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‘Fit-for-purpose?’ – challenges and opportunities for applications of blockchain technology in the future of healthcare
Blockchain is a shared distributed digital ledger technology that can better facilitate data management, provenance and security, and has the potential to transform healthcare. Importantly, blockchain represents a data architecture, whose application goes far beyond Bitcoin – the cryptocurrency that relies on blockchain and has popularized the technology. In the health sector, blockchain is being aggressively explored by various stakeholders to optimize business processes, lower costs, improve patient outcomes, enhance compliance, and enable better use of healthcare-related data. However, critical in assessing whether blockchain can fulfill the hype of a technology characterized as ‘revolutionary’ and ‘disruptive’, is the need to ensure that blockchain design elements consider actual healthcare needs from the diverse perspectives of consumers, patients, providers, and regulators. In addition, answering the real needs of healthcare stakeholders, blockchain approaches must also be responsive to the unique challenges faced in healthcare compared to other sectors of the economy. In this sense, ensuring that a health blockchain is ‘fit-for-purpose’ is pivotal. This concept forms the basis for this article, where we share views from a multidisciplinary group of practitioners at the forefront of blockchain conceptualization, development, and deployment.
Journal Article
Health Analytics
A hands-on, analytics road map for health industry leaders The industry-wide transformation taking place across the health and life sciences ecosystem is mandating that organizations adopt new decision-making capabilities, based on science and real-world information. Analytics will be a required competency for the modern health enterprise; this book is about how to \"cross the chasm.\" The ultimate analytics guide for the health industry leader, this essential book equips business leaders with little-to-no experience in analytics to understand how to incorporate analytics as a cornerstone of their 21st century competitive business strategy. * Paints the picture for a new health enterprise, one focused on the patient * Explores the financial components of this new operating model, using analytics to optimize the tradeoffs between cost and value * Deals with the rising role of the consumer, using analytics to create a completely new health engagement model with individual recipients of care * Looks at how analytics can drive innovations in care practice, patient-experienced medical outcomes, and analytically driven novel therapies optimized for the individual patient * Presents a variety of text, tables, and graphics illustrating the various concepts being described Within each section and chapter, Health Analytics assesses the current landscape, proposing a new model/concept, sharing real-world stories of how the old and new world come together, and framing a \"how-to\" for the reader in terms of growing that particular set of capabilities in their own enterprises.
eBook
Testing health information technology tools to facilitate health insurance support: a protocol for an effectiveness-implementation hybrid randomized trial
Background
Patients with gaps in health insurance coverage often defer or forgo cancer prevention services. These delays in cancer detection and diagnoses lead to higher rates of morbidity and mortality and increased costs. Recent advances in health information technology (HIT) create new opportunities to enhance insurance support services that reduce coverage gaps through automated processes applied in healthcare settings. This study will assess the implementation of insurance support HIT tools and their effectiveness at improving patients’ insurance coverage continuity and cancer screening rates.
Methods/design
This study uses a hybrid cluster-randomized design—a combined effectiveness and implementation trial—in community health centers (CHCs) in the USA. Eligible CHC clinic sites will be randomly assigned to one of two groups in the trial’s implementation component: tools + basic training (Arm I) and tools + enhanced training + facilitation (Arm II). A propensity score-matched control group of clinics will be selected to assess the tools’ effectiveness. Quantitative analyses of the tools’ impact will use electronic health record and Medicaid data to assess effectiveness. Qualitative data will be collected to evaluate the implementation process, understand how the HIT tools are being used, and identify facilitators and barriers to their implementation and use.
Discussion
This study will test the effectiveness of HIT tools to enhance insurance support in CHCs and will compare strategies for facilitating their implementation in “real-world” practice settings. Findings will inform further development and, if indicated, more widespread implementation of insurance support HIT tools.
Trial registration
Clinical trial
NTC02355262
Journal Article
The increasing value of eHealth in the delivery of patient-centred cancer care
The increasing use of eHealth has ushered in a new era of patient-centred cancer care that moves beyond the traditional in-person care model to real-time, dynamic, and technology-assisted assessments and interventions. eHealth has the potential to better the delivery of cancer care through improved patient–provider communication, enhanced symptom and toxicity assessment and management, and optimised patient engagement across the cancer care continuum. In this Review, we provide a brief, narrative appraisal of the peer reviewed literature over the past 10 years related to the uses of patient-centred eHealth to improve cancer care delivery. These uses include the addressal of symptom management, health-related quality of life, and other patient-reported outcomes across cancer care. In addition, we discuss the challenges of, and opportunities for, accessibility, scalability, and implementation of these technologies, important areas for further development, and future research directions.
Journal Article
What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology
A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than$81 billion annually. Seven years later the empirical data on the technology's impact on health care efficiency and safety are mixed, and annual health care expenditures in the United States have grown by $ 800 billion. In our view, the disappointing performance of health IT to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT. We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more-standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume. [PUBLICATION ABSTRACT]
Journal Article
Maturity Models of Healthcare Information Systems and Technologies: a Literature Review
The maturity models are instruments to facilitate organizational management, including the management of its information systems function. These instruments are used also in hospitals. The objective of this article is to identify and compare the maturity models for management of information systems and technologies (IST) in healthcare. For each maturity model, it is identified the methodology of development and validation, as well as the scope, stages and their characteristics by dimensions or influence factors. This study resulted in the need to develop a maturity model based on a holistic approach. It will include a comprehensive set of influencing factors to reach all areas and subsystems of health care organizations.
Journal Article
Design considerations of a randomized clinical trial on a cognitive behavioural intervention using communication and information technologies for managing chronic low back pain
Background
Psychological treatments have been successful in treating chronic low back pain (CLBP). However, the effect sizes are still modest and there is room for improvement. A way to progress is by enhancing treatment adherence and self-management using information and communication technologies (ICTs). Therefore, the objective of this study was to design a trial investigating the short- and long-term efficacy of cognitive behavioural treatment (CBT) for CLBP using or not ICTs. A secondary objective of this trial will be to evaluate the influence of relevant variables on treatment response. Possible barriers in the implementation of CBT with and without ICT will also be investigated.
Methods
A randomised controlled trial with 180 CLBP patients recruited from specialised care will be conducted. Participants will be randomly assigned to three conditions: Control group (CG), CBT, and CBT supported by ICTs (CBT + ICT). Participants belonging to the three conditions will receive a conventional rehabilitation program (back school). The CBT group program will last six sessions. The CBT + ICT group will use the internet and SMS to practice the therapeutic strategies between sessions and in the follow-ups at their homes. Primary outcome variables will be self-reported disability and pain intensity. Assessment will be carried out by blinded assessors in five moments: pre-treatment, post-treatment and 3-, 6-, and 12-month follow-ups. The influence of catastrophizing, fear-avoidance beliefs, anxiety and depression in response to treatment in the primary outcomes will also be analysed.
Discussion
This study will show data of the possible benefits of using ICTs in the improvement of CBT for treating CLBP.
Trial registration
ClinicalTrials.gov, NCT01802671
Journal Article