‘The plural of silo is not ecosystem': Qualitative study on the role of innovation ecosystems in supporting ‘Internet of Things' applications in health and care

Background: Internet of Things (IoT) innovations such as wearables and sensors promise improved health outcomes and service efficiencies. Yet, most applications remain experimental with little routine use in health and care settings. We sought to examine the multiple interacting influences on IoT implementation, spread and scale-up, including the role of regional innovation ‘ecosystems' and the impact of the COVID-19 context. Methods: Qualitative study involving 20 participants with clinical, entrepreneurial and broader innovation experience in 18 in-depth interviews, focusing primarily on heart monitoring and assistive technology applications. Data analysis was informed by the NASSS (non-adoption, abandonment, scale-up, spread, sustainability) framework. Results: Interviewees discussed multiple tensions and trade-offs, including lack of organisational capacity for routine IoT use, limited ability to receive and interpret data, complex procurement and governance processes, and risk of health disparities and inequalities without system support and funding. Although the pandemic highlighted opportunities for IoT use, it was unclear whether these would be sustained, with framings of innovation as ‘disruption' coming at odds with immediate needs in healthcare settings. Even in an ‘ecosystem' with strong presence of academic and research institutions, support was viewed as limited, with impressions of siloed working, conflicting agendas, fragmentation and lack of collaboration opportunities. Conclusions: IoT development, implementation and roll-out require support from multiple ecosystem actors to be able to articulate a value proposition beyond experimental or small-scale applications. In contexts where clinical, academic and commercial worlds collide, sustained effort is needed to align needs, priorities and motives, and to strengthen potential for good value IoT innovation. © The Author(s) 2023.

Risk factors for SARS-CoV-2 infection in healthcare workers following an identified nosocomial COVID-19 exposure during waves 1-3 of the pandemic in Ireland.

Healthcare workers (HCWs) have increased exposure and subsequent risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This case-control study was conducted to investigate the contemporaneous risks associated with confirmed SARS-CoV-2 infection amongst HCWs following in-work exposure to a confirmed coronavirus disease-2019 (COVID-19) case. We assessed the influence of demographic (age, sex, nationality, high risk co-morbidities and vaccination status) and work-related factors (job role, exposure location, contact type, personal protective equipment (PPE) use) on infection risk following nosocomial SARS-CoV-2 exposure. All contact tracing records within the hospital site during waves 1-3 of the COVID-19 pandemic in Ireland were screened to identify exposure events, cases and controls. In total, 285 cases and 1526 controls were enrolled, as a result of 1811 in-work exposure events with 745 index cases. We demonstrate that male sex, Eastern European nationality, exposure location, PPE use and vaccination status all impact the likelihood of SARS-CoV-2 infection following nosocomial SARS-CoV-2 exposure. The findings draw attention to the need for continuing emphasis on PPE use and its persisting benefit in the era of COVID-19 vaccinations. We suggest that non-work-related factors may influence infection risk seen in certain ethnic groups and that infection risk in high-risk HCW roles (e.g. nursing) may be the result of repeated exposures rather than risks inherent to a single event.

Developing Machine Learning Model for Predicting Social Media Induced Fake News

Fake news has been associated with major global events such as Covid-19 and the political polarisation of the US presidential election in 2016. This paper investigates how fake news has affected society and advance understanding of the nature of its impact in the future of democratic societies. Taken from large datasets consisting of over 23,000 fake news story words and over 21,000 true news story words we use descriptive and predictive analytics, partly analysing more than 350 words during the selected period of October 2016 to April 2017. The findings show that Trump was the most popular word for both true and fake news. In this study, we compare and contrast the words used and the volume of true versus fake news stories related to the election and the inauguration. This study makes an important contribution as it develops a predictive model that highlights the severity of political polarization and its consequences in democratic societies, which inevitably have implications for inclusive societies in the 21st century. © 2021, IFIP International Federation for Information Processing.

PFAB-driven clinical and patient education

Objective: We sought to study how an adult cystic fibrosis (CF) Patient Family Advisory Board (PFAB) can influence and co-produce patient and staff education in collaboration with their CF care team. Novel approaches in this study are: 1) learner needs analyses were driven by the PFAB, 2) study and abstract were created by patient PFAB member. Background: In addition to improving quality of care, patient safety, satisfaction, and engagement, the Institute for Patient and Family Centered Care (IPFCC) recommends the establishment of a PFAB to design patient-centric initiatives such as quality improvement, patient education, as well as healthcare provider and clinical staff education (Johnson, Abraham. 2012). Despite this recommendation, there are few studies on how patientdriven education is designed or implemented. The INOVA Adult CF Clinic PFAB articulated their perspective of clinical staff learner needs for Respiratory Therapy (RT), Emergency Department (ED), and Inpatient Nursing Teams (APU). They also helped to advise the need for and content of educational COVID-19 webinars to the patient population. Patients who were PFAB members provided educational content and the patient perspective in these workshops. Methods: Thematic analysis of educational sessions and PFAB meetings were used to study how PFABs can influence and co-produce clinical staff and patient education. Qualitative data were collected and analyzed from observation of 7 PFAB meetings and digital collaborative planning documents used by the PFAB to discuss patient-driven educational needs and session plans. Observational data were collected from 3 staff education sessions that were co-presented with a CF care team member and CF patient PFAB member who gave a short personal account of their experience with their disease. These included: one RT session, two inpatient nursing staff sessions. Plans were made for an ED session in August. Observational qualitative data was also collected from two COVID-19 webinars that were conducted with input and participation of the PFAB in sharing experiences and presenting content. Results: Thematic analysis showed that PFABs can increase engagement of clinical staff and augment educational opportunities for both patients and staff by addressing patient-centered learning needs. Patients who provided first-person accounts of their lived experience as part of a learning session promoted empathy and engagement amongst both staff and patients. Co-produced COVID webinars resulted in a 250% increase in attendance over a three-month period. Chat-box and verbal question participation of co-produced COVID webinars also increased. In addition, the PFAB-driven educational initiatives promoted psychological ownership (Avey, et al. 2009) within the PFAB itself. This has led to attitudes such as higher commitment, responsibility, and engagement of patient PFAB members and CF clinical staff. Opportunities for further research in this area include exploring the extent to which these themes are also promoted by administering formal pre- and post-intervention assessments to staff learners as well as PFAB members.

Creating and deepening connections through technology during a pandemic

Purpose: The CF care team and the Metro Chapter of Cystic Fibrosis Foundation (CFF) collaborate by developing a virtual meeting providing emotional support and resources during the COVID-19 pandemic. Introduction: Online groups have been used for many years to provide support for communities of individuals living with chronic health conditions (Eysenback G, et al. BMJ. 2004;328:116). The dire consequences of the COVID-19 infection have made virtual communications surge in popularity. The care team moved to a telemedicine platform to conduct health visits with 160 patients. The team began identifying themes of anxiety, food scarcity, challenges with online education programming, medication access and financial duress due to business shut downs (Kirk S, et al. Health Expectations. 2016;309-21). Methods: The CF center social worker and the executive director of the CFF Metro Chapter collaborated to develop virtual meetings to support and educate patients and families during the pandemic. The goal was to engage more parents and young adults online to support one another in a community. Meetings were conducted on a Blue Jeans Platform and invitations were sent out via personal electronic mail addresses provided to the CF care center. A private RSVP link was sent to participants prior to the meeting. The meetings are held every two weeks in the evening for an hour, one in English the second in Spanish. Discussions are facilitated by parent volunteers and staff, some of whom are bilingual. Participants have joined from the metropolitan area, FL, CA and NM. Results: Attendance for groups has fluctuated from 5 participants to 25, including fathers, mothers, siblings, grandparents and young adults living with CF. Virtual programming includes individuals living with CF whereas in-person meetings could not due to infection protection and control guidelines. Meeting participation by the chapter leadership helps identify key issues and needs of the participants, including COVID-19 education and guidance, CF and COVID-19 affected individuals (gathered from the CFF weekly reports of CF Digest), isolation, phased reopening, school re-entry, food scarcity and resources, self-care, and CF FamilyCon 2020. Parents report hope after speaking with young adults. Participants shared obstructions to meeting regularly include child care, hospitalization of their family member and working later than usual. Shared benefits include reduced anxiety, a forum to share concerns about COVID-19 infection, information about the ways individuals in the CF community are affected by positive COVID-19 results, school re-entry for their children and support and self-care ideas. Conclusions: There are many challenges facing patients and families living with cystic fibrosis during the COVID-19 pandemic. Developing a collaborative virtual community has been an effective and reliable method of support and education for patients and family members. By resourcing staff with experience and language abilities we have been able to expand programming to non-English speaking persons who have been challenged by COVID-19 illness. Cost is minimal as staff is volunteering, and group members are using a computer or a telephone to participate, which many already own.