This research was supported by funding from the National Institutes of Health: K01HL135452 and R01HL152453. In order for telemedicine and digital health solutions to successfully increase use of, engagement with, motivation, and adherence to chronic disease self-management, telemedicine and digital health solutions must be personalized, contextualized, and rooted in behavioral science theories and gamification strategies through a pantheoretical approach. COVID-19 survivors who are at greater risk for a chronic disease, and 3. individuals with chronic disease, pre-COVID. Its definition is broader than that of telemedicine, which only includes the remote delivery of health care. The increased demand for remote health services due to COVID-19 spurred the largest and fastest implementation and utilization of telemedicine and digital health solutions in the US healthcare system.
Workplace Wellness Programs: Disadvantages and Solutions headaches neck and shoulder pain Contributing factors are screen glare, bad lighting, and improper viewing distance. Geneva, WHO, A regulatory framework emerges for digital medicine, Number of mHealth apps available in the Apple App Store from 1st quarter 2015 to 3rd quarter 2019, 325,000 mobile health apps available in 2017 Android now the leading mHealth platform, Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis, Popular diabetes apps and the impact of diabetes app use on self-care behaviour: a survey among the digital community of persons with diabetes on social media, Adjust to target in type 2 diabetes: comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine, Behavior change techniques in top-ranked mobile apps for physical activity, WellDoc Receives FDA 510(k) Clearance to Offer a Non-Prescription Version of BlueStar Digital Therapeutic for Type 2 Diabetes, Lecture presented at the 78th Scientific Sessions of the American Diabetes Association, 23 June, Hygieia receives 510(k) clearance from FDA for phone app that enhances companys d-Nav insulin guidance service, FDA Perspective: mobile medical apps in diabetes management. For example, a clinically validated gamification health application Rafi-Tone was developed to promote effective inhaler techniques in asthmatic children, who may be at higher risk of getting sick from COVID-19, through a series of challenging games (25). With telemedicine, depending on your schedule, you may not even have to take leave time from work or arrange for child care. A successful contextualization of a telemedicine and digital health solution can be seen in our digital social care navigator program which helps patients navigate contextual barriers to healthcare. Thus, while the available studies of app-based interventions show promise for promoting healthy behavior and managing complex diseases, such as diabetes, they are extremely limited in both quantity and quality. Edited by: Hajo Zeeb, Leibniz Institute for Prevention Research and Epidemiology (LG), Germany, Reviewed by: Benjamin Schz, University of Bremen, Germany; Abhilash Perisetti, University of Arkansas for Medical Sciences, United States, This article was submitted to Digital Public Health, a section of the journal Frontiers in Public Health. Below we outline nine major issues that need to be addressed by regulatory authorities, policy makers, professional organizations, researchers, product manufacturers, and HCPs.
Digital health - Statistics & Facts | Statista Contextualizing telemedicine and digital health solutions through deep idiographic profiling (based on sociodemographic, clinical, and psychographic signatures of the individual) can optimize adherence and minimizes non-adherence to the desired health behavior. Wang L, Weiss J, Ryan EB, Waldman J, Rubin S, Griffin JL. Although telemedicine and digital health have limited the amount of in-person ambulatory care, there is still a need to provide (1) real-time and convenient tracking of health parameters and behaviors; (2) flexible individualized and adaptive treatment and management programs, and (3) continuous support to manage health and wellness. The funding sources had no role in the design, conduct, analysis of the study, or in the decision to submit the manuscript for publication.
Diabetes Digital App Technology: Benefits, Challenges, and Telemedicine and digital health solutions also increased access to healthcare among demographic groups that have historically low utilization of healthcare services. Livongo captures and processes real-time data about barriers to self-management and through their algorithm provide customized educational materials and coaching tips to overcome these barriers. found these apps to positively affect outcomes, such as HbA1c, hypoglycemia incidence, and diabetes self-care measures, in the short term. Schmidt-Kraepelin M, Toussaint PA, Thiebes S, Hamari J, Sunyaev A. Archetypes of gamification: analysis of mhealth apps. Another digital health guru, so to speak (among many), is Los Angeles-based Dr. Brennan Spiegel, director of the Center for Outcomes Research and Education (CS-CORE) for Cedars-Sinai Health System . This program will allow the FDA to first look at the company, rather than primarily at the digital health software product being submitted, in order to expedite product reviews from vetted excellent companies (53). The success of pantheoretical approaches and solutions like Livongo prompted several professional organizations like the American Heart Association (AHA) to adopt digital solutions in their larger strategic mission. In addition, apps should clearly define the user group. Telemedicine, which enables video or phone appointments between a patient and their health care practitioner, benefits both health and convenience. A DTSec-certified product must pass evaluation by a DTSec-approved laboratory and the DTSec Working Group before it can be listed under a publicly disclosed DTSec evaluated products list (83). Personalizing the user's experience can also improve short- and long-term user engagement and adherence to telemedicine and digital health solutions. You can see your doctor from the comfort of your own bed or sofa. Such cybersecurity measures must be implemented to protect privacy and enhance data security so that people with diabetes have adequate privacy protection and are not judged or discriminated against based on their blood glucose levels, adherence to their care, or simply their diabetes diagnosis itself. Low income and underserved patients are most vulnerable to the inadequacies of the current chronic disease management infrastructure, as they are less likely receive basic care and management (6). Telemedicine increases access to buprenorphine initiation during the COVID-19 pandemic. Gamifying, contextualizing, and personalizing digital health solutions to increase engagement and use has been successfully done in the management of several chronic diseases (29, 30). Because the majority of mobile health apps are not subject to regulation, data for assessment of accuracy, defined as the ability to correctly differentiate patient and healthy cases (the sum of true positive and true negative cases divided by the sum of all cases) (65), often may not be available. While digital solutions cannot completely replace all of the rich experience that comes with a face-to-face encounter, and fix healthcare inequities there are some advantages.
5 Advantages Of Digital Wellness You Must Know Despite the foregoing strengths of creating engaging digital health solutions that will be used long-term through gamification, contextualizing and personalizing strategies, a few methodological limitations must be considered before scaling. Christopher AS, McCormick D, Woolhandler S, Himmelstein DU, Bor DH, Wilper AP. Although it is important for HCPs to stay up to date on the digital health app landscape, we acknowledge that it is unrealistic for HCPs to meet this expectation on top of their high workload burden. Corresponding author: G. Alexander Fleming. G.A.F. Mobile health and inhaler-based monitoring devices for asthma management, How technology in care at home affects patient self-care and self-management: a scoping review. Livongo uses historical participant data to train and refine a forecasting model that can accurately predict future demand.
Challenges for the evaluation of digital health solutionsA call for However, these solutions are not panaceas as they are replete with several limitations, such as low uptake, poor engagement, and low long-term use. . Although, the burgeoning of telemedicine is widely seen as a positive step to improve access, delivery of healthcare, and management of disease, it does not solve some of the fundamental flaws of the delivery and management system, such as the lack of seamless patient experience and wraparound and continuous support to patients to better self-manage chronic disease. No use, distribution or reproduction is permitted which does not comply with these terms. Seasonal allergies and your brain.
22 Living in Texas Pros and Cons - Vittana.org As a result, we bring to light several issues that the diabetes community, including regulatory authorities, policy makers, professional organizations, researchers, people with diabetes, and health care professionals, needs to address to ensure that diabetes health technology can meet its full potential. Need for a national evaluation system for health technology, ISPAD clinical practice consensus guidelines 2018: diabetes technologies, Guidance document medical devices - scope, field of application, definition - qualification and classification of stand alone software - MEDDEV 2.1/6, Transformation of health and care in the digital single market, Regulation of medical devices in the United States and European Union, The Blue Guide on the implementation of EU products rules, Drugs and devices: comparison of European and U.S. approval processes, Medical Information Systems guidance for qualification and classification of standalone software with a medical purpose, Uppsala, Sweden, Lkemedelsverket Medical Products Agency, European Network of Research Ethics Committee, The Act on Medical Devices (Medical Devices Act) (Medizinproduktegesetz MPG) (especially 19-24), Food and Drug Administration. Applications of digital technology in COVID-19 pandemic planning and response. The AHA incorporated digital health as a core interventional strategy to assess, diagnose, and improve several health outcomes, like blood pressure and atrial fibrillation (3639). An evidence review, Mobile Applications for Self-Management of Diabetes, Technical Brief No. In 2015, it released a guidance document (updated in 2019) for mobile medical applications for apps that meet the definition of a device in section 201(h) of the Federal Food, Drug, and Cosmetic Act (FDCA) (32). Telehealth can be delivered in one of three ways: Using technology to deliver health care has several advantages, including cost savings, convenience, and the ability to provide care to people with mobility limitations, or those in rural areas who don't have access to a local doctor or clinic. The model of gamification principles for digital health interventions: evaluation of validity and potential utility. But, with the benefits come new risks to the security of these systems and the privacy of the data they hold and transmit. From the user perspective, this provides greater medical choice in medical apps, but makes it more challenging to find and ensure acceptable performance among many apps of varying quality. It also presents health system challenges and digital health interventions to address them. Other community resources may be found through the Internet or calling 2-1-1. Despite the promise and perils of telemedicine and digital health solutions, early evidence suggest that they are underutilized due to poor engagement, uptake, and long-term use and adherence (17). Several of the apps assessed in this study improved short-term adherence and enhanced intervention effectiveness, but many others yielded no effect. Seixas AA, Henclewood DA, Williams SK, Jagannathan R, Ramos A, Zizi F, et al.. Sleep duration and physical activity profiles associated with self-reported stroke in the United States: application of Bayesian belief network modeling techniques. Advantages Of Wellness Programs: Advantages of wellness programs include improved morale and enhanced work ethic, reduced absenteeism, reduced health care costs due to fewer sick days taken off . Of these 23 articles, there were only 10 described studies relevant to diabetes management. Inclusion in an NLM database does not imply endorsement of, or agreement with, increased communication and cooperation across stakeholder groups (1dg; 2e, f; 3a, b, f; 6ac; 7ac). Digital health has a broad scope and includes the use of wearable devices, mobile health, telehealth, health information technology, and telemedicine. It allows them to prioritize sustainable and inclusive health measures like wellness, care, post-care approaches, diagnosis, etc. Over 20% of the adults living in Texas currently have no health insurance compared to the national average of 12%. Insufficient evidence (at least from a conventional way of looking at evidence) of clinical validity, effectiveness, accuracy, and safety are some of the largest issues that limit the effectiveness of diabetes digital health technology. This roadmap has now expanded into other health conditions and programs, including heart failure, cardiac rehabilitation, stroke, diabetes, cholesterol, and mental well-being, through a network of technology solutions, including wearables, digital therapeutics, virtual and augmented reality designed to improve the digital health literacy, through knowledge, numeracy, navigation, communication, and decision making (40). Consequently, apps targeted for older people with diabetes must be designed with their expected level of technology proficiency kept in mind. Streamlined review: FDA review of the information received, which is made streamlined because 1. and 2. provide information that does not need to be submitted again. Establishing employee health and wellness programs is crucial for corporations for many reasons: it can help reducing employee turnovers, cuts health care costs, and supports maintaining a better employer branding. These are intended to improve health outcomes and quality of life by coaching people with diabetes, supporting healthy nutrition and weight control, encouraging glucose monitoring and remote monitoring, assisting with the interpretation of results, maintaining lifestyle modifications, guiding medication dosing, and, ultimately, reducing complications (12). Improved technology has made telemedicine easier, even for those who dont consider themselves computer savvy. Every patient's file needs to be protected as it is stored in the network database. Rodriguez JA, Betancourt JR, Sequist TD, Ganguli I. Advances in integration and automation of data collection have come far, and we anticipate these advances to continue. The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s. Pantheoretical approaches, which can be categorized as part of a suite of innovative behavioral approaches such as just-in-time adaptive interventions (1820), adds a unique workflow and evidence for achieving more ecologically valid approaches to overcome barriers and accentuate facilitators of engagement and adherence to telemedicine and digital solutions. Effects of telecare intervention on glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials, Mobile applications for diabetics: a systematic review and expert-based usability evaluation considering the special requirements of diabetes patients age 50 years or older, Evidence-based mobile medical applications in diabetes, Policy for Device Software Functions and Mobile Medical Applications. Approximately a third of apps alerted users to hypoglycemia or hyperglycemia, and only 10% of apps educated users on blood glucose management (69). 3. 10 Lessons From Empowered Patients. The available evidence on the safety and effectiveness of mobile health apps, especially for diabetes, remains limited. Coincident with the diabetes pandemic of the last three decades has been a revolution in digital and wireless technology (1). Second, digital health solutions have inherent limitations such as: problems with access to devices and internet, low patient technology literacy and mastery of using digital tools, and lack of trust in the privacy and confidentiality of digital solutions. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. For these reasons, the use of telehealth has grown significantly over the last decade. It is therefore an imperative to urgently develop and implement innovative and personalized strategies to optimize chronic disease care for all, especially for disparity communities (710). Bashar AHM, Hakim ME, Rahman MM, Dey NK, Chowdhury SMMH, Islam MM, et al.. Long term complications and rehabilitation of COVID-19 patients. While a mobile health app cannot (and should not) replace an HCP, mobile health apps can certainly supplement and bolster medical practice. By the end of 2019, the FDA will launch version 1.0 of the National Evaluation System for health Technology (NEST) initiative, which will be coordinated by the NEST Coordinating Center (NESTcc) (48). It isn't possible to do every type of visit remotely. Telecare. Bridge the gap: reducing inequity in hospital readmissions for African American patients with heart failure through quality improvement initiatives. He was formerly the Group Leader of the Division of Metabolism and Endocrine Drug Products at the FDA. 1. This approach can also be used to encourage health outcomes (76); examples exist within mySugr and Medtronic Inner Circle (77,78). Hasselfeld is assistant medical director for digital health innovations at Johns Hopkins Medicine. All-in-one Healthcare and Wellness solutions Digital advancement has made things a lot easier, like keeping track of one's mental and physical health. Feature 10 tips to promote digital wellness in the workplace Some tips for addressing workplace digital wellness include using time management apps, establishing digital boundaries and integrating activity into workstations. Our intention is not to slow growth but, rather, to make a realistic assessment of what is safe and truly beneficial for people with diabetes. FOIA Lett HS, Blumenthal JA, Babyak MA, Strauman TJ, Robins C, Sherwood A. Search for other works by this author on: Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants, Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis, Diabetes Prevention Program Research Group, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance, New technologies for diabetes: a review of the present and the future, Using digital health technology to prevent and treat diabetes, mHealth: New horizons for health through mobile technologies, Based on the findings of the second global survey on eHealth. Ornelas C, Fadadu RP, Richardson MA, Agboghidi OH, Davis JD. How can clinicians, specialty societies and others evaluate and improve the quality of apps for patient use?
The Continued Use of Mobile Health Apps: Insights From a Longitudinal RWPA will consist of real-world health analytics (RWHA: human factors and usability engineering, clinical safety and health benefits), user experience analytics (UXA: user satisfaction, engagement, feedback channels, and issue resolution) and product performance analytics (PPA: cybersecurity and product performance; data to be collected by the respective company) (54).