Catalyzing healthcare transformation with digital health: Performance indicators and lessons learned from a Digital Health Innovation Group

Implementation of a Continuous Patient Monitoring System in the Hospital Setting: A Qualitative Study

BACKGROUND

Technology can improve care delivery, patient outcomes, and staff satisfaction, but integration into the clinical workflow remains challenging. To contribute to this knowledge area, this study examined the implementation continuum of a contact-free, continuous monitoring system (CFCM) in an inpatient setting. CFCM monitors vital signs and uses the information to alert clinicians of important changes, enabling early detection of patient deterioration.

METHODS

Data were collected throughout the entire implementation continuum at a community teaching hospital. Throughout the study, 3 group and 24 individual interviews and five process observations were conducted. Postimplementation alarm response data were collected. Analysis was conducted using triangulation of information sources and two-coder consensus.

RESULTS

Preimplementation perceived barriers were alarm fatigue, questions about accuracy and trust, impact on patient experience, and challenges to the status quo. Stakeholders identified the value of CFCM as preventing deterioration and benefitting patients who are not good candidates for telemetry. Educational materials addressed each barrier and emphasized the shared CFCM values. Mean alarm response times were below the desired target of two minutes. Postimplementation interview analysis themes revealed lessened concerns of alarm fatigue and improved trust in CFCM than anticipated. Postimplementation challenges included insufficient training for secondary users and impact on patient experience.

CONCLUSION

In addition to understanding the preimplementation anticipated barriers to implementation and establishing shared value before implementation, future recommendations include studying strategies for optimal tailoring of education to each user group, identifying and reinforcing positive process changes after implementation, and including patient experience as the overarching element in frameworks for digital tool implementation.

Triage to electrocardiogram sign-off time in patients with acute coronary syndrome at a metropolitan Sydney hospital

OBJECTIVE

To compare the time from triage to ECG sign-off in patients with acute coronary syndrome, before and after the introduction of an electronic medical record-integrated ECG workflow system (Epiphany). Additionally, to assess for any correlation between patient characteristics and ECG sign-off times.

METHODS

A retrospective, single-centre cohort study was performed at Prince of Wales Hospital, Sydney. Patients were included if they were over 18 years, presented to Prince of Wales Hospital ED during 2021, had an ED diagnosis code of 'ACS', 'UA', 'NSTEMI' or 'STEMI' and were subsequently admitted under the cardiology team. ECG sign-off times and demographic data were compared between patients presenting prior to 29 June (pre-Epiphany group) and those presenting after (post-Epiphany group). Those without ECGs signed-off were excluded.

RESULTS

There were 200 patients (100 each group) included in the statistical analysis. There was a significant decrease in the median triage to ECG sign-off time, from 35 min (IQR 18-69) pre-Epiphany, to 21 min (IQR 13-37) post-Epiphany. There were only 10 (5%) patients in the pre-Epiphany group and 16 (8%) in the post-Epiphany group, who had ECG sign-off times less than the 10-min. There was no correlation between gender, triage category, age or time of shift with triage to ECG sign-off time.

CONCLUSIONS

The introduction of the Epiphany system has significantly reduced the triage to ECG sign-off time in the ED. Despite this, there remains a large proportion of patients with acute coronary syndrome who do not have an ECG signed-off within the guideline-recommended 10 min.

A European arena for joint innovation in healthcare: The Platform for Innovation of Procurement and Procurement of Innovation (PiPPi)

By 2000 the European Union (EU) had recognized that its innovation capacity was underperforming in comparison to similar competitors and trading partners. Although the EU has made an effort to stimulate public research and development (R&D) through policy tools like Pre-Commercial Procurement (PCP) and Public Procurement of Innovation (PPI), starting with the 2000 Lisbon strategy and continuing through the 2021 updated Guidance on Innovation Procurement, there has remained a gap in knowledge of and use of these tools, in particular within healthcare. The past decades have seen an explosion in the number and use of digital technologies across the entire spectrum of healthcare. Demand-driven R&D has lagged here, while new digital health R&D has largely been driven by the supply side in a linear fashion, which can have disappointing results. PCP and PPI could have big impacts on the development and uptake of innovative health technology. The Platform for Innovation of Procurement and Procurement of Innovation (PiPPi) project was a Horizon 2020-funded project that ran from December 2018 to May 2022 with a consortium including seven of Europe's premier research hospitals and the Catalan Agency for Health Information. To promote PCP and PPI, PiPPi established a virtual Community of Practice (CoP) that brings together all stakeholder groups to share and innovate around unmet healthcare needs. This perspective presents a brief history of PCP and PPI in Europe with a focus on digital innovation in healthcare before introducing the PiPPi project and its value proposition.

A review on attraction factors of science and technology parks to firms in health sector

BACKGROUND

Over the past few years, a rapidly growing number of science and technology parks (STPs) in health sector have emerged across the world. There has been little discussion in the literature to show how STPs could make an attractive environment to absorb and retain potential firms. This is even more challenging for specialized STPs in health sector. The aim of this study is to identify the attractive factors for firms in a STP in health sector.

MATERIALS AND METHODS

A scoping review method was undertaken to review the literature on seven databases (ScienceDirect, Scopus, ProQuest, Google Scholar, EconPapers, PubMed, and ISI Web of Science) for peer-reviewed articles published until 2019. The search results were screened against the inclusion of criteria to ensure they met the objectives. The eligible papers were then assessed on the basis of the full text, and finally the results were extracted.

RESULTS

The attractive factors for firms and talents in multidimensional STPs and those in health sector are extracted and summarized. The attractive factors of multidimensional STPs, which includes health sector firms, and those specialized in health sector are summarized in three main categories; factors created by government and universities, and factors related to STP policies and those expected by the firms.

CONCLUSION

To make STPs attractive for firms in health sector, there is a list of factors that are required to be done not only by STP itself, but also by the national and local government and industries. It is important to consider the factors that are expected by the firms to be implemented. The results of this study suggest that making STPs attractive for health sector firms needs close collaboration between government, universities, related industries, and STPs all together.

Deploying digital health tools within large, complex health systems: key considerations for adoption and implementation

In recent years, the number of digital health tools with the potential to significantly improve delivery of healthcare services has grown tremendously. However, the use of these tools in large, complex health systems remains comparatively limited. The adoption and implementation of digital health tools at an enterprise level is a challenge; few strategies exist to help tools cross the chasm from clinical validation to integration within the workflows of a large health system. Many previously proposed frameworks for digital health implementation are difficult to operationalize in these dynamic organizations. In this piece, we put forth nine dimensions along which clinically validated digital health tools should be examined by health systems prior to adoption, and propose strategies for selecting digital health tools and planning for implementation in this setting. By evaluating prospective tools along these dimensions, health systems can evaluate which existing digital health solutions are worthy of adoption, ensure they have sufficient resources for deployment and long-term use, and devise a strategic plan for implementation.

What Makes for a Successful Digital Health Integrated Program of Work? Lessons Learnt and Recommendations From the Melbourne Children's Campus

Embedding digital technologies in healthcare has the potential to streamline and personalize medical care. However, healthcare systems are often fragmented, and therefore achieving a truly integrated digital health program can be challenging. To promote a streamlined, evidence-based approach to implementing digital health solutions in a healthcare system, the Murdoch Children's Research Institute (MCRI) established the Digital Health Translation and Implementation Program (DHTI) bringing together clinicians, researchers and digital health experts. From the program commencement, frontline clinical innovators have collaborated with DHTI team members to develop and implement digital solutions to address pain-points in the healthcare system. Throughout this program, important lessons have been learnt relating to the development, evaluation and implementation of digital solutions in the healthcare system. This paper explores these lessons and makes recommendations for the successful implementation of digital health solutions in healthcare systems under five main categories: (1) design and usability, (2) stakeholder engagement and uptake, (3) project management and resourcing, (4) process and implementation, and (5) evaluation. Recommendations suggested here are designed to support future healthcare-based digital health programs to maximize the impact digital solutions can have on the healthcare system and patients.

Catalyzing Digital Health Innovation in Ontario: The Role of an Academic Medical Centre

Overcoming barriers to health system innovation is an ongoing challenge in Canada. A total of 51 participants attended a digital health symposium in October 2017 to discuss the role of an academic medical centre (AMC) in advancing innovation. The conversation centred around (i) the current state of innovation in healthcare; (ii) the need for an innovation catalyst; and (iii) the roadmap for an AMC to drive change. AMCs can address the barriers to digital health innovation in Canada by providing a centralized network and infrastructure that supports innovation throughout its journey from "bench to bedside" as well as supporting educational reform.

Benefits, Facilitators, and Recommendations for Digital Health Academic-Industry Collaboration: A Mini Review

Digital health remains a growing and challenging niche in public health practice. Academic-industry collaboration (AIC) offers a mechanism to bring disparate sectors together to alleviate digital health challenges of engagement, reach, sustainability, dissemination, evaluation, and equity. Despite the ongoing endorsements for AIC in digital health, limited understanding exists of successful AIC exists. Most published research highlights the barriers of collaboration rather than efficacy, leaving collaborators asking: What are the benefits and facilitators of AIC and do they apply in digital health? As an initial effort to fill the gap in the literature, the purpose of this mini review outlines the benefits and facilitators from previous AIC and offers recommendations specific to digital health.

Advancing evidence-based digital health through an innovative research environment: an academic-industry collaboration case report

The proliferation of technology enthuses clinicians, researchers, and entrepreneurs to revolutionize health care and care delivery. Intersecting in the field of digital health, academic-industry collaboration (AIC) play a critical role in advancing evidence-based innovations into real world application. AIC models vary, but historically have not included the strong emphasis on rapid research and discovery that the digital health field demands. Due to the voluminous availability of real time patient and client data, academic health centers offer a rich interdisciplinary environment to develop, pilot and evaluate innovations in pragmatic settings. Despite the opportunity between academic health centers and industry to advance digital health innovation through rapid research, limited evidence exists of such collaboration. The purpose of this case report is to examine an AIC facilitating research of new health technologies within an academic health center. This paper presents a case report involving collaboration between diverse technology industry partners and an academic health center that encompasses a university health system (UCHealth), a university technology transfer office (CU Innovations), an innovation center (CARE Innovation Center), and research collaborators (mHealth Impact Laboratory). Case assertions discuss the lessons learned and recommendations when implementing such collaboration in practice. The principal finding is that academic health centers offer an innovative environment for AIC in digital health. Collaborations between academia and industry provide much promise in ensuring health innovations are scientifically sound while meeting the needs of a rapidly evolving technical climate.

Using digital health to enable ethical health research in conflict and other humanitarian settings

Conducting research in a humanitarian setting requires quantifiable quality measures to ensure ethical study conduct. Digital health technologies are proven to improve research study quality and efficacy via automated data collection, improvement of data reliability, fidelity and resilience and by improved data provenance and traceability. Additionally, digital health methodologies can improve patient identity, patient privacy, study transparency, data sharing, competent informed consent, and the confidentiality and security of humanitarian operations. It can seem counterintuitive to press forward aggressively with digital technologies at a time of heightened population vulnerability and cyber security concerns, but new approaches are essential to meet the rapidly increasing demands of humanitarian research. In this paper we present the case for the digital modernization of humanitarian research in conflict and other humanitarian settings as a vehicle for improved research quality and ethics.