin; Moon, Mikyung; Baeg, Jung Hoon

2014-09-01

Cancer is a critical disease with a high mortality rate in the US. Although useful information exists on the Internet, many people experience difficulty finding information about cancer prevention because they have limited eHealth literacy. This study aimed to identify relationships between the level of eHealth literacy and cancer information seeking experience or prior experience with cancer screening tests. A total of 108 adults participated in this study through questionnaires. Data covering demographics, eHealth literacy, cancer information seeking experience, educational needs for cancer information searching, and previous cancer screening tests were obtained. Study findings show that the level of eHealth literacy influences cancer information seeking. Individuals with low eHealth literacy are likely to be less confident about finding cancer information. In addition, people who have a low level of eHealth literacy need more education about seeking information than do those with a higher level of eHealth literacy. However, there is no significant relationship between eHealth literacy and cancer screening tests. More people today are using the Internet for access to information to maintain good health. It is therefore critical to educate those with low eHealth literacy so they can better self-manage their health.

Facilitating eHealth for All Through Connecting Nurses and the Women Observatory for eHealth.

PubMed

Thouvenot, Veronique Ines; Hardiker, Nicholas

2016-01-01

Nurses are at the forefront of health care delivery and are key to health improvements across populations worldwide. They play vital role in the treatment of communicable diseases and in maintaining optimal quality of life for those living with long-term conditions. A number of factors such as an ageing population, a shrinking nursing workforce, inequity and variable access to health services naturally point towards technology-focused solutions. However the uptake of eHealth tools and techniques by nurses and their integration with nursing practice remain patchy, not least because of nurses simply 'not knowing' that good solutions exist. The purpose of this panel is to describe initiatives that seek to identify and showcase good practice in the use of eHealth in nursing.

Effective weight-loss using an e-health delivered physical activity and dietary intervention: A federal credit union pilot study.

PubMed

Gregoski, Mathew J; Newton, Janis; Ling, Catherine G; Blaylock, Kathleen; Smith, Sheila A O; Paguntalan, John; Treiber, Frank A

2016-04-06

This pilot study investigated the effectiveness of a distance-based e-health program delivered across multiple rural Federal Credit Union worksites that focused on physical activity and dietary education. Program design and implementation were based on the premises of Social Impact Theory (SIT). A sample of fifty-four participants (47 white. 7 black) aged 24 to 58 across different worksite locations completed 10 weeks of e-health delivered physical activity and dietary intervention. Pre to post weight changes were examined as a primary outcome. The findings showed that regardless of worksite location, participants on average reduced their weight by 10.13 lbs if they completed both the exercise and lunch and learn components of the study compared to a decrease of 2.73 lbs for participants who chose not to engage in the exercise related activities. Participant dropout from either group was less than four percent. The results of this study show the beneficial influence of physical activity integration using SIT upon distance programs targeting weight loss. In addition, the high adherence and weight loss success show promise and demonstrates the potential for e-health delivered exercise and lifestyle interventions. Further replication of results via additional randomized controlled trials is needed.

Nutrition Interventions for Prevention and Management of Childhood Obesity: What Do Parents Want from an eHealth Program?

PubMed

Burrows, Tracy; Hutchesson, Melinda; Chai, Li Kheng; Rollo, Megan; Skinner, Geoff; Collins, Clare

2015-12-15

With the growth of Internet technologies, offering interventions for child and family weight management in an online format may address barriers to accessing services. This study aimed to investigate (i) whether an eHealth family healthy lifestyle program would be of interest to parents; and (ii) preferences and/or expectations for program components and features. Parents of children aged four to18 years were recruited through social media and completed an online survey (54 items) including closed and open-ended questions. Responses were collated using descriptive statistics and thematic analysis. Seventy-five participants were included (92% mothers, mean age 39.1 ± 8.6 years, mean BMI 27.6 ± 6.3 kg/m²). The index child had a mean age of 11 ± 6.2 years with 24% overweight/obese. The majority of parents (90.3%) reported interest in an online program, with preference expressed for a non-structured program to allow flexibility users to log-on and off as desired. Parents wanted a program that was easy to use, practical, engaging, endorsed by a reputable source, and able to provide individual tailoring and for their children to be directly involved. The current study supports the need for online delivery of a healthy lifestyle program that targets greater parental concerns of diet rather than child weight.

Facilitating the appropriate use of e-health solutions.

PubMed

Stern, Hartley S; Ceresia, Patrick; Lapner, Martin

2014-01-01

In this issue, the lead article proposes that e-health technologies should be used more broadly and that patients should have greater access to their information through such technologies. The Canadian Medical Protective Association (CMPA) agrees with this statement and suggests that to facilitate the timely and appropriate adoption of new technologies among healthcare providers to enhance patient care, barriers in the existing regulatory, legislative and legal frameworks must be addressed. While much of the discussion to date on e-health has focused primarily on high-level issues regarding regulatory compliance, "privacy by design" and the e-health "panacea," CMPA suggests that there needs to be a refocus on achieving more concrete change and gains through consideration of the specific impact on the drivers of healthcare delivery. An integrated or holistic approach is required involving healthcare providers, regulators, legislators, stakeholders, ministries of health, privacy commissioners and the courts. To better leverage potential advantages, efficiencies and enhanced, safer care for our healthcare system, all parties must work together to develop an acceptable and flexible approach to the "appropriate use" of e-health technologies that will facilitate adoption by healthcare professionals in a manner that is consistent with the expectations of the profession and applicable standards of practice.

Large Scale eHealth Deployment in Europe: Insights from Concurrent Use of Standards.

PubMed

Eichelberg, Marco; Chronaki, Catherine

2016-01-01

Large-scale eHealth deployment projects face a major challenge when called to select the right set of standards and tools to achieve sustainable interoperability in an ecosystem including both legacy systems and new systems reflecting technological trends and progress. There is not a single standard that would cover all needs of an eHealth project, and there is a multitude of overlapping and perhaps competing standards that can be employed to define document formats, terminology, communication protocols mirroring alternative technical approaches and schools of thought. eHealth projects need to respond to the important question of how alternative or inconsistently implemented standards and specifications can be used to ensure practical interoperability and long-term sustainability in large scale eHealth deployment. In the eStandards project, 19 European case studies reporting from R&D and large-scale eHealth deployment and policy projects were analyzed. Although this study is not exhaustive, reflecting on the concepts, standards, and tools for concurrent use and the successes, failures, and lessons learned, this paper offers practical insights on how eHealth deployment projects can make the most of the available eHealth standards and tools and how standards and profile developing organizations can serve the users embracing sustainability and technical innovation.

[Developing Japanese version of the eHealth Literacy Scale (eHEALS)].

PubMed

Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Okazaki, Kanzo; Oka, Koichiro

2011-05-01

With the rapid developing an internet society, ehealth literacy, defined as the ability to seek, find, understand, and appraise and apply the knowledge gained to addressing or solving a health problem, becomes important to promote and aid health care at the individual level. However, the eHealth Literacy Scale (eHEALS) was only a scale developed to assess the ehealth literacy. Thus, the present study was conducted to evaluated the validity and reliability of a Japanese version of the eHEALS (J-eHEALS), and examine the association of ehealth literacy with demographic attributes and characteristics on health information searching among Japanese adults. Data were analyzed for 3,000 Japanese adults (males: 50.0%,mean age: 39.6 + 10.9 years) who responded to an Internet-based cross-sectional survey. The J-eHEALS, 6 demographic attributes, resources for obtaining health information (health resources), and contents of health information obtained from internet (ehealth contents) were obtained with a questionnaire. Confirmatory factor analysis and correlation with the communicative and critical health literacy scale were utilized to assess construct validity and criterion validity. Cronbach alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Also, differences in J-eHEALS scores with each demographic attribute were examined with ANOVA and the independent t-test. Finally, chi-square tests were used to determine differences in the proportions of ehealth literacy groups (high or low) classified with a median split within health resources and ehealth contents. Principal components analysis produced a single factor solution and confirmatory factor analysis for the 8-items model demonstrated high indices (GFI = .988, CFI = .993, RMSEA= .056). A significant positive correlation was found between the J-eHEALS and communicative and critical health literacy scores. Cronbach alpha was 0.93 (P < .01), and test-retest reliability was r

Support for e-Health Services Among Elderly Primary Care Patients

PubMed Central

Pirogowicz, Iwona

2014-01-01

Abstract Background: E-health has a substantial potential to improve access to as well as support efficient and effective care for the elderly. Questions remain and must be addressed, however, regarding the challenges faced by the elderly in the use of this technology. The aim of the study was to assess the attitude (needs) and preferences of the elderly in a selected region of Poland regarding selected e-health services and the factors associated with them. Materials and Methods: The study was conducted among 286 patients over 60 years of age being served by general practitioners in southwest Poland's Lower Silesia Province. The assessment pertaining to e-health was based on a specially designed questionnaire. Results: Nearly one-third of the study respondents had a computer at home, and 61% of these (19% of all surveyed elderly) used it. Twenty-two percent of respondents used the Internet, at least occasionally, whereas 62% used mobile phones. Approximately 41% (n=116) of the elderly had a favorable attitude toward e-health services (labeled here as supporters) and were willing to use it if/when offered an opportunity to do so. A substantial majority (84%) of supporters expressed a desire to receive simple medical recommendations via mobile phone or a computer, although significant majorities (61% and 60%, respectively) would like to receive the results of tests by e-mail or short message service reminders for scheduled visits or prescribed medications. Slightly less than half (47%) of e-health supporters would request appointments online. Among the more important factors associated with support of e-health services were urban residence, higher education, and normal cognitive function, as well as having a computer, Internet access, or a mobile phone. Conclusions: The majority of elderly patients in this Polish community are not overly enthusiastic about using information and communications technology tools in their healthcare. Nevertheless, a substantial

Governance of extended lifecycle in large-scale eHealth initiatives: analyzing variability of enterprise architecture elements.

PubMed

Mykkänen, Juha; Virkanen, Hannu; Tuomainen, Mika

2013-01-01

The governance of large eHealth initiatives requires traceability of many requirements and design decisions. We provide a model which we use to conceptually analyze variability of several enterprise architecture (EA) elements throughout the extended lifecycle of development goals using interrelated projects related to the national ePrescription in Finland.

The Influence of eHealth Literacy on Perceived Trust in Online Health Communication Channels and Sources

PubMed Central

Krieger, Janice L.; Stellefson, Michael L.

2017-01-01

Disparities in online health information accessibility are partially due to varying levels of eHealth literacy and perceived trust. This study examined the relationship between eHealth literacy and perceived trust in online health communication channels and sources among diverse socio-demographic groups. A stratified sample of Black/African Americans (n = 402) and Caucasians (n = 409) completed a web-based survey that measured eHealth literacy and perceived trustworthiness of online health communication channels and information sources. eHealth literacy positively predicted perceived trust in online health communication channels and sources, but disparities existed by socio-demographic factors. Segmenting audiences according to eHealth literacy level provides a detailed understanding of how perceived trust in discrete online health communication channels and information sources vary among diverse audiences. Black/AAs with low eHealth literacy had high perceived trust in YouTube and Twitter, while Black/AAs with high eHealth literacy had high perceived trust in online government and religious organizations. Older adults with low eHealth literacy had high perceived trust in Facebook but low perceived trust in online support groups. Researchers and practitioners should consider the socio-demographics and eHealth literacy level of an intended audience when tailoring information through trustworthy online health communication channels and information sources. PMID:28001489

The Influence of eHealth Literacy on Perceived Trust in Online Health Communication Channels and Sources.

PubMed

Paige, Samantha R; Krieger, Janice L; Stellefson, Michael L

2017-01-01

Disparities in online health information accessibility are partially due to varying levels of eHealth literacy and perceived trust. This study examined the relationship between eHealth literacy and perceived trust in online health communication channels and sources among diverse sociodemographic groups. A stratified sample of Black/African Americans (n = 402) and Caucasians (n = 409) completed a Web-based survey that measured eHealth literacy and perceived trustworthiness of online health communication channels and information sources. eHealth literacy positively predicted perceived trust in online health communication channels and sources, but disparities existed by sociodemographic factors. Segmenting audiences according to eHealth literacy level provides a detailed understanding of how perceived trust in discrete online health communication channels and information sources varies among diverse audiences. Black/African Americans with low eHealth literacy had high perceived trust in YouTube and Twitter, whereas Black/African Americans with high eHealth literacy had high perceived trust in online government and religious organizations. Older adults with low eHealth literacy had high perceived trust in Facebook but low perceived trust in online support groups. Researchers and practitioners should consider the sociodemographics and eHealth literacy level of an intended audience when tailoring information through trustworthy online health communication channels and information sources.

eHealth adoption factors in medical hospitals: A focus on the Netherlands.

PubMed

Faber, Sander; van Geenhuizen, Marina; de Reuver, Mark

2017-04-01

Despite strong policy interest in eHealth, actual adoption in many European hospitals is low. This study develops and tests in a preliminary way an organisational eHealth adoption model rooted in several adoption frameworks to improve understanding of this phenomenon. The model is explored through a survey among hospitals in the Netherlands using a Structural Equation Modelling (SEM) approach. Specific attention is paid to measurement of organisational readiness and to adoption as a process including different stages. Our results suggest a sharp decrease in the adoption process by hospitals after the stage of interest/commitment. Adoption tends to be significantly affected by size of the hospital, organisational readiness including technical aspects, and top management support. eHealth adoption tends to be not a linear process nor a linear function of contextual antecedents. Organisational readiness is an important antecedent for eHealth adoption. The paper concludes with organisational strategies and policies to foster eHealth adoption in hospitals and suggestions for future study. Copyright © 2017 Elsevier B.V. All rights reserved.

eHealth Literacy: Essential Skills for Consumer Health in a Networked World.

PubMed

Norman, Cameron D; Skinner, Harvey A

2006-06-16

Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review.

PubMed

Domínguez-Mayo, F J; Escalona, M J; Mejías, M; Aragón, G; García-García, J A; Torres, J; Enríquez, J G

2015-01-01

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review

PubMed Central

Escalona, M. J.; Mejías, M.; Aragón, G.; García-García, J. A.; Torres, J.; Enríquez, J. G.

2015-01-01

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems. PMID:26146656

Critical analysis of e-health readiness assessment frameworks: suitability for application in developing countries.

PubMed

Mauco, Kabelo Leonard; Scott, Richard E; Mars, Maurice

2018-02-01

Introduction e-Health is an innovative way to make health services more effective and efficient and application is increasing worldwide. e-Health represents a substantial ICT investment and its failure usually results in substantial losses in time, money (including opportunity costs) and effort. Therefore it is important to assess e-health readiness prior to implementation. Several frameworks have been published on e-health readiness assessment, under various circumstances and geographical regions of the world. However, their utility for the developing world is unknown. Methods A literature review and analysis of published e-health readiness assessment frameworks or models was performed to determine if any are appropriate for broad assessment of e-health readiness in the developing world. A total of 13 papers described e-health readiness in different settings. Results and Discussion Eight types of e-health readiness were identified and no paper directly addressed all of these. The frameworks were based upon varying assumptions and perspectives. There was no underlying unifying theory underpinning the frameworks. Few assessed government and societal readiness, and none cultural readiness; all are important in the developing world. While the shortcomings of existing frameworks have been highlighted, most contain aspects that are relevant and can be drawn on when developing a framework and assessment tools for the developing world. What emerged is the need to develop different assessment tools for the various stakeholder sectors. This is an area that needs further research before attempting to develop a more generic framework for the developing world.

What happens when seniors participate in new eHealth schemes?

PubMed

Frennert, Susanne; Östlund, Britt

2016-10-01

This article adds empirical depth to our understanding of seniors' involvement in the making of eHealth systems. Multi-sited interviews and observations were conducted at seniors' homes before an eHealth system was installed, during the home trials and post-removal of the system. Our findings indicate that although the senior participants chose to participate in the home trials, the choice itself was configured by the stigmatization of seniors as technophobes, fear of "falling behind" and the association of technology with youth, the future and being up-to-date. Being a participant in home trials of an eHealth system became an identity of its own, representing a forward thinking and contemporary person who embraced changes and new technology. Implications for Rehabilitation This article highlights the importance of understanding the participants' drive to participate in field trials and the impact this motivation has on how, during field trials, they perceive using an eHealth system and its perceived usefulness. When studying eHealth systems "in the making at senior" participants' homes, the seniors become part of the research team. The senior participants' learning and knowledge transfer evolves from the dialogue with the research team. For equal participation and power there is a need for ethical, mutual and equal power-relations in the research team (between researchers from different paradigms such as engineers and sociologists) as well as between the researchers' and the participants'.

Experience of nurses with using eHealth in Gilgit-Baltistan, Pakistan: a qualitative study in primary and secondary healthcare.

PubMed

Gulzar, Saleema; Khoja, Shariq; Sajwani, Afroz

2013-03-02

To improve the quality of health care in remote parts of Pakistan, a research project was initiated in the mountainous region of Gilgit-Baltistan using information and communication technology to improve patient care and support continuing education of health providers (eHealth). This paper describes the experience of nurses in using eHealth in their routine practices. All health centres of Gilgit-Baltistan, Pakistan using eHealth as part of this study, were taken as a single case. These include four primary healthcare centres, three secondary care centres and one medical centre. In-depth interviews were conducted using semi-structured interview guide to study nurses' perspective about using eHealth, and its perceived impact on their professional lives. According to the respondents, eHealth enhanced access to care for remote communities, and improved quality of health services by providing opportunities for continuing learning. Nurses also appreciated eHealth for reducing their professional isolation, and providing exposure to new knowledge through teleconsultations and eLearning.The responses categorized under six major headings include: gaps in health services prior to eHealth; role of eHealth in addressing these gaps; benefits of eHealth; challenges in eHealth implementation; community's perception about eHealth; and future recommendations. Low-cost and simple eHealth solutions have shown to benefit nurses, and the communities in the remote mountainous regions of Pakistan.

The eHealth agenda for developing countries.

PubMed

Drury, Peter

2005-01-01

Delivering eHealth in developing countries faces different health and socio-economic challenges to the developed one. But, if a global health infrastructure is to evolve, then developing countries need to play their part. So, whilst the context may differ, the localization-globalization of content issues needs to be jointly addressed. In providing robust and affordable connectivity, particularly to rural areas, developing countries can fully exploit the potential of handheld computers and wireless connectivity. Over such an infrastructure new ways of building capacity, both locally and globally, can be supported. Finally, an eHealth infrastructure can support the delivery of healthcare in communities, thereby supporting individuals and community development.

Dropout From an eHealth Intervention for Adults With Type 2 Diabetes: A Qualitative Study

PubMed Central

Karlsen, Bjørg; Oord, Ellen Renate; Graue, Marit; Oftedal, Bjørg

2017-01-01

Background Adequate self-management is the cornerstone of type 2 diabetes treatment, as people make the majority of daily treatment measures and health decisions. The increasing prevalence of type 2 diabetes mellitus (T2DM) and the complexity of diabetes self-management demonstrate the need for innovative and effective ways to deliver self-management support. eHealth interventions are promoted worldwide and hold a great potential in future health care for people with chronic diseases such as T2DM. However, many eHealth interventions face high dropout rates. This led to our interest in the experiences of participants who dropped out of an eHealth intervention for adults with T2DM, based on the Guided Self-Determination (GSD) counseling method. Objective In this study, we aimed to explore experiences with an eHealth intervention based on GSD in general practice from the perspective of those who dropped out and to understand their reasons for dropping out. To the best of our knowledge, no previous qualitative study has focused on participants who withdrew from an eHealth self-management support intervention for adults with T2DM. Methods A qualitative design based on telephone interviews was used to collect data. The sample comprised 12 adults with type 2 diabetes who dropped out of an eHealth intervention. Data were collected in 2016 and subjected to qualitative content analysis. Results We identified one overall theme: “Losing motivation for intervention participation.” This theme was illustrated by four categories related to the participants’ experiences of the eHealth intervention: (1) frustrating technology, (2) perceiving the content as irrelevant and incomprehensible, (3) choosing other activities and perspectives, and (4) lacking face-to-face encounters. Conclusions Our findings indicate that the eHealth intervention based on GSD without face-to-face encounters with nurses reduced participants’ motivation for engagement in the intervention. To maintain

A new method for assessing content validity in model-based creation and iteration of eHealth interventions.

PubMed

Kassam-Adams, Nancy; Marsac, Meghan L; Kohser, Kristen L; Kenardy, Justin A; March, Sonja; Winston, Flaura K

2015-04-15

The advent of eHealth interventions to address psychological concerns and health behaviors has created new opportunities, including the ability to optimize the effectiveness of intervention activities and then deliver these activities consistently to a large number of individuals in need. Given that eHealth interventions grounded in a well-delineated theoretical model for change are more likely to be effective and that eHealth interventions can be costly to develop, assuring the match of final intervention content and activities to the underlying model is a key step. We propose to apply the concept of "content validity" as a crucial checkpoint to evaluate the extent to which proposed intervention activities in an eHealth intervention program are valid (eg, relevant and likely to be effective) for the specific mechanism of change that each is intended to target and the intended target population for the intervention. The aims of this paper are to define content validity as it applies to model-based eHealth intervention development, to present a feasible method for assessing content validity in this context, and to describe the implementation of this new method during the development of a Web-based intervention for children. We designed a practical 5-step method for assessing content validity in eHealth interventions that includes defining key intervention targets, delineating intervention activity-target pairings, identifying experts and using a survey tool to gather expert ratings of the relevance of each activity to its intended target, its likely effectiveness in achieving the intended target, and its appropriateness with a specific intended audience, and then using quantitative and qualitative results to identify intervention activities that may need modification. We applied this method during our development of the Coping Coach Web-based intervention for school-age children. In the evaluation of Coping Coach content validity, 15 experts from five countries

[Training, the key to improving eHealth literacy of upper secondary school students].

PubMed

Hernández-Rabanal, Carme; Vall, Aurora; Boter, Clara

To explore whether training on strategies to identify and assess health-related information online has a positive impact on students' perception of their own eHealth literacy. The validated eHealth Literacy Scale (eHEALS) was administered to a sample of upper secondary school students, aged 15-18. One week later, they attended a training session on how to search and identify reliable health-related information and resources online. The eHEALS was administered again at the end of this session. Information about gender and school year was collected in both sessions. Perceived eHealth literacy was assessed by comparing the scores obtained before and after the session. Bivariate and multiple linear regressions were completed. Of the 298 students enrolled in upper secondary school (Bachillerato), 285 were included in the study. Approximately 52.28% (149) were female, and 47.72% (136) were male. The mean eHEALS score before the session was 24.19 (range: 8-40), and was 28.54 after it. The training was associated with higher perceived eHealth literacy scores (p <0,0001). Health literacy was positively associated with the usefulness and importance students give the Internet. Attendance at a training session on strategies to identify and assess health-related resources online is associated with higher levels of perceived eHealth literacy. Implementing specific training sessions on eHealth literacy in upper secondary school is a promising approach for enhancing students' eHealth literacy. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Assessing the Coverage of E-Health Services in Sub-Saharan Africa. A Systematic Review and Analysis.

PubMed

Adeloye, Davies; Adigun, Taiwo; Misra, Sanjay; Omoregbe, Nicholas

2017-05-18

E-Health has attracted growing interests globally. The relative lack of facilities, skills, funds and information on existing e-Health initiatives has affected progress on e-Health in Africa. To review publicly available literature on e-Health in sub-Saharan Africa (sSA) towards providing information on existing and ongoing e-Health initiatives in the region. Searches of relevant literature were conducted on Medline, EMBASE and Global Health, with search dates set from 1990 to 2016. We included studies on e-Health initiatives (prototypes, designs, or completed projects) targeting population groups in sSA. Our search returned 2322 hits, with 26 studies retained. Included studies were conducted in 14 countries across the four sub-regions in sSA (Central, East, South and West) and spreading over a 12-year period, 2002-2014. Six types of e-Health interventions were reported, with 17 studies (65 %) based on telemedicine, followed by mHealth with 5 studies (19 %). Other e-Health types include expert system, electronic medical records, e-mails, and online health module. Specific medical specialties covered include dermatology (19 %), pathology (12 %) and radiology (8 %). Successes were 'widely reported' (representing 50 % overall acceptance or positive feedbacks in a study) in 10 studies (38 %). The prominent challenges reported were technical problems, poor internet and connectivity, participants' selection biases, contextual issues, and lack of funds. E-Health is evolving in sSA, but with poorly published evidence. While we call for more quality research in the region, it is also important that population-wide policies and on-going e-Health initiatives are contextually feasible, acceptable, and sustainable.

eHealth in Latin America and the Caribbean: Development and Policy Issues

PubMed Central

Risk, Ahmad

2003-01-01

This paper reviews trends and issues in health and in the information and communication technologies (ICT) market as they relate to the deployment of eHealth solutions in Latin America and the Caribbean. Heretofore designed for industrialized countries and large organizations, eHealth solutions are being proposed as an answer to a variety of health-system management problems and health care demands faced by all health organizations including those in developing societies. Particularly, eHealth is seen as especially useful in the operational support of the new health care models being implemented in many countries. The authors examine those developments vis-à-vis the characteristics of the Latin American and the Caribbean health-sector organizational preparedness and technological infrastructure, and propose policy and organizational actions to foster the development of eHealth solutions in the region. PMID:12746209

Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care

PubMed Central

Huygens, Martine Wilhelmina Johanna; Schoenmakers, Tim M; Oude Nijeweme-D'Hollosy, Wendy; van Velsen, Lex; Vermeulen, Joan; Schoone-Harmsen, Marian; Jansen, Yvonne JFM; van Schayck, Onno CP; Friele, Roland; de Witte, Luc

2018-01-01

Background Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated. Objective This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives. Methods Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care. Results The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use

Consumer e-health solutions: the cure for Baumol's disease?

PubMed

Brown, Adalsteinn D

2014-01-01

Baumol's disease is the fact that costs in persistently labour-intensive sectors such as healthcare do not drop, despite increased use of technology. The idea of consumer e-health solutions is seductive, because it provides one option for treating Baumol's disease. However, barriers to the implementation of these solutions exist, and the successful treatment of Baumol's disease with consumer e-health solutions rests on more than their removal. In this introduction, the editor-in-chief adds to the conversation four shifts that are critical to reaping the benefits of consumer e-health solutions: moving the focus from privacy to protection; from mere access to the use of information in decision-making; from the patient-provider dyad to one that includes a full formal and informal care team; and from structural solutions in healthcare to ones designed around the goals we have for our health system.

Experience of nurses with using eHealth in Gilgit-Baltistan, Pakistan: a qualitative study in primary and secondary healthcare

PubMed Central

2013-01-01

Background To improve the quality of health care in remote parts of Pakistan, a research project was initiated in the mountainous region of Gilgit-Baltistan using information and communication technology to improve patient care and support continuing education of health providers (eHealth). This paper describes the experience of nurses in using eHealth in their routine practices. Methods All health centres of Gilgit-Baltistan, Pakistan using eHealth as part of this study, were taken as a single case. These include four primary healthcare centres, three secondary care centres and one medical centre. In-depth interviews were conducted using semi-structured interview guide to study nurses’ perspective about using eHealth, and its perceived impact on their professional lives. Results According to the respondents, eHealth enhanced access to care for remote communities, and improved quality of health services by providing opportunities for continuing learning. Nurses also appreciated eHealth for reducing their professional isolation, and providing exposure to new knowledge through teleconsultations and eLearning. The responses categorized under six major headings include: gaps in health services prior to eHealth; role of eHealth in addressing these gaps; benefits of eHealth; challenges in eHealth implementation; community’s perception about eHealth; and future recommendations. Conclusions Low-cost and simple eHealth solutions have shown to benefit nurses, and the communities in the remote mountainous regions of Pakistan. PMID:23452373

Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update).

PubMed

Ross, Jamie; Stevenson, Fiona; Lau, Rosa; Murray, Elizabeth

2016-10-26

There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementation. Furthermore, the large body of reviews in the e-health implementation field, often based on one particular technology, setting or health condition make it difficult to access a comprehensive and comprehensible summary of available evidence to help plan and undertake implementation. This review provides an update and re-analysis of a systematic review of the e-health implementation literature culminating in a set of accessible and usable recommendations for anyone involved or interested in the implementation of e-health. MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library were searched for studies published between 2009 and 2014. Studies were included if they were systematic reviews of the implementation of e-health. Data from included studies were synthesised using the principles of meta-ethnography, and categorisation of the data was informed by the Consolidated Framework for Implementation Research (CFIR). Forty-four reviews mainly from North America and Europe were included. A range of e-health technologies including electronic medical records and clinical decision support systems were represented. Healthcare settings included primary care, secondary care and home care. Factors important for implementation were identified at the levels of the following: the individual e-health technology, the outer setting, the inner setting and the individual health professionals as well as the process of implementation. This systematic review of reviews provides a synthesis of the literature that both acknowledges the multi-level complexity of e-health implementation and provides an accessible and useful guide for those planning implementation. New interpretations of a large amount of data

Special issue on eHealth and mHealth: Challenges and future directions for assessment, treatment, and dissemination.

PubMed

Borrelli, Belinda; Ritterband, Lee M

2015-12-01

This special issue is intended to promote a discussion of eHealth and mHealth and its connection with health psychology. "eHealth" generally refers to the use of information technology, including the Internet, digital gaming, virtual reality, and robotics, in the promotion, prevention, treatment, and maintenance of health. "mHealth" refers to mobile and wireless applications, including text messaging, apps, wearable devices, remote sensing, and the use of social media such as Facebook and Twitter, in the delivery of health related services. This special issue includes 11 articles that begin to address the need for more rigorous methodology, valid assessment, innovative interventions, and increased access to evidence-based programs and interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Dropout From an eHealth Intervention for Adults With Type 2 Diabetes: A Qualitative Study.

PubMed

Lie, Silje Stangeland; Karlsen, Bjørg; Oord, Ellen Renate; Graue, Marit; Oftedal, Bjørg

2017-05-30

Adequate self-management is the cornerstone of type 2 diabetes treatment, as people make the majority of daily treatment measures and health decisions. The increasing prevalence of type 2 diabetes mellitus (T2DM) and the complexity of diabetes self-management demonstrate the need for innovative and effective ways to deliver self-management support. eHealth interventions are promoted worldwide and hold a great potential in future health care for people with chronic diseases such as T2DM. However, many eHealth interventions face high dropout rates. This led to our interest in the experiences of participants who dropped out of an eHealth intervention for adults with T2DM, based on the Guided Self-Determination (GSD) counseling method. In this study, we aimed to explore experiences with an eHealth intervention based on GSD in general practice from the perspective of those who dropped out and to understand their reasons for dropping out. To the best of our knowledge, no previous qualitative study has focused on participants who withdrew from an eHealth self-management support intervention for adults with T2DM. A qualitative design based on telephone interviews was used to collect data. The sample comprised 12 adults with type 2 diabetes who dropped out of an eHealth intervention. Data were collected in 2016 and subjected to qualitative content analysis. We identified one overall theme: "Losing motivation for intervention participation." This theme was illustrated by four categories related to the participants' experiences of the eHealth intervention: (1) frustrating technology, (2) perceiving the content as irrelevant and incomprehensible, (3) choosing other activities and perspectives, and (4) lacking face-to-face encounters. Our findings indicate that the eHealth intervention based on GSD without face-to-face encounters with nurses reduced participants' motivation for engagement in the intervention. To maintain motivation, our study points to the importance of

Implementation science approaches for integrating eHealth research into practice and policy.

PubMed

Glasgow, Russell E; Phillips, Siobhan M; Sanchez, Michael A

2014-07-01

To summarize key issues in the eHealth field from an implementation science perspective and to highlight illustrative processes, examples and key directions to help more rapidly integrate research, policy and practice. We present background on implementation science models and emerging principles; discuss implications for eHealth research; provide examples of practical designs, measures and exemplar studies that address key implementation science issues; and make recommendations for ways to more rapidly develop and test eHealth interventions as well as future research, policy and practice. The pace of eHealth research has generally not kept up with technological advances, and many of our designs, methods and funding mechanisms are incapable of providing the types of rapid and relevant information needed. Although there has been substantial eHealth research conducted with positive short-term results, several key implementation and dissemination issues such as representativeness, cost, unintended consequences, impact on health inequities, and sustainability have not been addressed or reported. Examples of studies in several of these areas are summarized to demonstrate this is possible. eHealth research that is intended to translate into policy and practice should be more contextual, report more on setting factors, employ more responsive and pragmatic designs and report results more transparently on issues important to potential adopting patients, clinicians and organizational decision makers. We outline an alternative development and assessment model, summarize implementation science findings that can help focus attention, and call for different types of more rapid and relevant research and funding mechanisms. Published by Elsevier Ireland Ltd.

Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults

PubMed Central

Ware, Patrick; Bartlett, Susan J; Paré, Guy; Symeonidis, Iphigenia; Tannenbaum, Cara; Bartlett, Gillian; Poissant, Lise

2017-01-01

Background The Internet and eHealth technologies represent new opportunities for managing health. Age, sex, socioeconomic status, and current technology use are some of the known factors that influence individuals’ uptake of eHealth; however, relatively little is known about facilitators and barriers to eHealth uptake specific to older adults, particularly as they relate to their experiences in accessing health care. Objective The aim of our study was to explore the interests, preferences, and concerns of older adults in using the Internet and eHealth technologies for managing their health in relation to their experiences with the current health care system. Methods Two focus groups (n=15) were conducted with adults aged 50+ years. Pragmatic thematic analysis using an inductive approach was conducted to identify the interests, preferences, and concerns of using the Internet and eHealth technologies. Results Five themes emerged that include (1) Difficulty in identifying credible and relevant sources of information on the Web; (2) Ownership, access, and responsibility for medical information; (3) Peer communication and support; (4) Opportunities to enhance health care interactions; and (5) Privacy concerns. These findings support the potential value older adults perceive in eHealth technologies, particularly in their ability to provide access to personal health information and facilitate communication between providers and peers living with similar conditions. However, in order to foster acceptance, these technologies will need to provide personal and general health information that is secure, readily accessible, and easily understood. Conclusions Older adults have diverse needs and preferences that, in part, are driven by their experiences and frustrations with the health care system. Results can help inform the design and implementation of technologies to address gaps in care and access to health information for older adults with chronic conditions who may

The Role of Libraries in eHealth Service Delivery in Australia

ERIC Educational Resources Information Center

Rao, Sarada

2009-01-01

eHealth is an emerging service sector which has great potential to improve health care delivery to rural and remote communities, facilitate health surveillance, and promote health education and research. Despite the critical need for eHealth services in Australia based on the challenges of distance and human resources, its utility has yet to be…

eHealth and Global Health: Investments Opportunities and Challenges for Industry in Developing Countries

NASA Astrophysics Data System (ADS)

Iluyemi, Adesina; Briggs, Jim

eHealth investments from developed countries to developing countries are expected to follow the emerging trend of eHealth for meeting global health problems. However, eHealth industry from developed countries will need to learn to make this impending venture a ‘win-win’ situation with profitable return on investments. This short paper highlights some of these challenges that must be overcome in order to achieve these objectives.

Heuristic Evaluation of Ehealth Interventions: Establishing Standards That Relate to the Therapeutic Process Perspective

PubMed Central

Muench, Fred

2016-01-01

In recent years, the number of available eHealth interventions aimed at treating behavioral and mental health challenges has been growing. From the perspective of health care providers, there is a need for eHealth interventions to be evaluated prior to clinical trials and for the limited resources allocated to empirical research to be invested in the most promising products. Following a literature review, a gap was found in the availability of eHealth interventions evaluation principles related to the patient experience of the therapeutic process. This paper introduces principles and concepts for the evaluation of eHealth interventions developed as a first step in a process to outline general evaluation guidelines that relate to the clinical context from health care providers’ perspective. Our approach was to conduct a review of literature that relates to the examination of eHealth interventions. We identified the literature that was most relevant to our study and used it to define guidelines that relate to the clinical context. We then compiled a list of heuristics we found to be useful for the evaluation of eHealth intervention products’ suitability for empirical examination. Four heuristics were identified with respect to the therapeutic process: (1) the product’s ease of use (ie, usability), (2) the eHealth intervention’s compatibility with the clinical setting, (3) the presence of tools that make it easier for the user to engage in therapeutic activities, and (4) the provision of a feasible therapeutic pathway to growth. We then used this set of heuristics to conduct a detailed examination of MyFitnessPal. This line of work could help to set the bar higher for product developers and to inform health care providers about preferred eHealth intervention designs. PMID:26764209

Heuristic Evaluation of Ehealth Interventions: Establishing Standards That Relate to the Therapeutic Process Perspective.

PubMed

Baumel, Amit; Muench, Fred

2016-01-13

In recent years, the number of available eHealth interventions aimed at treating behavioral and mental health challenges has been growing. From the perspective of health care providers, there is a need for eHealth interventions to be evaluated prior to clinical trials and for the limited resources allocated to empirical research to be invested in the most promising products. Following a literature review, a gap was found in the availability of eHealth interventions evaluation principles related to the patient experience of the therapeutic process. This paper introduces principles and concepts for the evaluation of eHealth interventions developed as a first step in a process to outline general evaluation guidelines that relate to the clinical context from health care providers' perspective. Our approach was to conduct a review of literature that relates to the examination of eHealth interventions. We identified the literature that was most relevant to our study and used it to define guidelines that relate to the clinical context. We then compiled a list of heuristics we found to be useful for the evaluation of eHealth intervention products' suitability for empirical examination. Four heuristics were identified with respect to the therapeutic process: (1) the product's ease of use (ie, usability), (2) the eHealth intervention's compatibility with the clinical setting, (3) the presence of tools that make it easier for the user to engage in therapeutic activities, and (4) the provision of a feasible therapeutic pathway to growth. We then used this set of heuristics to conduct a detailed examination of MyFitnessPal. This line of work could help to set the bar higher for product developers and to inform health care providers about preferred eHealth intervention designs.

Analysis of central enterprise architecture elements in models of six eHealth projects.

PubMed

Virkanen, Hannu; Mykkänen, Juha

2014-01-01

Large-scale initiatives for eHealth services have been established in many countries on regional or national level. The use of Enterprise Architecture has been suggested as a methodology to govern and support the initiation, specification and implementation of large-scale initiatives including the governance of business changes as well as information technology. This study reports an analysis of six health IT projects in relation to Enterprise Architecture elements, focusing on central EA elements and viewpoints in different projects.

Discovering eHealth Technology: An Innovative Interprofessional Graduate Student Learning Experience.

PubMed

Estes, Krista; Gilliam, Eric; Knapfel, Sarah; Lee, Chanmi; Skiba, Diane

2016-01-01

The use of eHealth has grown in recent years and is projected to continue to increase exponentially. In order to empower and prepare advanced practice providers to integrate eHealth into their clinical practice, curricular changes need to occur. The iTEAM grant provides a unique opportunity to prepare advanced practice disciplines to provide collaborative care using eHealth. Through the integration of a simulated telehealth using a standardized patient, Doctor of Pharmacy and Advanced Practice Registered Nursing students learned how to apply health information technology and coordinate care in an interprofessional manner. Opportunities and challenges to guide future efforts to integrate eHealth-learning experiences into the curriculum are identified.

Interdisciplinary eHealth Practice in Cancer Care: A Review of the Literature

PubMed Central

Janssen, Anna; Hines, Monique; Nagarajan, Srivalli Vilapakkam; Kielly-Carroll, Candice; Shaw, Tim

2017-01-01

This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer was conducted by systematically searching research databases in March 2015, and repeated in September 2016. Searches resulted in 8531 citations, of which 140 were retrieved and scanned in full, with twenty-six studies included in the review. Analysis of data extracted from the included articles revealed five broad themes: (i) data collection and accessibility; (ii) virtual multidisciplinary teams; (iii) communication between individuals involved in the delivery of health services; (iv) communication pathways between patients and cancer care teams; and (v) health professional-led change. Use of eHealth interventions in cancer care was widespread, particularly to support interdisciplinary care. However, research has focused on development and implementation of interventions, rather than on long-term impact. Further research is warranted to explore design, evaluation, and long-term sustainability of eHealth systems and interventions in interdisciplinary cancer care. Technology evolves quickly and researchers need to provide health professionals with timely guidance on how best to respond to new technologies in the health sector. PMID:29068377

Interdisciplinary eHealth Practice in Cancer Care: A Review of the Literature.

PubMed

Janssen, Anna; Brunner, Melissa; Keep, Melanie; Hines, Monique; Nagarajan, Srivalli Vilapakkam; Kielly-Carroll, Candice; Dennis, Sarah; McKeough, Zoe; Shaw, Tim

2017-10-25

This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer was conducted by systematically searching research databases in March 2015, and repeated in September 2016. Searches resulted in 8531 citations, of which 140 were retrieved and scanned in full, with twenty-six studies included in the review. Analysis of data extracted from the included articles revealed five broad themes: (i) data collection and accessibility; (ii) virtual multidisciplinary teams; (iii) communication between individuals involved in the delivery of health services; (iv) communication pathways between patients and cancer care teams; and (v) health professional-led change. Use of eHealth interventions in cancer care was widespread, particularly to support interdisciplinary care. However, research has focused on development and implementation of interventions, rather than on long-term impact. Further research is warranted to explore design, evaluation, and long-term sustainability of eHealth systems and interventions in interdisciplinary cancer care. Technology evolves quickly and researchers need to provide health professionals with timely guidance on how best to respond to new technologies in the health sector.

eHealth in the future of medications management: personalisation, monitoring and adherence.

PubMed

Car, Josip; Tan, Woan Shin; Huang, Zhilian; Sloot, Peter; Franklin, Bryony Dean

2017-04-05

Globally, healthcare systems face major challenges with medicines management and medication adherence. Medication adherence determines medication effectiveness and can be the single most effective intervention for improving health outcomes. In anticipation of growth in eHealth interventions worldwide, we explore the role of eHealth in the patients' medicines management journey in primary care, focusing on personalisation and intelligent monitoring for greater adherence. eHealth offers opportunities to transform every step of the patient's medicines management journey. From booking appointments, consultation with a healthcare professional, decision-making, medication dispensing, carer support, information acquisition and monitoring, to learning about medicines and their management in daily life. It has the potential to support personalisation and monitoring and thus lead to better adherence. For some of these dimensions, such as supporting decision-making and providing reminders and prompts, evidence is stronger, but for many others more rigorous research is urgently needed. Given the potential benefits and barriers to eHealth in medicines management, a fine balance needs to be established between evidence-based integration of technologies and constructive experimentation that could lead to a game-changing breakthrough. A concerted, transdisciplinary approach adapted to different contexts, including low- and middle-income contries is required to realise the benefits of eHealth at scale.

e-Health promises and challenges: some ethical considerations.

PubMed

Kluge, Eike-Henner W

2011-01-01

eHealth is a cost-effective and efficient way of providing health care to patients who would otherwise be excluded or underserviced. However, eHealth also presents a series of ethical and legal challenges which, if not met before its implementation, can undermine its success. Among other things, privacy, consent and liability are implicated, as are changes in the health care professional-patient relationship and in the role of health informatics professionals. Legacy systems and interoperability present further challenges, and outsourcing may pose special problems. This paper highlights some of these issues and outlines their implications.

eHealth and mHealth initiatives in Bangladesh: a scoping study.

PubMed

Ahmed, Tanvir; Lucas, Henry; Khan, Azfar Sadun; Islam, Rubana; Bhuiya, Abbas; Iqbal, Mohammad

2014-06-16

The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully

eHealth and mHealth initiatives in Bangladesh: A scoping study

PubMed Central

2014-01-01

Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth

Diffusion of e-health innovations in 'post-conflict' settings: a qualitative study on the personal experiences of health workers.

PubMed

Woodward, Aniek; Fyfe, Molly; Handuleh, Jibril; Patel, Preeti; Godman, Brian; Leather, Andrew; Finlayson, Alexander

2014-04-23

Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging 'post-conflict' contexts. However, analyses on the adoption of technology for health (that is, 'e-health') and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger's diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more

Requirements model for an e-Health awareness portal

NASA Astrophysics Data System (ADS)

Hussain, Azham; Mkpojiogu, Emmanuel O. C.; Nawi, Mohd Nasrun M.

2016-08-01

Requirements engineering is at the heart and foundation of software engineering process. Poor quality requirements inevitably lead to poor quality software solutions. Also, poor requirement modeling is tantamount to designing a poor quality product. So, quality assured requirements development collaborates fine with usable products in giving the software product the needed quality it demands. In the light of the foregoing, the requirements for an e-Ebola Awareness Portal were modeled with a good attention given to these software engineering concerns. The requirements for the e-Health Awareness Portal are modeled as a contribution to the fight against Ebola and helps in the fulfillment of the United Nation's Millennium Development Goal No. 6. In this study requirements were modeled using UML 2.0 modeling technique.

Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care.

PubMed

Swinkels, Ilse Catharina Sophia; Huygens, Martine Wilhelmina Johanna; Schoenmakers, Tim M; Oude Nijeweme-D'Hollosy, Wendy; van Velsen, Lex; Vermeulen, Joan; Schoone-Harmsen, Marian; Jansen, Yvonne Jfm; van Schayck, Onno Cp; Friele, Roland; de Witte, Luc

2018-03-29

Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated. This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives. Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care. The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self

Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya.

PubMed

Njoroge, Martin; Zurovac, Dejan; Ogara, Esther A A; Chuma, Jane; Kirigia, Doris

2017-02-10

The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya. The projects were examined based on strategic area of implementation, health purpose and focus, geographic location, evaluation status and thematic area. A total of 114 citations comprising 69 eHealth projects fulfilled the inclusion criteria. The eHealth projects included 47 mHealth projects, 9 health information system projects, 8 eLearning projects and 5 telemedicine projects. In terms of projects geographical distribution, 24 were executed in Nairobi whilst 15 were designed to have a national coverage but only 3 were scaled up. In terms of health focus, 19 projects were mainly on primary care, 17 on HIV/AIDS and 11 on maternal and child health (MNCH). Only 8 projects were rigorously evaluated under randomized control trials. This review discovered that there is a myriad of eHealth projects being implemented in Kenya, mainly in the mHealth strategic area and focusing mostly on primary care and HIV/AIDs. Based on our analysis, most of the projects were rarely evaluated. In addition, few projects are implemented in marginalised areas and least urbanized counties with more health care needs, notwithstanding the fact that adoption of information and communication technology should aim to improve health equity (i.e. improve access to health care particularly in remote parts of the country in order to reduce geographical inequities) and contribute to overall health systems strengthening.

Development of Saudi e-health literacy scale for chronic diseases in Saudi Arabia: using integrated health literacy dimensions.

PubMed

Zakaria, Nasriah; AlFakhry, Ohoud; Matbuli, Abeer; Alzahrani, Asma; Arab, Noha Samir Sadiq; Madani, Alaa; Alshehri, Noura; Albarrak, Ahmed I

2018-05-01

Health literacy has become a global issue, and it is important that patients and individuals are able to use information technology to access health information and educational services. The research objective is to develop a Saudi e-health literacy scale (SeHL) for measuring e-health literacy among Saudis suffering from non-communicable diseases (NCD). Overall, 14 relevant papers in related interdisciplinary fields were reviewed to select the most useful literacy dimensions. From these articles, we extracted the most common dimensions used to measure e-health literacy across the disciplines. Multiple workshops with multidisciplinary team members reviewed and evaluated items for SeHL. Four key aspects of e-health literacy-use of technology/media, information-seeking, usefulness and confidence-were identified and integrated as e-health literacy dimensions. These will be used to measure e-health literacy among Saudi patients with NCDs. A translation from Arabic to English was performed in order to ensure that translation process was accurate. A SeHL scale was developed to measure e-health literacy among Saudi patients. By understanding e-health literacy levels, we will be able to create a patient-education system to be used by patients in Saudi Arabia. As information technology is increasingly used by people of all ages all over the world, e-health literacy has been identified as a key factor in determining health outcomes. To date, no comprehensive scale exists to assess e-health literacy levels among speakers of Arabic, particularly among people with NCD such as diabetes, cardiovascular diseases and hypertension.

Barriers and Facilitators to eHealth Use in Daily Practice: Perspectives of Patients and Professionals in Dermatology

PubMed Central

Schussler-Raymakers, Florine ML; Frima, Cynthia; Flinterman, Annebeth; Hamminga, Eefje; Arents, Bernd WM; Bruijnzeel-Koomen, Carla AFM; de Bruin-Weller, Marjolein S; van Os-Medendorp, Harmieke

2017-01-01

Background The number of eHealth interventions in the management of chronic diseases such as atopic dermatitis (AD) is growing. Despite promising results, the implementation and use of these interventions is limited. Objectives This study aimed to assess opinions of the most important stakeholders influencing the implementation and use of eHealth services in daily dermatology practice. Methods The perspectives of health care professionals and patients towards the implementation and use of eHealth services in daily practice were assessed by using a mixed method design. A cross-sectional survey based on the eHealth implementation toolkit (eHit) was conducted to explore factors influencing the adoption of eHealth interventions offering the possibility of e-consultations, Web-based monitoring, and Web-based self-management training among dermatologists and dermatology nurses. The perspectives of patients with atopic dermatitis (AD) regarding the use of eHealth services were discussed in an online focus group. Results Health care professionals (n=99) and patients (n=9) acknowledged the value of eHealth services and were willing to use these digital tools in daily dermatology practice. Key identified barriers (statements with <50% of the participants scoring totally agree or agree) in the implementation and adoption of eHealth interventions included concerns about the availability (12/99, 12%) and allocation (14/99, 14%) of resources, financial aspects (26/99, 26%), reliability, security, and confidentially of the intervention itself (29/99, 29%), and the lack of education and training (6/99, 6%). Conclusions Health care professionals and patients acknowledge the benefits arising from the implementation and use of eHealth services in daily dermatology practice. However, some important barriers were identified that might be useful in addressing the implementation strategy in order to enhance the implementation success of eHealth interventions in dermatology. PMID:28874336

Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

PubMed Central

Holmner, Åsa; Rocklöv, Joacim; Ng, Nawi; Nilsson, Maria

2012-01-01

Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT)’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies. PMID:22679398

Climate change and eHealth: a promising strategy for health sector mitigation and adaptation.

PubMed

Holmner, Asa; Rocklöv, Joacim; Ng, Nawi; Nilsson, Maria

2012-01-01

Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on 'green information and communication technology (ICT)' are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies.

"Initiate-build-operate-transfer"--a strategy for establishing sustainable telemedicine programs in developing countries: initial lessons from the balkans.

PubMed

Latifi, Rifat; Merrell, Ronald C; Doarn, Charles R; Hadeed, George J; Bekteshi, Flamur; Lecaj, Ismet; Boucha, Kathe; Hajdari, Fatmir; Hoxha, Astrit; Koshi, Dashurije; de Leonni Stanonik, Mateja; Berisha, Blerim; Novoberdaliu, Kadri; Imeri, Arben; Weinstein, Ronald S

2009-12-01

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in Kosova has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in the Balkans. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy, "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services in developing countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs, was discussed. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the healthcare infrastructure. The endpoint is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program will be transitioned to the national Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Albania, Macedonia, and other countries around the world. The IBOT model has been effective in creating

eHealth Literacy Skills Among Undergraduate Nursing Students in the U.S. and South Korea.

PubMed

Park, Hyejin; Park, Hyunmi

2016-01-01

Online health information is a critical resource for health consumers. Nursing professionals need to be eHealth literate to support patients and their families. The purpose of the study was to explore eHealth literacy skills among undergraduate nursing students in the U.S. and South Korea. One hundred and sixty-nine undergraduate nursing students in two universities, one in the southern area of the U.S. and one in the eastern area of South Korea, participated. Participants were asked to complete the eHealth Literacy Scale. The majority of participants perceived that the Internet is a useful or very useful tool in helping them make health-related decisions. The participants either agreed or strongly agreed with the 7 items of the eHealth literacy scale except an item such as they can call high to low quality of online health information. The U.S students have higher mean scores of all eHealth literacy items than students of South Korea.

Security Attacks and Solutions in Electronic Health (E-health) Systems.

PubMed

Zeadally, Sherali; Isaac, Jesús Téllez; Baig, Zubair

2016-12-01

For centuries, healthcare has been a basic service provided by many governments to their citizens. Over the past few decades, we have witnessed a significant transformation in the quality of healthcare services provided by healthcare organizations and professionals. Recent advances have led to the emergence of Electronic Health (E-health), largely made possible by the massive deployment and adoption of information and communication technologies (ICTs). However, cybercriminals and attackers are exploiting vulnerabilities associated primarily with ICTs, causing data breaches of patients' confidential digital health information records. Here, we review recent security attacks reported for E-healthcare and discuss the solutions proposed to mitigate them. We also identify security challenges that must be addressed by E-health system designers and implementers in the future, to respond to threats that could arise as E-health systems become integrated with technologies such as cloud computing, the Internet of Things, and smart cities.

Towards Usable E-Health. A Systematic Review of Usability Questionnaires.

PubMed

Sousa, Vanessa E C; Dunn Lopez, Karen

2017-05-10

The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen. To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality. We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table. Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7). Existing questionnaires provide a foundation for research on e-health usability. However

eHealth and adolescents in Serbia: psychometric properties of eHeals questionnaire and contributing factors to better online health literacy.

PubMed

Gazibara, Tatjana; Cakic, Jelena; Cakic, Milica; Pekmezovic, Tatjana; Grgurevic, Anita

2018-05-25

Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach's alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers' education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07-2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education.

What Is eHealth (3): A Systematic Review of Published Definitions

PubMed Central

Oh, Hans; Rizo, Carlos; Enkin, Murray

2005-01-01

Context The term eHealth is widely used by many individuals, academic institutions, professional bodies, and funding organizations. It has become an accepted neologism despite the lack of an agreed-upon clear or precise definition. We believe that communication among the many individuals and organizations that use the term could be improved by comprehensive data about the range of meanings encompassed by the term. Objective To report the results of a systematic review of published, suggested, or proposed definitions of eHealth. Data Sources Using the search query string “eHealth” OR “e-Health” OR “electronic health”, we searched the following databases: Medline and Premedline (1966-June 2004), EMBASE (1980-May 2004), International Pharmaceutical Abstracts (1970-May 2004), Web of Science (all years), Information Sciences Abstracts (1966-May 2004), Library Information Sciences Abstracts (1969-May 2004), and Wilson Business Abstracts (1982-March 2004). In addition, we searched dictionaries and an Internet search engine. Study Selection We included any source published in either print format or on the Internet, available in English, and containing text that defines or attempts to define eHealth in explicit terms. Two of us independently reviewed titles and abstracts of citations identified in the bibliographic databases and Internet search, reaching consensus on relevance by discussion. Data Extraction We retrieved relevant reports, articles, references, letters, and websites containing definitions of eHealth. Two of us qualitatively analyzed the definitions and coded them for content, emerging themes, patterns, and novel ideas. Data Synthesis The 51 unique definitions that we retrieved showed a wide range of themes, but no clear consensus about the meaning of the term eHealth. We identified 2 universal themes (health and technology) and 6 less general (commerce, activities, stakeholders, outcomes, place, and perspectives). Conclusions The widespread use of

eHealth Literacy and Partner Involvement in Treatment Decision Making for Men With Newly Diagnosed Localized Prostate Cancer.

PubMed

Song, Lixin; Tatum, Kimberly; Greene, Giselle; Chen, Ronald C

2017-03-01

To examine how the eHealth literacy of partners of patients with newly diagnosed prostate cancer affects their involvement in decision making, and to identify the factors that influence their eHealth literacy.
. Cross-sectional exploratory study.
. North Carolina.
. 142 partners of men with newly diagnosed localized prostate cancer. 
. A telephone survey and descriptive and multiple linear regression analyses were used.
. The partners' eHealth literacy, involvement in treatment decision making, and demographics, and the health statuses of the patients and their partners. 
. Higher levels of eHealth literacy among partners were significantly associated with their involvement in getting a second opinion, their awareness of treatment options, and the size of the social network they relied on for additional information and support for treatment decision making for prostate cancer. The factor influencing eHealth literacy was the partners' access to the Internet for personal use, which explained some of the variance in eHealth literacy.
. This study described how partners' eHealth literacy influenced their involvement in treatment decision making for prostate cancer and highlighted the influencing factors (i.e., partners' access to the Internet for personal use).
. When helping men with prostate cancer and their partners with treatment decision making, nurses need to assess eHealth literacy levels to determine whether nonelectronically based education materials are needed and to provide clear instructions on how to use eHealth resources.

Behavior Change Techniques in Physical Activity eHealth Interventions for People With Cardiovascular Disease: Systematic Review

PubMed Central

Duff, Orlaith Mairead; Walsh, Deirdre MJ; Furlong, Bróna A; O'Connor, Noel E; Woods, Catherine B

2017-01-01

Background Cardiovascular disease (CVD) is the leading cause of premature death and disability in Europe, accounting for 4 million deaths per year and costing the European Union economy almost €196 billion annually. There is strong evidence to suggest that exercise-based secondary rehabilitation programs can decrease the mortality risk and improve health among patients with CVD. Theory-informed use of behavior change techniques (BCTs) is important in the design of cardiac rehabilitation programs aimed at changing cardiovascular risk factors. Electronic health (eHealth) is the use of information and communication technologies (ICTs) for health. This emerging area of health care has the ability to enhance self-management of chronic disease by making health care more accessible, affordable, and available to the public. However, evidence-based information on the use of BCTs in eHealth interventions is limited, and particularly so, for individuals living with CVD. Objective The aim of this systematic review was to assess the application of BCTs in eHealth interventions designed to increase physical activity (PA) in CVD populations. Methods A total of 7 electronic databases, including EBSCOhost (MEDLINE, PsycINFO, Academic Search Complete, SPORTDiscus with Full Text, and CINAHL Complete), Scopus, and Web of Science (Core Collection) were searched. Two authors independently reviewed references using the software package Covidence (Veritas Health Innovation). The reviewers met to resolve any discrepancies, with a third independent reviewer acting as an arbitrator when required. Following this, data were extracted from the papers that met the inclusion criteria. Bias assessment of the studies was carried out using the Cochrane Collaboration’s tool for assessing the risk of bias within Covidence; this was followed by a narrative synthesis. Results Out of the 987 studies that were identified, 14 were included in the review. An additional 9 studies were added following a

eHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults.

PubMed

Tennant, Bethany; Stellefson, Michael; Dodd, Virginia; Chaney, Beth; Chaney, Don; Paige, Samantha; Alber, Julia

2015-03-17

Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t217.60=-2.98, P=.003. Younger age (b=-0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R(2) =.17, R(2)adj =.14, F9,229=5.277, P<.001). Women were nearly three times more likely than men to use Web 2.0 for health information (OR 2.63, Wald= 8.09, df=1

Conceptual design of an e-health strategy for the Spanish health care system.

PubMed

González, Marvin E; Quesada, Gioconda; Urrutia, Ignacio; Gavidia, José V

2006-01-01

The purpose of this article is to describe the design and development of an e-health strategy for the Spanish health care system. Using quality function deployment and benchmarking analysis as an analytical model, a strategy in e-health care is proposed. This article uses the case of a Spanish community to build a general framework for e-health system development. Based on a multi-disciplinary literature, and the specific needs of a community, the process of e-health system development is analyzed and reduced into a series of phases that form an integrated method. Best practice managerial techniques are adapted to the healthcare industry and the inter-relationships between them are mapped in a theoretical model that results in the desired outcomes. This analysis produces a road-map to e-health system development consisting of several phases: analysis of the current situation of the system and determination of objectives; collection and analysis of customer expectations; development of an action plan through cross-evaluation of customer and system needs; cost and strategic analyses; and evaluation and control systems. Managerial implications are provided. The strategy proposed in this article is a prototype and an ongoing study in the Castilla-La Mancha community.

A Conceptual Measurement Model for eHealth Readiness: a Team Based Perspective

PubMed Central

Phillips, James; Poon, Simon K.; Yu, Dan; Lam, Mary; Hines, Monique; Brunner, Melissa; Power, Emma; Keep, Melanie; Shaw, Tim; Togher, Leanne

2017-01-01

Despite the shift towards collaborative healthcare and the increase in the use of eHealth technologies, there does not currently exist a model for the measurement of eHealth readiness in interdisciplinary healthcare teams. This research aims to address this gap in the literature through the development of a three phase methodology incorporating qualitative and quantitative methods. We propose a conceptual measurement model consisting of operationalized themes affecting readiness across four factors: (i) Organizational Capabilities, (ii) Team Capabilities, (iii) Patient Capabilities, and (iv) Technology Capabilities. The creation of this model will allow for the measurement of the readiness of interdisciplinary healthcare teams to use eHealth technologies to improve patient outcomes. PMID:29854207

An integrated strategy of knowledge application for optimal e-health implementation: A multi-method study protocol

PubMed Central

Gagnon, Marie-Pierre; Légaré, France; Fortin, Jean-Paul; Lamothe, Lise; Labrecque, Michel; Duplantie, Julie

2008-01-01

Background E-health is increasingly valued for supporting: 1) access to quality health care services for all citizens; 2) information flow and exchange; 3) integrated health care services and 4) interprofessional collaboration. Nevertheless, several questions remain on the factors allowing an optimal integration of e-health in health care policies, organisations and practices. An evidence-based integrated strategy would maximise the efficacy and efficiency of e-health implementation. However, decisions regarding e-health applications are usually not evidence-based, which can lead to a sub-optimal use of these technologies. This study aims at understanding factors influencing the application of scientific knowledge for an optimal implementation of e-health in the health care system. Methods A three-year multi-method study is being conducted in the Province of Quebec (Canada). Decision-making at each decisional level (political, organisational and clinical) are analysed based on specific approaches. At the political level, critical incidents analysis is being used. This method will identify how decisions regarding the implementation of e-health could be influenced or not by scientific knowledge. Then, interviews with key-decision-makers will look at how knowledge was actually used to support their decisions, and what factors influenced its use. At the organisational level, e-health projects are being analysed as case studies in order to explore the use of scientific knowledge to support decision-making during the implementation of the technology. Interviews with promoters, managers and clinicians will be carried out in order to identify factors influencing the production and application of scientific knowledge. At the clinical level, questionnaires are being distributed to clinicians involved in e-health projects in order to analyse factors influencing knowledge application in their decision-making. Finally, a triangulation of the results will be done using mixed

Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies.

PubMed

Latulippe, Karine; Hamel, Christine; Giroux, Dominique

2017-04-27

eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users' literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth technologies calls for rigorous consideration of

Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies

PubMed Central

Hamel, Christine; Giroux, Dominique

2017-01-01

Background eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. Objectives The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. Methods Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. Results Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users’ literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. Conclusions eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth

Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

PubMed Central

2013-01-01

Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the changes in ownership required

Authentication Architecture for Region-Wide e-Health System with Smartcards and a PKI

NASA Astrophysics Data System (ADS)

Zúquete, André; Gomes, Helder; Cunha, João Paulo Silva

This paper describes the design and implementation of an e-Health authentication architecture using smartcards and a PKI. This architecture was developed to authenticate e-Health Professionals accessing the RTS (Rede Telemática da Saúde), a regional platform for sharing clinical data among a set of affiliated health institutions. The architecture had to accommodate specific RTS requirements, namely the security of Professionals' credentials, the mobility of Professionals, and the scalability to accommodate new health institutions. The adopted solution uses short-lived certificates and cross-certification agreements between RTS and e-Health institutions for authenticating Professionals accessing the RTS. These certificates carry as well the Professional's role at their home institution for role-based authorization. Trust agreements between e-Health institutions and RTS are necessary in order to make the certificates recognized by the RTS. As a proof of concept, a prototype was implemented with Windows technology. The presented authentication architecture is intended to be applied to other medical telematic systems.

An empowerment-based approach to developing innovative e-health tools for self-management.

PubMed

Alpay, Laurence; van der Boog, Paul; Dumaij, Adrie

2011-12-01

E-health is seen as an important technological tool in achieving self-management; however, there is little evidence of how effective e-health is for self-management. Example tools remain experimental and there is limited knowledge yet about the design, use, and effects of this class of tools. By way of introducing a new view on the development of e-health tools dedicated to self-management we aim to contribute to the discussion for further research in this area. Our assumption is that patient empowerment is an important mechanism of e-health self-management and we suggest incorporating it within the development of self-management tools. Important components of empowerment selected from literature are: communication, education and health literacy, information, self-care, decision aids and contact with fellow patients. All components require skills of both patients and the physicians. In this discussion paper we propose how the required skills can be used to specify effective self-management tools.

CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

PubMed Central

2011-01-01

Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved

Business Modeling to Implement an eHealth Portal for Infection Control: A Reflection on Co-Creation With Stakeholders.

PubMed

van Limburg, Maarten; Wentzel, Jobke; Sanderman, Robbert; van Gemert-Pijnen, Lisette

2015-08-13

It is acknowledged that the success and uptake of eHealth improve with the involvement of users and stakeholders to make technology reflect their needs. Involving stakeholders in implementation research is thus a crucial element in developing eHealth technology. Business modeling is an approach to guide implementation research for eHealth. Stakeholders are involved in business modeling by identifying relevant stakeholders, conducting value co-creation dialogs, and co-creating a business model. Because implementation activities are often underestimated as a crucial step while developing eHealth, comprehensive and applicable approaches geared toward business modeling in eHealth are scarce. This paper demonstrates the potential of several stakeholder-oriented analysis methods and their practical application was demonstrated using Infectionmanager as an example case. In this paper, we aim to demonstrate how business modeling, with the focus on stakeholder involvement, is used to co-create an eHealth implementation. We divided business modeling in 4 main research steps. As part of stakeholder identification, we performed literature scans, expert recommendations, and snowball sampling (Step 1). For stakeholder analyzes, we performed "basic stakeholder analysis," stakeholder salience, and ranking/analytic hierarchy process (Step 2). For value co-creation dialogs, we performed a process analysis and stakeholder interviews based on the business model canvas (Step 3). Finally, for business model generation, we combined all findings into the business model canvas (Step 4). Based on the applied methods, we synthesized a step-by-step guide for business modeling with stakeholder-oriented analysis methods that we consider suitable for implementing eHealth. The step-by-step guide for business modeling with stakeholder involvement enables eHealth researchers to apply a systematic and multidisciplinary, co-creative approach for implementing eHealth. Business modeling becomes an

Business Modeling to Implement an eHealth Portal for Infection Control: A Reflection on Co-Creation With Stakeholders

PubMed Central

Wentzel, Jobke; Sanderman, Robbert; van Gemert-Pijnen, Lisette

2015-01-01

Background It is acknowledged that the success and uptake of eHealth improve with the involvement of users and stakeholders to make technology reflect their needs. Involving stakeholders in implementation research is thus a crucial element in developing eHealth technology. Business modeling is an approach to guide implementation research for eHealth. Stakeholders are involved in business modeling by identifying relevant stakeholders, conducting value co-creation dialogs, and co-creating a business model. Because implementation activities are often underestimated as a crucial step while developing eHealth, comprehensive and applicable approaches geared toward business modeling in eHealth are scarce. Objective This paper demonstrates the potential of several stakeholder-oriented analysis methods and their practical application was demonstrated using Infectionmanager as an example case. In this paper, we aim to demonstrate how business modeling, with the focus on stakeholder involvement, is used to co-create an eHealth implementation. Methods We divided business modeling in 4 main research steps. As part of stakeholder identification, we performed literature scans, expert recommendations, and snowball sampling (Step 1). For stakeholder analyzes, we performed “basic stakeholder analysis,” stakeholder salience, and ranking/analytic hierarchy process (Step 2). For value co-creation dialogs, we performed a process analysis and stakeholder interviews based on the business model canvas (Step 3). Finally, for business model generation, we combined all findings into the business model canvas (Step 4). Results Based on the applied methods, we synthesized a step-by-step guide for business modeling with stakeholder-oriented analysis methods that we consider suitable for implementing eHealth. Conclusions The step-by-step guide for business modeling with stakeholder involvement enables eHealth researchers to apply a systematic and multidisciplinary, co-creative approach for

Associations of eHealth literacy with health-promoting behaviours among hospital nurses: A descriptive cross-sectional study.

PubMed

Cho, Hyeonmi; Han, Kihye; Park, Bu Kyung

2018-07-01

To investigate the associations of eHealth Literacy with health-promoting behaviours among hospital nurses in South Korea. Health-promoting behaviours of nurses are crucial for their own improved health and health-related behaviours of patients. eHealth literacy refers to the ability to search, understand and evaluate health information available online. With the growing use of the Internet, eHealth literacy is emerging as an important factor enhancing health-promoting behaviours. Descriptive cross-sectional design with self-reported questionnaires. Data were collected between March-May 2016 from five hospitals in South Korea. Health-promoting behaviours and eHealth literacy were assessed using Health Promoting Lifestyle Profile-II and K-eHEALS, respectively. Multiple linear regression models were used to examine the associations of eHealth literacy and health-promoting behaviours. Nurses with high level of eHealth literacy had significantly positive overall health-promoting behaviours, stress management, interpersonal relations, self-actualization and health responsibility, but not for nutrition and physical activity. Improving eHealth literacy through various strategies could be an effective way to boost health-promoting behaviours among nurses. However, improvement of actual health-promoting behaviours such as nutrition and physical activity will require systematic and organizational changes. © 2018 John Wiley & Sons Ltd.

Barriers and Facilitators to eHealth Use in Daily Practice: Perspectives of Patients and Professionals in Dermatology.

PubMed

Ariens, Lieneke Fm; Schussler-Raymakers, Florine Ml; Frima, Cynthia; Flinterman, Annebeth; Hamminga, Eefje; Arents, Bernd Wm; Bruijnzeel-Koomen, Carla Afm; de Bruin-Weller, Marjolein S; van Os-Medendorp, Harmieke

2017-09-05

The number of eHealth interventions in the management of chronic diseases such as atopic dermatitis (AD) is growing. Despite promising results, the implementation and use of these interventions is limited. This study aimed to assess opinions of the most important stakeholders influencing the implementation and use of eHealth services in daily dermatology practice. The perspectives of health care professionals and patients towards the implementation and use of eHealth services in daily practice were assessed by using a mixed method design. A cross-sectional survey based on the eHealth implementation toolkit (eHit) was conducted to explore factors influencing the adoption of eHealth interventions offering the possibility of e-consultations, Web-based monitoring, and Web-based self-management training among dermatologists and dermatology nurses. The perspectives of patients with atopic dermatitis (AD) regarding the use of eHealth services were discussed in an online focus group. Health care professionals (n=99) and patients (n=9) acknowledged the value of eHealth services and were willing to use these digital tools in daily dermatology practice. Key identified barriers (statements with <50% of the participants scoring totally agree or agree) in the implementation and adoption of eHealth interventions included concerns about the availability (12/99, 12%) and allocation (14/99, 14%) of resources, financial aspects (26/99, 26%), reliability, security, and confidentially of the intervention itself (29/99, 29%), and the lack of education and training (6/99, 6%). Health care professionals and patients acknowledge the benefits arising from the implementation and use of eHealth services in daily dermatology practice. However, some important barriers were identified that might be useful in addressing the implementation strategy in order to enhance the implementation success of eHealth interventions in dermatology. ©Lieneke FM Ariens, Florine ML Schussler-Raymakers, Cynthia

Expectations and needs of patients with a chronic disease toward self-management and eHealth for self-management purposes.

PubMed

Huygens, Martine W J; Vermeulen, Joan; Swinkels, Ilse C S; Friele, Roland D; van Schayck, Onno C P; de Witte, Luc P

2016-07-08

Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients' expectations and needs regarding self-management and eHealth. The objectives of this study are to investigate expectations and needs of people with a chronic condition regarding self-management and eHealth for self-management purposes, their willingness to use eHealth, and possible differences between patient groups regarding these topics. Five focus groups with people with diabetes (n = 14), COPD (n = 9), and a cardiovascular condition (n = 7) were conducted in this qualitative research. Separate focus groups were organized based on patients' chronic condition. The following themes were discussed: 1) the impact of the chronic disease on patients' daily life; 2) their opinions and needs regarding self-management; and 3) their expectations and needs regarding, and willingness to use, eHealth for self-management purposes. A conventional content analysis approach was used for coding. Patient groups seem to differ in expectations and needs regarding self-management and eHealth for self-management purposes. People with diabetes reported most needs and benefits regarding self-management and were most willing to use eHealth, followed by the COPD group. People with a cardiovascular condition mentioned having fewer needs for self-management support, because their disease had little impact on their life. In all patient groups it was reported that the patient, not the care professional, should choose whether or not to use eHealth. Moreover, participants reported that eHealth should not replace, but complement personal care. Many participants reported expecting feelings of anxiety by doing measurement themselves and uncertainty about follow-up of deviant data of measurements. In addition

E-health strategies to support adherence

USDA-ARS?s Scientific Manuscript database

Adherence to healthy behaviors and self-care strategies is a concern among clinicians. E-health applications, such as the internet, personal communication devices, electronic health records and web portals, and electronic games, may be a way to provide health information in a way that is reliable, c...

eHealth in cardiovascular medicine: A clinical update.

PubMed

Saner, Hugo; van der Velde, Enno

2016-10-01

Demographic changes, progress in medicine technology and regional problems in providing healthcare to low density populations are posing great challenges to our healthcare systems. Rapid progress in computer sciences and information technologies have a great impact on the way healthcare will be delivered in the near future. This article describes opportunities and challenges of eHealth and telemedicine in the framework of our health systems and, in particular, in the context of today's cardiology services. The most promising applications of eHealth and telemedicine include: (a) prevention and lifestyle interventions; (b) chronic disease management including hypertension, diabetes and heart failure; (c) arrhythmia detection including early detection of atrial fibrillation and telemonitoring of devices such as pacemaker, internal cardioverter defibrillators and implantable rhythm monitoring devices; (d) telerehabilitation. Major obstacles to the integration of eHealth and telemedicine into daily clinical practice include limited large-scale evidence, in particular, for cost-effectiveness, as well as lack of interoperability, inadequate or fragmented legal frameworks and lack of reimbursement. An important challenge for those involved in these new technologies will be to keep the main focus on patient's individual needs and to carefully evaluate the evidence behind the practice. © The European Society of Cardiology 2016.

A Model for Usability Evaluation for the Development and Implementation of Consumer eHealth Interventions.

PubMed

Parry, David; Carter, Philip; Koziol-McLain, Jane; Feather, Jacqueline

2015-01-01

Consumer eHealth products are often used by people in their own homes or other settings without dedicated clinical supervision, and often with minimal training and limited support--much as eCommerce and eGovernment applications are currently deployed. Internet based self-care systems have been advocated for over a decade as a way to reduce costs and allow more convenient care, and--because of the expectation that they will be used to reduced health cost--, by increasing self-care and avoiding hospitalization. However, the history of consumer eHealth interventions is mixed, with many unsuccessful implementations. Many consumer eHealth products will form part of a broader complex intervention, with many possible benefits and effects on both individuals and society. This poster describes a model of consumer eHealth assessment based on multiple methods of usability evaluation at different stages in the design and fielding of eHealth systems. We argue that different methods of usability evaluation are able to give valuable insights into the likely effects of an intervention in a way that is congruent with software development processes.

A Proposed Intelligent Policy-Based Interface for a Mobile eHealth Environment

NASA Astrophysics Data System (ADS)

Tavasoli, Amir; Archer, Norm

Users of mobile eHealth systems are often novices, and the learning process for them may be very time consuming. In order for systems to be attractive to potential adopters, it is important that the interface should be very convenient and easy to learn. However, the community of potential users of a mobile eHealth system may be quite varied in their requirements, so the system must be able to adapt easily to suit user preferences. One way to accomplish this is to have the interface driven by intelligent policies. These policies can be refined gradually, using inputs from potential users, through intelligent agents. This paper develops a framework for policy refinement for eHealth mobile interfaces, based on dynamic learning from user interactions.

Tribes and tribulations: interdisciplinary eHealth in providing services for people with a traumatic brain injury (TBI).

PubMed

Hines, M; Brunner, M; Poon, S; Lam, M; Tran, V; Yu, D; Togher, L; Shaw, T; Power, E

2017-11-21

eHealth has potential for supporting interdisciplinary care in contemporary traumatic brain injury (TBI) rehabilitation practice, yet little is known about whether this potential is being realised, or what needs to be done to further support its implementation. The purpose of this study was to explore health professionals' experiences of, and attitudes towards eHealth technologies to support interdisciplinary practice within rehabilitation for people after TBI. A qualitative study using narrative analysis was conducted. One individual interview and three focus groups were conducted with health professionals (n = 17) working in TBI rehabilitation in public and private healthcare settings across regional and metropolitan New South Wales, Australia. Narrative analysis revealed that participants held largely favourable views about eHealth and its potential to support interdisciplinary practice in TBI rehabilitation. However, participants encountered various issues related to (a) the design of, and access to electronic medical records, (b) technology, (c) eHealth implementation, and (d) information and communication technology processes that disconnected them from the work they needed to accomplish. In response, health professionals attempted to make the most of unsatisfactory eHealth systems and processes, but were still mostly unsuccessful in optimising the quality, efficiency, and client-centredness of their work. Attention to sources of disconnection experienced by health professionals, specifically design of, and access to electronic health records, eHealth resourcing, and policies and procedures related to eHealth and interdisciplinary practice are required if the potential of eHealth for supporting interdisciplinary practice is to be realised.

Constructive eHealth evaluation: lessons from evaluation of EHR development in 4 Danish hospitals.

PubMed

Høstgaard, Anna Marie Balling; Bertelsen, Pernille; Nøhr, Christian

2017-04-20

Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented. A case study evaluation of the EHR development process in the North Denmark Region was conducted from 2004 to 2010. The population consisted of clinicians, IT professionals, administrators, and vendors. The study involved 4 hospitals in the region. Data were collected using questionnaires, observations, interviews, and insight gathered from relevant documents. The evaluation showed a need for a) Early involvement of clinicians, b) The best possible representation of clinicians, and c) Workload reduction for those involved. The consequences of not providing this were a lack of ownership of decisions and negative attitudes towards the clinical benefits related to these decisions. Further, the result disclosed that by following the above recommendations, and by providing feedback to the 4 actor groups, the physicians' involvement was improved. As a result they took ownership of decisions and gained a positive attitude to the clinical benefits. The CeHEM has proven successful in formative evaluation of EHR development and can point at important issues that need to be taken care of by management

eHealth literacy in chronic disease patients: An item response theory analysis of the eHealth literacy scale (eHEALS).

PubMed

Paige, Samantha R; Krieger, Janice L; Stellefson, Michael; Alber, Julia M

2017-02-01

Chronic disease patients are affected by low computer and health literacy, which negatively affects their ability to benefit from access to online health information. To estimate reliability and confirm model specifications for eHealth Literacy Scale (eHEALS) scores among chronic disease patients using Classical Test (CTT) and Item Response Theory techniques. A stratified sample of Black/African American (N=341) and Caucasian (N=343) adults with chronic disease completed an online survey including the eHEALS. Item discrimination was explored using bi-variate correlations and Cronbach's alpha for internal consistency. A categorical confirmatory factor analysis tested a one-factor structure of eHEALS scores. Item characteristic curves, in-fit/outfit statistics, omega coefficient, and item reliability and separation estimates were computed. A 1-factor structure of eHEALS was confirmed by statistically significant standardized item loadings, acceptable model fit indices (CFI/TLI>0.90), and 70% variance explained by the model. Item response categories increased with higher theta levels, and there was evidence of acceptable reliability (ω=0.94; item reliability=89; item separation=8.54). eHEALS scores are a valid and reliable measure of self-reported eHealth literacy among Internet-using chronic disease patients. Providers can use eHEALS to help identify patients' eHealth literacy skills. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Interoperable and standard e-Health solution over Bluetooth.

PubMed

Martinez, I; Del Valle, P; Munoz, P; Trigo, J D; Escayola, J; Martínez-Espronceda, M; Muñoz, A; Serrano, L; Garcia, J

2010-01-01

The new paradigm of e-Health demands open sensors and middleware components that permit transparent integration and end-to-end interoperability of new personal health devices. The use of standards seems to be the internationally adopted way to solve these problems. This paper presents the implementation of an end-to-end standards-based e-Health solution. This includes ISO/IEEE11073 standard for the interoperability of the medical devices in the patient environment and EN13606 standard for the interoperable exchange of the Electronic Healthcare Record. The design strictly fulfills all the technical features of the most recent versions of both standards. The implemented prototype has been tested in a laboratory environment to demonstrate its feasibility for its further transfer to the healthcare system.

eHealth Literacy and Web 2.0 Health Information Seeking Behaviors Among Baby Boomers and Older Adults

PubMed Central

Tennant, Bethany; Dodd, Virginia; Chaney, Beth; Chaney, Don; Paige, Samantha; Alber, Julia

2015-01-01

Background Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. Objective The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. Methods A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. Results Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t 217.60=−2.98, P=.003. Younger age (b=−0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R 2 =.17, R 2adj =.14, F9,229=5.277, P<.001). Women were nearly three times more likely than men to use Web 2.0 for health

Engaging Men in Prenatal Health Promotion: A Pilot Evaluation of Targeted e-Health Content

PubMed Central

Mackert, Michael; Guadagno, Marie; Lazard, Allison; Donovan, Erin; Rochlen, Aaron; Garcia, Alexandra; Damásio, Manuel José

2016-01-01

Pregnancy outcomes in the United States continue to rank among the worst in the developed world. Traditional maternal–child health promotion tends to focus exclusively on women, leaving men out of programs that can affect family health. Scholars advocate including men in prenatal health to reduce maternal and infant mortality and morbidity. This study explored the perceived role of men in prenatal health, the use of an e-health application, and participant-suggested ways of improving the application moving forward. This study interviewed men in a large Southwestern U.S. city with an average age of 26.0 years (N = 23). The sample was 52% White, 26% Hispanic, 9% Asian, 9% multiracial or other, and 4% Black. Participants were asked about pregnancy health and used a pregnancy-related e-health application on a tablet computer. Participants provided opinions on content, ease of use of tablets, and recommendations for a stronger application. Despite perceived barriers such as time constraints, financial burdens, and an unclear role, men believe it is important to be involved in pregnancy health. Most found the application to contain useful and interesting information. Participants recommended the addition of videos and interactive modules to make the application stronger. This study explored the use of a targeted e-health application to introduce men to prenatal health education. Results indicate men feel favorable to this type of intervention. Additional refinement of the application could include interactive tools or “push content” to further engage men in this important topic. PMID:27956587

Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

PubMed Central

2014-01-01

Background Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging ‘post-conflict’ contexts. However, analyses on the adoption of technology for health (that is, ‘e-health’) and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. Methods This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger’s diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. Results All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. Conclusions Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post

Association of eHealth Literacy With Colorectal Cancer Knowledge and Screening Practice Among Internet Users in Japan

PubMed Central

2012-01-01

Background In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables. Objective The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices. Methods Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age ± SD, 39.7 ± 10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models. Results eHealth literacy was positively associated with CRC knowledge (β = .116, < .001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI = 1.01–1.05) more likely to undergo CRC screening. Conclusions Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy. PMID:23149453

Association of eHealth literacy with colorectal cancer knowledge and screening practice among internet users in Japan.

PubMed

Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2012-11-13

In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables. The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices. Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age±SD, 39.7±10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models. eHealth literacy was positively associated with CRC knowledge (β=.116, <.001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI=1.01-1.05) more likely to undergo CRC screening. Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy.

Integrity mechanism for eHealth tele-monitoring system in smart home environment.

PubMed

Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

2009-01-01

During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described.

Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review

PubMed Central

2017-01-01

Background Most developing countries, including Uganda, have embraced the use of e-Health and m-Health applications as a means to improve primary healthcare delivery and public health for their populace. In Uganda, the growth in the information and communications technology industry has benefited the rural communities and also created opportunities for new innovations, and their application into healthcare has reported positive results, especially in the areas of disease control and prevention through disease surveillance. However, most are mere proof-of-concepts, only demonstrated in use within a small context and lack sustainability. This study reviews the literature to understand e-Health’s current implementation status within Uganda and documents the barriers and opportunities to sustainable e-Health intervention programmes in Uganda. Methods A structured literature review of e-Health in Uganda was undertaken between May and December 2015 and was complemented with hand searching and a document review of grey literature in the form of policy documents and reports obtained online or from the Ministry of Health’s Resource Centre. Results The searches identified a total of 293 resources of which 48 articles met the inclusion criteria of being in English and describing e-Health implementation in Uganda. These were included in the study and were examined in detail. Conclusion Uganda has trialled several e-Health and m-Health solutions to address healthcare challenges. Most were donor funded, operated in silos and lacked sustainability. Various barriers have been identified. Evidence has shown that e-Health implementations in Uganda have lacked prior planning stages that the literature notes as essential, for example strategy and need readiness assessment. Future research should address these shortcomings prior to introduction of e-Health innovations. PMID:28582996

Predicting Continuance—Findings from a Longitudinal Study of Older Adults Using an eHealth Newsletter

PubMed Central

Forquer, Heather A.; Christensen, John L.; Tan, Andy S.L.

2014-01-01

While eHealth technologies are promisingly efficient and widespread, theoretical frameworks capable of predicting long-term use, termed continuance, are lacking. Attempts to extend prominent information technology (IT) theories to the area of eHealth have been limited by small sample sizes, cross-sectional designs, self-reported as opposed to actual use measures, and a focus on technology adoption rather than continuance. To address these gaps in the literature, the present analysis includes empirical evidence of actual use of an eHealth technology over the course of one year. This large (n=4,570) longitudinal study focuses on older adults, a population with many health needs, and among whom eHealth use may be particularly important. With three measurement points over the course of a year, this study examined the effects of utilitarian and hedonic beliefs on the continued use of an eHealth newsletter using constructs from IT adoption and continuance theories. Additional analyses compared the relative strength of intentions compared to earlier use in predicting later use. Usage intention was strongly predicted by both hedonic beliefs and utilitarian beliefs. In addition, utilitarian beliefs had both direct effects on intention, as well as indirect effects, mediated by hedonic beliefs. While intention predicted subsequent use, earlier use was a significantly stronger predictor of use than intention. These findings make a theoretical contribution to an emerging literature by shedding light on the complex interplay of reasoned action and automaticity in the context of eHealth continuance. PMID:24446900

Predicting continuance-findings from a longitudinal study of older adults using an eHealth newsletter.

PubMed

Forquer, Heather A; Christensen, John L; Tan, Andy S L

2014-01-01

While eHealth technologies are promisingly efficient and widespread, theoretical frameworks capable of predicting long-term use, termed continuance, are lacking. Attempts to extend prominent information technology (IT) theories to the area of eHealth have been limited by small sample sizes, cross-sectional designs, self-reported as opposed to actual use measures, and a focus on technology adoption rather than continuance. To address these gaps in the literature, this analysis includes empirical evidence of actual use of an eHealth technology over the course of one year. This large (n = 4,570) longitudinal study focuses on older adults, a population with many health needs and among whom eHealth use may be particularly important. With three measurement points over the course of a year, this study examined the effects of utilitarian and hedonic beliefs on the continued use of an eHealth newsletter using constructs from IT adoption and continuance theories. Additional analyses compared the relative strength of intentions compared to earlier use in predicting later use. Usage intention was strongly predicted by both hedonic beliefs and utilitarian beliefs. In addition, utilitarian beliefs had both direct effects on intention and indirect effects, mediated by hedonic beliefs. While intention predicted subsequent use, earlier use was a significantly stronger predictor of use than intention. These findings make a theoretical contribution to an emerging literature by shedding light on the complex interplay of reasoned action and automaticity in the context of eHealth continuance.

Behavior Change Techniques in Physical Activity eHealth Interventions for People With Cardiovascular Disease: Systematic Review.

PubMed

Duff, Orlaith Mairead; Walsh, Deirdre Mj; Furlong, Bróna A; O'Connor, Noel E; Moran, Kieran A; Woods, Catherine B

2017-08-02

Cardiovascular disease (CVD) is the leading cause of premature death and disability in Europe, accounting for 4 million deaths per year and costing the European Union economy almost €196 billion annually. There is strong evidence to suggest that exercise-based secondary rehabilitation programs can decrease the mortality risk and improve health among patients with CVD. Theory-informed use of behavior change techniques (BCTs) is important in the design of cardiac rehabilitation programs aimed at changing cardiovascular risk factors. Electronic health (eHealth) is the use of information and communication technologies (ICTs) for health. This emerging area of health care has the ability to enhance self-management of chronic disease by making health care more accessible, affordable, and available to the public. However, evidence-based information on the use of BCTs in eHealth interventions is limited, and particularly so, for individuals living with CVD. The aim of this systematic review was to assess the application of BCTs in eHealth interventions designed to increase physical activity (PA) in CVD populations. A total of 7 electronic databases, including EBSCOhost (MEDLINE, PsycINFO, Academic Search Complete, SPORTDiscus with Full Text, and CINAHL Complete), Scopus, and Web of Science (Core Collection) were searched. Two authors independently reviewed references using the software package Covidence (Veritas Health Innovation). The reviewers met to resolve any discrepancies, with a third independent reviewer acting as an arbitrator when required. Following this, data were extracted from the papers that met the inclusion criteria. Bias assessment of the studies was carried out using the Cochrane Collaboration's tool for assessing the risk of bias within Covidence; this was followed by a narrative synthesis. Out of the 987 studies that were identified, 14 were included in the review. An additional 9 studies were added following a hand search of review paper references

eHealth Intervention for Problematic Internet Use (PIU).

PubMed

Lam, Lawrence T; Lam, Mary K

2016-12-01

Excessive use of the Internet is considered a problematic behaviour by clinicians and researchers. Cognitive behaviour therapy (CBT) has been advocated for a long time as a treatment approach and has been extended to include family therapy in the recent years. As eTherapy (eHealth) has become an important component in the treatment of many mental health problems, it is prudent to explore the current status of the eHealth approach as an intervention option for this problem. This systematic review aims to examine the current development of online intervention programmes for this particular condition. The PRISMA guidelines for systematic reviews and meta-analysis were employed to conduct the search for literature following a systematic and structured approach. Of the 182 articles screened, three satisfied the selection criteria. Information was extracted and analysed systematically for each study and tabulated. All these studies were pilot studies with small sample sizes. Two of these articles aimed to explore the therapeutic efficacy of newly developed online intervention programmes for Internet addiction (IA) and online gaming addiction. The third article described the design and development of an App for smartphone addiction. The results obtained from this review have provided insight into the on-going development of eHealth interventions as well as the health informatics approaches in offering a possible and practical solution to tackle this growing problem.

Searching for a Role of Nursing Personnel in Developing Landscape of Ehealth: Factors Determining Attitudes toward Key Patient Empowering Applications.

PubMed

Duplaga, Mariusz

2016-01-01

Nurses may play an important role in the delivery of medical services based on the use of ehealth tools. Nevertheless, their taking an active role in an ehealth environment depends on their possessing the appropriate skills and mindset. The main objective of this paper was to assess nurses' opinions and to analyze the predictors of their acceptance of ehealth features relevant to patient empowerment with a strong focus on chronic care. A survey was conducted among nurses from hospital centers of south-eastern Poland based on a questionnaire designed to assess their attitudes toward the ehealth domain. The predictors of the nurses' acceptance of ehealth usage within specific contexts were assessed with uni- and multivariate logistic regression. An analysis was performed on data from 648 questionnaires retained after a quality check. The duration of Internet use was consistently related to higher acceptance of ehealth applications and more certainty regarding the reliability of health-related information available on the Internet. Nurses from urban medical centers were more skeptical about the use of specific ehealth solutions. Previous experience in using information technologies is the main factor influencing the acceptance of specific ehealth solutions relevant for care provided to patients suffering from chronic conditions.

Global eHealth, Social Business and Citizen Engagement: A Natural Convergence?

PubMed

Liaw, Siaw-Teng; Marcelo, Alvin; Narasimhan, Padmanesan; Ashraf, Md Mahfuz; Ray, Pradeep

2017-01-01

This paper draws on the vision, mission and experience with the WHO Collaborating Centre on eHealth (WHOCC-eHealth) and Yunus Social Business Health Hub (YSBHH) based at UNSW Australia, and the Asia electronic Health Information Network (AeHIN). Global eHealth aims to provide equitable access to ICT and health care, particularly to the poor, vulnerable and disadvantaged. Social business aims to solve social and economic problem. Its best known product is microcredit financial services for the poor which are small loans that enable them to "produce something, sell something, earn something to develop self-reliance and a life of dignity". Citizen engagement and community participation is integral to both constructs within the context of global partnerships for Integrated People-Centred Health Services (IPCHS) and Sustainable Development Goals (SDGs). The eHealth dimension is consumer heath informatics, social media, mHealth and the Internet of Things. The convergence is multidimensional, mutually beneficial and requires good governance and leadership.

Development of a virtual lab for practical eLearning in eHealth.

PubMed

Herzog, Juliane; Forjan, Mathias; Sauermann, Stefan; Mense, Alexander; Urbauer, Philipp

2015-01-01

In recent years an ongoing development in educational offers for professionals working in the field of eHealth has been observed. This education is increasingly offered in the form of eLearning courses. Furthermore, it can be seen that simulations are a valuable part to support the knowledge transfer. Based on the knowledge profiles defined for eHealth courses a virtual lab should be developed. For this purpose, a subset of skills and a use case is determined. After searching and evaluating appropriate simulating and testing tools six tools were chosen to implement the use case practically. Within an UML use case diagram the interaction between the tools and the user is represented. Initially tests have shown good results of the tools' feasibility. After an extensive testing phase the tools should be integrated in the eHealth eLearning courses.

eHealth in Belgium, a new "secure" federal network: role of patients, health professions and social security services.

PubMed

France, Francis Roger

2011-02-01

eHealth platform is the official federal network in Belgium (created by law on 21 August 2008) devoted to a secure exchange of health data in many types of applications, such as health care purposes, simplification of administrative procedures and contribution to health policy. It implies a controlled access to decentralized databases and uses encrypted personal data. The national identification number has been chosen in order to authenticate the requester, the patient, and the receiver of information exchange. Authorizations have to be respected in order to obtain personal health data. Several questions are raised about its security: the lack of mandatory request for systematic journaling on accesses to the electronic patient record as well as the absence of explicit procedures for sanctions in case of unauthorized access, the new role of social security administration in managing security where a eHealth manager can be both judge and party (in the function of trusted third party for health data encryption and of a required lawyer for texts proposed by physicians to the Commission for the protection of private life). Another critic concerns the number of physicians in minority and the absence of patients' delegates in the eHealth Board. At a time when the patient is becoming a partner in the care team, should not he be the gate-keeper for the access to his own health record? How could networks help him to get the appropriate knowledge to contribute to care and to write his testament of life? Recent laws (on private life, patient rights and euthanasia) have contributed to a behavioural change in citizens and physician attitudes. Recommendations are made in order to improve the acceptability of eHealth platform. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

eHealth services and Directive on Electronic Commerce 2000/31/EC.

PubMed

Van Gyseghem, Jean-Marc

2008-01-01

We often restrict the analysis of eHealth services to a concept of privacy. In this article, we'll demonstrate that other legislation can apply to those services as Directive 2000/31/EC on Ecommerce. By creating telematic networks or infrastructure, eHealth services are offering information services. But what are the consequences with such concept? What are the duties and rights for the actors of the network(s)? We'll try to answer to some questions, even if it won't be exhaustive.

Cyber-Management of People with Chronic Disease: A Potential Solution to eHealth Challenges

ERIC Educational Resources Information Center

Laakso, E-Liisa; Armstrong, Kylie; Usher, Wayne

2012-01-01

The evolving eHealth agenda presents a range of potential opportunities for the management and prevention of chronic disease. This paper identifies issues and barriers to the uptake of eHealth and describes a strategy ("Healthy Outcomes for Australians"[C]-HOFA) for creating a central knowledge filter and cyber space method for tracking…

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

PubMed

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity H K; Seddoh, Janet

2005-12-20

The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

PubMed Central

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity HK; Seddoh, Janet

2005-01-01

Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. Results There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income

Using a screening tool to evaluate potential use of e-health services for older people with and without cognitive impairment.

PubMed

Malinowsky, Camilla; Nygård, Louise; Kottorp, Anders

2014-01-01

E-health services are increasingly offered to provide clients with information and a link to healthcare services. The aim of this study is to investigate the perceived access to and the potential to use technologies important for e-health services among older adults with mild cognitive impairment (MCI) or mild Alzheimer's disease (AD) and controls. The perceived access to and perception of difficulty in the use of everyday technology (such as cell phones, coffee machines, computers) was investigated in a sample of older adults (n = 118) comprising three subsamples: adults with MCI (n = 37), with mild AD (n = 37), and controls (n = 44) using the Everyday Technology Use Questionnaire (ETUQ). The use of seven technologies important for e-health services was specifically examined for each subsample and compared between the subsamples. The findings demonstrated that the older adults in all subsamples perceive access to e-health technologies and potentially would use them competently in several e-health services. However, among persons with AD a lower proportion of perceived access to the technology was described, as well as for persons with MCI. To make the benefits of e-health services available and used by all clients, it is important to consider access to the technology required in e-health services and also to support the clients' capabilities to understand and use the technologies. Also, the potential use of the ETUQ to explore the perceived access to and competence in using e-health technologies is a vital issue in the use of e-health services.

Impact of Patient-centered eHealth Applications on Patient Outcomes: A Review on the Mediating Influence of Human Factor Issues.

PubMed

Wildenbos, G A; Peute, L W; Jaspers, M W M

2016-11-10

To examine the evidence of the impact of patient- centered eHealth applications on patient care and to analyze if and how reported human factor issues mediated the outcomes. We searched PubMed (2014-2015) for studies evaluating the impact of patient-centered eHealth applications on patient care (behavior change, self-efficacy, and patient health-related outcomes). The Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model was used as a guidance framework to identify the reported human factors possibly impacting the effectiveness of an eHealth intervention. Of the 348 potentially relevant papers, 10 papers were included for data analysis. None of the 10 papers reported a negative impact of the eHealth intervention. Seven papers involved a randomized controlled trial (RCT) study. Six of these RCTs reported a positive impact of the eHealth intervention on patient care. All 10 papers reported on human factor issues possibly mediating effects of patient-centered eHealth. Human factors involved patient characteristics, perceived social support, and (type of) interaction between patient and provider. While the amount of patient-centered eHealth interventions increases, many questions remain as to whether and to what extent human factors mediate their use and impact. Future research should adopt a formal theory-driven approach towards human factors when investigating those factors' influence on the effectiveness of these interventions. Insights could then be used to better tailor the content and design of eHealth solutions according to patient user profiles, so as to enhance eHealth interventions impact on patient behavior, self-efficacy, and health-related outcomes.

Analysis of QoS Requirements for e-Health Services and Mapping to Evolved Packet System QoS Classes

PubMed Central

Skorin-Kapov, Lea; Matijasevic, Maja

2010-01-01

E-Health services comprise a broad range of healthcare services delivered by using information and communication technology. In order to support existing as well as emerging e-Health services over converged next generation network (NGN) architectures, there is a need for network QoS control mechanisms that meet the often stringent requirements of such services. In this paper, we evaluate the QoS support for e-Health services in the context of the Evolved Packet System (EPS), specified by the Third Generation Partnership Project (3GPP) as a multi-access all-IP NGN. We classify heterogeneous e-Health services based on context and network QoS requirements and propose a mapping to existing 3GPP QoS Class Identifiers (QCIs) that serve as a basis for the class-based QoS concept of the EPS. The proposed mapping aims to provide network operators with guidelines for meeting heterogeneous e-Health service requirements. As an example, we present the QoS requirements for a prototype e-Health service supporting tele-consultation between a patient and a doctor and illustrate the use of the proposed mapping to QCIs in standardized QoS control procedures. PMID:20976301

The divided communities of shared concerns: mapping the intellectual structure of e-Health research in social science journals.

PubMed

Jiang, L Crystal; Wang, Zhen-Zhen; Peng, Tai-Quan; Zhu, Jonathan J H

2015-01-01

Social scientific approach has become an important approach in e-Health studies over the past decade. However, there has been little systematical examination of what aspects of e-Health social scientists have studied and how relevant and informative knowledge has been produced and diffused by this line of inquiry. This study performed a systematic review of the body of e-Health literature in mainstream social science journals over the past decade by testing the applicability of a 5A categorization (i.e., access, availability, appropriateness, acceptability, and applicability), proposed by the U.S. Department of Health and Human Services, as a framework for understanding social scientific research in e-Health. This study used a quantitative, bottom-up approach to review the e-Health literature in social sciences published from 2000 to 2009. A total of 3005 e-Health studies identified from two social sciences databases (i.e., Social Sciences Citation Index and Arts & Humanities Citation Index) were analyzed with text topic modeling and structural analysis of co-word network, co-citation network, and scientific food web. There have been dramatic increases in the scale of e-Health studies in social sciences over the past decade in terms of the numbers of publications, journal outlets and participating disciplines. The results empirically confirm the presence of the 5A clusters in e-Health research, with the cluster of applicability as the dominant research area and the cluster of availability as the major knowledge producer for other clusters. The network analysis also reveals that the five distinctive clusters share much more in common in research concerns than what e-Health scholars appear to recognize. It is time to explicate and, more importantly, tap into the shared concerns cutting across the seemingly divided scholarly communities. In particular, more synergy exercises are needed to promote adherence of the field. Copyright © 2014 Elsevier Ireland Ltd. All

Closing the "Know-Do" Gap: eHealth Strategies for the Global South.

PubMed

2008-01-01

For years, the Internet has been the new black, the "in" thing, the must have. And the virtual fever is spreading. According to the World Bank, global Internet use more than quadrupled between 2000 and 2005, from 15 users per 1000 population to 67.[1] Yet, many Global South countries are stalled on the Information Superhighway: the same World Bank report found that only 15 per 1000 population in sub-Saharan Africa are connected to the Internet, and only 21 per1000 in South Asia. To say nothing of glaring access inequalities within countries, lack of foreign investment in the communications sector of developing nations, and deficient connectivity in key areas of national infrastructure - schools, government centers, and health facilities. Yet the same World Bank report noted that eHealth initiatives ranked last in a list of technology strategies among countries surveyed.[1].

Can eHealth tools enable health organizations to reach their target audience?

PubMed

Zbib, Ahmad; Hodgson, Corinne; Calderwood, Sarah

2011-01-01

Data from the health risk assessment operated by the Heart and Stroke Foundation found users were more likely to be female; married; have completed post secondary education; and report hypertension, stroke, or being overweight or obese. In developing and operating eHealth tools for health promotion, organizations should compare users to their target population(s). eHealth tools may not be optimal for reaching some higher-risk sub-groups, and a range of social marketing approaches may be required.

Forging e-health partnerships: strategic perspectives from international executives.

PubMed

Caro, Denis H J

2005-01-01

International executives underscore the key management frontiers of strategic e-health partnerships between information and communication technology and health care sectors for innovative growth, systems integration, and social responsibility.

The Acceptance of e-Health Solutions Among Patients with Chronic Respiratory Conditions

PubMed Central

2013-01-01

Abstract Objective: The main objective of this study was to assess the acceptance of the use of e-health applications by patients suffering from bronchial asthma and other chronic respiratory conditions. Subjects and Methods: The questionnaire, consisting of 73 items, was distributed among 200 patients remaining under the care of a tertiary-care pulmonology center in Krakow, Poland (return rate, 82.5%; n=165). Results: The mean age (standard deviation) of respondents was 50.8 (14.9) years. Of the respondents, 48.5% (n=80) suffered from bronchial asthma, 29.1% (n=48) from chronic obstructive pulmonary disease, and 32.1% (n=53) from other respiratory diseases. The Internet was used by 58.2% (n=96) of respondents. The most frequent types of health-related information searched for online included diseases (59.4%) and treatments (medication, 54.2%; treatment options, 58.3%), as well as information about physicians and healthcare institutions (32.3% and 31.3%, respectively). The differences between acceptance scores for specific e-health applications were significant (analysis of variance, Friedman chi-squared=166.315, p<0.001). The respondents revealed the highest acceptance of e-health solutions allowing them to book appointments with physicians, access laboratory test results, view educational resources, and renew prescriptions. The acceptance of the most popular e-health applications depended on the duration of disease, respondent's age and education, and his or her use of computers and the Internet. Conclusions: Patients suffering from chronic respiratory conditions demonstrate higher levels of acceptance of e-health applications such as appointment booking, prescription renewal, and access to information (laboratory test results, educational resources) than of solutions directly related to medical care (communication with healthcare providers, disease monitoring). PMID:23734700

eHealth Search Patterns: A Comparison of Private and Public Health Care Markets Using Online Panel Data

PubMed Central

2017-01-01

Background Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics. Objectives The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market. Methods A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets. Results The health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website. Conclusions The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in

eHealth Search Patterns: A Comparison of Private and Public Health Care Markets Using Online Panel Data.

PubMed

Schneider, Janina Anne; Holland, Christopher Patrick

2017-04-13

Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics. The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market. A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets. The health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website. The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per

A Cloud Based Real-Time Collaborative Platform for eHealth.

PubMed

Ionescu, Bogdan; Gadea, Cristian; Solomon, Bogdan; Ionescu, Dan; Stoicu-Tivadar, Vasile; Trifan, Mircea

2015-01-01

For more than a decade, the eHealth initiative has been a government concern of many countries. In an Electronic Health Record (EHR) System, there is a need for sharing the data with a group of specialists simultaneously. Collaborative platforms alone are just a part of a solution, while a collaborative platform with parallel editing capabilities and with synchronized data streaming are stringently needed. In this paper, the design and implementation of a collaborative platform used in healthcare is introduced by describing the high level architecture and its implementation. A series of eHealth services are identified and usage examples in a healthcare environment are given.

Self-managed eHealth Disease Monitoring in Children and Adolescents with Inflammatory Bowel Disease: A Randomized Controlled Trial.

PubMed

Carlsen, Katrine; Jakobsen, Christian; Houen, Gunnar; Kallemose, Thomas; Paerregaard, Anders; Riis, Lene B; Munkholm, Pia; Wewer, Vibeke

2017-03-01

To evaluate the impact of eHealth on disease activity, the need for hospital contacts, and medical adherence in children and adolescents with inflammatory bowel disease (IBD). Furthermore, to assess eHealth's influence on school attendance and quality of life (QoL). Patients with IBD, 10 to 17 years attending a public university hospital, were prospectively randomized to a 2-year open label case-controlled eHealth intervention. The eHealth-group used the web-application young.constant-care.com (YCC) on a monthly basis and in case of flare-ups, and were seen at one annual preplanned outpatient visit. The control-group continued standard visits every third month. Every 3 months, both groups had blood and fecal calprotectin tested and the following were assessed: escalation in medication, disease activity, hospital contacts, medical adherence, school absence, and QoL. Fifty-three patients in nonbiological treatment were included (27 eHealth/26 control). We found no differences between the groups regarding escalation in treatment and disease activity (symptoms, fecal calprotectin, and blood). The number of total outpatient visits (mean: eHealth 3.26, SEM 0.51; control 7.31, SEM 0.69; P < 0.0001) and IBD-related school absence (mean days: eHealth 1.6, SEM 0.5; control 16.5, SEM 4.4; P < 0.002) was significantly lower in the eHealth-group. No differences in medical adherence and QoL were found. Adherence to YCC was 81% (384 of the 475 expected entries). None of the patients or parents felt unsafe using the eHealth system. The use of eHealth in children and adolescents with IBD is feasible, does not lead to impaired disease control, and can be managed by the patients without risk of increased disease activity.

Applying national survey results for strategic planning and program improvement: the National Diabetes Education Program.

PubMed

Griffey, Susan; Piccinino, Linda; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane

2015-02-01

Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs.

Integration of eHealth Tools in the Process of Workplace Health Promotion: Proposal for Design and Implementation.

PubMed

Jimenez, Paulino; Bregenzer, Anita

2018-02-23

Electronic health (eHealth) and mobile health (mHealth) tools can support and improve the whole process of workplace health promotion (WHP) projects. However, several challenges and opportunities have to be considered while integrating these tools in WHP projects. Currently, a large number of eHealth tools are developed for changing health behavior, but these tools can support the whole WHP process, including group administration, information flow, assessment, intervention development process, or evaluation. To support a successful implementation of eHealth tools in the whole WHP processes, we introduce a concept of WHP (life cycle model of WHP) with 7 steps and present critical and success factors for the implementation of eHealth tools in each step. We developed a life cycle model of WHP based on the World Health Organization (WHO) model of healthy workplace continual improvement process. We suggest adaptations to the WHO model to demonstrate the large number of possibilities to implement eHealth tools in WHP as well as possible critical points in the implementation process. eHealth tools can enhance the efficiency of WHP in each of the 7 steps of the presented life cycle model of WHP. Specifically, eHealth tools can support by offering easier administration, providing an information and communication platform, supporting assessments, presenting and discussing assessment results in a dashboard, and offering interventions to change individual health behavior. Important success factors include the possibility to give automatic feedback about health parameters, create incentive systems, or bring together a large number of health experts in one place. Critical factors such as data security, anonymity, or lack of management involvement have to be addressed carefully to prevent nonparticipation and dropouts. Using eHealth tools can support WHP, but clear regulations for the usage and implementation of these tools at the workplace are needed to secure quality and reach

Integration of eHealth Tools in the Process of Workplace Health Promotion: Proposal for Design and Implementation

PubMed Central

2018-01-01

Background Electronic health (eHealth) and mobile health (mHealth) tools can support and improve the whole process of workplace health promotion (WHP) projects. However, several challenges and opportunities have to be considered while integrating these tools in WHP projects. Currently, a large number of eHealth tools are developed for changing health behavior, but these tools can support the whole WHP process, including group administration, information flow, assessment, intervention development process, or evaluation. Objective To support a successful implementation of eHealth tools in the whole WHP processes, we introduce a concept of WHP (life cycle model of WHP) with 7 steps and present critical and success factors for the implementation of eHealth tools in each step. Methods We developed a life cycle model of WHP based on the World Health Organization (WHO) model of healthy workplace continual improvement process. We suggest adaptations to the WHO model to demonstrate the large number of possibilities to implement eHealth tools in WHP as well as possible critical points in the implementation process. Results eHealth tools can enhance the efficiency of WHP in each of the 7 steps of the presented life cycle model of WHP. Specifically, eHealth tools can support by offering easier administration, providing an information and communication platform, supporting assessments, presenting and discussing assessment results in a dashboard, and offering interventions to change individual health behavior. Important success factors include the possibility to give automatic feedback about health parameters, create incentive systems, or bring together a large number of health experts in one place. Critical factors such as data security, anonymity, or lack of management involvement have to be addressed carefully to prevent nonparticipation and dropouts. Conclusions Using eHealth tools can support WHP, but clear regulations for the usage and implementation of these tools at the

eHealth Networking Information Systems - The New Quality of Information Exchange.

PubMed

Messer-Misak, Karin; Reiter, Christoph

2017-01-01

The development and introduction of platforms that enable interdisciplinary exchange on current developments and projects in the area of eHealth have been stimulated by different authorities. The aim of this project was to develop a repository of eHealth projects that will make the wealth of eHealth projects visible and enable mutual learning through the sharing of experiences and good practice. The content of the database and search criteria as well as their categories were determined in close co-ordination and cooperation with stakeholders from the specialist areas. Technically, we used Java Server Faces (JSF) for the implementation of the frontend of the web application. Access to structured information on projects can support stakeholders to combining skills and knowledge residing in different places to create new solutions and approaches within a network of evolving competencies and opportunities. A regional database is the beginning of a structured collection and presentation of projects, which can then be incorporated into a broader context. The next step will be to unify this information transparently.

The potential of eHealth in otorhinolaryngology-head and neck surgery: patients' perspectives.

PubMed

Holderried, Martin; Ernst, C; Holderried, F; Rieger, M; Blumenstock, G; Tropitzsch, A

2017-07-01

The use of modern information and communication technologies (ICT) in daily life has significantly increased during the last several years. These essential online technologies have also found their way into the healthcare system. The use of modern ICT for health reasons can be summarized by the term 'eHealth'. Despite the potential importance of eHealth in the field of otorhinolaryngology (ORL), there is little understanding of patients' attitudes towards the deeper integration of these technologies into intersectoral care. The aim of this study was to gain a better understanding of patients' attitudes towards the use of modern ICT for intersectoral communication and information transfer in the field of ORL. Therefore, a structured interview was developed by an interdisciplinary team of otorhinolaryngologists, public health researchers, and information technology (IT) specialists. Overall, 211 ORL patients were interviewed at the Department of Otorhinolaryngology-Head and Neck Surgery, Tuebingen University Hospital, Germany, and 203 of these patients completed the interview. This study revealed ORL patients' perspectives on the potential of eHealth, especially for appointment scheduling, appointment reminders, and intersectoral communication of personal medical information. Furthermore, this study provides evidence that data security and the impacts of eHealth on the physician-patient relationship and on treatment quality warrant special attention in future research.

Secure and Efficient Two-Factor User Authentication Scheme with User Anonymity for Network Based E-Health Care Applications.

PubMed

Li, Xiong; Niu, Jianwei; Karuppiah, Marimuthu; Kumari, Saru; Wu, Fan

2016-12-01

Benefited from the development of network and communication technologies, E-health care systems and telemedicine have got the fast development. By using the E-health care systems, patient can enjoy the remote medical service provided by the medical server. Medical data are important privacy information for patient, so it is an important issue to ensure the secure of transmitted medical data through public network. Authentication scheme can thwart unauthorized users from accessing services via insecure network environments, so user authentication with privacy protection is an important mechanism for the security of E-health care systems. Recently, based on three factors (password, biometric and smart card), an user authentication scheme for E-health care systems was been proposed by Amin et al., and they claimed that their scheme can withstand most of common attacks. Unfortunate, we find that their scheme cannot achieve the untraceability feature of the patient. Besides, their scheme lacks a password check mechanism such that it is inefficient to find the unauthorized login by the mistake of input a wrong password. Due to the same reason, their scheme is vulnerable to Denial of Service (DoS) attack if the patient updates the password mistakenly by using a wrong password. In order improve the security level of authentication scheme for E-health care application, a robust user authentication scheme with privacy protection is proposed for E-health care systems. Then, security prove of our scheme are analysed. Security and performance analyses show that our scheme is more powerful and secure for E-health care systems when compared with other related schemes.

The impact of eHealth on the quality and safety of health care: a systematic overview.

PubMed

Black, Ashly D; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

2011-01-18

There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment

The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview

PubMed Central

Black, Ashly D.; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

2011-01-01

Background There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. Methods and Findings We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective

The use of eHealth to promote physical activity in cancer survivors: a systematic review.

PubMed

Haberlin, Ciarán; O'Dwyer, Tom; Mockler, David; Moran, Jonathan; O'Donnell, Dearbhaile M; Broderick, Julie

2018-06-16

Achieving adequate levels of physical activity (PA) and avoiding sedentary behaviour are particularly important in cancer survivors. eHealth, which includes, but is not limited to, the delivery of health information through Internet and mobile technologies, is an emerging concept in healthcare which may present opportunities to improve PA in cancer survivors. The aim of this systematic review was to explore the effects of eHealth in the promotion of PA among cancer survivors. Suitable articles were searched using PubMed, CINAHL, EMBASE, PsychInfo, Web of Science and SCOPUS databases using a combination of keywords and medical subject headings. Articles were included if they described an eHealth intervention designed to improve PA in cancer survivors. Two reviewers screened studies for inclusion. In total, 1065 articles were considered. Ten studies met eligibility criteria. A variety of platforms designed to increase PA were described in these studies: web application (app) (n = 5), web and mobile application (n = 2), mobile app (n = 1), website only (n = 1), e-mail based (n = 1). All studies measured PA using self-report outcome measures with the exception of one study which measured steps using a Fitbit. Meta-analysis was not performed because of variations in study design and interventions. All studies reported improvements in PA, with 8/10 studies reporting statistically significant changes. The use of eHealth to promote PA in cancer survivors is a relatively new concept, which is supported by the recent emergent evidence described in this review. eHealth shows promise as a means of promoting and increasing daily PA, but further high-quality, longer term studies are needed to establish the feasibility and effectiveness of eHealth platforms aimed at that goal.

Knowledge and attitudes of doctors towards e-health use in healthcare delivery in government and private hospitals in Northern Uganda: a cross-sectional study.

PubMed

Olok, Geoffrey Tabo; Yagos, Walter Onen; Ovuga, Emilio

2015-11-04

E-health is an essential information sharing tool in healthcare management and delivery worldwide. However, utilization of e-health may only be possible if healthcare professionals have positive attitudes towards e-health. This study aimed to determine the relationships between healthcare professionals' attitudes towards e-health, level of ICT skills and e-Health use in healthcare delivery in government and private hospitals in northern Uganda. Cross-sectional survey design was used. Sixty-eight medical doctors in three government hospitals and four private hospitals in Northern Uganda participated in the study. A pretested self-administered questionnaire was used to collect the required data. Data was analysed using SPSS software Version 19. Out of the 68 respondents, 39 (57.4 %) reported access to computer and 29 (48.5 %) accessed Internet in the workplace. Majority of healthcare professionals had positive attitudes towards e-health attributes (mean 3.5). The level of skills was moderate (mean 3.66), and was the most important and significant predictor of ICT use among healthcare professionals (r = .522, p < .001); however, attitudes towards e-health attributes did not contribute significantly in predicting e-health use. The findings suggest need for hospitals managements to strengthen e-health services in healthcare delivery in Northern Uganda.

National School Lunch Program

ERIC Educational Resources Information Center

US Department of Agriculture, 2009

2009-01-01

The National School Lunch Program is a federally assisted meal program operating in over 101,000 public and non-profit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to more than 30.5 million children each school day in 2008. In 1998, Congress expanded the National School Lunch…

"Initiate-build-operate-transfer" - a strategy for establishing sustainable telemedicine programs not only in the developing countries.

PubMed

Latifi, Rifat

2011-01-01

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in the Balkans has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in Kosova. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy developed by IVeH "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services not only in developing countries, but in developed countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs is described. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the very core of healthcare infrastructure. The end point is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova and Albania has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program is transitioned to the Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Macedonia, Montenegro and other countries

Intensifying Innovation Adoption in Educational eHealth

ERIC Educational Resources Information Center

Rissanen, M. K.

2014-01-01

In demanding innovation areas such as eHealth, the primary emphasis is easily placed on the product and process quality aspects in the design phase. Customer quality may receive adequate attention when the target audience is well-defined. But if the multidimensional evaluative focus does not get enough space until the implementation phase, this…

The Promise and Challenge of eHealth Interventions.

ERIC Educational Resources Information Center

Atkinson, Nancy L.; Gold, Robert S.

2002-01-01

Discusses how health education researchers can use the Internet to both intervene in health behavior and evaluate the effects of interventions (eHealth), describing the potential of computer technology for behavior interventions via message tailoring, intervention tailoring, simulations, games, and online communities, and noting implementation…

A methodological and operative framework for the evaluation of an e-health project.

PubMed

Buccoliero, Luca; Calciolari, Stefano; Marsilio, Marta

2008-01-01

Assessing public sector ICT investments represents the premise for successful implementation of an e-health strategy. The recent literature stresses the importance of going beyond the mere financial and/or technical dimensions of the analysis. Consequently, the paper proposes an example of e-health project evaluation aiming to develop measures which get close to the notion of benefits to the different stakeholders involved: top management, patients, local community. The case study refers to an Italian health care organization that implemented a project of digitalization of its clinical reports production few years ago. Based on on-field research, different approaches are used to assess costs and benefits from different stakeholders' perspectives. The results of a multidimensional evaluation are reported to emphasize the need for different measures to assess the sustainability of an e-health project according to the financial convenience, the social role of the organization, and the contingent situation.

Enhancing the provision of health and social care in Europe through eHealth.

PubMed

De Raeve, P; Gomez, S; Hughes, P; Lyngholm, T; Sipilä, M; Kilanska, D; Hussey, P; Xyrichis, A

2017-03-01

To report on the outcomes of the European project ENS4Care, which delivered evidence-based guidelines enabling implementation of eHealth services in nursing and social care. Within a policy context of efficiency, safety and quality in health care, this project brought together a diverse group of stakeholders from academia, industry, patient and professional organizations to lead the development of five eHealth guidelines in the areas of prevention, clinical practice, integrated care, advanced roles and nurse ePrescribing. Data were collected through a cross-sectional, online, questionnaire survey of health professionals from 21 countries. Quantitative data were analysed using descriptive and summary statistics, while comments to open questions underwent a process of content analysis. Representing an evidence-based consensus statement, the five guidelines outline key steps and considerations for the deployment of eHealth services at different levels of enablement. Through analysis of the data, and sharing of best practices, common deployment processes and implementation lessons were identified. Findings reveal the richness, diversity and potential that eHealth holds for enabling the delivery of safer, more efficient and patient-centred health care. Nurses and social care workers as the main proprietors of such practices hold the key to a healthier future for citizens across Europe. The preparation, agreement and dissemination of the ENS4Care guidelines will enable European Union leaders to diagnose the organizational changes needed and prescribe the development of new skills and roles in the workforce to meet the challenge of eHealth. Nurses and social care workers, with the right knowledge and skills will add considerable value and form an important link between technological innovation, health promotion and disease prevention. © 2016 International Council of Nurses.

Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance

PubMed Central

2017-01-01

Background The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. Objective The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. Methods Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. Results We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). Conclusions To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did

How can research keep up with eHealth? Ten strategies for increasing the timeliness and usefulness of eHealth research.

PubMed

Baker, Timothy B; Gustafson, David H; Shah, Dhavan

2014-02-19

eHealth interventions appear and change so quickly that they challenge the way we conduct research. By the time a randomized trial of a new intervention is published, technological improvements and clinical discoveries may make the intervention dated and unappealing. This and the spate of health-related apps and websites may lead consumers, patients, and caregivers to use interventions that lack evidence of efficacy. This paper aims to offer strategies for increasing the speed and usefulness of eHealth research. The paper describes two types of strategies based on the authors' own research and the research literature: those that improve the efficiency of eHealth research, and those that improve its quality. Efficiency strategies include: (1) think small: conduct small studies that can target discrete but significant questions and thereby speed knowledge acquisition; (2) use efficient designs: use such methods as fractional-factorial and quasi-experimental designs and surrogate endpoints, and experimentally modify and evaluate interventions and delivery systems already in use; (3) study universals: focus on timeless behavioral, psychological, and cognitive principles and systems; (4) anticipate the next big thing: listen to voices outside normal practice and connect different perspectives for new insights; (5) improve information delivery systems: researchers should apply their communications expertise to enhance inter-researcher communication, which could synergistically accelerate progress and capitalize upon the availability of "big data"; and (6) develop models, including mediators and moderators: valid models are remarkably generative, and tests of moderation and mediation should elucidate boundary conditions of effects and treatment mechanisms. Quality strategies include: (1) continuous quality improvement: researchers need to borrow engineering practices such as the continuous enhancement of interventions to incorporate clinical and technological progress; (2

How Can Research Keep Up With eHealth? Ten Strategies for Increasing the Timeliness and Usefulness of eHealth Research

PubMed Central

2014-01-01

Background eHealth interventions appear and change so quickly that they challenge the way we conduct research. By the time a randomized trial of a new intervention is published, technological improvements and clinical discoveries may make the intervention dated and unappealing. This and the spate of health-related apps and websites may lead consumers, patients, and caregivers to use interventions that lack evidence of efficacy. Objective This paper aims to offer strategies for increasing the speed and usefulness of eHealth research. Methods The paper describes two types of strategies based on the authors’ own research and the research literature: those that improve the efficiency of eHealth research, and those that improve its quality. Results Efficiency strategies include: (1) think small: conduct small studies that can target discrete but significant questions and thereby speed knowledge acquisition; (2) use efficient designs: use such methods as fractional-factorial and quasi-experimental designs and surrogate endpoints, and experimentally modify and evaluate interventions and delivery systems already in use; (3) study universals: focus on timeless behavioral, psychological, and cognitive principles and systems; (4) anticipate the next big thing: listen to voices outside normal practice and connect different perspectives for new insights; (5) improve information delivery systems: researchers should apply their communications expertise to enhance inter-researcher communication, which could synergistically accelerate progress and capitalize upon the availability of “big data”; and (6) develop models, including mediators and moderators: valid models are remarkably generative, and tests of moderation and mediation should elucidate boundary conditions of effects and treatment mechanisms. Quality strategies include: (1) continuous quality improvement: researchers need to borrow engineering practices such as the continuous enhancement of interventions to

Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice.

PubMed

Keasberry, Justin; Scott, Ian A; Sullivan, Clair; Staib, Andrew; Ashby, Richard

2017-12-01

alert fatigue, increased technology interaction time, creation of disruptive workarounds and new prescribing errors. Conclusion eHealth technologies in hospital settings appear to improve efficiency and appropriateness of care, prescribing safety and disease control. Effects on mortality, readmissions, total costs and patient and provider experience remain uncertain. What is known about the topic? Healthcare systems internationally are undertaking large-scale digitisation programs with hospitals being a major focus. Although predictive analyses suggest that eHealth technologies have the potential to markedly transform health care delivery, contemporary peer-reviewed research evidence detailing their benefits and harms is limited. What does this paper add? This narrative overview of 19 systematic reviews and two reviews of systematic reviews published over the past 5 years provides a summary of cumulative evidence of clinical and organisational effects of contemporary eHealth technologies in hospital practice. EMRs have the potential to increase accuracy and completeness of clinical information, reduce documentation time and enhance information transfer and organisational efficiency. CPOE appears to improve laboratory turnaround times and decrease resource utilisation. ePrescribing significantly reduces medication errors and adverse drug events. CDSS, especially those used at the point of care and integrated into workflows, attract the strongest evidence for substantially increasing clinician adherence to guidelines, appropriateness of disease and treatment monitoring and optimal medication use. Evidence of effects of eHealth technologies on discrete clinical outcomes, such as morbid events, mortality and readmissions, is currently limited and conflicting. What are the implications for practitioners? eHealth technologies confer benefits in improving quality and safety of care with little evidence of major hazards. Whether EMRs and CPOE can affect clinical outcomes or

Implementation of safety driving system using e-health and telematics technology.

PubMed

Lee, Youngbum; Lee, Myoungho

2008-08-01

This research aimed to develop a safety driving system using e-health and telematics technology. Biosignal sensors were installed in an automobile to check the driver's health status with an automatic diagnosis system providing health information to the driver. Measured data were sent to the e-health center through a telematics device, and a medical doctor analyzed these data, sending diagnosis and prescription information to the driver. This system recognizes the driver's sleeping, drinking impairment, excitability, and fatigue using biosensors. The system initially provides alerts in the automobile. It also controls the driving environment in the car, searches for a highway service area using Global Positioning System (GPS), and provides additional information for safety driving. If a car accident has occurred, it makes an emergency call to the nearest hospital, emergency center, and insurance company. A conceptual and prototype model for an imbedded system is presented with initial data for driver condition. Such a system could prevent car accidents caused by drivers driving while intoxicated and falling asleep at the wheel using the driver's biosignals measured by biosensors. The system can provide various e-health services using a telematics system to enhance the technical compatibility of the automobile.

Patient-Centered e-Health Record over the Cloud.

PubMed

Koumaditis, Konstantinos; Themistocleous, Marinos; Vassilacopoulos, George; Prentza, Andrianna; Kyriazis, Dimosthenis; Malamateniou, Flora; Maglaveras, Nicos; Chouvarda, Ioanna; Mourouzis, Alexandros

2014-01-01

The purpose of this paper is to introduce the Patient-Centered e-Health (PCEH) conceptual aspects alongside a multidisciplinary project that combines state-of-the-art technologies like cloud computing. The project, by combining several aspects of PCEH, such as: (a) electronic Personal Healthcare Record (e-PHR), (b) homecare telemedicine technologies, (c) e-prescribing, e-referral, e-learning, with advanced technologies like cloud computing and Service Oriented Architecture (SOA), will lead to an innovative integrated e-health platform of many benefits to the society, the economy, the industry, and the research community. To achieve this, a consortium of experts, both from industry (two companies, one hospital and one healthcare organization) and academia (three universities), was set to investigate, analyse, design, build and test the new platform. This paper provides insights to the PCEH concept and to the current stage of the project. In doing so, we aim at increasing the awareness of this important endeavor and sharing the lessons learned so far throughout our work.

Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs.

PubMed

Kayser, Lars; Kushniruk, Andre; Osborne, Richard H; Norgaard, Ole; Turner, Paul

2015-05-20

eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information technology (IT) designs may not accommodate the needs, skills, cognitive capacities, and/or contexts of use of the intended broader population of health consumers. This may result in challenges for consumers who use the health IT systems, and could lead to limitations in adoption if the diversity of user attributes has not been adequately considered by health IT designers. The objective of this paper is to propose how users' needs and competences can be taken into account when designing new information and communications technology solutions in health care by expanding the user-task-context matrix model with the domains of a new concept of eHealth literacy. This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs and requirements are under differing contexts of use. The extension of this model involved including knowledge about users' competences within the seven domains of eHealth literacy, which had been identified based on systematic engagement with computer scientists, academics, health professionals, and patients recruited from various patient organizations and primary care. A concept map was constructed based on a structured brainstorm procedure, card sorting, and computational analysis. The new eHealth literacy

Internet use and eHealth literacy of low-income parents whose children have special health care needs.

PubMed

Knapp, Caprice; Madden, Vanessa; Wang, Hua; Sloyer, Phyllis; Shenkman, Elizabeth

2011-09-29

The Internet has revolutionized the way in which many Americans search for health care information. Unfortunately, being able to use the Internet for this purpose is predicated on having access to the Internet and being able to understand and comprehend online health information. This is especially important for parents of children with special health care needs who are forced to make many medical decisions throughout the lives of their children. Yet, no information is available about this vulnerable group. For parents of children with special health care needs we sought to (1) describe their Internet access and use, (2) determine which child and household factors were associated with Internet use, (3) describe eHealth literacy of Internet users, and (4) determine which child and household factors were associated with greater eHealth literacy. This was a cross-sectional telephone survey of 2371 parents whose children with special health care needs were enrolled in Florida's Medicaid and State Children's Health Insurance Plan (SCHIP) programs (4072 parents were approached). To be enrolled in the program, families must have incomes that are less than or equal to 200% of the federal poverty level. The eHealth Literacy Scale (eHEALS) was used to measure eHealth literacy. Descriptive and multivariate analyses were conducted to address the study objectives. The survey response rate was 58.2%. Participating parents were mainly female (2154/2371, 91%), white non-Hispanic (915/2371, 39%), English speaking (1827/2371, 77%), high school graduates (721/2371, 30%), married (1252/2371, 53%), and living in a two-parent household (1212/2371, 51%). Additionally, 82% of parents (1945/2371) in the sample reported that they used the Internet, and 49% of those parents used it daily (1158/2371). Almost three-quarters of Internet users had access to the Internet at home while about one-half had access at work. Parents who were African American, non-English speaking, older, and not

How to Measure Costs and Benefits of eHealth Interventions: An Overview of Methods and Frameworks.

PubMed

Bergmo, Trine Strand

2015-11-09

Information on the costs and benefits of eHealth interventions is needed, not only to document value for money and to support decision making in the field, but also to form the basis for developing business models and to facilitate payment systems to support large-scale services. In the absence of solid evidence of its effects, key decision makers may doubt the effectiveness, which, in turn, limits investment in, and the long-term integration of, eHealth services. However, it is not realistic to conduct economic evaluations of all eHealth applications and services in all situations, so we need to be able to generalize from those we do conduct. This implies that we have to select the most appropriate methodology and data collection strategy in order to increase the transferability across evaluations. This paper aims to contribute to the understanding of how to apply economic evaluation methodology in the eHealth field. It provides a brief overview of basic health economics principles and frameworks and discusses some methodological issues and challenges in conducting cost-effectiveness analysis of eHealth interventions. Issues regarding the identification, measurement, and valuation of costs and benefits are outlined. Furthermore, this work describes the established techniques of combining costs and benefits, presents the decision rules for identifying the preferred option, and outlines approaches to data collection strategies. Issues related to transferability and complexity are also discussed.

Education for eHealth--a status analysis.

PubMed

Herzog, Juliane; Pohn, Birgit; Forjan, Mathias; Sauermann, Stefan; Urbauer, Philipp

2014-01-01

eHealth is not only a growing market, but also an important factor for new healthcare systems. National and European initiatives implicitly demand a higher level of knowledge in the areas of healthcare, engineering and management. As part of the eLearning4eHealth project an initial web based study was performed concentrating on European and global eHealth related educational programs. The results show that eHealth related courses do not evenly exist for the identified professions. 43% of the offered programs are focused on the engineering sector, whereas only 21% are available for the management sector. In order to offer compatible and comparable state of knowledge in the identified fields of profession and knowledge, further educational programs may be necessary. Despite the found shortcomings, results have shown that international activities have started in order to close the gaps and improve the quality of knowledge in the interdisciplinary field of eHealth.

eHealth and the use of individually tailored information: A systematic review.

PubMed

Conway, Nicholas; Webster, Clare; Smith, Blair; Wake, Deborah

2017-09-01

Tailored messages are those that specifically target individuals following an assessment of their unique characteristics. This systematic review assesses the evidence regarding the effectiveness of tailoring within eHealth interventions aimed at chronic disease management. OVID Medline/Embase databases were searched for randomised control trials, controlled clinical, trials, before -after studies, and time series analyses from inception - May 2014. Objectively measured clinical processes/outcomes were considered. Twenty-two papers were eligible for inclusion: 6/22 used fully tailored messaging and 16/22 used partially tailored messages. Two studies isolated tailoring as the active component. The remainder compared intervention with standard care. In all, 12/16 studies measuring clinical processes and 2/6 studies reporting clinical outcomes showed improvements, regardless of target group. Study quality was low and design did not allow for identification of interventions' active component. Heterogeneity precluded meta-analysis. This review has demonstrated that there is a lack of evidence to suggest that tailoring within an eHealth context confers benefit over non-tailored eHealth interventions.

The effect of e-health contents on health science students' attitude toward the efficiency of health ICT in care provision.

PubMed

Lam, Mary K; Amon, Krestina L; Nguyen, Melanie; Campbell, Andrew J; Neville, Victoria

2012-01-01

This study aimed to examine the effects of e-health education content on the attitude of undergraduate health science students towards the efficiency of health ICT in healthcare provision. A cross-sectional survey design was used. Participants were Health Sciences students attending The University of Sydney. Students were divided into three groups: junior students enrolled in a subject with non e-health content; senior students enrolled in a subject with non e-health content; and students enrolled in a subject with e-health content. Students' attitude towards the efficiency of ICT in healthcare provision was measured by a modified version of the Information Technology Attitude Scales for Health (ITASH). Students enrolled in the subject with e-health content had a significantly higher average baseline attitude score than the other two groups (T198=-3.47, p=0.001; T93=-2.43, p=0.017). The repeat measures analysis yielded a result with significant interaction between survey time and student group (F2, 267=4.99, p=0.007) suggesting that changes of score was dependent on student group status. Subjects rich in e-health content significantly enhanced student attitudes, even with a group of students with a rather positive initial attitude. To facilitate the uptake and utilisation of health ICT by the future health workforce, it is important for tertiary educational institutes to provide students with sufficient exposure to specific health-related ICT training, via specifically designed subjects delivering both generic and specific e-health content.

E-health interventions for suicide prevention.

PubMed

Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne

2014-08-12

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.

E-Health Interventions for Suicide Prevention

PubMed Central

Christensen, Helen; Batterham, Philip J.; O’Dea, Bridianne

2014-01-01

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals’ posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain. PMID:25119698

Home e-health system integration in the Smart Home through a common media server.

PubMed

Pau, I; Seoane, F; Lindecrantz, K; Valero, M A; Carracedo, J

2009-01-01

Home e-health systems and services are revealed as one of the most important challenges to promote Quality of Life related to Health in the Information Society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated with Smart Home services platform to support home based e-care. Thus, the home e-health system and architecture detailed in this research work is ready to supply a seamless personal care solution both from the biomedical data analysis, service provision, security guarantee and information management s point of view. The solution is ready to be integrated within the Accessible Digital Home, a living lab managed by Universidad Politécnica de Madrid for R&D activities.

Steps to consider for effective decision making when selecting and prioritizing eHealth services.

PubMed

Vimarlund, Vivian; Davoody, Nadia; Koch, Sabine

2013-01-01

Making the best choice for an organization when selecting IT applications or eHealth services is not always easy as there are a lot of parameters to take into account. The aim of this paper is to explore some steps to support effective decision making when selecting and prioritizing eHealth services prior to implementation and/or procurement. The steps presented in this paper were identified by interviewing nine key stakeholders at Stockholm County Council. They are supposed to work as a guide for decision making and aim to identify objectives and expected effects, technical, organizational, and economic requirements, and opportunities important to consider before decisions are taken. The steps and their respective issues and variables are concretized in a number of templates to be filled in by decision makers when selecting and prioritizing eHealth services.

Administrator, National Security Education Program

DTIC Science & Technology

1993-01-19

1. Administer, direct, and manage the resources for the lit program. 2. Establish and direct an international education center, as approved by the...approve the hiring of, and evaluate the performance of personnel who staff the international education center. 4. Ensure appropriate internal management...Administrator, National Security Education Program * References: (a) DoD Directive 1025.2 , "National Security * Education Program," January 13, 1993

Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs

PubMed Central

2015-01-01

Background eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information technology (IT) designs may not accommodate the needs, skills, cognitive capacities, and/or contexts of use of the intended broader population of health consumers. This may result in challenges for consumers who use the health IT systems, and could lead to limitations in adoption if the diversity of user attributes has not been adequately considered by health IT designers. Objective The objective of this paper is to propose how users’ needs and competences can be taken into account when designing new information and communications technology solutions in health care by expanding the user-task-context matrix model with the domains of a new concept of eHealth literacy. Methods This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs and requirements are under differing contexts of use. The extension of this model involved including knowledge about users’ competences within the seven domains of eHealth literacy, which had been identified based on systematic engagement with computer scientists, academics, health professionals, and patients recruited from various patient organizations and primary care. A concept map was constructed based on a structured brainstorm procedure, card sorting, and computational

Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion.

PubMed

Heffernan, Kayla Joanne; Chang, Shanton; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

2016-02-09

The now ubiquitous catchphrase, "There's an app for that," rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of "do no harm." There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to use, design for simplicity). This research has

Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion

PubMed Central

Heffernan, Kayla Joanne; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

2016-01-01

Background The now ubiquitous catchphrase, “There’s an app for that,” rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of “do no harm.” There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. Objective This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. Methods For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. Results By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature

PubMed Central

Janssen, Wouter; Johansen, Monika Alise

2018-01-01

Background eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Objective Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. Methods We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Results Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow

Web-assisted tobacco interventions: empowering change in the global fight for the public's (e)Health.

PubMed

Norman, Cameron D; McIntosh, Scott; Selby, Peter; Eysenbach, Gunther

2008-11-25

Tobacco control in the 21(st) century faces many of the same challenges as in the past, but in different contexts, settings and enabled by powerful new tools including those delivered by information and communication technologies via computer, videocasts, and mobile handsets to the world. Building on the power of electronic networks, Web-assisted tobacco interventions (WATI) provide a vehicle for delivering tobacco prevention, cessation, social support and training opportunities on-demand and direct to practitioners and the public alike. The Framework Convention on Tobacco Control, the world's first global public health treaty, requires that all nations develop comprehensive tobacco control strategies that include provision of health promotion information, population interventions, and decision-support services. WATI research and development has evolved to provide examples of how eHealth can address all of these needs and provide exemplars for other areas of public health to follow. This paper discusses the role of WATI in supporting tobacco control and introduces a special issue of the Journal of Medical Internet Research that broadens the evidence base and provides illustrations of how new technologies can support health promotion and population health overall, empowering change and ushering in a new era of public eHealth.

Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: a systematic review of systematic reviews and meta-analyses.

PubMed

Elbert, Niels J; van Os-Medendorp, Harmieke; van Renselaar, Wilco; Ekeland, Anne G; Hakkaart-van Roijen, Leona; Raat, Hein; Nijsten, Tamar E C; Pasmans, Suzanne G M A

2014-04-16

eHealth potentially enhances quality of care and may reduce health care costs. However, a review of systematic reviews published in 2010 concluded that high-quality evidence on the benefits of eHealth interventions was still lacking. We conducted a systematic review of systematic reviews and meta-analyses on the effectiveness/cost-effectiveness of eHealth interventions in patients with somatic diseases to analyze whether, and to what possible extent, the outcome of recent research supports or differs from previous conclusions. Literature searches were performed in PubMed, EMBASE, The Cochrane Library, and Scopus for systematic reviews and meta-analyses on eHealth interventions published between August 2009 and December 2012. Articles were screened for relevance based on preset inclusion and exclusion criteria. Citations of residual articles were screened for additional literature. Included papers were critically appraised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement before data were extracted. Based on conclusions drawn by the authors of the included articles, reviews and meta-analyses were divided into 1 of 3 groups: suitable, promising, or limited evidence on effectiveness/cost-effectiveness. Cases of uncertainty were resolved by consensus discussion. Effect sizes were extracted from papers that included a meta-analysis. To compare our results with previous findings, a trend analysis was performed. Our literature searches yielded 31 eligible reviews, of which 20 (65%) reported on costs. Seven papers (23%) concluded that eHealth is effective/cost-effective, 13 (42%) underlined that evidence is promising, and others found limited or inconsistent proof. Methodological quality of the included reviews and meta-analyses was generally considered high. Trend analysis showed a considerable accumulation of literature on eHealth. However, a similar percentage of papers concluded that eHealth is effective/cost-effective or

How to Measure Costs and Benefits of eHealth Interventions: An Overview of Methods and Frameworks

PubMed Central

2015-01-01

Information on the costs and benefits of eHealth interventions is needed, not only to document value for money and to support decision making in the field, but also to form the basis for developing business models and to facilitate payment systems to support large-scale services. In the absence of solid evidence of its effects, key decision makers may doubt the effectiveness, which, in turn, limits investment in, and the long-term integration of, eHealth services. However, it is not realistic to conduct economic evaluations of all eHealth applications and services in all situations, so we need to be able to generalize from those we do conduct. This implies that we have to select the most appropriate methodology and data collection strategy in order to increase the transferability across evaluations. This paper aims to contribute to the understanding of how to apply economic evaluation methodology in the eHealth field. It provides a brief overview of basic health economics principles and frameworks and discusses some methodological issues and challenges in conducting cost-effectiveness analysis of eHealth interventions. Issues regarding the identification, measurement, and valuation of costs and benefits are outlined. Furthermore, this work describes the established techniques of combining costs and benefits, presents the decision rules for identifying the preferred option, and outlines approaches to data collection strategies. Issues related to transferability and complexity are also discussed. PMID:26552360

e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China.

PubMed

Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; Macintyre, C Raina

2013-03-13

To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). PRIMARY AND SECONDARY MEASURES: For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers' exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient

e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China

PubMed Central

Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; MacIntyre, C Raina

2013-01-01

Objective To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. Design This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. Setting In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. Participants In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). Primary and secondary measures For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers’ exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. Results This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness

Pediatric injury information seeking for mothers with young children: The role of health literacy and ehealth literacy.

PubMed

Manganello, Jennifer A; Falisi, Angela L; Roberts, Kristin J; Smith, Katherine C; McKenzie, Lara B

2016-01-01

An understanding of preferred sources of injury information among parents is needed to develop best practices for information dissemination. Yet, almost no research examines injury information seeking for a national sample of mothers. A cross-sectional online survey was conducted in 2013 with 1081 mothers in the United States (U.S.) with at least one child <6 years. We measured self-report health literacy with the Morris Single-Item Screener (18% low), and eHealth literacy using the eHEALS (28% low). The internet was the most preferred source for injury information (76%), followed by health providers (44%), and family/friends (35%). Most mothers selected the internet as the first choice for information about bicycle helmets (65%) and car seats (63%). For poison prevention, preferences were mixed; 48% internet compared with 41% health providers. Mothers with low health literacy were more likely to have discussed injury prevention with their doctors ( P = 0.022) and searched for injury information ( P = 0.001), but less likely to report the internet as a top source ( P < .0001). Mothers with low eHealth literacy were less likely to search for injury information ( P < 0.0001) and report the internet as a top source ( P < 0.0001), and slightly more likely to rely on health providers for information ( P = 0.028). Findings suggest the internet is a common source of injury prevention information, but health providers remain a valuable resource for mothers, especially those with lower literacy skills. Despite widespread internet use, health providers should be sure to communicate injury prevention information to mothers, especially those at risk for low health literacy and eHealth literacy.

Pediatric injury information seeking for mothers with young children: The role of health literacy and ehealth literacy

PubMed Central

Manganello, Jennifer A.; Falisi, Angela L.; Roberts, Kristin J.; Smith, Katherine C.; McKenzie, Lara B.

2017-01-01

Background An understanding of preferred sources of injury information among parents is needed to develop best practices for information dissemination. Yet, almost no research examines injury information seeking for a national sample of mothers. Methods A cross-sectional online survey was conducted in 2013 with 1081 mothers in the United States (U.S.) with at least one child <6 years. We measured self-report health literacy with the Morris Single-Item Screener (18% low), and eHealth literacy using the eHEALS (28% low). Results The internet was the most preferred source for injury information (76%), followed by health providers (44%), and family/friends (35%). Most mothers selected the internet as the first choice for information about bicycle helmets (65%) and car seats (63%). For poison prevention, preferences were mixed; 48% internet compared with 41% health providers. Mothers with low health literacy were more likely to have discussed injury prevention with their doctors (P = 0.022) and searched for injury information (P = 0.001), but less likely to report the internet as a top source (P < .0001). Mothers with low eHealth literacy were less likely to search for injury information (P < 0.0001) and report the internet as a top source (P < 0.0001), and slightly more likely to rely on health providers for information (P = 0.028). Conclusions Findings suggest the internet is a common source of injury prevention information, but health providers remain a valuable resource for mothers, especially those with lower literacy skills. Despite widespread internet use, health providers should be sure to communicate injury prevention information to mothers, especially those at risk for low health literacy and eHealth literacy. PMID:29051785

easyHealthApps: e-Health Apps dynamic generation for smartphones & tablets.

PubMed

Paschou, Mersini; Sakkopoulos, Evangelos; Tsakalidis, Athanasios

2013-06-01

Mobile phones and especially smartphones have been embraced by a rapidly increasing number of people worldwide and this trend is expected to evolve even more in the years to come. There are numerous smartphone Apps that record critical medical data in an effort to solve a particular health issue each time. We studied such applications and not surprisingly, we have found that development and design effort is often repeated. Software patterns have been detected to exist, however re-usability has not been enforced. This leads to lost programming manpower and to increased probability of repeating bugs in Apps. Moreover, at the moment smartphone e-Health Apps demand time, effort and costs for development. Unfortunately even simple data recording Apps are practically impossible to be produced by multiple health domain users who are not developers. In this work, we propose, design and implement a simple and integrated solution which gives healthcare professionals and researchers the ability to create their own data intensive smartphone applications, independent of the desired healthcare domain. The proposed approach applies efficient software techniques that hide development from the users and enable App creation through a simple Web User Interface. The Apps produced are in native format and it is possible to dynamically receive m-Health business logic and the chosen UI. Evaluation of the proposed solution has shown that the generated Apps are functionally and UI equivalent to human-coded Apps according to a number of comparison parameters. Furthermore, e-Health professionals show particular interest in developing Apps on their own for a particular domain they focus on.

The Anticipated Positive Psychosocial Impact of Present Web-Based E-Health Services and Future Mobile Health Applications: An Investigation among Older Swedes.

PubMed

Wiklund Axelsson, S; Nyberg, L; Näslund, A; Melander Wikman, A

2013-01-01

This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample's of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.

National Program for e-Learning in Taiwan

ERIC Educational Resources Information Center

Chang, Maiga; Wang, Chin-Yeh; Chen, Gwo-Dong

2009-01-01

Taiwan government has initiated a five-year program since 2002: the National Science and Technology Program for e-Learning. The national program started from 2003 and was completed at the end of year 2007, involving thirteen government agencies. This paper describes the results that the national program has accomplished at its first phase, 2003 to…

Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States.

PubMed

Chesser, Amy; Burke, Anne; Reyes, Jared; Rohrberg, Tessa

2016-01-01

eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

eHealth and mHealth in prostate cancer detection and active surveillance

PubMed Central

Venderbos, Lionne D. F.

2018-01-01

eHealth and mobile health (mHealth) offer patients, healthcare providers, researchers, and policy makers new potential to improve wellness, practice prevention and reduce suffering from diseases. While the eHealth market is growing to an expected US $26 billion, its potential in the field of Urology is still underused. Research has shown that currently only 176 apps (of the 300,000 medical apps available) were found in the Apple App Store and Google Play Store, of which 20 were prostate cancer related. Three good examples of eHealth/mHealth applications are the Rotterdam Prostate Cancer Risk Calculator (RPCRC) website and app, the Prostate cancer Research International Active Surveillance (PRIAS) website and the Follow MyPSA app for men on active surveillance for prostate cancer: they are tools with a clear vision that offer true added value in daily clinical practice and which positively influence healthcare beyond borders. To increase the uptake of eHealth applications in the coming years, it is important to involve professionals in their design and development, and to guarantee the safety and privacy of its users and their data. PMID:29594031

eHealth Literacy and Intervention Tailoring Impacts the Acceptability of a HIV/STI Testing Intervention and Sexual Decision Making Among Young Gay and Bisexual Men.

PubMed

Horvath, Keith J; Bauermeister, José A

2017-02-01

We assessed whether young men who have sex with men's acceptability with the online Get Connected! intervention and subsequent sexual health decision making were influenced by their baseline eHealth literacy (high vs. low competency) and intervention tailoring (tailored or nontailored intervention condition). Compared to the high eHealth literacy/tailored intervention group: (1) those in the low eHealth literacy/tailored intervention condition and participants in the nontailored intervention condition (regardless of eHealth literacy score) reported lower intervention information quality scores; and (2) those in the low eHealth literacy/nontailored intervention group reported lower intervention system quality scores and that the intervention had less influence on their sexual health decision making. Future similar intervention research should consider how eHealth literacy might influence participants' abilities to navigate intervention content and integrate it into their sexual decision making.

eHealth Technologies as an intervention to improve adherence to topical antipsoriatics: a systematic review.

PubMed

Svendsen, Mathias Tiedemann; Andersen, Flemming; Andersen, Klaus Ejner

2018-03-01

Topical antipsoriatics are recommended first-line treatment of psoriasis, but rates of adherence are low. Patient support by use of electronic health (eHealth) services is suggested to improve medical adherence. To review randomised controlled trials (RCTs) testing eHealth interventions designed to improve adherence to topical antipsoriatics and to review applications for smartphones (apps) incorporating the word psoriasis. Literature review: Medline, Embase, Cochrane, PsycINFO and Web of Science were searched using search terms for eHealth, psoriasis and topical antipsoriatics. General analysis of apps: The operating systems (OS) for smartphones, iOS, Google Play, Microsoft Store, Symbian OS and Blackberry OS were searched for apps containing the word psoriasis. Literature review: Only one RCT was included, reporting on psoriasis patients' Internet reporting their status of psoriasis over a 12-month period. The rate of adherence was measured by Medication Event Monitoring System (MEMS ® ). An improvement in medical adherence and reduction of severity of psoriasis were reported. General analysis of apps: A total 184 apps contained the word psoriasis. There is a critical need for high-quality RCTs testing if the ubiquitous eHealth technologies, for example, some of the numerous apps, can improve psoriasis patients' rates of adherence to topical antipsoriatics.

Acceptance by laypersons and medical professionals of the personalized eHealth platform, eHealthMonitor.

PubMed

Griebel, Lena; Kolominsky-Rabas, Peter; Schaller, Sandra; Siudyka, Jakub; Sierpinski, Radoslaw; Papapavlou, Dimitrios; Simeonidou, Aliki; Prokosch, Hans-Ulrich; Sedlmayr, Martin

2017-09-01

Often, eHealth services are not accepted because of factors such as eHealth literacy or trust. Within this study, eHealthMonitor was evaluated in three European countries (Germany, Greece, and Poland) by medical professionals and laypersons with respect to numerous acceptance factors. Questionnaires were created on the basis of factors from literature and with the help of scales which have already been validated. A qualitative survey was conducted in Germany, Poland, and Greece. The eHealth literacy of all participants was medium/high. Laypersons mostly agreed that they could easily become skillful with eHealthMonitor and that other people thought that they should use eHealthMonitor. Amongst medical professionals, a large number were afraid that eHealthMonitor could violate their privacy or the privacy of their patients. Overall, the participants thought that eHealthMonitor was a good concept and that they would use it. The main hindrances to the use of eHealthMonitor were found in trust issues including data privacy. In the future, more research on the linkage of all measured factors is needed, for example, to address the question of whether highly educated people tend to mistrust eHealth information more than people with lower levels of education.

How Can eHealth Technology Address Challenges Related to Multimorbidity? Perspectives from Patients with Multiple Chronic Conditions.

PubMed

Zulman, Donna M; Jenchura, Emily C; Cohen, Danielle M; Lewis, Eleanor T; Houston, Thomas K; Asch, Steven M

2015-08-01

Patient eHealth technology offers potential support for disease self-management, but the value of existing applications for patients with multiple chronic conditions (MCCs) is unclear. To understand self-management and health care navigation challenges that patients face due to MCCs and to identify opportunities to support these patients through new and enhanced eHealth technology. After administering a screening survey, we conducted 10 focus groups of 3-8 patients grouped by age, sex, and common chronic conditions. Patients discussed challenges associated with having MCCs and their use of (and desires from) technology to support self-management. Three investigators used standard content analysis methods to code the focus group transcripts. Emergent themes were reviewed with all collaborators, and final themes and representative quotes were validated with a sample of participants. Fifty-three individuals with ≥3 chronic conditions and experience using technology for health-related purposes. Focus group participants had an average of five chronic conditions. Participants reported using technology most frequently to search for health information (96%), communicate with health care providers (92%), track medical information (83%), track medications (77%), and support decision-making about treatment (55%). Three themes emerged to guide eHealth technology development: (1) Patients with MCCs manage a high volume of information, visits, and self-care tasks; (2) they need to coordinate, synthesize, and reconcile health information from multiple providers and about different conditions; (3) their unique position at the hub of multiple health issues requires self-advocacy and expertise. Focus groups identified desirable eHealth resources and tools that reflect these themes. Although patients with multiple health issues use eHealth technology to support self-care for specific conditions, they also desire tools that transcend disease boundaries. By addressing the holistic

Clinic Personnel, Facilitator, and Parent Perspectives of eHealth Familias Unidas in Primary Care

PubMed Central

Molleda, Lourdes; Bahamon, Monica; St. George, Sara M.; Perrino, Tatiana; Estrada, Yannine; Herrera, Deborah Correa; Pantin, Hilda; Prado, Guillermo

2018-01-01

Introduction The purpose of this qualitative study was to understand the feasibility and acceptability of implementing eHealth Familias Unidas, an Internet-based, family-based, preventive intervention for Hispanic adolescents, in primary care. Methods Semistructured individual interviews with clinic personnel and facilitators (i.e., physicians, nurse practitioners, administrators, and mental health workers; n = 9) and one focus group with parents (n = 6) were audiorecorded, transcribed verbatim, and analyzed using a general inductive approach. Results Nine major themes emerged, including recommendations to minimize disruption to clinic flow, improve collaboration and training of clinic personnel and the research team, promote the clinic as a trusted setting for improving children’s behavioral health, and highlight the flexibility and convenience of the eHealth format. Discussion This study provides feasibility and acceptability findings, along with important considerations for researchers and primary care personnel interested in collaborating to implement an eHealth preventive intervention in pediatric primary care. PMID:28012799

Use of eHealth technologies to enable the implementation of musculoskeletal Models of Care: Evidence and practice.

PubMed

Slater, Helen; Dear, Blake F; Merolli, Mark A; Li, Linda C; Briggs, Andrew M

2016-06-01

Musculoskeletal (MSK) conditions are the second leading cause of morbidity-related burden of disease globally. EHealth is a potentially critical factor that enables the implementation of accessible, sustainable and more integrated MSK models of care (MoCs). MoCs serve as a vehicle to drive evidence into policy and practice through changes at a health system, clinician and patient level. The use of eHealth to implement MoCs is intuitive, given the capacity to scale technologies to deliver system and economic efficiencies, to contribute to sustainability, to adapt to low-resource settings and to mitigate access and care disparities. We follow a practice-oriented approach to describing the 'what' and 'how' to harness eHealth in the implementation of MSK MoCs. We focus on the practical application of eHealth technologies across care settings to those MSK conditions contributing most substantially to the burden of disease, including osteoarthritis and inflammatory arthritis, skeletal fragility-associated conditions and persistent MSK pain. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving access to supportive cancer care through an eHealth application: a qualitative needs assessment among cancer survivors.

PubMed

Lubberding, Sanne; van Uden-Kraan, Cornelia F; Te Velde, Elisabeth A; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

2015-05-01

To gain insight into cancer survivors' needs towards an eHealth application monitoring quality of life and targeting personalised access to supportive care. Supportive care in cancer addresses survivors' concerns and needs. However, many survivors are not taking advantage of supportive care provided. To enable cancer survivors to benefit, survivors' needs must be identified timely and effectively. An eHealth application could be a solution to meet patients' individual supportive care needs. A qualitative approach. Thirty cancer survivors (15 head and neck and 15 breast cancer survivors) participated. The majority were female (n = 20·67%). The mean age was 60 (SD 8·8) years. Mean time interval since treatment was 13·5 months (SD 10·5). All interviews were audio-recorded and transcribed verbatim. During the interviews, participants were asked about their unmet needs during follow-up care and a potential eHealth application. Data were analyzed independently by two coders and coded into key issues and themes. Cancer survivors commented that they felt unprepared for the post-treatment period and that their symptoms often remained unknown to care providers. Survivors also mentioned a suboptimal referral pattern to supportive care services. Mentioned advantages of an eHealth application were as follows: insight into the course of symptoms by monitoring, availability of information among follow-up appointments, receiving personalised advice and tailored supportive care. Cancer survivors identified several unmet needs during follow-up care. Most survivors were positive towards the proposed eHealth application and expressed that it could be a valuable addition to follow-up cancer care. Study results provide care providers with insight into barriers that impede survivors from obtaining optimal supportive care. This study also provides insight into the characteristics needed to design, build and implement an eHealth application targeting personalised access to supportive

eHealth in Treatment of Offenders in Forensic Mental Health: A Review of the Current State.

PubMed

Kip, Hanneke; Bouman, Yvonne H A; Kelders, Saskia M; van Gemert-Pijnen, Lisette J E W C

2018-01-01

Treatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients. To examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness. A systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients. The search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of. To overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth's potential, further research on development, implementation, and evaluation should be conducted.

Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance.

PubMed

Sudbury-Riley, Lynn; FitzPatrick, Mary; Schulz, Peter J

2017-02-27

The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature.

PubMed

Granja, Conceição; Janssen, Wouter; Johansen, Monika Alise

2018-05-01

eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical

Modeling the Cost-Effectiveness of Health Care Systems for Alcohol Use Disorders: How Implementation of eHealth Interventions Improves Cost-Effectiveness

PubMed Central

Lokkerbol, Joran; Riper, Heleen; Majo, Maria Cristina; Boon, Brigitte; Blankers, Matthijs

2011-01-01

Background Informing policy decisions about the cost-effectiveness of health care systems (ie, packages of clinical interventions) is probably best done using a modeling approach. To this end, an alcohol model (ALCMOD) was developed. Objective The aim of ALCMOD is to estimate the cost-effectiveness of competing health care systems in curbing alcohol use at the national level. This is illustrated for scenarios where new eHealth technologies for alcohol use disorders are introduced in the Dutch health care system. Method ALCMOD assesses short-term (12-month) incremental cost-effectiveness in terms of reductions in disease burden, that is, disability adjusted life years (DALYs) and health care budget impacts. Results Introduction of new eHealth technologies would substantially increase the cost-effectiveness of the Dutch health care system for alcohol use disorders: every euro spent under the current system returns a value of about the same size (€ 1.08, ie, a “surplus” of 8 euro cents) while the new health care system offers much better returns on investment, that is, every euro spent generates € 1.62 in health-related value. Conclusion Based on the best available evidence, ALCMOD's computations suggest that implementation of new eHealth technologies would make the Dutch health care system more cost-effective. This type of information may help (1) to identify opportunities for system innovation, (2) to set agendas for further research, and (3) to inform policy decisions about resource allocation. PMID:21840836

Web-Assisted Tobacco Interventions: Empowering Change in the Global Fight for the Public’s (e)Health

PubMed Central

McIntosh, Scott; Selby, Peter; Eysenbach, Gunther

2008-01-01

Tobacco control in the 21st century faces many of the same challenges as in the past, but in different contexts, settings and enabled by powerful new tools including those delivered by information and communication technologies via computer, videocasts, and mobile handsets to the world. Building on the power of electronic networks, Web-assisted tobacco interventions (WATI) provide a vehicle for delivering tobacco prevention, cessation, social support and training opportunities on-demand and direct to practitioners and the public alike. The Framework Convention on Tobacco Control, the world’s first global public health treaty, requires that all nations develop comprehensive tobacco control strategies that include provision of health promotion information, population interventions, and decision-support services. WATI research and development has evolved to provide examples of how eHealth can address all of these needs and provide exemplars for other areas of public health to follow. This paper discusses the role of WATI in supporting tobacco control and introduces a special issue of the Journal of Medical Internet Research that broadens the evidence base and provides illustrations of how new technologies can support health promotion and population health overall, empowering change and ushering in a new era of public eHealth. PMID:19033147

Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence

PubMed Central

Kelders, Saskia M; van Gemert-Pijnen, Julia EWC

2017-01-01

Background In electronic health (eHealth) evaluations, there is increasing attention for studying the actual usage of a technology in relation to the outcomes found, often by studying the adherence to the technology. On the basis of the definition of adherence, we suggest that the following three elements are necessary to determine adherence to eHealth technology: (1) the ability to measure the usage behavior of individuals; (2) an operationalization of intended use; and (3) an empirical, theoretical, or rational justification of the intended use. However, to date, little is known on how to operationalize the intended usage of and the adherence to different types of eHealth technology. Objective The study aimed to improve eHealth evaluations by gaining insight into when, how, and by whom the concept of adherence has been used in previous eHealth evaluations and finding a concise way to operationalize adherence to and intended use of different eHealth technologies. Methods A systematic review of eHealth evaluations was conducted to gain insight into how the use of the technology was measured, how adherence to different types of technologies was operationalized, and if and how the intended use of the technology was justified. Differences in variables between the use of the technology and the operationalization of adherence were calculated using a chi-square test of independence. Results In total, 62 studies were included in this review. In 34 studies, adherence was operationalized as “the more use, the better,” whereas 28 studies described a threshold for intended use of the technology as well. Out of these 28, only 6 reported a justification for the intended use. The proportion of evaluations of mental health technologies reporting a justified operationalization of intended use is lagging behind compared with evaluations of lifestyle and chronic care technologies. The results indicated that a justification of intended use does not require extra measurements to

Developing Customer Oriented eHealth Services to High Schools in City of Espoo.

PubMed

Rosenqvist, Susanne; Rajalahti, Elina

2016-01-01

The purpose of this research was to study the hopes and needs of high school first grade students and student healthcare nurses about development of eServices for student healthcare mainly by improving existing ITC solutions and planning new eHealth services. The secondary purpose was to innovate how to share general knowledge about health to students. Four (n=4) high school nurses were group interviewed and an electronic questionnaire was made for high school first grade students. Nearly 15% (n=247) of the target group answered the questionnaire. Preventive eHealth solutions need improvements in student health care in Finland.

[Evaluation of electronic health programs in Peru: multidisciplinary approach and current perspectives].

PubMed

Henríquez-Suarez, Milagro; Becerra-Vera, Charito E; Laos-Fernández, Elena L; Espinoza-Portilla, Elizabeth

2017-01-01

Electronic health (eHealth) requires a multidisciplinary approach and involves different areas of knowledge, including medicine, computer science, engineering, sociology, anthropology, social work, administration, law, and communication sciences. The assessment of eHealth should consider that information and communication technologies (ICTs) are only part of the information system of an organization. Understanding the human factors involved in health systems, the environment, and the contexts in which ICTs are used in health is essential. The objectives of this study were to describe the status of the assessment of eHealth in Peru and to discuss the strategies for multidisciplinary evaluation that should be considered to achieve the success and sustainability of these initiatives based on national and international experience.

A systematic review of eHealth behavioral interventions targeting smoking, nutrition, alcohol, physical activity and/or obesity for young adults.

PubMed

Oosterveen, Emilie; Tzelepis, Flora; Ashton, Lee; Hutchesson, Melinda J

2017-06-01

A systematic review of randomized control trials (RCT) was undertaken to evaluate the effectiveness of eHealth behavioral interventions aiming to improve smoking rates, nutrition behaviors, alcohol intake, physical activity levels and/or obesity (SNAPO) in young adults. Seven electronic databases were searched for RCTs published in English from 2000 to April 2015 and evaluating eHealth interventions aiming to change one or multiple SNAPO outcomes, and including young adult (18-35years) participants. Of 2,159 articles identified, 45 studies met the inclusion criteria. Most interventions targeted alcohol (n=26), followed by smoking (n=7), physical activity (n=4), obesity (n=4) and nutrition (n=1). Three interventions targeted multiple behaviors. The eHealth interventions were most often delivered via websites (79.5%). Most studies (n=32) compared eHealth interventions to a control group (e.g. waiting list control, minimal intervention), with the majority (n=23) showing a positive effect on a SNAPO outcome at follow-up. Meta-analysis demonstrated a significantly lower mean number of drinks consumed/week in brief web or computer-based interventions compared to controls (Mean Difference -2.43 [-3.54, -1.32], P<0.0001, n=10). Sixteen studies compared eHealth delivery modes, with inconsistent results across target behaviors and technology types. Nine studies compared eHealth to other modes of delivery (e.g. in person) with all finding no difference in SNAPO outcomes between groups at follow-up. This review provides some evidence for the efficacy of eHealth SNAPO interventions for young adults, particularly in the short-term and for alcohol interventions. But there is insufficient evidence for their efficacy in the longer-term, as well as which mode of delivery is most effective. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

eHealth integration and interoperability issues: towards a solution through enterprise architecture.

PubMed

Adenuga, Olugbenga A; Kekwaletswe, Ray M; Coleman, Alfred

2015-01-01

Investments in healthcare information and communication technology (ICT) and health information systems (HIS) continue to increase. This is creating immense pressure on healthcare ICT and HIS to deliver and show significance in such investments in technology. It is discovered in this study that integration and interoperability contribute largely to this failure in ICT and HIS investment in healthcare, thus resulting in the need towards healthcare architecture for eHealth. This study proposes an eHealth architectural model that accommodates requirement based on healthcare need, system, implementer, and hardware requirements. The model is adaptable and examines the developer's and user's views that systems hold high hopes for their potential to change traditional organizational design, intelligence, and decision-making.

HIV-Positive Youth's Perspectives on the Internet and eHealth

PubMed Central

Flicker, Sarah; Goldberg, Eudice; Read, Stanley; Veinot, Tiffany; McClelland, Alex; Saulnier, Paul

2004-01-01

Background Globally, half of all new HIV infections occur among young people. Despite this incidence, there is a profound lack of resources for HIV-positive youth. Objective To investigate Internet access, use and acceptability as a means for health promotion and health service delivery among HIV-positive youth. Methods A community-based participatory approach was used to conduct a mixed methods research study. Thirty-five qualitative in-depth semi-structured interviews were conducted with youth (ages 12-24) living with HIV in Ontario. Also, brief structured demographic surveys were administered at the time of the interview. A stakeholder group of youth living with HIV, professionals and researchers collaboratively analyzed the data for emerging themes. Results Five main themes were identified with respect to the youth's use of and interest in the Internet as a health promotion strategy. These include: (1) high rates of Internet use and access; (2) issues around public and private terminals; (3) their use of the Internet primarily for communication and entertainment; (4) the rarity of health information seeking behavior in this group; and (5) wanting "one-stop shopping" from an e-health site. HIV-positive youth were enthusiastic about the possibility of content that was developed specifically to target them and their needs. Also, they were keen about the possibilities for increased social support that youth-specific online chat rooms and message boards might provide. Conclusion Given high rates of use, access and interest, the Internet provides an important way to reach young people living with HIV using health services and health promotion programs. The onus is on e-Health developers to understand the particular needs of HIV-positive youth and create relevant content. PMID:15471758

Health Information Needs and Reliability of Sources Among Nondegree Health Sciences Students: A Prerequisite for Designing eHealth Literacy.

PubMed

Haruna, Hussein; Tshuma, Ndumiso; Hu, Xiao

Understanding health information needs and health-seeking behavior is a prerequisite for developing an electronic health information literacy (EHIL) or eHealth literacy program for nondegree health sciences students. At present, interest in researching health information needs and reliable sources paradigms has gained momentum in many countries. However, most studies focus on health professionals and students in higher education institutions. The present study was aimed at providing new insight and filling the existing gap by examining health information needs and reliability of sources among nondegree health sciences students in Tanzania. A cross-sectional study was conducted in 15 conveniently selected health training institutions, where 403 health sciences students were participated. Thirty health sciences students were both purposely and conveniently chosen from each health-training institution. The selected students were pursuing nursing and midwifery, clinical medicine, dentistry, environmental health sciences, pharmacy, and medical laboratory sciences courses. Involved students were either in their first year, second year, or third year of study. Health sciences students' health information needs focus on their educational requirements, clinical practice, and personal information. They use print, human, and electronic health information. They lack eHealth research skills in navigating health information resources and have insufficient facilities for accessing eHealth information, a lack of specialists in health information, high costs for subscription electronic information, and unawareness of the availability of free Internet and other online health-related databases. This study found that nondegree health sciences students have limited skills in EHIL. Thus, designing and incorporating EHIL skills programs into the curriculum of nondegree health sciences students is vital. EHIL is a requirement common to all health settings, learning environments, and

Effectiveness of a Web-based tailored intervention (E-health4Uth) and consultation to promote adolescents' health: randomized controlled trial.

PubMed

Bannink, Rienke; Broeren, Suzanne; Joosten-van Zwanenburg, Evelien; van As, Els; van de Looij-Jansen, Petra; Raat, Hein

2014-05-30

To promote well-being and health behaviors among adolescents, 2 interventions were implemented at 12 secondary schools. Adolescents in the E-health4Uth group received Web-based tailored messages focused on their health behaviors and well-being. Adolescents in the E-health4Uth and consultation group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems. This study evaluated the effect of E-health4Uth and E-health4Uth and consultation on well-being (ie, mental health status and health-related quality of life) and health behaviors (ie, alcohol and drug use, smoking, safe sex). A cluster randomized controlled trial was conducted among third- and fourth-year secondary school students (mean age 15.9, SD 0.69). School classes (clusters) were randomly assigned to (1) E-health4Uth group, (2) E-health4Uth and consultation group, or (3) control group (ie, care as usual). Adolescents completed a questionnaire at baseline and at 4-month follow-up assessing alcohol consumption, smoking, drug use, condom use, mental health via the Strengths and Difficulties Questionnaire (SDQ) and the Youth Self Report (YSR; only measured at follow-up), and health-related quality of life. Multilevel logistic, ordinal, and linear regression analyses were used to reveal differences in health behavior and well-being between the intervention groups and the control group at follow-up. Subsequently, it was explored whether demographics moderated the effects. Data from 1256 adolescents were analyzed. Compared to the control intervention, the E-health4Uth intervention, as a standalone intervention, showed minor positive results in health-related quality of life (B=2.79, 95% CI 0.72-4.87) and condom use during intercourse among adolescents of Dutch ethnicity (OR 3.59, 95% CI 1.71-7.55) not replicated in the E-health4Uth and consultation group. The E-health4Uth and consultation intervention showed minor

Effectiveness of a Web-Based Tailored Intervention (E-health4Uth) and Consultation to Promote Adolescents’ Health: Randomized Controlled Trial

PubMed Central

Bannink, Rienke; Broeren, Suzanne; Joosten-van Zwanenburg, Evelien; van As, Els; van de Looij-Jansen, Petra

2014-01-01

Background To promote well-being and health behaviors among adolescents, 2 interventions were implemented at 12 secondary schools. Adolescents in the E-health4Uth group received Web-based tailored messages focused on their health behaviors and well-being. Adolescents in the E-health4Uth and consultation group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems. Objective This study evaluated the effect of E-health4Uth and E-health4Uth and consultation on well-being (ie, mental health status and health-related quality of life) and health behaviors (ie, alcohol and drug use, smoking, safe sex). Methods A cluster randomized controlled trial was conducted among third- and fourth-year secondary school students (mean age 15.9, SD 0.69). School classes (clusters) were randomly assigned to (1) E-health4Uth group, (2) E-health4Uth and consultation group, or (3) control group (ie, care as usual). Adolescents completed a questionnaire at baseline and at 4-month follow-up assessing alcohol consumption, smoking, drug use, condom use, mental health via the Strengths and Difficulties Questionnaire (SDQ) and the Youth Self Report (YSR; only measured at follow-up), and health-related quality of life. Multilevel logistic, ordinal, and linear regression analyses were used to reveal differences in health behavior and well-being between the intervention groups and the control group at follow-up. Subsequently, it was explored whether demographics moderated the effects. Results Data from 1256 adolescents were analyzed. Compared to the control intervention, the E-health4Uth intervention, as a standalone intervention, showed minor positive results in health-related quality of life (B=2.79, 95% CI 0.72-4.87) and condom use during intercourse among adolescents of Dutch ethnicity (OR 3.59, 95% CI 1.71-7.55) not replicated in the E-health4Uth and consultation group. The E-health4Uth and

Emerging mHealth and eHealth Interventions for Serious Mental Illness: A Review of the Literature

PubMed Central

Naslund, John A.; Marsch, Lisa A.; McHugo, Gregory J.; Bartels, Stephen J.

2016-01-01

Background Serious mental illness is one of the leading causes of disability worldwide. Emerging mobile health (mHealth) and eHealth interventions may afford opportunities for reaching this at-risk group. Aim To review the evidence on using emerging mHealth and eHealth technologies among people with serious mental illness. Methods We searched MEDLINE, PsychINFO, CINAHL, Scopus, Cochrane Central, and Web of Science through July 2014. Only studies reporting outcomes for mHealth or eHealth interventions, defined as remotely delivered using mobile, online, or other devices, targeting people with schizophrenia, schizoaffective disorder, or bipolar disorder, were included. Results Forty-six studies spanning 12 countries were included. Interventions were grouped into four categories: 1) illness self-management and relapse prevention; 2) promoting adherence to medications and/or treatment; 3) psychoeducation, supporting recovery, and promoting health and wellness; and 4) symptom monitoring. The interventions were consistently found to be highly feasible and acceptable, though clinical outcomes were variable but offered insight regarding potential effectiveness. Conclusions Our findings confirm the feasibility and acceptability of emerging mHealth and eHealth interventions among people with serious mental illness; however, it is not possible to draw conclusions regarding effectiveness. Further rigorous investigation is warranted to establish effectiveness and cost benefit in this population. PMID:26017625

Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature.

PubMed

Naslund, John A; Marsch, Lisa A; McHugo, Gregory J; Bartels, Stephen J

2015-01-01

Serious mental illness (SMI) is one of the leading causes of disability worldwide. Emerging mobile health (mHealth) and eHealth interventions may afford opportunities for reaching this at-risk group. To review the evidence on using emerging mHealth and eHealth technologies among people with SMI. We searched MEDLINE, PsychINFO, CINAHL, Scopus, Cochrane Central, and Web of Science through July 2014. Only studies which reported outcomes for mHealth or eHealth interventions, defined as remotely delivered using mobile, online, or other devices, targeting people with schizophrenia, schizoaffective disorder, or bipolar disorder, were included. Forty-six studies spanning 12 countries were included. Interventions were grouped into four categories: (1) illness self-management and relapse prevention; (2) promoting adherence to medications and/or treatment; (3) psychoeducation, supporting recovery, and promoting health and wellness; and (4) symptom monitoring. The interventions were consistently found to be highly feasible and acceptable, though clinical outcomes were variable but offered insight regarding potential effectiveness. Our findings confirm the feasibility and acceptability of emerging mHealth and eHealth interventions among people with SMI; however, it is not possible to draw conclusions regarding effectiveness. Further rigorous investigation is warranted to establish effectiveness and cost benefit in this population.

Compliance Patterns and Utilization of e-Health for Glucose Monitoring: Standalone Internet Gateway and Tablet Device.

PubMed

Rho, Mi Jung; Kim, Hun-Sung; Yoon, Kun-Ho; Choi, In Young

2017-04-01

Knowledge regarding compliance patterns and service utilization in e-health is important for the development of effective services. To develop proper e-health, the characteristics of compliance patterns and utilization of e-health should be studied. We studied these for glucose monitoring of diabetic patients from primary clinics. Data were collected from 160 outpatients who participated in e-health for glucose monitoring funded by the Korean government. Specifically, this study focused on two device types: a standalone Internet gateway and a tablet device. The SPSS 18.0 software was used for statistical analyses of demographic characteristics, survival data, and Cox proportional hazards regression model. Standalone Internet gateway users demonstrated a more stable compliance pattern than did tablet device users. The compliance rate differed according to the device type. Typically, compliance decreases considerably around 8 months. In these results, standalone Internet gateway users utilized the service for longer periods than tablet device users. Gateway type and location also influenced utilization (p < 0.05). The service should be designed according to the device type to develop appropriate service models. Thus, service designers should understand the different characteristics of service devices. This study provides insight into compliance patterns and utilization to develop appropriate service models and service interventions depending on the device.

Digital age and the public eHealth perspective: Prevailing health app use among Austrian Internet users.

PubMed

Naszay, Marlene; Stockinger, Andreas; Jungwirth, David; Haluza, Daniela

2017-12-19

New technological developments affect almost every sector of our daily lives including the healthcare sector. Successful adoption and sustainable integration of eHealth and telemedicine in Public Health strategies (also known as Public eHealth) depend on knowledge and constant evaluation of consumers' needs, proficiencies, and preferences. We therefore assessed how the general Austrian population perceived innovative Public eHealth solutions. The online survey on 562 Austrian adults (58.9% females) collected self-reported data on current and expected use of smartphone-based health applications (apps) of digital natives (35 years and younger) and digital immigrants (aged 35+). In total, 26.7% (95% CI 23.0-30.4) of participants already used health apps, especially lifestyle-associated apps for monitoring exercise habits and nutritional habits. We found substantial digital age group differences; compared to digital immigrants digital natives were more likely to use mobile devices and health apps. Health apps have the potential to improve community health and prevent lifestyle diseases cost-effectively and efficiently, and thus build an important pillar of Public eHealth. With regard to aging societies, healthcare providers could take advantage of consumer-oriented health apps by assessing individual needs of specific target groups such as elderly people.

Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses

PubMed Central

Elbert, Niels J; van Os-Medendorp, Harmieke; van Renselaar, Wilco; Ekeland, Anne G; Hakkaart-van Roijen, Leona; Raat, Hein; Nijsten, Tamar EC

2014-01-01

Background eHealth potentially enhances quality of care and may reduce health care costs. However, a review of systematic reviews published in 2010 concluded that high-quality evidence on the benefits of eHealth interventions was still lacking. Objective We conducted a systematic review of systematic reviews and meta-analyses on the effectiveness/cost-effectiveness of eHealth interventions in patients with somatic diseases to analyze whether, and to what possible extent, the outcome of recent research supports or differs from previous conclusions. Methods Literature searches were performed in PubMed, EMBASE, The Cochrane Library, and Scopus for systematic reviews and meta-analyses on eHealth interventions published between August 2009 and December 2012. Articles were screened for relevance based on preset inclusion and exclusion criteria. Citations of residual articles were screened for additional literature. Included papers were critically appraised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement before data were extracted. Based on conclusions drawn by the authors of the included articles, reviews and meta-analyses were divided into 1 of 3 groups: suitable, promising, or limited evidence on effectiveness/cost-effectiveness. Cases of uncertainty were resolved by consensus discussion. Effect sizes were extracted from papers that included a meta-analysis. To compare our results with previous findings, a trend analysis was performed. Results Our literature searches yielded 31 eligible reviews, of which 20 (65%) reported on costs. Seven papers (23%) concluded that eHealth is effective/cost-effective, 13 (42%) underlined that evidence is promising, and others found limited or inconsistent proof. Methodological quality of the included reviews and meta-analyses was generally considered high. Trend analysis showed a considerable accumulation of literature on eHealth. However, a similar percentage of papers concluded that eHealth

eHealth Use Among First-Generation Immigrants From Pakistan in the Oslo Area, Norway, With Focus on Diabetes: Survey Protocol

PubMed Central

Kjøllesdal, Marte Karoline Råberg; Mirkovic, Jelena; Andreassen, Hege Kristin

2016-01-01

Background A variety of eHealth services are available and commonly used by the general public. eHealth has the potential to engage and empower people with managing their health. The prerequisite is, however, that eHealth services are adapted to the sociocultural heterogeneity of the user base and are available in a language and with contents that fit the users’ preference, skills, and abilities. Pakistani immigrants in the Oslo area, Norway, have a much higher risk of Type-2 diabetes (T2D) than their Norwegian counterparts do. In spite of having access to information and communication technology (ICT) and the Internet, ICT skills in this population are reported to be relatively low. Further, there is insufficient information about their use of and attitudes toward eHealth services, necessitating investigation of this group in particular. Objective This study targets first-generation immigrants from Pakistan living in the Oslo area and examines their use of and attitudes toward eHealth services, specifically: information searches, communication using ICT, and use of ICT for self-management or decision making, all concerning T2D. Methods Due to a high prevalence of low literacy among the target population, we employed questionnaire-based individual interviews. The questionnaire was developed by implementing potentially relevant theoretical constructs (technology acceptance model (TAM) and health belief model (HBM)) as measures. To explore issues around language, culture, and general ICT skills, we also implemented questions that we assume were particularly relevant in the context studied but do not appear in any theoretical frameworks. The questionnaire was revised to reflect results of a pilot study involving 10 participants. We employed culturally sensitive sampling methods to reach informants who could otherwise fail to be included in the survey. Results This paper presents a survey protocol. The data collection is ongoing. The aim is to collect 200 responses

eHealth and mHealth interventions in the treatment of fatigued cancer survivors: A systematic review and meta-analysis.

PubMed

Seiler, Annina; Klaas, Vanessa; Tröster, Gerhard; Fagundes, Christopher P

2017-09-01

To (1) evaluate existing eHealth/mHealth interventions developed to help manage cancer-related fatigue (CRF); and (2) summarize the best available evidence on their effectiveness. A comprehensive literature search of PubMed, MEDLINE, EMBASE, and the Cochrane Library up to November 2016 was conducted. Study outcomes were extracted, tabulated, and summarized. Random effects meta-analyses were conducted for the primary outcome (fatigue), and the secondary outcomes quality of life and depression, yielding pooled effect sizes (r), and 95% confidence intervals (CI). For eHealth interventions, our search of published papers identified 9 completed studies and 6 protocols for funded projects underway. No studies were identified for mHealth interventions that met our inclusion criteria. A meta-analysis of the 9 completed eHealth studies revealed a statistically significant beneficial effect of eHealth interventions on CRF (r = .27, 95% CI [.1109 - .4218], P < 0.01). Therapist-guided eHealth interventions were more efficacious then self-guided interventions (r = .58, 95% CI: [.3136 - .5985, P < 0.001). Small to moderate therapeutic effects were also observed for HRQoL (r = .17, 95% CI [.0384 - .3085], P < 0.05) and depression (r = .24, 95% CI [.1431 - .3334], P < 0.001). eHealth interventions appear to be effective for managing fatigue in cancer survivors with CRF. Continuous development of eHealth interventions for the treatment of CRF in cancer survivors and their testing in long-term, large-scale efficacy outcome studies is encouraged. The degree to which mHealth interventions can change CRF in cancer survivors need to be assessed systematically and empirically. Copyright © 2017 John Wiley & Sons, Ltd.

Enabling eHealth as a Pathway for Patient Engagement: a Toolkit for Medical Practice.

PubMed

Graffigna, Guendalina; Barello, Serena; Triberti, Stefano; Wiederhold, Brenda K; Bosio, A Claudio; Riva, Giuseppe

2014-01-01

Academic and managerial interest in patient engagement is rapidly earning attention and becoming a necessary tool for researchers, clinicians and policymakers worldwide to manage the increasing burden of chronic conditions. The concept of patient engagement calls for a reframe of healthcare organizations' models and approaches to care. This also requires innovations in the direction of facilitating the exchanges between the patients and the healthcare. eHealth, namely the use of new communication technologies to provide healthcare, is proved to be proposable to innovate healthcare organizations and to improve exchanges between patients and health providers. However, little attention has been still devoted to how to best design eHealth tools in order to engage patients in their care. eHealth tools have to be appropriately designed according to the specific patients' unmet needs and priorities featuring the different phases of the engagement process. Basing on the Patient Engagement model and on the Positive Technology paradigm, we suggest a toolkit of phase-specific technological resources, highlighting their specific potentialities in fostering the patient engagement process.

Performance of eHealth data sources in local influenza surveillance: a 5-year open cohort study.

PubMed

Timpka, Toomas; Spreco, Armin; Dahlström, Örjan; Eriksson, Olle; Gursky, Elin; Ekberg, Joakim; Blomqvist, Eva; Strömgren, Magnus; Karlsson, David; Eriksson, Henrik; Nyce, James; Hinkula, Jorma; Holm, Einar

2014-04-28

There is abundant global interest in using syndromic data from population-wide health information systems--referred to as eHealth resources--to improve infectious disease surveillance. Recently, the necessity for these systems to achieve two potentially conflicting requirements has been emphasized. First, they must be evidence-based; second, they must be adjusted for the diversity of populations, lifestyles, and environments. The primary objective was to examine correlations between data from Google Flu Trends (GFT), computer-supported telenursing centers, health service websites, and influenza case rates during seasonal and pandemic influenza outbreaks. The secondary objective was to investigate associations between eHealth data, media coverage, and the interaction between circulating influenza strain(s) and the age-related population immunity. An open cohort design was used for a five-year study in a Swedish county (population 427,000). Syndromic eHealth data were collected from GFT, telenursing call centers, and local health service website visits at page level. Data on mass media coverage of influenza was collected from the major regional newspaper. The performance of eHealth data in surveillance was measured by correlation effect size and time lag to clinically diagnosed influenza cases. Local media coverage data and influenza case rates showed correlations with large effect sizes only for the influenza A (A) pH1N1 outbreak in 2009 (r=.74, 95% CI .42-.90; P<.001) and the severe seasonal A H3N2 outbreak in 2011-2012 (r=.79, 95% CI .42-.93; P=.001), with media coverage preceding case rates with one week. Correlations between GFT and influenza case data showed large effect sizes for all outbreaks, the largest being the seasonal A H3N2 outbreak in 2008-2009 (r=.96, 95% CI .88-.99; P<.001). The preceding time lag decreased from two weeks during the first outbreaks to one week from the 2009 A pH1N1 pandemic. Telenursing data and influenza case data showed

Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence.

PubMed

Sieverink, Floor; Kelders, Saskia M; van Gemert-Pijnen, Julia Ewc

2017-12-06

In electronic health (eHealth) evaluations, there is increasing attention for studying the actual usage of a technology in relation to the outcomes found, often by studying the adherence to the technology. On the basis of the definition of adherence, we suggest that the following three elements are necessary to determine adherence to eHealth technology: (1) the ability to measure the usage behavior of individuals; (2) an operationalization of intended use; and (3) an empirical, theoretical, or rational justification of the intended use. However, to date, little is known on how to operationalize the intended usage of and the adherence to different types of eHealth technology. The study aimed to improve eHealth evaluations by gaining insight into when, how, and by whom the concept of adherence has been used in previous eHealth evaluations and finding a concise way to operationalize adherence to and intended use of different eHealth technologies. A systematic review of eHealth evaluations was conducted to gain insight into how the use of the technology was measured, how adherence to different types of technologies was operationalized, and if and how the intended use of the technology was justified. Differences in variables between the use of the technology and the operationalization of adherence were calculated using a chi-square test of independence. In total, 62 studies were included in this review. In 34 studies, adherence was operationalized as "the more use, the better," whereas 28 studies described a threshold for intended use of the technology as well. Out of these 28, only 6 reported a justification for the intended use. The proportion of evaluations of mental health technologies reporting a justified operationalization of intended use is lagging behind compared with evaluations of lifestyle and chronic care technologies. The results indicated that a justification of intended use does not require extra measurements to determine adherence to the technology. The

A Novel ECG Data Compression Method Using Adaptive Fourier Decomposition With Security Guarantee in e-Health Applications.

PubMed

Ma, JiaLi; Zhang, TanTan; Dong, MingChui

2015-05-01

This paper presents a novel electrocardiogram (ECG) compression method for e-health applications by adapting an adaptive Fourier decomposition (AFD) algorithm hybridized with a symbol substitution (SS) technique. The compression consists of two stages: first stage AFD executes efficient lossy compression with high fidelity; second stage SS performs lossless compression enhancement and built-in data encryption, which is pivotal for e-health. Validated with 48 ECG records from MIT-BIH arrhythmia benchmark database, the proposed method achieves averaged compression ratio (CR) of 17.6-44.5 and percentage root mean square difference (PRD) of 0.8-2.0% with a highly linear and robust PRD-CR relationship, pushing forward the compression performance to an unexploited region. As such, this paper provides an attractive candidate of ECG compression method for pervasive e-health applications.

The ins and outs of an online bipolar education program: a study of program attrition.

PubMed

Nicholas, Jennifer; Proudfoot, Judith; Parker, Gordon; Gillis, Inika; Burckhardt, Rowan; Manicavasagar, Vijaya; Smith, Meg

2010-12-19

The science of eHealth interventions is rapidly evolving. However, despite positive outcomes, evaluations of eHealth applications have thus far failed to explain the high attrition rates that are associated with some eHealth programs. Patient adherence remains an issue, and the science of attrition is still in its infancy. To our knowledge, there has been no in-depth qualitative study aimed at identifying the reasons for nonadherence to-and attrition from- online interventions. This paper explores the predictors of attrition and participant-reported reasons for nonadherence to an online psycho-education program for people newly diagnosed with a bipolar disorder. As part of an ongoing randomized controlled trial (RCT) evaluating an online psycho-education program for people newly diagnosed with a bipolar disorder, we undertook an in-depth qualitative study to identify participants' reasons for nonadherence to, and attrition from, the online intervention as well as a quantitative study investigating predictors of attrition. Within the RCT, 370 participants were randomly allocated to 1 of 2 active interventions or an attention control condition. Descriptive analyses and chi-square tests were used to explore the completion rates of 358 participants, and standard regression analysis was used to identify predictors of attrition. The data from interviews with a subsample of 39 participants who did not complete the online program were analyzed using "thematic analysis" to identify patterns in reported reasons for attrition. Overall, 26.5% of the sample did not complete their assigned intervention. Standard multiple regression analysis revealed that young age (P= .004), male gender (P= .001), and clinical recruitment setting (P= .001) were significant predictors of attrition (F(7,330)= 8.08, P< .001). Thematic analysis of interview data from the noncompleter subsample revealed that difficulties associated with the acute phases of bipolar disorder, not wanting to think about

A Machine-to-Machine protocol benchmark for eHealth applications - Use case: Respiratory rehabilitation.

PubMed

Talaminos-Barroso, Alejandro; Estudillo-Valderrama, Miguel A; Roa, Laura M; Reina-Tosina, Javier; Ortega-Ruiz, Francisco

2016-06-01

M2M (Machine-to-Machine) communications represent one of the main pillars of the new paradigm of the Internet of Things (IoT), and is making possible new opportunities for the eHealth business. Nevertheless, the large number of M2M protocols currently available hinders the election of a suitable solution that satisfies the requirements that can demand eHealth applications. In the first place, to develop a tool that provides a benchmarking analysis in order to objectively select among the most relevant M2M protocols for eHealth solutions. In the second place, to validate the tool with a particular use case: the respiratory rehabilitation. A software tool, called Distributed Computing Framework (DFC), has been designed and developed to execute the benchmarking tests and facilitate the deployment in environments with a large number of machines, with independence of the protocol and performance metrics selected. DDS, MQTT, CoAP, JMS, AMQP and XMPP protocols were evaluated considering different specific performance metrics, including CPU usage, memory usage, bandwidth consumption, latency and jitter. The results obtained allowed to validate a case of use: respiratory rehabilitation of chronic obstructive pulmonary disease (COPD) patients in two scenarios with different types of requirement: Home-Based and Ambulatory. The results of the benchmark comparison can guide eHealth developers in the choice of M2M technologies. In this regard, the framework presented is a simple and powerful tool for the deployment of benchmark tests under specific environments and conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Participant Recruitment and Engagement in Automated eHealth Trial Registration: Challenges and Opportunities for Recruiting Women Who Experience Violence.

PubMed

Koziol-McLain, Jane; McLean, Christine; Rohan, Maheswaran; Sisk, Rose; Dobbs, Terry; Nada-Raja, Shyamala; Wilson, Denise; Vandal, Alain C

2016-10-25

Automated eHealth Web-based research trials offer people an accessible, confidential opportunity to engage in research that matters to them. eHealth trials may be particularly useful for sensitive issues when seeking health care may be accompanied by shame and mistrust. Yet little is known about people's early engagement with eHealth trials, from recruitment to preintervention autoregistration processes. A recent randomized controlled trial that tested the effectiveness of an eHealth safety decision aid for New Zealand women in the general population who experienced intimate partner violence (isafe) provided the opportunity to examine recruitment and preintervention participant engagement with a fully automated Web-based registration process. The trial aimed to recruit 340 women within 24 months. The objective of our study was to examine participant preintervention engagement and recruitment efficiency for the isafe trial, and to analyze dropout through the registration pathway, from recruitment to eligibility screening and consent, to completion of baseline measures. In this case study, data collection sources included the trial recruitment log, Google Analytics reports, registration and program metadata, and costs. Analysis included a qualitative narrative of the recruitment experience and descriptive statistics of preintervention participant engagement and dropout rates. A Koyck model investigated the relationship between Web-based online marketing website advertisements (ads) and participant accrual. The isafe trial was launched on September 17, 2012. Placement of ads in an online classified advertising platform increased the average number of recruited participants per month from 2 to 25. Over the 23-month recruitment period, the registration website recorded 4176 unique visitors. Among 1003 women meeting eligibility criteria, 51.55% (517) consented to participate; among the 501 women who enrolled (consented, validated, and randomized), 412 (82.2%) were

Privacy Protection through pseudonymisation in eHealth.

PubMed

De Meyer, F; De Moor, G; Reed-Fourquet, L

2008-01-01

The ISO TC215 WG4 pseudonymisation task group has produced in 2008 a first version of a technical specification for the application of pseudonymisation in Healthcare Informatics 0. This paper investigates the principles set out in the technical specification as well as its implications in eHealth. The technical specification starts out with a conceptual model and evolves from a theoretical model to a real life model by adding assumptions on the observability of personal data.

Weird Project: E-Health Service Improvement Using WiMAX

NASA Astrophysics Data System (ADS)

Cimmino, Antonio; Casali, Fulvio; Mambretti, Cinzia

Today the major obstacle to massive deployment of telemedicine applications are the security issues related to the exchange of real time information between different elements that are not at fixed locations. WiMAX, the new standard for wireless communications, is one of the most promising technologies for broadband access in a fixed and mobile environment and it is expected to overcome the above mentioned obstacle. The FP6-WEIRD [1] (WiMax Extension to Isolated Remote Data networks) project has: analysed how this technology can guarantee secure real time data transmission between mobile elements, built some successful demonstrations and paved the way to future commercial applications. This paper in particular describes: main promising e-health applications that WiMax would enable; the technological highlights and the main challenges that WiMax has to face in e-health applications such as accounting, privacy, security, data integrity; the way in which the WEIRD project 0 has studied the wireless access to medical communities and equipment in remote or impervious areas. 0 0; some envisaged implementations.

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PubMed

O'Connor, Martin; Munnelly, Anita; Whelan, Robert; McHugh, Louise

2018-05-01

eHealth is an innovative method of delivering therapeutic content with the potential to improve access to third-wave behaviural and cognitive therapies. This systematic review and meta-analysis aimed to determine the efficacy and acceptability of third-wave eHealth treatments in improving mental health outcomes. A comprehensive search of electronic bibliographic databases including PubMed, PsycINFO, Web of Science, and CENTRAL was conducted to identify randomized controlled trials of third-wave treatments in which eHealth was the main component. Twenty-one studies were included in the review. Meta-analyses revealed that third-wave eHealth significantly outperformed inactive control conditions in improving anxiety, depression, and quality-of-life outcomes and active control conditions in alleviating anxiety and depression with small to medium effect sizes. No statistically significant differences were found relative to comparison interventions. Findings from a narrative synthesis of participant evaluation outcomes and meta-analysis of participant attrition rates provided preliminary support for the acceptability of third-wave eHealth. Third-wave eHealth treatments are efficacious in improving mental health outcomes including anxiety, depression, and quality of life, but not more so than comparison interventions. Preliminary evidence from indices of participant evaluation and attrition rates supports the acceptability of these treatments. Copyright © 2017. Published by Elsevier Ltd.

Towards sustainable e-health networks: does modeling support efficient management and operation?

PubMed

Staemmler, Martin

2007-01-01

e-Health Networks require cost-effective approaches for routine operation to achieve long-lasting sustainability. By using a model to represent (i) the network's enterprise functions, (ii) the applications used and (iii) the physical implementations, the tasks of management, adapting to changes and providing continued maintenance can be effectively supported. The paper discusses approaches for modeling, assesses their usefulness for the above tasks and decides on the use of the 3LGM meta model. Based on this concept, three ways for modeling the specific properties of an e-Health network are presented, leading to the decision to represent the hospitals involved in only one layer. As a result the model derived is presented, assessed and proved to support strategic management, day-to-day maintenance and documentation.

Using an eHealth Intervention to Stimulate Health Behavior for the Prevention of Cognitive Decline in Dutch Adults: A Study Protocol for the Brain Aging Monitor.

PubMed

Aalbers, Teun; Baars, Maria Ae; Qin, Li; de Lange, Annet; Kessels, Roy Pc; Olde Rikkert, Marcel Gm

2015-11-10

Internet-delivered intervention programs are an effective way of changing health behavior in an aging population. The same population has an increasing number of people with cognitive decline or cognitive impairments. Modifiable lifestyle risk factors such as physical activity, nutrition, smoking, alcohol consumption, sleep, and stress all influence the probability of developing neurodegenerative diseases such as Alzheimer's disease. This study aims to answer two questions: (1) Is the use of a self-motivated, complex eHealth intervention effective in changing multiple health behaviors related to cognitive aging in Dutch adults in the work force, especially those aged 40 and over? and (2) Does this health behavior change result in healthier cognitive aging patterns and contribute to preventing or delaying future onset of neurodegenerative syndromes? The Brain Aging Monitor study uses a quasi-experimental 2-year pre-posttest design. The Brain Aging Monitor is an online, self-motivated lifestyle intervention program. Recruitment is done both in medium to large organizations and in the Dutch general population over the age of 40. The main outcome measure is the relationship between lifestyle change and cognitive aging. The program uses different strategies and modalities such as Web content, email, online newsletters, and online games to aid its users in behavior change. To build self-regulatory skills, the Brain Aging Monitor offers its users goal-setting activities, skill-building activities, and self-monitoring. Study results are expected to be published in early 2016. This study will add to the body of evidence on the effectiveness of eHealth intervention programs with the combined use of state-of-the-art applied games and established behavior change techniques. This will lead to new insights on how to use behavior change techniques and theory in multidimensional lifestyle eHealth research, and how these techniques and theories apply when they are used in a setting

Using eHealth strategies in delivering dietary and other therapies in patients with irritable bowel syndrome and inflammatory bowel disease.

PubMed

Ankersen, Dorit Vedel; Carlsen, Katrine; Marker, Dorte; Munkholm, Pia; Burisch, Johan

2017-03-01

Health-care systems around the world are facing increasing costs. Non-adherent, chronically ill patients are one such expense incurred by health-care providers. Web-based home-monitoring of patients-or eHealth-has been shown to increase adherence to medical therapy, facilitate contact between patients and health-care professionals, and reduce time to remission for patients with inflammatory bowel disease (IBD). Web-based treatment is a supportive tool for the health-care provider in an out-patient clinic. eHealth web-programs, such as the Constant Care application, visualize disease activity in a traffic light system and empower patients to screen for disease activity, enabling them to respond appropriately to their symptoms. The eHealth screening procedure for monitoring both pediatric and adult IBD patients is based on a self-obtained symptom score, together with a fecal biomarker for inflammation (fecal calprotectin) that the patients can measure independently using their smart phone, providing both patient and physician with an immediate disease status that they can react to instantaneously. Likewise, web applications for IBD patients, web applications for irritable bowel syndrome (IBS) patients and also IBD patients with co-existing IBS, have proven valuable for monitoring and treating IBS symptoms with a diet low in fermentable oligo-, di-, monosaccharides and polyols (low-FODMAP diet). With careful disease monitoring via the web application and increased patient adherence, eHealth might be capable of improving the natural disease course of IBD and IBS. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop

PubMed Central

Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D

2013-01-01

Background The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. Objective The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. Methods A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. Results The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. Conclusions This paper describes the health care professionals�

eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop.

PubMed

Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D; Kort, Helianthe S M

2013-01-01

The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. This paper describes the health care professionals' competencies and requirements needed for the use of eHealth

eHealth patient-provider communication in the United States: interest, inequalities, and predictors.

PubMed

Spooner, Kiara K; Salemi, Jason L; Salihu, Hamisu M; Zoorob, Roger J

2017-04-01

Health-related Internet use and eHealth technologies, including online patient-provider communication (PPC), are continually being integrated into health care environments. This study aimed to describe sociodemographic and health- and Internet-related correlates that influence adult patients' interest in and electronic exchange of medical information with health care providers in the United States. Nationally representative cross-sectional data from the 2014 Health Information National Trends Survey ( N  = 3677) were analyzed. Descriptive statistics and multivariable regression analyses were performed to examine associations between patient-level characteristics and online PPC behavior and interests. Most respondents were Internet users (82.8%), and 61.5% of information seekers designated the Internet as their first source for health information. Younger respondents (<50 years), Hispanics, those from higher-income households, and those perceiving access to personal health information as important were more likely to be interested in online PPC. Despite varying levels of patient interest, 68.5% had no online PPC in the last year. However, Internet users (odds ratio, OR = 2.87, 95% CI, 1.35-6.08), college graduates (OR = 2.92, 95% CI, 1.42-5.99), and those with frequent provider visits (OR = 1.94, 95% CI, 1.02-3.71) had a higher likelihood of online PPC via email or fax, while Hispanics and those from higher-income households were 2-3 times more likely to communicate via text messaging or phone/mobile apps. Patients' interest in and display of online PPC-related behaviors vary by age, race/ethnicity, education, income, Internet access/behaviors, and information type. These findings can inform efforts aimed at improving the use and adoption of eHealth technologies, which may contribute to a reduction in communication inequalities and health care disparities. © The Author 2016. Published by Oxford University Press on behalf of the American Medical

Modelling and Predicting eHealth Usage in Europe: A Multidimensional Approach From an Online Survey of 13,000 European Union Internet Users.

PubMed

Torrent-Sellens, Joan; Díaz-Chao, Ángel; Soler-Ramos, Ivan; Saigí-Rubió, Francesc

2016-07-22

More advanced methods and models are needed to evaluate the participation of patients and citizens in the shared health care model that eHealth proposes. The goal of our study was to design and evaluate a predictive multidimensional model of eHealth usage. We used 2011 survey data from a sample of 13,000 European citizens aged 16-74 years who had used the Internet in the previous 3 months. We proposed and tested an eHealth usage composite indicator through 2-stage structural equation modelling with latent variables and measurement errors. Logistic regression (odds ratios, ORs) to model the predictors of eHealth usage was calculated using health status and sociodemographic independent variables. The dimensions with more explanatory power of eHealth usage were health Internet attitudes, information health Internet usage, empowerment of health Internet users, and the usefulness of health Internet usage. Some 52.39% (6811/13,000) of European Internet users' eHealth usage was more intensive (greater than the mean). Users with long-term health problems or illnesses (OR 1.20, 95% CI 1.12-1.29) or receiving long-term treatment (OR 1.11, 95% CI 1.03-1.20), having family members with long-term health problems or illnesses (OR 1.44, 95% CI 1.34-1.55), or undertaking care activities for other people (OR 1.58, 95% CI 1.40-1.77) had a high propensity toward intensive eHealth usage. Sociodemographic predictors showed that Internet users who were female (OR 1.23, 95% CI 1.14-1.31), aged 25-54 years (OR 1.12, 95% CI 1.05-1.21), living in larger households (3 members: OR 1.25, 95% CI 1.15-1.36; 5 members: OR 1.13, 95% CI 0.97-1.28; ≥6 members: OR 1.31, 95% CI 1.10-1.57), had more children <16 years of age (1 child: OR 1.29, 95% CI 1.18-1.14; 2 children: OR 1.05, 95% CI 0.94-1.17; 4 children: OR 1.35, 95% CI 0.88-2.08), and had more family members >65 years of age (1 member: OR 1.33, 95% CI 1.18-1.50; ≥4 members: OR 1.82, 95% CI 0.54-6.03) had a greater propensity toward

How user diversity and country of origin impact the readiness to adopt E-health technologies: an intercultural comparison.

PubMed

Wilkowsk, Wiktoria; Ziefle, Martina; Alagöz, Firat

2012-01-01

In recent years, due to the demographical change and the resulting overload of healthcare systems, there has been an increasing interest focusing on the global proliferation of assistive medical technologies (=E-health) in home environments. The present study examines how users' diversity influences the readiness to adopt novel medical technologies, comparing users' attitudes in terms of perceived advantages and disadvantages in three technically and culturally different countries: Germany, Poland and Turkey. This investigation also intended to verify if acceptance of information and communication technologies is associated with the sensitive acceptance of E-health. Results revealed overall a considerably higher motivation to use medical technology compared to perceived barriers, with Polish users more willing to use E-health, higher than German or Turkish ones. Older participants showed a highly positive attitude, comparable to young and middle-aged respondents' receptiveness, differing from the latter in terms of greater appreciation of the advantage of higher independency when being supported by medical technology. With respect to gender, woman showed higher motivation to use E-health technology than men, although utilization barriers were not gendered. Following these results, an unconditional transfer of acceptance from information and communication to medical technology is not justified.

The Impact of eHealth on the Quality and Safety of Healthcare

NASA Astrophysics Data System (ADS)

Majeed, Azeem; Black, Ashly; Car, Josip; Anandan, Chantelle; Cresswell, Kathrin; McKinstry, Brian; Pagliari, Claudia; Procter, Rob; Sheikh, Aziz

There is considerable interest in using information technology (IT) to enhance the quality and safety of healthcare. We undertook a systematic literature review to assess the impact of eHealth applications on the quality and safety of healthcare. We retrieved 46,349 potentially relevant publications, from which we selected 67 relevant systematic reviews for inclusion. The literature was found to be poorly collated and of variable quality in its methodology, reporting and utility. We categorised eHealth applications into three main areas: i). storing, managing and transmission of data; ii). supporting clinical decision-making; and iii). facilitating care from a distance. We found that relative to the potential benefits noted within the literature, little empirical evidence exists in support of these applications. Of the few studies revealing the clearest evidence of benefits, many are from academic clinical centres where developers of new applications have also been directly associated with their evaluation. It is therefore unclear how effective these applications would be if deployed outside the environment in which they were developed. Our review of the impact of eHealth applications on quality and safety of healthcare demonstrated a vast gap between the postulated and empirically demonstrated benefits. In addition, there is a lack of robust research on risks and costs. Consequently, the cost-effectiveness of these interventions has yet to be demonstrated.

36 CFR 230.32 - National program administration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false National program... AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.32 National program... three geographic funding areas based on the criteria set out in the Forest Service Manual Chapter 3310...

36 CFR 230.32 - National program administration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false National program... AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.32 National program... three geographic funding areas based on the criteria set out in the Forest Service Manual Chapter 3310...

Women health extension workers: Capacities, opportunities and challenges to use eHealth to strengthen equitable health systems in Southern Ethiopia.

PubMed

Dusabe-Richards, John N; Tesfaye, Hayley Teshome; Mekonnen, Jarso; Kea, Aschenaki; Theobald, Sally; Datiko, Daniel G

2016-12-27

This study assesses the feasibility of female health extension workers (HEWs) using eHealth within their core duties, supporting both the design and capacity building for an eHealth system project focussed initially on tuberculosis, maternal child health, and gender equity. Health extension workers, Health Centre Heads, District Health Officers, Zonal Health Department and Regional Health Bureau representatives in Southern Ethiopia. The study was undertaken in Southern Ethiopia with three districts in Sidama zone (population of 3.5 million) and one district in Gedeo zone (control zone with similar health service coverage and population density). Mixed method baseline data collection was undertaken, using quantitative questionnaires (n = 57) and purposively sampled qualitative face-to-face semi-structured interviews (n = 10) and focus group discussions (n = 3). Themes were identified relating to HEW commitment and role, supervision, and performance management. The Health Management Information System (HMIS) was seen as important by all participants, but with challenges of information quality, accuracy, reliability and timeliness. Participants' perceptions varied by group regarding the purpose and benefits of HMIS as well as the potential of an eHealth system. Mobile phones were used regularly by all participants. eHealth technology presents a new opportunity for the Ethiopian health system to improve data quality and community health. Front-line female HEWs are a critical bridge between communities and health systems. Empowering HEWs, supporting them and responding to the challenges they face will be an important part of ensuring the sustainability and responsiveness of eHealth strategies. Findings have informed the subsequent eHealth technology design and implementation, capacity strengthening approach, supervision, and performance management approach.

Structural and legal implications of e-health.

PubMed

Terry, N P

2000-01-01

Web and attendant e-Commerce phenomena are irretrievably at odds with the traditional structure and hence legal regulation of health delivery. E-Health delivers healthcare information, diagnosis, treatment, care, and prescribing of drugs in a nonlinear, nonhierarchical manner that encourages patients to "enter" the system at an infinite number of points, thus defying current regulatory constructs. Similarly, e-Commerce fundamentals such as disintermediation and disaggregation result in medical information being delivered through unfamiliar channels, creating immensely difficult questions for health lawyers.

'Second generation' Internet e-health: the gladiator for HIPAA compliance?

PubMed

Korpman, R A; Rose, J S

2001-01-01

The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administrative processes and improve health information security. There are a number of traditional ways to address the expense and complexities of simplification, but none of them are bargains or beauties to behold: (1) Do-it-yourself encryption; (2) new back-end system purchases; (3) legacy system re-programming; or (4) onerous paper documentation. The good news is that 'second generation' e-health solutions are emerging that act as internal "wrappers" for health plan or provider data systems. They provide both an interface for end-users and a layer of security for organizational information and allow detailed patient-related data to remain at the system owner's physical location. These second generation solutions don't just 'connect,' data, they actually 'understand' the information, and can use data elements to invoke necessary rules, processing pathways, or personalization for specific stakeholders as required by HIPAA.

Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

PubMed

Piette, John D; Lun, K C; Moura, Lincoln A; Fraser, Hamish S F; Mechael, Patricia N; Powell, John; Khoja, Shariq R

2012-05-01

E-health encompasses a diverse set of informatics tools that have been designed to improve public health and health care. Little information is available on the impacts of e-health programmes, particularly in low- and middle-income countries. We therefore conducted a scoping review of the published and non-published literature to identify data on the effects of e-health on health outcomes and costs. The emphasis was on the identification of unanswered questions for future research, particularly on topics relevant to low- and middle-income countries. Although e-health tools supporting clinical practice have growing penetration globally, there is more evidence of benefits for tools that support clinical decisions and laboratory information systems than for those that support picture archiving and communication systems. Community information systems for disease surveillance have been implemented successfully in several low- and middle-income countries. Although information on outcomes is generally lacking, a large project in Brazil has documented notable impacts on health-system efficiency. Meta-analyses and rigorous trials have documented the benefits of text messaging for improving outcomes such as patients' self-care. Automated telephone monitoring and self-care support calls have been shown to improve some outcomes of chronic disease management, such as glycaemia and blood pressure control, in low- and middle-income countries. Although large programmes for e-health implementation and research are being conducted in many low- and middle-income countries, more information on the impacts of e-health on outcomes and costs in these settings is still needed.

Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

PubMed Central

Lun, KC; Moura, Lincoln A; Fraser, Hamish SF; Mechael, Patricia N; Powell, John; Khoja, Shariq R

2012-01-01

Abstract E-health encompasses a diverse set of informatics tools that have been designed to improve public health and health care. Little information is available on the impacts of e-health programmes, particularly in low- and middle-income countries. We therefore conducted a scoping review of the published and non-published literature to identify data on the effects of e-health on health outcomes and costs. The emphasis was on the identification of unanswered questions for future research, particularly on topics relevant to low- and middle-income countries. Although e-health tools supporting clinical practice have growing penetration globally, there is more evidence of benefits for tools that support clinical decisions and laboratory information systems than for those that support picture archiving and communication systems. Community information systems for disease surveillance have been implemented successfully in several low- and middle-income countries. Although information on outcomes is generally lacking, a large project in Brazil has documented notable impacts on health-system efficiency. Meta-analyses and rigorous trials have documented the benefits of text messaging for improving outcomes such as patients’ self-care. Automated telephone monitoring and self-care support calls have been shown to improve some outcomes of chronic disease management, such as glycaemia and blood pressure control, in low- and middle-income countries. Although large programmes for e-health implementation and research are being conducted in many low- and middle-income countries, more information on the impacts of e-health on outcomes and costs in these settings is still needed. PMID:22589570

Cardiac patients' experiences with a telerehabilitation web portal: Implications for eHealth literacy.

PubMed

Melholt, Camilla; Joensson, Katrine; Spindler, Helle; Hansen, John; Andreasen, Jan Jesper; Nielsen, Gitte; Noergaard, Astrid; Tracey, Anita; Thorup, Charlotte; Kringelholt, Rikke; Dinesen, Birthe Irene

2018-05-01

The aims of this study are two-fold: 1) To explore how cardiac patients experience their use of a telerehabilitation tool for recuperation from surgery, and 2) To study how the patients' use of the interactive 'Active Heart' web portal affected their eHealth literacy skills. The 'Active Heart' telerehabilitation web portal offers patients and their relatives information and exercises for recovery from cardiac surgery. 109 cardiac patients were using the Active Heart web portal for a duration of three months. 49 patients completed questionnaires that were administered both before and after their use of the portal, resulting in a 45% response rate. Respondents had a mean age of 60.64 ± 10.75 years, and 82% of the respondents were males. The respondents had a positive impression of Active Heart, reporting that it was easy to access, user-friendly, and written in an understandable language. The patients' eHealth literacy skills increased during the trial period. Use of a cardiac telerehabilitation web portal can be beneficial for patient education and can increase cardiac patients' eHealth literacy skills. Online telerehabilitation portals may be used as a tool in patient education and cardiac rehabilitation. Copyright © 2017 Elsevier B.V. All rights reserved.

Adopting customers' empowerment and social networks to encourage participations in e-health services.

PubMed

Anshari, Muhammad; Almunawar, Mohammad Nabil; Low, Patrick Kim Cheng; Wint, Zaw; Younis, Mustafa Z

2013-01-01

The aim of this article is to present an e-health model that embeds empowerment and social network intervention that may extend the role of customers in health care settings. A 25-item Likert-type survey instrument was specifically developed for this study and administered to a sample of 108 participants in Indonesia from October to November 2012. The data were analyzed to provide ideas on how to move forward with the e-health initiative as a means to improve e-health services. The survey revealed that there is a high demand for customers' empowerment and involvement in social networks to improve their health literacy and customer satisfaction. Regardless of the limitations of the study, the participants have responded with great support for the abilities of the prototype systems drawn from the survey. The survey results were used as requirements to develop a system prototype that incorporates the expectations of the people. The prototype (namely Clinic 2.0) was derived from the model and confirmed from the survey. Participants were selected to use the system for three months, after which we measured its impact towards their health literacy and customer satisfaction. The results show that the system intervention through Clinic 2.0 leads to a high level of customer satisfaction and health literacy.

Understanding health literacy for strategic health marketing: eHealth literacy, health disparities, and the digital divide.

PubMed

Bodie, Graham D; Dutta, Mohan Jyoti

2008-01-01

Even despite policy efforts aimed at reducing health-related disparities, evidence mounts that population-level gaps in literacy and healthcare quality are increasing. This widening of disparities in American culture is likely to worsen over the coming years due, in part, to our increasing reliance on Internet-based technologies to disseminate health information and services. The purpose of the current article is to incorporate health literacy into an Integrative Model of eHealth Use. We argue for this theoretical understanding of eHealth literacy and propose that macro-level disparities in social structures are connected to health disparities through the micro-level conduits of eHealth literacy, motivation, and ability. In other words, structural inequities reinforce themselves and continue to contribute to healthcare disparities through the differential distribution of technologies that simultaneously enhance and impede literacy, motivation, and ability of different groups (and individuals) in the population. We conclude the article by suggesting pragmatic implications of our analysis.

Implementation experiences of ISO/IEEE11073 standard applied to new use cases for e-health environments.

PubMed

Martinez, I; Escayola, J; Martinez-Espronceda, M; Serrano, L; Trigo, J D; Led, S; Garcia, J

2009-01-01

Recent advances in biomedical engineering and continuous technological innovations in last decade are promoting new challenges, especially in e-Health environments. In this context, the medical devices interoperability is one of the interest fields wherein these improvements require a standard-based design in order to achieve homogeneous solutions. Furthermore, the spreading of wearable devices, oriented to the paradigm of patient environment and supported by wireless technologies as Bluetooth or ZigBee, is bringing new medical use cases based on Ambient Assisted Living, home monitoring of elderly, heart failure, chronic, under palliative care or patients who have undergone surgery, urgencies and emergencies, or even fitness auto-control and health follow-up. In this paper, several implementation experiences based on ISO/IEEE11073 standard are detailed. These evolved e-Health services can improve the quality of the patient's care, increase the user's interaction, and assure these e-Health applications to be fully compatible with global telemedicine systems.

Performance of eHealth Data Sources in Local Influenza Surveillance: A 5-Year Open Cohort Study

PubMed Central

Spreco, Armin; Dahlström, Örjan; Eriksson, Olle; Gursky, Elin; Ekberg, Joakim; Blomqvist, Eva; Strömgren, Magnus; Karlsson, David; Eriksson, Henrik; Nyce, James; Hinkula, Jorma; Holm, Einar

2014-01-01

Background There is abundant global interest in using syndromic data from population-wide health information systems—referred to as eHealth resources—to improve infectious disease surveillance. Recently, the necessity for these systems to achieve two potentially conflicting requirements has been emphasized. First, they must be evidence-based; second, they must be adjusted for the diversity of populations, lifestyles, and environments. Objective The primary objective was to examine correlations between data from Google Flu Trends (GFT), computer-supported telenursing centers, health service websites, and influenza case rates during seasonal and pandemic influenza outbreaks. The secondary objective was to investigate associations between eHealth data, media coverage, and the interaction between circulating influenza strain(s) and the age-related population immunity. Methods An open cohort design was used for a five-year study in a Swedish county (population 427,000). Syndromic eHealth data were collected from GFT, telenursing call centers, and local health service website visits at page level. Data on mass media coverage of influenza was collected from the major regional newspaper. The performance of eHealth data in surveillance was measured by correlation effect size and time lag to clinically diagnosed influenza cases. Results Local media coverage data and influenza case rates showed correlations with large effect sizes only for the influenza A (A) pH1N1 outbreak in 2009 (r=.74, 95% CI .42-.90; P<.001) and the severe seasonal A H3N2 outbreak in 2011-2012 (r=.79, 95% CI .42-.93; P=.001), with media coverage preceding case rates with one week. Correlations between GFT and influenza case data showed large effect sizes for all outbreaks, the largest being the seasonal A H3N2 outbreak in 2008-2009 (r=.96, 95% CI .88-.99; P<.001). The preceding time lag decreased from two weeks during the first outbreaks to one week from the 2009 A pH1N1 pandemic. Telenursing data

Cultural and Contextual Adaptation of an eHealth Intervention for Youth Receiving Services for First-Episode Psychosis: Adaptation Framework and Protocol for Horyzons-Canada Phase 1.

PubMed

Lal, Shalini; Gleeson, John; Malla, Ashok; Rivard, Lysanne; Joober, Ridha; Chandrasena, Ranjith; Alvarez-Jimenez, Mario

2018-04-23

eHealth interventions have the potential to address challenges related to access, service engagement, and continuity of care in the delivery of mental health services. However, the initial development and evaluation of such interventions can require substantive amounts of financial and human resource investments to bring them to scale. Therefore, it may be warranted to pay greater attention to policy, services, and research with respect to eHealth platforms that have the potential to be adapted for use across settings. Yet, limited attention has been placed on the methods and processes for adapting eHealth interventions to improve their applicability across cultural, geographical, and contextual boundaries. In this paper, we describe an adaptation framework and protocol to adapt an eHealth intervention designed to promote recovery and prevent relapses in youth receiving specialized services for first-episode psychosis. The Web-based platform, called Horyzons, was initially developed and tested in Australia and is now being prepared for evaluation in Canada. Service users and service providers from 2 specialized early intervention programs for first-episode psychosis located in different provinces will explore a beta-version of the eHealth intervention through focus group discussions and extended personal explorations to identify the need for, and content of contextual and cultural adaptations. An iterative consultation process will then take place with service providers and users to develop and assess platform adaptations in preparation for a pilot study with a live version of the platform. Data collection was completed in August 2017, and analysis and adaptation are in process. The first results of the study will be submitted for publication in 2018 and will provide preliminary insights into the acceptability of the Web-based platform (eg, perceived use and perceived usefulness) from service provider and service user perspectives. The project will also provide

Using eHealth to Increase Autonomy Supportive Care: A Multicenter Intervention Study in Antenatal Care.

PubMed

Johnsen, Helle; Blom, Karina Fischer; Lee, Anne; Nørgaard, Birgitte

2018-02-01

eHealth solutions are increasingly implemented in antenatal care to enhance women's involvement. The main aim of this study was to evaluate women's assessment of autonomy supportive care during the antenatal care visits among low-risk pregnant women. An intervention study was conducted including a control group attending standard antenatal care and an intervention group having access to an eHealth knowledge base, in addition to standard care. A total of 87 women were included in the control group and a total of 121 women in the intervention group. Data were collected using an online questionnaire 2 weeks after participants had given birth. Data were analyzed using χ tests and Wilcoxon rank sums. Use of an eHealth knowledge base was associated with statistically significant higher scores for women's overall assessment of antenatal care visits, the organization of antenatal care visits, confidence after antenatal care visits, and involvement during antenatal care visits. We also found a statistically significant higher overall self-perceived autonomy supportive care in the intervention group compared with the control group.

Ill Literates or Illiterates? Investigating the eHealth Literacy of Users of Online Health Communities

PubMed Central

Atanasova, Sara; Kamin, Tanja

2017-01-01

Background Electronic health (eHealth) literacy is an important skill that allows patients to navigate intelligibly through the vast, often misleading Web-based world. Although eHealth literacy has been investigated in general and specific demographic populations, it has not yet been analyzed on users of online health communities (OHCs). Evidence shows that OHCs are important Web 2.0 applications for patients for managing their health, but at the same time, warnings have been expressed regarding the quality and relevance of shared information. No studies exist that investigate levels of eHealth literacy among users of OHCs and differences in eHealth literacy between different types of users. Objective The study aimed to investigate eHealth literacy across different types of users of OHCs based on a revised and extended eHealth literacy scale (eHEALS). Methods The study was based on a cross-sectional Web survey on a simple random sample of 15,000 registered users of the most popular general OHC in Slovenia. The final sample comprised 644 users of the studied OHC. An extended eHEALS (eHEALS-E) was tested with factor analytical procedures, whereas user types were identified with a hierarchical clustering algorithm. The research question was analyzed with analysis of variance (ANOVA) procedure and pairwise comparison tests. Results Factor analysis of the revised and extended eHEALS revealed six dimensions: awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information, and being smart on the Net. The factor solution demonstrates a good fit to the data (root mean square error of approximation [RMSEA]=.059). The most developed dimension of eHEALS-E is awareness of different Internet sources (mean=3.98, standard deviation [SD]=0.61), whereas the least developed is understanding information (mean=3.11, SD=0.75). Clustering resulted in four user types: active help-seekers (48.3%, 311/644), lurkers (31.8%, 205

National Nuclear Forensics Expertise Development Program

NASA Astrophysics Data System (ADS)

Kentis, Samantha E.; Ulicny, William D.

2009-08-01

Over the course of the 2009 Federal Fiscal Year the United States (U.S.) Department of Homeland Security (DHS), in partnership with the Departments of Defense (DoD) and Energy (DOE), is continuing existing programs and introducing new programs designed to maintain a highly qualified, enduring workforce capable of performing the technical nuclear forensics mission. These student and university programs are designed to recruit the best and brightest students, develop university faculty and research capabilities, and engage the national laboratories in fields of study with application in nuclear forensics. This comprehensive effort constitutes the National Nuclear Forensics Expertise Development Program.

Parent-Focused Childhood and Adolescent Overweight and Obesity eHealth Interventions: A Systematic Review and Meta-Analysis.

PubMed

Hammersley, Megan L; Jones, Rachel A; Okely, Anthony D

2016-07-21

Effective broad-reach interventions to reduce childhood obesity are needed, but there is currently little consensus on the most effective approach. Parental involvement in interventions appears to be important. The use of eHealth modalities in interventions also seems to be promising. To our knowledge, there have been no previous reviews that have specifically investigated the effectiveness of parent-focused eHealth obesity interventions, a gap that this systematic review and meta-analysis intends to address. The objective of this study was to review the evidence for body mass index (BMI)/BMI z-score improvements in eHealth overweight and obesity randomized controlled trials for children and adolescents, where parents or carers were an agent of change. A systematic review and meta-analysis was conducted, which conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Seven databases were searched for the period January 1995 to April 2015. Primary outcome measures were BMI and/or BMI z-score at baseline and post-intervention. Secondary outcomes included diet, physical activity, and screen time. Interventions were included if they targeted parents of children and adolescents aged 0-18 years of age and used an eHealth medium such as the Internet, interactive voice response (IVR), email, social media, telemedicine, or e-learning. Eight studies were included, involving 1487 parent and child or adolescent dyads. A total of 3 studies were obesity prevention trials, and 5 were obesity treatment trials. None of the studies found a statistically significant difference in BMI or BMI z-score between the intervention and control groups at post-intervention, and a meta-analysis demonstrated no significant difference in the effects of parent-focused eHealth obesity interventions compared with a control on BMI/BMI z-score (Standardized Mean Difference -0.15, 95% CI -0.45 to 0.16, Z=0.94, P=.35). Four of seven studies that reported on

Modelling and Predicting eHealth Usage in Europe: A Multidimensional Approach From an Online Survey of 13,000 European Union Internet Users

PubMed Central

Soler-Ramos, Ivan

2016-01-01

Background More advanced methods and models are needed to evaluate the participation of patients and citizens in the shared health care model that eHealth proposes. Objective The goal of our study was to design and evaluate a predictive multidimensional model of eHealth usage. Methods We used 2011 survey data from a sample of 13,000 European citizens aged 16–74 years who had used the Internet in the previous 3 months. We proposed and tested an eHealth usage composite indicator through 2-stage structural equation modelling with latent variables and measurement errors. Logistic regression (odds ratios, ORs) to model the predictors of eHealth usage was calculated using health status and sociodemographic independent variables. Results The dimensions with more explanatory power of eHealth usage were health Internet attitudes, information health Internet usage, empowerment of health Internet users, and the usefulness of health Internet usage. Some 52.39% (6811/13,000) of European Internet users’ eHealth usage was more intensive (greater than the mean). Users with long-term health problems or illnesses (OR 1.20, 95% CI 1.12–1.29) or receiving long-term treatment (OR 1.11, 95% CI 1.03–1.20), having family members with long-term health problems or illnesses (OR 1.44, 95% CI 1.34–1.55), or undertaking care activities for other people (OR 1.58, 95% CI 1.40–1.77) had a high propensity toward intensive eHealth usage. Sociodemographic predictors showed that Internet users who were female (OR 1.23, 95% CI 1.14–1.31), aged 25–54 years (OR 1.12, 95% CI 1.05–1.21), living in larger households (3 members: OR 1.25, 95% CI 1.15–1.36; 5 members: OR 1.13, 95% CI 0.97–1.28; ≥6 members: OR 1.31, 95% CI 1.10–1.57), had more children <16 years of age (1 child: OR 1.29, 95% CI 1.18–1.14; 2 children: OR 1.05, 95% CI 0.94–1.17; 4 children: OR 1.35, 95% CI 0.88–2.08), and had more family members >65 years of age (1 member: OR 1.33, 95% CI 1.18–1.50; ≥4 members

EPA'S NATIONAL COASTAL ASSESSMENT PROGRAM

EPA Science Inventory

The National Coastal Assessment (NCA) is an environmental monitoring program initiated by the US Environmental Protection Agency's Office of Research and Development in 2000. The goal is to monitor selected ecological indicators in the nation's estuarine waters and to produce an...

E-health beyond technology: analyzing the paradigm shift that lies beneath.

PubMed

Moerenhout, Tania; Devisch, Ignaas; Cornelis, Gustaaf C

2018-03-01

Information and computer technology has come to play an increasingly important role in medicine, to the extent that e-health has been described as a disruptive innovation or revolution in healthcare. The attention is very much focused on the technology itself, and advances that have been made in genetics and biology. This leads to the question: What is changing in medicine today concerning e-health? To what degree could these changes be characterized as a 'revolution'? We will apply the work of Thomas Kuhn, Larry Laudan, Michel Foucault and other philosophers-which offers an alternative understanding of progress and revolution in medicine to the classic discovery-oriented approach-to our analysis. Nowadays, the long-standing curative or reactive paradigm in medicine is facing a crisis due to an aging population, a significant increase in chronic diseases and the development of more expensive diagnostic tools and therapies. This promotes the evolution towards a new paradigm with an emphasis on preventive medicine. E-health constitutes an essential part of this new paradigm that seeks to solve the challenges presented by an aging population, skyrocketing costs and so forth. Our approach changes the focus from the technology itself toward the underlying paradigm shift in medicine. We will discuss the relevance of this approach by applying it to the surge in digital self-tracking through health apps and wearables: the recognition of the underlying paradigm shift leads to a more comprehensive understanding of self-tracking than a solely discovery-oriented or technology-focused view can provide.

A systematic review of school-based eHealth interventions targeting alcohol use, smoking, physical inactivity, diet, sedentary behaviour and sleep among adolescents: a review protocol.

PubMed

Champion, Katrina E; Newton, Nicola C; Spring, Bonnie; Wafford, Q Eileen; Parmenter, Belinda J; Teesson, Maree

2017-12-06

Six key behavioural risk factors (risky alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. School-based interventions targeting these multiple health risk behaviours among adolescents have the potential to halt the trajectory towards later disease, whilst online and mobile technology interventions offer advantages in terms of student engagement, reach and scalability. Despite this, the efficacy of eHealth school-based interventions targeting these six health risk behaviours among adolescents has not been evaluated. The proposed systematic review aims to address this by determining the nature and efficacy of existing eHealth school-based interventions targeting multiple health risk behaviours among adolescents. A systematic search of the MEDLINE, Embase, PsycINFO and Cochrane Library databases will be conducted to identify eligible published papers. Eligible studies will be randomised controlled trials, including cluster randomised controlled trials, of interventions targeting two or more of the following lifestyle risk behaviours: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and sleep. Eligible studies will be those evaluating interventions delivered in a secondary school setting among participants 11-18 years of age, via an eHealth platform (Internet, computers of mobile technology). Two reviewers will independently screen studies for eligibility, extract data and assess the risk of bias. Study outcomes will be summarised in a narrative synthesis, and meta-analyses will be conducted where it is appropriate to combine studies. It is anticipated that the results from this review will serve to inform the development of future eHealth multiple health behaviour interventions for adolescents by identifying common characteristics of effective programs and highlighting