Cheng Lan, Chan W K, Peng Yi, Qin Harry
Big Data Bio-Intelligence Lab, Big Data Institute, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong.
Department of Computer Science and Engineering, Chinese University of Hong Kong, Sha Tin, Hong Kong.
Health Inf Sci Syst. 2023 Mar 14;11(1):14. doi: 10.1007/s13755-022-00198-4. eCollection 2023 Dec.
Telemedicine are experiencing an unprecedented boom globally since the beginning of the COVID-19 pandemic. As the most vulnerable groups amid COVID-19, the digital delivery of healthcare poses great challenges to the elderly population, caregiver, health service providers, and health policy makers. To bridge the service delivery gaps between the telemedicine demand side and supply side, explore evidence-based approach for integrated care, address challenges for aging policy, and build foundation for the development of data-driven and community-based telemedicine, our R&D team applied translational research to design and develop telemedicine "SMART" for enhancing elderly mental health wellbeing amid COVID-19. Our aim is to investigate the preparedness mechanisms of mental health disease including response, intervention, and connection these three healthcare delivery pipelines with the collection, consolidation, and synergy of heath parameters and social determinants, using data analytics approach to achieve Evidence-Based Medicine (EBM).
A mix of quantitative and qualitative research design for scientifically rigorous consultation and analysis was conducted from Jan 2020 to June 2021 in Hong Kong. An exploratory and descriptive qualitative design was used in this study. The data were collected through focus group discussions conducted from elderly and their caregivers living in 10 main districts of Hong Kong. Our research pilot tested "SMART" targeting for elderly with mental health improvement needs. Baseline questionnaire with 110 tele-medicine product users includes questions on demographic information, self-rated mental health digital adoption. The follow-up five focus group discussions with 57 users (elderly and their caregivers) further explore the social determinants of telemedicine transformation and help propose the integrated telemedicine paradigm shift framework establishment, development, and enhancement.
Grounded on the baseline needs assessment and feedbacks collected, it is evident that multi-dimensional health information from the four various streams (community, clinic, home, remote) and customized digital health solutions are playing a key role in addressing elderly mental health digital service needs and bridging digital divide. The designed tele-medicine product lines up health service provider (supplier side) and elderly specific needs (demand side) with our three-level design, enables elderly and their families to follow and control their own health management and connect with the service provider, community of practice (CoP), and health policy makers.
It's beneficial to involve elderly and gerontechnology stakeholders as part of Community-Based Participatory Research (CBPR) before and throughout the developing and delivery phases an integrated and age-friendly digital intervention. The challenges in applying and disseminating telemedicine reflected by the elderly and caregivers can be used as important input for further development and indicators for the sustainable and integrated elderly primary care framework.
The online version contains supplementary material available at 10.1007/s13755-022-00198-4.
自新冠疫情开始以来,远程医疗在全球范围内正经历前所未有的繁荣。作为新冠疫情期间最脆弱的群体,医疗保健的数字化交付给老年人群体、护理人员、医疗服务提供者和卫生政策制定者带来了巨大挑战。为了弥合远程医疗需求方和供应方之间的服务交付差距,探索基于证据的综合护理方法,应对老龄化政策挑战,并为数据驱动和基于社区的远程医疗发展奠定基础,我们的研发团队应用转化研究来设计和开发远程医疗“SMART”,以在新冠疫情期间增强老年人的心理健康。我们的目标是研究心理健康疾病的准备机制,包括反应、干预,并将这三个医疗保健交付管道与健康参数和社会决定因素的收集、整合和协同作用联系起来,使用数据分析方法实现循证医学(EBM)。
2020年1月至2021年6月在香港进行了定量和定性研究设计相结合的科学严谨的咨询和分析。本研究采用探索性和描述性定性设计。数据通过对居住在香港10个主要地区的老年人及其护理人员进行焦点小组讨论收集。我们的研究试点测试了针对有心理健康改善需求的老年人的“SMART”。110名远程医疗产品用户的基线问卷包括人口统计信息、自评心理健康数字采用情况等问题。与57名用户(老年人及其护理人员)进行的后续五次焦点小组讨论进一步探讨了远程医疗转型的社会决定因素,并有助于提出综合远程医疗范式转变框架的建立、发展和完善。
基于基线需求评估和收集的反馈,很明显来自四个不同来源(社区、诊所、家庭、远程)的多维度健康信息和定制的数字健康解决方案在满足老年人心理健康数字服务需求和弥合数字鸿沟方面发挥着关键作用。所设计的远程医疗产品通过我们的三级设计将医疗服务提供者(供应方)与老年人的特定需求(需求方)相匹配,使老年人及其家庭能够跟踪和控制自己的健康管理,并与服务提供者、实践社区(CoP)和卫生政策制定者建立联系。
在综合且对年龄友好的数字干预的开发和交付阶段之前及整个过程中,让老年人和老年技术利益相关者作为基于社区的参与式研究(CBPR)的一部分参与进来是有益的。老年人和护理人员所反映的远程医疗应用和传播中的挑战可作为进一步发展的重要输入以及可持续和综合的老年初级保健框架的指标。
在线版本包含可在网址10.1007/s13755-022-00198-4获取的补充材料。