The countrywide lockdown in India has necessitated healthcare providers consider alternate options for providing care during the COVID-19 pandemic. While there has been a tremendous focus in coping with emergency and inpatient care for COVID-19 related illness, there is also an increasing need to address management of non-communicable disease. The pandemic and the associated lockdown have witnessed the onset or worsening of sleep disorders often related to changing lifestyle, including inactivity, fear of the disease, and generalised anxiety caused by the uncertainty of the future. We propose the term ‘Lockdown Sleep Syndrome’ to describe this grouping of signs and symptoms. The wide coverage and extensive use of smartphones and more importantly, the appropriately timed Telemedicine Practice Guidelines from the Government of India, have made telehealth an attractive option, particularly in specialities such as Sleep Medicine which involves minimal physical examination. The experience of restricting personal visits to the clinic and promoting teleconsultation during the initial fifty days of lockdown is described. It was observed that two thirds of consultations shifted to a telehealth platform, and this was effective in giving satisfactory care and valid prescriptions, including to those outside the city of Chennai. Telemedicine not only helped provide uncompromised care to existing patients but also helped in identifying and managing the onset of new sleep problems with a pattern of signs and symptoms which are described as “Lockdown Sleep Syndrome”.
{"title":"Tele-sleep Medicine: An Opportunity in a Crisis","authors":"N. Ramakrishnan, Pon Thelac, Nileena Mana","doi":"10.29086/jisfteh.8.e7","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e7","url":null,"abstract":"The countrywide lockdown in India has necessitated healthcare providers consider alternate options for providing care during the COVID-19 pandemic. While there has been a tremendous focus in coping with emergency and inpatient care for COVID-19 related illness, there is also an increasing need to address management of non-communicable disease. The pandemic and the associated lockdown have witnessed the onset or worsening of sleep disorders often related to changing lifestyle, including inactivity, fear of the disease, and generalised anxiety caused by the uncertainty of the future. We propose the term ‘Lockdown Sleep Syndrome’ to describe this grouping of signs and symptoms. The wide coverage and extensive use of smartphones and more importantly, the appropriately timed Telemedicine Practice Guidelines from the Government of India, have made telehealth an attractive option, particularly in specialities such as Sleep Medicine which involves minimal physical examination. The experience of restricting personal visits to the clinic and promoting teleconsultation during the initial fifty days of lockdown is described. It was observed that two thirds of consultations shifted to a telehealth platform, and this was effective in giving satisfactory care and valid prescriptions, including to those outside the city of Chennai. Telemedicine not only helped provide uncompromised care to existing patients but also helped in identifying and managing the onset of new sleep problems with a pattern of signs and symptoms which are described as “Lockdown Sleep Syndrome”.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41432520","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}
S. Shimizu, Shunta Tomimatsu, Kuriko Kudo, Shintaro Ueda, A. Kekalih, D. Makmun, R. Estiasari, A. Oki, T. Moriyama
Introduction: With ongoing development of technology, and especially amid the current COVID-19 pandemic, there is rapidly increasing need for remote communications, including in the field of medical education. This study aimed to evaluate our telemedicine activities between Japan and Indonesia. Methods: We retrospectively analysed the data acquired for the period 2010–2019 inclusive, looking at number of programmes, content, participating sites, and videoconferencing systems. We also digitally sent questionnaires to attendees to request their evaluation of image quality and programmes. Results: There were a total 135 programmes, with 29 participating institutions in Indonesia. The number of programmes increased rapidly in 2017, following a rapid increase of participating sites in 2016. Programmes included endoscopy (50 programmes, 37%), neurology (25, 19%), and dentistry (12, 9%). Between 5 and 10 sites connected with 81 programmes (60% of all), and more than 10 sites with 33 (24%). The most commonly used videoconferencing system was Vidyo (108, 80%), followed by Zoom (15, 11%). Participating institutions were located among 19 cities on the five major islands. Image quality received a favourable evaluation from 98% (504/516) of questionnaire respondents, with 100% (400/400) holding a favourable view of the programmes. Conclusion: Remote medical education expanded in Indonesia in the 10 years under review. This expansion is expected to continue to foster more specialists and it is anticipated to improve medical care nationwide.
{"title":"Remote Medical Education in Indonesia: Analysis of 10 Years of Activities","authors":"S. Shimizu, Shunta Tomimatsu, Kuriko Kudo, Shintaro Ueda, A. Kekalih, D. Makmun, R. Estiasari, A. Oki, T. Moriyama","doi":"10.29086/jisfteh.8.e6","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e6","url":null,"abstract":"Introduction: With ongoing development of technology, and especially amid the current COVID-19 pandemic, there is rapidly increasing need for remote communications, including in the field of medical education. This study aimed to evaluate our telemedicine activities between Japan and Indonesia. Methods: We retrospectively analysed the data acquired for the period 2010–2019 inclusive, looking at number of programmes, content, participating sites, and videoconferencing systems. We also digitally sent questionnaires to attendees to request their evaluation of image quality and programmes. Results: There were a total 135 programmes, with 29 participating institutions in Indonesia. The number of programmes increased rapidly in 2017, following a rapid increase of participating sites in 2016. Programmes included endoscopy (50 programmes, 37%), neurology (25, 19%), and dentistry (12, 9%). Between 5 and 10 sites connected with 81 programmes (60% of all), and more than 10 sites with 33 (24%). The most commonly used videoconferencing system was Vidyo (108, 80%), followed by Zoom (15, 11%). Participating institutions were located among 19 cities on the five major islands. Image quality received a favourable evaluation from 98% (504/516) of questionnaire respondents, with 100% (400/400) holding a favourable view of the programmes. Conclusion: Remote medical education expanded in Indonesia in the 10 years under review. This expansion is expected to continue to foster more specialists and it is anticipated to improve medical care nationwide.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44231083","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}
Telecare services have an established place within the United Kingdom Through using online technologies to help mostly older people to remain at home, they are recognised as having a support role for health as well as social care This positions telecare services within the broader realm of 'digital health' As that position becomes more embedded, it poses questions about the nature of tasks that are (or should be) undertaken by telecare staff, and regarding the knowledge and skills that are required A convergence of telecare and telehealth services is indicated together with a need for some kind of accord or accommodation This paper summarises the United Kingdom policy context;references the technologies that are provided by telecare services or can be linked to them;notes briefly the impact of the COVID-19 pandemic;and proposes six knowledge and skills sets Outcomes of the UTOPIA study undertaken in England from 2016 to 2017 are drawn upon: this study provided important information from over 100 local authority telecare managers
{"title":"Knowledge and Skills Sets for Telecare Service Staff in the Context of Digital Health","authors":"M. Fisk, J. Woolham, N. Steils","doi":"10.29086/JISFTEH.8.E15","DOIUrl":"https://doi.org/10.29086/JISFTEH.8.E15","url":null,"abstract":"Telecare services have an established place within the United Kingdom Through using online technologies to help mostly older people to remain at home, they are recognised as having a support role for health as well as social care This positions telecare services within the broader realm of 'digital health' As that position becomes more embedded, it poses questions about the nature of tasks that are (or should be) undertaken by telecare staff, and regarding the knowledge and skills that are required A convergence of telecare and telehealth services is indicated together with a need for some kind of accord or accommodation This paper summarises the United Kingdom policy context;references the technologies that are provided by telecare services or can be linked to them;notes briefly the impact of the COVID-19 pandemic;and proposes six knowledge and skills sets Outcomes of the UTOPIA study undertaken in England from 2016 to 2017 are drawn upon: this study provided important information from over 100 local authority telecare managers","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42535570","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}
The discipline of public health informatics, part of the broader eHealth field, brings methods, knowledge, and theories from computer science and information science to support population health and well-being. This branch of informatics is most often found in governmental public health agencies that focus on population-level activities, including surveillance of disease as well as disease prevention. There are several specialised public health information systems used to prevent or mitigate disease, including syndromic surveillance, electronic laboratory reporting, and population health dashboards. This article defines and describes public health informatics and its role in eHealth. The article further discusses the role of public health information systems and challenges they face for the future. Strengthening public health will require greater investment in interoperability as well as analytics and the workforce. Disease outbreaks like COVID-19, Ebola, and H1N1 demonstrate the need for robust public health informatics applications and methods. Yet there is much work to be done to evolve existing tools and methods to strengthen the public health infrastructure for the next pandemic.
{"title":"Applied Public Health Informatics: An eHealth Discipline Focused on Populations","authors":"B. Dixon","doi":"10.29086/jisfteh.8.e14","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e14","url":null,"abstract":"The discipline of public health informatics, part of the broader eHealth field, brings methods, knowledge, and theories from computer science and information science to support population health and well-being. This branch of informatics is most often found in governmental public health agencies that focus on population-level activities, including surveillance of disease as well as disease prevention. There are several specialised public health information systems used to prevent or mitigate disease, including syndromic surveillance, electronic laboratory reporting, and population health dashboards. This article defines and describes public health informatics and its role in eHealth. The article further discusses the role of public health information systems and challenges they face for the future. Strengthening public health will require greater investment in interoperability as well as analytics and the workforce. Disease outbreaks like COVID-19, Ebola, and H1N1 demonstrate the need for robust public health informatics applications and methods. Yet there is much work to be done to evolve existing tools and methods to strengthen the public health infrastructure for the next pandemic.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46113086","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}
There is now an urgent need to scale up our collective capability to learn insights from health data, to improve patient care pathways and health services, to ensure that public health measures and strategies are underpinned by real time evidence, and to accelerate research such as the development of drugs, vaccines and AI algorithms. Europe is investing within and across countries in research infrastructures to enable this scaling up, most frequently through federated architectures. The latest development is the plan from the European Commission to create a European Health Data Space. However, any architecture to combine data or to run distributed queries is critically dependent upon the data being held or mapped to a standardised form (structurally and semantically). Standards exist to achieve this, although more stakeholder engagement is needed in defining practical clinical models and value sets, but the real adoption of interoperability is disappointing and needs further incentivisation and investment. Data quality is another concern that can only be improved if there is awareness that this is important, a willingness to invest and a recognition that many stakeholders need to become motivated to improve quality. Scaling up the uses of data also means involving new actors such as industry. Societal trust is a vital prerequisite for enabling novel uses of data. Transparency is a critical success factor for trust. Data access governance rules must be developed through open public consultation. The bodies who make access decisions must publish information about the data accesses they have permitted. For the public to be on board they have to understand much more than most people do about the nature of health data, how it can be used for the benefit of society and what safeguards protect them when the data are used.
{"title":"Scaling up the Big Health Data Ecosystem: Engaging all Stakeholders!","authors":"D. Kalra","doi":"10.29086/jisfteh.8.e16","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e16","url":null,"abstract":"There is now an urgent need to scale up our collective capability to learn insights from health data, to improve patient care pathways and health services, to ensure that public health measures and strategies are underpinned by real time evidence, and to accelerate research such as the development of drugs, vaccines and AI algorithms. Europe is investing within and across countries in research infrastructures to enable this scaling up, most frequently through federated architectures. The latest development is the plan from the European Commission to create a European Health Data Space. However, any architecture to combine data or to run distributed queries is critically dependent upon the data being held or mapped to a standardised form (structurally and semantically). Standards exist to achieve this, although more stakeholder engagement is needed in defining practical clinical models and value sets, but the real adoption of interoperability is disappointing and needs further incentivisation and investment. Data quality is another concern that can only be improved if there is awareness that this is important, a willingness to invest and a recognition that many stakeholders need to become motivated to improve quality. Scaling up the uses of data also means involving new actors such as industry. Societal trust is a vital prerequisite for enabling novel uses of data. Transparency is a critical success factor for trust. Data access governance rules must be developed through open public consultation. The bodies who make access decisions must publish information about the data accesses they have permitted. For the public to be on board they have to understand much more than most people do about the nature of health data, how it can be used for the benefit of society and what safeguards protect them when the data are used.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43335628","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}
Using advances in information and communication technologies (ICT), telemedicine and eHealth are providing a means to transform systems of care for people throughout the world by providing greater access to clinical service, consultation, sharing knowledge, education and training, public and community health, health systems development, epidemiology and research. Leap-frogging over prior barriers, rapid advances in information communication technologies (ICT), computing, and wireless networks are offering greater continuity in access to these services in both developed and developing countries. The use of telehealth must be put in the context of the critical health needs in each country, cultural perspectives, current and future communication infrastructure, other supportive resources, and likelihood for sustainability. Furthermore, these telehealth efforts should be aimed at improving the local capacity in providing ongoing health services in each country and blend into that country’s current and future health care strategies. As the world continues to “shrink”, developing this international telehealth “network of networks” offers an opportunity for cooperation, collaboration, knowledge sharing and improving the health of every individual in the world, applying information technologies for peace and the betterment of mankind. The time is now for open and constructive dialogue designed to facilitate that coordination between key stakeholders and other international organisations. These types of international exchange experiences enhanced with telehealth offer significant opportunities for understanding the common denominators, as well as unique differences, related to global health among countries and cultures around the world. These programs can promote international understanding and mutual respect in a manner that can improve the health of the entire global community.
{"title":"The International Digital Transformation of Healthcare: Telehealth Development in the Global Community","authors":"D. Alverson","doi":"10.29086/jisfteh.8.e13","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e13","url":null,"abstract":"Using advances in information and communication technologies (ICT), telemedicine and eHealth are providing a means to transform systems of care for people throughout the world by providing greater access to clinical service, consultation, sharing knowledge, education and training, public and community health, health systems development, epidemiology and research. Leap-frogging over prior barriers, rapid advances in information communication technologies (ICT), computing, and wireless networks are offering greater continuity in access to these services in both developed and developing countries. The use of telehealth must be put in the context of the critical health needs in each country, cultural perspectives, current and future communication infrastructure, other supportive resources, and likelihood for sustainability. Furthermore, these telehealth efforts should be aimed at improving the local capacity in providing ongoing health services in each country and blend into that country’s current and future health care strategies. As the world continues to “shrink”, developing this international telehealth “network of networks” offers an opportunity for cooperation, collaboration, knowledge sharing and improving the health of every individual in the world, applying information technologies for peace and the betterment of mankind. The time is now for open and constructive dialogue designed to facilitate that coordination between key stakeholders and other international organisations. These types of international exchange experiences enhanced with telehealth offer significant opportunities for understanding the common denominators, as well as unique differences, related to global health among countries and cultures around the world. These programs can promote international understanding and mutual respect in a manner that can improve the health of the entire global community.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49258491","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}
Objectives: Health services have been disrupted due to Coronavirus disease 2019 (COVID-19). With patients, unable to access face to face healthcare, many turn to sources such as the Internet for health-related information. Other patients ignore all other health related issues and focus on the threat posed by a pandemic. This study sought to analyse the Internet health-seeking behaviour related to urological cancer of patients in the United Kingdom (UK) during the COVID-19 Pandemic. Methods: Internet search volumes over a 3-month period, during the UK pandemic, were analysed using Google TrendsTM to obtain a search volume index (SVI) and compared to an equivalent pre COVID-19 period. The SVI measures relative search volume and was obtained for “Prostate Cancer”, “Kidney Cancer”, “Bladder Cancer” and Testicular Cancer” searches. Results: The average SVI for Prostate Cancer before the COVID-19 pandemic was 49.3, compared to 42.6 during the pandemic (p=0.001). Kidney cancer had an average SVI of 45.5 before the pandemic compared to 35.4 during the pandemic (p <0.001). Similar results were obtained for Bladder and Testicular Cancer. There was a 23% decrease in SVI for urological cancer searches during the pandemic compared to before the pandemic (p <0.001). Conclusions: The decline in searches for urological cancer during the pandemic may have implications. Patients maybe ignoring new cancer related symptoms which could result in late diagnoses, public health campaigns are required. Patients with cancer may not be utilising online resources available to them and healthcare professionals should reach out to patients at a time when face-face interaction is limited.
{"title":"The Impact of COVID-19 on Urological Cancer: An internet Search Volume Analysis","authors":"D. Nyanhongo","doi":"10.29086/jisfteh.8.e12","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e12","url":null,"abstract":"Objectives: Health services have been disrupted due to Coronavirus disease 2019 (COVID-19). With patients, unable to access face to face healthcare, many turn to sources such as the Internet for health-related information. Other patients ignore all other health related issues and focus on the threat posed by a pandemic. This study sought to analyse the Internet health-seeking behaviour related to urological cancer of patients in the United Kingdom (UK) during the COVID-19 Pandemic. Methods: Internet search volumes over a 3-month period, during the UK pandemic, were analysed using Google TrendsTM to obtain a search volume index (SVI) and compared to an equivalent pre COVID-19 period. The SVI measures relative search volume and was obtained for “Prostate Cancer”, “Kidney Cancer”, “Bladder Cancer” and Testicular Cancer” searches. Results: The average SVI for Prostate Cancer before the COVID-19 pandemic was 49.3, compared to 42.6 during the pandemic (p=0.001). Kidney cancer had an average SVI of 45.5 before the pandemic compared to 35.4 during the pandemic (p <0.001). Similar results were obtained for Bladder and Testicular Cancer. There was a 23% decrease in SVI for urological cancer searches during the pandemic compared to before the pandemic (p <0.001). Conclusions: The decline in searches for urological cancer during the pandemic may have implications. Patients maybe ignoring new cancer related symptoms which could result in late diagnoses, public health campaigns are required. Patients with cancer may not be utilising online resources available to them and healthcare professionals should reach out to patients at a time when face-face interaction is limited.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48959513","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}
The advent of digital technology in healthcare presents opportunities for the improvement of healthcare systems around the world and the move towards value-based treatment. However, this move must be accompanied by strong legal and regulatory frameworks that will not only facilitate but encourage the good use of technology. The goal of the study was to assess the amenability and furtherance of regulatory frameworks in digital health by evaluating and comparing the processes, effectiveness and outcomes of these frameworks in the European Union and United States. Methods: This study incorporated two research methodologies. The first was a research of current legal and regulatory frameworks in digital health in the European Union and United States. A comprehensive online search for publications was carried out which included laws, regulations, policies, green papers, guidelines and recommendations. This research was complemented with interviews of five purposively sampled key informants in the legal and regulatory landscape. Results: Mind-maps revealed key features and challenges of the digital health field in the topics of the current state of regulation of digital health in the EU, Germany and US, regulatory pathways for digital health devices, protection and privacy of health data, mobile health validation, risk-based classification of medical devices, regulation of clinical decision support systems, telemedicine, artificial intelligence and emerging technologies, reimbursement for digital health services and liability for digital health products. The experts expressed and explained key points where current regulation is deficient. The review of the legal frameworks revealed deficiencies which provide opportunities and recommendations to further develop and strengthen the regulatory landscape. Conclusions: A key element to a robust regulatory framework is the ability to ensure trust and confidence in using digital health technology. Technology must measure the impact on quality of life and burden of disease and not merely involve the collection of data.
{"title":"Analysis of Legal and Regulatory Frameworks in Digital Health: A Comparison of Guidelines and Approaches in the European Union and United States","authors":"Fara Aninha Fernandes, Georgi V Chaltikyan","doi":"10.29086/jisfteh.8.e11","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e11","url":null,"abstract":"The advent of digital technology in healthcare presents opportunities for the improvement of healthcare systems around the world and the move towards value-based treatment. However, this move must be accompanied by strong legal and regulatory frameworks that will not only facilitate but encourage the good use of technology. The goal of the study was to assess the amenability and furtherance of regulatory frameworks in digital health by evaluating and comparing the processes, effectiveness and outcomes of these frameworks in the European Union and United States. Methods: This study incorporated two research methodologies. The first was a research of current legal and regulatory frameworks in digital health in the European Union and United States. A comprehensive online search for publications was carried out which included laws, regulations, policies, green papers, guidelines and recommendations. This research was complemented with interviews of five purposively sampled key informants in the legal and regulatory landscape. Results: Mind-maps revealed key features and challenges of the digital health field in the topics of the current state of regulation of digital health in the EU, Germany and US, regulatory pathways for digital health devices, protection and privacy of health data, mobile health validation, risk-based classification of medical devices, regulation of clinical decision support systems, telemedicine, artificial intelligence and emerging technologies, reimbursement for digital health services and liability for digital health products. The experts expressed and explained key points where current regulation is deficient. The review of the legal frameworks revealed deficiencies which provide opportunities and recommendations to further develop and strengthen the regulatory landscape. Conclusions: A key element to a robust regulatory framework is the ability to ensure trust and confidence in using digital health technology. Technology must measure the impact on quality of life and burden of disease and not merely involve the collection of data.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43026560","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}
Telemedicine used to be slow, difficult, expensive and widely neglected by doctors and patients. COVID-19 changed everything; telemedicine is entering a period of rapid economic and business growth. This paper discusses the reasons for change in telemedicine over the last 20 years, through real-life medical technology projects, telemetry, ehealth and health IT. Our methods are based on the analysis of telemedicine projects we have implemented and characteristic historical data. The results of our investigation demonstrate a clear increase of significance in telemedicine in the present and near future. We envision the evolution of mobile phones to personal telehealth monitors. Prior to COVID-19, market penetration and economic factors of telemedicine evolved slowly and in an uneven manner on a global scale. Many of the projects remained active only as long as the grant or corporate or national support was provided. The age of novel globally spreading infectious diseases, exemplified by COVID-19, has created an unusual, different setting. Recent pandemics and epidemics have changed global economics significantly and generated a new motivation and a new market with a projected trillion-dollar market value. Post COVID-19, regular and periodic epidemics and pandemics are expected to continue to occur. This will generate an enormous global market for isolated high-tech services, including telemedicine and telemetry.
{"title":"Telemedicine Pre and Post Covid-19: Lessons for Commercialisation Based on Previous Use Cases","authors":"G. Ferenczi, A. Mahmood, R. Bergmann","doi":"10.29086/jisfteh.8.e8","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e8","url":null,"abstract":"Telemedicine used to be slow, difficult, expensive and widely neglected by doctors and patients. COVID-19 changed everything; telemedicine is entering a period of rapid economic and business growth. This paper discusses the reasons for change in telemedicine over the last 20 years, through real-life medical technology projects, telemetry, ehealth and health IT. Our methods are based on the analysis of telemedicine projects we have implemented and characteristic historical data. The results of our investigation demonstrate a clear increase of significance in telemedicine in the present and near future. We envision the evolution of mobile phones to personal telehealth monitors. Prior to COVID-19, market penetration and economic factors of telemedicine evolved slowly and in an uneven manner on a global scale. Many of the projects remained active only as long as the grant or corporate or national support was provided. The age of novel globally spreading infectious diseases, exemplified by COVID-19, has created an unusual, different setting. Recent pandemics and epidemics have changed global economics significantly and generated a new motivation and a new market with a projected trillion-dollar market value. Post COVID-19, regular and periodic epidemics and pandemics are expected to continue to occur. This will generate an enormous global market for isolated high-tech services, including telemedicine and telemetry.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49517761","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}
This article explores digital technology used in the health sector today. There are several ways digital technology is being used for quantitative study aims during the current COVID-19 Pandemic e.g. online symptom checkers. The knowledge gap in COVID-19 as in all novel conditions, consist of both quantitative and qualitative attributes. Digital tool use is prevalent during the COVID-19 Pandemic but most of the data being collected is quantitative in nature. We therefore recommend taking advantage of this telemedicine era and explore optimisation of qualitative data collection, for the purpose of gaining a better understanding of the phenomenon.
{"title":"Telemedicine and Online Platforms as an Opportunity to Optimise Qualitative Data Collection, Explore and Understand Disease Pathways in a Novel Pandemic Like COVID-19","authors":"J. Michel, W. Hautz, T. Sauter","doi":"10.29086/jisfteh.8.e9","DOIUrl":"https://doi.org/10.29086/jisfteh.8.e9","url":null,"abstract":"This article explores digital technology used in the health sector today. There are several ways digital technology is being used for quantitative study aims during the current COVID-19 Pandemic e.g. online symptom checkers. The knowledge gap in COVID-19 as in all novel conditions, consist of both quantitative and qualitative attributes. Digital tool use is prevalent during the COVID-19 Pandemic but most of the data being collected is quantitative in nature. We therefore recommend taking advantage of this telemedicine era and explore optimisation of qualitative data collection, for the purpose of gaining a better understanding of the phenomenon.","PeriodicalId":93212,"journal":{"name":"Journal of the International Society for Telemedicine and eHealth","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69683822","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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