How Should Organizations Promote Equitable Distribution of Benefits from Technological Innovation in Health Care?

Nambisan, Satish; Nambisan, Priya

doi:10.1001/journalofethics.2017.19.11.stas1-1711

Cited by 11 publications

(3 citation statements)

References 24 publications

(33 reference statements)

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“…Equitable distribution of innovative healthcare technology is predicated on co-creation: inclusion of all stakeholders at all stages of a product's development (Nambisan and Nambisan, 2017). VR is inherently an interdisciplinary platform, informed by the fields of psychology, computer science, game studies, architecture, and among others.…”

Section: Discussionmentioning

confidence: 99%

Virtually Real, But Not Quite There: Social and Economic Barriers to Meeting Virtual Reality’s True Potential for Mental Health

Pimentel

Foxman

Davis

et al. 2021

Front. Virtual Real.

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Strategies to mitigate the spread of COVID-19, namely quarantine and social distancing protocols, have exposed a troubling paradox: mandated isolation meant to preserve well-being has inadvertently contributed to its decline. Prolonged isolation has been associated with widespread loneliness and diminished mental health, with effects compounded by limited face-to-face access to clinical and social support systems. While remote communication technologies (e.g., video chat) can connect individuals with healthcare providers and social networks, remote technologies might have limited effectiveness in clinical and social contexts. In this review, we articulate the promise of Virtual Reality as a conduit to clinical resources and social connection. Furthermore, we outline various social and economic factors limiting the virtual reality industry’s ability to maximize its potential to address mental health issues brought upon by the pandemic. These barriers are delineated across five dimensions: sociocultural, content, affordability, supply chain, and equitable design. After examining potential short- and long-term solutions to these hurdles, we outline potential avenues for applied and theoretical research seeking to validate these solutions. Through this evaluation we seek to (a) emphasize virtual reality’s capacity to improve mental health by connecting communities to clinical and social support systems, (b) identify socioeconomic barriers preventing users from accessing these systems through virtual reality, and (c) discuss solutions that ensure these systems can be equitably accessed via changes to existing and future virtual reality infrastructures.

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Section: Discussionmentioning

confidence: 99%

Virtually Real, But Not Quite There: Social and Economic Barriers to Meeting Virtual Reality’s True Potential for Mental Health

Pimentel

Foxman

Davis

et al. 2021

Front. Virtual Real.

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“…Patients have concerns about losing their relationship with professionals or “being lost in the data” [ 11 , 14 ]. This digital divide and the risk of digital inequalities [ 15 - 18 ] must be noted when considering what kinds of patient groups to target with digital services.…”

Section: Introductionmentioning

confidence: 99%

Segmenting Patients With Diabetes With the Navigator Service in Primary Care and a Description of the Self-Acting Patient Group: Cross-Sectional Study

Riihimies¹,

Koskela²,

Kosunen³

2023

J Med Internet Res

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Background The aim of patient segmentation is to recognize patients with similar health care needs. The Finnish patient segmentation service Navigator segregates patients into 4 groups, including a self-acting group, who presumably manages their everyday life and coordinates their health care. Digital services could support their self-care. Knowledge on self-acting patients’ characteristics is lacking. Objective The study aims are to describe how Navigator assigns patients with diabetes to the 4 groups at nurses’ appointments at a health center, the self-acting patient group’s characteristics compared with other patient groups, and the concordance between the nurse’s evaluation of the patient’s group and the actual group assigned by Navigator (criterion validity). Methods Patients with diabetes ≥18 years old visiting primary care were invited to participate in this cross-sectional study. Patients with disability preventing informed consent for participation were excluded. Nurses estimated the patients’ upcoming group results before the appointment. We describe the concordance (%) between the evaluation and actual groups. Nurses used Navigator patients with diabetes (n=304) at their annual follow-up visits. The self-acting patients’ diabetes care values (glycated hemoglobin [HbA1c], urine albumin to creatinine ratio, low-density lipoprotein cholesterol, blood pressure, BMI), chronic conditions, medication, smoking status, self-rated health, disability (World Health Organization Disability Assessment Schedule [WHODAS] 2.0), health-related quality of life (EQ-5D-5L), and well-being (Well-being Questionnaire [WBQ-12]) and the patients’ responses to Navigator’s question concerning their digital skills as outcome variables were compared with those of the other patients. We used descriptive statistics for the patients’ distribution into the 4 groups and demographic data. We used the Mann-Whitney U test with nonnormally distributed variables, independent samples t test with normally distributed variables, and Pearson chi-square tests with categorized variables to compare the groups. Results Most patients (259/304, 85.2%) were in the self-acting group. Hypertension, hyperlipidemia, and joint ailments were the most prevalent comorbidities among all patients. Self-acting patients had less ischemic cardiac disease (P=.001), depression or anxiety (P=.03), asthma or chronic obstructive pulmonary disease (P<.001), long-term pain (P<.001), and related medication. Self-acting patients had better self-rated health (P<.001), functional ability (P<.001), health-related quality of life (P<.001), and general well-being (P<.001). All patients considered their skills at using electronic services to be good. Conclusions The patients in the self-acting group had several comorbidities. However, their functional ability was not yet diminished compared with patients in the other groups. Therefore, to prevent diabetic complications and disabilities, support for patients’ self-management should be emphasized in their integrated care services. Digital services could be involved in the care of patients willing to use them. The study was performed in 1 health center, the participants were volunteers, and most patients were assigned to self-acting patient group. These facts limit the generalizability of our results. International Registered Report Identifier (IRRID) RR2-10.2196/20570

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“…Cocreation is a process to plan and define public services specifically aimed at reducing the mismatch between beneficiary needs and provided services. Its application in health services and prevention has been recommended [17,18], in particular when IT tools are proposed [19][20][21][22]. There are published case studies on the development of apps and other eHealth tools [19,[23][24][25][26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Describing the Process and Tools Adopted to Cocreate a Smartphone App for Obesity Prevention in Childhood: Mixed Method Study (Preprint)

Rossi¹,

Ferrari²,

Amarri³

et al. 2019

Preprint

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BACKGROUND Childhood obesity prevention is a public health priority in industrialized countries. The Reggio Emilia Local Health Authority has implemented a program involving primary and secondary prevention as well as the care of obese children. There are many health-promoting mobile apps, but few are targeted to children and very few are sponsored by public health agencies. OBJECTIVE The goal of the research was to describe the process and tools adopted to cocreate a mobile app sponsored by the Reggio Emilia Local Health Authority to be installed in parents’ phones aimed at promoting child health and preventing obesity. METHODS After stakeholder mapping, a consulting committee including relevant actors, stakeholders, and users was formed. Key persons for childhood obesity prevention were interviewed, focus groups with parents and pediatricians were conducted, and community reporting storytelling was collected. The results of these activities were presented to the consulting committee in order to define the functionalities and contents of the mobile app. RESULTS Three key trends emerged from community reporting: being active, playing, and being outdoors; time for oneself, family, and friends; and the pressures of life and work and not having time to be active and socialize. In focus groups, interviews, and labs, mothers showed a positive attitude toward using an app to manage their children's weight, while pediatricians expressed concerns that the app could increase their workload. When these findings were explored by the consulting committee, four key themes were extracted: strong relationships with peers, family members, and the community; access to safe outdoor spaces; children’s need for age-appropriate independence; and professional support should be nonjudgmental and stigma-free. It should be a dialogue that promotes family autonomy. The app functions related to these needs include the following: (1) newsletter with anticipatory guidance, recipes, and vaccination and well-child visit reminders; (2) regional map indicating where physical activity can be done; (3) information on how to manage emergencies (eg, falls, burns, fever); (4) module for reinforcing the counseling intervention conducted by pediatricians for overweight children; and (5) a function to build a balanced daily diet. CONCLUSIONS The pilot study we conducted showed that cocreation in health promotion is feasible, with the consulting committee being the key co-governance and cocreation tool. The involvement of stakeholders in this committee made it possible to expand the number of persons and institutions actively contributing to the project.

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How Should Organizations Promote Equitable Distribution of Benefits from Technological Innovation in Health Care?

Cited by 11 publications

References 24 publications

Virtually Real, But Not Quite There: Social and Economic Barriers to Meeting Virtual Reality’s True Potential for Mental Health

Virtually Real, But Not Quite There: Social and Economic Barriers to Meeting Virtual Reality’s True Potential for Mental Health

Segmenting Patients With Diabetes With the Navigator Service in Primary Care and a Description of the Self-Acting Patient Group: Cross-Sectional Study

Describing the Process and Tools Adopted to Cocreate a Smartphone App for Obesity Prevention in Childhood: Mixed Method Study (Preprint)

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