| Title | Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. |
| Authors | de la Torre-Díez, I; López-Coronado, M; Vaca, C; Aguado, JS; de Castro, C |
| Journal | Telemedicine journal and e-health : the official journal of the American Telemedicine Association |
| Publication Date | 1 Feb 2015 |
| Date Added to PubMed | 5 Dec 2014 |
| Abstract | A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures. |
| Link | http://doi.org/10.1089/tmj.2014.0053 |
| Title | Exploring digital health care: eHealth, mHealth, and librarian opportunities. |
| Authors | Chan, J |
| Journal | Journal of the Medical Library Association : JMLA |
| Publication Date | 1 Jul 2021 |
| Date Added to PubMed | 12 Oct 2021 |
| Abstract | Technology advances in eHealth and mHealth are changing the way that health care consumers and providers communicate, receive and deliver care, and access health information. As electronic health records and smartphones have become ubiquitous in the United States, opportunities and applications for the integration of eHealth and mHealth have increased. In addition to technology advances, the changing health care model is simultaneously adapting to and driving initiatives in digital health care. With these digital initiatives have come challenges, including data overload, security and privacy concerns, deficits in technological and health literacy skills, and sorting through the vast number of choices of digital applications. Navigating this changing landscape can be overwhelming and time consuming for both health care providers and consumers. Librarians are uniquely positioned to assist providers and consumers to break down barriers within the digital health care landscape through data management initiatives, technology and health literacy instruction, and finding and evaluating health information and digital health technologies. |
| Link | http://doi.org/10.5195/jmla.2021.1180 |
| Title | Electronic health records in Brazil: Prospects and technological challenges. |
| Authors | Barbalho, IMP; Fernandes, F; Barros, DMS; Paiva, JC; Henriques, J; Morais, AHF; Coutinho, KD; Coelho Neto, GC; Chioro, A; Valentim, RAM |
| Journal | Frontiers in public health |
| Publication Date | 1 Dec 2022 |
| Date Added to PubMed | 22 Nov 2022 |
| Abstract | Electronic Health Records (EHR) are critical tools for advancing digital health worldwide. In Brazil, EHR development must follow specific standards, laws, and guidelines that contribute to implementing beneficial resources for population health monitoring. This paper presents an audit of the main approaches used for EHR development in Brazil, thus highlighting prospects, challenges, and existing gaps in the field. We applied a systematic review protocol to search for articles published from 2011 to 2021 in seven databases (Science Direct, Web of Science, PubMed, Springer, IEEE Xplore, ACM Digital Library, and SciELO). Subsequently, we analyzed 14 articles that met the inclusion and quality criteria and answered our research questions. According to this analysis, 78.58% (11) of the articles state that interoperability between systems is essential for improving patient care. Moreover, many resources are being designed and deployed to achieve this communication between EHRs and other healthcare systems in the Brazilian landscape. Besides interoperability, the articles report other considerable elements: (i) the need for increased security with the deployment of permission resources for viewing patient data, (ii) the absence of accurate data for testing EHRs, and (iii) the relevance of defining a methodology for EHR development. Our review provides an overview of EHR development in Brazil and discusses current gaps, innovative approaches, and technological solutions that could potentially address the related challenges. Lastly, our study also addresses primary elements that could contribute to relevant components of EHR development in the context of Brazil's public health system. Systematic review registration: PROSPERO, identifier CRD42021233219, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233219. |
| Link | http://doi.org/10.3389/fpubh.2022.963841 |
| Title | Anaphylaxis and digital medicine. |
| Authors | Anto, A; Sousa-Pinto, B; Bousquet, J |
| Journal | Current opinion in allergy and clinical immunology |
| Publication Date | 1 Oct 2021 |
| Date Added to PubMed | 23 Jul 2021 |
| Abstract | Digital medicine (mHealth) aims to help patients and healthcare providers (HCPs) improve and facilitate the provision of patient care. It encompasses equipment/connected medical devices, mHealth services and mHealth apps (apps). An updated review on digital health in anaphylaxis is proposed. In anaphylaxis, mHealth is used in electronic health records and registries.It will greatly benefit from the new International Classification of Diseases-11 rules and artificial intelligence. Telehealth has been revolutionised by the coronavirus disease 2019 pandemic, and lessons learnt should be extended to shared decision making in anaphylaxis. Very few nonvalidated apps exist and there is an urgent need to develop and validate such tools. Although digital health appears to be of great importance in anaphylaxis, it is still insufficiently used. |
| Link | http://doi.org/10.1097/ACI.0000000000000764 |
| Title | EHR-QC: A streamlined pipeline for automated electronic health records standardisation and preprocessing to predict clinical outcomes. |
| Authors | Ramakrishnaiah, Y; Macesic, N; Webb, GI; Peleg, AY; Tyagi, S |
| Journal | Journal of biomedical informatics |
| Publication Date | 1 Nov 2023 |
| Date Added to PubMed | 13 Oct 2023 |
| Abstract | The adoption of electronic health records (EHRs) has created opportunities to analyse historical data for predicting clinical outcomes and improving patient care. However, non-standardised data representations and anomalies pose major challenges to the use of EHRs in digital health research. To address these challenges, we have developed EHR-QC, a tool comprising two modules: the data standardisation module and the preprocessing module. The data standardisation module migrates source EHR data to a standard format using advanced concept mapping techniques, surpassing expert curation in benchmarking analysis. The preprocessing module includes several functions designed specifically to handle healthcare data subtleties. We provide automated detection of data anomalies and solutions to handle those anomalies. We believe that the development and adoption of tools like EHR-QC is critical for advancing digital health. Our ultimate goal is to accelerate clinical research by enabling rapid experimentation with data-driven observational research to generate robust, generalisable biomedical knowledge. |
| Link | http://doi.org/10.1016/j.jbi.2023.104509 |
| Title | E-health and multiple sclerosis. |
| Authors | Matthews, PM; Block, VJ; Leocani, L |
| Journal | Current opinion in neurology |
| Publication Date | 1 Jun 2020 |
| Date Added to PubMed | 24 Apr 2020 |
| Abstract | To outline recent applications of e-health data and digital tools for improving the care and management of healthcare for people with multiple sclerosis. The digitization of most clinical data, along with developments in communication technologies, miniaturization of sensors and computational advances are enabling aggregation and clinically meaningful analyses of real-world data from patient registries, digital patient-reported outcomes and electronic health records (EHR). These data are allowing more confident descriptions of prognoses for multiple sclerosis patients and the long-term relative benefits and safety of disease-modifying treatments (DMT). Registries allow detailed, multiple sclerosis-specific data to be shared between clinicians more easily, provide data needed to improve the impact of DMT and, with EHR, characterize clinically relevant interactions between multiple sclerosis and other diseases. Wearable sensors provide continuous, long-term measures of performance dynamics in relevant ecological settings. In conjunction with telemedicine and online apps, they promise a major expansion of the scope for patients to manage aspects of their own care. Advances in disease understanding, decision support and self-management using these Big Data are being accelerated by machine learning and artificial intelligence. Both health professionals and patients can employ e-health approaches and tools for development of a more patient-centred learning health system. |
| Link | http://doi.org/10.1097/WCO.0000000000000823 |
| Title | e-Cardiology and e-Health: from industry-driven technical progress to clinical application. |
| Authors | Saner, H |
| Journal | European journal of preventive cardiology |
| Publication Date | 1 Nov 2014 |
| Date Added to PubMed | 31 Oct 2014 |
| Abstract | |
| Link | http://doi.org/10.1177/2047487314553160 |
| Title | Electronic health records, mobile health, and the challenge of improving global health. |
| Authors | Faulkenberry, JG; Luberti, A; Craig, S |
| Journal | Current problems in pediatric and adolescent health care |
| Publication Date | 1 Jan 2022 |
| Date Added to PubMed | 1 Jan 2022 |
| Abstract | Technology continues to impact healthcare around the world. This provides great opportunities, but also risks. These risks are compounded in low-resource settings where errors in planning and implementation may be more difficult to overcome. Global Health Informatics provides lessons in both opportunities and risks by building off of general Global Health. Global Health Informatics also requires a thorough understanding of the local environment and the needs of low-resource settings. Forming effective partnerships and following the lead of local experts are necessary for sustainability; it also ensures that the priorities of the local community come first. There is an opportunity for partnerships between low-resource settings and high income areas that can provide learning opportunities to avoid the pitfalls that plague many digital health systems and learn how to properly implement technology that truly improves healthcare. |
| Link | http://doi.org/10.1016/j.cppeds.2021.101111 |
| Title | Transforming health care through Bhutan's digital health strategy: progress to date. |
| Authors | Gurung, MS; Dorji, G; Khetrapal, S; Ra, S; Babu, GR; Krishnamurthy, RS |
| Journal | WHO South-East Asia journal of public health |
| Publication Date | 1 Sep 2019 |
| Date Added to PubMed | 24 Aug 2019 |
| Abstract | Bhutan, a landlocked country in the eastern Himalayas with some of the most rugged and mountainous terrain in the world, is actively engaged in digital health strategy reforms aimed at improving the efficiency of the health information system. Aligned with Bhutan’s e-Government master plan, the National eHealth strategy and action plan aims to improve health by empowering health-care providers and citizens through technology and by enabling data exchange for service delivery. The strategy has four primary areas of focus: (i) ensuring digital health governance arrangements; (ii) concentrating on strong foundations in terms of infrastructure and standards; (iii) prioritizing improvements in the current health system in a phased, selective manner; and (iv) building the digital skills and knowledge of health workers. With support from the Asian Development Bank and the World Health Organization, phase 1 of the strategy has been completed and the blueprint for the digital health information system is in development. Phase 2 of the strategy will be implemented during 2020–2023 and will include work on (i) identity management for the health workforce; (ii) the implementation of a master patient index and a secure longitudinal patient information system; and (iii) enabling all health facilities to access the systems. Bhutan’s eHealth strategy has the potential to fundamentally transform the delivery of health services, strengthen primary health care and enable the development of a “One Health” public health surveillance system. |
| Link | http://doi.org/10.4103/2224-3151.264850 |
| Title | mUzima Mobile Electronic Health Record (EHR) System: Development and Implementation at Scale. |
| Authors | Were, MC; Savai, S; Mokaya, B; Mbugua, S; Ribeka, N; Cholli, P; Yeung, A |
| Journal | Journal of medical Internet research |
| Publication Date | 14 Dec 2021 |
| Date Added to PubMed | 15 Dec 2021 |
| Abstract | The predominant implementation paradigm of electronic health record (EHR) systems in low- and middle-income countries (LMICs) relies on standalone system installations at facilities. This implementation approach exacerbates the digital divide, with facilities in areas with inadequate electrical and network infrastructure often left behind. Mobile health (mHealth) technologies have been implemented to extend the reach of digital health, but these systems largely add to the problem of siloed patient data, with few seamlessly interoperating with the EHR systems that are now scaled nationally in many LMICs. Robust mHealth applications that effectively extend EHR systems are needed to improve access, improve quality of care, and ameliorate the digital divide. We report on the development and scaled implementation of mUzima, an mHealth extension of the most broadly deployed EHR system in LMICs (OpenMRS). The "Guidelines for reporting of health interventions using mobile phones: mobile (mHealth) evidence reporting assessment (mERA)" checklist was employed to report on the mUzima application. The World Health Organization (WHO) Principles for Digital Development framework was used as a secondary reference framework. Details of mUzima's architecture, core features, functionalities, and its implementation status are provided to highlight elements that can be adapted in other systems. mUzima is an open-source, highly configurable Android application with robust features including offline management, deduplication, relationship management, security, cohort management, and error resolution, among many others. mUzima allows providers with lower-end Android smartphones (version 4.4 and above) who work remotely to access historical patient data, collect new data, view media, leverage decision support, conduct store-and-forward teleconsultation, and geolocate clients. The application is supported by an active community of developers and users, with feature priorities vetted by the community. mUzima has been implemented nationally in Kenya, is widely used in Rwanda, and is gaining scale in Uganda and Mozambique. It is disease-agnostic, with current use cases in HIV, cancer, chronic disease, and COVID-19 management, among other conditions. mUzima meets all WHO's Principles of Digital Development, and its scaled implementation success has led to its recognition as a digital global public good and its listing in the WHO Digital Health Atlas. Greater emphasis should be placed on mHealth applications that robustly extend reach of EHR systems within resource-limited settings, as opposed to siloed mHealth applications. This is particularly important given that health information exchange infrastructure is yet to mature in many LMICs. The mUzima application demonstrates how this can be done at scale, as evidenced by its adoption across multiple countries and for numerous care domains. |
| Link | http://doi.org/10.2196/26381 |