Towards a contextual theory of Mobile Health Data Protection (MHDP): A realist perspective

Disease-Agnostic Electronic Adherence Aid for Subcutaneous at-Home and Self-Administration Devices-The Lowest Common Denominator Based on a Cross-Indication Survey

The value of connected devices and health apps with features such as adherence trackers, dosing reminders, and remote communication tools for users and healthcare providers has been assessed to support home-based subcutaneous administration. A comprehensive survey was conducted with 605 participants, including users and caregivers, from eight countries. Medical conditions encompassed ankylosing spondylitis, asthma, cerebral palsy, cluster headaches, Crohn's disease, hemophilia, lupus, migraine, multiple sclerosis, Parkinson's disease, plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, spasticity, spondyloarthritis, and ulcerative colitis. Utilizing a maximum difference scaling methodology, the survey gauged participant preferences regarding specific attributes and features of connected drug delivery devices. Irrespective of demographic factors like age, gender, nationality, or the specific medical condition, the device's ability to verify a successful injection stood out as universally valued. The second and third most valued attributes pertained to temperature-related indicators or warnings. These features do not necessitate the use of a connected device and can be integrated into existing autoinjector platforms. The survey findings support the development of a universal adherence tool for at-home subcutaneous dosing, independent of a specific medical condition. This tool may be gradually improved with disease-specific features. Once established as a platform, manufacturers can launch any subcutaneous medication and later integrate real-world evidence for enhanced educational, treatment, and diagnostic capabilities. This approach is crucial for advancing connected adherence tools in decentralized healthcare, aligning with user and healthcare system needs while translating scientific innovation into practical solutions.

Telemedicine with special focus on allergic diseases and asthma-Status 2022: An EAACI position paper

Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID-19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face-to-face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described.

Information security and privacy in hospitals: a literature mapping and review of research gaps

Information security and privacy are matters of concern in every industry. The healthcare sector has lagged in terms of implementing cybersecurity measures. Therefore, hospitals are more exposed to cyber events due to the criticality of patient data. Currently, little is known about state-of-the-art research on information security and privacy in hospitals. The purpose of this study is to report the outcome of a systematic literature review on research about the application of information security and privacy in hospitals. A systematic literature review following the PRISMA methodology was conducted. To reference our sample according to cybersecurity domains, we benchmarked each article against two cybersecurity frameworks: ISO 27001 Annex A and the NIST framework core. Limited articles in our papers referred to the policies and compliance sections of ISO 27001. In addition, most of our sample is classified by the NIST function "Protect," meaning activities related to identity management, access control and data security. Furthermore, we have identified key domains where research in security and privacy are critical, such as big data, IOT, cloud computing, standards and regulations. The results indicate that although cybersecurity is a growing concern in hospitals, research is still weak in some areas. Considering the recrudescence of cyber-attacks in the healthcare sector, we call for more research in hospitals in managerial and non-technical domains of information security and privacy that are uncovered by our analysis.

The digital rainbow: Digital determinants of health inequities

The widely used socioecological rainbow model from Dahlgren and Whitehead specifies determinants of health inequity on multiple hierarchical levels and suggests that these determinants may interact both within and between levels. At the time of its inception, digital determinants only played a minor role in tackling inequities in public health and were therefore not specifically considered. This has dramatically changed: From today's perspective, health inequities increasingly depend on digital determinants. In this article, we suggest adapting the Dahlgren-Whitehead model to reflect these developments. We propose a model that allows formulating testable hypotheses, interpreting research findings, and developing policy implications against the background of the global spread of digital technologies. This may facilitate the development of a new line of research and logic models for public health interventions in the digital age. Using the COVID-19 pandemic as a case study, we illustrate how the digitization of all aspects of life affects the different levels of determinants of health inequities in the Dahlgren-Whitehead model. In doing so, we deliberately argue for not introducing a separate digital sphere in its own right, but for understanding digitization as a phenomenon that permeates all levels of determinants of health inequities. As a result, we present a digital rainbow model that integrates Dahlgren and Whitehead's 1991 model with digital environments to identify current health promotion and research issues without changing the rainbow model's initial structure.

[Mobile technologies in healthcare: reflections on development, application, legal aspects, and ethicsTecnologías sanitarias móviles: reflexiones sobre desarrollo, aplicación, legislación y ética]

The association between fast-growing mobile technologies and increasingly more mobile devices has allowed the introduction of virtual environments into daily activities. That includes the health care domain, where concepts such telemedicine, telehealth, eHealth, and mHealth have emerged. In addition to presenting these new concepts, this article aims to discuss the advancements and challenges of mobile health technologies stemming from considerations regarding development, application, legal aspects, and ethics. Because of their innovative nature, mobile health technologies entail the engagement of many actors in the journey to reach end users, covering conception, technical development, sanitary regulations, and design of clinical guidelines, having raised a great deal or interest in terms of monitoring and care across a variety of clinical conditions. However, assessment of the effectiveness and safety of mobile health technologies does not seem to involve the same methodological rigor imposed for clinical trials of drugs and other health products; still, the enthusiasm produced by this innovation counters some of the regulatory and ethics concerns relating to data protection, privacy, access to mobile devices, and technological or social inequality. Despite possible limitations, mobile technologies, as well as other telehealth resources, have produced promising results. Digital healthcare has great potential for expansion and represents an opportunity for the review of traditional practices with selection of mobile technologies for incorporation into the health care system whenever evidence-based benefits are verified.

A Blockchain-Enabled Framework for mHealth Systems

Presently modern technology makes a significant contribution to the transition from traditional healthcare to smart healthcare systems. Mobile health (mHealth) uses advances in wearable sensors, telecommunications and the Internet of Things (IoT) to propose a new healthcare concept centered on the patient. Patients' real-time remote continuous health monitoring, remote diagnosis, treatment, and therapy is possible in an mHealth system. However, major limitations include the transparency, security, and privacy of health data. One possible solution to this is the use of blockchain technologies, which have found numerous applications in the healthcare domain mainly due to theirs features such as decentralization (no central authority is needed), immutability, traceability, and transparency. We propose an mHealth system that uses a private blockchain based on the Ethereum platform, where wearable sensors can communicate with a smart device (a smartphone or smart tablet) that uses a peer-to-peer hypermedia protocol, the InterPlanetary File System (IPFS), for the distributed storage of health-related data. Smart contracts are used to create data queries, to access patient data by healthcare providers, to record diagnostic, treatment, and therapy, and to send alerts to patients and medical professionals.

Profiling adopters (and non-adopters) of a contact tracing mobile application: Insights from Australia

OBJECTIVE

Many governments are using contact tracing mobile applications (CTMAs) yet public adoption of such systems has been relatively low. The main objective of this paper is to profile adopters (and non-adopters) of Australia's COVIDSafe CTMA.

MATERIALS AND METHODS

We use latent profile analysis to examine predictors of CTMA download behaviour. Specifically, we draw on a representative Australian sample (N = 2575) to examine the interplay between age, education, income, dispositional desire for privacy and political ideology on download behaviour. We examine trust in government as a mediating mechanism between profiles and download behaviour.

RESULTS

Our analysis produces seven profiles. Trust in government mediates the relationship between most profiles and download behaviour. A combination of wealth and education appear to be key explanatory factors of CTMA download behaviour. Two profiles -- comprising individuals with high income and education -- had the highest rates of download behaviour. Profiles with low download percentages comprised politically left-leaning participants with average to low income and education.

CONCLUSION

Our findings clearly indicate the profiles of people who are (not) likely to download a CTMA. Practical ways to improve widespread adoption include providing structural support to the more vulnerable members of society, making clear the societal benefits of downloading CTMAs, and engaging in bipartisan promotion of such apps.