C. Paton, Jørn A. Braa, A. Muhire, Luis Marco-Ruiz, Shinji Kobayashi, Hamish S. F. Fraser, Luis Falcón, A. Marcelo
Summary Objective : To assess the impact of open-source projects on making healthcare systems more resilient, accessible and equitable. Methods : In response to the International Medical Informatics Association (IMIA) call for working group contributions for the IMIA Yearbook, the Open Source Working Group (OSWG) conducted a rapid review of current open source digital health projects to illustrate how they can contribute to making healthcare systems more resilient, accessible and equitable. We sought case studies from the OSWG membership to illustrate these three concepts and how open source software (OSS) addresses these concepts in the real world. These case studies are discussed against the background of literature identified through the rapid review. Results : To illustrate the concept of resilience, we present case studies from the adoption of District Health Information Software version 2 (DHIS2) for managing the Covid pandemic in Rwanda, and the adoption of the OpenEHR open Health IT standard. To illustrate accessibility, we show how open source design systems for user interface design have been used by governments to ensure accessibility of digital health services for patients and healthy individuals, and by the OpenMRS community to standardise their user interface design. Finally, to illustrate the concept of equity, we describe the OpenWHO framework and two open source digital health projects, GNU Health and openIMIS, that both aim to reduce health inequities through the use of open source digital health software. Conclusion : This review has demonstrated that open source software addresses many of the challenges involved in making healthcare more accessible, equitable and resilient in high and low income settings.
{"title":"Open Source Digital Health Software for Resilient, Accessible and Equitable Healthcare Systems","authors":"C. Paton, Jørn A. Braa, A. Muhire, Luis Marco-Ruiz, Shinji Kobayashi, Hamish S. F. Fraser, Luis Falcón, A. Marcelo","doi":"10.1055/s-0042-1742508","DOIUrl":"https://doi.org/10.1055/s-0042-1742508","url":null,"abstract":"Summary Objective : To assess the impact of open-source projects on making healthcare systems more resilient, accessible and equitable. Methods : In response to the International Medical Informatics Association (IMIA) call for working group contributions for the IMIA Yearbook, the Open Source Working Group (OSWG) conducted a rapid review of current open source digital health projects to illustrate how they can contribute to making healthcare systems more resilient, accessible and equitable. We sought case studies from the OSWG membership to illustrate these three concepts and how open source software (OSS) addresses these concepts in the real world. These case studies are discussed against the background of literature identified through the rapid review. Results : To illustrate the concept of resilience, we present case studies from the adoption of District Health Information Software version 2 (DHIS2) for managing the Covid pandemic in Rwanda, and the adoption of the OpenEHR open Health IT standard. To illustrate accessibility, we show how open source design systems for user interface design have been used by governments to ensure accessibility of digital health services for patients and healthy individuals, and by the OpenMRS community to standardise their user interface design. Finally, to illustrate the concept of equity, we describe the OpenWHO framework and two open source digital health projects, GNU Health and openIMIS, that both aim to reduce health inequities through the use of open source digital health software. Conclusion : This review has demonstrated that open source software addresses many of the challenges involved in making healthcare more accessible, equitable and resilient in high and low income settings.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"39 1","pages":"67 - 73"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83036824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Hersh, R. Haux, E. Huesing, M. Ball, M. Kimura, P. Otero, D. Detmer, S. Koch, K. Saranto, G. Wright
Summary Objectives : To summarize the activities of the International Academy of Health Sciences Informatics (IAHSI) in 2021 and welcome its 2021 Class of Fellows. Methods : Report on governance, strategic directions, newly elected fellows, plenary meetings, and other activities of the Academy. Results : As in 2020, all of the Academy's activities were carried out virtually due to the COVID-19 pandemic. In 2021, new Board members were elected. Strategic activities in data standards and interoperability and in mentorship moved forward. A new class of 26 Fellows was elected, bringing the total membership of the Academy to 204 Fellows from all regions of the world. In addition, a virtual plenary meeting was held. Conclusions : The Academy has continued to pursue its role as the honorific society globally for biomedical and health informatics. Expansion of strategic activities and membership will continue moving forward.
{"title":"The International Academy of Health Sciences Informatics: 2021 Update","authors":"W. Hersh, R. Haux, E. Huesing, M. Ball, M. Kimura, P. Otero, D. Detmer, S. Koch, K. Saranto, G. Wright","doi":"10.1055/s-0042-1742501","DOIUrl":"https://doi.org/10.1055/s-0042-1742501","url":null,"abstract":"Summary Objectives : To summarize the activities of the International Academy of Health Sciences Informatics (IAHSI) in 2021 and welcome its 2021 Class of Fellows. Methods : Report on governance, strategic directions, newly elected fellows, plenary meetings, and other activities of the Academy. Results : As in 2020, all of the Academy's activities were carried out virtually due to the COVID-19 pandemic. In 2021, new Board members were elected. Strategic activities in data standards and interoperability and in mentorship moved forward. A new class of 26 Fellows was elected, bringing the total membership of the Academy to 204 Fellows from all regions of the world. In addition, a virtual plenary meeting was held. Conclusions : The Academy has continued to pursue its role as the honorific society globally for biomedical and health informatics. Expansion of strategic activities and membership will continue moving forward.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"24 1","pages":"7 - 10"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83222684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlene Esteban Ronquillo First Co-Author, James Mitchell First Co-Author, Dari Alhuwail, Laura-Maria Peltonen, M. Topaz, L. Block
Summary Objectives : The objective of this paper is to draw attention to the currently underused potential of clinical documentation by nursing and allied health professions to improve the representation of social determinants of health (SDoH) and intersectionality data in electronic health records (EHRs), towards the development of equitable artificial intelligence (AI) technologies. Methods : A rapid review of the literature on the inclusion of nursing and allied health data and the nature of health equity information representation in the development and/or use of artificial intelligence approaches alongside expert perspectives from the International Medical Informatics Association (IMIA) Student and Emerging Professionals Working Group. Results : Consideration of social determinants of health and intersectionality data are limited in both the medical AI and nursing and allied health AI literature. As a concept being newly discussed in the context of AI, the lack of discussion of intersectionality in the literature was unsurprising. However, the limited consideration of social determinants of health was surprising, given its relatively longstanding recognition and the importance of representation of the features of diverse populations as a key requirement for equitable AI. Conclusions : Leveraging the rich contextual data collected by nursing and allied health professions has the potential to improve the capture and representation of social determinants of health and intersectionality. This will require addressing issues related to valuing AI goals (e.g., diagnostics versus supporting care delivery) and improved EHR infrastructure to facilitate documentation of data beyond medicine. Leveraging nursing and allied health data to support equitable AI development represents a current open question for further exploration and research.
{"title":"The Untapped Potential of Nursing and Allied Health Data for Improved Representation of Social Determinants of Health and Intersectionality in Artificial Intelligence Applications: A Rapid Review","authors":"Charlene Esteban Ronquillo First Co-Author, James Mitchell First Co-Author, Dari Alhuwail, Laura-Maria Peltonen, M. Topaz, L. Block","doi":"10.1055/s-0042-1742504","DOIUrl":"https://doi.org/10.1055/s-0042-1742504","url":null,"abstract":"Summary Objectives : The objective of this paper is to draw attention to the currently underused potential of clinical documentation by nursing and allied health professions to improve the representation of social determinants of health (SDoH) and intersectionality data in electronic health records (EHRs), towards the development of equitable artificial intelligence (AI) technologies. Methods : A rapid review of the literature on the inclusion of nursing and allied health data and the nature of health equity information representation in the development and/or use of artificial intelligence approaches alongside expert perspectives from the International Medical Informatics Association (IMIA) Student and Emerging Professionals Working Group. Results : Consideration of social determinants of health and intersectionality data are limited in both the medical AI and nursing and allied health AI literature. As a concept being newly discussed in the context of AI, the lack of discussion of intersectionality in the literature was unsurprising. However, the limited consideration of social determinants of health was surprising, given its relatively longstanding recognition and the importance of representation of the features of diverse populations as a key requirement for equitable AI. Conclusions : Leveraging the rich contextual data collected by nursing and allied health professions has the potential to improve the capture and representation of social determinants of health and intersectionality. This will require addressing issues related to valuing AI goals (e.g., diagnostics versus supporting care delivery) and improved EHR infrastructure to facilitate documentation of data beyond medicine. Leveraging nursing and allied health data to support equitable AI development represents a current open question for further exploration and research.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"44 1","pages":"94 - 99"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73502725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary This paper deals with data handling in health care on three distinct and different levels. The three levels can be classified in the following way: ethical level based on principles, political level based on negotiations and relations, and phenomenological level based on relation in between the physical and digital world. The paper takes an outset in a recent report, published in October 2021, from the Lancet and Financial Times Commission on governing health futures 2030 (ethical level), and a recent publication (2020) and exhibition at the Biennale of Architecture in Venice (2021) on Data Publics (political level), and finally makes an attempt to frame our being with digital technology on a philosophical and phenomenological level. It is the assumption that all these levels are needed the moment we try to appropriate and incorporate data in different arenas and worlds, might they be global, national, institutional, or/and individual.
{"title":"Datafication: the Flavor and Scent of Data","authors":"Lars Botin","doi":"10.1055/s-0042-1742505","DOIUrl":"https://doi.org/10.1055/s-0042-1742505","url":null,"abstract":"Summary This paper deals with data handling in health care on three distinct and different levels. The three levels can be classified in the following way: ethical level based on principles, political level based on negotiations and relations, and phenomenological level based on relation in between the physical and digital world. The paper takes an outset in a recent report, published in October 2021, from the Lancet and Financial Times Commission on governing health futures 2030 (ethical level), and a recent publication (2020) and exhibition at the Biennale of Architecture in Venice (2021) on Data Publics (political level), and finally makes an attempt to frame our being with digital technology on a philosophical and phenomenological level. It is the assumption that all these levels are needed the moment we try to appropriate and incorporate data in different arenas and worlds, might they be global, national, institutional, or/and individual.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"148 1","pages":"11 - 14"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79374493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Kuziemsky, Inga M. Hunter, Jai Ganesh Udayasankaran, P. Ranatunga, G. Kulatunga, S. John, Oommen John, José F FlÓrez-Arango, Marcia Ito, K. Ho, Shahi B Gogia, Kleber Araujo, V. Rajput, Wouter Meijer, Arindam Basu
Summary Objective : The goal of this paper is to provide a consensus review on telehealth delivery prior to and during the COVID-19 pandemic to develop a set of recommendations for designing telehealth services and tools that contribute to system resilience and equitable health. Methods : The IMIA-Telehealth Working Group (WG) members conducted a two-step approach to understand the role of telehealth in enabling global health equity. We first conducted a consensus review on the topic followed by a modified Delphi process to respond to four questions related to the role telehealth can play in developing a resilient and equitable health system. Results : Fifteen WG members from eight countries participated in the Delphi process to share their views. The experts agreed that while telehealth services before and during COVID-19 pandemic have enhanced the delivery of and access to healthcare services, they were also concerned that global telehealth delivery has not been equal for everyone. The group came to a consensus that health system concepts including technology, financing, access to medical supplies and equipment, and governance capacity can all impact the delivery of telehealth services. Conclusion : Telehealth played a significant role in delivering healthcare services during the pandemic. However, telehealth delivery has also led to unintended consequences (UICs) including inequity issues and an increase in the digital divide. Telehealth practitioners, professionals and system designers therefore need to purposely design for equity as part of achieving broader health system goals.
{"title":"Telehealth as a Means of Enabling Health Equity","authors":"C. Kuziemsky, Inga M. Hunter, Jai Ganesh Udayasankaran, P. Ranatunga, G. Kulatunga, S. John, Oommen John, José F FlÓrez-Arango, Marcia Ito, K. Ho, Shahi B Gogia, Kleber Araujo, V. Rajput, Wouter Meijer, Arindam Basu","doi":"10.1055/s-0042-1742500","DOIUrl":"https://doi.org/10.1055/s-0042-1742500","url":null,"abstract":"Summary Objective : The goal of this paper is to provide a consensus review on telehealth delivery prior to and during the COVID-19 pandemic to develop a set of recommendations for designing telehealth services and tools that contribute to system resilience and equitable health. Methods : The IMIA-Telehealth Working Group (WG) members conducted a two-step approach to understand the role of telehealth in enabling global health equity. We first conducted a consensus review on the topic followed by a modified Delphi process to respond to four questions related to the role telehealth can play in developing a resilient and equitable health system. Results : Fifteen WG members from eight countries participated in the Delphi process to share their views. The experts agreed that while telehealth services before and during COVID-19 pandemic have enhanced the delivery of and access to healthcare services, they were also concerned that global telehealth delivery has not been equal for everyone. The group came to a consensus that health system concepts including technology, financing, access to medical supplies and equipment, and governance capacity can all impact the delivery of telehealth services. Conclusion : Telehealth played a significant role in delivering healthcare services during the pandemic. However, telehealth delivery has also led to unintended consequences (UICs) including inequity issues and an increase in the digital divide. Telehealth practitioners, professionals and system designers therefore need to purposely design for equity as part of achieving broader health system goals.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"20 1","pages":"60 - 66"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75904526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Peute, G. Wildenbos, Thomas Engelsma, Blake J. Lesselroth, Valentina Lichtner, H. Monkman, David P. Neal, L. van Velsen, M. Jaspers, R. Marcilly
Summary Objectives : Involving representative users in usability testing of health information technology (HIT) is central to user-centered design. However, (vulnerable) older adults as representative users have unique requirements. Aging processes may affect physical capabilities and cognitive skills, which can hamper testing with this demographic and may require special attention and revised protocols. This study was performed to provide expert-based recommendations for HIT user-testing with (vulnerable) older adults to support inclusive HIT design and evaluation. Methods : First, we conducted a structured workshop with ten experts in HIT implementation and research, recruited through purposeful sampling, to generate insights into how characteristics of older adults may influence user-testing. Next, five Human Factor researchers experienced in HIT user-testing with (vulnerable) older adults validated the results and provided additional textual insights to gain consensus on the most important recommendations. A thematic analysis was performed on the resulting inquiries. Applied codes were based on the User-Centered Design framework. Results : The analysis resulted in nine recommendations for user-testing of HIT with older adults, divided into three main themes: (1) empathetic approach and trust-building, (2) new requirements for testing and study design, and (3) adjustments to usability evaluation methods. For each theme a checklist of relevant items to follow-up on the recommendation is provided. Conclusions : The recommendations generated through expert inquiry contribute to more effective usability testing of HIT with older adults. This provides an important step towards improved accessibility of HIT amongst older adults through inclusive user-centered design.
{"title":"Overcoming Challenges to Inclusive User-based Testing of Health Information Technology with Vulnerable Older Adults: Recommendations from a Human Factors Engineering Expert Inquiry","authors":"L. Peute, G. Wildenbos, Thomas Engelsma, Blake J. Lesselroth, Valentina Lichtner, H. Monkman, David P. Neal, L. van Velsen, M. Jaspers, R. Marcilly","doi":"10.1055/s-0042-1742499","DOIUrl":"https://doi.org/10.1055/s-0042-1742499","url":null,"abstract":"Summary Objectives : Involving representative users in usability testing of health information technology (HIT) is central to user-centered design. However, (vulnerable) older adults as representative users have unique requirements. Aging processes may affect physical capabilities and cognitive skills, which can hamper testing with this demographic and may require special attention and revised protocols. This study was performed to provide expert-based recommendations for HIT user-testing with (vulnerable) older adults to support inclusive HIT design and evaluation. Methods : First, we conducted a structured workshop with ten experts in HIT implementation and research, recruited through purposeful sampling, to generate insights into how characteristics of older adults may influence user-testing. Next, five Human Factor researchers experienced in HIT user-testing with (vulnerable) older adults validated the results and provided additional textual insights to gain consensus on the most important recommendations. A thematic analysis was performed on the resulting inquiries. Applied codes were based on the User-Centered Design framework. Results : The analysis resulted in nine recommendations for user-testing of HIT with older adults, divided into three main themes: (1) empathetic approach and trust-building, (2) new requirements for testing and study design, and (3) adjustments to usability evaluation methods. For each theme a checklist of relevant items to follow-up on the recommendation is provided. Conclusions : The recommendations generated through expert inquiry contribute to more effective usability testing of HIT with older adults. This provides an important step towards improved accessibility of HIT amongst older adults through inclusive user-centered design.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"14 1","pages":"74 - 81"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85602712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary Background : Inclusive digital health prioritizes public engagement through digital literacies and internet/web connectivity for advancing and scaling healthcare equitably by informatics technologies. This is badly needed, largely desirable and uncontroversial. However, historically, medical and healthcare practices and their informatics processes assume that individual clinical encounters between practitioners and patients are the indispensable foundation of clinical practice. This assumption has been dramatically challenged by expansion of digital technologies, their interconnectable mobility, virtuality, surveillance informatics, and the vastness of data repositories for individuals and populations that enable and support them. This article is a brief historical commentary emphasizing critical ethical issues about decisions in clinical interactions or encounters raised in the early days of the field. These questions, raised eloquently by François Grémy in 1985, have become urgently relevant to the equity/fairness, inclusivity and unbiasedness desired of today's pervasive digital health systems. Objectives : The main goal of this article is to highlight how the personal freedoms of choice, values, and responsibilities arising in relationships between physicians and healthcare practitioners and their patients in the clinical encounter can be distorted by digital health technologies which focus more on efficiency, productivity, and scalability of healthcare processes. Understanding the promise and limitations of early and current decision-support systems and the analytics of community or population data can help place into historical context the often exaggerated claims made today about Artificial Intelligence and Machine Learning “solving” clinical problems with algorithms and data, downplaying the role of the clinical judgments and responsibilities inherent in personal clinical encounters. Methods : A review of selected early articles in medical informatics is related to current literature on the ethical issues and technological inadequacies involved in the design and implementation of clinical systems for decision-making. Early insights and cautions about the development of decision support technologies raised questions about the ethical responsibilities in clinical encounters where freedom of personal choice can be so easily limited through the constraints from information processing and reliance on prior expertise frequently driven more by administrative rather than clinical objectives. These anticipated many of the deeper ethical problems that have arisen since then in clinical informatics. Conclusions : Early papers on ethics in clinical decision-making provide prescient commentary on the dangers of not taking into account the complexities of individual human decision making in clinical encounters. These include the excessive reliance on data and experts, and oversimplified models of human reasoning, all of which persist and have b
{"title":"Ethics in the History of Medical Informatics for Decision-Making: Early Challenges to Digital Health Goals","authors":"C. Kulikowski","doi":"10.1055/s-0042-1742491","DOIUrl":"https://doi.org/10.1055/s-0042-1742491","url":null,"abstract":"Summary Background : Inclusive digital health prioritizes public engagement through digital literacies and internet/web connectivity for advancing and scaling healthcare equitably by informatics technologies. This is badly needed, largely desirable and uncontroversial. However, historically, medical and healthcare practices and their informatics processes assume that individual clinical encounters between practitioners and patients are the indispensable foundation of clinical practice. This assumption has been dramatically challenged by expansion of digital technologies, their interconnectable mobility, virtuality, surveillance informatics, and the vastness of data repositories for individuals and populations that enable and support them. This article is a brief historical commentary emphasizing critical ethical issues about decisions in clinical interactions or encounters raised in the early days of the field. These questions, raised eloquently by François Grémy in 1985, have become urgently relevant to the equity/fairness, inclusivity and unbiasedness desired of today's pervasive digital health systems. Objectives : The main goal of this article is to highlight how the personal freedoms of choice, values, and responsibilities arising in relationships between physicians and healthcare practitioners and their patients in the clinical encounter can be distorted by digital health technologies which focus more on efficiency, productivity, and scalability of healthcare processes. Understanding the promise and limitations of early and current decision-support systems and the analytics of community or population data can help place into historical context the often exaggerated claims made today about Artificial Intelligence and Machine Learning “solving” clinical problems with algorithms and data, downplaying the role of the clinical judgments and responsibilities inherent in personal clinical encounters. Methods : A review of selected early articles in medical informatics is related to current literature on the ethical issues and technological inadequacies involved in the design and implementation of clinical systems for decision-making. Early insights and cautions about the development of decision support technologies raised questions about the ethical responsibilities in clinical encounters where freedom of personal choice can be so easily limited through the constraints from information processing and reliance on prior expertise frequently driven more by administrative rather than clinical objectives. These anticipated many of the deeper ethical problems that have arisen since then in clinical informatics. Conclusions : Early papers on ethics in clinical decision-making provide prescient commentary on the dangers of not taking into account the complexities of individual human decision making in clinical encounters. These include the excessive reliance on data and experts, and oversimplified models of human reasoning, all of which persist and have b","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"20 1","pages":"317 - 322"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89468838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Cresswell, M. Rigby, A. Georgiou, Z. S. Wong, Polina V. Kukhareva, S. Medlock, N. D. de Keizer, F. Magrabi, P. Scott, E. Ammenwerth
Summary Objectives : Patient portals are increasingly implemented to improve patient involvement and engagement. We here seek to provide an overview of ways to mitigate existing concerns that these technologies increase inequity and bias and do not reach those who could benefit most from them. Methods : Based on the current literature, we review the limitations of existing evaluations of patient portals in relation to addressing health equity, literacy and bias; outline challenges evaluators face when conducting such evaluations; and suggest methodological approaches that may address existing shortcomings. Results : Various stakeholder needs should be addressed before deploying patient portals, involving vulnerable groups in user-centred design, and studying unanticipated consequences and impacts of information systems in use over time. Conclusions : Formative approaches to evaluation can help to address existing shortcomings and facilitate the development and implementation of patient portals in an equitable way thereby promoting the creation of resilient health systems.
{"title":"The Role of Formative Evaluation in Promoting Digitally-based Health Equity and Reducing Bias for Resilient Health Systems: The Case of Patient Portals","authors":"K. Cresswell, M. Rigby, A. Georgiou, Z. S. Wong, Polina V. Kukhareva, S. Medlock, N. D. de Keizer, F. Magrabi, P. Scott, E. Ammenwerth","doi":"10.1055/s-0042-1742498","DOIUrl":"https://doi.org/10.1055/s-0042-1742498","url":null,"abstract":"Summary Objectives : Patient portals are increasingly implemented to improve patient involvement and engagement. We here seek to provide an overview of ways to mitigate existing concerns that these technologies increase inequity and bias and do not reach those who could benefit most from them. Methods : Based on the current literature, we review the limitations of existing evaluations of patient portals in relation to addressing health equity, literacy and bias; outline challenges evaluators face when conducting such evaluations; and suggest methodological approaches that may address existing shortcomings. Results : Various stakeholder needs should be addressed before deploying patient portals, involving vulnerable groups in user-centred design, and studying unanticipated consequences and impacts of information systems in use over time. Conclusions : Formative approaches to evaluation can help to address existing shortcomings and facilitate the development and implementation of patient portals in an equitable way thereby promoting the creation of resilient health systems.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"3 1","pages":"33 - 39"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82553145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Rivera-Romero, E. Gabarron, T. Miron-Shatz, C. Petersen, K. Denecke
Summary Objective : Social media is used in the context of healthcare, for example in interventions for promoting health. Since social media are easily accessible they have potential to promote health equity. This paper studies relevant factors impacting on health equity considered in social media interventions. Methods : We searched for literature to identify potential relevant factors impacting on health equity considered in social media interventions. We included studies that reported examples of health interventions using social media, focused on health equity, and analyzed health equity factors of social media. We identified Information about health equity factors and targeted groups. Results : We found 17 relevant articles. Factors impacting on health equity reported in the included papers were extracted and grouped into three categories: digital health literacy, digital ethics, and acceptability. Conclusions : Literature shows that it is likely that digital technologies will increase health inequities associated with increased age, lower level of educational attainment, and lower socio-economic status. To address this challenge development of social media interventions should consider participatory design principles, visualization, and theories of social sciences.
{"title":"Social Media, Digital Health Literacy, and Digital Ethics in the Light of Health Equity","authors":"O. Rivera-Romero, E. Gabarron, T. Miron-Shatz, C. Petersen, K. Denecke","doi":"10.1055/s-0042-1742503","DOIUrl":"https://doi.org/10.1055/s-0042-1742503","url":null,"abstract":"Summary Objective : Social media is used in the context of healthcare, for example in interventions for promoting health. Since social media are easily accessible they have potential to promote health equity. This paper studies relevant factors impacting on health equity considered in social media interventions. Methods : We searched for literature to identify potential relevant factors impacting on health equity considered in social media interventions. We included studies that reported examples of health interventions using social media, focused on health equity, and analyzed health equity factors of social media. We identified Information about health equity factors and targeted groups. Results : We found 17 relevant articles. Factors impacting on health equity reported in the included papers were extracted and grouped into three categories: digital health literacy, digital ethics, and acceptability. Conclusions : Literature shows that it is likely that digital technologies will increase health inequities associated with increased age, lower level of educational attainment, and lower socio-economic status. To address this challenge development of social media interventions should consider participatory design principles, visualization, and theories of social sciences.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"81 1","pages":"82 - 87"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90086409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Román-Villarán, E. Ammenwerth, Jayathri Wijayaratne, C. Parra-Calderón
Summary Objectives : This research addresses several factors relevant to inequity in healthcare that may be susceptible to being addressed in a new generation of electronic health records (EHRs). Methods : Through a scoping review of the literature, inequities related to ethnicity, gender, and socioeconomic aspects in healthcare in general and, more specifically in EHRs, have been considered. Papers have been identified between 2011 and 2022 in three categories: EHR, gender inequalities, and ethnicity inequalities. Results : Twenty-two recommendations have been identified within the scope of the three categories indicated above. These exposed requirements focus on two spheres: (1) technical sphere, mainly focused on the characteristics and tools that the EHR should develop from taking into account the studied inequalities; and (2) clinical sphere, which mainly affects patients, health professionals, and health providers. Conclusions : Ethnic and gender inequalities are essential factors to take into account when diagnosing, monitoring, preventing, and treating a patient. These factors give us the keys to discovering recommendations for a new generation of EHRs to help mitigate these needs.
{"title":"Desiderata for a New Generation of EHRs for Inclusive Healthcare","authors":"E. Román-Villarán, E. Ammenwerth, Jayathri Wijayaratne, C. Parra-Calderón","doi":"10.1055/s-0042-1742507","DOIUrl":"https://doi.org/10.1055/s-0042-1742507","url":null,"abstract":"Summary Objectives : This research addresses several factors relevant to inequity in healthcare that may be susceptible to being addressed in a new generation of electronic health records (EHRs). Methods : Through a scoping review of the literature, inequities related to ethnicity, gender, and socioeconomic aspects in healthcare in general and, more specifically in EHRs, have been considered. Papers have been identified between 2011 and 2022 in three categories: EHR, gender inequalities, and ethnicity inequalities. Results : Twenty-two recommendations have been identified within the scope of the three categories indicated above. These exposed requirements focus on two spheres: (1) technical sphere, mainly focused on the characteristics and tools that the EHR should develop from taking into account the studied inequalities; and (2) clinical sphere, which mainly affects patients, health professionals, and health providers. Conclusions : Ethnic and gender inequalities are essential factors to take into account when diagnosing, monitoring, preventing, and treating a patient. These factors give us the keys to discovering recommendations for a new generation of EHRs to help mitigate these needs.","PeriodicalId":40027,"journal":{"name":"Yearbook of medical informatics","volume":"33 1","pages":"88 - 93"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90352014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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