METHOD: A systematic Boolean search in PubMed, EMBase and EBSCOhost research databases was performed. Keyword search and citation analysis were also conducted. Empirical studies reporting ICT based interventions, and their implications on relative effectiveness in reducing unnecessary diagnostic tests (pathology tests or medical imaging) were evaluated independently by two reviewers based on a rigorously developed coding protocol.
RESULTS: 92 research articles from peer-reviewed journals were identified as eligible. 47 studies involved a single-method intervention and 45 involved multi-method interventions. Regardless of the number of interventions involved in the studies, ICT-based interventions were utilized by 71 studies and 59 of them were shown to be effective in reducing unnecessary testing. A clinical decision support (CDS) tool appeared to be the most adopted ICT approach, with 46 out of 71 studies using CDS tools. The CDS tool showed effectiveness in reducing test volume in 38 studies and reducing cost in 24 studies.
CONCLUSIONS: This review investigated five frequently utilized intervention methods, ICT-based, education, introduction of guidelines or protocols, audit and feedback, and reward and punishment. It provides in-depth analysis of the efficacy of different types of interventions and sheds insights about the benefits of ICT based interventions, especially those utilising CDS tools, to reduce unnecessary diagnostic testing. The replicability of the studies is limited due to the heterogeneity of the studies in terms of context, study design, and targeted types of tests.
METHODS: Eight scientific databases were searched. Two independent reviewers screened the literature in title and abstract stages, followed by full-text appraisal, data extraction, and synthesis of eligible studies. Studies were extracted to capture details of the mhealth tools used, the service issues addressed, the study design, and the outcomes evaluated. We then mapped the included studies using the 20 sub-strategies of the WHO Framework on Integrated People-Centred Health Services (IPCHS); as well as with the RE-AIM (Reach, effectiveness, adoption, implementation and maintenance) framework, to understand how studies implemented and evaluated interventions.
RESULTS: We identified 39 studies, predominantly from Australia (n = 16), China (n = 7), Malaysia (n = 4) and New Zealand (n = 4), and little from low income countries. The mHealth modalities included text messaging, voice and video communication, mobile applications and devices (point-of-care, GPS, and Bluetooth). Health issues addressed included: medication adherence, smoking cessation, cardiovascular disease, heart failure, asthma, diabetes, and lifestyle activities respectively. Almost all were community-based and focused on service issues; only half were disease-specific. mHealth facilitated integrated IPCHS by: enabling citizens and communities to bypass gatekeepers and directly access services; increasing affordability and accessibility of services; strengthening governance over the access, use, safety and quality of clinical care; enabling scheduling and navigation of services; transitioning patients and caregivers between care sectors; and enabling the evaluation of safety and quality outcomes for systemic improvement. Evaluations of mHealth interventions did not always report the underlying theories. They predominantly reported cognitive/behavioural changes rather than patient outcomes. The utility of mHealth to support and improve IPCHS was evident. However, IPCHS strategy 2 (participatory governance and accountability) was addressed least frequently. Implementation was evaluated in regard to reach (n = 30), effectiveness (n = 24); adoption (n = 5), implementation (n = 9), and maintenance (n = 1).
CONCLUSIONS: mHealth can transition disease-centred services towards people-centred services. Critical appraisal of studies highlighted methodological issues, raising doubts about validity. The limited evidence for large-scale implementation and international variation in reporting of mHealth practice, modalities used, and health domains addressed requires capacity building. Information-enhanced implementation and evaluation of IPCHS, particularly for participatory governance and accountability, is also important.
OBJECTIVE: This study reviewed progress in the use and adoption of telemedicine in Middle Eastern countries. The key dimensions affecting the progress of telemedicine in these countries were identified.
METHOD: A systematic review of the literature was conducted on 43 peer reviewed articles from 2010 to 2020. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis, and interpretation of findings.
RESULTS: The results showed that progress made in the utilization of telemedicine was insufficient and varies across Middle Eastern countries. Certain cultural, financial, organizational, individual, technological, legal, and regulatory challenges were found to prevent telemedicine from being fully used to the point where the full range of medical services can be provided. For example, doctor and patient resistance, poor infrastructure, lack of funding, poor system quality, and lack of information technology training were associated with the low adoption of telemedicine in the region.
CONCLUSION: This review provides a number of recommendations that will help policymakers to move toward the integration of innovative technologies in order to facilitate access to health information, health services, and training. It also recommends that health initiatives should focus on health education and health promotion in order to increase public awareness of the benefits of telemedicine services in the region.
STUDY DESIGN: A descriptive content analysis of patient organisation websites was conducted.
METHODS: The Google® search engine was interrogated using search terms related to the principal chronic diseases from the Global Burden of Disease Study. Data relating to 41 travel health variables were extracted from each eligible website. An aggregate quality score was derived for each organisation based on the presence of specific website information. Visitor usage and search analytics for each organisation's website were also described.
RESULTS: We examined 145 official organisation websites relating to 10 major chronic illnesses. The largest number of websites was retrieved for patients with cancer (n = 36). Only 21 (16.5%) websites provided information on fitness-to-travel considerations. COPD websites had the highest average quality score (17.68%), followed by diabetes (14.91%) and dementia (13.28%). Mental health illness websites had the lowest score of 1.33%. There was a trend towards increased emphasis on pre-travel preparation and medications. Insect bite avoidance, malaria, animal bites, jet lag, and repatriation were addressed to the least extent.
CONCLUSIONS: Our analysis exposes significant deficits in the coverage of travel health topics. Patient organisations should provide accessible pre-travel health advice to website users. Future research should elucidate the influence of web-based pre-travel health information on the behaviour of travellers with chronic disease.
OBJECTIVES: This study aims to identify the determinants associated with Twitter use in psychiatric consultations and to assess the level of satisfaction in using the microblogging platform. In addition, the level of e-health literacy is also assessed among users.
METHODS: The target population included Twitter users seeking psychiatric consultation. A leading psychiatrist's twitter account with 4.5 million followers was selected and consent obtained. A validated Patient Satisfaction Questionnaire was adopted to assess the level of satisfaction in Twitter use and e-health literacy. The questionnaire was tagged to the chosen Twitter account and reminders were sent until the sample size was reached. Data was analysed using SPSS version 22.0. The analysis included descriptive statistics tabulation, multi-response analysis, and cross-tabulation for satisfaction variables and the chi-square test was used to measure association between different variables.
RESULTS: The study obtained 155 completed response sheets, of which 52 were Twitter users seeking psychiatric advice while the rest sought general health advice. Most of the study participants were females (71.6 %). Women, single status and income range between 4000-9000 Saudi riyal were found to be significantly associated with Twitter use for psychiatric consultation. Generally, most of the participants were satisfied with Twitter in seeking psychiatric consultation that reduced financial disbursement. Furthermore, concerns were expressed regarding the waiting period, word limitations and issues of privacy. The e-health literacy was higher among the participants.
CONCLUSION: Psychiatric consultations via Twitter is more popular among women. By addressing privacy issues and reducing response time, Twitter may be used as a major platform to deliver mental health services to the population.
METHODS: A systematic literature search was conducted on six electronic databases from database inception until May 31st 2021. Studies that reported on the clinical use or economic analysis of digital health technology for LTBI care were included. Two investigators independently evaluated, extracted relevant studies, and assessed the risk of bias of using the Cochrane tools. The studies were synthesized qualitatively.
RESULTS: Fifteen articles describing 14 studies were included. Voice and/or textual reminders and synchronous video call to improve LTBI treatment adherence were the most commonly examined digital health interventions. Other interventions examined the use of mobile phones to improve the number of patients who returned for tuberculin skin test follow-up measurement (screening retention) and eLearning videos to enhance health literacy in LTBI care. The economic analysis supported the use of textual reminders in LTBI treatment as a cost-effective option for widescale implantation.
CONCLUSIONS: Despite limited evidence on the effects of digital health technologies in LTBI, available studies suggest they are at least equivalent to current practice. This means digital health can potentially supplement current practice, to constantly monitor and engage with people undergoing LTBI screening or treatment, as an initiative to ensure the provision of continuous and optimal care to all LTBI-affected individuals.
METHOD: A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand.
RESULTS: Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives.
CONCLUSION: Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients.