Jutai Jeffrey W, Hatoum Farah, Bhardwaj Devvrat, Hosseini Marjan
Interdisciplinary School of Health Sciences and AGE-WELL Network of Centres of Excellence, University of Ottawa, Ottawa, ON, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Front Aging. 2024 May 7;5:1349520. doi: 10.3389/fragi.2024.1349520. eCollection 2024.
The critical importance of technological innovation in home care for older adults is indisputable. Less well understood is the question of how to measure its performance and impact on the delivery of healthcare to older adults who are living with chronic illness and disability. Knowing how well digital technologies, such as smartphones, tablets, wearable devices, and Ambient Assisted Living Technologies (AAL) systems "work" should certainly include assessing their impact on older adults' health and ability to function in daily living but that will not guarantee that it will necessarily be adopted by the user or implemented by a healthcare facility or the healthcare system. Technology implementation is a process of planned and guided activities to launch, introduce and support technologies in a certain context to innovate or improve healthcare, which delivers the evidence for adoption and upscaling a technology in healthcare practices. Factors in addition to user acceptance and clinical effectiveness require investigation. Failure to appreciate these factors can result in increased likelihood of technology rejection or protracted procurement decision at the "adoption decision" stage or delayed or incomplete implementation or discontinuance (following initial adoption) during implementation. The aim of our research to analyze research studies on the effectiveness of digital health technologies for older adults to answer the question, "How well do these studies address factors that affect the implementation of technology?" We found common problems with the conceptualization, design, and methodology in studies of digital technology that have contributed to the slow pace of implementation in home care and long-term care. We recommend a framework for improving the quality of research in this critical area. https://archive.org/details/osf-registrations-f56rb-v1, identifier osf-registrations-f56rb-v1.
技术创新在老年人居家护理中的至关重要性无可争议。然而，对于如何衡量其性能以及对患有慢性病和残疾的老年人提供医疗服务的影响，人们却了解得较少。了解诸如智能手机、平板电脑、可穿戴设备和环境辅助生活技术（AAL）系统等数字技术的“运行”情况，当然应该包括评估它们对老年人健康和日常生活功能能力的影响，但这并不能保证用户一定会采用，或者医疗机构或医疗系统一定会实施。技术实施是一个有计划、有指导的活动过程，旨在在特定背景下推出、引入并支持技术，以创新或改善医疗保健，为在医疗实践中采用和扩大技术规模提供依据。除了用户接受度和临床有效性之外，其他因素也需要进行调查。如果忽视这些因素，可能会导致在“采用决策”阶段技术被拒绝或采购决策延长的可能性增加，或者在实施过程中出现延迟或不完全实施或（在最初采用后）停止使用的情况。我们研究的目的是分析关于数字健康技术对老年人有效性的研究，以回答“这些研究在多大程度上解决了影响技术实施的因素？”这一问题。我们发现数字技术研究在概念化、设计和方法方面存在常见问题，这些问题导致了居家护理和长期护理中技术实施的缓慢步伐。我们推荐一个框架来提高这一关键领域的研究质量。https://archive.org/details/osf-registrations-f56rb-v1，标识符osf-registrations-f56rb-v1。
