Digital Technologies to Support Better Outcome and Experience of Care in Patients with Heart Failure

Factors affecting the adoption of metaverse in healthcare: The moderating role of digital division, and meta-culture

This research aims to find out the factors affecting the adoption of Metaverse in healthcare. This study explores the effect of perceived ease of use, perceived usefulness, and trust on adopting Metaverse in healthcare by keeping digital division and metaculture as moderating variables. The philosophical foundation is rooted in the positivism paradigm, the methodology is quantitative, and the approach used is deductive. Data was collected in Pakistan and China through judgmental sampling from 384 respondents. Partial Least Square Structural Equation Modelling (PLS-SEM) was used to analyze the collected data. The findings validate the relationship between perceived ease of use and the adoption of metaverse with β-value 0.236, t-value 5.207 and p-value 0.000, the relationship between perceived usefulness and the adoption of metaverse with β-value 0.233, t-value 4.017 and p-value 0.000, and the relationship between trust and adoption of a metaverse with β-value 0.192, t-value 3.589 and p-value 0.000. Results also show that the digital divide moderates the relation between perceived ease of use and adopting the metaverse having β-value 0.078, t-value 1.848 and p-value 0.032. Similarly, the findings also show that the digital divide does not moderate the relationships of perceived usefulness and trust with adopting the metaverse. Moreover, the meta culture also does not moderate the relationships of perceived ease of use, usefulness, and trust with adopting the metaverse. The study contributes to theoretical research on adopting a metaverse in healthcare by examining various factors necessary for its development. It also provides guidelines for the developers and adopters of suitable metaverse technology.

Heart Failure Nurses within the Primary Care Setting

Cardiology services within primary care often focus on disease prevention, early identification of illness and prompt referral for diagnosis and specialist treatment. Due to advances in pharmaceuticals, implantable cardiac devices and surgical interventions, individuals with heart failure are living longer, which can place a significant strain on global healthcare resources. Heart failure nurses in a primary care setting offer a wealth of clinical knowledge and expertise across all phases of the heart failure trajectory and are able to support patients, family members and other community services, including general practitioners. This review examines the recently published evidence on the current and potential future practice of heart failure nurses within primary care.

The Heart and Artificial Intelligence-How Can We Improve Medicine Without Causing Harm

PURPOSE OF REVIEW

The introduction of Artificial Intelligence into the healthcare system offers enormous opportunities for biomedical research, the improvement of patient care, and cost reduction in high-end medicine. Digital concepts and workflows are already playing an increasingly important role in cardiology. The fusion of computer science and medicine offers great transformative potential and enables enormous acceleration processes in cardiovascular medicine.

RECENT FINDINGS

As medical data becomes smart, it is also becoming more valuable and vulnerable to malicious actors. In addition, the gap between what is technically possible and what is allowed by privacy legislation is growing. Principles of the General Data Protection Regulation that have been in force since May 2018, such as transparency, purpose limitation, and data minimization, seem to hinder the development and use of Artificial Intelligence. Concepts to secure data integrity and incorporate legal and ethical principles can help to avoid the potential risks of digitization and may result in an European leadership in regard to privacy protection and AI. The following review provides an overview of relevant aspects of Artificial Intelligence and Machine Learning, highlights selected applications in cardiology, and discusses central ethical and legal considerations.

Smartphone-Based Remote Monitoring in Heart Failure With Reduced Ejection Fraction: Retrospective Cohort Study of Secondary Care Use and Costs

BACKGROUND

Despite effective therapies, the economic burden of heart failure with reduced ejection fraction (HFrEF) is driven by frequent hospitalizations. Treatment optimization and admission avoidance rely on frequent symptom reviews and monitoring of vital signs. Remote monitoring (RM) aims to prevent admissions by facilitating early intervention, but the impact of noninvasive, smartphone-based RM of vital signs on secondary health care use and costs in the months after a new diagnosis of HFrEF is unknown.

OBJECTIVE

The purpose of this study is to conduct a secondary care health use and health-economic evaluation for patients with HFrEF using smartphone-based noninvasive RM and compare it with matched controls receiving usual care without RM.

METHODS

We conducted a retrospective study of 2 cohorts of newly diagnosed HFrEF patients, matched 1:1 for demographics, socioeconomic status, comorbidities, and HFrEF severity. They are (1) the RM group, with patients using the RM platform for >3 months and (2) the control group, with patients referred before RM was available who received usual heart failure care without RM. Emergency department (ED) attendance, hospital admissions, outpatient use, and the associated costs of this secondary care activity were extracted from the Discover data set for a 3-month period after diagnosis. Platform costs were added for the RM group. Secondary health care use and costs were analyzed using Kaplan-Meier event analysis and Cox proportional hazards modeling.

RESULTS

A total of 146 patients (mean age 63 years; 42/146, 29% female) were included (73 in each group). The groups were well-matched for all baseline characteristics except hypertension (P=.03). RM was associated with a lower hazard of ED attendance (hazard ratio [HR] 0.43; P=.02) and unplanned admissions (HR 0.26; P=.02). There were no differences in elective admissions (HR 1.03, P=.96) or outpatient use (HR 1.40; P=.18) between the 2 groups. These differences were sustained by a univariate model controlling for hypertension. Over a 3-month period, secondary health care costs were approximately 4-fold lower in the RM group than the control group, despite the additional cost of RM itself (mean cost per patient GBP £465, US $581 vs GBP £1850, US $2313, respectively; P=.04).

CONCLUSIONS

This retrospective cohort study shows that smartphone-based RM of vital signs is feasible for HFrEF. This type of RM was associated with an approximately 2-fold reduction in ED attendance and a 4-fold reduction in emergency admissions over just 3 months after a new diagnosis with HFrEF. Costs were significantly lower in the RM group without increasing outpatient demand. This type of RM could be adjunctive to standard care to reduce admissions, enabling other resources to help patients unable to use RM.

The Widening Gap between the Digital Capability of the Care Workforce and Technology-Enabled Healthcare Delivery: A Nursing and Allied Health Analysis

There is a need to ensure that healthcare organisations enable their workforces to use digital methods in service delivery. This study aimed to evaluate the current level of digital understanding and ability in nursing, midwifery, and allied health workforces and identify some of the training requirements to improve digital literacy in these health professionals. Representatives from eight healthcare organizations in Victoria, Australia participated in focus groups. Three digital frameworks informed the focus group topic guide that sought to examine the barriers and enablers to adopting digital healthcare along with training requirements to improve digital literacy. Twenty-three participants self-rated digital knowledge and skills using Likert scales and attended the focus groups. Mid-range scores were given for digital ability in nursing, midwifery, and allied health professionals. Focus group participants expressed concern over the gap between their organizations’ adoption of digital methods relative to their digital ability, and there were concerns about cyber security. Participants also saw a need for the inclusion of consumers in digital design. Given the widening gap between digital innovation and health workforce digital capability, there is a need to accelerate digital literacy by rapidly deploying education and training and policies and procedures for digital service delivery.

Informal Caregivers’ Experiences with Performing Telemonitoring in Heart Failure Care at Home—A Qualitative Study

Informal caregivers have an important role in caring for family members at home. Supporting persons with a chronic illness such as heart failure (HF) in managing their self-care is reported to be a challenge and telemonitoring has been suggested to be of support. Aim: to explore informal caregivers’ experiences with performing non-invasive telemonitoring to support persons with HF at home for 30 days following hospital discharge in Norway and Lithuania. Methods: A qualitative explorative study of informal caregivers performing non-invasive telemonitoring using lung-impedance measurements and short message service (SMS). Data was collected using semi-structured interviews with informal caregivers of persons with HF in NYHA class III-IV in Norway and Lithuania. Results: Nine interviews were conducted with informal caregivers of persons with HF who performed non-invasive telemonitoring at home. A sequential process of three categories emerged from the data: access to support, towards routinizing, and mastering non-invasive telemonitoring. Conclusion: Informal caregivers performed non-invasive telemonitoring for the first time in this study. Their experiences were of a sequential process that included access to support from health care professionals, establishing a routine together, and access to nurses or physicians in HF care as part of mastering. This study highlights involving informal caregivers and persons with HF together in the implementation and future research of telemonitoring in HF care.