The new digital health innovations have opened up several opportunities to help the clinicians, patients and other caregivers of rheumatology healthcare system in maximizing efficiencies resulting in better patient outcomes. In the global context, digital health technology has the potential to bridge the distance gap between all the key stakeholders involved in rheumatology health care. In this review, we update on the recent advances in the field of digital health and highlight unique features of these technologies which would help in routine care. Application of technology in any form to enable, facilitate or enhance the quality of care is the foundation of digitised care. The components could be smartphone apps, sensors, video, social media platforms or messenger platforms, wearables or a combination of these enabling healthcare delivery and overcoming the constraints of distance, location and time. Digital therapeutics have started evolving and an important step in this direction is the involvement of FDA in the approval process. Speciality specific apps, personalised patient education as per disease status, remote specialist consultations or virtual health coach to guide on lifestyle modifications are some of the developments which have been facilitated by increased digitization in all walks of life. Assisted care with the help of robots rendering care in the hospitals or an intelligent robot guiding a patient by voice and visual sense at home are already at the threshold of entering the mainstream of patient care. Wearable devices equipped with powerful sensors are coming handy in keeping a watch on patient symptoms all the time and providing useful insights on disease progression, clinical response or complications. In chronic care such as rheumatology the implications, possibilities and benefits seem unprecedented. Real time data analytics and artificial intelligence are helping the clinicians, healthcare systems and policy makers optimise the resources and improve patient outcomes. Digitization of healthcare has gained momentum in the recent years and it is envisaged that it could be a catalyst to change, bridge the quality of care and most important democratise the healthcare access across the globe. However, more data, efficacy and objective results are needed which would be fulfilled by ongoing observational studies, clinical trials, systematic review and meta-analysis to further establish the role of digital health in the realms of patient care.
An information strategy for the modern NHSplaces the strategy in the context of broader Government policy, and describes the strategic information objectives and targets 2 Supporting patient care sets out how electronic patient and health records will be developed to support the healthcare process 3 Supporting integrated care through NHS-wide standards and infrastructure identifies the national infrastructure that must be in place to support local action 4 Information for improving health and more effective management addresses what must be done to improve the flow and use of information for health improvement, clinical governance, performance management and national service frameworks 5 Meeting public and patients' needs addresses how the information needs of patients and the general public will be met 6 Making it all happen outlines what needs to happen at national and local levels 7 Implementation programme sets the scene for detailed implementation guidance by discussing resources and local implementation timescales Annex -Local Implementation Strategies Glossary Contents 1 The new NHS: Modern • Dependable, Cm 3807, December 1997 'fast and convenient public access to information and care'Modernising Government -The Information Age 1.5 In his foreword to Our Information Age, which sets out the Government's vision for the exploitation of new technology in Britain, the Prime Minister said:1.6 The new information and communications technologies represent a major vehicle for modernisation, and are rapidly transforming the way we do business, receive services and live our lives. They are global and pervasive. Their speed and power is such that most sectors of the economy now have virtually no choice about whether and when to adopt them. 1.7The Government is both one of the most important service providers in the country and one of the most significant customers. It must provide its services in ways geared to the convenience of the citizen and business rather than to the boundaries of Government departments and agencies.1.8 Today access to public services is too often complicated, slow and inconvenient. People often have to contact or visit different departments or agencies, each dealing with separate aspects of the same problem. Although many people do appreciate the service they get, it is easy for them to feel that the seven day, 24 hour world that they normally live in appears to have passed the public sector by.1.9 Information technology can transform the way we live because it enables us to:s communicate with people wherever they are s communicate faster and more conveniently with a wider group of people s obtain goods and services in different, more convenient ways. 1.10Latest figures for the UK show that 6.2 million people have access to the Internet. UK companies covering 37% of our workforce now have websites and 33% of all companies will do business over the Internet. Digital technology is driving these changes, providing a shared language for computers, telecommunications, broadcasting and information. T...
The diversity of diseases in rheumatology and variability in disease prevalence necessitates greater data parity in disease presentation, treatment responses including adverse events to drugs and various co-morbidities. Randomized Controlled Trials (RCTs) are the gold standard for drug development and performance evaluation. However, when the drug is applied outside the controlled environment the outcomes may differ in patient population. In this context, the need to understand the macro and micro changes involved in disease evolution and progression becomes important and so is the need for harvesting and harnessing the Real-World Data (RWD) from various resources to use them in generating Real World Evidence (RWE). Digital tools with potential relevance to rheumatology can be potentially leveraged to obtain greater patient insights, greater information on disease progression and disease micro processes and even in the early diagnosis of diseases. Since the patients spend only a minuscule proportion of their time in hospital or in a clinic, using the modern digital tools to generate realistic, bias proof RWD in non-invasive patient friendly manner becomes critical. In this review we have appraised different digital mediums and mechanisms for collecting RWD and proposed digital care models for generating RWE in rheumatology.
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