Chouvarda Ioanna, Maramis Christos, Livitckaia Kristina, Trajkovik Vladimir, Burmaoglu Serhat, Belani Hrvoje, Kool Jan, Lewandowski Roman
Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Faculty of Computer Science and Engineering, Saints Cyril and Methodius University, Skopje, North Macedonia.
J Med Internet Res. 2019 Sep 3;21(9):e14005. doi: 10.2196/14005.
Connected health (CH), as a new paradigm, manages individual and community health in a holistic manner by leveraging a variety of technologies and has the potential for the incorporation of telehealth and integrated care services, covering the whole spectrum of health-related services addressing healthy subjects and chronic patients. The reorganization of services around the person or citizen has been expected to bring high impact in the health care domain. There are a series of concerns (eg, contextual factors influencing the impact of care models, the cost savings associated with CH solutions, and the sustainability of the CH ecosystem) that should be better addressed for CH technologies to reach stakeholders more successfully. Overall, there is a need to effectively establish an understanding of the concepts of CH impact. As services based on CH technologies go beyond standard clinical interventions and assessments of medical devices or medical treatments, the need for standardization and for new ways of measurements and assessments emerges when studying CH impact.
This study aimed to introduce the CH impact framework (CHIF) that serves as an approach to assess the impact of CH services.
This study focused on the subset of CH comprising services that directly address patients and citizens on the management of disease or health and wellness. The CHIF was developed through a multistep procedure and various activities. These included, as initial steps, a literature review and workshop focusing on knowledge elicitation around CH concepts. Then followed the development of the initial version of the framework, refining of the framework with the experts as a result of the second workshop, and, finally, composition and deployment of a questionnaire for preliminary feedback from early-stage researchers in the relevant domains.
The framework contributes to a better understanding of what is CH impact and analyzes the factors toward achieving it. CHIF elaborates on how to assess impact in CH services. These aspects can contribute to an impact-aware design of CH services. It can also contribute to a comparison of CH services and further knowledge of the domain. The CHIF is based on 4 concepts, including CH system and service outline, CH system end users, CH outcomes, and factors toward achieving CH impact. The framework is visualized as an ontological model.
The CHIF is an initial step toward identifying methodologies to objectively measure CH impact while recognizing its multiple dimensions and scales.
作为一种新范式，连接健康（CH）通过利用多种技术以整体方式管理个人和社区健康，并具有整合远程医疗和综合护理服务的潜力，涵盖针对健康人群和慢性病患者的全系列与健康相关的服务。围绕个人或公民重新组织服务预计将在医疗保健领域产生重大影响。对于CH技术要更成功地触及利益相关者，存在一系列问题（例如，影响护理模式效果的背景因素、与CH解决方案相关的成本节约以及CH生态系统的可持续性）需要更好地加以解决。总体而言，有必要有效地确立对CH影响概念的理解。由于基于CH技术的服务超越了标准临床干预以及医疗设备或治疗的评估，在研究CH影响时就出现了标准化以及新的测量和评估方法的需求。
本研究旨在介绍作为评估CH服务影响方法的CH影响框架（CHIF）。
本研究聚焦于CH的一个子集，该子集包括直接针对患者和公民进行疾病管理或健康与保健的服务。CHIF是通过多步骤程序和各种活动开发而成的。这些活动包括，作为初始步骤，进行文献综述以及举办侧重于围绕CH概念进行知识引出的研讨会。接着是框架初稿的开发，由于第二次研讨会的结果，与专家一起对框架进行完善，最后编制并发放一份问卷，以获取相关领域早期研究人员的初步反馈。
该框架有助于更好地理解什么是CH影响，并分析实现CH影响的因素。CHIF详细阐述了如何评估CH服务中的影响。这些方面有助于对CH服务进行有影响意识的设计。它还有助于比较CH服务并增进对该领域的进一步了解。CHIF基于4个概念，包括CH系统和服务概述、CH系统最终用户、CH结果以及实现CH影响的因素。该框架被可视化为一个本体模型。
CHIF是朝着识别客观测量CH影响的方法迈出的第一步，同时认识到其多维度和多尺度特性。
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