Pub Date : 2025-12-01Epub Date: 2025-09-09DOI: 10.1016/j.hlpt.2025.101117
Yuetong Ren , Huilan Xu , Sue Amanatidis , Limin Mao , Miranda Shaw , Lisa Simone , Li Ming Wen
<div><h3>Objectives</h3><div>The rapid adoption of telemedicine during the COVID-19 pandemic has transformed healthcare delivery. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. However, the uptake of virtual care among non-English-speaking patients remains understudied. This study aimed to profile COVID-19 patients cared for by rpavirtual and examine the association between patients’ demographics and service utilization.</div></div><div><h3>Method</h3><div>A retrospective study was conducted using routinely collected electronic medical records. Participants were 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. Multiple logistic regression models were built to examine the association between service utilization and preferred language and other demographics. Subgroup analyses were conducted by patients’ age group and preferred language.</div></div><div><h3>Results</h3><div>Compared to English-speaking patients, non-English-speaking patients were less likely to register with rpavirtual ≥ 2 times (adjusted odds ratio (AOR) 0.86, 95 % CI 0.77 – 0.96), receive ≥ 3 services (AOR 0.92, 95 % CI 0.85 – 1.00), and have service duration ≥76 min (AOR 0.92, 95 % CI 0.85 – 0.99). Among patients aged 50 years or older, these associations were particularly pronounced, with AOR 0.77 (95 % CI 0.66 – 0.89), AOR 0.86 (95 % CI 0.78 – 0.96), and AOR 0.86 (95 % CI 0.78 – 0.95) for number of registrations and services and total service duration, respectively. Among non-English-speaking patients, interpreter use was strongly associated with increased service utilization.</div></div><div><h3>Conclusion</h3><div>Preferred language shapes virtual care utilization patterns. Providing language support improves equitable access and engagement in virtual care platforms.</div></div><div><h3>Lay summary</h3><div>There was a significant pivot towards virtual care during the COVID-19 pandemic. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. This study analyzed routinely collected electronic medical records of 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. The study found that COVID-19 patients’ demographics were associated with rpavirtual utilization, and interpreter use was strongly associated with increased service utilization. There were significant disparities in utilization between non-English-speaking and English-speaking patients. Non-English-speaking patients were less likely to register with rpavirtual multiple times, receive more services, and have longer service duration. The associations of preferred language with service utilization were particularly pronounced among patients aged 50 years or older. The results suggest that preferred language shapes virtual care utilization. Language support is
在2019冠状病毒病大流行期间,远程医疗的迅速普及改变了医疗保健服务。在澳大利亚,RPA虚拟医院(rpavirual)已成为远程医疗的关键医疗保健提供者。然而,非英语患者对虚拟护理的接受程度仍未得到充分研究。本研究旨在分析由虚拟医院护理的COVID-19患者,并检查患者人口统计数据与服务利用率之间的关系。方法采用常规收集的电子病历资料进行回顾性研究。参与者是2020年7月1日至2022年6月30日在新南威尔士州悉尼地方卫生区注册的21814名COVID-19患者。建立了多个逻辑回归模型来检验服务利用率与首选语言和其他人口统计学之间的关系。按患者年龄和首选语言进行亚组分析。结果与英语患者相比,非英语患者登记≥2次(调整优势比(AOR) 0.86, 95% CI 0.77 ~ 0.96),接受≥3次服务(AOR 0.92, 95% CI 0.85 ~ 1.00),服务时间≥76 min (AOR 0.92, 95% CI 0.85 ~ 0.99)的可能性较小。在50岁及以上的患者中,这些关联尤为明显,分别为AOR 0.77 (95% CI 0.66 - 0.89)、AOR 0.86 (95% CI 0.78 - 0.96)和AOR 0.86 (95% CI 0.78 - 0.95)。在非英语患者中,口译员的使用与服务利用率的增加密切相关。结论首选语言塑造了虚拟护理使用模式。提供语言支持可改善虚拟护理平台的公平获取和参与。在2019冠状病毒病大流行期间,出现了向虚拟医疗的重大转变。在澳大利亚,RPA虚拟医院(rpavirual)已成为远程医疗的关键医疗保健提供者。本研究分析了2020年7月1日至2022年6月30日期间在新南威尔士州悉尼地方卫生区注册的21814名COVID-19患者的常规电子病历。研究发现,COVID-19患者的人口统计数据与虚拟服务的利用率有关,口译员的使用与服务利用率的提高密切相关。非英语患者和英语患者在用药方面存在显著差异。非英语患者不太可能多次登记,接受更多的服务,服务时间更长。在50岁或以上的患者中,首选语言与服务利用的关联尤为明显。结果表明,首选语言影响虚拟护理的利用。语言支持是提高虚拟护理可及性和参与度的关键。
{"title":"Association of demographic characteristics of COVID-19 patients with RPA Virtual Hospital service utilization in 2020-22","authors":"Yuetong Ren , Huilan Xu , Sue Amanatidis , Limin Mao , Miranda Shaw , Lisa Simone , Li Ming Wen","doi":"10.1016/j.hlpt.2025.101117","DOIUrl":"10.1016/j.hlpt.2025.101117","url":null,"abstract":"<div><h3>Objectives</h3><div>The rapid adoption of telemedicine during the COVID-19 pandemic has transformed healthcare delivery. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. However, the uptake of virtual care among non-English-speaking patients remains understudied. This study aimed to profile COVID-19 patients cared for by rpavirtual and examine the association between patients’ demographics and service utilization.</div></div><div><h3>Method</h3><div>A retrospective study was conducted using routinely collected electronic medical records. Participants were 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. Multiple logistic regression models were built to examine the association between service utilization and preferred language and other demographics. Subgroup analyses were conducted by patients’ age group and preferred language.</div></div><div><h3>Results</h3><div>Compared to English-speaking patients, non-English-speaking patients were less likely to register with rpavirtual ≥ 2 times (adjusted odds ratio (AOR) 0.86, 95 % CI 0.77 – 0.96), receive ≥ 3 services (AOR 0.92, 95 % CI 0.85 – 1.00), and have service duration ≥76 min (AOR 0.92, 95 % CI 0.85 – 0.99). Among patients aged 50 years or older, these associations were particularly pronounced, with AOR 0.77 (95 % CI 0.66 – 0.89), AOR 0.86 (95 % CI 0.78 – 0.96), and AOR 0.86 (95 % CI 0.78 – 0.95) for number of registrations and services and total service duration, respectively. Among non-English-speaking patients, interpreter use was strongly associated with increased service utilization.</div></div><div><h3>Conclusion</h3><div>Preferred language shapes virtual care utilization patterns. Providing language support improves equitable access and engagement in virtual care platforms.</div></div><div><h3>Lay summary</h3><div>There was a significant pivot towards virtual care during the COVID-19 pandemic. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. This study analyzed routinely collected electronic medical records of 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. The study found that COVID-19 patients’ demographics were associated with rpavirtual utilization, and interpreter use was strongly associated with increased service utilization. There were significant disparities in utilization between non-English-speaking and English-speaking patients. Non-English-speaking patients were less likely to register with rpavirtual multiple times, receive more services, and have longer service duration. The associations of preferred language with service utilization were particularly pronounced among patients aged 50 years or older. The results suggest that preferred language shapes virtual care utilization. Language support is","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101117"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-07-16DOI: 10.1016/j.hlpt.2025.101069
Beatriz Araujo Oliveira , Erika Regina Manuli , Fábio Eudes Leal , Edgar Casado Barreta Souza , Ana Paula Illi , Ana Paula Barreto de Paiva , Camila da Silva Fachini , Beatriz Aparecida Munhoz Cano , Priscila de Lima Barros , Ligia Capuani , Helves Humberto Domingues , Maria Rita dos Santos e Passos-Bueno , Ester Cerdeira Sabino , Silvia Figueiredo Costa
Children were the last that were vaccinated during the COVID-19 pandemic. In this scenario, schools were the site of amplification and spread of COVID-19 and new variants during the pandemia.
Objective
To evaluate a respiratory symptoms screening system and test asymptomatic individuals (high school students and employees) at a public school in Brazil.
Methods
An online COVID-19 symptom surveillance platform was implemented for employees and students answered a questionnaire by mobile phone and/or website before going to school. Symptomatic individuals were referred to primary care unit. SARS-CoV-2 reverse transcription loop- mediated isothermal amplification (RT-LAMP) of saliva samples was performed weekly. The test cost was estimated.
Results
A total of 969 samples were tested (mean of 108 tests per week). A professor was symptomatic and tested positive during the study period. However, no asymptomatic participants tested positive for COVID-19, and no cases of SARS-CoV-2 transmission occurred at school despite the high transmissibility of the Delta variant, the local predominant variant at the time of the study and several outbreaks that occurred in public schools in Brazil. The average cost of our test was $13,6 per test.
Conclusion
Implementation of an online system of COVID-19 respiratory symptom screening and testing SARS-CoV-2 through saliva in asymptomatic individuals is a feasible, low-cost and practical option to be used, especially in low-income countries.
{"title":"Digital COVID-19 symptom screening and SARS-CoV-2 testing through RT-LAMP saliva of students and asymptomatic employees in a public school in Brazil","authors":"Beatriz Araujo Oliveira , Erika Regina Manuli , Fábio Eudes Leal , Edgar Casado Barreta Souza , Ana Paula Illi , Ana Paula Barreto de Paiva , Camila da Silva Fachini , Beatriz Aparecida Munhoz Cano , Priscila de Lima Barros , Ligia Capuani , Helves Humberto Domingues , Maria Rita dos Santos e Passos-Bueno , Ester Cerdeira Sabino , Silvia Figueiredo Costa","doi":"10.1016/j.hlpt.2025.101069","DOIUrl":"10.1016/j.hlpt.2025.101069","url":null,"abstract":"<div><div>Children were the last that were vaccinated during the COVID-19 pandemic. In this scenario, schools were the site of amplification and spread of COVID-19 and new variants during the pandemia.</div></div><div><h3>Objective</h3><div>To evaluate a respiratory symptoms screening system and test asymptomatic individuals (high school students and employees) at a public school in Brazil.</div></div><div><h3>Methods</h3><div>An online COVID-19 symptom surveillance platform was implemented for employees and students answered a questionnaire by mobile phone and/or website before going to school. Symptomatic individuals were referred to primary care unit. SARS-CoV-2 reverse transcription loop- mediated isothermal amplification (RT-LAMP) of saliva samples was performed weekly. The test cost was estimated.</div></div><div><h3>Results</h3><div>A total of 969 samples were tested (mean of 108 tests per week). A professor was symptomatic and tested positive during the study period. However, no asymptomatic participants tested positive for COVID-19, and no cases of SARS-CoV-2 transmission occurred at school despite the high transmissibility of the Delta variant, the local predominant variant at the time of the study and several outbreaks that occurred in public schools in Brazil. The average cost of our test was $13,6 per test.</div></div><div><h3>Conclusion</h3><div>Implementation of an online system of COVID-19 respiratory symptom screening and testing SARS-CoV-2 through saliva in asymptomatic individuals is a feasible, low-cost and practical option to be used, especially in low-income countries.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101069"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-08-08DOI: 10.1016/j.hlpt.2025.101105
Tom Brandsma , Rogier van de Wetering , Jol Stoffers
Objectives
Increasing healthcare organizations’ digital innovation readiness is crucial to ensuring future availability, accessibility, affordability, and quality of healthcare. This study identifies themes that contribute to the digital innovation readiness of healthcare organizations.
Methods
A qualitative study was conducted using 17 semi-structured interviews among multiple stakeholders, clustered into 5 groups—academics, consultants, (top) managers (e.g., CIO/CEO), digital innovation managers, and primary care workers with digital innovation as a field of interest. Thematic analysis was used to analyze data.
Results
Five themes that contribute to digital innovation readiness of healthcare organizations were identified—strategic guidance, organization, adaptive climate, leading digital innovation, and digital foundation.
Conclusions
This study identifies themes that contribute to digital innovation readiness of healthcare organizations, helping such organizations prepare to innovate using digital technologies. Future research should validate these themes and explore interrelationships among them.
{"title":"Digital innovation readiness of Dutch healthcare organizations: an interview study with multiple stakeholders","authors":"Tom Brandsma , Rogier van de Wetering , Jol Stoffers","doi":"10.1016/j.hlpt.2025.101105","DOIUrl":"10.1016/j.hlpt.2025.101105","url":null,"abstract":"<div><h3>Objectives</h3><div>Increasing healthcare organizations’ digital innovation readiness is crucial to ensuring future availability, accessibility, affordability, and quality of healthcare. This study identifies themes that contribute to the digital innovation readiness of healthcare organizations.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted using 17 semi-structured interviews among multiple stakeholders, clustered into 5 groups—academics, consultants, (top) managers (e.g., CIO/CEO), digital innovation managers, and primary care workers with digital innovation as a field of interest. Thematic analysis was used to analyze data.</div></div><div><h3>Results</h3><div>Five themes that contribute to digital innovation readiness of healthcare organizations were identified—strategic guidance, organization, adaptive climate, leading digital innovation, and digital foundation.</div></div><div><h3>Conclusions</h3><div>This study identifies themes that contribute to digital innovation readiness of healthcare organizations, helping such organizations prepare to innovate using digital technologies. Future research should validate these themes and explore interrelationships among them.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101105"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-23DOI: 10.1016/j.hlpt.2025.101118
Y. Tony Yang
{"title":"Beyond checkbox participation: The radical promise of reflective stakeholder engagement in medical device assessment","authors":"Y. Tony Yang","doi":"10.1016/j.hlpt.2025.101118","DOIUrl":"10.1016/j.hlpt.2025.101118","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101118"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-07-18DOI: 10.1016/j.hlpt.2025.101076
Augustino Mwogosi
Background
Tanzania has prioritized EHR systems adoption through systems like GoTHoMIS to enhance healthcare delivery and data management. However, the success of EHR implementation depends critically on system usability and healthcare providers’ satisfaction, which influence system acceptance and continued use.
Objectives
This study assessed the determinants of EHR system usability and satisfaction among healthcare providers in Tanzania’s public primary healthcare facilities. Specific objectives were to examine the influence of EHR system usability on provider satisfaction, the role of organizational factors, the contribution of usability to frequency of system use, and variations across demographic and professional groups.
Methods
A cross-sectional quantitative survey was conducted among 288 healthcare providers in Dodoma and Dar es Salaam regions. The regions were purposively selected to represent urban, peri‑urban and rural settings based on EHR system implementation maturity. Data were collected through a structured questionnaire administered via Google Forms. Google Forms data were encrypted and complied with Tanzania’s Data Protection Act 2022. Multiple linear regression and Structural Equation Modeling using SmartPLS were employed to analyze factors associated with EHR systems satisfaction and usage frequency.
Results
Improvement in work efficiency was the strongest predictor of provider satisfaction (β = 0.258, p < 0.001), followed by system reliability, adequate training, and organizational support. Factors such as ease of integration into clinical workflows and enhancement of collaboration significantly predicted the frequency of EHR system use. Demographic variables had limited moderating effects. Generally, system usability, organizational environment, and perceived efficiency gains were critical for successful EHR adoption.
Conclusion
Effective EHR systems implementation in primary healthcare settings in Tanzania requires a complex approach addressing not only technical usability but also organizational support, user training, and workflow integration. Policy interventions should prioritize these areas to enhance user satisfaction and system sustainability.
Public interest summary
This study looked at how healthcare providers in Tanzania use electronic health record systems, which are digital tools for storing patient information. The results showed that healthcare workers were more satisfied and used the systems more often when the records were reliable, easy to use, and supported by strong training and leadership. These insights could help healthcare organizations improve digital systems and make healthcare services better for patients
坦桑尼亚通过GoTHoMIS等系统优先采用电子病历系统,以加强医疗保健服务和数据管理。然而,EHR实施的成功主要取决于系统可用性和医疗保健提供者的满意度,这影响系统的接受度和持续使用。目的:本研究评估坦桑尼亚公共初级卫生保健机构医疗服务提供者的电子病历系统可用性和满意度的决定因素。具体目标是检查EHR系统可用性对提供者满意度的影响,组织因素的作用,可用性对系统使用频率的贡献,以及人口统计学和专业群体之间的差异。方法对多马和达累斯萨拉姆地区288名医疗服务提供者进行横断面定量调查。根据EHR系统实施成熟度,有目的地选择代表城市、城郊和农村的区域。数据通过谷歌表格进行结构化问卷调查收集。谷歌表单数据经过加密,并符合坦桑尼亚2022年数据保护法。采用多元线性回归和SmartPLS结构方程模型分析影响电子病历系统满意度和使用频率的因素。结果工作效率的提高是服务提供者满意度的最强预测因子(β = 0.258, p <;0.001),其次是系统可靠性、充分的培训和组织支持。整合到临床工作流程的便利性和加强协作等因素显著预测了电子病历系统的使用频率。人口统计变量的调节作用有限。一般来说,系统可用性、组织环境和可感知的效率收益对于成功采用EHR至关重要。结论:在坦桑尼亚初级卫生保健机构实施有效的电子病历系统需要一个复杂的方法,不仅要解决技术可用性问题,还要解决组织支持、用户培训和工作流程集成问题。政策干预应优先考虑这些领域,以提高用户满意度和系统可持续性。本研究着眼于坦桑尼亚的医疗保健提供者如何使用电子健康记录系统,这是存储患者信息的数字工具。结果表明,当记录可靠、易于使用,并得到强有力的培训和领导支持时,卫生保健工作者更满意并更频繁地使用系统。这些见解可以帮助医疗机构改进数字系统,为患者提供更好的医疗服务
{"title":"Determinants of EHR systems’ usability and provider satisfaction in public primary healthcare facilities in Tanzania","authors":"Augustino Mwogosi","doi":"10.1016/j.hlpt.2025.101076","DOIUrl":"10.1016/j.hlpt.2025.101076","url":null,"abstract":"<div><h3>Background</h3><div>Tanzania has prioritized EHR systems adoption through systems like GoTHoMIS to enhance healthcare delivery and data management. However, the success of EHR implementation depends critically on system usability and healthcare providers’ satisfaction, which influence system acceptance and continued use.</div></div><div><h3>Objectives</h3><div>This study assessed the determinants of EHR system usability and satisfaction among healthcare providers in Tanzania’s public primary healthcare facilities. Specific objectives were to examine the influence of EHR system usability on provider satisfaction, the role of organizational factors, the contribution of usability to frequency of system use, and variations across demographic and professional groups.</div></div><div><h3>Methods</h3><div>A cross-sectional quantitative survey was conducted among 288 healthcare providers in Dodoma and Dar es Salaam regions. The regions were purposively selected to represent urban, peri‑urban and rural settings based on EHR system implementation maturity. Data were collected through a structured questionnaire administered via Google Forms. Google Forms data were encrypted and complied with Tanzania’s Data Protection Act 2022. Multiple linear regression and Structural Equation Modeling using SmartPLS were employed to analyze factors associated with EHR systems satisfaction and usage frequency.</div></div><div><h3>Results</h3><div>Improvement in work efficiency was the strongest predictor of provider satisfaction (β = 0.258, <em>p</em> < 0.001), followed by system reliability, adequate training, and organizational support. Factors such as ease of integration into clinical workflows and enhancement of collaboration significantly predicted the frequency of EHR system use. Demographic variables had limited moderating effects. Generally, system usability, organizational environment, and perceived efficiency gains were critical for successful EHR adoption.</div></div><div><h3>Conclusion</h3><div>Effective EHR systems implementation in primary healthcare settings in Tanzania requires a complex approach addressing not only technical usability but also organizational support, user training, and workflow integration. Policy interventions should prioritize these areas to enhance user satisfaction and system sustainability.</div></div><div><h3>Public interest summary</h3><div>This study looked at how healthcare providers in Tanzania use electronic health record systems, which are digital tools for storing patient information. The results showed that healthcare workers were more satisfied and used the systems more often when the records were reliable, easy to use, and supported by strong training and leadership. These insights could help healthcare organizations improve digital systems and make healthcare services better for patients</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101076"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-08-30DOI: 10.1016/j.hlpt.2025.101108
Casper Craamer , Thomas Timmers , Walter van der Weegen , Rudolf B Kool
Background
Computer-assisted history taking (CAHT) could increase patient flow efficiency and healthcare resources optimization. By assessing reported clinical and patient-reported outcomes, we can clarify the benefits, limitations, and practical considerations of CAHT in clinical care. This systematic review synthesizes literature on CAHT in acute and elective care.
Methods
This systematic review followed PRISMA guidelines. A comprehensive search of MEDLINE, Embase, CINAHL, and Web of Science identified studies published between January 2014 and December 2024. Two reviewers independently screened articles, assessed study quality, and extracted data narratively.
Results
In total, 19 studies (involving 11,885 unique patients and 151 healthcare providers) were included. CAHT-questionnaire completion rates were high (75–95%) in larger samples but lower (51–67%) in smaller ones. Satisfaction was consistently high across different delivery methods and devices. Positive outcomes on patient engagement, such as active involvement and enhanced communication, were demonstrated. Clinical efficiency did improve in terms of streamlined workflows and resource utilization. Mixed results were reported on consultation duration. Finally, improved diagnostic accuracy was reported through comprehensive data capture and better alignment with clinical standards.
Conclusion
CAHT offers opportunities to contribute to patient engagement, workflows, and diagnostic accuracy, with high completion rates. We need sound implementation studies to explore how CAHT-systems can streamline processes and minimize needed resources. Future implementations should ensure integration into electronic health records and address digital inclusion across age groups and regions to realize CAHT’s potential in routine, patient-centered care.
计算机辅助历史记录(CAHT)可以提高患者流程效率并优化医疗资源。通过评估报告的临床和患者报告的结果,我们可以澄清临床护理中CAHT的益处、局限性和实际考虑。本系统综述综合了CAHT在急性和择期护理方面的文献。方法本系统评价遵循PRISMA指南。对MEDLINE, Embase, CINAHL和Web of Science进行全面搜索,确定了2014年1月至2024年12月之间发表的研究。两位审稿人独立筛选文章,评估研究质量,并以叙述方式提取数据。结果共纳入19项研究,涉及11,885名特殊患者和151名医护人员。caht问卷完成率在较大样本中较高(75-95%),而在较小样本中较低(51-67%)。在不同的交付方式和设备中,满意度始终很高。患者参与的积极结果,如积极参与和加强沟通,被证明。在简化工作流程和资源利用方面,临床效率确实有所提高。关于咨询时间的报告结果好坏参半。最后,通过全面的数据采集和更好地符合临床标准,提高了诊断的准确性。结论caht提供了促进患者参与、工作流程和诊断准确性的机会,并具有高完成率。我们需要进行合理的实施研究,以探索caht系统如何简化流程并最大限度地减少所需资源。未来的实施应确保整合到电子健康记录中,并解决跨年龄组和地区的数字包容问题,以实现CAHT在以患者为中心的常规护理中的潜力。
{"title":"Computer assisted history taking in elective and acute care: Systematic review","authors":"Casper Craamer , Thomas Timmers , Walter van der Weegen , Rudolf B Kool","doi":"10.1016/j.hlpt.2025.101108","DOIUrl":"10.1016/j.hlpt.2025.101108","url":null,"abstract":"<div><h3>Background</h3><div>Computer-assisted history taking (CAHT) could increase patient flow efficiency and healthcare resources optimization. By assessing reported clinical and patient-reported outcomes, we can clarify the benefits, limitations, and practical considerations of CAHT in clinical care. This systematic review synthesizes literature on CAHT in acute and elective care.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines. A comprehensive search of MEDLINE, Embase, CINAHL, and Web of Science identified studies published between January 2014 and December 2024. Two reviewers independently screened articles, assessed study quality, and extracted data narratively.</div></div><div><h3>Results</h3><div>In total, 19 studies (involving 11,885 unique patients and 151 healthcare providers) were included. CAHT-questionnaire completion rates were high (75–95%) in larger samples but lower (51–67%) in smaller ones. Satisfaction was consistently high across different delivery methods and devices. Positive outcomes on patient engagement, such as active involvement and enhanced communication, were demonstrated. Clinical efficiency did improve in terms of streamlined workflows and resource utilization. Mixed results were reported on consultation duration. Finally, improved diagnostic accuracy was reported through comprehensive data capture and better alignment with clinical standards.</div></div><div><h3>Conclusion</h3><div>CAHT offers opportunities to contribute to patient engagement, workflows, and diagnostic accuracy, with high completion rates. We need sound implementation studies to explore how CAHT-systems can streamline processes and minimize needed resources. Future implementations should ensure integration into electronic health records and address digital inclusion across age groups and regions to realize CAHT’s potential in routine, patient-centered care.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101108"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-08-23DOI: 10.1016/j.hlpt.2025.101107
Yuwen Liu, Zheng Zhang, Yige Chen, Kexin Du, Weiguang Ma
Objective
To review wearable protective devices for individuals at high risk of falling and to analyze the feasibility of these wearable protective tools in reducing fall-related harm.
Design
A systematic search was conducted across 7 databases to identify studies that met the inclusion criteria for analysis.
Results
A total of 31 studies were included. 28 studies involved the design of pre-impact fall protective devices, while 3 studies utilized commercially available products. The primary target population was the elderly, with some designed for children, blind person, and patients with craniocerebral disease. The wearing methods mainly included clothing, accessories, and protective gears. The protective areas primarily focused on the hip or head. The core components of these tools were airbags triggered by falls or protective layers made of special materials. 11 devices included emergency call systems. 7 studies conducted clinical trials for empirical, showing protective tools had certain effectiveness in mitigating injuries caused by falls, but some of these devices exhibit poor wearing comfort and compliance among users.
Conclusions
The targeted design of the application population and the design of wearable pre-impact fall protection system need to be further improved. The effectiveness of these devices in practical application needs to be verified by more clinical studies.
{"title":"Wearable pre-impact fall protection system: a scoping review","authors":"Yuwen Liu, Zheng Zhang, Yige Chen, Kexin Du, Weiguang Ma","doi":"10.1016/j.hlpt.2025.101107","DOIUrl":"10.1016/j.hlpt.2025.101107","url":null,"abstract":"<div><h3>Objective</h3><div>To review wearable protective devices for individuals at high risk of falling and to analyze the feasibility of these wearable protective tools in reducing fall-related harm.</div></div><div><h3>Design</h3><div>A systematic search was conducted across 7 databases to identify studies that met the inclusion criteria for analysis.</div></div><div><h3>Results</h3><div>A total of 31 studies were included. 28 studies involved the design of pre-impact fall protective devices, while 3 studies utilized commercially available products. The primary target population was the elderly, with some designed for children, blind person, and patients with craniocerebral disease. The wearing methods mainly included clothing, accessories, and protective gears. The protective areas primarily focused on the hip or head. The core components of these tools were airbags triggered by falls or protective layers made of special materials. 11 devices included emergency call systems. 7 studies conducted clinical trials for empirical, showing protective tools had certain effectiveness in mitigating injuries caused by falls, but some of these devices exhibit poor wearing comfort and compliance among users.</div></div><div><h3>Conclusions</h3><div>The targeted design of the application population and the design of wearable pre-impact fall protection system need to be further improved. The effectiveness of these devices in practical application needs to be verified by more clinical studies.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101107"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-07-13DOI: 10.1016/j.hlpt.2025.101071
Marie-Lien Gerits, Samantha Bielen
Objectives
Contingent valuation (CV) is widely used in health economics, as it enables the quantification of diverse benefits within a single monetary measure. However, a key methodological debate that remains underexplored is whether patients or non-patients should complete the CV task and how this choice may influence willingness to pay (WTP) estimates. This study aimed to investigate that question in the context of two home blood pressure (BP) monitoring approaches for pregnant women at risk of gestational hypertensive disorders, remote monitoring (RM) and patient self-monitoring (PSM). We also examined the role of patient status and treatment experience in shaping WTP.
Methods
The WTP of 199 patients and 222 non-patients was examined using a CV survey, combining a payment card and open-ended question. Propensity score matching analysis with regression adjustment assessed WTP differences between patients and non-patients. Subgroup analyses explored whether these differences were driven solely by being a patient or also by home BP monitoring experience.
Results
The mean WTP was €130 for RM and €85 for PSM. Patients exhibited a €31 higher WTP for RM compared to non-patients, a difference that was marginally significant at the 10 % level. This effect was driven by treatment experience status. We found no significant difference in WTP PSM between patients and non-patients.
Conclusions
Simply being a patient does not affect WTP for home BP monitoring. When patients have treatment experience, this can increase WTP compared to non-patients, but not for approaches for which the potential benefits are apparent without experiencing them, like PSM.
{"title":"Willingness to pay for remote and self-monitoring: Comparing patients and non-patients in gestational hypertensive care","authors":"Marie-Lien Gerits, Samantha Bielen","doi":"10.1016/j.hlpt.2025.101071","DOIUrl":"10.1016/j.hlpt.2025.101071","url":null,"abstract":"<div><h3>Objectives</h3><div>Contingent valuation (CV) is widely used in health economics, as it enables the quantification of diverse benefits within a single monetary measure. However, a key methodological debate that remains underexplored is whether patients or non-patients should complete the CV task and how this choice may influence willingness to pay (WTP) estimates. This study aimed to investigate that question in the context of two home blood pressure (BP) monitoring approaches for pregnant women at risk of gestational hypertensive disorders, remote monitoring (RM) and patient self-monitoring (PSM). We also examined the role of patient status and treatment experience in shaping WTP.</div></div><div><h3>Methods</h3><div>The WTP of 199 patients and 222 non-patients was examined using a CV survey, combining a payment card and open-ended question. Propensity score matching analysis with regression adjustment assessed WTP differences between patients and non-patients. Subgroup analyses explored whether these differences were driven solely by being a patient or also by home BP monitoring experience.</div></div><div><h3>Results</h3><div>The mean WTP was €130 for RM and €85 for PSM. Patients exhibited a €31 higher WTP for RM compared to non-patients, a difference that was marginally significant at the 10 % level. This effect was driven by treatment experience status. We found no significant difference in WTP PSM between patients and non-patients.</div></div><div><h3>Conclusions</h3><div>Simply being a patient does not affect WTP for home BP monitoring. When patients have treatment experience, this can increase WTP compared to non-patients, but not for approaches for which the potential benefits are apparent without experiencing them, like PSM.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101071"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-07-26DOI: 10.1016/j.hlpt.2025.101077
Akhil Sasidharan , Sajith Kumar S , Suchitralakshmi G , Kavitha Rajsekar , Bhavani Shankara Bagepally
Background
Heart failure with reduced ejection fraction (HFrEF) imposes significant clinical burden and costs in India. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated clinical benefits, their cost-effectiveness within the Indian healthcare perspective remains unassessed.
Methods
A Markov model with a lifetime horizon and one-year cycles was developed to evaluate the cost-effectiveness of SGLT2i as an add-on therapy to standard of care (SoC) compared to SoC alone in patients with HFrEF in India. The analysis adopted an abridged societal perspective, incorporating direct medical and non-medical costs, as well as out-of-pocket expenditures. Clinical efficacy data were obtained from meta-analyses while cost data were sourced from published Indian studies and databases. Costs (2024) and Quality-Adjusted Life Years (QALYs) were used to determine the incremental cost-utility ratio (ICURs). A willingness-to-pay (WTP) threshold of one time India’s GDP per capita [₹2,26,765 (US$2,710)] per QALY was used. Uncertainty was assessed through one-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA). Scenario analyses were conducted to test structural assumptions, and a price threshold analysis was performed to estimate the price at which SGLT2i would become cost-effective.
Results
Despite additional gains in QALYs, add-on SGLT2i were not cost-effective at their current market prices, with an ICUR of ₹6,12,406 (US$7,318) per QALY. Cost-effectiveness estimates were sensitive to variations in drug pricing. PSA confirmed the robustness of these findings. Price threshold analysis indicated that a 71 % reduction in the average market prices for SGLT2i would be required for cost-effectiveness.
Conclusions
While SGLT2i improve clinical outcomes in HFrEF, their current cost renders them not cost-effective in the Indian healthcare setting. Substantial price reductions, potentially through price negotiations with manufacturers, are necessary to enhance their affordability and optimize resource allocation for Heart failure management in India.
{"title":"Cost-utility analysis of add-on SGLT2 inhibitors for heart failure with reduced ejection fraction in India","authors":"Akhil Sasidharan , Sajith Kumar S , Suchitralakshmi G , Kavitha Rajsekar , Bhavani Shankara Bagepally","doi":"10.1016/j.hlpt.2025.101077","DOIUrl":"10.1016/j.hlpt.2025.101077","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with reduced ejection fraction (HFrEF) imposes significant clinical burden and costs in India. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated clinical benefits, their cost-effectiveness within the Indian healthcare perspective remains unassessed.</div></div><div><h3>Methods</h3><div>A Markov model with a lifetime horizon and one-year cycles was developed to evaluate the cost-effectiveness of SGLT2i as an add-on therapy to standard of care (SoC) compared to SoC alone in patients with HFrEF in India. The analysis adopted an abridged societal perspective, incorporating direct medical and non-medical costs, as well as out-of-pocket expenditures. Clinical efficacy data were obtained from meta-analyses while cost data were sourced from published Indian studies and databases. Costs (2024) and Quality-Adjusted Life Years (QALYs) were used to determine the incremental cost-utility ratio (ICURs). A willingness-to-pay (WTP) threshold of one time India’s GDP per capita [₹2,26,765 (US$2,710)] per QALY was used. Uncertainty was assessed through one-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA). Scenario analyses were conducted to test structural assumptions, and a price threshold analysis was performed to estimate the price at which SGLT2i would become cost-effective.</div></div><div><h3>Results</h3><div>Despite additional gains in QALYs, add-on SGLT2i were not cost-effective at their current market prices, with an ICUR of ₹6,12,406 (US$7,318) per QALY. Cost-effectiveness estimates were sensitive to variations in drug pricing. PSA confirmed the robustness of these findings. Price threshold analysis indicated that a 71 % reduction in the average market prices for SGLT2i would be required for cost-effectiveness.</div></div><div><h3>Conclusions</h3><div>While SGLT2i improve clinical outcomes in HFrEF, their current cost renders them not cost-effective in the Indian healthcare setting. Substantial price reductions, potentially through price negotiations with manufacturers, are necessary to enhance their affordability and optimize resource allocation for Heart failure management in India.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101077"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-09DOI: 10.1016/j.hlpt.2025.101115
Pablo Gaitán-Rossi , Jair Yañez-Santaolalla , Andrea Jiménez-Ortiz , Brenda Zaira Tapia-Hernández , Hortensia Reyes-Morales
Objective
Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.
Methods
Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.
Results
At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.
Conclusions
The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.
Lay summary
During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.
{"title":"Mexico city monitoring system during the COVID-19 pandemic: A case-study","authors":"Pablo Gaitán-Rossi , Jair Yañez-Santaolalla , Andrea Jiménez-Ortiz , Brenda Zaira Tapia-Hernández , Hortensia Reyes-Morales","doi":"10.1016/j.hlpt.2025.101115","DOIUrl":"10.1016/j.hlpt.2025.101115","url":null,"abstract":"<div><h3>Objective</h3><div>Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.</div></div><div><h3>Methods</h3><div>Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.</div></div><div><h3>Results</h3><div>At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.</div></div><div><h3>Conclusions</h3><div>The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.</div></div><div><h3>Lay summary</h3><div>During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101115"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}