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This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations.

The study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records.

The authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation.

To the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services received, whether public or private. The use of the application by patients and physicians has provided efficiency and cost advantages. The success of e-Nabız depends on the level of technology acceptance of health-care service providers and recipients. While there is a large research literature on the technology acceptance of service recipients in health-care services, there is a limited number of studies on physicians providing services. This study aims to determine the level of influence of trust and privacy variables in addition to performance expectancy, effort expectancy, social influence and facilitating factors in the unified theory of acceptance and use of technology (UTAUT) model on the intention and behavior of using e-Nabız application.

The population of the study consisted of general practitioners and specialist physicians actively working in any health facility in Turkey. Data were collected cross-sectionally from 236 physicians on a voluntary basis through a questionnaire. The response rate of data collection was calculated as 47.20%. Data were collected cross-sectionally from 236 physicians through a questionnaire. Descriptive statistics, correlation analysis and structural equation modeling were used to analyze the data.

The study found that performance expectancy, effort expectancy, trust and perceived privacy had a significant effect on physicians’ behavioral intentions to adopt the e-Nabız system. In addition, facilitating conditions and behavioral intention were determinants of usage behavior (p < 0.05). However, no significant relationship was found between social influence and behavioral intention (p > 0.05).

This study confirms that the UTAUT model provides an appropriate framework for predicting factors influencing physicians’ behaviors and intention to use e-Nabız. In addition, the empirical findings show that trust and perceived privacy, which are additionally considered in the model, are also influential.

This paper aims to examine the global pattern of growth and development of eHealth research based on publication headcount, and analysis of the characteristics, of the keywords used by authors and indexers to represent their research content during 1945–2019.

This study adopted a bibliometric research design and a quantitative approach. The source of the data was Elsevier’s Scopus database. The search query involved multiple search terms because researchers’ choice of keywords varies very significantly. The search for eHealth research publications was limited to conference papers and research articles published before 2020.

eHealth originated in the late 1990s, but it has become an envelope term for describing much older terms such as telemedicine, and its variants that originated much earlier. The keywords were spread through the 27 Scopus Subject Areas, with medicine (44.04%), engineering (12.84%) and computer science (11.47%) leading, while by Scopus All Science Journal Classification Health Sciences accounted for 55.83% of the keywords. Physical sciences followed with 30.62%. The classifications social sciences and life sciences made only single-digit contributions. eHealth is about meeting health needs, but the work of engineers and computer scientists is very outstanding in achieving this goal.

This study demonstrates that eHealth is an unexplored aspect of health literature and highlights the nature of the accumulated literature in the area. It further demonstrates that eHealth is a multidisciplinary area that is attractive to researchers from all disciplines because of its sensitive focus on health, and therefore requires pooling and integration of human resources and expertise, methods and approaches.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

The purpose of this study is to design a wearable medical device as a human care platform and to introduce the design details, key technologies and practical implementation methods of the system.

A multi-channel data acquisition scheme based on PCI-E (rapid interconnection of peripheral components) was proposed. The flexible biosensor is integrated with the flexible data acquisition card with monitoring capability, and the embedded (device that can operate independently) chip STM32F103VET6 is used to realize the simultaneous processing of multi-channel human health parameters. The human health parameters were transferred to the upper computer LabVIEW by intelligent clothing through USB or wireless Bluetooth to complete the transmission and processing of clinical data, which facilitates the analysis of medical data.

The smart clothing provides a mobile medical cloud platform for wearable medical through cloud computing, which can continuously monitor the body's wrist movement, body temperature and perspiration for 24 h. The result shows that each channel is completely accurate to the top computer display, which can meet the expected requirements, and the wearable instant care system can be applied to healthcare.

The smart clothing in this study is based on the monitoring and diagnosis of textiles, and the electronic communication devices can cooperate and interact to form a wearable textile system that provides medical monitoring and prevention services to individuals in the fastest and most accurate way. Each channel of the system is precisely matched to the display screen of the host computer and meets the expected requirements. As a real-time human health protection platform technology, continuous monitoring of human vital signs can complete the application of human motion detection, medical health monitoring and human–computer interaction. Ultimately, such an intelligent garment will become an integral part of our everyday clothing.

This paper aims to discover and analyze the challenges hampering blockchain technology’s (BT’s) implementation in the Indian health-care sector. A total of 18 challenges have been prioritized and modeled based on an extensive literature search and professional views.

An integrated multi-criteria decision-making approach has been used in two phases. Best worst method (BWM) is used in the first phase to prioritize the challenges with sensitivity analysis to validate the findings and eliminate a few challenges. In the second phase, interpretive structural modeling is applied to the remaining 15 challenges to obtain relative relationships among them with cross-impact matrix multiplication applied to classification analysis for their categorization.

The study’s results reveal that limited knowledge and expertise, cost and risk involved, technical issues, lack of clear regulations, resistance to change and lack of top management support are the top-ranked or high-intensity challenges according to the BWM. Interpretive structural modelling findings suggest that the lack of government initiatives has been driving other challenges with the highest driving power.

This work has been conducted in the Indian context, so careful generalization of the results is needed.

This work will give health-care stakeholders a better perspective regarding blockchain’s adoption. It will help health-care stakeholders, service providers, researchers and policymakers get a glimpse of the strategies for eradicating mentioned challenges. The analysis will help reduce the challenges’ impact on blockchain’s adoption in the Indian health-care sector.

The adoption of BT is a novel concept, especially in developing countries such as India. This is one of the few works addressing the challenges to BT adoption in the Indian health-care sector.

The purpose of this paper Computing is a recent emerging cloud model that affords clients limitless facilities, lowers the rate of customer storing and computation and progresses the ease of use, leading to a surge in the number of enterprises and individuals storing data in the cloud. Cloud services are used by various organizations (education, medical and commercial) to store their data. In the health-care industry, for example, patient medical data is outsourced to a cloud server. Instead of relying onmedical service providers, clients can access theirmedical data over the cloud.

This section explains the proposed cloud-based health-care system for secure data storage and access control called hash-based ciphertext policy attribute-based encryption with signature (hCP-ABES). It provides access control with finer granularity, security, authentication and user confidentiality of medical data. It enhances ciphertext-policy attribute-based encryption (CP-ABE) with hashing, encryption and signature. The proposed architecture includes protection mechanisms to guarantee that health-care and medical information can be securely exchanged between health systems via the cloud. Figure 2 depicts the proposed work's architectural design.

For health-care-related applications, safe contact with common documents hosted on a cloud server is becoming increasingly important. However, there are numerous constraints to designing an effective and safe data access method, including cloud server performance, a high number of data users and various security requirements. This work adds hashing and signature to the classic CP-ABE technique. It protects the confidentiality of health-care data while also allowing for fine-grained access control. According to an analysis of security needs, this work fulfills the privacy and integrity of health information using federated learning.

The Internet of Things (IoT) technology and smart diagnostic implants have enhanced health-care systems by allowing for remote access and screening of patients’ health issues at any time and from any location. Medical IoT devices monitor patients’ health status and combine this information into medical records, which are then transferred to the cloud and viewed by health providers for decision-making. However, when it comes to information transfer, the security and secrecy of electronic health records become a major concern. This work offers effective data storage and access control for a smart healthcare system to protect confidentiality. CP-ABE ensures data confidentiality and also allows control on data access at a finer level. Furthermore, it allows owners to set up a dynamic patients health data sharing policy under the cloud layer. hCP-ABES proposed fine-grained data access, security, authentication and user privacy of medical data. This paper enhances CP-ABE with hashing, encryption and signature. The proposed method has been evaluated, and the results signify that the proposed hCP-ABES is feasible compared to other access control schemes using federated learning.

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

This paper aims to concentrate on recent innovations in flexible wearable sensor technology tailored for monitoring vital signals within the contexts of wearable sensors and systems developed specifically for monitoring health and fitness metrics.

In recent decades, wearable sensors for monitoring vital signals in sports and health have advanced greatly. Vital signals include electrocardiogram, electroencephalogram, electromyography, inertial data, body motions, cardiac rate and bodily fluids like blood and sweating, making them a good choice for sensing devices.

This report reviewed reputable journal articles on wearable sensors for vital signal monitoring, focusing on multimode and integrated multi-dimensional capabilities like structure, accuracy and nature of the devices, which may offer a more versatile and comprehensive solution.

The paper provides essential information on the present obstacles and challenges in this domain and provide a glimpse into the future directions of wearable sensors for the detection of these crucial signals. Importantly, it is evident that the integration of modern fabricating techniques, stretchable electronic devices, the Internet of Things and the application of artificial intelligence algorithms has significantly improved the capacity to efficiently monitor and leverage these signals for human health monitoring, including disease prediction.