Graduate School of Public Health, St. Luke's International University, Japan.
School of Social, Political and Global Studies, and School of Primary, Community and Social Care, Keele University, UK.
Int J Med Inform. 2022 Jan;157:104639. doi: 10.1016/j.ijmedinf.2021.104639. Epub 2021 Nov 6.
BACKGROUND AND OBJECTIVE: The COVID-19 pandemic has accelerated digital health applications in multifaceted disease management dimensions. This study aims (1) to identify risk issues relating to the rapid development and redeployment of COVID-19 related e-health systems, in primary care, and in the health ecosystems interacting with it and (2) to suggest evidence-based evaluation directions under emergency response. METHOD: After initial brainstorming of digital health risks posed in this pandemic, a scoping review method was adopted to collect evidence across databases of PubMed, CINAHL, and EMBASE. Peer-review publications, reports, news sources, and websites that credibly identified the challenges relating digital health scaled for COVID-19 were scrutinized. Additional supporting materials were obtained through snowball sampling and the authors' global digital health networks. Studies satisfying the selection criteria were charted based on their study design, primary care focus, and coverage of e-health areas of risk. RESULTS: Fifty-eight studies were mapped for qualitative synthesis. Five identified digital health risk areas associated with the pandemic were governance, system design and coordination, information access, service provision, and user (professional and public) reception. We observed that rapid digital health responses may embed challenges in health system thinking, the long-term development of digital health ecosystems, and interoperability of health IT infrastructure, with concomitant weaknesses in existing evaluation theories. CONCLUSION: Through identifying digital health risks posed during the pandemic, this paper discussed potential directions for next-generation informatics evaluation development, to better prepare for the post-COVID-19 era, a new future epidemic, or other unforeseen global health emergencies. An updated evidence-based approach to health informatics is essential to gain public confidence in digital health across primary and other health sectors.
背景与目的:COVID-19 大流行加速了数字健康在多方面疾病管理层面的应用。本研究旨在:(1) 确定与 COVID-19 相关电子医疗系统在初级保健中的快速开发和重新部署相关的风险问题,以及与该系统相互作用的健康生态系统;(2) 提出在应急响应下基于证据的评估方向。
方法:在对本次大流行中数字健康带来的风险进行初步头脑风暴后,采用范围综述方法,从 PubMed、CINAHL 和 EMBASE 数据库中收集证据。仔细审查了可信地确定与 COVID-19 相关的数字健康规模挑战的同行评议出版物、报告、新闻来源和网站。通过滚雪球抽样和作者的全球数字健康网络获得了额外的支持材料。根据研究设计、初级保健重点以及电子健康风险领域的覆盖范围,对符合选择标准的研究进行图表绘制。
结果:对 58 项研究进行了定性综合分析。确定了与大流行相关的五个数字健康风险领域,包括治理、系统设计与协调、信息获取、服务提供以及用户(专业人员和公众)接受程度。我们发现,快速的数字健康应对措施可能会给卫生系统思维、数字健康生态系统的长期发展以及卫生信息技术基础设施的互操作性带来挑战,同时也存在现有评估理论的薄弱环节。
结论:通过确定大流行期间出现的数字健康风险,本文讨论了下一代信息学评估发展的潜在方向,以便更好地为 COVID-19 后时代、新的未来流行病或其他不可预见的全球卫生紧急情况做好准备。需要更新基于证据的健康信息学方法,以在初级保健和其他卫生部门赢得公众对数字健康的信任。
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