A good app is effective, cost-effective, feasible, profitable, user-friendly, safe, relevant, and usable. It also clearly shows any side effects and dose responses. However, many current health apps lack evidence on their effectiveness, safety, and how they were developed. Developing apps through a scientific process that involves users can help address these issues. This includes conceptualizing designs based on theory and user input, testing prototypes, and iterative development and field testing. The goal is to produce evidence-based, innovative health apps that can be safely implemented and improve outcomes.
Strengthening Health Systems through the application of Wireless TechnologyOPS Colombia
Presentación realizada por el Dr. Trishan Panch, de Harvard School of Public Health, el 20 de Septiembre en OPS Colombia, en el espacio de intercambio sobre e-health.
El Dr. Panch, participa, con el auspicio de esta Representación, como conferencista en el IV Congreso Colombiano de Bioingeniería e Ingeniería Biomédica que se realizará en Barranquilla del 21 al 24 de septiembre del 2011.
In this presentation from the Beryl Institute's 2016 Patient Experience Conference, Edwards-Elmhurst Healthcare’s ED Chair and Patient Experience Director detail how they are leveraging technology to follow up with ED Patients and the exceptional results they’ve enjoyed.
What does “patient centricity” really mean and how is it actually done? This was the driving question of the DayOne Experts Meeting in Basel, co-hosted by Arcondis.
Virtual health is supporting continuing efforts to further humanize health care by extending and expanding the concept of a patient-centric care delivery model into one that is truly life-centric.
Virtual health uses telecommunication and networked technologies to connect clinicians with patients (and with other clinicians) to remotely deliver health care services and support well-being. For providers, committing to virtual health at a personal and organizational level affords ever-increasing opportunities to deliver the right care at the right time in the right place, in a connected and coordinated manner.
By strengthening and facilitating a therapeutic alliance between clinicians and patients, virtual health is an important step on our continuous journey to humanize health care. It works within and around a patient’s life, as opposed to their sickness, to deliver care when, where, and how they need and want it. Also, virtual health works its way into consumers’ daily routines by being embedded in electronic devices associated with living life (e.g., smartphones and personal computers) more so than caring for sickness.
The healthcare industry is primed for expanded adoption of virtual health; a 2016 report estimated that the US virtual health market will reach $3.5 billion in revenues by 2022. Several factors are elevating stakeholder interest, including expected physician shortages, continued growth in digital technologies, changing reimbursement models, increasing consumer demand, and the evolving regulatory landscape. One game-changer: Today, nine in 10 American adults use the internet, giving clinicians the capability and flexibility to communicate with and serve health care consumers via the web.
The slides in this deck are what were discussed in the first of five Aging Well workshops. This first workshop focused on mobility for aging adults. Take a look.
This final webinar will emphasise the importance of understanding the problem before brainstorming solutions to better ensure a match between barriers and the solutions.
MORE INFO: http://bit.ly/2KctiLH
Strengthening Health Systems through the application of Wireless TechnologyOPS Colombia
Presentación realizada por el Dr. Trishan Panch, de Harvard School of Public Health, el 20 de Septiembre en OPS Colombia, en el espacio de intercambio sobre e-health.
El Dr. Panch, participa, con el auspicio de esta Representación, como conferencista en el IV Congreso Colombiano de Bioingeniería e Ingeniería Biomédica que se realizará en Barranquilla del 21 al 24 de septiembre del 2011.
In this presentation from the Beryl Institute's 2016 Patient Experience Conference, Edwards-Elmhurst Healthcare’s ED Chair and Patient Experience Director detail how they are leveraging technology to follow up with ED Patients and the exceptional results they’ve enjoyed.
What does “patient centricity” really mean and how is it actually done? This was the driving question of the DayOne Experts Meeting in Basel, co-hosted by Arcondis.
Virtual health is supporting continuing efforts to further humanize health care by extending and expanding the concept of a patient-centric care delivery model into one that is truly life-centric.
Virtual health uses telecommunication and networked technologies to connect clinicians with patients (and with other clinicians) to remotely deliver health care services and support well-being. For providers, committing to virtual health at a personal and organizational level affords ever-increasing opportunities to deliver the right care at the right time in the right place, in a connected and coordinated manner.
By strengthening and facilitating a therapeutic alliance between clinicians and patients, virtual health is an important step on our continuous journey to humanize health care. It works within and around a patient’s life, as opposed to their sickness, to deliver care when, where, and how they need and want it. Also, virtual health works its way into consumers’ daily routines by being embedded in electronic devices associated with living life (e.g., smartphones and personal computers) more so than caring for sickness.
The healthcare industry is primed for expanded adoption of virtual health; a 2016 report estimated that the US virtual health market will reach $3.5 billion in revenues by 2022. Several factors are elevating stakeholder interest, including expected physician shortages, continued growth in digital technologies, changing reimbursement models, increasing consumer demand, and the evolving regulatory landscape. One game-changer: Today, nine in 10 American adults use the internet, giving clinicians the capability and flexibility to communicate with and serve health care consumers via the web.
The slides in this deck are what were discussed in the first of five Aging Well workshops. This first workshop focused on mobility for aging adults. Take a look.
This final webinar will emphasise the importance of understanding the problem before brainstorming solutions to better ensure a match between barriers and the solutions.
MORE INFO: http://bit.ly/2KctiLH
Gamification as a means to manage chronic diseaseEngagingPatients
UPMC is exploring ways to better engage patients through shared decision making and new approaches to encourage patients and their families to take control of their health. This presentation describes a pilot program UPMC has initiated to leverage gamification as a means to manage chronic heart failure.
Healthcare delivery in the periphery workshop outputDayOne
A tri-national (CH, D, F) group of healthcare and labor experts came together at the DayOne lab to brainstorm on common initiatives to tackle the challenges of Healthcare delivery in our region. Please find attached the output of our workshop here.
United States Diagnostics Market Size, Share, Trend and Forecast 2026 | TechS...TechSci Research
According to #TechSci Research report, United States Diagnostics Market stood at USD30.08billion in 2020 and is expected to grow at a steady rate of 5.17% during the forecast period.
Gain More Insight: https://bit.ly/3wWI0do
Get Sample Report: https://bit.ly/3ltFdo6
Website: https://www.techsciresearch.com/
Market Research News: https://techsciblog.com/
Early benefits and impacts of Electronic Patient Record implementation: Findings from the UK. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 11 November 2014, 12pm, Marlborough Room 3
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
The fourth webinar picks-up directly from the third session, focusing on the next key step to inform implementation initiatives: identifying barriers and enablers to implementation.
READ MORE: http://bit.ly/2kIxtQo
Avident Health created by doctors to allow better teamwork in healthcare and to engage and educate patients. More teamwork leads to value: Better quality at lower cost.
This presentation was used for the Ryan White Part B Quality Management Committee to support more effective recruitment of patients for quality management activities
Case Study “Investment in a Health IT Infrastructure, the Future Quality Imperative”
Steven Anderman
Chief Operating Officer & SVP, Operations
Bronx-Lebanon Hospital Center
Patient & Family Advisory Councils: the Business Case for Starting a PFAC & P...EngagingPatients
This webinar was presented on March 12, 2015 by Barbara Lewis. It looks at the prevalence and roles that Patient & Family Advisory Councils (PFACs) are playing in U.S. hospitals today, and builds a business case for their implementation:
Authentic happiness comes from doing good deeds to others.
Good App is a game to challenge yourself to do good.
You can see your positive impact on the world around you.
Gamification as a means to manage chronic diseaseEngagingPatients
UPMC is exploring ways to better engage patients through shared decision making and new approaches to encourage patients and their families to take control of their health. This presentation describes a pilot program UPMC has initiated to leverage gamification as a means to manage chronic heart failure.
Healthcare delivery in the periphery workshop outputDayOne
A tri-national (CH, D, F) group of healthcare and labor experts came together at the DayOne lab to brainstorm on common initiatives to tackle the challenges of Healthcare delivery in our region. Please find attached the output of our workshop here.
United States Diagnostics Market Size, Share, Trend and Forecast 2026 | TechS...TechSci Research
According to #TechSci Research report, United States Diagnostics Market stood at USD30.08billion in 2020 and is expected to grow at a steady rate of 5.17% during the forecast period.
Gain More Insight: https://bit.ly/3wWI0do
Get Sample Report: https://bit.ly/3ltFdo6
Website: https://www.techsciresearch.com/
Market Research News: https://techsciblog.com/
Early benefits and impacts of Electronic Patient Record implementation: Findings from the UK. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 11 November 2014, 12pm, Marlborough Room 3
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
The fourth webinar picks-up directly from the third session, focusing on the next key step to inform implementation initiatives: identifying barriers and enablers to implementation.
READ MORE: http://bit.ly/2kIxtQo
Avident Health created by doctors to allow better teamwork in healthcare and to engage and educate patients. More teamwork leads to value: Better quality at lower cost.
This presentation was used for the Ryan White Part B Quality Management Committee to support more effective recruitment of patients for quality management activities
Case Study “Investment in a Health IT Infrastructure, the Future Quality Imperative”
Steven Anderman
Chief Operating Officer & SVP, Operations
Bronx-Lebanon Hospital Center
Patient & Family Advisory Councils: the Business Case for Starting a PFAC & P...EngagingPatients
This webinar was presented on March 12, 2015 by Barbara Lewis. It looks at the prevalence and roles that Patient & Family Advisory Councils (PFACs) are playing in U.S. hospitals today, and builds a business case for their implementation:
Authentic happiness comes from doing good deeds to others.
Good App is a game to challenge yourself to do good.
You can see your positive impact on the world around you.
MIE Medical Informatics in Europe: European Federation for Medical Informatics (EFMI) annual meeting
Worklshop: Addressing Patient Adherence Issues by Engaging Enabling Technologies
Chair: Pei-Yun Sabrina Hsueh (IBM T.J. Watson Research Center)
Pei-Yun Sabrina HSUEHa, , Marion BALL b,a, Michael MARSCHOLLEKc, Fernando J. MARTIN-SANCHEZd , Chohreh PARTOVIANa, and Vimla PATELe
aIBM T.J. Watson Research Center, NY, USA
b John Hopkins University, MD, USA
c Hannover Medical School, Germany
d Melbourne Medical School, Australia
e Center for Cognitive Studies in Medicine and Public Health, The New York Academy, USA
Abstract One of the well known issues providers have contended with for many years is the issue of patients’ adherence to their care plans and medications outside clinical encounters. In this workshop, we review proof of concept studies using technology at the point of care to assess patient literacy and self-efficacy to provide timely intervention, remedy, and improvements in cost and quality. We focus on patient-generated information, including patient reported data and measurements from devices and sensors, as key to improving patient safety, gaining “meaningful use” data, improving patient centric care, and assisting providers in learning more about their patient needs to improve outcomes. We look into barriers to adherence, basic understanding of the patients and providers roles in improving adherence, and the use of technology to assist patients in staying on track. The participants will address their findings in the integration of patient-generated information into everyday life and clinical practice and share lessons learned from implementing these designs in practice. This workshop aims to share requirements for the next-generation healthcare systems, especially in areas where the explosive availability of patient-generated data is expected to make impacts.
Big data, RWE and AI in Clinical Trials made simpleHadas Jacoby
Technology is slowly but surely penetrating the healthcare industry in general and the clinical trials sector in particular. New and advanced solutions offer a variety of possibilities aimed to both improving existing processes and creating new and more efficient ones. And on top of all stands the desire to make clinical trials more patient centric.
In all of this, even though some of the technologies have yet to mature enough to meet the high quality standards necessary, it is important to know them and begin imagining the promise they hold for clinical trials.
Making Healthcare Waste Reduction and Patient Safety Actionable - HAS Session 6Health Catalyst
Multiple studies have estimated that at least 30% of US healthcare expenditures are wasteful. But how do you identify and reduce that waste? In this session, we will share with you a three-part framework for understanding, measuring and addressing waste reduction. In particular, we will highlight the importance patient safety and injury prevention, framing the importance of shifting from a system of incident reporting (which creates a culture of blame and guilt) to a system in which patient injury is regarded as a process failure rather than a person failure. To make that transition, health systems will need to 1) define process flows and metrics for each major type of patient injury; and 2) create a learning environment in which team members are engaged in process redesign to prevent process failure and injury. A leading health system in patient safety and quality will also share their best practices in how they have created a culture of patient safety and quality.
Protocols and Evidence based Healthcare: information technology tools to support best practices in health care, information technology tools that inform and empower patients.
2. What is a good app ?
Effective (is it good for us )
Cost-effective
Feasible
Profitable
User-friendly
Safe
Relevant
Usable
Side effects shown
Dose response known
Mode of action known
4. What is a good app ?
Effective
Cost-effective
Feasible
Profitable
User-friendly
Safe
Relevant
Usable
Side effects shown
Dose response known
Mode of action known
How much
uncertainty / bias
do we accept ?
5. Should we delay access to massive
improvements over the status quo while we
wait for the perfect study to satisfy
academic criteria
Why all the fuss...
Isn’t innovation always good ?
Exposure to
innovation
6. Connecting the dots…
Aging
Chronic disease
Healthcare
utilization / costs
(super) Computers / networks
Robotica
Regenerative medicine
3d /4d Printing
Sensors / imaging
Omics
Artificial intelligence
+ Mobile technology / wearables
Prosperity
Autonomy claim /
paradigm shift
Smartphone use
Innovation
Challenges
Solutions
Changes
7. The Mhealth revolution.....
Over 97.000 medical applications available and growing big time….
…..and the sky is the limit regarding the possibilities
• Academic focused innovation Private sector focused innovation
‘Zolderkamer’ focused innovation
• High thresholds for implementation based on level of evicence Relatively
low thresholds for implementation based on:
• CE licence
• Expert ratings
• Subjective user ratings (i.e. 5 starr ratings)
9. Drawbacks / Risks
• Proliferation (overgrowth) of apps (+wearables) without adequate
regulation leaves both patients, healthcare providers and policy
makers behind in how to select apps
Lack of knowledge or transparency in:
o Level of evidence (minimal threshold = non-inferiority / cost-
neutrality
o Underlying principles and theoretical background
o Development / engineering processes
User centered principles / experts involved ?
Usability/acceptability/manageability ?
Technical features ? Both software and hardware
o Safety issues
o Ethical issues
o Medical costs issues
Introduces risk of non-use, low
effectiveness, mobile ‘kwakzalverij’
or even adverse / hazardous effects
10. What is a good app ?
Financial transactions and incentives
Conditional cash transfers
Insurance
Payment for services
Performance-based incentives
Savings accounts
Information systems
Data collection and reporting
Service delivery statistics
Household surveys
Surveillance (public health)
Electronic health records
Registries/vital events tracking
Service delivery and support
Electronic decision support
Disease diagnosis/Point-of-care diagnostics
Disease management
Disease prevention
Provider-to-provider communication
Referrals
Remote client-to-provider consultations (Telemedicine)
Social and behavior change communication
Appointment reminders
Health education or promotion
Hotlines and information services
Mass messaging campaigns
Treatment adherence
Supply management
Cold chain management
Commodity tracking/replenishment
Counterfeit prevention
Maintenance of equipment
◦tock out prevention
Workforce development and performance support
Constituent feedback on service quality
Human resource management
Provider training and education
Provider work planning and scheduling
Supportive supervision
11. Example (I)
• Opioid conversion apps
• N= 26 (Android, Appstore etc.)
• Findings:
• calculated dosages are highly variable, with statistically significant
differences in conversion outputs between apps with stated medical
involvement and those without in some cases
• few apps appear to identify the primary data source underlying their
calculation algorithm
• Unknown whether there has been involvement in app creation or
content of individuals who have practical experience in or insight into
the undertaking of these high-risk prescribing decisions
Haffey et al. Drug Saf (2013) 36:111–117
12. Example (II)
• Melanoma detection apps
• N= 4 scanning 60 melanoma cases and 128 benign lesion
controls
• Findings:
• The performance of smart phone applications in assessing melanoma
risk is highly variable, and 3 out of 4 smart phone applications
incorrectly classified 30% or more of melanomas as unconcerning.
• Reliance on these applications has the potential to delay the diagnosis
of melanoma and to harm users.
Wolf et al. JAMA Dermatol. 2013 April ; 149(4): 422–426
13. What is a good app ?
Financial transactions and incentives
Conditional cash transfers
Insurance
Payment for services
Performance-based incentives
Savings accounts
Information systems
Data collection and reporting
Service delivery statistics
Household surveys
Surveillance (public health)
Electronic health records
Registries/vital events tracking
Service delivery and support
Electronic decision support
Disease diagnosis/Point-of-care diagnostics
Disease management
Disease prevention
Provider-to-provider communication
Referrals
Remote client-to-provider consultations (Telemedicine)
Social and behavior change communication
Appointment reminders
Health education or promotion
Hotlines and information services
Mass messaging campaigns
Treatment adherence
Supply management
Cold chain management
Commodity tracking/replenishment
Counterfeit prevention
Maintenance of equipment
◦tock out prevention
Workforce development and performance support
Constituent feedback on service quality
Human resource management
Provider training and education
Provider work planning and scheduling
Supportive supervision
What/who is:
• the end-user
• the primary outcome,
• the sequence of
anticipated effects
• degree of acceptable
uncertainty
?
?
?
?
?
?
14. What is a good app ?
Regular care
mHealth
innovation
outcome = f (mHealth innovation) + (regular care)
What do we aim to evaluate ?
• superiority
• non-inferiority
• equivalence
Regular care
vs
mHealth
innovation
16. Example 1: Airstrip – obstetrical monitoring
Remote fetal monitoring
in at risk deliveries.
partly replacing regular
outpatient care
↓ delay in
diagnosis fetal
distress
↓ communication
breakdowns
among clinicians
↓ fetal deaths
↓ admission
days
Exposure Intermediates Outcomes
↓ delay in
treatment fetal
distress
17. Taxonomy
Proof of mechanism
(theory, requirement
analysis)
Proof of concept
(usability, safety,
dose-response )
Proof of principle
(effectiveness,
safety, process)
Mechanism of mHealth
application is reasonably:
relevant
safe
feasible
(cost-)effective
Concept of mHealth application is
provisionally:
safe & side effects known
feasible
usable
Mode of action as anticipated
+ dose-response known
Principle of mHealth application is
certainly:
safe
≥ non-inferior
feasible to implement
presumably/reasonably/potentially provisionally certainly
Pre-clinical Clinical
18. Engineering meets science
To develop and evaluate future according to pre-
defined quality standards and user-centered principles
(co-creation)
Development through science
(scientific engineering)
19. Advantages of scientific/academic engineering
State of the art:
• Access to theory (epidemiology, treatment and healthcare processes)
• Multidisciplinary expertise
• Research + (meta-)datamanagement facilities
• facilities + Platforms for knowledge dissemination
• ABOVE ALL : (early) access to large groups of
target users (patients + care providers)
20. No ivory towers…
Science
TechnologyCare
Collaborative research & development
Collaborative R&D
strategic alliances
reduces financial and
technical risk and encourages
knowledge exchange, supply
chain development and
parallel working on complex
challenges.
• Partnership fund
application
• Direct investments
cofinancing
• Crowd funding
21. Iterative and user-centered Mhealth
development
Background analysis &
design conceptualization
Alpha-usability
(paper prototype)
Field-usability
Iterative
software
development
Theory
(review)
Patients
Focus
group
+
interviews
Experts
Focus
group
Patients
Task analysis
+
interviews
Patients
Field study
(task analysis,
usability +
interviews
phase 2 phase 3 phase 4phase 1
22. Phase 1: design conceptualization
Background analysis &
design conceptualization
Theory
(review)
Patients
Focus
group
+
interviews
Experts
Focus
group
phase 1
Aim:
to conceptualize the preliminary design of the Mhealth intervention and to identify a set of
delivery components that are active and make a difference in the intervention outcome
23. Iterative and user-centered Mhealth
development
Background analysis &
design conceptualization
Alpha-usability
(paper prototype)
Theory
(review)
Patients
Focus
group
+
interviews
Experts
Focus
group
Patients
Task analysis
+
interviews
phase 2phase 1
Aim:
to observe the human interaction with user interfaces even before ‘real’
interfaces are designed and developed.
24. Iterative and user-centered Mhealth
development
Background analysis &
design conceptualization
Alpha-usability
(paper prototype) Iterative
software
development
Theory
(review)
Patients
Focus
group
+
interviews
Experts
Focus
group
Patients
Task analysis
+
interviews
phase 2 phase 3phase 1
Aim:
To carry out a standard iterative production process with information
derrived from phase 1 & 2
25. Phase 4: Field/lab Usability
Background analysis &
design conceptualization
Alpha-usability
(paper prototype)
Field/Lab-usability
Iterative
software
development
Theory
(review)
Patients
Focus
group
+
interviews
Experts
Focus
group
Patients
Task analysis
+
interviews
Patients
Field study
(task analysis,
usability +
interviews
phase 2 phase 3 phase 4phase 1
Aim:
to assess the degree to which a system is effective, efficient, accessible and favors positive
attitudes and responses from the intended users
1-1 meetings. Field or lab ‘think aloud’ task analysis with
n=5 patients
• Learnability
Assessment of how easy it is for users to accomplish basic tasks the first time through
and to be able to work quickly without spending much time searching for instructions and
screen interface commands.
• Efficiency
Refers to how quickly a user takes to perform each of sequential tasks.
• Memorability
Assessment of the ease at re-establishing each of the tasks after a period of nonuse.
• Errors
Assessment of user errors and ability to quickly recovery from errors.
• Satisfaction
Assessment of pleasantness for users.
26. Development of complex interventions
User-centered development
Testing / pilot
Evaluation
Implementation /
exploitation
Chief engineering = PhD student
Dissemination
of knowledge
27. Output
• Evidence-based innovative mHealth applications
• Far-reaching knowledge exchange
• Peer-reviewed / professional publications
• PhD thesis
• Etc.
• Valorisation and implementation