Association of Financial Factors and Telemedicine Adoption for Heart Attack and Stroke Care Among Rural and Urban Hospitals: A Longitudinal Study

Tabriz, Amir Alishahi; Turner, Kea; Williams, Dunc; Babu, Nimmy; North, Steve; Shea, Christopher M.

doi:10.1089/tmj.2021.0341

Cited by 4 publications

(5 citation statements)

References 42 publications

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“…Relevant factors include how easy the digital therapeutic is to use [ 13 , 42 , 44 , 202 , 218 ], how health professionals perceive the digital capabilities and risk profile of the patient and the quality of the digital therapeutic [ 90 , 145 , 172 , 184 , 211 , 218 ], how the technology will affect organizational workflow, and professional responsibilities and autonomy [ 13 , 42 , 54 , 62 , 110 , 116 , 133 , 155 , 189 , 197 , 198 , 202 , 207 , 211 , 221 , 273 ]. Barriers to implementation (eg, financial, human resource, or time- and workload-related barriers) were also frequently cited [ 42 , 43 , 62 , 63 , 90 , 104 , 115 , 139 , 145 , 155 , 156 , 199 , 200 , 202 , 218 ].…”

Section: Resultsmentioning

confidence: 99%

“…With respect to process measures, professionals reported rigidity in their work process [ 146 , 187 , 192 , 196 ], as well as a tendency to be risk averse and to resist change unless a digital therapeutic had been nationally accredited or endorsed [ 63 , 104 , 139 , 147 , 231 , 248 ], reemphasizing the need for policy mechanisms aimed at the accreditation of digital therapeutics. Approval from the institutional or social environment was also reported as an important indicator of the uptake and use of digital therapeutics by health professionals [ 19 , 42 , 62 , 104 , 112 , 115 , 139 , 156 , 159 , 174 , 200 , 202 , 203 ]. Finally, certain medical specialties (eg, psychology, psychiatry, and neurology) may be more amenable to adopting digital therapeutics than other specialties (eg, ophthalmology, dermatology, and surgery) [ 140 , 145 , 146 , 162 , 167 , 183 , 196 , 213 , 235 , 236 , 247 ], which may be explained by the varying degrees of availability or applicability of digital therapeutics for different medical specialties [ 183 , 196 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

van Kessel,

Roman-Urrestarazu,

Anderson

et al. 2023

J Med Internet Res

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Background Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products. Objective In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals. Methods A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis. Results We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure. Conclusions The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system’s readiness for digital therapeutics.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

van Kessel,

Roman-Urrestarazu,

Anderson

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Relevant factors include how easy the digital therapeutic is to use [13,42,44,202,218], how health professionals perceive the digital capabilities and risk profile of the patient and the quality of the digital therapeutic [90,145,172,184,211,218], how the technology will affect organizational workflow, and professional responsibilities and autonomy [13,42,54,62,110,116,133,155,189,197,198,202,207,211,221,273]. Barriers to implementation (eg, financial, human resource, or time-and workload-related barriers) were also frequently cited [42,43,62,63,90,104,115,139,145,155,156,199,200,202,218].…”

Section: Health Professionalsmentioning

confidence: 99%

“…With respect to process measures, professionals reported rigidity in their work process [146,187,192,196], as well as a tendency to be risk averse and to resist change unless a digital therapeutic had been nationally accredited or endorsed [63,104,139,147,231,248], reemphasizing the need for policy mechanisms aimed at the accreditation of digital therapeutics. Approval from the institutional or social environment was also reported as an important indicator of the uptake and use of digital therapeutics by health professionals [19,42,62,104,112,115,139,156,159,174,200,202,203]. Finally, certain medical specialties (eg, psychology, psychiatry, and neurology) may be more amenable to adopting digital therapeutics than other specialties (eg, ophthalmology, dermatology, and surgery) [140,145,146,162,167,183,196,213,235,236,247], which may be explained by the varying degrees of availability or applicability of digital therapeutics for different medical specialties [183,196].…”

Section: Health Professionalsmentioning

confidence: 99%

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review (Preprint)

Kessel¹,

Román-Urrestarazu²,

Anderson³

et al. 2023

Preprint

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BACKGROUND Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products. OBJECTIVE In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals. METHODS A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis. RESULTS We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure. CONCLUSIONS The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system’s readiness for digital therapeutics.

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“…Telehealth is another financially debated innovation despite its potential to provide greater access to stroke specialists 18 and guideline-based care. Tabriz et al 19 provided an analysis of the telemedicine adoption rate for cardiac and stroke care in the United States between 2012 and 2017. Use increased during the study period, and the financial status of the hospital (for profit or not for profit) was a major driver of adoption for urban hospitals compared with rural hospitals.…”

Section: Cost-effectiveness Of Alternate Care Modelsmentioning

confidence: 99%

Stroke Care Costs and Cost-Effectiveness to Inform Health Policy

Bettger

Cadilhac

2022

Stroke

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dvances in stroke care policy during 2021 remained influenced by the COVID-19 pandemic, but several notable papers called attention to the costs of stroke care or the cost-effectiveness of options for care. Despite the variation in how costs were measured, estimated, and reported, policy recommendations for resourcing stroke services to support guideline-based care were found. The availability of cost data associated with all facets of stroke care and different perspectives (patients, hospitals, and payors) is increasing, but there are advances still to be made (Figure). This synthesis of a selection of papers published in 2021 on costs and stroke care effectiveness highlights the most recent efforts in examining the intersection of stroke care delivery and financial implications that could inform policy. The attention to appropriately financing stroke care delivery and its infrastructure for optimal quality and outcomes needs to remain at the forefront for decision makers who are responsible for allocating resources.

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Association of Financial Factors and Telemedicine Adoption for Heart Attack and Stroke Care Among Rural and Urban Hospitals: A Longitudinal Study

Cited by 4 publications

References 42 publications

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review (Preprint)

Stroke Care Costs and Cost-Effectiveness to Inform Health Policy

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