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Louch G, Berzins K, Walker L, Wormald G, Blackwell K, Stephens M, Brown M, Baker J. Promoting a Patient-Centered Understanding of Safety in Acute Mental Health Wards: A User-Centered Design Approach to Develop a Real-Time Digital Monitoring Tool. JMIR Form Res 2024; 8:e53726. [PMID: 38607663 PMCID: PMC11053394 DOI: 10.2196/53726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Acute mental health services report high levels of safety incidents that involve both patients and staff. The potential for patients to be involved in interventions to improve safety within a mental health setting is acknowledged, and there is a need for interventions that proactively seek the patient perspective of safety. Digital technologies may offer opportunities to address this need. OBJECTIVE This research sought to design and develop a digital real-time monitoring tool (WardSonar) to collect and collate daily information from patients in acute mental health wards about their perceptions of safety. We present the design and development process and underpinning logic model and programme theory. METHODS The first stage involved a synthesis of the findings from a systematic review and evidence scan, interviews with patients (n=8) and health professionals (n=17), and stakeholder engagement. Cycles of design activities and discussion followed with patients, staff, and stakeholder groups, to design and develop the prototype tool. RESULTS We drew on patient safety theory and the concepts of contagion and milieu. The data synthesis, design, and development process resulted in three prototype components of the digital monitoring tool (WardSonar): (1) a patient recording interface that asks patients to input their perceptions into a tablet computer, to assess how the ward feels and whether the direction is changing, that is, "getting worse" or "getting better"; (2) a staff dashboard and functionality to interrogate the data at different levels; and (3) a public-facing ward interface. The technology is available as open-source code. CONCLUSIONS Recent patient safety policy and research priorities encourage innovative approaches to measuring and monitoring safety. We developed a digital real-time monitoring tool to collect information from patients in acute mental health wards about perceived safety, to support staff to respond and intervene to changes in the clinical environment more proactively.
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Affiliation(s)
- Gemma Louch
- School of Healthcare, University of Leeds, Leeds, United Kingdom
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, United Kingdom
| | - Kathryn Berzins
- Health Technology Assessment Unit, Applied Health Research Hub, Implementation and Capacity Building Team, NIHR Applied Research Collaboration North West Coast, University of Central Lancashire, Preston, United Kingdom
| | - Lauren Walker
- School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Gemma Wormald
- Thrive by Design, Leeds and York Partnership NHS Foundation Trust, Leeds, United Kingdom
| | - Kirstin Blackwell
- Thrive by Design, Leeds and York Partnership NHS Foundation Trust, Leeds, United Kingdom
| | | | - Mark Brown
- Social Spider CIC, London, United Kingdom
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, United Kingdom
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Leal Neto O, Von Wyl V. Digital Transformation of Public Health for Noncommunicable Diseases: Narrative Viewpoint of Challenges and Opportunities. JMIR Public Health Surveill 2024; 10:e49575. [PMID: 38271097 PMCID: PMC10853859 DOI: 10.2196/49575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/13/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
The recent SARS-CoV-2 pandemic underscored the effectiveness and rapid deployment of digital public health interventions, notably the digital proximity tracing apps, leveraging Bluetooth capabilities to trace and notify users about potential infection exposures. Backed by renowned organizations such as the World Health Organization and the European Union, digital proximity tracings showcased the promise of digital public health. As the world pivots from pandemic responses, it becomes imperative to address noncommunicable diseases (NCDs) that account for a vast majority of health care expenses and premature disability-adjusted life years lost. The narrative of digital transformation in the realm of NCD public health is distinct from infectious diseases. Public health, with its multifaceted approach from disciplines such as medicine, epidemiology, and psychology, focuses on promoting healthy living and choices through functions categorized as "Assessment," "Policy Development," "Resource Allocation," "Assurance," and "Access." The power of artificial intelligence (AI) in this digital transformation is noteworthy. AI can automate repetitive tasks, facilitating health care providers to prioritize personal interactions, especially those that cannot be digitalized like emotional support. Moreover, AI presents tools for individuals to be proactive in their health management. However, the human touch remains irreplaceable; AI serves as a companion guiding through the health care landscape. Digital evolution, while revolutionary, poses its own set of challenges. Issues of equity and access are at the forefront. Vulnerable populations, whether due to economic constraints, geographical barriers, or digital illiteracy, face the threat of being marginalized further. This transformation mandates an inclusive strategy, focusing on not amplifying existing health disparities but eliminating them. Population-level digital interventions in NCD prevention demand societal agreement. Policies, like smoking bans or sugar taxes, though effective, might affect those not directly benefiting. Hence, all involved parties, from policy makers to the public, should have a balanced perspective on the advantages, risks, and expenses of these digital shifts. For a successful digital shift in public health, especially concerning NCDs, AI's potential to enhance efficiency, effectiveness, user experience, and equity-the "quadruple aim"-is undeniable. However, it is vital that AI-driven initiatives in public health domains remain purposeful, offering improvements without compromising other objectives. The broader success of digital public health hinges on transparent benchmarks and criteria, ensuring maximum benefits without sidelining minorities or vulnerable groups. Especially in population-centric decisions, like resource allocation, AI's ability to avoid bias is paramount. Therefore, the continuous involvement of stakeholders, including patients and minority groups, remains pivotal in the progression of AI-integrated digital public health.
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Affiliation(s)
- Onicio Leal Neto
- Department of Computer Science, ETH Zurich, Zurich, Switzerland
- Global Health Institute, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Department of Epidemiology and Biostatistics, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Viktor Von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics & Prevention Institute, University of Zurich, Zurich, Switzerland
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OWUSU ISAAC, ACHEAMPONG GIDEONKWARTENG, AKYEREKO ERNEST, AGYEI NIIARYEETEY, ASHONG MAWUFEMOR, AMOFA ISAAC, MPANGAH REBECCAANN, KENU ERNEST, ABOAGYE RICHARDGYAN, ADU COLLINS, AGYEMANG KINGSLEY, NSIAH-ASARE ANTHONY, ASIEDU-BEKOE FRANKLIN. The role of digital surveillance during outbreaks: the Ghana experience from COVID-19 response. J Public Health Afr 2023; 14:2755. [PMID: 38020270 PMCID: PMC10658462 DOI: 10.4081/jphia.2023.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/30/2023] [Indexed: 12/01/2023] Open
Abstract
Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and information dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana during the COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digital surveillance tools to combat the pandemic. These included the 'Surveillance Outbreak Response Management and Analysis System (SORMAS)', the digitalized health declaration form, ArcGIS Survey123, Talkwalker, 'Lightwave Health information Management System' (LHIMS), and the 'District Health Information Management System (DHIMS)'. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely production of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions. This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths and challenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation.
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Affiliation(s)
| | | | - ERNEST AKYEREKO
- Ghana Health Service, Headquarters
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | | | | | | | | | - ERNEST KENU
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana
| | - RICHARD GYAN ABOAGYE
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - COLLINS ADU
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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van Mol MMC, Tummers N, Leerentveld C, Tieben R, Buise M. The usability of a digital diary from the perspectives of intensive care patients' relatives: A pilot study. Nurs Crit Care 2023. [PMID: 37897098 DOI: 10.1111/nicc.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Diaries have been used regularly in international settings as an evidence-based and easily applicable intervention following a person-centred approach in the intensive care unit (ICU). In addition, a diary web application known as 'Post-ICU' has been implemented. AIM To explore the usability of an innovative digital diary from the perspectives of intensive care patients' relatives. STUDY DESIGN A cross-sectional online survey study was applied among a convenience sample of relatives in the ICUs of two hospitals in the Netherlands. The investigator-developed questionnaire included, among other things, items with the appreciation of the layout, user friendliness and functionality of the diary. Relevance and applicability were rated between 1 and 10. Data were analysed with SPSS© software, version 27, and reported as the means (±standard deviation [SD]) and percentages. RESULTS Sixty-three relatives with an average age of 51 years (SD ± 14.3) participated in the study; there was a slight predominance of women (57%). All but one participant found using the digital diary easy and were able to upload photos to the diary. The participants had invited other relatives (75%) and nurses (61%) to write in the diary, which they viewed as easily feasible (89%). The relevance and applicability of the diary were rated with mean scores of 8.1 (SD ± 1.9) and 8.3 (SD ± 1.6), respectively. CONCLUSIONS The participants found the Post-ICU diary web application highly valuable and easily feasible. Perceived ease of use, perceived usefulness and technophobia were not found to influence the usability of the digital diary. RELEVANCE TO CLINICAL PRACTICE The implementation of this new digital tool supports a person-centred ICU policy because of its focus on the personal diary entries of the patient and the collaborative writing process featuring relatives and professionals.
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Affiliation(s)
- Margo M C van Mol
- Department of Intensive Care Adults, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nanda Tummers
- Department of Intensive Care Adults, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Crista Leerentveld
- Department of Intensive Care Adults, Isala Ziekenhuis, Zwolle, The Netherlands
| | - Rob Tieben
- Games for Health (Game Solutions Lab), Eindhoven, The Netherlands
| | - Marc Buise
- Games for Health (Game Solutions Lab), Eindhoven, The Netherlands
- Department of Anesthesia and Intensive Care, Maastricht University Medical Center, Maastricht, The Netherlands
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Nassani AA, Javed A, Rosak-Szyrocka J, Pilar L, Yousaf Z, Haffar M. Major Determinants of Innovation Performance in the Context of Healthcare Sector. Int J Environ Res Public Health 2023; 20:5007. [PMID: 36981916 PMCID: PMC10049359 DOI: 10.3390/ijerph20065007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Through the innovation network (IN) and the use of artificial intelligence (AI), this study aims to look into the innovation performance (IP) of the healthcare industry. Digital innovation (DI) is also tested as a mediator. For the collection of data, cross-sectional methods and quantitative research designs were used. To test the study hypotheses, the SEM technique and multiple regression technique were used. Results reveal that AI and the innovation network support the attainment of innovation performance. The finding demonstrates that the relationship between INs and IP links and AI adoption and IP links is mediated through DI. The healthcare industry plays a vital role in facilitating public health and improving the living standards of the people. This sector's growth and development are largely dependent on its innovativeness. This study highlights the major determinants of IP in the healthcare industry in terms of IN and AI adoption. This study adds to the literature's knowledge via an innovative proposal in which the mediation role of DI among IN-IP and AI adoption-innovation links is investigated.
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Affiliation(s)
- Abdelmohsen A. Nassani
- Department of Management, College of Business Administration, King Saud University, P.O. Box. 71115, Riyadh 11587, Saudi Arabia
| | - Asad Javed
- Department of Management Sciences, Hazara University, Mansehra 21120, Pakistan
| | - Joanna Rosak-Szyrocka
- Department of Production Engineering and Safety, Faculty of Management, Czestochowa University of Technology, 42-200 Czestochowa, Poland
| | - Ladislav Pilar
- Department of Management, Faculty of Economics and Management, Czech University of Life Sciences Prague, 16500 Prague, Czech Republic
| | - Zahid Yousaf
- Higher Education Department, Government College of Management Sciences, Mansehra 21300, Pakistan
| | - Mohamed Haffar
- Department of Management, Birmingham Business School, University of Birmingham, Birmingham B15 2TY, UK
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Nur Aisyah D, Lokopessy AF, Naman M, Diva H, Manikam L, Adisasmito W, Kozlakidis Z. The Use of Digital Technology for COVID-19 Detection and Response Management in Indonesia: Mixed Methods Study. Interact J Med Res 2023; 12:e41308. [PMID: 36623206 PMCID: PMC10012204 DOI: 10.2196/41308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has triggered a greater use of digital technologies as part of the health care response in many countries, including Indonesia. It is the world's fourth-most populous nation and Southeast Asia's most populous country, with considerable public health pressures. OBJECTIVE The aim of our study is to identify and review the use of digital health technologies in COVID-19 detection and response management in Indonesia. METHODS We conducted a literature review of publicly accessible information in technical and scientific journals, as well as news articles from September 2020 to August 2022 to identify the use case examples of digital technologies in COVID-19 detection and response management in Indonesia. RESULTS The results are presented in 3 groups, namely (1) big data, artificial intelligence, and machine learning (technologies for the collection or processing of data); (2) health care system technologies (acting at the public health level); and (3) COVID-19 screening, population treatment, and prevention population treatment (acting at the individual patient level). Some of these technologies are the result of government-academia-private sector collaborations during the pandemic, which represent a novel, multisectoral practice in Indonesia within the public health care ecosystem. A small number of the identified technologies pre-existed the pandemic but were upgraded and adapted for current needs. CONCLUSIONS Digital technologies were developed in Indonesia during the pandemic, with a direct impact on supporting COVID-19 management, detection, response, and treatment. They addressed different areas of the technological spectrum and with different levels of adoption, ranging from local to regional to national. The indirect impact of this wave of technological creation and use is a strong foundation for fostering future multisectoral collaboration within the national health care system of Indonesia.
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Affiliation(s)
- Dewi Nur Aisyah
- Indonesia One Health University Network, Depok, Indonesia
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Alfiano Fawwaz Lokopessy
- Indonesia One Health University Network, Depok, Indonesia
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Maryan Naman
- Aceso Global Health Consultants Pte Limited, Singapore, Singapore
| | - Haniena Diva
- Indonesia One Health University Network, Depok, Indonesia
| | - Logan Manikam
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
- Aceso Global Health Consultants Pte Limited, Singapore, Singapore
| | - Wiku Adisasmito
- Indonesia One Health University Network, Depok, Indonesia
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Zisis Kozlakidis
- International Agency for Research on Cancer World Health Organization, Lyon, France
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Widdicks K, Lucivero F, Samuel G, Croxatto LS, Smith MT, Holter CT, Berners-Lee M, Blair GS, Jirotka M, Knowles B, Sorrell S, Rivera MB, Cook C, Coroamă VC, Foxon TJ, Hardy J, Hilty LM, Hinterholzer S, Penzenstadler B. Systems thinking and efficiency under emissions constraints: Addressing rebound effects in digital innovation and policy. Patterns (N Y) 2023; 4:100679. [PMID: 36873905 PMCID: PMC9982294 DOI: 10.1016/j.patter.2023.100679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Innovations and efficiencies in digital technology have lately been depicted as paramount in the green transition to enable the reduction of greenhouse gas emissions, both in the information and communication technology (ICT) sector and the wider economy. This, however, fails to adequately account for rebound effects that can offset emission savings and, in the worst case, increase emissions. In this perspective, we draw on a transdisciplinary workshop with 19 experts from carbon accounting, digital sustainability research, ethics, sociology, public policy, and sustainable business to expose the challenges of addressing rebound effects in digital innovation processes and associated policy. We utilize a responsible innovation approach to uncover potential ways forward for incorporating rebound effects in these domains, concluding that addressing ICT-related rebound effects ultimately requires a shift from an ICT efficiency-centered perspective to a "systems thinking" model, which aims to understand efficiency as one solution among others that requires constraints on emissions for ICT environmental savings to be realized.
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Affiliation(s)
| | | | | | | | | | | | | | - Gordon S. Blair
- Lancaster University, Lancaster, UK
- UK Centre for Ecology and Hydrology, Lancaster, UK
| | | | | | | | | | | | | | | | | | | | | | - Birgit Penzenstadler
- Chalmers University of Technology, Göteborg, Sweden
- Lappeenranta University of Technology, Lappeenranta, Finland
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Eysenbach G, Goldsack JC, Cordovano G, Downing A, Fields KK, Geoghegan C, Grewal U, Nieva J, Patel N, Rollison DE, Sah A, Said M, Van De Keere I, Way A, Wolff-Hughes DL, Wood WA, Robinson EJ. Advancing Digital Health Innovation in Oncology: Priorities for High-Value Digital Transformation in Cancer Care. J Med Internet Res 2023; 25:e43404. [PMID: 36598811 PMCID: PMC9850283 DOI: 10.2196/43404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/17/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
Although health care delivery is becoming increasingly digitized, driven by the pursuit of improved access, equity, efficiency, and effectiveness, progress does not appear to be equally distributed across therapeutic areas. Oncology is renowned for leading innovation in research and in care; digital pathology, digital radiology, real-world data, next-generation sequencing, patient-reported outcomes, and precision approaches driven by complex data and biomarkers are hallmarks of the field. However, remote patient monitoring, decentralized approaches to care and research, "hospital at home," and machine learning techniques have yet to be broadly deployed to improve cancer care. In response, the Digital Medicine Society and Moffitt Cancer Center convened a multistakeholder roundtable discussion to bring together leading experts in cancer care and digital innovation. This viewpoint highlights the findings from these discussions, in which experts agreed that digital innovation is lagging in oncology relative to other therapeutic areas. It reports that this lag is most likely attributed to poor articulation of the challenges in cancer care and research best suited to digital solutions, lack of incentives and support, and missing standardized infrastructure to implement digital innovations. It concludes with suggestions for actions needed to bring the promise of digitization to cancer care to improve lives.
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Affiliation(s)
| | | | | | | | - Karen K Fields
- Center for Digital Health, Moffitt Cancer Center, Tampa, FL, United States
| | | | | | - Jorge Nieva
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, United States
| | - Nikunj Patel
- AstraZeneca PLC, Gaithersburg, MD, United States
| | - Dana E Rollison
- Center for Digital Health, Moffitt Cancer Center, Tampa, FL, United States
| | - Archana Sah
- AS Pharma Advisors, Inc, San Francisco, CA, United States
| | - Maya Said
- Outcomes4Me Inc, Boston, MA, United States
| | | | - Amanda Way
- Jazz Venture Partners, San Francisco, CA, United States
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Populations Sciences, National Cancer Institute, Bethesda, MD, United States
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Edmondo J Robinson
- Center for Digital Health, Moffitt Cancer Center, Tampa, FL, United States
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Li Y, Fu K, Gong X, Xiang Z, Zhang J, Liao C. Research on value co-creation mechanism of platform enterprises in digital innovation ecosystem: A case study on Haier HOPE platform in China. Front Psychol 2022; 13:1055932. [PMID: 36506963 PMCID: PMC9732454 DOI: 10.3389/fpsyg.2022.1055932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/01/2022] [Indexed: 11/27/2022] Open
Abstract
Digital technology has given the innovation subject a new way of value creation, expanded the existing innovation ecosystem theory, and triggered scholars' in-depth thinking on the digital innovation ecosystem. Based on the event system theory and taking Haier's hope platform as a vertical case study, this paper deeply explores the research mechanism of value creation of platform enterprises in the digital innovation ecosystem, and reveals the role and impact of digital innovation ability, openness, and business innovation model on the process of co-creation. The research results show that: in the open connection stage, the platform solves the problem of weakening the advantages of the platform, and improves the innovation efficiency of enterprises by continuously improving the digital innovation ability; in the interactive and iterative stage, the platform carries out open innovation, breaks through the difficulties of platform expansion, and realizes the benign expansion of the platform. In the co-creation stage, the user experience is blocked, and the platform adopts the platform community business model to connect the user relationship and improve the user experience. In the digital innovation ecosystem, platform enterprises gradually form self-organization and self-circulation value co-creation through internal self-construction and external cooperation, and form a data-driven co-creation model.
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10
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Zou KH, Li JZ. Enhanced Patient-Centricity: How the Biopharmaceutical Industry Is Optimizing Patient Care through AI/ML/DL. Healthcare (Basel) 2022; 10:1997. [PMID: 36292444 DOI: 10.3390/healthcare10101997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/19/2022] [Accepted: 10/07/2022] [Indexed: 11/04/2022] Open
Abstract
Technologies utilizing cutting-edge methodologies, including artificial intelligence (AI), machine learning (ML) and deep learning (DL), present powerful opportunities to help evaluate, predict, and improve patient outcomes by drawing insights from real-world data (RWD) generated during medical care. They played a role during and following the Coronavirus Disease 2019 (COVID-19) pandemic by helping protect healthcare providers, prioritize care for vulnerable populations, predict disease trends, and find optimal therapies. Potential applications across therapeutic areas include diagnosis, disease management and patient journey mapping. Use of fit-for-purpose datasets for ML models is seeing growth and may potentially help additional enterprises develop AI strategies. However, biopharmaceutical companies often face specific challenges, including multi-setting data, system interoperability, data governance, and patient privacy requirements. There remains a need for evolving regulatory frameworks, operating models, and data governance to enable further developments and additional research. We explore recent literature and examine the hurdles faced by researchers in the biopharmaceutical industry to fully realize the promise of AI/ML/DL for patient-centric purposes.
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11
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Chen X, Mao S, Lv S, Fang Z. A Study on the Non-Linear Impact of Digital Technology Innovation on Carbon Emissions in the Transportation Industry. Int J Environ Res Public Health 2022; 19:12432. [PMID: 36231730 PMCID: PMC9565135 DOI: 10.3390/ijerph191912432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Transportation is an important part of social and economic development and is also a typical high-energy and high-emissions industry. Achieving low-carbon development in the transportation industry is a much-needed requirement and the only way to achieve high-quality development. Therefore, based on the relevant data of 30 provinces in China from 2010 to 2018, this research uses the static panel model, panel threshold model and spatial Durbin model to conduct an empirical study on the impact and mechanism of digital innovation on carbon emissions in the transportation industry, and draws the following conclusions. (1) Carbon emissions in the transportation industry have dynamic and continuous adjustment characteristics. (2) There is a significant inverted U-shape non-linear relationship between the level of digital innovation and carbon emissions in the industry. In regions with a low level of digital innovation, the application of digital technology increases carbon emissions in this industry, but as the level of digital innovation continues to increase its application suppresses carbon emissions, showing an effect of carbon emission reduction. (3) The impact of digital innovation on carbon emissions in the transportation industry has a spatial spillover effect, and its level in one province significantly impacts carbon emissions in other provinces' transportation industry through the spatial spillover effect. Therefore, it is recommended to further strengthen the exchange and cooperation of digital innovation in the transportation industry between regions, improve the scale of digitalization in this industry, and accelerate its green transformation through digital innovation, thus promoting the green, low-carbon, and sustainable development of China's economy.
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Affiliation(s)
- Xiaoqin Chen
- School of Economics, Fujian Normal University, Fuzhou 350007, China
- Department of International Economics and Trade, School of Business, Wuyi University, Wuyishan 354300, China
| | - Shenya Mao
- School of Economics, Fujian Normal University, Fuzhou 350007, China
| | - Siqi Lv
- School of Economics, Fujian Normal University, Fuzhou 350007, China
| | - Zhong Fang
- School of Economics, Fujian Normal University, Fuzhou 350007, China
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12
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Li HX, Hassan K, Malik HA, Anuar MM, Khan TI, Yaacob MR. Impulsive and Compulsive Buying Tendencies and Consumer Resistance to Digital Innovations: The Moderating Role of Perceived Threat of COVID-19. Front Psychol 2022; 13:912051. [PMID: 35719554 PMCID: PMC9202452 DOI: 10.3389/fpsyg.2022.912051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022] Open
Abstract
Based on the theory of reasoned action and innovation resistance theory, this study aims to explore the tendencies of consumer resistance to digital innovation and the moderating role of a perceived threat of coronavirus disease 2019 (COVID-19). Data were collected using a cross-sectional online survey of 1,000 consumers of fast-moving consumer goods (FMCGs) in Pakistan. The results revealed several significant relationships between tendencies (impulsive and compulsive) of consumer resistance to digital innovation and the perceived threat of COVID-19. This study brings several key insights for consumers of FMCG products from Pakistan, and many theoretical and practical implications and future research directions are suggested.
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Affiliation(s)
- Hung Xin Li
- Department of Logistics Management, Faculty of Operation Research, National Defence University, Taoyuan, Taiwan
| | - Komal Hassan
- Department of Home Economics, Faculty of Arts and Social Sciences, Lahore College for Women University, Lahore, Pakistan
| | - Haider Ali Malik
- FAST School of Management, National University of Computer and Emerging Sciences, Islamabad, Pakistan
| | - Marhana Mohamed Anuar
- Faculty of Business Economics and Social Development, Universiti Malaysia Terengganu, Kuala Nerus, Malaysia
| | - Tariq Iqbal Khan
- Department of Management Sciences, The University of Haripur, Haripur, Pakistan
| | - Mohd Rafi Yaacob
- Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Malaysia
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13
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Wang M, Teng W. Digital Innovation and Firm Environmental Performance: The Mediating Role of Supply Chain Management Capabilities. Front Psychol 2022; 13:897080. [PMID: 35572298 PMCID: PMC9096443 DOI: 10.3389/fpsyg.2022.897080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Given the omnipresence and profoundness of the ongoing pandemic from the Coronavirus disease 2019, its potential spread can be minimized through social distancing. However, this practice causes increasing difficulties and undesirability of traditional transactions or interactions. Accordingly, various manufacturing firms around the world have become more committed not only to accelerating the development of digital technologies, but also to integrating them with existing processes. In this study, we address an important issue of how manufacturing firms can adapt to the ever-changing volatility and unpredictable global business environment, and achieve sustainable growth by developing a strong supply chain management capability. Two specific interrelated research questions are considered: (1) How do supply chain management capabilities contribute to firm environmental performance; and (2) What are the sources of such capabilities? In so doing, we integrate various forms of digital innovation into a supply chain management capability logic to explore their antecedents and consequences. By using survey data from 272 manufacturing firms in China, we examine the relationship between three key forms of digital innovation (i.e., product, platform, and service) and firm environmental performance. Results show that digital product, platform, and service innovations all have positive contributions to supply chain management capability. In turn, supply chain management capabilities have a partial mediating effect between digital product innovation and firm environmental performance, but a full mediating effect between digital platform and service innovations and firm environmental performance.
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Affiliation(s)
- Mengmeng Wang
- College of Business, Gachon University, Seongnam, South Korea
| | - Wei Teng
- College of Business, Gachon University, Seongnam, South Korea
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14
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Simmons MB, Nicholas J, Chinnery G, O'Sullivan S, D'Alfonso S, Bendall S, Cagliarini D, Hamilton M, Gleeson J, Killackey E, Alvarez-Jimenez M. The youth online training and employment system: Study protocol for a randomized controlled trial of an online vocational intervention for young people with mental ill health. Early Interv Psychiatry 2021; 15:1602-1611. [PMID: 33426790 DOI: 10.1111/eip.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/03/2020] [Accepted: 12/13/2020] [Indexed: 11/26/2022]
Abstract
AIM People diagnosed with mental disorders experience higher rates of unemployment than those without. Career adaptability, defined as the ability to respond flexibly and make informed career decisions in work and throughout career transitions, is becoming increasingly important as the nature of work changes rapidly. Early vocational intervention may ameliorate poor education and employment outcomes experienced by young people with mental ill-health and promote transferable skills and adaptability. Online-based career support allows for ongoing access throughout different career stages. The current study combines mental health-informed digital career and peer motivation, to create a Youth Online Training and Employment System (YOTES) that supports young people with mental ill-health obtain and remain in education or employment. METHODS This study is an unblinded randomized controlled trial for young people with mental ill-health, aged 16-25, who are seeking vocational support. Participants will be randomized to receive either YOTES, a moderated, online intervention with vocational, social, and peer motivation, or a control intervention, the headspace Digital Work and Study Service. Both groups will have access to in-person career support if seeking employment. The primary outcome will be career adaptability compared between the YOTES and control groups at 6-months post baseline. Secondary outcomes include number of hours worked in the past 7 days, hope, career confidence, psychological distress and health economic outcomes at 6- and 12-months post baseline. CONCLUSION Results will demonstrate whether an online career intervention moderated by career practitioners with peer motivation can result in improved career adaptability in young people with mental ill-health.
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Affiliation(s)
- Magenta B Simmons
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Nicholas
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Shaunagh O'Sullivan
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simon D'Alfonso
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Bendall
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Daniela Cagliarini
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Hamilton
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Victoria, Australia
| | - Eóin Killackey
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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15
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Selby E, Allabyrne C, Keenan JR. Delivering clinical evidence-based child-parent interventions for emotional development through a digital platform: A feasibility trial. Clin Child Psychol Psychiatry 2021; 26:1271-1283. [PMID: 34479455 PMCID: PMC8593313 DOI: 10.1177/13591045211041580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the prevalence of mental health conditions in childhood increases, there are growing concerns around the accessibility and scale of evidence-based support. However, barriers to referral, time commitment and engagement rates means recommended traditional group-based parenting programmes are unable to provide population level support at scale. The aim of this feasibility study was to establish whether a suite of purposively constructed animated films and digital resources could positively impact on parent and child outcomes in the early years. Families from a range of backgrounds (n = 129) participated in a mixed method evaluation of the digital programme. After completing online surveys and interviews, the test group was given access to the Embers the Dragon platform for 8 weeks whilst the control group continued as usual. 98% of test group parents showed an improvement in parental response in relation to effective parenting styles. During qualitative interviews, child participants verbally recalled an increased range of emotions and coping strategies highlighted in the programme. Digital interventions can be used to support children's emotional development independent of clinicians and may provide a solution to sustainable family psychoeducation, thereby fulfilling a preventative agenda and potentially lessening the future impact on Child and Adolescent Mental Health Services.
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Affiliation(s)
| | - Clare Allabyrne
- School of Health and Social Care, 14283London Southbank University, London, UK
| | - Joseph R Keenan
- School of Psychology, 5289Manchester Metropolitan University, Manchester, UK
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16
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Terranova N, Venkatakrishnan K, Benincosa LJ. Application of Machine Learning in Translational Medicine: Current Status and Future Opportunities. AAPS J 2021; 23:74. [PMID: 34008139 PMCID: PMC8130984 DOI: 10.1208/s12248-021-00593-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/08/2021] [Indexed: 02/06/2023]
Abstract
The exponential increase in our ability to harness multi-dimensional biological and clinical data from experimental to real-world settings has transformed pharmaceutical research and development in recent years, with increasing applications of artificial intelligence (AI) and machine learning (ML). Patient-centered iterative forward and reverse translation is at the heart of precision medicine discovery and development across the continuum from target validation to optimization of pharmacotherapy. Integration of advanced analytics into the practice of Translational Medicine is now a fundamental enabler to fully exploit information contained in diverse sources of big data sets such as “omics” data, as illustrated by deep characterizations of the genome, transcriptome, proteome, metabolome, microbiome, and exposome. In this commentary, we provide an overview of ML applications in drug discovery and development, aligned with the three strategic pillars of Translational Medicine (target, patient, dose) and offer perspectives on their potential to transform the science and practice of the discipline. Opportunities for integrating ML approaches into the discipline of Pharmacometrics are discussed and will revolutionize the practice of model-informed drug discovery and development. Finally, we posit that joint efforts of Clinical Pharmacology, Bioinformatics, and Biomarker Technology experts are vital in cross-functional team settings to realize the promise of AI/ML-enabled Translational and Precision Medicine.
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Affiliation(s)
- Nadia Terranova
- Translational Medicine, Merck Institute for Pharmacometrics, Merck Serono S.A., Lausanne, Switzerland
| | - Karthik Venkatakrishnan
- Translational Medicine, EMD Serono Research & Development Institute, Inc., Billerica, Massachusetts, USA
| | - Lisa J Benincosa
- Translational Medicine, EMD Serono Research & Development Institute, Inc., Billerica, Massachusetts, USA.
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17
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Danilin IV. The Impact of the COVID Crisis on the Innovative Potential of China's Internet Platforms. Her Russ Acad Sci 2021; 90:779-788. [PMID: 33495683 PMCID: PMC7818070 DOI: 10.1134/s1019331620060271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/04/2020] [Accepted: 09/20/2020] [Indexed: 06/12/2023]
Abstract
Although the COVID-19 crisis has hit the Chinese economy hard, China's Internet companies have benefited from the quarantine. However, the long-term consequences of the 2020 crisis for the development of the innovative potential of Chinese Internet corporations, primarily the largest platforms such as Alibaba, Baidu, Tencent, and JD.com as integrators of the Chinese Internet economy, are still unclear. This article provides a general overview of changes in the consumption of services of large platforms, including moderate growth in demand, strengthening of the segment of high-tech services (cloud solutions for business, digital healthcare, etc.), digitalization of small and medium enterprises, and expansion of the user audience. The innovative and technological initiatives of the platforms are analyzed. Within the framework of the announced state plans, large platforms, in partnership with regional authorities, business, and universities, intend to develop an advanced digital infrastructure (5G, data centers, etc.) and innovation infrastructure (digital clusters, technology parks, and research centers). Despite the lack of new breakthrough initiatives, the innovation capacity of the platforms is expected to strengthen in the long term. Presumably, the key role will be played by qualitative changes in the markets owing to the diffusion of digital technologies and competences, which will lead to an increase in demand for Internet innovations. The mechanisms of transforming market changes into a resource for innovative development of the platforms are associated with the expansion of market data, the emergence of a complex system of services, and unique innovative ecosystems of the platforms, making it possible to organize and coordinate the innovative activities of various entities, as well as to coopt promising start-ups able to create breakthrough innovations during the crisis.
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Affiliation(s)
- I. V. Danilin
- Primakov National Research Institute of the World Economy and International Relations, Russian Academy of Sciences, Moscow, Russia
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18
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Awan KA, Ud Din I, Almogren A, Almajed H. AgriTrust-A Trust Management Approach for Smart Agriculture in Cloud-based Internet of Agriculture Things. Sensors (Basel) 2020; 20:s20216174. [PMID: 33138295 PMCID: PMC7662657 DOI: 10.3390/s20216174] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/14/2020] [Accepted: 10/26/2020] [Indexed: 02/04/2023]
Abstract
Internet of Things (IoT) provides a diverse platform to automate things where smart agriculture is one of the most promising concepts in the field of Internet of Agriculture Things (IoAT). Due to the requirements of more processing power for computations and predictions, the concept of Cloud-based smart agriculture is proposed for autonomic systems. This is where digital innovation and technology helps to improve the quality of life in the area of urbanization expansion. For the integration of cloud in smart agriculture, the system is shown to have security and privacy challenges, and most significantly, the identification of malicious and compromised nodes along with a secure transmission of information between sensors, cloud, and base station (BS). The identification of malicious and compromised node among soil sensors communicating with the BS is a notable challenge in the BS to cloud communications. The trust management mechanism is proposed as one of the solutions providing a lightweight approach to identify these nodes. In this article, we have proposed a novel trust management mechanism to identify malicious and compromised nodes by utilizing trust parameters. The trust mechanism is an event-driven process that computes trust based on the pre-defined time interval and utilizes the previous trust degree to develop an absolute trust degree. The system also maintains the trust degree of a BS and cloud service providers using distinct approaches. We have also performed extensive simulations to evaluate the performance of the proposed mechanism against several potential attacks. In addition, this research helps to create friendlier environments and efficient agricultural productions for the migration of people to the cities.
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Affiliation(s)
- Kamran Ahmad Awan
- Department of Information Technology, The University of Haripur, Haripur 22620, Pakistan; (K.A.A.); (I.U.D.)
| | - Ikram Ud Din
- Department of Information Technology, The University of Haripur, Haripur 22620, Pakistan; (K.A.A.); (I.U.D.)
| | - Ahmad Almogren
- Department of Computer Science, College of Computer and Information Sciences, King Saud University, Riyadh 11633, Saudi Arabia;
- Correspondence:
| | - Hisham Almajed
- Department of Computer Science, College of Computer and Information Sciences, King Saud University, Riyadh 11633, Saudi Arabia;
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19
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Moro Visconti R, Morea D. Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing. Int J Environ Res Public Health 2020; 17:E2318. [PMID: 32235517 PMCID: PMC7177756 DOI: 10.3390/ijerph17072318] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022]
Abstract
This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public-private partnerships (PPPs) is significant due to the consistency of digital platforms with health issues and the complexity of the stakeholder's interaction. In infrastructural PPPs, public and private players cooperate, usually following PF patterns. This relationship is complemented by digitized supply chains and is increasingly patient-centric. This paper reviews the literature, analyzes some supply chain bottlenecks, addresses solutions concerning the networking effects of platforms to improve PPP interactions, and investigates the cost-benefit analysis of digital health with an empirical case. Whereas diagnostic or infrastructural technology is an expensive investment with long-term payback, leapfrogging digital applications reduce contingent costs. "Digital" savings can be shared by key stakeholders with P4P schemes, incentivizing value co-creation patterns. Efficient sharing may apply network theory to a comprehensive PPP ecosystem where stakeholding nodes are digitally connected. This innovative approach improves stakeholder relationships, which are re-engineered around digital platforms that enhance patient-centered satisfaction and sustainability. Digital technologies are useful even for infectious disease surveillance, like that of the coronavirus pandemic, for supporting massive healthcare intervention, decongesting hospitals, and providing timely big data.
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Affiliation(s)
- Roberto Moro Visconti
- Department of Business Management, Catholic University of Sacred Heart, Via Ludovico Necchi, 7, 20123 Milan, Italy
| | - Donato Morea
- Faculty of Economics, Universitas Mercatorum, Piazza Mattei, 10, 00186 Rome, Italy
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20
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Improta G, De Luca V, Illario M, Triassi M. Digital Innovation in Healthcare: A Device with A Method for Monitoring, Managing and Preventing the Risk of Chronic Polypathological Patients. Transl Med UniSa 2020; 21:61-64. [PMID: 32123685 PMCID: PMC7039264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
New digital technologies can have a huge impact on the traditional healthcare sector, both from a clinical and economic perspective. Doctors and health specialists will increasingly need technology to improve the services they provide to their patients. Here a novel patented device for automatic processing of clinical data of chronic poly-pathological patients is presented. The invention consists of a reconfigurable equipment that allows the assessment of clinical risk severity indexes that can be customized for polypathological patients and which acts both as a decision support system for specialist doctors in the diagnosis and treatment phases, and as a monitoring system in the clinical environment.
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Affiliation(s)
- G Improta
- Department of Public Health, School of Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - V De Luca
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - M Illario
- Department of Public Health, School of Medicine and Surgery, University of Naples “Federico II”, Naples, Italy,Research and Development Unit, Federico II University Hospital, Naples, Italy,Health Innovation Division, General Directorate for Health, Campania Region, Naples, Italy
| | - M Triassi
- Department of Public Health, School of Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
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