Disruptive digital innovations in healthcare: Knowing the past and anticipating the future

The twin focus on healthcare and digital transformation during the past two decades, which was intensified by the COVID-19 pandemic to an unanticipated level, has resulted in the mushrooming of literature in the area. While this has enriched the available insights, it has also created a certain amount of confusion, and there is now a need to make sense of what has been achieved before undertaking research that contributes more meaningfully to theory and practice in the area. Motivated by this need, we systematically analyze and evaluate the existing empirical research on the topic of disruptive digital innovations in healthcare. We followed a five-step approach to identify and analyze 42 congruent studies spread across domains, publishers, and geographies to achieve our objective. The outcome of our review is a conceptual framework that could serve to motivate and support future research. First, we presented a bibliographic sketch of the literature to clarify the milieu and descriptives. Next, we performed content analysis to organize the existing evidence into meaningful streams. Towards this end, we followed a structured approach to the review by defining the scope through a matrix–form conceptual framework to guide thematic analysis. Accordingly, we reported on the findings from three perspectives—theoretical, enabler, and barrier—anchoring them in four innovation implementations/outcomes: products, services, processes, and business models. Our analysis suggests that existing scholarship has drawn upon various interdisciplinary theories to map the enablers as well as the barriers that may inhibit the adoption and usage of these disruptive innovations. Based on the findings of our structured approach, we offer useful recommendations to advance research and practice in this field.

Distance is no longer a barrier to healthcare services: current state and future trends of telehealth research

PurposeTaking a business lens of telehealth, this article aims to review and provide a state-of-the-art overview of telehealth research.Design/methodology/approachThis research conducts a systematic literature review using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) protocol and a collection of bibliometric analytical techniques (i.e. performance analysis, keyword co-occurrence, keyword clustering and content analysis).FindingsUsing performance analysis, this article unpacks the publication trend and the top contributing journals, authors, institutions and regions of telehealth research. Using keyword co-occurrence and keyword clustering, this article reveals 10 major themes underpinning the intellectual structure of telehealth research: design and development of personal health record systems, health information technology (HIT) for public health management, perceived service quality among mobile health (m-health) users, paradoxes of virtual care versus in-person visits, Internet of things (IoT) in healthcare, guidelines for e-health practices and services, telemonitoring of life-threatening diseases, change management strategy for telehealth adoption, knowledge management of innovations in telehealth and technology management of telemedicine services. The article proposes directions for future research that can enrich our understanding of telehealth services.Originality/valueThis article offers a seminal state-of-the-art overview of the performance and intellectual structure of telehealth research from a business perspective.

Oral and Dental Needs and Teledentistry Applications in the Elderly: Real-Time Surveillance Using Google Trends

Featured ApplicationThe present cross-sectional analysis aimed to evaluate the level of interest in oral and dental needs and teledentistry applications among the elderly, as well as whether COVID-19 pandemic outbreaks were influenced by real-time surveillance, using Google Trends. As the number of elderly dental patients continues to increase, there is a growing need for specific interventions that address the biological and psychological issues of this population. Teledentistry represents a healthcare delivery system that can overcome these problems, although the oral and dental care provision methods involved are still unknown to most people. Indeed, there is a need to raise awareness of the indications for teledentistry, the available interventions, and the potential benefits for the oral and dental care of elderly patients.Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients' concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users' interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for "elderly” and "teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users' interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for "Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages.

African American Women's Willingness to Participate in Online Health Communities During COVID-19.

Introduction: The use of online health communities (OHCs) for health information, disease self-management, and social support increased during the COVID-19 pandemic. However, there are limited data on the willingness of African American women (AAW) to participate in OHCs. Materials and Methods: A sample of 985 AAW completed an online survey. Multinomial logistic regression examined associations between three age groups (18-29, 30-50, and 51+ years) and 10 motivators and 10 barriers to participating in OHCs. Women 51+ years were the referent group. Results: Women 51+ years were more likely to have been diagnosed with obesity and hypertension than the other groups (p < 0.01), but less likely to be diagnosed with a mental health condition than the other groups (p < 0.01). The top 2 motivators were to learn about a disease/condition (70%) and to prevent a disease/condition (64%). There were no significant differences with these variables. However, compared with women 18-29 years of age, women 51+ years were more likely to be motivated to manage an illness (p < 0.001), and more likely than the other groups to be motivated to support others (p = 0.011). The top 2 barriers were being too busy (53%) and privacy concerns (45%). Compared with women in the two other groups, women 51+ years were more concerned about privacy (p < 0.001). Discussion: AAW expressed a willingness to participate in OHCs. Willingness to participate in OHCs will vary by the topic and disease/condition and the age group. Conclusions: Opportunities exist to recruit AAW in age-specific OHCs.

Telehealth Systems for Midwifery Care Management during the COVID-19 Pandemic: A Systematic Review

Background: Intrinsic features of COVID-19 disease, including the severity of the virus transmission and mortality rates, make it difficult to provide obstetric care to pregnant women. In this regard, telemedicine can provide comprehensive midwifery care relying on new technologies, such as virtual clinic, telehealth, tele-monitoring, m-Health, wearable sensors, and the internet of medical things. The objective of this study is to identify the application and requirements of a telehealth system for midwifery care. Methods: We conducted a literature search from 2019/12/1 to 2022/10/1 using the following electronic scientific databases: Web of Science, Scopus, PubMed, Science Direct, and Google Scholar. We carried out hand searches from the reference lists of retrieved studies of journals. Results: We showed that, during COVID-19 pandemic, prenatal care via telehealth increased and telehealth is a good strategy for prenatal and post-partum disease managements. Mental health services are also feasible via telehealth. These new technologies also reduce the risks associated with interpersonal contacts in COVID-19 pandemic. Conclusion: With the COVID-19 pandemic, telehealth became the norm. The future of medical services will be built around this technology and that is a great opportunity to move toward a great evolution. Copyright © 2023, Journal of Iranian Medical Council. All rights reserved. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designing an Artifact to Empower Chronic Patients for Monitoring Health During a Pandemic: A COVID-19 Screening App

Chronic diseases have been declared as an invisible epidemic by the World Health Organization (WHO, 2005). Over the past fifty years, the prevalence of chronic conditions has increased, leading to the disease burden caused by cancer, cardiovascular diseases, diabetes, musculoskeletal conditions, and mental and substance use disorders (DOH, 2021). Chronic patients need to reimagine how they will empower themselves to effectively manage and monitor their health and wellbeing in a COVID-19 era, when frequent in-person health care visits will no longer be feasible. In this study, we propose the features for the design of a mobile based application that will aid chronic patients and end-users to self-manage and monitor their health during the pandemic era. Based on an empirical investigation involving pharmacists and researchers, we designed and developed a prototype capable of empowering chronic patients. This study particularly focuses on how technological interventions can help chronic patients to self-manage and monitor their health and wellbeing related to COVID-19 where the user expectations are met with less attrition rates. © 2023 IEEE Computer Society. All rights reserved.

Digital health, cardiometabolic disease and ethnicity: an analysis of United Kingdom government policies from 2010 to 2022.

Recent health policies in the United Kingdom (UK) and internationally have focussed on digitisation of healthcare. We examined UK policies for evidence of government action addressing health inequalities and digital health, using cardiometabolic disease as an exemplar. Using a systematic search methodology, we identified 87 relevant policy documents published between 2010 and 2022. We found increasing emphasis on digital health, including for prevention, diagnosis and management of cardiometabolic disease. Several policies also focused on tackling health inequalities and improving digital access. The COVID-19 pandemic amplified inequalities. No policies addressed ethnic inequalities in digital health for cardiometabolic disease, despite high prevalence in minority ethnic communities. Our findings suggest that creating opportunities for digital inclusion and reduce longer-term health inequalities, will require future policies to focus on: the heterogeneity of ethnic groups; cross-sectoral disadvantages which contribute to disease burden and digital accessibility; and disease-specific interventions which lend themselves to culturally tailored solutions.

Digital Health Solutions for Weight Loss and Obesity: A Narrative Review.

Personal exercise programmes have long been used and prescribed for weight loss and the improvement of quality of life in obese patients. While individualised programmes are usually the preferred option, they can be more costly and challenging to deliver in person. A move to digital programmes with a wider reach has commenced, and demand has increased due to the SARS-CoV-2 pandemic. In this review, we evaluate the current status of digital exercise programme delivery and its evolution over the past decade, with a focus on personalisation. We used specific keywords to search for articles that met our predetermined inclusion and exclusion criteria in order to provide valuable evidence and insights for future research. We identified 55 studies in total in four key areas of focus, from the more recent development of apps and personal digital assistants to web-based programmes and text or phone call interventions. In summary, we observed that apps may be useful for a low-intensity approach and can improve adherence to programmes through self-monitoring, but they are not always developed in an evidence-based manner. Engagement and adherence are important determinants of weight loss and subsequent weight maintenance. Generally, professional support is required to achieve weight loss goals.

The Revolutionary Impacts of the COVID-19 Pandemic on Mobile Health; Highlights of the Fourth Shiraz International Congress on Mobile Health.

Mobile health (m-health) is considered an undeniable part of health service delivery, planning, and marketing, which has dramatically changed due to the unique situation caused by the COVID-19 pandemic. The Forth International Congress of Mobile Health, from February 14th to 16th, 2021, in Shiraz, Iran, aimed to provide a venue to exchange ideas, techniques, relevant experiments, and applications with a particular focus on the COVID-19 pandemic impacts. More than 70 experts from different countries in engineering, biomedical sciences, and humanities presented their recent experiences in m-health advancements, particularly in response to the COVID-19 outbreak. In this article, highlights of the most valuable ideas presented at the congress are concisely summarized to give scientists, entrepreneurs, policymakers, and other stakeholders a better understanding of the growing opportunities, and challenges toward the development of m-health.

Role of Digital Healthcare in Rehabilitation During a Pandemic

The pandemic turned life upside down, including causing unavailability and an inability to access rehabilitation in the hospital. However, the need to be fit and healed does not stop, so rehabilitation innovation from the digital sectors plays a role in approaching the patient, as the patient requires a medical professional to be healed. Rehabilitation via a digital pathway is fraught with difficulties, but advances in technology and research have enabled it to be used to the greatest extent possible in this disaster. Digital health has increased its efficacy in response to the pandemic, as it is now available in developing countries where there is an inability to visit a clinic for rehabilitation, and now the rehabilitation tool is accessible to the patients in their hands and they can connect to their therapist at any time. The rehabilitation is designed based on the patient's illness, feedback, and health data stored on the application devices, which regulate and provide feedback from both sides, from the patient and other improvement changes gathered with the help of digital applications. Digital health allows for online consultation, assessment, and 24-h monitoring, all of which are directly shared with the rehabilitation team. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Becoming Holy Grail of Health on the Move: Identifying and Prioritizing Factors Affecting the Commercialization of m-Health

The need for mobile-based solutions for healthcare after COVID pandemic is more obvious than ever as mobile itself is an integral part of everyday life. m-Health is not an unfamiliar phenomenon, but despite the progress that has been made in this area, it is still difficult for m-health platforms to enter and stabilize in the market, especially in developing countries. So, in this study, we tried to prioritize the factors affecting the commercialization of m-Health and platforms. By reviewing related researches to the field of mobile health commercialization, 30 main effective indicators in mobile health commercialization were identified. After surveying experts and conducting exploratory factor analysis, these 30 indicators have been prioritized in 6 dimensions of efficiency and effectiveness, market, organizational and legal, technology and infrastructure, property and project management, and macro contexts. According to experts, the most important indicator is the timeliness of technology, and least important factor is the index of technology convergence with the laws and regulations in the field of health and treatment of the country. © 2022 IEEE.

E-Health and telemedicine applications in plastic surgery and the treatment of facial palsy

Facial palsy (FP) is a life changing condition with physical, aesthetic, functional and psychosocial consequences, which requires specialized diagnosis, rehabilitation and (surgical) management to improve facial function and reduce its negative effects. Since patients remain in follow-up during their life and often have to travel far to receive treatment, improvements can be made in the field of telemedicine. Telemedicine is a growing field of study in medical practice and several advances have been made in the field of plastic surgery. Especially during the COVID-19 pandemic, considerable experience was gained in this way of consultation. This review provides an overview of current research available in the field of E-Health and M-Health in plastic surgery and for patients with a peripheral facial palsy.Copyright © 2021 The Author(s)

Technology readiness and the older citizen's acceptance of m-health services in India

PurposeThe purpose of this study was to create a theoretical model by combining the technology acceptance model (TAM) with the theory of technology readiness (TR) and then empirically test it to identify the key factors influencing older citizens' intention to adopt and use mobile health (m-health), which has emerged as a tool to facilitate health-care rights for all.Design/methodology/approachThe convenience sampling method was used to collect data from 465 respondents aged 60 and up from the Delhi-National capital region of India using a questionnaire survey method. The data collected for this study were analyzed using partial least squares structural equation modeling using SmartPLS 3.0.FindingsThe study's findings indicate that all TR components influence perceived usefulness (PU) and ease of use. The exception is discomfort, which does not affect perceived ease of use (PEOU). Furthermore, PU and PEOU influenced the older citizen's attitude toward m-health, and attitude influenced their intention to use m-health applications.Originality/valueTo the best of the authors' knowledge, this is the first study to apply the TAM in combination with TR index to examine the acceptability of m-health consulting by the older citizen in an emerging economy like India.

A Scoping Review and a Taxonomy to Assess the Impact of Mobile Apps on Cancer Care Management.

Mobile Health (mHealth) has a great potential to enhance the self-management of cancer patients and survivors. Our study aimed to perform a scoping review to evaluate the impact and trends of mobile application-based interventions on adherence and their effects on health outcomes among the cancer population. In addition, we aimed to develop a taxonomy of mobile-app-based interventions to assist app developers and healthcare researchers in creating future mHealth cancer care solutions. Relevant articles were screened from the online databases PubMed, EMBASE, and Scopus, spanning the time period from 1 January 2016 to 31 December 2022. Of the 4135 articles initially identified, 55 were finally selected for the review. In the selected studies, breast cancer was the focus of 20 studies (36%), while mixed cancers were the subject of 23 studies (42%). The studies revealed that the usage rate of mHealth was over 80% in 41 of the 55 studies, with factors such as guided supervision, personalized suggestions, theoretical intervention foundations, and wearable technology enhancing adherence and efficacy. However, cancer progression, technical challenges, and unfamiliarity with devices were common factors that led to dropouts. We also proposed a taxonomy based on diverse theoretical foundations of mHealth interventions, delivery methods, psycho-educational programs, and social platforms. We suggest that future research should investigate, improve, and verify this taxonomy classification to enhance the design and efficacy of mHealth interventions.

Studying Users' Perceptions of COVID-19 Mobile Applications in Saudi Arabia

In Saudi Arabia, several mitigating measures were implemented in response to the COVID-19 pandemic, including the creation of COVID-19 mobile applications (apps) for public use. The Saudi government has made the use of these apps mandatory for its citizens and residents. However, it is essential to explore the perception that common users have regarding using these apps in terms of usability and user experience. Therefore, this paper assesses user experience in terms of effectiveness, efficiency, and user satisfaction with the usability of the Saudi COVID-19 apps. The reviews of five mobile apps launched by the Saudi Data and AI Authority (SDAIA) and the Ministry of Health in the Apple Store were extracted using an online tool and analyzed using the content analysis method. The number of collected reviews was 29 for Sehha, 406 for Sehhaty, 442 for Mawid, 107 for Tabaud, and 1338 for Tawakkalna. The results of the study showed that Mawid (82%) and Tabaud (81%) had the highest usability of all the apps studied. Sehha (-138%) and Sehhaty (-107%) received the lowest usability scores, followed by Tawakkalna (-22%). Based on these results, we identified several usability issues with each app. Some of the main problems reported by users were increased battery drain, lack of privacy, and technical issues.

An empirical investigation into the altering health perspectives in the internet of health things.

Healthcare is on top of the agenda of all governments in the world as it is related to the well-being of the people. Naturally, this domain has attracted the attention of many researchers globally, who have studied the development of its different phases, including E-Health and the Internet of Health Things (IoHT). In this paper, the difference between the recent concepts of healthcare (E-health, M-Health, S-Health, I-Health, U-Health, and IoHT/IoMT) is analyzed based on the main services, applications, and technologies in each concept. The paper has also studied the latest developments in IoHT, which are linked to existing phases of development. A classification of groups of services and constituents of IoHT, linked to the latest technologies, is also provided. In addition, challenges, and future scope of research in this domain concerning the wellbeing of the people in the face of ongoing COVID-19 and future pandemics are explored.

Transfer learning for the efficient detection of COVID-19 from smartphone audio data.

Disease detection from smartphone data represents an open research challenge in mobile health (m-health) systems. COVID-19 and its respiratory symptoms are an important case study in this area and their early detection is a potential real instrument to counteract the pandemic situation. The efficacy of this solution mainly depends on the performances of AI algorithms applied to the collected data and their possible implementation directly on the users' mobile devices. Considering these issues, and the limited amount of available data, in this paper we present the experimental evaluation of 3 different deep learning models, compared also with hand-crafted features, and of two main approaches of transfer learning in the considered scenario: both feature extraction and fine-tuning. Specifically, we considered VGGish, YAMNET, and L3-Net (including 12 different configurations) evaluated through user-independent experiments on 4 different datasets (13,447 samples in total). Results clearly show the advantages of L3-Net in all the experimental settings as it overcomes the other solutions by 12.3% in terms of Precision-Recall AUC as features extractor, and by 10% when the model is fine-tuned. Moreover, we note that to fine-tune only the fully-connected layers of the pre-trained models generally leads to worse performances, with an average drop of 6.6% with respect to feature extraction. Finally, we evaluate the memory footprints of the different models for their possible applications on commercial mobile devices.

Digital Health Initiatives in Transforming Healthcare Delivery During Pandemic outbreak

eHealth or Digital health is the pioneer project funded by Government of India and Department of Health and Family Welfare, Government of Kerala, designed to provide residents of Kerala with convenient centralized healthcare system. It describes the integration of information technology and electronic communications used for different healthcare processes for people's health and their wellbeing. It has introduced since 1920s as Telemedicine and later it expanded in 2009 as e-Health due to advancement of technology. When the countries healthcare industry was facing tough times, we observed that the e-Health came to the rescue of many times during multiple waves of the pandemic. This study mainly focusses on analysing various digital health initiatives by MHFW and an attempt has been made to know what are telemedicine schemes, web portals and mobile applications and global digital health agenda used for implementation of digital health and how far it benefited in the pandemic days. Copyright © 2022, Anka Publishers. All rights reserved.

Digital health shopping assistant with React Native: a simple technological solution to a complex health problem

Today, more and more people are reporting allergies, which can range from simple reactions / discomfort to anaphylactic shocks. Other people may not be allergic but avoid certain foods for personal reasons. Daily food shopping of these people is hampered by the fact that unwanted ingredients can be hidden in any food, and it is difficult to find them all. The paper presents a digital health shopping assistant called 'Diet Helper', aimed to make life easier for such people by making it easy to determine whether a product is suitable for consumption, according to the specific dietary requirements of both types - existing diet and self-defined. This is achieved by capturing ingredient label, received by the app as an input, which the app analyses, converting the captured label to text, and filters out unwanted ingredients that according to the user should be avoided as either allergens or products to which the consumer is intolerant, helping the user decide if the product is suitable for consumption. This should make daily grocery shopping easier by providing the user with more accurate and simplified product selection in seconds, reducing the total time spent in the grocery stores, which is especially relevant in light of COVID-19, although it was and will remain out of it due to the busy schedules and active rhythm of life of modern society. The app is developed using the React Native framework and Google Firebase platform, which makes it easy to develop, use and extend such solutions thereby encouraging to start actively developing solutions that could improve wellbeing. © 2022 IEEE.

Patient Engagement Using Telemedicine in Primary Care during COVID-19 Pandemic: A Trial Study.

The correct treatment of most non-transmissible diseases requires, in addition to adequate medication, adherence to physical activity and diet guidelines, as well as health data monitoring and patient motivation. The restrictions caused by the COVID-19 pandemic made telemedicine tools and mobile apps the best choice for monitoring patient compliance. The objective of this study was to analyze the benefits of an m-Health solution designed specifically for chronic patients during the COVID-19 pandemic. A pragmatic clinical trial with pre-post measurements of a single group was carried out with 70 patients (aged 40+) with one or more chronic conditions. Patients were provided with an ad hoc mobile app and health data measuring devices according to their diseases. The health status of the patients was monitored remotely by health professionals who could also modify the patient's objectives according to their evolution. The results obtained show an average fulfillment of objectives of 77%. Higher fulfillment values: medication adherence (98%) and oxygen saturation (82%); lower fulfillment values: weight (48%), glucose (57%), and distance walked (57%). Globally, the ad hoc app was rated 8.72 points out of 10 (standard deviation 1.10). Concerning the pre-post analysis, there were significant improvements vs. prior apps used by the participants in the following items: improved physical activation and better control of blood pressure, diet, weight, glucose, and oxygen saturation. In conclusion, the telemedicine tool developed was useful in increasing patient engagement and adherence to treatment.