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This chapter discusses the design of the LHS and the steps taken to ensure data privacy and security. Usage of the application programming interface (API) is discussed, paying attention to how an Electronic Health Record (EHR) provider would use the API. Finally, the clinician’s interaction with the system is discussed.

Taking a business lens of telehealth, this article aims to review and provide a state-of-the-art overview of telehealth research.

This research conducts a systematic literature review using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) protocol and a collection of bibliometric analytical techniques (i.e. performance analysis, keyword co-occurrence, keyword clustering and content analysis).

Using performance analysis, this article unpacks the publication trend and the top contributing journals, authors, institutions and regions of telehealth research. Using keyword co-occurrence and keyword clustering, this article reveals 10 major themes underpinning the intellectual structure of telehealth research: design and development of personal health record systems, health information technology (HIT) for public health management, perceived service quality among mobile health (m-health) users, paradoxes of virtual care versus in-person visits, Internet of things (IoT) in healthcare, guidelines for e-health practices and services, telemonitoring of life-threatening diseases, change management strategy for telehealth adoption, knowledge management of innovations in telehealth and technology management of telemedicine services. The article proposes directions for future research that can enrich our understanding of telehealth services.

This article offers a seminal state-of-the-art overview of the performance and intellectual structure of telehealth research from a business perspective.

Online health question-and-answer (Q&A) forums have developed a new business model whereby listeners (peer patients) can pay to read health information derived from consultations between askers (focal patients) and answerers (physicians). However, research exploring the mechanism behind peer patients' purchase decisions and the specific nature of the information driving these decisions has remained limited. This study aims to develop a theoretical model for understanding how peer patients make such decisions based on limited information, i.e. the first question displayed in each focal patient-physician interaction record, considering argument quality (interrogative form and information details) and source credibility (patient experience of focal patients), including the contingent role of urgency.

The model was tested by text mining 1,960 consultation records from a popular Chinese online health Q&A forum on the Yilu App. These records involved interactions between focal patients and physicians and were purchased by 447,718 peer patients seeking health-related information until this research.

Patient experience embedded in focal patients' questions plays a significant role in inducing peer patients to purchase previous consultation records featuring exchanges between focal patients and physicians; in particular, increasingly detailed information is associated with a reduced probability of making a purchase. When focal patients demonstrate a high level of urgency, the effect of information details is weakened, while the interrogative form is strengthened.

The originality of this study lies in its exploration of the monetization mechanism forming the trilateral relationship between askers (focal patients), answerers (physicians) and listeners (peer patients) in the business model “paying to view others' answers” in the online health Q&A forum and the moderating role of urgency in explaining the mechanism of how first questions influence peer patients' purchasing behavior.

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.

This chapter more clearly identifies the distinction between Electronic Health Record (EHR) and Electronic Medical Record (EMR), and states their value in obtaining individual-level data. Synthetic medical records may be used as a surrogate for EHR data in order to ensure digital data privacy is maintained during the development of the LHS. Synthea is an open-source simulation tool available through GitHub.¹ Extensive descriptive analysis of synthesized data is provided as a foundation for the analysis in Chapter 7.

The increase in the number of healthcare wearable (Internet of Things) IoT options is making it difficult for individuals, healthcare experts and physicians to find the right smart device that best matches their requirements or treatments. The purpose of this research is to propose a framework for a recommender system to advise on the best device for the patient using machine learning algorithms and social media sentiment analysis. This approach will provide great value for patients, doctors, medical centers, and hospitals to enable them to provide the best advice and guidance in allocating the device for that particular time in the treatment process.

This data-driven approach comprises multiple stages that lead to classifying the diseases that a patient is currently facing or is at risk of facing by using and comparing the results of various machine learning algorithms. Hereupon, the proposed recommender framework aggregates the specifications of wearable IoT devices along with the image of the wearable product, which is the extracted user perception shared on social media after applying sentiment analysis. Lastly, a proposed computation with the use of a genetic algorithm was used to compute all the collected data and to recommend the wearable IoT device recommendation for a patient.

The proposed conceptual framework illustrates how health record data, diseases, wearable devices, social media sentiment analysis and machine learning algorithms are interrelated to recommend the relevant wearable IoT devices for each patient. With the consultation of 15 physicians, each a specialist in their area, the proof-of-concept implementation result shows an accuracy rate of up to 95% using 17 settings of machine learning algorithms over multiple disease-detection stages. Social media sentiment analysis was computed at 76% accuracy. To reach the final optimized result for each patient, the proposed formula using a Genetic Algorithm has been tested and its results presented.

The research data were limited to recommendations for the best wearable devices for five types of patient diseases. The authors could not compare the results of this research with other studies because of the novelty of the proposed framework and, as such, the lack of available relevant research.

The emerging trend of wearable IoT devices is having a significant impact on the lifestyle of people. The interest in healthcare and well-being is a major driver of this growth. This framework can help in accelerating the transformation of smart hospitals and can assist doctors in finding and suggesting the right wearable IoT for their patients smartly and efficiently during treatment for various diseases. Furthermore, wearable device manufacturers can also use the outcome of the proposed platform to develop personalized wearable devices for patients in the future.

In this study, by considering patient health, disease-detection algorithm, wearable and IoT social media sentiment analysis, and healthcare wearable device dataset, we were able to propose and test a framework for the intelligent recommendation of wearable and IoT devices helping healthcare professionals and patients find wearable devices with a better understanding of their demands and experiences.

The purpose of this paper is to ensure the anonymity and security of health data and improve the integrity and authenticity among patients, doctors and insurance providers. Simulation and validation algorithms are proposed in this work to ensure the proper implementation of the distributed system to secure and manage healthcare data. The author also aims to examine the methodology of Wireless Body Area Networks and how it contributes to the health monitoring system.

Wireless Body Area Network (WBAN) plays an important role in patient health data monitoring. In this paper, a novel framework is designed and proposed to generate data by the sensor machines and be stored in the cloud, and the transactions can be secured by blockchain. DNA cryptography is used in the framework to encrypt the hashes of the blocks. The proposed framework will ensure the anonymity and security of the health data and improve the integrity and authenticity among the patients, doctors and insurance providers.

Cloud Computing and Distributed Networking have transformed the IT industry and their amalgamation with intelligent systems would revolutionize the Healthcare Industry. The data being generated by devices is huge and storing it in the cloud environment would be a better decision. However, the privacy and security of healthcare data are still a concern because medical data is very confidential and desires to be safe and secure. The blockchain is a promising distributed network that ensures the security aspect of the data and makes the transactions authentic and transparent. In this work, the data is collected using various sensor devices and is transmitted to the cloud through the WBAN via the blockchain network.

In this paper, a framework for securing and managing the healthcare data generated by intelligent systems is proposed. As the data generated by these devices are heterogeneous and huge in nature, the cloud environment is chosen for its storage and analysis. Therefore, the transactions to and from the cloud are secured by using the blockchain-based distributed network.

The target end-users of our system are the patients to keep themselves informed and healthy, healthcare providers to monitor the conditions of their patients virtually, and the health insurance providers to have a track of the history of the patients, so that no fraudulent claims can be made.

The target end-users of our system are the patients for keeping themselves informed and healthy, healthcare providers for monitoring the conditions of their patients virtually and the health insurance providers to have a track of the history of the patients, so that no fraudulent claims can be made.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

To investigate ethnographically how patient experience data, as a named category in healthcare organisations, is actively “made” through the co-creative interactions of data, people and meanings in English hospitals.

The authors draw on fieldnotes, interview recordings and transcripts produced from 13 months (2016–2017) of ethnographic research on patient experience data work at five acute English National Health Service (NHS) hospitals, including observation, chats, semi-structured interviews and documentary analysis. Research sites were selected based on performance in a national Adult Inpatient Survey, location, size, willingness to participate and research burden. Using an analytical approach inspired by actor–network theory (ANT), the authors examine how data acquired meanings and were made to act by clinical and administrative staff during a type of meeting called a “learning session” at one of the hospital study sites.

The authors found that the processes of systematisation in healthcare organisations to act on patient feedback to improve to the quality of care, and involving frontline healthcare staff and their senior managers, produced shifting understandings of what counts as “data” and how to make changes in response to it. Their interactions produced multiple definitions of “experience”, “data” and “improvement” which came to co-exist in the same systematised encounter.

The article's distinctive contribution is to analyse how patient experience data gain particular attributes. It suggests that healthcare organisations and researchers should recognise that acting on data in standardised ways will constantly create new definitions and possibilities of such data, escaping organisational and scholarly attempts at mastery.