Internet of Things (IoT) offers a seamless platform to connect people and objects to one another for enriching and making our lives easier. This vision carries us from compute-based centralized ...schemes to a more distributed environment offering a vast amount of applications such as smart wearables, smart home, smart mobility, and smart cities. In this paper we discuss applicability of IoT in healthcare and medicine by presenting a holistic architecture of IoT eHealth ecosystem. Healthcare is becoming increasingly difficult to manage due to insufficient and less effective healthcare services to meet the increasing demands of rising aging population with chronic diseases. We propose that this requires a transition from the clinic-centric treatment to patient-centric healthcare where each agent such as hospital, patient, and services are seamlessly connected to each other. This patient-centric IoT eHealth ecosystem needs a multi-layer architecture: (1) device, (2) fog computing and (3) cloud to empower handling of complex data in terms of its variety, speed, and latency. This fog-driven IoT architecture is followed by various case examples of services and applications that are implemented on those layers. Those examples range from mobile health, assisted living, e-medicine, implants, early warning systems, to population monitoring in smart cities. We then finally address the challenges of IoT eHealth such as data management, scalability, regulations, interoperability, device–network–human interfaces, security, and privacy.
Because health care delivery organizations (HDOs) increasingly rely on information technology (IT) in their delivery of health care services, recognition of how to exploit innovative electronic ...health (eHealth) technologies is crucial. We integrated absorptive capacity and governance perspectives to theorize that an HDO’s eHealth absorptive capacity is a dynamic IT capability to exploit eHealth innovations through the appropriate use of IT governance mechanisms. Drawing on absorptive capacity theory, we conceptualized an HDO’s eHealth potential absorptive capacity as consisting of eHealth entrepreneurial alertness and assimilation. We draw on the theoretical perspectives of IT governance to identify two modes of eHealth governance—relational and contractual—and theorize how each of them affected the relationship between eHealth potential absorptive capacity and eHealth exploitation. Valid empirical data were gathered from 182 senior executive representatives in 111 HDOs; we discovered that (1) eHealth potential absorptive capacity can be formatively conceptualized as a second-order construct consisting of eHealth entrepreneurial alertness and eHealth assimilation, (2) eHealth potential absorptive capacity affects eHealth exploitation, and (3) relational governance significantly moderates the influence of eHealth potential absorptive capacity on eHealth exploitation. We discussed the implications of our work for how HDOs can govern eHealth initiatives to expand absorptive capacity for eHealth innovations and effectively exploit them.
•Absorptive capacity (ACAP) consists of potential ACAP and realized ACAP.•eHealth potential ACAP can be conceptualized as a second-order construct.•eHealth potential ACAP influences innovative eHealth exploitation.•Relational governance moderates the impact of ACAP on eHealth exploitation.•Contractual governance has a positive effect on eHealth exploitation.
This study examined access to digital technologies, skills and experience, and preferences for using web-based and other digital technologies to obtain health information and advice among older ...adults in a large health plan. A primary aim was to assess the extent to which digital divides by race/ethnicity and age group might affect the ability of a large percentage of seniors, and especially those in vulnerable groups, to engage with online health information and advice modalities (eHIA) and mobile health (mHealth) monitoring tools.
A mailed survey was conducted with age-sex stratified random samples of English-speaking non-Hispanic white, African-American/black (black), Hispanic/Latino (Latino), Filipino-American (Filipino), and Chinese-American (Chinese) Kaiser Permanente Northern California members who were aged 65-79 years. Respondent data were weighted to the study population for the cross-sectional analyses.
Older seniors and black, Latino, and Filipino seniors have less access to digital tools, less experience performing a variety of online tasks, and are less likely to believe that they would be capable of going online for health information and advice compared to younger and white Non-Hispanic seniors. Consequently, they are also less likely to be interested in using eHIA modalities.
The same subgroups of seniors that have previously been shown to have higher prevalence of chronic conditions and greater difficulties with healthcare access are also less likely to adopt use of eHIA and mHealth monitoring technologies. At the patient population level, this digital divide is important to take into account when planning health information and chronic disease management programs. At the individual patient level, to provide good patient-centered care, it is important for providers to assess rather than assume digital access, eHealth skills, and preferences prior to recommending use of web-based resources and mHealth tools.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Maintenance of good health and a healthy lifestyle have significant impacts on the lives of university students. However, university students are prone to engage in risky health behaviors, resulting ...in impaired health status. Electronic health (eHealth) literacy is an important factor in maintaining a healthy lifestyle. However, no studies have assessed the eHealth literacy levels and the associated lifestyle behaviors among university students in Japan.
The purposes of this study were to clarify the eHealth literacy level, the participant characteristics associated with eHealth literacy, and the association of eHealth literacy with lifestyle behaviors of students in a Japanese university.
A questionnaire-based cross-sectional study of 3183 students at a national university in Japan was conducted. eHealth literacy was quantified using the Japanese version of the eHealth Literacy Scale (eHEALS). The association between participant characteristics (gender, school year, department of study, and living status) and eHEALS score was assessed using t tests. Additionally, the associations of eHealth literacy with lifestyle behaviors (exercise, smoking, alcohol consumption, etc.) were evaluated using logistic regression analyses.
The mean eHEALS score was 23.6/40 points. The mean eHEALS score for students in medical departments was 27.0/40 points, which was 2.9 points higher than that of nonmedical students (P<.001). Similarly, the graduate school participants had higher scores than the undergraduate students. The proportion of participants who exercised regularly was higher in the high eHEALS score group than in the low score group, with an adjusted odds ratio of 1.39 (P<.001).
The eHealth literacy level of university students in Japan was comparable to that of the general Japanese population. Graduate students, as well as those in medical departments, had higher eHealth literacy. Furthermore, students with higher eHealth literacy had better exercise routines.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The development of ehealth applications is a complex task, not only in technological terms, but also in the understanding of both the users' needs, expectations and contexts, and the business models. ...Therefore, initial conceptual validations might be essential to verify whether the proposed solutions are adequate, sustainable, and worth to be developed. The study reported by this paper applied the nominal group technique to verify the potential suitability and sustainability of a diverse set of ehealth applications to support older adults. The study identified a set of transversal advantages (i.e., promotion of active and healthy, integrated care, and healthcare equity) and barriers (i.e., contextual, personal, and development and deployment barriers. As a conclusion, the nominal group technique was adequate for the conceptual validation of the proposed ehealth solutions and provided comprehensive information about issues that must be carefully considered during the development of these solutions to assure their viability and to reduce research waste.
Although its structure and strategies are rapidly evolving, the impact of the eHealth on the healthcare services is evident. Implementing eHealth systems on a national level can drastically enhance ...the health practices and services provided to the patients and community. Hence, the engineering of a new model and a holistic framework for eHealth systems becomes a necessity in order to have an effective implementation of these systems. The vast and rapid development in computers, communication, and Internet technologies has significantly affected the contemporary health systems. However, the complexity of the healthcare environment, the abundance of information, the compatibility and the lack of unified eHealth framework creates real challenges to present efficient and attractive eHealth model that encompasses all these elements. Furthermore, the security of the health records and the secure access to the information add a new dimension of complexity. This work presents a new model and an integrated framework for an efficient implementation of eHealth systems at the national level. The proposed model and framework successfully incorporate all the success factors of efficient eHealth system along with a new security model to access the health records.
Purpose of Review
This review summarizes HIV care delivered via telemedicine before and during the COVID-19 pandemic and highlights areas of study to inform optimal usage of telemedicine in HIV ...clinical practice in the future.
Recent Findings
To address barriers to care created by the COVID-19 pandemic, regulatory agencies and payors waived longstanding restrictions, which enabled rapid expansion of telemedicine across the country. Preliminary data show that providers and persons with HIV (PWH) view telemedicine favorably. Some data suggest telemedicine has facilitated retention in care, but other studies have found increasing numbers of PWH lost to follow-up and worsened virologic suppression rates despite offering video and/or telephone visits.
Summary
The COVID-19 pandemic has exacerbated gaps in the HIV care continuum. To help mitigate the impact, most clinics have adopted new virtual care options and are now evaluating usage, impact, and concerns. Further research into the effects of telemedicine on HIV care and continued work towards universal access are needed.
Co-design, defined as collective creativity across the entire design process, can lead to the development of interventions that are more engaging, satisfying, and useful to potential users. However, ...using this methodology within the research arena requires a shift from traditional practice. Co-design of eHealth interventions with children and young people has additional challenges. This review summarizes the applied core principles of co-design and recommends techniques for undertaking co-design with children and young people. Three examples of co-design during the development of eHealth interventions (Starship Rescue, a computer game for treating anxiety in children with long-term physical conditions, a self-monitoring app for use during treatment of depression in young people, and HABITS, the development of an emotional health and substance use app, and eHealth platform for young people) are provided to illustrate the value and challenges of this contemporary process.
Background A specific eHealth device, a surf tablet, was developed for bridging between advanced in-hospital care and children's homes. Since little is known about determinators for parental eHealth ...usage, the study's aim was to explore if parents' usage of the device was associated with their eHealth literacy, or their satisfaction with their child's healthcare or with the specific surf tablet. Methods In this explorative usage and questionnaire study, parents to neonates who were discharged home after advanced in-hospital care were included. Their surf tablet usage at maximum 30 days after discharge was reported as frequency (%) of active days (usage days/days having the device) and median number of tablet activities (chat and photo) per usage day. eHealth literacy (eHealth Literacy Questionnaire; eHLQ), healthcare satisfaction (PedsQL Healthcare Satisfaction Generic Module), and satisfaction with the surf tablet were explored regarding tablet usage. Statistics were described in median (range) and (%) using non-parametric and regression models (p < 0.05). Results Parents to 32 children (11 premature, 21 operated) were included. Active days with eHealth communication using the device was 39% (9.0/29.5), with 2.0 (1.0-4.2) usage occasions per active day. Activity on the tablet was higher among parents reporting to be very satisfied or satisfied with the device (n = 25) compared with neutral/dissatisfied parents (n = 7) (2.8 vs. 2.2 vs. 1.6 activities) (p = 0.030), while their frequency of active days did not differ (31.6% vs. 38.3% vs. 40%) (p = 0.963). A higher eHealth literacy was not associated with frequency of active days (0.926 (0.652-1.317); p = 0.659) or number of eHealth activities (0.973 (0.758-1.250); p = 0.825). Healthcare satisfaction was not associated with higher frequency of active days 0.996 (0.983-1.009; p = 0.519); neither was number of eHealth activities 1.001 (0.991-1.011; p = 0.883). Conclusion In this study, eHealth usage was associated with parental satisfaction with the specific eHealth device, but not with eHealth literacy or healthcare satisfaction. To assure equal access to healthcare when using eHealth, the user-friendliness of the device seems to be crucial, and technical support needs to be in place. ClinicalTrials.gov registration identifier NCT04150120 (04/11/2019). Keywords: eHealth, eHealth literacy, eHealth usage, Health care satisfaction, User satisfaction
The wide deployment of cloud-assisted electronic health (eHealth) systems has already shown great benefits in managing electronic health records (EHRs) for both medical institutions and patients. ...However, it also causes critical security concerns. Since once a medical institution generates and outsources the patients’ EHRs to cloud servers, patients would not physically own their EHRs but the medical institution can access the EHRs as needed for diagnosing, it makes the EHRs integrity protection a formidable task, especially in the case that a medical malpractice occurs, where the medical institution may collude with the cloud server to tamper with the outsourced EHRs to hide the medical malpractice. Traditional cryptographic primitives for the purpose of data integrity protection cannot be directly adopted because they cannot ensure the security in the case of collusion between the cloud server and medical institution.
In this paper, a secure cloud-assisted eHealth system is proposed to protect outsourced EHRs from illegal modification by using the blockchain technology (blockchain-based currencies, e.g., Ethereum). The key idea is that the EHRs only can be outsourced by authenticated participants and each operation on outsourcing EHRs is integrated into the public blockchain as a transaction. Since the blockchain-based currencies provide a tamper-proofing way to conduct transactions without a central authority, the EHRs cannot be modified after the corresponding transaction is recorded into the blockchain. Therefore, given outsourced EHRs, any participant can check their integrity by checking the corresponding transaction. Security analysis and performance evaluation demonstrate that the proposed system can provide a strong security guarantee with a high efficiency.
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