Development of digital mental health in Ireland

This paper provides an overview of the development and current status of digital mental health in Ireland. It will present the results of the work carried out on this topic as part of Interreg Europe's eMEN project. This charts the trajectory of digital mental health developments in Ireland across three phases: pre-, mid-, and post-COVID-19 pandemic. Before the pandemic hit, the field of digital mental health was gradually growing through a combination of bottom-up and top-down activities. The pandemic triggered a rapid shift to the online provision of mental health services, which often involved remote consultations via video platforms. As we come out of the pandemic, the focus has shifted to consolidating these pandemic-driven changes, as well as continuing to build on existing initiatives. This article outlines the key elements of each phase, as well discussing certain key issues that should be factored into healthcare policies and provision.These include quality assurance frameworks designed to cover a range of digital mental health applications, as well as new ontological frameworks to characterize the emerging ecosystem of technology-based care in the post-pandemic "new normal”. Copyright © 2023 John Libbey Eurotext. Téléchargé;Ce document présente un aperçu de l'évolution et du statut actuel de la santé mentale numérique en Irlande. Il présente les résultats du travail effectué par les auteurs dans le cadre du projet Interreg eMEN. Il décrit la trajectoire d'évolution de la santé mentale numérique en Irlande selon trois phases: avant, pendant et après la pandémie de Covid-19. Avant la pandémie, la santé mentale numérique évoluait progressivement grâce à une combinaison d'activités ascendantes et descendantes. La période de pandémie a déclenché une évolution rapide vers la fourniture en ligne de services de santé mentale, notamment les consultations à distance via des plateformes vidéo. Au sortir de la pandémie, l'accent est mis sur la consolidation des changements induits par la pandémie, ainsi que sur la poursuite du développement des initiatives déjà lancées auparavant. Cet article présente les éléments clés de chaque phase et examine certaines questions essentielles à prendre en compte dans les politiques et l'offre de soins. Il s'agit notamment des cadres d'assurance qualité destinés à couvrir les applications de santé mentale numérique, ainsi que de nouveaux cadres ontologiques pour caractériser l'écosystème émergent des soins basés sur la technologie dans la « nouvelle normalité» post-pandémique. Copyright © 2023 John Libbey Eurotext. Téléchargé;Este documento ofrece una panorámica de la evolución y el estado actual de la salud mental digital en Irlanda. Presenta los resultados del trabajo de los autores sobre este tema como parte del proyecto Interreg eMEN. Describe la trayectoria de evolución de la salud mental digital en Irlanda según tres fases: antes, durante y después de la pandemia de la COVID-19. Antes de la pandemia, la salud mental digital evolucionaba gradualmente mediante una combinación de actividades ascendentes y descendentes. El periodo pandémico desencadenó una rápida evolución hacia la prestación en línea de servicios de salud mental, en particular las consultas a distancia a través de plataformas de vídeo. Después de la pandemia, la atención se ha centrado en consolidar los cambios provocados por la pandemia, así como en seguir desarrollando las iniciativas ya puestas en marcha anteriormente. Este artículo presenta los elementos claves de cada fase y examina algunas de las cuestiones fundamentales que deben tenerse en cuenta en las políticas y la prestación de asistencia. Entre ellas se incluyen en primer lugar los marcos de garantía de calidad con el fin de cubrir las aplicaciones digitales de salud mental, así como los nuevos marcos ontológicos para caracterizar el ecosistema emergente de atención basada en la tecnología en la "nueva normalidad” pospandémica. Copyright © 2023 John Lib ey Eurotext. Téléchargé

A Mobile Application-Based Relational Agent as a Health Professional for COVID-19 Patients: Design, Approach, and Implications.

Relational Agents' (RAs) ability to maintain socio-emotional relationships with users can be an asset to COVID-19 patients. The goal of this research was to identify principles for designing an RA that can act as a health professional for a COVID-19 patient. We first identified tasks that such an RA can provide by interviewing 33 individuals, who had recovered from COVID-19. The transcribed interviews were analyzed using qualitative thematic analysis. Based on the findings, four sets of hypothetical conversations were handcrafted to illustrate how the proposed RA will execute the identified tasks. These conversations were then evaluated by 43 healthcare professionals in a qualitative study. Thematic analysis was again used to identify characteristics that would be suitable for the proposed RA. The results suggest that the RA must: model clinical protocols; incorporate evidence-based interventions; inform, educate, and remind patients; build trusting relationships, and support their socio-emotional needs. The findings have implications for designing RAs for other healthcare contexts beyond the pandemic.

A Conceptual Framework to Design Connected Mental Health Solutions in the United Arab Emirates: Questionnaire Study.

BACKGROUND: Connected mental health (CMH) is a field presenting information and communications technology-based mental care interventions that could help overcome many mental care delivery barriers. Culture and background influence people's attitudes, preferences, and acceptance of such solutions. Therefore, the suitability of CMH solutions to the targeted population is an important factor in their successful adoption. OBJECTIVE: The aim of this study is to develop a framework for the design and creation of CMH solutions suitable for the UAE context. The framework is based on investigating enablers and barriers of CMH adoption in the United Arab Emirates, from the mental health professional's (MHP) perspective and from related literature. METHODS: A survey of literature on relevant studies addressing the use of technology for mental care in Arab countries, and a web-based questionnaire-based survey with 17 MHPs practicing in the United Arab Emirates investigating their attitudes and views toward CMH was conducted. Results from the questionnaire and from related studies were analyzed to develop the design framework. RESULTS: On the basis of findings from the literature survey and analyzing MHP answers to the web-based survey, a framework for the design of CMH solutions for the UAE population was developed. The framework presents four types of recommendation categories: favorable criteria, which included blended care, anonymity, and ease of use; cultural factors including availability in multiple languages, mainly Arabic and English, in addition to religious and cultural considerations; technical considerations, including good-quality communication, availability in formats compatible with mobile phones, and providing technical support; and users' health and data safety considerations, including users' suitability testing, confidentiality, and ensuring MHP integrity. CONCLUSIONS: CMH has the potential to help overcome many mental care barriers in the United Arab Emirates in particular and in the Arab world in general. CMH adoption in the United Arab Emirates has a potential for success. However, many factors should be taken into account, mainly cultural, religious, and linguistic aspects.

Human-Centered Design of Mobile Health Apps for Older Adults: Systematic Review and Narrative Synthesis.

BACKGROUND: The world is aging. The number of older patients is on the rise, and along with it comes the burden of noncommunicable diseases, both clinical and economic. Attempts with mobile health (mHealth) have been made to remedy the situation with promising outcomes. Researchers have adopted human-centered design (HCD) in mHealth creation to ensure those promises become a reality. OBJECTIVE: This systematic review aims to explore existing literature on relevant primary research and case studies to (1) illustrate how HCD can be used to create mHealth solutions for older adults and (2) summarize the overall process with recommendations specific to the older population. METHODS: We conducted a systematic review to address the study objectives. IEEE Xplore, Medline via Ovid, PubMed, and Scopus were searched for HCD research of mHealth solutions for older adults. Two independent reviewers then included the papers if they (1) were written in English, (2) included participants equal to or older than 60 years old, (3) were primary research, and (4) reported about mHealth apps and their HCD developments from start to finish. The 2 reviewers continued to assess the included studies' qualities using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was then carried out and completed. RESULTS: Eight studies passed the eligibility criteria: 5 were mixed methods studies and 3 were case studies. Some studies were about the same mHealth projects with a total of 5 mHealth apps. The included studies differed in HCD goals, target groups, and details of their HCD methodologies. The HCD process was explored through narrative synthesis in 4 steps according to the International Standardization Organization (ISO) standard 9241-210: (1) understand and specify the context of use, (2) specify the user requirements, (3) produce design solutions to meet these requirements, and (4) evaluate the designs against requirements. The overall process and recommendations unique to older adults are summarized logically with structural order and time order based on the Minto pyramid principle and ISO 9241-210. CONCLUSIONS: Findings show that HCD can be used to create mHealth solutions for older adults with positive outcomes. This review has also summarized practical HCD steps and additional suggestions based on existing literature in the subfield. However, evidence-based results are still limited because most included studies lacked details about their sampling methods and did not set objective and quantifiable goals, leading to failure to draw significant conclusions. More studies of HCD application on mHealth for older adults with measurable design goals and rigorous research strategy are warranted.

Culture-Specific Observations in a Saudi Arabian Digital Home Health Care Program: Focus Group Discussions With Patients and Their Caregivers.

BACKGROUND: There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to the aspects of the Saudi Arabian culture that need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for patients who are chronically and terminally ill. OBJECTIVE: This study aims to explore the specific cultural factors related to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home, a connected health program in the Home Health Care department at King Saud University Medical City, Riyadh, Saudi Arabia. METHODS: A qualitative study design was adopted to conduct a focus group discussion in July 2019 using a semistructured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. RESULTS: A total of 2 categories emerged from the focus group discussion that influenced the experiences of digital health program intervention: first, culture-related factors including language and communication, cultural views on using cameras during consultation, nonadherence to web-based consultations, and family role and commitment and second, caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with patients and their family members may work as a barrier to proper communication through the Remotely Accessible Healthcare At Home program. CONCLUSIONS: We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving direct family members with the health care providers.

Insourcing and scaling a telemedicine solution in under 2 weeks: Lessons for the digital transformation of health care.

The Covid-19 pandemic required rapid scale of telemedicine as well as other digital workflows to maintain access to care while reducing infection risk. Both patients and clinicians who hadn't used telemedicine before were suddenly faced with a multi-step setup process to log into a virtual meeting. Unlike in-person examination rooms, locking a virtual meeting room was more error-prone and posed a risk of multiple patients joining the same online session. There was administrative burden on the practice staff who were generating and manually sending links to patients, and educating patients on device set up was time-consuming and unsustainable. A solution had to be deployed rapidly system-wide, without the usual roll out across months. Our answer was to design and implement a novel EHR-integrated web application called the Switchboard, in just two weeks. The Switchboard leverages a commercial, cloud-based video meeting platform and facilitates an end-to-end virtual care encounter workflow, from pre-visit reminders to post-visit SMS text message-based measurement of patient experience, with tools to extend contact-less workflows to in-person appointments. Over the first 11 months of the pandemic, the in-house platform has been adopted across 6 hospitals and >200 practices, scaled to 8,800 clinicians who at their peak conducted an average of 30,000 telemedicine appointments/week, and enabled over 10,000-20,000 text messages/day to be exchanged through the platform. Furthermore, it enabled our organization to convert from an average of 75% of telehealth visits being conducted via telephone to 75% conducted via video within weeks.

Perspective: Wearable Internet of Medical Things for Remote Tracking of Symptoms, Prediction of Health Anomalies, Implementation of Preventative Measures, and Control of Virus Spread During the Era of COVID-19.

The COVID-19 pandemic has highly impacted the communities globally by reprioritizing the means through which various societal sectors operate. Among these sectors, healthcare providers and medical workers have been impacted prominently due to the massive increase in demand for medical services under unprecedented circumstances. Hence, any tool that can help the compliance with social guidelines for COVID-19 spread prevention will have a positive impact on managing and controlling the virus outbreak and reducing the excessive burden on the healthcare system. This perspective article disseminates the perspectives of the authors regarding the use of novel biosensors and intelligent algorithms embodied in wearable IoMT frameworks for tackling this issue. We discuss how with the use of smart IoMT wearables certain biomarkers can be tracked for detection of COVID-19 in exposed individuals. We enumerate several machine learning algorithms which can be used to process a wide range of collected biomarkers for detecting (a) multiple symptoms of SARS-CoV-2 infection and (b) the dynamical likelihood of contracting the virus through interpersonal interaction. Eventually, we enunciate how a systematic use of smart wearable IoMT devices in various social sectors can intelligently help controlling the spread of COVID-19 in communities as they enter the reopening phase. We explain how this framework can benefit individuals and their medical correspondents by introducing Systems for Symptom Decoding (SSD), and how the use of this technology can be generalized on a societal level for the control of spread by introducing Systems for Spread Tracing (SST).

Reading List: Select Healthcare Transformation Library 2.0.

Reading List: Select Healthcare Transformation Library 2.0 represents a broad-based, annotated, general reading list for students of health care innovation. The books were drawn from the 5,000-book private home library of Ronald S. Weinstein, MD, President Emeritus of the American Telemedicine Association. Weinstein is a lifelong book collector with special interests in the history of medical innovation and poetry. A Massachusetts General Hospital-trained pathologist and inductee into the US Distance Learning Association's Hall of Fame, he is known as a pioneer in telemedicine and the "father of telepathology" for his invention, patenting, and commercialization of telepathology, a subspecialty of telemedicine that is a billion-dollar worldwide industry today. This Reading List: Select Healthcare Transformation Library 2.0 consists of 41 books divided into 10 sections: (1) Human Intelligence, Behavior, and Creativity; (2) Societal Revolutions; (3) Innovation; (4) Healthcare System Transformations; (5) Education; (6) Transformational Technologies-Part 1 (AI, Automation, and Robotics); (7) Transformational Technologies-Part 2 (Telemedicine and Telehealth); (8) Digital Medicine; (9) Healthcare Transformation Implementation; and (10) COVID-19 Pandemic as an Innovation Accelerator.

The role of Connected Health technologies in supporting families affected by paediatric cancer: A systematic review.

OBJECTIVES: Families impacted by paediatric cancer are met with logistical, financial and psychological impacts, with severe acute respiratory syndrome coronavirus two creating additional barriers and stressors for these families. Connected Health (CH) may facilitate cancer care. The objective of the present study was to systematically review CH for families/informal caregivers affected by paediatric cancer. METHODS: Using search terms relating to: (1) paediatric cancer, (2) family/caregivers and (3) CH, the databases of PsycINFO, Pubmed, EMBASE and Web of Science were searched. Inclusion criteria included an evaluation of CH technologies for supportive care for families/caregivers affected by paediatric cancer at any stage of treatment or survivorship. RESULTS: Sixteen studies met inclusion criteria. CH was primarily web-based (n = 6), however smartphone applications (n = 5), telehealth (n = 2) and online groups (n = 3) were utilised. Intervention areas included psycho-social (n = 6), health and information provision (n = 8) and palliative care (n = 2). CONCLUSIONS: While limited studies have evaluated the impact of CH on families living with paediatric cancer, emerging evidence suggests potential benefits. More evidenced-based interventions are required.

Wearable Technology and How This Can Be Implemented into Clinical Practice.

PURPOSE OF REVIEW: Our day-to-day life is saturated with health data that was previously out of reach. Over the last decade, new devices and fitness technology companies are attempting to tap into this data, uncovering a treasure trove of useful information that, when applied correctly, has the potential to revolutionize the way we approach healthcare and chronic conditions like asthma, especially in the wake of the COVID-19 pandemic. RECENT FINDINGS: By harnessing exciting developments in personalization, digitization, wellness, and patient engagement, care providers can improve health outcomes for our patients in a way we have never been able to do in the past. While new technologies to capture individual health metrics are everywhere, how can we use this information to make a real difference in our patients' lives? Navigating the complicated landscape of personal wearable devices, asthma inhaler sensors, and exercise apps can be daunting to even the most tech savvy physician. This manuscript will give you the tools necessary to make lasting changes in your patients' lives by exposing them to a world of usable, affordable, and relatable health technology that resonates with their personal fitness and wellness goals. These tools will be even more important post-COVID-19, as the landscape of clinical outpatient care changes from mainly in-person visits to a greater reliance on telemedicine and remote monitoring.