A SCOPING REVIEW EXPLORATION OF THE INTENDED AND UNINTENDED CONSEQUENCES OF EHEALTH ON OLDER PEOPLE: A HEALTH EQUITY IMPACT ASSESSMENT

eHealth is one perceived mechanism to extend the range and reach of limited health-care resources for older adults. A decade-scoping review (2007–2017) was conducted to systematically search and synthesize evidence to understand the intended and unintended consequences of eHealth initiatives, informed by a health equity impact assessment framework. Scoping review sources included international academic and grey literature on eHealth initiatives (e.g., eHealth records, telemedicine/telecare, and mobile eHealth application) focused on the varying needs of older adults (aged 60+), particularly individuals experiencing sociocultural and economic difficulties. Findings suggest that eHealth has several potential benefits for older adults, but also the possibility of further excluding already marginalized groups, thereby exacerbating existing health disparities. Ongoing evaluation of eHealth initiatives for older adults is necessary and requires attention to unique individual-level, socioeconomic, and cultural characteristics to heighten benefits and better capture both the intended and unintended outcomes of advanced eHealth systems.

The full article can be downloaded below.  

From Point-of-Care Testing to eHealth Diagnostic Devices (eDiagnostics)

Point-of-care devices were originally designed to allow medical testing at or near the point of care by healthcare professionals. Some point-of-care devices allow medical self-testing at home but cannot fully cover the growing diagnostic needs of eHealth systems that are under development in many countries. A number of easy-to-use, network connected diagnostic devices for self-testing are needed to allow remote monitoring of patients’ health. This Outlook highlights the essential characteristics of diagnostic devices for eHealth settings and indicates point-of-care technologies that may lead to the development of new devices. It also describes the most representative examples of simple-to-use, point-of-care devices that have been used for analysis of untreated biological samples.

The full article can be downloaded below.  

Building More Trust Between Doctors and Patients

The general lesson that we have learned from these experiences is that building an empathetic, trust-based relationship with patients is not a nice-to-have but a must-have.  It creates the possibility of identifying underlying hidden conditions whose treatment prevents the occurrence of overt symptomatic conditions that cause distress to patients and place huge strains on the capacity of healthcare services.  Empathy saves not only lives but also money and time.  It’s time to build a place for it in the clinical process.

The full Harvard Business Review article can be viewed at this link. 

The Need to Implement and Evaluate Telehealth Competency Frameworks to Ensure Quality Care across Behavioral Health Professions

Technology is rapidly becoming a key player in care delivery, lifelong learning, and education/training. The American Psychiatric Association Practice-Based Learning and Improvement Core Competencies include the use information technology and lifelong learning. Current competencybased education (CBE) focuses on skills rather than on what is taught. Competency may be defined as a measurable human capability required for effective performance. The Institute of Medicine (IOM) suggested three key elements for patient-centered care: skills-focused education, interdisciplinary team-based care, and a technology/informaticsoriented administrative approach.

A key premise of telepsychiatric competencies published in 2015 is that faculty clinicians and educators have to first improve their care via clinical and technological competence, in order to then oversee trainees’ use of technologies in clinical care. Fundamental steps to this work are the alignment of clinical outcomes with teaching/supervisory methods, evaluation, and feedback. Professional association standards and guidelines typically do not focus on competencies, are complex, and are frequently incomplete (e.g., diverse populations and settings), and comparisons across professions are rare.

Telebehavioral health (TBH) is a broad term inclusive across behavioral health professions and technically includes both mental health and substance use care; in this paper, it will also include TP. Each BH discipline and field has its own nomenclature for telehealth (e.g., telepsychiatry, telepsychology, distance counseling) [9], though competencies related to technological standards were suggested years ago. A TBH competency set arrived in and a specific one for use of social media arrived in 2018. Care delivered by TBH may require additional skills—or adjusted behaviors—compared to in-person care.

The current paper will:

1. Review TBH evidence relevant to competencies, guidelines, and standards and compare similarities and differences across professions related to integrating technology in practice

2. Highlight TBH competency sets to date

3. Discuss implications of implementing TBH competencies across professions.

The full article can be downloaded below.  

Rural Individuals’ Telehealth Practices: An Overview

Telehealth—i.e., health services or activities conducted via phone, Internet, and other technologies—has emerged as a new way for consumers to meet their health care needs. The benefits of telehealth may be greater in rural areas, where remoteness and provider shortages may make accessing health care more difficult for rural residents. Using detailed 2015 household data, the report analyzes three basic telehealth activities as practiced by consumers age 15 or older: (1) online health research; (2) online health maintenance (communication with health providers, including communicating with medical practitioners, maintaining records, and paying bills); and (3) online health monitoring via devices that exchange data remotely with medical personnel. Rural residents were less likely than urban people to engage in the telehealth activities, with 17 percent of rural people conducting online health research, 7 percent engaging in online health maintenance, and 1.3 percent using online health monitoring (compared with 20 percent, 11 percent, and 2.5 percent of urban residents, respectively). Use of all of these telehealth activities increased among individuals with higher levels of education. Generally, use increased among individuals with higher household income, but income’s effect varied across the telehealth activities.

The full report from the U.S. Department of Agriculture's Economic Research Service can be downloaded below.  

What If AI Could Uber The Healthcare Industry?

Yes, it may seem like a stretch to imagine our complicated and flawed healthcare system changing overnight due to developments from AI startups. However, this is what’s meant by “little things add up.” In our lifetimes we have seen how the entrenched retail industry has morphed, taking down once seemingly invincible bastions, such as Sears. We have watched Uber challenge the taxi transportation model and Airbnb upset the regal hotels of yore. What might AI medical startups accomplish for the health industry? That future is uncertain. However, what's true is that change is in the air and that little things can add up ­— sometimes for good.

The full Forbes article can be viewed at this link.  

Breaking Borders in Patient-Centric Medicine

Patient-centric care means faster, more accurate, painless and hopefully, failsafe delivery of medical care to patients with the smallest margin of error possible. This type of care is continuously evolving.

A number of companies have created systems that personalize patient care while ensuring all data regarding each and every patient is accurate, protected, and easily accessible 24/7. In an industry that is so huge, one thing modern technology brings back to the medical arena is personalized care—but with the accuracy, speed, and interface of modern technology.  

This article highlights a number of topics, including: 

1. Introducing telemedicine
2. Continuous patient monitoring
3. Wind tunnel technology fights lung disease
4. Biosensor monitors critical signs
5. Needle free blood collection

The full ECN article can be viewed at this link.  

How Is AI Revolutionizing Elderly Care

There is an unprecedented growth in the percentage of aging population throughout the world, particularly in growing economies such as Europe, Japan and China. Form 2000 to 2050, the percentage of the world’s population who is 60 years of age and older will approximately double from about 12% to 22% (from 605 million to 2 billion). During the same period, the number of people aged 80 years and older will quadruple. In the USA, 14.5% of the population is 65 years or older, but by 2030 these number is anticipated to grow to 20%.

This rapid aging demographic will directly affect social, economic and health outcomes for these growing economies. Particularly healthcare delivery pathways need to be readjusted, keeping in mind the prevalence of chronic diseases, comorbidities and polypharmacy requirements of the elderly and geriatric patients. Geriatric diseases such as atherosclerosis, osteoporosis, cardiovascular diseases, obesity, diabetes, dementia and osteoarthritis require quick diagnosis and continuous supervision by a professional caregiver. This is coupled with the fact that we are not training enough physicians and caregivers to account for the increased demands of healthcare. The US will face a shortage of between 40,800 and 104,900 physicians by 2030.

Given the situation, healthcare providers are starting to offload certain parts of the care-pathways to artificial intelligence (AI) based automatization. AI can now be found in every step of the care-pathway, starting from intelligent tracking of biometric information to early diagnosis of diseases. AI is helping patients and their families understand the treatment pathways. AI is also helping clinicians to treat the conditions more efficiently.

Here are 5 ways in which AI is revolutionizing elder care:

1. At home health monitoring
2. Smart device assisted daily living
3. Smart device assisted fall detection
4. Virtual companions
5. Anti-aging research

The detailed Forbes article can be viewed at this link.