Semi-automated contact tracing and management of contact precautions during the COVID-19 pandemic within a tertiary hospital

Effectiveness of digital contact tracing interventions for COVID-19: A systematic scoping review

OBJECTIVES

Digital contact tracing (DCT) interventions have been deployed at unprecedented scale during COVID-19. However, no comprehensive appraisal of the evidence exists to date regarding their effectiveness. We aimed to systematically review the global literature for a holistic understanding of DCT effectiveness during COVID-19, and to identify factors that enabled or hindered its effectiveness.

STUDY DESIGN

Systematic scoping review.

METHODS

We searched six databases for peer-reviewed literature relevant to the evaluation of DCT interventions during COVID-19 (January 2024) (CRD42021268586). We compiled implemented DCT interventions from grey literature. Effectiveness appraisals, different operationalizations, measurements, and definitions of DCT effectiveness, as well as associated factors were synthesized qualitatively. Study quality was assessed using the Mixed Methods Appraisal Tool. We followed Cochrane and PRISMA guidance.

RESULTS

We identified 133 studies evaluating 121 different DCT implementations. Seventy-three (60 %) studies found DCT to be effective, mostly when evaluating epidemiological impact metrics. Public trust emerged as crucial for DCT to be effective, which requires high and enforceable data safety and privacy standards, clear and transparent communication, high accuracy and reliability of the intervention, and an acceptance-enhancing implementation approach of other pandemic response measures by public health authorities more broadly. Most evaluations took place in high rather than low-resource settings.

CONCLUSION

While technical performance matters, DCT effectiveness primarily depends on a relatively small number of non-technical drivers centred around public trust. DCT should only be implemented as integrated part of a broader public health framework. Our findings hold important insights for the design, implementation, and evaluation of other digital technology for pandemic response.

Efficiency dynamics in Latin American healthcare reforms: a comprehensive growth mixture analysis within institutional theory

PURPOSE

This study examines the efficiency dynamics of public health service providers in Colombia between 2010 and 2021. In order to achieve this objective, a data panel is utilized to assess the effectiveness of 841 institutions across three levels of complexity (1, 2 and 3) in providing patient care, taking into account user satisfaction from 2010 to 2021.

DESIGN/METHODOLOGY/APPROACH

By employing growth mixture analysis (GMA) and other statistical techniques, we may identify unique efficiency profiles among hospitals with different levels of complexity.

FINDINGS

The results demonstrate varied efficiency patterns, with certain profiles generally retaining or improving efficiency over time, while others observe fluctuations or reductions. Efficiency outcomes are significantly impacted by factors such as capital investment, operational costs and workforce mix. Efficiency levels can be improved by making strategic investments in capital infrastructure and implementing effective operational cost management.

ORIGINALITY/VALUE

Changes in the healthcare market conditions in recent years in Colombia have compelled healthcare providers (IPS) to transform themselves into sustainable organizations.

Digital Contact Tracing Implementation Among Leaders and Health Care Workers in a Pediatric Hospital During the COVID-19 Pandemic: Qualitative Interview Study

BACKGROUND

Health systems had to rapidly implement infection control strategies to sustain their workforces during the COVID-19 pandemic. Various outbreak response tools, such as digital contact tracing (DCT), have been developed to monitor exposures and symptoms of health care workers (HCWs). Limited research evidence exists on the experiences with these technologies and the impacts of DCT innovations from the perspective of stakeholders in health care environments.

OBJECTIVE

This study aims to identify the factors influencing the adoption of DCT, highlight variations in perspectives across 3 key stakeholder groups concerning the impact of DCT, and provide benchmarking evidence for future pandemic preparedness.

METHODS

Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we conducted an exploratory qualitative study to investigate the implementation and impact of DCT at the Children's Hospital of Eastern Ontario between December 2022 and April 2023. We conducted 21 semistructured interviews with key stakeholders, including health care administrators (6/21, 29%), occupational health and safety specialists (8/21, 38%), and HCWs (7/21, 33%). Stakeholders were asked about the factors influencing engagement with the DCT tool, organizational-level uptake, the implementation process, long-term use and sustainability of DCT, and unintended consequences. Verbatim transcripts were subject to thematic analysis using NVivo (QSR International).

RESULTS

The implementation of DCT was viable and well received. End users indicated that their engagement with the DCT tool was facilitated by its perceived ease of use and the ability to gain awareness of probable COVID-19 exposures; however, risk assessment consequences and access concerns were reported as barriers (reach). Participants commonly agreed that the DCT technology had a positive influence on the hospital's capacity to meet the demands of COVID-19 (effectiveness). Implementors and occupational specialists referred to negative staffing impacts and the loss of nuanced information as unintended consequences (effectiveness). Safety-focused communication strategies and having a DCT tool that was human-centered were crucial factors driving staff adoption of the technology. Conversely, adoption was challenged by the misaligned delivery of the DCT tool with HCWs' standard practices, alongside the evolving perceived threat of COVID-19. Stakeholders collectively agreed on the viability of DCT and its applicability to infectious disease practices (maintenance).

CONCLUSIONS

Hospital stakeholders were highly satisfied with DCT technology and it was perceived as feasible, efficient, and having a positive impact on organizational safety. Challenges related to the alignment and delivery of DCT, alongside the evolving perspectives on COVID-19, posed obstacles to continued adoption by HCWs. Our findings contribute to evidence-based practices and present benchmarks that can inform preparedness for future pandemics and infectious disease outbreaks and help other organizations implement similar technologies.

The leading global health challenges in the artificial intelligence era

Millions of people's health is at risk because of several factors and multiple overlapping crises, all of which hit the vulnerable the most. These challenges are dynamic and evolve in response to emerging health challenges and concerns, which need effective collaboration among countries working toward achieving Sustainable Development Goals (SDGs) and securing global health. Mental Health, the Impact of climate change, cardiovascular diseases (CVDs), diabetes, Infectious diseases, health system, and population aging are examples of challenges known to pose a vast burden worldwide. We are at a point known as the "digital revolution," characterized by the expansion of artificial intelligence (AI) and a fusion of technology types. AI has emerged as a powerful tool for addressing various health challenges, and the last ten years have been influential due to the rapid expansion in the production and accessibility of health-related data. The computational models and algorithms can understand complicated health and medical data to perform various functions and deep-learning strategies. This narrative mini-review summarizes the most current AI applications to address the leading global health challenges. Harnessing its capabilities can ultimately mitigate the Impact of these challenges and revolutionize the field. It has the ability to strengthen global health through personalized health care and improved preparedness and response to future challenges. However, ethical and legal concerns about individual or community privacy and autonomy must be addressed for effective implementation.