The rapid integration of digital technologies in health care has emphasized the need to ensure that medical students are well-equipped with the knowledge and competencies related to digital health.

This study aimed to evaluate the impact of the "Digital Health" curriculum at our university on the perceptions of medical students regarding the relevance of digital health topics for their future professions and their self-assessed competence in these areas.

The "Digital Health" curriculum was introduced at a German university for 2 consecutive semesters. The perceived relevance of topics for their future careers and their subjective competence were evaluated before and after the curriculum using a Likert scale. Furthermore, the practical gamification-based teaching part of the robotics teaching unit was evaluated. In total, 6 months after completing the last semester, a follow-up analysis was performed with questions on the significance of the completed curriculum for current and future professional challenges regarding digital health and suggestions for improvement for innovative teaching. The study was meticulously planned and supported by an approved ethics vote of the local ethics committee to ensure that all ethical guidelines were adhered to (A 2022-0137).

A total of 20 students participated, with 13 (65%) being women. In particular, data protection and information security were considered the most relevant topics both before and after the curriculum. Significant increases in perceived importance were observed for messenger apps (mean increase of 0.8 [SD 1.2]; P<.01). Regarding self-assessed competence, significant development was observed on almost all topics. The greatest development was observed in robotics (mean increase of 1.8 [SD 1.2]; P<.001), open educational resources (mean increase of 1.7 [SD 1.5]; P<.001), and simulation-training (mean increase of 1.6 [SD 1.3]; P<.001). The gamification-based, robot-related teaching was predominantly rated suitable and very enjoyable for the students.

The results highlight the potential to integrate more innovative teaching techniques, such as gamification, augmented reality, virtual reality, and simulation training, into a technologically advanced health care environment. Finally, the overarching importance of artificial intelligence and digital health applications signals the need to further integrate them, given their potential in remote and personalized medicine.

The health care sector faces increasing pressure, with demand outpacing supply and multiple challenges in accessibility, affordability, and quality. The current organization of health care systems is unsustainable-exacerbated by labor shortages and escalating expenditures in Europe, particularly the Netherlands. To address these issues, hospitals are increasingly adopting digital transformation strategies. This digital transformation involves the systematic implementation of digital technologies and processes. To achieve high-quality hybrid care, hospitals must integrate digital health care seamlessly into existing workflows. However, there is no definitive strategy for implementing these transformations.

This study examines how Dutch hospitals organize their digital transformation, the strategies they employ, and the best practices they follow, to provide evidence-based recommendations for hospitals embarking on similar initiatives.

A qualitative multicase study was conducted using purposive sampling. A total of 11 Dutch hospitals were invited, and 8 participated. Professionals-project or program managers of digital care, or advisors in policy, management, strategy, or related positions-from these hospitals took part in semistructured interviews. Topics included digital transformation strategies, organizational structures, barriers and facilitators, and lessons learned. All interviews were recorded, transcribed verbatim, and analyzed using directed content analysis.

Although hospitals organize their digital transformation in different ways and with different teams or departments, they encounter similar facilitators and barriers. Inspired by the Consolidated Framework for Implementation Research, the ExpandNet Scaling Up framework, and the Hybrid Health Care Quality Assessment, these factors were grouped into the following categories: the structure of the digital program, cultural factors within the organization, financial factors (internal or external), political factors (internal or external), patient needs, resources and skills, and technical factors.

Despite variations in implementation, hospitals share key challenges and enablers in digital transformation. Common factors-such as organizational culture, financial resources, and technical infrastructure-may serve as foundational elements for effective digital transformation in hospital care.

In the 21st century, health care has been going through a paradigm shift called digital health. Due to major advances and breakthroughs in information technologies, most recently artificial intelligence, the patriarchy of the doctor-patient relationship has started evolving toward an equal-level partnership with initial signs of patient autonomy. Being an underused resource for centuries, patients have started to contribute to their care with information, data, insights, preferences, and knowledge. It is important to recognize that at its core, digital health represents a cultural transformation, where patient empowerment has likely played the most significant role in driving these changes. This viewpoint paper traces the remarkable journey of patient empowerment from its nascent stages to its current prominence in shaping health care's future. Spanning over two and a half decades, we explore pivotal moments and technological advancements that have revolutionized the patient's role in health care. We dive into a few historical milestones, mainly in the United States, that have challenged and redefined societal norms around agency, drawing parallels between patient empowerment and broader social movements, such as the women's suffrage and civil rights movements. Through these lenses, we argue that patient empowerment is not solely a function of knowledge or technology but requires a fundamental shift in societal attitudes, policies, health care culture, and practices. As we look to the future, we posit that the continued empowerment of patients will play a pivotal role in the development of more equitable, effective, and personalized health care systems. This paper calls for an ongoing commitment to fostering environments that support patient agency, access to resources, and the realization of patient potential in navigating and contributing to their health outcomes with an emphasis on the emerging significance of patient design.

Digital transformation is widely understood as a process where technology is used to modify an organization's products and services and to create new ones. It is rapidly advancing in all sectors of society. Researchers have shown that it is a multidimensional process determined by human decisions based on ideologies, ideas, beliefs, goals, and the ways in which technology is used. In health care and health, the end result of digital transformation is digital health. In this study, a detailed literature review covering 560 research articles published in major journals was performed, followed by an analysis of ideas, beliefs, and goals guiding digital transformation and their possible consequences for privacy, human rights, dignity, and autonomy in health care and health. Results of literature analyses demonstrated that from the point of view of privacy, dignity, and human rights, the current laws, regulations, and system architectures have major weaknesses. One possible model of digital health is based on the dominant ideas and goals of the business world related to the digital economy and neoliberalism, including privatization of health care services, monetization and commodification of health data, and personal responsibility for health. These ideas represent meaningful risks to human rights, privacy, dignity, and autonomy. In this paper, we present an alternative solution for digital health called human-centric digital health (HCDH). Using system thinking and system modeling methods, we developed a system model for HCDH. It uses 5 views (ideas, health data, principles, regulation, and organizational and technical innovations) to align with human rights and values and support dignity, privacy, and autonomy. To make HCDH future proof, extensions to human rights, the adoption of the principle of restricted informational ownership of health data, and the development of new duties, responsibilities, and laws are needed. Finally, we developed a system-oriented, architecture-centric, ontology-based, and policy-driven approach to represent and manage HCDH ecosystems.

The rapid progress in the development of artificial intelligence (AI) is having a substantial impact on health care (HC) delivery and the physician-patient interaction.

This scoping review aims to offer a thorough analysis of the current status of integrating AI into medical practice as well as the apprehensions expressed by HC professionals (HCPs) over its application.

This scoping review used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to examine articles that investigated the apprehensions of HCPs about medical AI. Following the application of inclusion and exclusion criteria, 32 of an initial 217 studies (14.7%) were selected for the final analysis. We aimed to develop an attitude range that accurately captured the unfavorable emotions of HCPs toward medical AI. We achieved this by selecting attitudes and ranking them on a scale that represented the degree of aversion, ranging from mild skepticism to intense fear. The ultimate depiction of the scale was as follows: skepticism, reluctance, anxiety, resistance, and fear.

In total, 3 themes were identified through the process of thematic analysis. National surveys performed among HCPs aimed to comprehensively analyze their current emotions, worries, and attitudes regarding the integration of AI in the medical industry. Research on technostress primarily focused on the psychological dimensions of adopting AI, examining the emotional reactions, fears, and difficulties experienced by HCPs when they encountered AI-powered technology. The high-level perspective category included studies that took a broad and comprehensive approach to evaluating overarching themes, trends, and implications related to the integration of AI technology in HC. We discovered 15 sources of attitudes, which we classified into 2 distinct groups: intrinsic and extrinsic. The intrinsic group focused on HCPs' inherent professional identity, encompassing their tasks and capacities. Conversely, the extrinsic group pertained to their patients and the influence of AI on patient care. Next, we examined the shared themes and made suggestions to potentially tackle the problems discovered. Ultimately, we analyzed the results in relation to the attitude scale, assessing the degree to which each attitude was portrayed.

The solution to addressing resistance toward medical AI appears to be centered on comprehensive education, the implementation of suitable legislation, and the delineation of roles. Addressing these issues may foster acceptance and optimize AI integration, enhancing HC delivery while maintaining ethical standards. Due to the current prominence and extensive research on regulation, we suggest that further research could be dedicated to education.

A growing number of health technology solutions are designed for people with diabetes to ease disease self-management. However, according to some studies, technology can also bring dissatisfaction. According to the Motivation, Engagement, and Thriving in User Experience model, the use of technology is only beneficial if it is linked to the experience of autonomy. The study aimed to investigate the associations between health technology use and technology adoption motivation and associated health behavior of people with type 1 and type 2 diabetes.

A cross-sectional questionnaire study was conducted on a sample of 315 patients with diabetes. The Technology Adoption Propensity Questionnaire was applied to assess general attitudes toward technology, the Autonomy and Competence in Technology Adoption Questionnaire for underlying motives of technology use, and the Summary of Diabetes Self-Care Activities tool for health behavior.

The results showed that technology use was predicted by proficiency (but not optimism) and lower levels of vulnerability and dependence. In addition, technology use predicted health behavior (diet and physical exercise) frequency. After refining the results further, among technology users, only autonomous motivation of technology use predicted health behavior, while controlled motivation had a slightly negative predictive effect on following the diet.

Particular attention should be paid to person-based health-related technology interventions for enhancing proficiency and reducing feelings of vulnerability and dependence on technologies. Ultimately, it is not the adoption of a technology per se, but the autonomous motivation for adoption that is associated with more favorable health behavior.

The Family-Centered Care (FCC) model has been linked to improved clinical outcomes and family satisfaction. However, implementing this model can be challenging, especially in neonatal and pediatric critical care units. This review aims to map the literature on FCC in neonatal and pediatric critical care units, identify barriers and facilitators of effective interventions, and suggest a practical step-by-step approach for implementing FCC interventions.

This scoping review was guided by the PRISMA-ScR guidelines and followed the Arksey and O'Malley 5-step scoping review framework. We accessed the databases on the 28 th of April, 2024, and included all prospective and randomized controlled trials (RCT) implementing FCC interventions from PubMed and Web of Science databases. Data were organized, tabulated, and described narratively.

Out of 1,577 potentially relevant citations after duplicate removal, 17 articles met our eligibility criteria (4 RCTs and 13 prospective studies). Nine of these studies were conducted in neonatal intensive care units (NICU) and eight in pediatric intensive care units (PICU). Three NICU interventions were single-type interventions, while six were part of comprehensive programs; in the PICU, seven were single-type interventions and one was part of a comprehensive program. All interventions incorporated elements of FCC principles (respect, information sharing, collaboration, and participation). Barriers included institutional factors, provider attitudes, cultural issues, communication challenges, environmental constraints, training needs, and emotional stress. FCC facilitators included enhanced environment, empowerment and training, supportive Infrastructure, collaborative communication, parental Involvement, adaptive interventions, and continuous feedback.

Effective implementation of FCC interventions requires careful planning and needs assessment. It ensures management support, regular staff training, family orientation, and a continuous feedback loop. Incorporating FCC principles and delivering culturally acceptable interventions is key while acknowledging possible barriers and utilizing available facilitators. FCC interventions can help foster a healthcare culture that values partnerships with families and can transform the neonatal and pediatric critical care experience for patients, families, and providers alike.

At present, doctor-patient communication is undergoing significant transformation due to digital technologies. The rise of the internet, social media, and digital tools that support medical purposes requires that doctors have new skills. This study presents the experiences of a new course for undergraduate medical students at the University of Pécs Medical School in Hungary. The course endeavors to demonstrate the internet's impact on the doctor-patient relationship by giving medical students the opportunity to practice communication strategies with 'Google patients' and e-patients, and use telemedicine in simulation-based training. We also explain how simulated patient consultations and feedback are incorporated into the curriculum and the methods used to prepare the students for these interactions. We explored the students' evaluations with the help of a course feedback questionnaire and written reflective essays. Based on the responses, students were satisfied with the training content and found the course innovative and relevant in the post-pandemic period. They highlighted the novel combination of theoretical teaching with simulation training and emphasized the need for practice in the field.

This paper examines the societal, demographic, and health-related determinants of online stress management information-seeking (OSMIS) behavior in Hungary. We processed the International Social Survey Program: Health and Healthcare (n = 1008) dataset of 2021. Relationships between variables were assessed using weighted multiple logistic regression. The bootstrapping method was applied to gauge the robustness and reliability of the estimates. Subgroup analyses were also utilized to explore potential confounding effects between OSMIS behavior and various socioeconomic and health-related lifestyle factors. Empirical findings indicate that socially excluded strata were the most likely to seek online stress management information to cope with stressful situations. OSMIS behavior was significantly associated with divorced marital status (OR = 3.13; 95% CI: [1.92-5.17]), unemployment (OR = 2.22 [1.64-2.99]), living in a rural village (OR = 1.39 [1.12-1.93]), and distrust in the healthcare system (OR = 2.03 [1.33-3.11]). During the COVID-19 pandemic, the concept of techquity played a pivotal role in Hungary, bridging gaps in health access. Policymakers, healthcare practitioners, and digital health developers may harness our results to enhance digital health tools within integrated healthcare systems, prioritizing equitable access to ensure that marginalized populations can fully benefit from the advantages of techquity and digital inclusion.

With the increased adoption of digital health solutions, such as telehealth, there is a need to consider current practices and considerations towards digital health Literacy. The objective of this review is to explore what digital health literacy considerations have been detailed in cystic fibrosis telehealth papers.

The found papers published from a recent systematic review exploring telehealth within cystic fibrosis care were taken and analysed. These papers were obtained from PubMed, Web of Science, and Scopus databases and included any paper written in English up to May 2021. Data pertaining to Health Literacy, Digital Literacy/Competency, Digital Health Literacy, Training, Readiness Assessments, and Sustained Use were extrapolated using Elicit AI Research Assistant 2024.

From the 26 papers, the data of interest was sparse and mostly unavailable for this review. This may be due to several reasons; however the implication of this mitigation is discussed with reference to the digital divide, health in-equalities, and safety.

This review highlights that a structured approach to assess digital health literacy of care teams and people with cystic fibrosis is critical to the future success of safe telehealth use, and other digital health solutions.

Cannabis is the most widely used illicit drug, and admissions for cannabis use disorders (CUDs) are increasing globally, posing a significant public health challenge. Despite its negative consequences, a substantial proportion of individuals with problematic use do not seek treatment. In recent years, digital health interventions (DHIs) have emerged as accessible and cost-effective solutions, empowering users to manage their health care. CANreduce is one such eHealth intervention that has demonstrated effectiveness in reducing cannabis use (CU); however, its suboptimal adherence rates underscore the need for strategies to enhance user engagement and motivation.

This study aims to improve the effectiveness, adherence, and user experience of the Spanish version of CANreduce 2.0 by employing focus groups (FGs) within a user-centered design approach that actively involves both users and professionals.

Separate FGs were conducted for users and professionals, involving a total of 10 participants. Users were recruited from individuals registered on the CANreduce 2.0 platform and active cannabis users, while professionals comprised addiction specialists familiar with the platform. Each session was held remotely and moderated by 2 interviewers following a semistructured script. Qualitative analysis of the transcripts was performed using MAXQDA software and content analysis methodology to identify key themes related to the acceptability, usability, and utility of CANreduce 2.0.

The qualitative analysis identified 3 main themes, encompassing 15 subcodes. Within the "motivation and awareness" theme, both users (n=6, mean age 31.8 years, SD 4.1 years) and professionals (n=4, mean age 37.25 years, SD 1.71 years) frequently discussed the importance of "motivation" and "problem awareness" as crucial for the success of CANreduce 2.0. In the "guidance and use" theme, the subcode "complement to face-to-face therapy" was the most emphasized. Professionals supported CANreduce 2.0 as a valuable adjunct to in-person therapy, serving as both an educational and monitoring tool, with no objections raised by either group. Lastly, within the "content and design" theme, "information," "small achievements," and "personalized content" emerged as key areas for improvement, highlighting the need to enhance motivation and adherence through gamification and tailored content.

Personalization, robust motivational strategies, and an engaging, interactive design are essential for the success of DHIs, particularly in addiction treatment. Collaboration among technology developers, health care professionals, and users should be central to the development process, fostering the cocreation of practical and effective solutions that are responsive to the needs of those seeking treatment. This approach ensures that DHIs are not only functional but also widely accepted and impactful. Insights from this study will inform the ongoing refinement of CANreduce 2.0, enhancing its relevance and effectiveness in addressing CU.

The digitization of healthcare, through electronic medical records (EMRs), is recognized globally as a transformative initiative. Indonesia mandated all healthcare facilities to adopt EMRs by December 31, 2023. However, this transition is complicated by diverse technological, cultural, and infrastructural challenges, with little research addressing the recordkeeping culture's impact on EMR adoption. This study investigates the electronic recordkeeping culture in Indonesian hospitals following a government mandate to adopt Electronic Medical Records (EMRs). It aims to understand the readiness and challenges in implementing EMRs across hospitals on Java and Sulawesi islands, focusing on infrastructure, staff digital skills, and varied adoption approaches.

A qualitative case study approach was utilized, involving focus groups and semi-structured interviews with 150 staff from 12 hospitals. Conducted between November 2023 and June 2024, the study applied thematic analysis based on Oliver and Foscarini's (2020) recordkeeping culture framework to explore organizational readiness, technological infrastructure, and healthcare professionals' skills in managing electronic records.

The findings reveal significant differences in EMR adoption between the islands. Hospitals on Java exhibited proactive engagement, supported by better technological infrastructure and staff training programs, while Sulawesi hospitals adopted EMRs primarily to meet regulatory requirements. Challenges included inconsistent internet connectivity, low digital literacy among staff, and ongoing reliance on paper records during the transition. Some Java hospitals have begun fostering a culture conducive to electronic recordkeeping by focusing on developing staff skills in EMR management.

The effectiveness of EMR adoption in Indonesia relies on addressing technological infrastructure issues and enhancing staff digital literacy. While progress has been made, particularly in more developed regions, a cohesive national strategy emphasizing technological support and targeted training is essential to fully realize the benefits of EMRs in improving healthcare and recordkeeping standards across Indonesia.

Background: The Ayushman Bharat Digital Mission (ABDM) aims to enhance healthcare delivery in India through digital integration. The ABDM, an essential part of India's healthcare system, aspires to transform healthcare delivery through digitization, by emphasizing affordability, accessibility, and transparency. This qualitative study investigated the awareness, challenges, and perceptions of the ABDM among postgraduate students in coastal Karnataka, focusing on their experiences and interactions with digital health technologies. Methodology: A qualitative descriptive approach was employed, involving semi-structured interviews with 17 purposively selected participants from a health science university. The interviews were audio-recorded, transcribed, and analyzed using the NVivo 12 software for thematic analysis. Results: This study revealed that, while many students recognized the ABDM's goal of establishing comprehensive digital health infrastructure to seamlessly integrate healthcare services and information systems, detailed knowledge about its functionalities, implementation processes, and challenges was limited. Participants highlighted the need for improved digital literacy and support to maximize the effective use of the ABDM. Conclusions: The successful implementation of the ABDM depends on overcoming major challenges such as poor awareness and concerns about data security. Addressing these issues will require focused educational campaigns, increased accessibility, and joint efforts by the government, healthcare providers, and technological partners.

The COVID-19 pandemic has catalysed the emergence of digital solutions in all areas of medicine. Our prior study on the digital health related experiences and opinions of Hungarian physicians highlights the crucial role of age in shaping attitudes towards digital health solutions among medical doctors. Our aim was to examine how under 35-year-old Hungarian physicians relate to digital technologies, the advantages and disadvantages they perceive, and how they would like to incorporate these technologies into their everyday medical practice.

As part of the "E-physicians and E-patients in Hungary" study, we conducted an online representative survey among medical practitioners in Hungary between July 2021 and May 2022 (n = 1,774). The main target group of our research were physicians under 35 years of age: n = 399 (25.3%). Besides descriptive statistical analyses, cluster analysis and binary logistic regression were applied to analyse the digital health related attitudes of the young age group.

Our cluster analysis confirmed that younger doctors perceived more advantages (on average 7.07 items vs. 8.52 items) and disadvantages (on average 4.06 vs. 4.42) of digital health solutions. They also demonstrated greater familiarity with (8.27 vs. 9.79) and use of (1.94 vs. 2.66) a broader spectrum of technologies. Proficiency and active utilization of diverse technologies correlates with a more comprehensive understanding of both pros and cons, as well as a more realistic self-assessment of areas of further improvement. Doctors under 35 years express a notable demand for significantly increased incentives, both in terms of knowledge transfer/training and infrastructure incentives. Multivariate analyses revealed that young doctors, compared to their older counterparts, perceived enhanced patient adherence as one of the greatest benefits of digital health solutions. Additionally, young doctors expect that digital health solutions could reduce burnout.

Our results underscore the inevitable transformation of the 21st-century physician role: the success of digital health solutions hinges on active patient involvement and management, which requires proper patient education and professional support in navigating the digital space. Digital health solutions can be a bridge between different generations of doctors, where young people can help their older colleagues navigate the digital world.

The unprovoked full-scale invasion of Ukraine in February 2022 severely damaged the national health system, disconnecting thousands of people living with human immunodeficiency virus (PLHIV) from essential health services. Digital health interventions (DHIs) offer the potential to reconnect war-affected PLHIV to healthcare and improve health system resilience in case of emergencies. This study aimed to present a comprehensive case study of the implementation and lessons learned from a DHI aimed at reconnecting Ukrainian PLHIV to healthcare in the context of war. A DHI called '#ARTporuch' was implemented in Ukraine in response to the war-related challenges for PLHIV. The case study methodology was used to present the DHI's life cycle, from creation to maintenance. Usage and geographic coverage data were analyzed descriptively. The multi-component DHI, consisting of a website, chatbot, database and information campaign, was implemented. The case study yielded pivotal insights into the DHI lifecycle, including rapid conceptualization, security considerations, agile implementation and continuous adaptation. The online advertising generated >10 million impressions within the information campaign. The website attracted 20 619 visitors, while the chatbot was activated by 2950 users. This case study underscores the potential of DHI as a crisis-response component to reconnect PLHIV to healthcare during wartime. While quantitative evidence of effectiveness is limited due to wartime constraints, the study provides insights into the implementation of DHI in conflict-affected or resource-constrained settings, contributing to the ongoing efforts to achieve universal health coverage and enhance health system resilience planning.

Pregnancy and childbirth are supposed to give a new beautiful meaning to life and it is a time of enormous delight and anticipation for both the women and their families. In these times, not only a baby is born, but a mother is born. However, inaccessibility and delays in obstetric care remain a common concern, particularly in low- and middle-income countries. Digital health technologies are being implemented to improve healthcare access worldwide, but there is a lack of documented data on available digital triage interventions. This article sought to examine and critique existing digital triage interventions in the healthcare system with reference to obstetrics.

Adopting a scoping review approach, using the five iterative steps proposed by Arksey and O'Malley, approximately 17 studies retrieved from databases like PubMed, Elsevier, EBSCohost, and google scholar were reviewed. Only the literature from 2014-2024 was included.

The review revealed that there are various types of digital triage interventions. However, they are flooded with weaknesses and threats among of which are diagnosis inaccuracy, insufficient information, and shortage of resources.

The study recommends that strengths, weaknesses, opportunities, and threats should not be overlooked, particularly when aiming to leverage digital health to improve access to emergency care in maternity units through digital triage. However, they should serve as a reference for the development of optimal digital triage systems for maternity and emergency units. Furthermore, the findings should also be a benchmark for digital triaging improvement strategies in the healthcare context.

Over the past decade, digital health technologies (DHTs) have grown rapidly, driven by innovations such as electronic health records and accelerated by the COVID-19 pandemic. Increased funding and regulatory support have further pushed the sector's expansion. Despite early success, many DHT companies struggle to scale, with notable examples like Pear Therapeutics and Proteus Digital Health, which both declared bankruptcy after initial breakthroughs. These cases highlight the challenges of sustaining growth in a highly regulated health care environment. While there is research on success factors across industries, a gap remains in understanding the specific challenges faced by growth-stage DHT companies.

This study aims to identify and discuss key factors that make growth-stage DHT companies successful. Specifically, we address three questions: (1) What are the success factors of growth-stage digital companies in general and (2) digital health companies in particular? (3) How do these success factors vary across DHTs?

Following established PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature review was conducted to answer the questions. A comprehensive literature search was conducted using management and medical literature databases: EBSCO, ProQuest, PubMed, Scopus, and Web of Science. The review spanned scientific articles published from 2000 to 2023, using a rigorous screening process and quality assessment using the Critical Appraisal Skills Programme (CASP) checklist.

From the 2972 studies initially screened, 36 were selected, revealing 52 success factors. We categorized them into internal factor categories (Product and Services, Operations, Business Models, and Team Composition) and external factor categories (Customers, Health Care System, Government and Regulators, Investors and Shareholders, Suppliers and Partners, and Competitors). Of the 52 factors, 19 were specific to DHT companies. The most frequently cited internal success factors included financial viability (n=18) and market demand and relevance of the product and service (n=13). External success factors emphasized the regulatory environment and policy framework (n=15). Key differences were observed between DHTs and broader digital companies in areas such as data security (P=.03), system interoperability (P=.01), and regulatory alignment (P=.02), with DHTs showing a higher frequency of these factors. In addition, success factors varied across different DHT categories. Health System Operational Software companies emphasized affordability and system integration, while Digital Therapeutics prioritized factors related to government regulations and regulatory approval.

Essential characteristics contributing to the success of growth-stage digital health companies have been identified. This work, therefore, fills a knowledge gap and provides relevant stakeholders, including investors and entrepreneurs, with a valuable resource that can support informed decision-making in investment decisions and, in turn, enhance the success of fast-growing digital health companies. In addition, it provides the research community with a direction for future studies, enhancing the understanding, implementation, and growth of DHTs.

RR2-10.1101/2024.05.06.24306674.

Digital health innovations are considered a promising avenue in transforming the resourcing, organization and delivery of healthcare services and are often nurtured in organization-based innovation labs. One of their biggest challenges is developing effective processes for sifting through ideas. To improve the existing work process, innovation management is often rooted in lean thinking principles. To illustrate the optimization of the efficiency of innovation processes, an example of a lean innovation process concept will be evaluated in this study.

The setting of this study was the Health Innovation Lab (HIL) of the Maastricht University Medical Center + (MUMC +) in the Netherlands. The aim was to evaluate its lean "speed dating" concept to improve the implementation of Digital Health innovations in secondary health care. A qualitative study was performed based on a focus group and semi-structured interviews. 36 stakeholders were selected by purposive sampling. Data was collected from 11 respondents. The transcripts of the focus group and interviews were coded according to the open and axial coding phases of the methods of Grounded Theory.

Five major themes emerged during the thematic analysis of the transcriptions: (1) Preparation before the Sign in, (2) Mapping out the process between Sign in and Sign out, (3) Defining the roles and deliverables of experts, (4) Guiding the idea owner, and (5) Supporting capacity of resources.

Through multidisciplinary interaction, by encouraging creative thinking and by fostering innovative behavior, innovation labs cultivate the development of innovative solutions. While the creative phase of innovation commonly exhibits non-linearity, most innovation pilots and implementations follow a linear path. This linearity seems to contradict the importance of flexible approaches to prevent waste in the context of innovation. However, our results suggest that improving cooperation between stakeholders may be a strategy to mitigate this effect. This paper broadens the knowledge on how multidisciplinary interaction during a lean innovation process can be improved, thereby enhancing the implementation of DH innovations.

Early detection and treatment of HIV and sexually transmitted infections (STIs) are crucial for effective control. We previously developed MySTIRisk, an artificial intelligence-based risk tool that predicts the risk of HIV and STIs. We examined the attributes that encourage potential users to use it.

Between January and March 2024, we sent text message invitations to the Melbourne Sexual Health Centre (MSHC) attendees to participate in an online survey. We also advertised the survey on social media, the clinic's website, and posters in affiliated general practice clinics. This anonymous survey used a discrete choice experiment (DCE) to examine which MySTIRisk attributes would encourage potential users. We analysed the data using random parameters logit (RPL) and latent class analysis (LCA) models.

The median age of 415 participants was 31 years (interquartile range, 26-38 years), with a minority of participants identifying as straight or heterosexual (31.8%, n = 132). The choice to use MySTIRisk was most influenced by two attributes: cost and accuracy, followed by the availability of a pathology request form, level of anonymity, speed of receiving results, and whether the tool was a web or mobile application. LCA revealed two classes: "The Precisionists" (66.0% of respondents), who demanded high accuracy and "The Economists" (34.0% of respondents), who prioritised low cost. Simulations predicted a high uptake (97.7%) for a tool designed with the most preferred attribute levels, contrasting with lower uptake (22.3%) for the least preferred design.

Participants were more likely to use MySTIRisk if it was free, highly accurate, and could send pathology request forms. Tailoring the tool to distinct user segments could enhance its uptake and effectiveness in promoting early detection and prevention of HIV and STIs.

The 42 days after delivery ("fourth trimester") are a high-risk period for birthing individuals and newborns, especially those who are racially and ethnically marginalized due to structural racism.

To fill a gap in the critical "fourth trimester," we developed 2 ruled-based chatbots-one for birthing individuals and one for newborn caregivers-that provided trusted information about postbirth warning signs and newborn care and connected patients with health care providers.

A total of 4370 individuals received the newborn chatbot outreach between September 1, 2022, and December 31, 2023, and 3497 individuals received the postpartum chatbot outreach between November 16, 2022, and December 31, 2023. We conducted surveys and interviews in English and Spanish to understand the acceptability and usability of the chatbot and identify areas for improvement. We sampled from hospital discharge lists that distributed the chatbot, stratified by prenatal care location, age, type of insurance, and racial and ethnic group. We analyzed quantitative results using descriptive analyses in SPSS (IBM Corp) and qualitative results using deductive coding in Dedoose (SocioCultural Research Consultants).

Overall, 2748 (63%) individuals opened the newborn chatbot messaging, and 2244 (64%) individuals opened the postpartum chatbot messaging. A total of 100 patients engaged with the chatbot and provided survey feedback; of those, 40% (n=40) identified as Black, 27% (n=27) identified as Hispanic/Latina, and 18% (n=18) completed the survey in Spanish. Payer distribution was 55% (n=55) for individuals with public insurance, 39% (n=39) for those with commercial insurance, and 2% (n=2) for uninsured individuals. The majority of surveyed participants indicated that chatbot messaging was timely and easy to use (n=80, 80%) and found the reminders to schedule the newborn visit (n=59, 59%) and postpartum visit (n=66, 66%) useful. Across 23 interviews (n=14, 61% Black; n=4, 17% Hispanic/Latina; n=2, 9% in Spanish; n=11, 48% public insurance), 78% (n=18) of interviewees engaged with the chatbot. Interviewees provided positive feedback on usability and content and recommendations for improving the outreach messages.

Chatbots are a promising strategy to reach birthing individuals and newborn caregivers with information about postpartum recovery and newborn care, but intentional outreach and engagement strategies are needed to optimize interaction. Future work should measure the chatbot's impact on health outcomes and reduce disparities.

During the COVID-19 pandemic, digital health solutions ensured the continuity of care especially in primary healthcare practices. COVID-19 accelerated the adoption of digital health solutions. The aim of this study is to describe the digital health-related attitudes and experiences of Hungarian Primary Care Physicians (PCPs) and also analyse the socio-demographic effects on digital health attitudes among PCPs.

This study used a quantitative and qualitative mixed methodological approach to examine the digital health-related attitudes and experience of Hungarian PCPs. As part of the "E-physicians and E-patients in Hungary" survey, we conducted an online survey among medical doctors working in Hungary between July 2021 to May 2022. A total of 1,774 questionnaires were received, consisting of 1,576 medical doctors and 198 dentists. Among the medical doctors there were 415 primary care physicians (PCPs). In addition to the online questionnaire survey, qualitative research in the form of semi-structured interviews with doctors was also conducted. These interviews took place between October 2021 and June 2022. A total of 62 interviews were conducted,19 with PCPs.

Primary care physicians are more open to technologies that facilitate communication and collaboration with patients, while showing less interest in technologies that support clinical work. Of the demographic variables (age, gender, type of settlement), age was found to have the most significant effect on digital health knowledge, use and intended use. Both the interviews and the multivariate analysis indicate that individuals with greater knowledge, expertise, and experience are more likely to perceive the advantages of digital solutions. This highlights the importance of training, especially given the significant aging population among Hungarian primary care physicians, who may not be accustomed to using these tools naturally. The way PCPs perceive patient expectations regarding the use of digital health tools has a significant impact on the PCPs' use and intended use of digital tools. When looking at perceived patient needs among PCPs the effect of age and municipality type of PCPs is significant. As age increases, the perception of patient needs decreases (from 5.02 to 4.47), and by municipality type, the average number of perceived needs decreases as one moves from larger cities to smaller municipalities (from 4.85 to 4.14).

Digital health solutions have the potential to enhance the work of PCPs, but successful implementation requires addressing specific needs, demographic differences, and challenges faced by PCPs. Development of infrastructure, education, and institutional support is necessary to ensure more efficient and higher-quality healthcare delivery through the use of digital technologies.

Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain.

This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective.

This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes.

We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised "social and personal," "technical and material," and "organization and policy" factors.

The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship.

Incremental advancements in artificial intelligence (AI) technology have facilitated its integration into various disciplines. In particular, the infusion of AI into medical education has emerged as a significant trend, with noteworthy research findings. Consequently, a comprehensive review and analysis of the current research landscape of AI in medical education is warranted.

This study aims to conduct a bibliometric analysis of pertinent papers, spanning the years 2013-2022, using CiteSpace and VOSviewer. The study visually represents the existing research status and trends of AI in medical education.

Articles related to AI and medical education, published between 2013 and 2022, were systematically searched in the Web of Science core database. Two reviewers scrutinized the initially retrieved papers, based on their titles and abstracts, to eliminate papers unrelated to the topic. The selected papers were then analyzed and visualized for country, institution, author, reference, and keywords using CiteSpace and VOSviewer.

A total of 195 papers pertaining to AI in medical education were identified from 2013 to 2022. The annual publications demonstrated an increasing trend over time. The United States emerged as the most active country in this research arena, and Harvard Medical School and the University of Toronto were the most active institutions. Prolific authors in this field included Vincent Bissonnette, Charlotte Blacketer, Rolando F Del Maestro, Nicole Ledows, Nykan Mirchi, Alexander Winkler-Schwartz, and Recai Yilamaz. The paper with the highest citation was "Medical Students' Attitude Towards Artificial Intelligence: A Multicentre Survey." Keyword analysis revealed that "radiology," "medical physics," "ehealth," "surgery," and "specialty" were the primary focus, whereas "big data" and "management" emerged as research frontiers.

The study underscores the promising potential of AI in medical education research. Current research directions encompass radiology, medical information management, and other aspects. Technological progress is expected to broaden these directions further. There is an urgent need to bolster interregional collaboration and enhance research quality. These findings offer valuable insights for researchers to identify perspectives and guide future research directions.

The current study aimed to identify digital health literacy levels among nurses with respect to their education, role and attitude towards digital technologies.

Cross-sectional study.

Through convenience sampling, all Registered Nurses, managers/leaders and nurse researchers employed in Hospitals, University Hospitals and Districts were recruited and surveyed using an online questionnaire. The data collection tool assessed: (I) demographics, (II) Digital Health Literacy (DHL) with the Health Literacy Survey19 Digital (HLS19-DIGI) instrument including DHL dealing with digital health information (HL-DIGI), interaction with digital resources for health (HL-DIGI-INT) and use of digital devices for health (HL-DIGI-DD); (III) attitudes on the use of digital technologies in clinical practice. The multiple correspondence analysis was applied to identify three clusters for the education/professional role (A, B, C) and three for digital technologies' use (1, 2, 3). The one-way nonparametric analysis of variance (Kruskal-Wallis test) was applied to compare HL-DIGI, HL-DIGI-INT and the HL-DIGI-DD scores among clusters.

Among 551 participants, the median scores of the HL-DIGI, the HL-DIGI-INT and the HL-DIGI-DD questionnaires were 70.2, 72 and 2.00, respectively. The distribution in the clusters 'educational/professional role' was A, (58.8%); B, (16.5%); and C, (24.7%). Nurses in a managerial or coordinator role and with a postgraduate degree used digital resources with greater frequency. The distribution in the clusters 'use of digital technologies' was: 1, (54.6%); 2, (12.2%); and 3, (33.2%). The HL-DIGI-DD and HL-DIGI scores of clusters 1, 2 and 3 differed significantly.

DHL among nurses is strongly influenced by the education level, professional role, habits and attitude towards digital technologies. Nurses with coordinator roles used digital technologies with greater frequency and had a higher level of DHL.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were used for reporting.

No Patient or Public Contribution.

Local Ethical Committee of the Polyclinic of Bari (code: DHL7454, date: 21/09/22).

The historical development and contemporary instances of futures studies, an interdisciplinary field that focuses on exploring and formulating alternative futures, exemplify the increasing significance of using futures methods in shaping the health care domain. Despite the wide array of these methodologies, there have been limited endeavors to employ them within the medical community thus far.

We undertook the first scoping review to date about the application of futures methodologies and published foresight projects in health care.

Through the use of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) method, we identified 59 studies that were subsequently categorized into the following 5 distinct themes: national strategies (n=19), strategic health care foresight (n=15), health care policy and workforce dynamics (n=6), pandemic preparedness and response (n=7), and specialized medical domains (n=12).

Our scoping review revealed that the application of futures methods and foresight has been successfully demonstrated in a wide range of fields, including national strategies, policy formulation, global threat preparedness, and technological advancements. The results of our review indicate that a total of 8 futures methods have already been used in medicine and health care, while there are more than 50 futures methods available. It may underscore the notion that the field is unexploited. Furthermore, the absence of structured methodologies and principles for employing foresight and futures techniques in the health care domain warrants the creation of medical futures studies as a separate scientific subfield within the broad domains of health care, medicine, and life sciences. This subfield would focus on the analysis of emerging technological trends, the evaluation of policy implications, and the proactive anticipation and mitigation of potential challenges.

Futures studies can significantly enhance medical science by addressing a crucial deficiency in the promotion of democratic participation, facilitating interdisciplinary dialogue, and shaping alternative futures. To further contribute to the development of a new research community in medical futures studies, it is recommended to establish a specialized scientific journal. Additionally, appointing dedicated futurists in decision-making and national strategy, and incorporating futures methods into the medical curriculum could be beneficial.

Hospital resilience has been well recognized among healthcare managers and providers as disruption of hospital services that threatens their business environment. However, the shocks identified in the recent hospital resilience concept are mainly related to disaster situations. This study aims to identify potential shocks that hospitals face during disruptions in Indonesia.

This qualitative study was conducted in Makassar, Indonesia in August-November 2022. Data was collected through semi-structured interviews with hospital managers and resilience experts using a semi-structured interview guide. 20 key informants were interviewed and data were analyzed by thematic analysis.

The study identified seven shocks to hospitals during the disruption era: policy, politics, economics, hospital management shifting paradigms, market and consumer behavior changes, disasters, and conflicts. It also identified barriers to making hospitals resilient, such as inappropriate organizational culture, weak cooperation across sectors, the traditional approach of hospital management, inadequate managerial and leadership skills, human resources inadequacies, a lack of business mindset and resistance to change.

This study provides a comprehensive understanding of hospital shocks during disruptions. This may serve as a guide to redesigning the instruments and capabilities needed for a resilient hospital.

Mobile health (mHealth) platforms are being used to understand patient-reported experiences before and after surgery. Currently, there is limited literature describing the feasibility of using mHealth to evaluate patient experience among older adults. The objective of this study was to determine the feasibility of using mHealth to evaluate patient-reported outcomes among patients older and younger than 65 years undergoing elective colectomy for diverticulitis.

A prospective pilot study was performed between June 1, 2020 and August 31, 2021, enrolling patients aged > 18 years undergoing elective colectomy for diverticulitis at a single academic center (n = 62). A Health Insurance Portability and Accountability Act-compliant mHealth platform was used to deliver patient-reported quality-of-life surveys at 3 time points: preoperatively, 3 months postoperatively, and 6 months postoperatively. The primary outcome was the feasibility of using mHealth in patients older and younger than 65 years to collect outcomes using recruitment, engagement, and survey completion rates. Preliminary findings of patient experiences were evaluated for patients older and younger than 65 years as secondary outcomes.

Overall, 33.9% of participants were older than 65 years with a median age of 59.8 years (IQR, 53.3-67.9). mHealth enrollment was high (100%) with survey response rates of 79% preoperatively, 64.5% at 3 months postoperatively, and 17.7% at 6 months postoperatively. Response rates were similar among patients older and younger than 65 years (P = .79 preoperatively and P = .39 at 3 months postoperatively).

Utilization of mHealth to evaluate patient-reported outcomes is feasible in the preoperative and early postoperative settings, including older adults undergoing elective surgery for diverticulitis. Future work will focus on improving long-term outcomes to better examine potential differences when considering patient-centered outcomes among older adult patients.

Background Mobile sensor data can provide vital information about patients' behavior and physical activity. In particular, the mobile accelerometer sensor data, if monitored effectively, can be used further for keeping watch on the physical activity of an individual and planning an intervention to improve it. These sensor data can also be used for improving clinical decision-making in sedentary lifestyle-related diseases. However, despite the availability of smartphone devices to the majority of the population, the sensor statistics captured by those devices are underused because of the lack of awareness about sensor metadata and the absence of clear-cut guidelines for using them. Objective The objective of this study is to study and encourage the use of the accelerometer sensor metadata of the mobile device in facilitating the delivery of interventions to enhance physical activity. At the end of the study, it should be able to lay down the basic guidelines for using the accelerometer sensor data of the mobile device for monitoring patients' activity and aiding the clinical decision monitoring. Methods A sequential explanatory mixed-method research design will be used between July 2023 and December 2024. Firstly, individuals between the ages of 30 and 45 visiting the clinic of healthcare workers and having lifestyle-related diseases will be screened for a sedentary lifestyle with the pre-tested sedentary lifestyle measuring tool. After enrolling patients with a sedentary lifestyle in the study, physical activity-related accelerometer sensor data will be collected from them. Based on the initial data recorded, an individualized activity plan will be created. Periodic monitoring of physical activity levels will be conducted over a three-month period. Participants will receive a message from clinicians based on their current physical activity levels to encourage them to adhere to the prescribed regimen suggested by clinicians. The improvement in physical activity over the period will be monitored, and feedback from clinicians to improve the mechanism will be recorded. Results The proposed research will help in exploring the role of remote monitoring of sensor data in improving adherence to physical activity plans as prescribed by their clinicians. It will also help in studying the variables that influence the monitoring of remote data collection. Conclusions This study will help create a protocol to bring improvement in the physical activity levels of patients with a sedentary lifestyle and with confirmed hypertension and type 2 diabetes through remote capturing and monitoring of mobile sensor data, ongoing messaging, and facilitation through clinical decision-making.

The increasing integration of new technologies is driving a fundamental revolution in the healthcare sector. Developments in artificial intelligence (AI), machine learning, and big data analytics have completely transformed the diagnosis, treatment, and care of patients. AI-powered solutions are enhancing the efficiency and accuracy of healthcare delivery by demonstrating exceptional skills in personalized medicine, early disease detection, and predictive analytics. Furthermore, telemedicine and remote patient monitoring systems have overcome geographical constraints, offering easy and accessible healthcare services, particularly in underserved areas. Wearable technology, the Internet of Medical Things, and sensor technologies have empowered individuals to take an active role in tracking and managing their health. These devices facilitate real-time data collection, enabling preventive and personalized care. Additionally, the development of 3D printing technology has revolutionized the medical field by enabling the production of customized prosthetics, implants, and anatomical models, significantly impacting surgical planning and treatment strategies. Accepting these advancements holds the potential to create a more patient-centered, efficient healthcare system that emphasizes individualized care, preventive care, and better overall health outcomes. This review's novelty lies in exploring how these technologies are radically transforming the healthcare industry, paving the way for a more personalized and effective healthcare for all. It highlights the capacity of modern technology to revolutionize healthcare delivery by addressing long-standing challenges and improving health outcomes. Although the approval and use of digital technology and advanced data analysis face scientific and regulatory obstacles, they have the potential for transforming translational research. as these technologies continue to evolve, they are poised to significantly alter the healthcare environment, offering a more sustainable, efficient, and accessible healthcare ecosystem for future generations. Innovation across multiple fronts will shape the future of advanced healthcare technology, revolutionizing the provision of healthcare, enhancing patient outcomes, and equipping both patients and healthcare professionals with the tools to make better decisions and receive personalized treatment. As these technologies continue to develop and become integrated into standard healthcare practices, the future of healthcare will probably be more accessible, effective, and efficient than ever before.

Digital health technology is utilized in contemporary nursing practice and education. This review explored the scope of digital health applications and major trends in nursing research involving digital health in Korea using topic modeling. Our analysis of data using the Latent Dirichlet Allocation model identified four distinct research topics: nursing education using digital technologies (35.17%), hospital-based nursing practice using digital technologies (19.88%), digital technologies for health education (25.75%), and development of digital technologies to support self-management of chronic conditions (19.20%). Our findings reveal trends, current issues, and gaps in digital health nursing research.

Abortion and its complications have always been associated with challenges such as the lack of awareness, high cost of receiving in-person services, lack of access to the skilled healthcare workers, distance from healthcare centers in remote areas, and cultural sensitivities. Therefore, the use of mobile health technology in post-abortion care has been suggested. This study aimed to investigate factors influencing the acceptance and use of mhealth technology in post-abortion care.

A mixed-methods study was completed in 2023. Initially, a literature review was conducted. Then, a five-point Likert-scale questionnaire was designed based on the results of the literature review. The research participants were gynecologists (n = 24), midwives (n = 38), and women who had experience of abortion (n = 183). Data were analyzed using descriptive and inferential statistics.

The findings revealed that the participants had different opinions about the importance of motivating and inhibiting factors which included individual, technical, economic, organizational, and ethico-legal aspects. It seems that the individual, organizational, economic, and ethico-legal motivating factors as well as the ethico-legal inhibiting factors were more important than other factors and had higher mean values. In addition, there was a statistically significant difference between the mean values of gynecologists and patients regarding the individual motivating (P = 0.014) and technical inhibiting factors (P = 0.016). The gynecologists' opinions regarding the technical motivating factors were also significantly different from midwives (P = 0.044) and patients (P = 0.010).

Multiple factors may influence the acceptance and use of mhealth technology in post-abortion care. Therefore, mhealth service developers must consider these factors to improve the quality of services and increase technology adoption. This will lead to saving costs, improving health, reducing abortion complications, and ultimately improving quality of life for women. However, further research in patient engagement and health interventions tailored to diverse cultural contexts are recommended.

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients' self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary, bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real-time patients' needs and the available resources. To achieve this goal, different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

Although Digital Health Technology is increasingly implemented in hospitals and clinics, physicians are not sufficiently equipped with the competencies needed to optimize technology utilization. Medical schools seem to be the most appropriate channel to better prepare future physicians for this development. The purpose of this research study is to investigate the extent to which top-ranked medical schools equip future physicians with the competencies necessary for them to leverage Digital Health Technology in the provision of care. This research work relied on a descriptive landscape analysis, and was composed of two phases: Phase I aimed at investigating the articulation of the direction of the selected universities and medical schools to identify any expressed inclination towards teaching innovation or Digital Health Technology. In phase II, medical schools' websites were analyzed to discover how innovation and Digital Health Technology are integrated in their curricula. Among the 60 medical schools that were analyzed, none mentioned any type of Digital Health Technology in their mission statements (that of the universities, in general, and medical schools, specifically). When investigating the medical schools' curricula to determine how universities nurture their learners in relation to Digital Health Technology, four universities covering different Digital Health Technology areas were identified. The results of the current study shed light on the untapped potential of working towards better equipping medical students with competencies that will enable them to leverage Digital Health Technology in their future practice and in turn enhance the quality of care.

Type-2 Diabetes Mellitus (T2D) is a growing concern worldwide, and family doctors are called to help diabetic patients manage this chronic disease, also with Medical Nutrition Therapy (MNT). However, MNT for Diabetes is usually standardized, while it would be much more effective if tailored to the patient. There is a gap in patient-tailored MNT which, if addressed, could support family doctors in delivering effective recommendations. In this context, decision support systems (DSSs) are valuable tools for physicians to support MNT for T2D patients - as long as DSSs are transparent to humans in their decision-making process. Indeed, the lack of transparency in data-driven DSS might hinder their adoption in clinical practice, thus leaving family physicians to adopt general nutrition guidelines provided by the national healthcare systems.

This work presents a prototypical ontology-based clinical Decision Support System (OnT2D- DSS) aimed at assisting general practice doctors in managing T2D patients, specifically in creating a tailored dietary plan, leveraging clinical expert knowledge. OnT2D-DSS exploits clinical expert knowledge formalized as a domain ontology to identify a patient's phenotype and potential comorbidities, providing personalized MNT recommendations for macro- and micro-nutrient intake. The system can be accessed via a prototypical interface.

Two preliminary experiments are conducted to assess both the quality and correctness of the inferences provided by the system and the usability and acceptance of the OnT2D-DSS (conducted with nutrition experts and family doctors, respectively).

Overall, the system is deemed accurate by the nutrition experts and valuable by the family doctors, with minor suggestions for future improvements collected during the experiments.

Digital technologies have impacted health care delivery globally, and are increasingly being deployed in clinical practice. However, there is limited research on patients' expectations of doctors' clinical competencies when using digital health care technologies (DHTs) in medical care. Understanding these expectations can reveal competency gaps, enhance patient confidence, and contribute to digital innovation initiatives.

This study explores patients' perceptions of doctors' use of DHTs in clinical care. Using Singapore as a case study, it examines patients' expectations regarding doctors' communication, diagnosis, and treatment skills when using telemedicine, health apps, wearable devices, electronic health records, and artificial intelligence.

Findings were drawn from individual semistructured interviews with patients from outpatient clinics. Participants were recruited using purposive sampling. Data were analyzed qualitatively using thematic analysis.

Twenty-five participants from different backgrounds and with various chronic conditions participated in the study. They expected doctors to be adept in handling medical data from apps and wearable devices. For telemedicine, participants expected a level of assessment of their medical conditions akin to in-person consultations. In addition, they valued doctors recognizing when a physical examination was necessary. Interestingly, eye contact was appreciated but deemed nonessential by participants across all age bands when electronic health records were used, as they valued the doctor's efficiency more than eye contact. Nonetheless, participants emphasized the need for empathy throughout the clinical encounter regardless of DHT use. Furthermore, younger participants had a greater expectation for DHT use among doctors compared to older ones, who preferred DHTs as a complement rather than a replacement for clinical skills. The former expected doctors to be knowledgeable about the algorithms, principles, and purposes of DHTs such as artificial intelligence technologies to better assist them in diagnosis and treatment.

By identifying patients' expectations of doctors amid increasing health care digitalization, this study highlights that while basic clinical skills remain crucial in the digital age, the role of clinicians needs to evolve with the introduction of DHTs. It has also provided insights into how DHTs can be integrated effectively into clinical settings, aligning with patients' expectations and preferences. Overall, the findings offer a framework for high-income countries to harness DHTs in enhancing health care delivery in the digital era.

Digital technologies allow users to engage in health-related behaviors associated with positive outcomes. We aimed to identify classes of US adults with distinct digital technologies access and health use patterns and characterize class composition. Data came from Health Information National Trends Survey Wave 5 Cycles 1-4, a nationally representative cross-sectional survey of US adults (N=13,993). We used latent class analysis to identify digital technologies access and health use patterns based on 32 ternary variables of behaviors and access to requisite technologies and platforms, including the internet, internet-enabled devices, health monitors, and electronic health records (EHRs). We ran a multinomial logistic regression to identify sociodemographic and health correlates of class membership (n=10,734).

Ten classes captured patterns of digital technology access and health use among US adults. This included a digitally isolated, a mobile-dependent, and a super user class, which made up 8.9%, 7.8%, and 13.6% of US adults, respectively, and captured access patterns from only basic cellphones and health monitors to near complete access to web-, mobile-, and EHR-based platforms. Half of US adults belonged to classes that lacked access to EHRs and relied on alternative web-based tools typical of patient portals. The proportion of class members who used digital technologies for health purposes varied from small to large. Older and less educated adults had lower odds of belonging to classes characterized by access or engagement in health behaviors. Hispanic and Asian adults had higher odds of belonging to the mobile-dependent class. Individuals without a regular healthcare provider and those who had not visited a provider in the past year were more likely to belong to classes with limited digital technologies access or health use.

Only one third of US adults belonged to classes that had near complete access to digital technologies and whose members engaged in almost all health behaviors examined. Sex, age, and education were associated with membership in classes that lacked access to 1+ digital technologies or exhibited none to limited health uses of such technologies. Results can guide efforts to improve access and health use of digital technologies to maximize associated health benefits and minimize disparities.

The African continent has experienced an alarming increase in forcibly displaced individuals, driven by socio-political conflict, economic instability and climate-induced calamities. The urgent need for contextualized and adaptable health solutions in the face of ongoing conflicts and crises underscores the importance of harnessing digital health innovations while ensuring inclusivity and equity for all. This commentary explores the potential of digital health to address healthcare disparities among migrant populations, examining the barriers to adoption and providing recommendations for policymakers and stakeholders to promote inclusivity and improve healthcare access. While digital health emerged as a promising avenue for improving healthcare access, there is also a greater necessity for tailoring these innovations to the specific needs and vulnerabilities of the target populations.

Background and Objectives: Robotics is commonly used in the rehabilitation of neuro-musculoskeletal injuries and diseases. While in these conditions, robotics has clear benefits, it is unknown whether robotics will also enhance the outcome of cardiac rehabilitation. This systematic review evaluates the use of robotics in cardiac rehabilitation. Methods: A systematic literature search was conducted using PubMed (MEDLINE), CINAHL, AMED, SPORTDiscus, and the Physiotherapy Evidence Database. Longitudinal interventional studies were included if they met specified criteria. Two reviewers independently conducted title, abstract, and full-text screening and data extraction. The quality assessment and risk of bias were conducted according to the PEDRO scale and Cochrane Risk of Bias tool 2, respectively. Results: Four trials were included in this review out of 60 screened studies. The quality of the included studies was good with a low risk of bias. The trials used different robotic systems: Lokomat® system, Motomed Letto/Thera Trainer tigo, BEAR, and Myosuit. It was found that interventions that included the use of robotic assistance technologies improved the exercise capacity, VO2 max/peak, left ventricular ejection fraction, QOL, and physical functioning in people with cardiac diseases. Conclusions: Robotic assistance technologies can be used in cardiac rehabilitation programs. Further studies are needed to confirm the results and determine whether the use of robotics enhances intervention outcomes above standard interventions.

The public medical universities in Austria (educating 11,000 students) developed a joint public distance learning series in which clinicians discussed current digital lighthouse projects in their specialty. This study aims to examine the changes in attitude and knowledge of the participants before and after the lecture series to gain insights for future curriculum developments.

The lecture series was announced via various channels at the universities, in health newsletters and in social media. Attitudes toward digitalization in medicine were surveyed before and after the lecture series, together with demographic data. The data were analyzed statistically and descriptively for four groups of interest: female medical students, male medical students, faculty members and members from industry and public agencies.

Out of 351 subjects who attended at least 1 lecture, 117 took part in the survey before and 47 after the lectures. Most participants had a positive attitude towards digitalization (85.3%). They improved their self-assessment of their knowledge from 34.4% to 64.7% (p < 0.05). After the lecture series 55.8% of participants considered digital medical applications to be important or very important today and 68.6% in the future.

The study shows that the presentation and discussion of lighthouse projects improves understanding of digitalization in medicine but does not trigger a strong desire for additional further training.

Despite a recent rise in adoption, telemedicine consultations retention remains challenging, and aspects around the associated experiences and outcomes remain unclear. The need to further investigate these aspects was a motivating factor for conducting this scoping review.

With a focus on synchronous telemedicine consultations between patients with nonmalignant chronic illnesses and health care professionals (HCPs), this scoping review aimed to gain insights into (1) the available evidence on telemedicine consultations to improve health outcomes for patients, (2) the associated behaviors and attitudes of patients and HCPs, and (3) how supplemental technology can assist in remote consultations.

PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guided the scoping review process. Inclusion criteria were (1) involving adults with nonmalignant, noncommunicable chronic conditions as the study population; (2) focusing on health outcomes and experiences of and attitudes toward synchronous telemedicine consultations between patients and HCPs; and (3) conducting empirical research. A search strategy was applied to PubMed (including MEDLINE), CINAHL Complete, APA PsycNet, Web of Science, IEEE, and ACM Digital. Screening of articles and data extraction from included articles were performed in parallel and independently by 2 researchers, who corroborated their findings and resolved any conflicts.

Overall, 4167 unique articles were identified from the databases searched. Following multilayer filtration, 19 (0.46%) studies fulfilled the inclusion criteria for data extraction. They investigated 6 nonmalignant chronic conditions, namely chronic obstructive pulmonary disease, diabetes, chronic kidney disease, ulcerative colitis, hypertension, and congestive heart failure, and the telemedicine consultation modality varied in each case. Most observed positive health outcomes for patients with chronic conditions using telemedicine consultations. Patients generally favored the modality's convenience, but concerns were highlighted around cost, practical logistics, and thoroughness of clinical examinations. The majority of HCPs were also in favor of the technology, but a minority experienced reduced job satisfaction. Supplemental technological assistance was identified in relation to technical considerations, improved remote workflow, and training in remote care use.

For patients with noncommunicable chronic conditions, telemedicine consultations are generally associated with positive health outcomes that are either directly or indirectly related to their ailment, but sustained improvements remain unclear. These modalities also indicate the potential to empower such patients to better manage their condition. HCPs and patients tend to be satisfied with remote care experience, and most are receptive to the modality as an option. Assistance from supplemental technologies mostly resides in addressing technical issues, and additional modules could be integrated to address challenges relevant to patients and HCPs. However, positive outcomes and attitudes toward the modality might not apply to all cases, indicating that telemedicine consultations are more appropriate as options rather than replacements of in-person visits.

Background In the era of rapid digital advancement, the confidentiality and privacy of digital health and medical data have become paramount concerns. This study investigates the perspectives of individuals residing in Hail City regarding these critical issues, with a particular emphasis on the influence of demographic factors such as age, gender, and computer proficiency on individuals' discomfort with health professionals using computers and their trust in researchers. Gaining a deeper understanding of these factors is vital for the development of targeted interventions aimed at enhancing patient comfort and trust in digital health/medical technologies. Methodology This study employed a descriptive cross-sectional design, involving a survey of 775 individuals aged 18 and above in Hail City. The questionnaire was designed to gather information on participants' demographic characteristics, computer proficiency, experiences with digital health and medical information, and perceptions of health information safety and privacy. To examine the associations and predictive relationships between variables, chi-square tests, correlation analyses, and logistic regression were performed. Results Significant associations were found between gender and discomfort with health professionals using computers (chi-square = 60.29, p < 0.0001), and between age and trust in researchers regarding the privacy of medical information (chi-square = 50.14, p < 0.0001). Positive correlations were observed between computer proficiency and perception of health information safety (r = 0.12, p = 0.0002), while a negative correlation was found between computer ownership and avoidance of medical tests due to privacy concerns (r = -0.08, p = 0.03). Logistic regression analysis identified age, gender, and computer proficiency as significant predictors of discomfort with health professionals using computers. The findings highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Conclusions The findings of this study highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Gender and age were found to significantly influence individuals' levels of discomfort and trust, while computer proficiency was shown to enhance perceptions of safety. Based on these findings, the researchers recommend implementing targeted interventions, such as gender-sensitive training programs and initiatives, to enhance digital literacy and improve patient comfort and trust in digital health technologies.

To describe the role of patients with a chronic disease, healthcare professionals (HCPs) and technology in shared decision making (SDM) and the use of clinical decision support systems (CDSSs), and to evaluate the effectiveness of SDM and CDSSs interventions.

Randomized controlled studies published between 2011 and 2021 were identified and screened independently by two reviewers, followed by data extraction and analysis. SDM elements and interactive styles were identified to shape the roles of patients, HCPs and technology.

Forty-three articles were identified and reported on 21 SDM-studies, 15 CDSS-studies, 2 studies containing both an SDM-tool and a CDSS, and 5 studies with other decision support components. SDM elements were mostly identified in SDM-tools and interactions styles were least common in the other decision support components.

Patients within the included RCTs mainly received information from SDM-tools and occasionally CDSSs when it concerns treatment strategies. HCPs provide and clarify information using SDM-tools and CDSSs. Technology provides interactions, which can support more active SDM. SDM-tools mostly showed evidence for positive effects on SDM outcomes, while CDSSs mostly demonstrated positive effects on clinical outcomes.

Technology-supported SDM has potential to optimize SDM when patients, HCPs and technology collaborate well together.

Youth overweight and obesity is a public health crisis and increases the risk of poor cardiovascular health (CVH) and chronic disease. Health care providers play a key role in weight management, yet few tools exist to support providers in delivering tailored evidence-based behavior change interventions to patients.

The goal of this pilot randomized feasibility study was to determine the feasibility of implementing the Patient-Centered Real-Time Intervention (PREVENT) tool in clinical settings, generate implementation data to inform scale-up, and gather preliminary effectiveness data.

A pilot randomized clinical trial was conducted to examine the feasibility, implementation, and preliminary impact of PREVENT on patient knowledge, motivation, behaviors, and CVH outcomes. The study took place in a multidisciplinary obesity management clinic at a children's hospital within an academic medical center. A total of 36 patients aged 12 to 18 years were randomized to use PREVENT during their routine visit (n=18, 50%) or usual care control (n=18, 50%). PREVENT is a digital health tool designed for use by providers to engage patients in behavior change education and goal setting and provides resources to support change. Patient electronic health record and self-report behavior data were collected at baseline and 3 months after the intervention. Implementation data were collected via PREVENT, direct observation, surveys, and interviews. We conducted quantitative, qualitative, and mixed methods analyses to evaluate pretest-posttest patient changes and implementation data.

PREVENT was feasible, acceptable, easy to understand, and helpful to patients. Although not statistically significant, only PREVENT patients increased their motivation to change their behaviors as well as their knowledge of ways to improve heart health and of resources. Compared to the control group, PREVENT patients significantly improved their overall CVH and blood pressure (P<.05).

Digital tools can support the delivery of behavior change counseling in clinical settings to increase knowledge and motivate patients to change their behaviors. An appropriately powered trial is necessary to determine the impact of PREVENT on CVH behaviors and outcomes.

ClinicalTrials.gov NCT06121193; https://www.clinicaltrials.gov/study/NCT06121193.