[Digital health applications (DiGA) in the area of tension between progress and criticism : Discussion paper from the "Digital health" specialist group of the German Informatics Society]. / Digitale Gesundheitsanwendungen (DiGA) im Spannungsfeld von Fortschritt und Kritik : Diskussionsbeitrag der Fachgruppe "Digital Health" der Gesellschaft für Informatik e. V.

Since December 2019, digital health applications (DiGA) have been included in standard care in Germany and are therefore reimbursed by the statutory health insurance funds to support patients in the treatment of diseases or impairments. There are 48 registered DiGA listed in the directory of the Federal Institute of Drugs and Medical Devices (BfArM), mainly in the areas of mental health; hormones and metabolism; and muscles, bones, and joints. In this article, the "Digital Health" specialist group of the German Informatics Society describes the current developments around DiGA as well as the current sentiment on topics such as user-centricity, patient and practitioner acceptance, and innovation potential. In summary, over the past three years, DiGA have experienced a positive development, characterized by a gradually increasing availability of various DiGA and coverage areas as well as prescription numbers. Nevertheless, significant regulatory adjustments are still required in some areas to establish DiGA as a well-established instrument in long-term routine healthcare. Key challenges include user-centeredness and the sustainable use of the applications.

Digital Transformation in the Diagnostics and Therapy of Cardiovascular Diseases: Comprehensive Literature Review.

BACKGROUND: The digital transformation of our health care system has experienced a clear shift in the last few years due to political, medical, and technical innovations and reorganization. In particular, the cardiovascular field has undergone a significant change, with new broad perspectives in terms of optimized treatment strategies for patients nowadays. OBJECTIVE: After a short historical introduction, this comprehensive literature review aimed to provide a detailed overview of the scientific evidence regarding digitalization in the diagnostics and therapy of cardiovascular diseases (CVDs). METHODS: We performed an extensive literature search of the PubMed database and included all related articles that were published as of March 2022. Of the 3021 studies identified, 1639 (54.25%) studies were selected for a structured analysis and presentation (original articles: n=1273, 77.67%; reviews or comments: n=366, 22.33%). In addition to studies on CVDs in general, 829 studies could be assigned to a specific CVD with a diagnostic and therapeutic approach. For data presentation, all 829 publications were grouped into 6 categories of CVDs. RESULTS: Evidence-based innovations in the cardiovascular field cover a wide medical spectrum, starting from the diagnosis of congenital heart diseases or arrhythmias and overoptimized workflows in the emergency care setting of acute myocardial infarction to telemedical care for patients having chronic diseases such as heart failure, coronary artery disease, or hypertension. The use of smartphones and wearables as well as the integration of artificial intelligence provides important tools for location-independent medical care and the prevention of adverse events. CONCLUSIONS: Digital transformation has opened up multiple new perspectives in the cardiovascular field, with rapidly expanding scientific evidence. Beyond important improvements in terms of patient care, these innovations are also capable of reducing costs for our health care system. In the next few years, digital transformation will continue to revolutionize the field of cardiovascular medicine and broaden our medical and scientific horizons.

Supporting breast cancer decisions using formalized guidelines and experts decision patterns: initial prototype and evaluation.

Transparent decisions and its documentation of breast cancer patients' therapy are getting more important especially since modern therapeutic approaches favor personalized forms of treatment. The medical decisions for a treatment are very complex, because there are rules and different options for each patient. To support the decision process, we analyzed the current decision rules and implemented them in a prototype of a rule-based expert system. Thus, this system shall support the quality assurance regarding transparent documentation of individualized therapeutic decisions. For evaluating the system, we used data from a state tumor center and compared the decisions suggested by our system with expert ones. The system and the expert approach will be compared with each other as well as the differences in the treatment decisions. The first preliminary results show us that the human factor-like must be considered by creating a decision support system. The prototype delivers first results, which are restricted, but the results are promising for further developments.

Mobile IT solutions for home health care.

PURPOSE: Harnessing the advantage of mobile information technology (IT) solutions at the point of care and contributing to patients' safety by involving them. DESIGN/METHODOLOGY/APPROACH: International collaboration between specialists in health communication processes and information management and systems. METHODS USED: Case studies, design science. FINDINGS: User-friendly portable IT applications going beyond documentation of patient records and administration require an understanding of complex communication processes between patients and the different caregivers. Home care increasingly faces structural deficits to be mitigated by integration of IT solutions. Platforms chosen in combination with services should be well established. How to implement this must be scrutinized by comprehensive research as initiated here. Preliminary results indicate potentials for novel mobile applications. PRACTICAL IMPLICATIONS: Contribution to increasing patients' safety by developing mobile solutions to support health care. Those may also contribute to cost savings in health care. SOCIAL IMPLICATIONS: Health care experiences an increasing significance for Western industrialized countries because of demographic developments. Care generally shifts from inpatient to outpatient settings; the global shortage of qualified nurses becomes even more prevailing. More support, among others by IT and enhanced interprofessional communication, is demanded for an improved quality and efficiency of care processes. ORIGINALITY/VALUE: Mutual approach benefits from the partner's understanding of complex interactions among clinicians, health services, and patients: the ability to design, monitor, and evaluate research strategies integrating care (information) needs is invaluable when applying creative technology solutions within health care domain.