Digital health solutions: Improving administrative workflow in community health centers
Keywords:
digital health, rheumatoid arthritis, home monitoring, stakeholder engagement, participatory design, healthcare workflowAbstract
Background: Digital health interventions leverage telecommunication and virtual technologies to extend healthcare services beyond traditional settings. With increasing demand for healthcare systems, the integration of digital solutions has gained prominence. Rheumatoid arthritis (RA) management often requires time-intensive hospital visits, which complicates care delivery. Aim: The study aimed to design and implement a digital health solution for home-based monitoring of RA progression and treatment outcomes, reducing the need for outpatient visits. Methods: A stakeholder-centric approach was employed between 2015-2017. Data collection methods included previously published articles, reviews, interviews, cultural probes, and participatory workshops. Feedback was continuously integrated to refine the system. Results: Stakeholders appreciated the potential of reduced clinic visits through home monitoring. However, concerns emerged about resource allocation and the impact on clinical workflows. Nurses and doctors expressed differing views on handling patient data and responsibilities, revealing both opportunities and challenges in implementing digital solutions. Conclusion: The study highlights the benefits of integrating digital health interventions, such as reducing travel time and enabling continuous monitoring for RA patients. However, successful implementation requires addressing concerns related to workflow changes, resource allocation, and patient demographics.
Downloads
References
World Health Organization. 2010. Opportunities and developments in Member States URL: http://www.who.int/goe/publications/goe_telemedicine_2010.pdf
Dinesen B, Nonnecke B, Lindeman D, Toft E, Kidholm K, Jethwani K, et al. Personalized Telehealth in the Future: A Global Research Agenda. J Med Internet Res 2016 Mar 01;18(3):e53 DOI: https://doi.org/10.2196/jmir.5257
The Advisory Board. 2014. Critical Disruptions: The 5 Forces Shaping Health Care's Future URL: https://www.advisory.com/international/research/global-forum-for-health-care-innovators/research-briefs/2014/critical-disruptions-the-five-forces-shaping-health-cares-future
KORA. 2017. Fem megatrends der udfordrer fremtidens sundhedsvæsen URL: https://www.kora.dk/media/6844202/11325_fem-megatrends-der-udfordrer-fremtidens-sundhedsvaesen.pdf
Runz-Jørgensen, S. M., Schiøtz, M. L., & Christensen, U. (2017). Perceived value of eHealth among people living with multimorbidity: a qualitative study. Journal of comorbidity, 7(1), 96-111. DOI: https://doi.org/10.15256/joc.2017.7.98
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012 Dec 15;380(9859):2163-2196.
ELECTOR. Changing the Future Care of Arthritis Patients
Spradley J. The ethnograpich interview. In: The ethnograpich interview. Florida, USA: Rinehart and Winston Inc; 1979:0030444969.
Hansen MB, Vedung E. Theory-Based Stakeholder Evaluation. American Journal of Evaluation 2010 Sep 13;31(3):295-313. DOI: https://doi.org/10.1177/1098214010366174
Clemensen J, Larsen SB, Kyng M, Kirkevold M. Participatory design in health sciences: Using cooperative experimental methods in developing health services and computer technology. Qual Health Res 2007 Jan;17(1):122-130. DOI: https://doi.org/10.1177/1049732306293664
Simonsen J, Robertson T. Routledge International Handbook of Participatory Design. In: Routledge International Handbook of Participatory Design. NY, USA: Routledge International; 2013:978-0415720212. DOI: https://doi.org/10.4324/9780203108543
Simonsen J, Svabo C, Strandvad S, Samsom C, Hertzum M. Situated Design Methods. In: Hansen O, editor. Situated Design Methods. -Cambridge, Massachusetts: MIT Press; 2014:13. DOI: https://doi.org/10.7551/mitpress/9936.001.0001
Jaspers MWM, Steen T, van DBC, Geenen M. The think aloud method: a guide to user interface design. Int J Med Inform 2004 Nov;73(11-12):781-795. DOI: https://doi.org/10.1016/j.ijmedinf.2004.08.003
Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: what it is and how to do it. BMJ 2013 Nov 20;347:f6753.
Hassling L, Nordfeldt S, Eriksson H, Timpka T. Use of cultural probes for representation of chronic disease experience: exploration of an innovative method for design of supportive technologies. Technol Health Care 2005;13(2):87-95. DOI: https://doi.org/10.3233/THC-2005-13202
Catwell L, Sheikh A. Evaluating eHealth interventions: the need for continuous systemic evaluation. PLoS Med 2009 Aug;6(8):e1000126 DOI: https://doi.org/10.1371/journal.pmed.1000126
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655 DOI: https://doi.org/10.1136/bmj.a1655
Eysenbach G, CONSORT- E. CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions. J Med Internet Res 2011;13(4):e126 DOI: https://doi.org/10.2196/jmir.1923
Burmester, G. R., & Pope, J. E. (2017). Novel treatment strategies in rheumatoid arthritis. The Lancet, 389(10086), 2338-2348. DOI: https://doi.org/10.1016/S0140-6736(17)31491-5
Van VL, Wentzel J, Van GJE. Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach. JMIR Res Protoc 2013;2(1):e21 DOI: https://doi.org/10.2196/resprot.2547
Castensøe-Seidenfaden P, Reventlov HG, Teilmann G, Hommel E, Olsen BS, Kensing F. Designing a Self-Management App for Young People With Type 1 Diabetes: Methodological Challenges, Experiences, and Recommendations. JMIR Mhealth Uhealth 2017 Oct 23;5(10):e124 DOI: https://doi.org/10.2196/mhealth.8137
AlDossary, S., Martin-Khan, M. G., Bradford, N. K., & Smith, A. C. (2017). A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities. International journal of medical informatics, 97, 171-194. DOI: https://doi.org/10.1016/j.ijmedinf.2016.10.012
World Health Organization. 2012. Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output URL: http://www.who.int/bulletin/volumes/90/5/11-099143/en/ DOI: https://doi.org/10.2471/BLT.11.099143
Patton M. Developmental evaluation: applying complexity concepts to enhance innovation and use. In: Developmental evaluation: applying complexity concepts to enhance innovation and use. London: The Guilford Press; 2011:125-121.
Published
How to Cite
Issue
Section
Copyright (c) 2018 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
