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BackgroundTechnological tools such as Web-based social networks, telemedicine, apps, or wearable devices are becoming more widespread in health care like elsewhere. Although patients are the main users, for example, to monitor symptoms and clinical parameters or to communicate with the doctor, their perspective is seldom analyzed, and to the best of our knowledge, no one has focused on the patients’ health care advocacy associations’ point of view. ObjectiveThe objective of this study was to assess patients’ health care advocacy associations’ opinions about the use, usefulness, obstacles, negative aspects, and impact of health apps and wearable devices through a Web-based survey. MethodsWe conducted a Web-based survey through SurveyMonkey over nearly 3 months. Participants were contacted via an email explaining the aims of the survey and providing a link to complete the Web-based questionnaire. All the 20 items were mandatory, and the anonymized data were collected automatically into a database. Only fully completed questionnaires were considered for analysis. ResultsWe contacted 1998 patients’ health care advocacy associations; a total of 258 questionnaires were received back (response rate 12.91%), and 227 of the received questionnaires were fully completed (completion rate 88.0%). Informative apps, hospital apps for viewing medical reports or booking visits, and those for monitoring physical activity are the most used. They are considered especially useful to improve patients’ engagement and compliance with treatment. Wearable devices to check physical activity and glycemia are the most widespread considering, again, their benefits in increasing patients’ involvement and treatment compliance. For health apps and wearable devices, the main obstacles to their use are personal and technical reasons; the risk of overmedicalization is considered the most negative aspect of their constant use, while privacy and confidentiality of data are not rated a limitation. No statistical difference was found on stratifying the answers by responders’ technological level (P=.30), age (P=.10), and the composition of the association’s advisory board (P=.15). ConclusionsAccording to responders, health apps and wearable devices are sufficiently known and used and are considered potential supports for greater involvement in health management. However, there are still obstacles to their adoption, and the developers need to work to make them more accessible and more useful. The involvement of patients and their associations in planning services and products based on these technologies (as well as others) would be desirable to overcome these barriers and boost awareness about privacy and the confidentiality of data.

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness.

Background: Breast cancer is a global health problem, and sentinel lymph node biopsy (SLNB) is the standard procedure for early-stage breast cancer. Technetium-99 (TC-99), alone or combined with blue dye (BD) are conventional tracers for SLNB, but they have safety, availability, and cost limitations. Indocyanine green (ICG) is an alternative tracer that has been gaining acceptance among healthcare professionals. This study aimed at assessing the clinical and economic value of ICG in hospital settings, using the health technology assessment (HTA) framework. Methods: We conducted a comprehensive evaluation of ICG for SLNB, based on literature sources and data collected from two Italian hospitals that switched from TC-99 to ICG. We analyzed ICG's technical attributes through technology documentation and relevant databases. We performed a systematic literature review of 36 studies to assess the clinical effectiveness and safety of ICG. We obtained organizational insights from clinicians and the clinical engineer involved in the study. We applied Time-Driven Activity-Based Costing (TDABC) and Budget Impact Analysis (BIA) to estimate the economic impact of ICG. The ethical, legal, and social implications of ICG were considered through clinicians' inputs and technology documentation. Results: Our results showed that ICG had equivalent or superior clinical effectiveness compared to TC-99 and BD, with minimal adverse events. ICG simplified the surgical pathways, by streamlining procedures, reducing waiting times, and increasing flexibility in scheduling surgeries. Moreover, the TDABC analysis showed significant cost reductions by avoiding the need for pre-operative lymphoscintigraphy and hospitalization, with average savings per single care pathway of around 18% for ICG compared to TC-99. Finally, ICG improved patient experience, and proved regulatory compliance. Conclusions: This study provided strong evidence for ICG's clinical and economic value for SLNB in breast cancer. It ascertained ICG as a valuable alternative to conventional tracers, ensuring clinical effectiveness along with economic and organizational benefits. [ABSTRACT FROM AUTHOR]

Multi-professional service teams might isolate from the organisation and inhibit knowledge sharing with others. Professional organisations are thus stimulating their teams to bond more closely with other units, hoping this would facilitate knowledge sharing. Yet, studies on social bonding suggest this could actually deter from knowledge sharing. Our study investigates this further asking: do employees display greater intention to share knowledge when their teams possess greater structural, relational and cognitive social capital? Our cross-level study, grounded on a sample of 226 employees (39 teams in four Hospice & Palliative Care Organisations), shows that individuals embedded in teams with greater social capital are indeed more motivated to share knowledge; and that each form of social bonding—increasing frequency of interactions, trust and mutual support, and similarity of goals/meanings—stimulates different mechanisms of knowledge sharing (attitude, subjective norm and perceived behavioural control). [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONPurpose: Visual impairment poses significant challenges in daily life, especially when navigating unfamiliar environments, resulting in inequalities and reduced quality of life. This study aimed to gain an in-depth understanding of the needs and perspectives of visually impaired people in sports-related contexts through surveys and focus groups, and to understand whether their needs are being met by current technological solutions.Materials and methods: To accomplish this, opinions gathered from focus groups and interviews were compared to the technological solutions found in the literature. Since many unmet needs were identified, participants from associations and organizations were asked to identify key characteristics for the development of a robot guide. The results underscored the paramount importance of an easy-to-use guide that offers accurate and personalized assistance. Participants expressed a strong desire for advanced features such as object recognition and navigation in complex environments, as well as adaptability to the user’s speed while providing the necessary safety features to ensure a high level of autonomy.Results: This research serves as a bridge between technological advances and the needs of the visually impaired, contributing to a more accessible and inclusive society. By addressing the unique challenges faced by the visually impaired individuals and tailoring technology to meet their needs, this study takes a significant step toward reducing disparities and improving the independence and quality of life for this community.Conclusions: As technology continues to advance, it has the potential to be a powerful tool in breaking down barriers and fostering a world where everyone, regardless of their visual ability, can navigate the world with confidence and ease.Inclusive design: Recognizing the importance of incorporating the unique requirements and perspectives of visually impaired individuals can guide the development of rehabilitation technology and services, ensuring they effectively support daily activities and active participation in sports and physical pursuits.Tailored-assistive technology: Understanding the specific needs of visually impaired individuals with regards to assistive technology, such as dependable robotic guides and essential features, can inform the design and customization of rehabilitation aids to enhance mobility and independence.Promising technologies: Exploring promising technologies like Aira, Be My Eyes, RoboCart, and Wayband can inspire the integration of these innovations into rehabilitation programs, facilitating better orientation, mobility, and accessibility for individuals with visual impairments.Continued research and development: Emphasizing the necessity for ongoing research and development efforts underscores the importance of advancing rehabilitation solutions that effectively address the distinct needs of visually impaired individuals, particularly in navigating unfamiliar environments.Inclusive design: Recognizing the importance of incorporating the unique requirements and perspectives of visually impaired individuals can guide the development of rehabilitation technology and services, ensuring they effectively support daily activities and active participation in sports and physical pursuits.Tailored-assistive technology: Understanding the specific needs of visually impaired individuals with regards to assistive technology, such as dependable robotic guides and essential features, can inform the design and customization of rehabilitation aids to enhance mobility and independence.Promising technologies: Exploring promising technologies like Aira, Be My Eyes, RoboCart, and Wayband can inspire the integration of these innovations into rehabilitation programs, facilitating better orientation, mobility, and accessibility for individuals with visual impairments.Continued research and development: Emphasizing the necessity for ongoing research and development efforts underscores the importance of advancing rehabilitation solutions that effectively address the distinct needs of visually impaired individuals, particularly in navigating unfamiliar environments. [ABSTRACT FROM AUTHOR]

National healthcare systems face multiple challenges, including the increasing demand for care and decreasing availability of healthcare professionals. Digital health technologies represent opportunities that offer improved efficiency, accessibility, and patient care. In this scenario, Digital Therapeutics are technological advancements to treat or alleviate a disease and deliver a medical intervention with evidence-based therapeutic impacts and regulatory approval. Digital Therapeutics are a paradigm shift for physicians, who exercise caution in terms of trust and wide usage. Digital Therapeutics represents an opportunity and a challenge in healthcare system integration. The research investigates the factors explaining physicians' acceptance of Digital Therapeutics. A research model that combines organizational mechanisms derived from Institutional Theory and rational factors derived from the Technology Acceptance model was developed. The model was tested through 107 responses from a survey distributed to the members of the leading Italian scientific society in Diabetology. Literature-based hypotheses were empirically tested through Structural Equation Modelling. The analysis confirmed the influence of Perceived Ease of Use on Perceived Usefulness and Perceived Usefulness on the Intention To Use Digital Therapeutics. Rules and norms impact Perceived Usefulness when considering the influence of the scientific society. Culture and mindset towards innovation within the hospital positively affect Perceived Ease of Use. The readiness of hospital facilities enhances the extent to which physicians perceive the ease of employing Digital Therapeutics in their daily practice. Instead, esteemed colleagues' opinions and guidelines from the scientific society reveal to physicians the value of Digital Therapeutics in patients' care pathways. Institutions should prioritize cultural, normative, and regulative aspects to accelerate physicians' endorsement of Digital Therapeutics. Findings advance the theoretical knowledge around clinicians' adoption of innovative digital health technologies, unveiling the interaction between rational and institutional factors. The results highlight practical implications for healthcare institutions and Digital Therapeutics manufacturers willing to promote their adoption. [ABSTRACT FROM AUTHOR]

Innovating in Medical Device (MD) industry is challenging. This study aims to develop and validate an evidence-based framework that helps innovators of small and large enterprises (SEs and LEs) assess their readiness for successful MD development and deployment. We conducted a key-informant process (stage 1) where 25 international experts identified a list of emergent Health Technology Assessment (HTA) themes they believed were essential to company success. A sample of 22 European and US selected companies (13 SEs and 9 LEs) then reached a consensus on a list of key themes through a robust Delphi process (stage 2). Finally, we constructed (stage 3) and validated (stage 4) the checklist for SEs and LEs. The checklist for SEs and LEs included 21 and 15 items (i.e., fundamental Yes/No questions) with nine overlapping criteria for both SEs and LEs. In both groups, MD success was driven by three major item categories: (i) R&D assessment strategy; (ii) device-outcome measures; (iii) company profiling. Alongside the retrospective validation study, we collected 40 case studies on MDs (23 successes and 17 failures) across the selected enterprises. The retrospective validation provided the proportion of successful and failed case studies that met the 'MeDKET' criteria. We discovered that early HTA plays a pivotal role in MD industry success with different implications based on enterprise size. This study is the first of its kind to provide a holistic picture of the perceived role of early-stage HTA in MD industry success. [ABSTRACT FROM AUTHOR]

Hemiplegia is a form of disability that affects one side of the body and has a prevalence of 0.5–0.7 per 1000 live births. It has consequences not only at the medical level but also on psychological, cognitive, and social aspects, and it prevents children from social participation, especially in sports settings. The studies demonstrating the social impact of sports on the hemiplegic population and, in particular, children, are limited. In addition, previous evaluations of healthcare sports initiatives in the hemiplegic population are not available, and traditional methods of evaluation, which are mostly focused on economic outcomes, are not applicable. Thus, this article employs the social return on investment (SROI) methodology, which is able to determine the socio-economic impacts of an initiative, to evaluate the impact of an innovative ankle–foot orthosis (AFO) for hemiplegic children that was created to promote the possibility of "sports for all". The model was designed with the involvement of stakeholders in all the phases and with mixed methods to assess the input, outcomes, and impact indicators. The final SROI, computed for a time horizon of three years and with a focus on the Lombardy Region, was equal to 3.265:1. Based on this result, the initiative turned out to be worthy of investment. [ABSTRACT FROM AUTHOR]

Aims: We aim (i) to redesign sepsis's clinical pathway and fit the organizational requirements of a novel machine‐learning algorithm incorporating a novel biomarker test and (ii) to assess adoption drivers of the new combined technology. Background: There is an urgent need to achieve sepsis' early detection and diagnostic excellence. Methods: A qualitative study based on semi‐structured interviews conducted at the target site and across other Italian hospitals. A content analysis was undertaken, emergent themes were selected and categorized, and interviews were conducted until saturation was reached. Results: Sixteen nurses (10 at the target site and six across other hospitals) and nine non‐nursing professionals (seven at the target site and two across other hospitals) were interviewed. An organizational redesign was identified as the primary adoption driver. Even though nurses perceived workload increase related to the machine‐learning component, technology acceptability was relatively high, as the standardization of tasks was perceived as crucial to improving professional satisfaction. Conclusions: A novel business‐oriented solution based on machine learning requires interprofessional integration, new professional roles, infrastructure improvement, and data integration to be effectively implemented. Implications for Nursing Management: Lessons learned from this study suggest the need to involve nurses in the early stages of the design of new machine‐learning technologies and the importance of training nurses on sepsis management through the support of disruptive technological innovation. [ABSTRACT FROM AUTHOR]