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Keywords: Technology; Chronic disease; Prevention and control; Datasets as topic EN Technology Chronic disease Prevention and control Datasets as topic 384 388 5 05/17/23 20230515 NES 230515 Smartwatches can count every step towards a predict-prevent health care system, but clinical regulation is the first leap Australia is struggling with the ever-increasing burden of chronic disease. As health care professionals, we can further our understanding of smartwatch use in chronic disease through further research using real world data - with the ultimate goal of improving autonomy and health outcomes for consumers. [Extracted from the article]

Keywords: eHealth; Information management; Health financing; Health services research EN eHealth Information management Health financing Health services research 53 57 5 02/07/23 20230201 NES 230201 Focusing solely on financial measures is unlikely to deliver a comprehensive view of the value of digital health Digital health, which refers to the use of digital technology to provide and support health care services, promises to strengthen health systems worldwide and has been accelerated by the coronavirus disease 2019 (COVID-19) pandemic.[1] Amid the rapid digital transformation of health care,[[2]] the value of sizeable digital health investments remains unclear.[[3]] The investments required for digital health are often substantial and may come at a cost to existing health care delivery models. Conclusion Health care organisations are currently not measuring the true value of digital health implementations and, thus, digital investment may not be prioritised given the competing health care demands. With the burden on the health care system to continue service delivery with static resourcing, an ageing population and growing health inequities, digital health provides an unrivalled opportunity to improve care at scale. [Extracted from the article]

The article discusses the adoption of artificial intelligence (AI) in healthcare and the need for a thoughtful and inclusive approach to this data-driven revolution. The authors highlight the importance of amplifying the voices of people who receive healthcare and ensuring that they have control over their personal data. The article presents the findings of a citizens' jury, which recommended an independent national charter for AI in health and emphasized the importance of rigorous evaluation, fairness, patient rights, and community involvement. The authors conclude that while the advent of AI in healthcare is inevitable, it should be accompanied by robust governance and privacy measures, guided by the principle of "nothing about me without me." [Extracted from the article]

Background: Digital health in hospital settings is viewed as a panacea for achieving the “quadruple aim” of health care, yet the outcomes have been largely inconclusive. To optimize digital health outcomes, a strategic approach is necessary, requiring digital maturity assessments. However, current approaches to assessing digital maturity have been largely insufficient, with uncertainty surrounding the dimensions to assess. Objective: The aim of this study was to identify the current dimensions used to assess the digital maturity of hospitals. Methods: A systematic literature review was conducted of peer-reviewed literature (published before December 2020) investigating maturity models used to assess the digital maturity of hospitals. A total of 29 relevant articles were retrieved, representing 27 distinct maturity models. The articles were inductively analyzed, and the maturity model dimensions were extracted and consolidated into a maturity model framework. Results: The consolidated maturity model framework consisted of 7 dimensions: strategy; information technology capability; interoperability; governance and management; patient-centered care; people, skills, and behavior; and data analytics. These 7 dimensions can be evaluated based on 24 respective indicators. Conclusions: The maturity model framework developed for this study can be used to assess digital maturity and identify areas for improvement. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges at the Princess Alexandra Hospital (PAH) in Australia for transforming into an integrated digital tertiary hospital, with topics including the use of electronic medical records (EMR) in the hospital, medical technology management, and the medical care quality.

Background: Chronic diseases contribute to high rates of disability and mortality. Patient engagement in chronic disease self-management is an essential component of chronic disease models of health care. Wearables provide patient-centered health data in real time, which can help inform self-management decision-making. Despite the perceived benefits of wearables in improving chronic disease self-management, their influence on health care outcomes remains poorly understood.Objective: This review aimed to examine the influence of wearables on health care outcomes in individuals with chronic diseases through a systematic review of the literature.Methods: A narrative systematic review was conducted by searching 6 databases for randomized and observational studies published between January 1, 2016, and July 1, 2021, that included the use of a wearable intervention in a chronic disease group to assess its impact on a predefined outcome measure. These outcomes were defined as any influence on the patient or clinician experience, cost-effectiveness, or health care outcomes as a result of the wearable intervention. Data from the included studies were extracted based on 6 key themes, which formed the basis for a narrative qualitative synthesis. All outcomes were mapped against each component of the Quadruple Aim of health care. The guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement were followed in this study.Results: A total of 30 articles were included; studies reported 2446 participants (mean age: range 10.1-74.4 years), and the influence of 14 types of wearables on 18 chronic diseases was presented. The most studied chronic diseases were type 2 diabetes (4/30, 13%), Parkinson disease (3/30, 10%), and chronic lower back pain (3/30, 10%). The results were mixed when assessing the impact on a predefined primary outcome, with 50% (15/30) of studies finding a positive influence on the studied outcome and 50% (15/30) demonstrating a nil effect. There was a positive effect of 3D virtual reality systems on chronic pain in 7% (2/30) of studies that evaluated 2 distinct chronic pain syndromes. Mixed results were observed in influencing exercise capacity; weight; and biomarkers of disease, such as hemoglobin A1c, in diabetes. In total, 155 outcomes were studied. Most (139/155, 89.7%) addressed the health care outcomes component. This included pain (11/155, 7.5%), quality of life (7/155, 4.8%), and physical function (5/155, 3.4%). Approximately 7.7% (12/155) of outcome measures represented the patient experience component, with 1.3% (2/155) addressing the clinician experience and cost.Conclusions: Given their popularity and capability, wearables may play an integral role in chronic disease management. However, further research is required to generate a strong evidence base for safe and effective implementation.Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021244562; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=244562. [ABSTRACT FROM AUTHOR]

Background: Early warning tools identify patients at risk of deterioration in hospitals. Electronic medical records in hospitals offer real-time data and the opportunity to automate early warning tools and provide real-time, dynamic risk estimates.Objective: This review describes published studies on the development, validation, and implementation of tools for predicting patient deterioration in general wards in hospitals.Methods: An electronic database search of peer reviewed journal papers from 2008-2020 identified studies reporting the use of tools and algorithms for predicting patient deterioration, defined by unplanned transfer to the intensive care unit, cardiac arrest, or death. Studies conducted solely in intensive care units, emergency departments, or single diagnosis patient groups were excluded.Results: A total of 46 publications were eligible for inclusion. These publications were heterogeneous in design, setting, and outcome measures. Most studies were retrospective studies using cohort data to develop, validate, or statistically evaluate prediction tools. The tools consisted of early warning, screening, or scoring systems based on physiologic data, as well as more complex algorithms developed to better represent real-time data, deal with complexities of longitudinal data, and warn of deterioration risk earlier. Only a few studies detailed the results of the implementation of deterioration warning tools.Conclusions: Despite relative progress in the development of algorithms to predict patient deterioration, the literature has not shown that the deployment or implementation of such algorithms is reproducibly associated with improvements in patient outcomes. Further work is needed to realize the potential of automated predictions and update dynamic risk estimates as part of an operational early warning system for inpatient deterioration. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted the lack of readily available evaluation processes to provide health services with the assurance that PPE sourced using novel methods, such as crowdsourcing or 3D printing, is fit for purpose and TGA compliant. Protective devices, Health services research, Health services, Health systems, Quality assurance, health care, Risk management, COVID-19, Infectious diseases, Respiratory tract infections Keywords: Protective devices; Health services research; Health services; Health systems; Quality assurance; health care; Risk management; COVID-19; Infectious diseases; Respiratory tract infections EN Protective devices Health services research Health services Health systems Quality assurance health care Risk management COVID-19 Infectious diseases Respiratory tract infections 496 496 1 06/23/21 20210615 NES 210615 Novel PPE, such as 3D printed face shields, must be compliant with regulatory requirements and a clinical evaluation protocol should be developed Personal protective equipment (PPE) is critical in protecting hospital staff during the treatment of patients throughout the coronavirus disease 2019 (COVID-19) pandemic. [Extracted from the article]

Background: Engaging patients in the delivery of health care has the potential to improve health outcomes and patient satisfaction. Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication.Objective: The aim of this study was to review literature describing patient portals tethered to an EMR in inpatient settings, their role in patient engagement, and their impact on health care delivery in order to identify factors and best practices for successful implementation of this technology and areas that require further research.Methods: A systematic search for articles in the PubMed, CINAHL, and Embase databases was conducted using keywords associated with patient engagement, electronic health records, and patient portals and their respective subject headings in each database. Articles for inclusion were evaluated for quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) for systematic review articles and the Quality Assessment Tool for Studies with Diverse Designs for empirical studies. Included studies were categorized by their focus on input factors (eg, portal design), process factors (eg, portal use), and output factors (eg, benefits) and by the valence of their findings regarding patient portals (ie, positive, negative, or mixed).Results: The systematic search identified 58 articles for inclusion. The inputs category was addressed by 40 articles, while the processes and outputs categories were addressed by 36 and 46 articles, respectively: 47 articles addressed multiple themes across the three categories, and 11 addressed only a single theme. Nineteen articles had high- to very high-quality, 21 had medium quality, and 18 had low- to very low-quality. Findings in the inputs category showed wide-ranging portal designs; patients' privacy concerns and lack of encouragement from providers were among portal adoption barriers while information access and patient-provider communication were among facilitators. Several methods were used to train portal users with varying success. In the processes category, sociodemographic characteristics and medical conditions of patients were predictors of portal use; some patients wanted unlimited access to their EMRs, personalized health education, and nonclinical information; and patients were keen to use portals for communicating with their health care teams. In the outputs category, some but not all studies found patient portals improved patient engagement; patients perceived some portal functions as inadequate but others as useful; patients and staff thought portals may improve patient care but could cause anxiety in some patients; and portals improved patient safety, adherence to medications, and patient-provider communication but had no impact on objective health outcomes.Conclusions: While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact. [ABSTRACT FROM AUTHOR]

Objective: We explored the relationship between the National Emergency Access Target (NEAT) compliance rate, defined as the proportion of patients admitted or discharged from emergency departments (EDs) within 4 hours of presentation, and the risk-adjusted in-hospital mortality of patients admitted to hospital acutely from EDs.Design, Setting and Participants: Retrospective observational study of all de-identified episodes of care involving patients who presented acutely to the EDs of 59 Australian hospitals between 1 July 2010 and 30 June 2014.Main Outcome Measure: The relationship between the risk-adjusted mortality of inpatients admitted acutely from EDs (the emergency hospital standardised mortality ratio [eHSMR]: the ratio of the numbers of observed to expected deaths) and NEAT compliance rates for all presenting patients (total NEAT) and admitted patients (admitted NEAT).Results: ED and inpatient data were aggregated for 12.5 million ED episodes of care and 11.6 million inpatient episodes of care. A highly significant (P < 0.001) linear, inverse relationship between eHSMR and each of total and admitted NEAT compliance rates was found; eHSMR declined to a nadir of 73 as total and admitted NEAT compliance rates rose to about 83% and 65% respectively. Sensitivity analyses found no confounding by the inclusion of palliative care and/or short-stay patients.Conclusion: As NEAT compliance rates increased, in-hospital mortality of emergency admissions declined, although this direct inverse relationship is lost once total and admitted NEAT compliance rates exceed certain levels. This inverse association between NEAT compliance rates and in-hospital mortality should be considered when formulating targets for access to emergency care. [ABSTRACT FROM AUTHOR]