Impact of coordination mechanisms based on information and communication technologies on cross-level clinical coordination: A scoping review.

Background: Coordination mechanisms based on information and communication technologies (ICTs) are gaining attention, especially since the pandemic, due to their potential to improve communication between health professionals. However, their impact on cross-level clinical coordination remains unclear. The aim is to synthesize the evidence on the impact of ICT-based coordination mechanisms on clinical coordination between primary care and secondary care (SC) doctors and to identify knowledge gaps. Methods: A scoping review was conducted by searching for original articles in six electronic databases and a manual search, with no restrictions regarding time, area, or methodology. Titles and abstracts were screened. Full texts of the selected articles were reviewed and analysed to assess the impact of each mechanism, according to the cross-level clinical coordination conceptual framework. Results: Of the 6555 articles identified, 30 met the inclusion criteria. All had been conducted in high-income countries, most (n = 26) evaluated the impact of a single mechanism - asynchronous electronic consultations via electronic health records (EHR) - and were limited in terms of design and types and dimensions of cross-level clinical coordination analysed. The evaluation of electronic consultations showed positive impacts on the appropriateness of referrals and accessibility to SC, yet the qualitative studies also highlighted potential risks. Studies on other mechanisms were scarce (shared EHR, email consultations) or non-existent (videoconferencing, mobile applications). Conclusions: Evidence of the impact of ICT-based mechanisms on clinical coordination between levels is limited. Rigorous evaluations are needed to inform policies and strategies for improving coordination between healthcare levels, thus contributing to high-quality, efficient healthcare.

Innovative indenone-derivative colorimetric fluorescent probe: A approach for copper ion detection in water.

Copper (Cu2+) is a metal chemical element closely related to human life and is widely used in many fields. However, with the discharge of copper wastewater, the water quality will be seriously affected, leading to excessive intake of Cu2+ and a variety of diseases. Hence, there is a pressing need for an effective detection method for Cu2+ in aqueous environments. Leveraging the remarkable attributes of GFP chromophores and indenone derivatives, we have created a novel colorimetric fluorescent probe P-Cu2+, tailored for efficient copper ion detection. The addition of Cu2+ causes the solution to visibly change from colorless to a pronounced yellow, enabling naked-eye detection and offering promise for real sample analysis.

Patient and Provider Experiences With Compassionate Care in Virtual Physiatry: Qualitative Study.

BACKGROUND: Telemedicine in the realm of rehabilitation includes the remote delivery of rehabilitation services using communication technologies (eg, telephone, emails, and video). The widespread application of virtual care grants a suitable time to explore the intersection of compassion and telemedicine, especially due to the impact of COVID-19 and how it greatly influenced the delivery of health care universally. OBJECTIVE: The purpose of this study was to explore how compassionate care is understood and experienced by physiatrists and patients engaged in telemedicine. METHODS: We used a qualitative descriptive approach to conduct interviews with patients and physiatrists between June 2021 and March 2022. Patients were recruited across Canada from social media and from a single hospital network in Toronto, Ontario. Physiatrists were recruited across Canada through social media and the Canadian Association for Physical Medicine and Rehabilitation (CAPM&R) email listserve. Interviews were recorded and transcribed. Data were analyzed thematically. RESULTS: A total of 19 participants were interviewed-8 physiatrists and 11 patients. Two themes capturing physiatrists' and patients' experiences with delivering and receiving compassionate care, especially in the context of virtual care were identified: (1) compassionate care is inherently rooted in health care providers' inner intentions and are, therefore, expressed as caring behaviors and (2) virtual elements impact the delivery and receipt of compassionate care. CONCLUSIONS: Compassionate care stemmed from physiatrists' caring attitudes which then manifest as caring behaviors. In turn, these caring attitudes and behaviors enable individualized care and the establishment of a safe space for patients. Moreover, the virtual care modality both positively and negatively influenced how compassion is enacted by physiatrists and received by patients. Notably, there was large ambiguity around the norms and etiquette surrounding virtual care. Nonetheless, the flexibility and person-centeredness of virtual care cause it to be useful in health care settings.

How Has High School Learned from the Global Pandemic?

The study focuses on the consequences of the pandemic for the further development of higher education. The purpose of the article is to summarize the main consequences of the pandemic, which have become the result of scientific analysis and the object of many scientific studies. These are the degree of students' satisfaction with online learning, technological readiness of universities, the impact of new learning conditions on the psychological and emotional sphere, the problem of cheating at examinations, the problem of quality of education. Analysis of studies shows that in the academic environment there are different estimates of the pandemic period, sometimes they are of opposite nature. In spite of possibilities of online education universities tend to return to the full-time form of education. The study emphasizes that there are long-term consequences of the pandemic that are on the periphery of researchers' attention. These are the legal and economic consequences for universities, as the online form of learning has acquired a different legal status. In addition, the introduction of online learning is inevitably associated with additional hardware and software costs. Another important consequence is the impact of the pandemic on academic culture. Under the pandemic, students were isolated from the traditional academic environment, which affected the transformation of social rituals and academic ethics. Academic Values. Since there has been no complete return to previous conditions and the threat of a global pandemic exists, the new experience is integrated into the existing system of academic values and serves as a trigger for change in the long term.

Ratiometric detection and monitoring of cyanide in biological, environmental and food samples by a novel triphenylamine-xhantane based fluorescent probe.

BACKGROUND: As cyanide (CN-) is a significant hazard to the environment and human health, it is essential to monitor cyanide levels in water and food samples. Moreover, real-time visualization of CN-could provide an additional understanding of its critical physiological and toxicological roles in living cells. The fluorescence approach based on small organic probes is an effective way for the detection of CN-. In this approach, a triphenylamine-xhantane conjugate was applied to detect in many samples such as sewage water, soil, sprouted potato, apricot seed, and living cells. RESULTS: We report a new ratiometric near-infrared fluorescent probe based on a triphenylamine-xhantane derivative for CN-sensing in many samples. The probe displays high selectivity for only CN- ions among a series of analytes. The addition of cyanide to the dicyanovinyl moiety of the probe disrupts π-conjugation followed by the interruption of internal charge transfer. Consequently, the emission peak of the probe shifts hypsochromically from 655 to 495 nm. There is a linear correlation between the emission intensity (I495) and cyanide level, with a detection limit of 0.036 µM. The probe has many advantages over many probes, such as NIR fluorescence, ratiometric response, low cytotoxicity (85.0 % cell viability up to 50.0 µM of the probe), good membrane permeability, fast response time (4.0 min), high selectivity, good photostability, and anti-interference capability. SIGNIFICANCE: Although various probes have been reported in the literature, the use of triphenylamine-xhantane unit as CN- probe has yet to be explored. The probe can detect trace levels of cyanide in many samples such as sewage water, soil, sprouted potatoes, and apricot seeds. Furthermore, it is successfully utilized for the ratiometric fluorescent bioimaging of cyanide in living cells.

Peer mentoring experience related to information and communication technologies. A qualitative study.

INTRODUCTION: Quality and inclusive education must include Information and Communication Technologies (ICT), which is a growing trend in educational environments since the COVID-19 pandemic. These technologies have transformed learning towards more collaborative and interactive models, but they also pose a barrier due to the lack of skills or knowledge about their use. This circumstance has been identified among some first-year nursing students. OBJECTIVE: The present study focuses on exploring the perception of students who participated in the experience of peer mentoring to improve adaptation to the use of Information and Communication Technologies. DESIGN AND METHODS: The study employed a descriptive qualitative approach, relying on in-depth interviews and a focus group conducted with 29 students who participated in the project between 2020 and 2023. Additionally, sociodemographic data and information about Information and Communication Technologies were collected through a self-administered questionnaire. RESULTS: The findings indicate that mentors exhibited higher competencies than those being mentored, yet the experience was positive and satisfying for both, emerging as an effective strategy to facilitate learning. Another noteworthy result is the performance of younger students in the role of mentors, a fact that contradicts similar experiences. CONCLUSION: In conclusion, peer mentoring emerges as a valid strategy for acquiring digital competencies and Information and Communication Technologies among first-year nursing students, fostering more inclusive learning environments.

An Approach to the Design and Development of an Accredited Continuing Professional Development e-Learning Module on Virtual Care.

Unlabelled: Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers' experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.

Exploring the role of attitudes, self-efficacy, and digital competence in influencing teachers' integration of ICT: A partial least squares structural equation modeling study.

Effectively incorporating technology into teaching and learning can be accomplished through the application of information and communication technology (ICT). Nonetheless, the extent to which ICT is employed in educational environments is heavily impacted by numerous factors. Teachers' ICT integration in China was investigated with the aim of identifying the specific factors that influence it. The research sample consists of 680 educators, and it highlights three primary elements that affect their adoption of ICT: attitudes, self-efficacy, and digital competence. Employing a partial least squares structural equation modeling (PLS-SEM) method, the results indicate that all three elements play a significant role in the effective integration of ICT by educators. The study also indicated the mediating effect of attitudes and digital competence. Furthermore, the research identified no substantial disparities in the factors based on sex or age, except for the correlation between self-efficacy and attitudes. By providing useful insights for the development of successful instructional designs that integrate ICT, this study contributed to the advancement and impact of educational technology.

A coumarin-naphthalimide-based ratiometric fluorescent probe for nitroxyl (HNO) based on an ICT-FRET mechanism.

Nitroxyl (HNO) is an important reactive nitrogen that is associated with various states in physiology and pathology and plays a unique function in living systems. So, it is important to exploit fluorescent probes with high sensitivity and selectivity for sensing HNO. In this paper, a novel ratiometric fluorescent probe for HNO was developed utilizing intramolecular charge transfer (ICT) and fluorescence resonance energy transfer (FRET) mechanisms. The probe selected coumarin as energy donor, naphthalimide as energy receptor and 2-(diphenylphosphino)benzoate as the sensing site for detecting HNO. When HNO was not present, the 2-(diphenylphosphino)benzoate unit of the probe restricted electron transfer and the ICT process could not occur, leading to the inhibition of FRET process as well. Thus, in the absence of HNO the probe displayed the intrinsic blue fluorescence of coumarin. When HNO was added, the HNO reacted with the 2-(diphenylphosphino)benzoate unit of the probe to yield a hydroxyl group which resulting in the opening of ICT process and the occurring of FRET process. Thus, after providing HNO the probe displayed yellow fluorescence. In addition, the probe showed good linearity in the ratio of fluorescence intensity at 545 nm and 472 nm (I545 nm/I472 nm) with a concentration of HNO (0.1-20 µM). The probe processed a detection limit of 0.014 µM and a response time of 4 min. The probe also specifically identified HNO over a wide pH scope (pH = 4.00-10.00), including physiological conditions. Cellular experiments had shown that this fluorescent probe was virtually non-cytotoxic and could be applied for ratiometric sensing of HNO in A549 cells.

The Information and Communication Technology Maturity Assessment at Primary Health Care Services Across 9 Provinces in Indonesia: Evaluation Study.

Background: Indonesia has rapidly embraced digital health, particularly during the COVID-19 pandemic, with over 15 million daily health application users. To advance its digital health vision, the government is prioritizing the development of health data and application systems into an integrated health care technology ecosystem. This initiative involves all levels of health care, from primary to tertiary, across all provinces. In particular, it aims to enhance primary health care services (as the main interface with the general population) and contribute to Indonesia's digital health transformation. Objective: This study assesses the information and communication technology (ICT) maturity in Indonesian health care services to advance digital health initiatives. ICT maturity assessment tools, specifically designed for middle-income countries, were used to evaluate digital health capabilities in 9 provinces across 5 Indonesian islands. Methods: A cross-sectional survey was conducted from February to March 2022, in 9 provinces across Indonesia, representing the country's diverse conditions on its major islands. Respondents included staff from public health centers (Puskesmas), primary care clinics (Klinik Pratama), and district health offices (Dinas Kesehatan Kabupaten/Kota). The survey used adapted ICT maturity assessment questionnaires, covering human resources, software and system, hardware, and infrastructure. It was administered electronically and involved 121 public health centers, 49 primary care clinics, and 67 IT staff from district health offices. Focus group discussions were held to delve deeper into the assessment results and gain more descriptive insights. Results: In this study, 237 participants represented 3 distinct categories: 121 public health centers, 67 district health offices, and 49 primary clinics. These instances were selected from a sample of 9 of the 34 provinces in Indonesia. Collected data from interviews and focus group discussions were transformed into scores on a scale of 1 to 5, with 1 indicating low ICT readiness and 5 indicating high ICT readiness. On average, the breakdown of ICT maturity scores was as follows: 2.71 for human resources' capability in ICT use and system management, 2.83 for software and information systems, 2.59 for hardware, and 2.84 for infrastructure, resulting in an overall average score of 2.74. According to the ICT maturity level pyramid, the ICT maturity of health care providers in Indonesia fell between the basic and good levels. The need to pursue best practices also emerged strongly. Further analysis of the ICT maturity scores, when examined by province, revealed regional variations. Conclusions: The maturity of ICT use is influenced by several critical components. Enhancing human resources, ensuring infrastructure, the availability of supportive hardware, and optimizing information systems are imperative to attain ICT maturity in health care services. In the context of ICT maturity assessment, significant score variations were observed across health care levels in the 9 provinces, underscoring the diversity in ICT readiness and the need for regionally customized follow-up actions.

Evaluating the moderating role of governance on the relationships between social inclusion, ICT infrastructure, and financial inclusion.

In this paper, we examine the Moderating Role of Governance on the Relationships between social inclusion (SI), Information and communication technology infrastructure (ICT), and financial inclusion (FI) in 46 countries representing a global sample span from 2010 to 2020. We collect the data from the IMF's financial access survey and construct a multidimensional FI index. Based on the FI index, we divide the sample into two sub-samples (med-high level and low-level FI countries). For the empirics, we employed panel-corrected standard errors, fully modified ordinary least squares and dynamic ordinary least squares techniques. We find that SI is negatively related to FI. ICT infrastructure positively influences FI. Further, we find that governance with sound ICT infrastructure and socially inclusive communities enhances FI. The findings of sub-samples are similar to the full sample results except for a promoting effect of SI and governance in the case of med-high financially inclusive economies. Moreover, the Interaction term of governance and ICT infrastructure is insignificant in med-high financially inclusive economies and negatively significant in low financially inclusive economies. Our study reports novel findings which have significant implications for policymakers and financial institutions to effectively develop and implement new policies which strengthen the institutional base, develop digital banking infrastructure, enhance SI to boost up FI and ensure sustainable economic growth.

Environmental policy stringency, ICT, and technological innovation for achieving sustainable development: Assessing the importance of governance and infrastructure.

Achieving sustainable development goals (SDGs) has garnered significant attention from academia and policymakers worldwide. In this study, we examine the impact of ICT, technological innovation (TI), and environmental policy stringency (EPS) on SDI, considering the moderating role of governance quality (GQI) and transport infrastructure (TIS). A comprehensive dataset of 17 advanced nations is utilized from 1996 to 2021. To capture the dynamic and extreme marginal impacts of these policy instruments on SDG attainment, we employ the advanced technique of Feasible Generalized Least Square (FGLS). The results demonstrate that ICT has a positive and significant effect on SDGs, particularly when combined with high levels of governance quality (GOV) and transport infrastructure (TIS). Likewise, TI has a positive impact on SDGs, especially in the presence of strong governance. Furthermore, EPS exhibits a positive association with SDGs. The findings also reveal that while governance hurts SDGs, this effect diminishes when combined with higher levels of ICT, TI, and EPS, and when TIS positively moderates the relationships. The robustness estimations using DOLS and PCSE methods validate the FGLS findings. These results underscore the importance of ICT, TI, and EPS in advancing sustainable development. Moreover, they highlight the significance of good governance and robust transport infrastructure in maximizing the positive effects of these factors. These findings hold implications for policymakers and stakeholders involved in promoting sustainable development.

Digitalization and job stress: exploring the mediating roles of job and personal aversion risk with gender as a moderator.

Background: This time-lagged study delves into the impact of digitalization on job stress. Digitalization is defined as the incorporation of digital technologies into various aspects of work life, fundamentally transforming processes, interactions, and decision-making. Aim: The present research focuses on the mediating roles of job-related risk and personal risk, and the moderating effect of gender. We hypothesized that employees' aversion to risks, both in their professional and personal facets, mediates the relationship between the rapid digitalization of their work environment and the resultant job stress. Regarding gender as a moderator, recent research suggests that gender can influence the experience of workplace stress, with women often experiencing higher levels of stress than men in certain situations. This indicates that gender might also moderate the relationship between digital living, risk perception, and job-related stress. This approach allows for an examination of the ways in which digital technology adoption influences workplace stress, considering the temporally spaced data. Methods: Conducted over three waves of data collection among 795 Chinese employees, the research utilizes Hayes's Model 8, adept at revealing the dynamics of digitalization's influence in the workplace and its effects on individual well-being. Results: The study corroborates Hypothesis 1 by establishing a significant, albeit less pronounced, relationship between digital living and job stress. The findings also support Hypothesis 2 by demonstrating that both job risk and personal risk mediate this relationship. The study's results also validate Hypothesis 3, indicating that gender moderates the relationship between digital living, job risk, personal risk, and job stress. Finally, the significant interaction effects found in the study, particularly the stronger conditional negative effect of digital living on perceptions of job and personal risks for males, despite the absence of statistical significance failed to support Hypothesis 4. Implications: This study sheds light on the dynamics of job stress in the context of a digitalizing work environment. The results have important implications for designing workplace strategies and interventions that are sensitive to risk perceptions and gender differences in the digital era.

Telehealth Uptake Among Hispanic People During COVID-19: Retrospective Observational Study.

Background: The Hispanic community represents a sizeable community that experiences inequities in the US health care system. As the system has moved toward digital health platforms, evaluating the potential impact on Hispanic communities is critical. Objective: The study aimed to investigate demographic, socioeconomic, and behavioral factors contributing to low telehealth use in Hispanic communities. Methods: We used a retrospective observation study design to examine the study objectives. The COVID-19 Research Database Consortium provided the Analytics IQ PeopleCore consumer data and Office Alley claims data. The study period was from March 2020 to April 2021. Multiple logistic regression was used to determine the odds of using telehealth services. Results: We examined 3,478,287 unique Hispanic patients, 16.6% (577,396) of whom used telehealth. Results suggested that patients aged between 18 and 44 years were more likely to use telehealth (odds ratio [OR] 1.07, 95% CI 1.05-1.1; P<.001) than patients aged older than 65 years. Across all age groups, patients with high incomes were at least 20% more likely to use telehealth than patients with lower incomes (P<.001); patients who had a primary care physician (P=.01), exhibited high medical usage (P<.001), or were interested in exercise (P=.03) were more likely to use telehealth; patients who had unhealthy behaviors such as smoking and alcohol consumption were less likely to use telehealth (P<.001). Male patients were less likely than female patients to use telehealth among patients aged 65 years and older (OR 0.94, 95% CI 0.93-0.95; P<.001), while male patients aged between 18 and 44 years were more likely to use telehealth (OR 1.05, 95% CI 1.03-1.07; P<.001). Among patients younger than 65 years, full-time employment was positively associated with telehealth use (P<.001). Patients aged between 18 and 44 years with high school or less education were 2% less likely to use telehealth (OR 0.98, 95% CI 0.97-0.99; P=.005). Results also revealed a positive association with using WebMD (WebMD LLC) among patients aged older than 44 years (P<.001), while there was a negative association with electronic prescriptions among those who were aged between 18 and 44 years (P=.009) and aged between 45 and 64 years (P=.004). Conclusions: This study demonstrates that telehealth use among Hispanic communities is dependent upon factors such as age, gender, education, socioeconomic status, current health care engagement, and health behaviors. To address these challenges, we advocate for interdisciplinary approaches that involve medical professionals, insurance providers, and community-based services actively engaging with Hispanic communities and promoting telehealth use. We propose the following recommendations: enhance access to health insurance, improve access to primary care providers, and allocate fiscal and educational resources to support telehealth use. As telehealth increasingly shapes health care delivery, it is vital for professionals to facilitate the use of all available avenues for accessing care.

The impact of credit accessibility and information communication technology on the income of small-scale sugarcane farmers in Ndwedwe Local Municipality, KwaZulu-Natal Province, South Africa.

Introduction: Access to credit and information and communication technology (ICT) plays a pivotal role in enhancing the practices of small-scale sugarcane farmers, impacting their financial, social, and economic wellbeing. However, many small-scale farmers need help accessing these resources, thereby affecting their ability to generate sustainable income. This study aimed to assess the factors influencing the adoption of ICT and access to credit and their subsequent impact on small-scale farmers' income. Methods: Employing a multistage sampling technique, 300 small-scale farmers were selected as participants in the study. The recursive bivariate probit regression model was used to assess the factors affecting adoption ICT and a selectivity-corrected ordinary least square regression model was utilized to estimate the synergistic effect of ICT adoption and access to credit on the income of small-scale sugarcane farmers. Results and discussion: The findings revealed that approximately 77% of small-scale farmers had access to credit, while more than 80% had adopted ICT. The results derived from the recursive bivariate probit (RBP) regression model indicated that access to credit, education, and extension support positively and significantly influenced the adoption of ICT. Conversely, marital status and non-farm income exhibited a negative and significant influence on the adoption of ICT. Gender and marital status were positively and significantly associated with access to credit, whereas age, education, and non-farm income showed a negative and significant relationship on access to credit. Subsequently, a selectivity-corrected ordinary least square regression model analysis revealed that factors such as gender, marital status, extension, government support, and transportation costs positively and significantly influenced farmer's income. In contrast, education, employment status, and non-farm income exhibited a negative and significant influence on income. Conclusion and recommendations: The study concludes that socio-demographic factors, such as gender, marital status, extension support, government support, and transportation costs, positively contribute to farmers' income. Small-scale sugarcane farmer involvement in other non-farm activities is associated with reduced farm income. This implies that farmers' livelihoods options are reduced as they can only focus on sugarcane development as a source of income. There is a pressing need to educate small-scale farmers on ICT and provide them with access to agricultural credit. Additionally, extension workers should offer advisory support to small-scale farmers requiring assistance in accessing agricultural credit. There is a need to train sugarcane farmers on different agricultural income generating activities to reduce their over-reliance on sugarcane development. By addressing the identified socio-demographic factors and implementing targeted policy interventions, stakeholders can foster an enabling environment for small-scale farmers to thrive, ultimately contributing to the sustainable development of the sugarcane sector and the broader agricultural landscape in South Africa.

Measuring the adoption of internet and communication technologies among practitioners in routine disability services: a stepped inclusive approach.

PURPOSE: Existing measurements of the use of information and communication technologies (ICTs) among practitioners in disability services often treat ICT adoption as a monolithic concept, overlooking its multifaceted nature within the disability field. This study introduces a stepped, inclusive approach to capturing this complexity, elucidating disparities in the utilization of various ICT dimensions, the present vs. anticipated use, and variations among different clinical-demographic groups. MATERIALS AND METHODS: A cross-sectional survey was conducted in Hong Kong, gathering valid data from 324 practitioners spanning diverse disciplines and disability services. RESULTS: Data analysis produced a three-factor model categorizing ICT tools into (1) information and communication tools, (2) screening and monitoring tools, and (3) treatment and rehabilitation tools. The first category was identified as the predominant ICT utilized currently, with significant projected growth in the latter two categories' usage. Variances in current ICT adoption were influenced by practitioners' roles, clientele, positions, affiliating agencies, and educational attainments. CONCLUSIONS: This research provides a deeper understanding of the key dimensions of ICT adoption within disability services. It underscores the importance of devising specific and customized strategies for the effective integration of ICTs, ensuring a more tailored approach to meeting the unique demands of the disability field.

Future studies focusing on information and communication technologies (ICTs) adoption or relevant concepts, such as e-health and telerehabilitation may consider employing similar methodological approaches accustomed to one's local context.Future attention and investment in ICT adoption in disability services should focus more on domains directly relevant to clinical and rehabilitation practice, tailoring strategies to the specific needs of the field.There exists an urgent imperative to enhance ICT training, especially for psychosocial and medical professionals, while also increasing investments in non-governmental organizations.Such support needs to be gender- and age-inclusive, ensuring it meets the diverse needs of practitioners at all organizational levels.

Software Testing of eHealth Interventions: Existing Practices and the Future of an Iterative Strategy.

eHealth interventions are becoming a part of standard care, with software solutions increasingly created for patients and health care providers. Testing of eHealth software is important to ensure that the software realizes its goals. Software testing, which is comprised of alpha and beta testing, is critical to establish the effectiveness and usability of the software. In this viewpoint, we explore existing practices for testing software in health care settings. We scanned the literature using search terms related to eHealth software testing (eg, "health alpha testing," "eHealth testing," and "health app usability") to identify practices for testing eHealth software. We could not identify a single standard framework for software testing in health care settings; some articles reported frameworks, while others reported none. In addition, some authors misidentified alpha testing as beta testing and vice versa. There were several different objectives (ie, testing for safety, reliability, or usability) and methods of testing (eg, questionnaires, interviews) reported. Implementation of an iterative strategy in testing can introduce flexible and rapid changes when developing eHealth software. Further investigation into the best approach for software testing in health care settings would aid the development of effective and useful eHealth software, particularly for novice eHealth software developers.

Improving the Acceptability and Implementation of Information and Communication Technology-Based Health Care Platforms for Older People With Dementia or Parkinson Disease: Qualitative Study Results of Key Stakeholders.

BACKGROUND: The management of neurodegenerative diseases (NDDs) in older populations is usually demanding and involves care provision by various health care services, resulting in a greater burden on health care systems in terms of costs and resources. The convergence of various health services within integrated health care models, which are enabled and adopted jointly with information and communication technologies (ICTs), has been identified as an effective alternative health care solution. However, its widespread implementation faces formidable challenges. Both the development and implementation of integrated ICTs are linked to the collaboration and acceptance of different groups of stakeholders beyond patients and health care professionals, with reported discrepancies in the needs and preferences among these groups. OBJECTIVE: Complementing a previous publication, which reported on the needs and requirements of end users in the development of the European Union-funded project PROCare4Life (Personalized Integrated Care Promoting Quality of Life for Older People), this paper aimed to report on the opinions of other key stakeholders from various fields, including academia, media, market, and decision making, for improving the acceptability and implementation of an integrated ICT-based health care platform supporting the management of NDDs. METHODS: The study included 30 individual semistructured interviews that took place between June and August 2020 in 5 European countries (Germany, Italy, Portugal, Romania, and Spain). Interviews were mostly conducted online, except in cases where participants requested to be interviewed in person. In these cases, COVID-19 PROCare4Life safety procedures were applied. RESULTS: This study identified 2 themes and 5 subthemes. User engagement, providing training and education, and the role played by the media were identified as strategic measures to ensure the acceptability of ICT-based health care platforms. Sustainable funding and cooperation with authorities were foreseen as additional points to be considered in the implementation process. CONCLUSIONS: The importance of the user-centered design approach in ensuring the involvement of users in the development of ICT-based platforms has been highlighted. The most common challenges that hinder the acceptability and implementation of ICT-based health care platforms can be addressed by creating synergies among the efforts of users, academic stakeholders, developers, policy makers, and decision makers. To support future projects in developing ICT-based health care platforms, this study outlined the following recommendations that can be integrated when conducting research on users' needs: (1) properly identify the particular challenges faced by future user groups without neglecting their social and clinical contexts; (2) iteratively assess the digital skills of future users and their acceptance of the proposed platform; (3) align the functionalities of the ICT platform with the real needs of future users; and (4) involve key stakeholders to guide the reflection on how to implement the platform in the future. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/22463.

Care Integration for Hepatitis C Virus Treatment Through Facilitated Telemedicine Within Opioid Treatment Programs: Qualitative Study.

BACKGROUND: Telemedicine has the potential to remove geographic and temporal obstacles to health care access. Whether and how telemedicine can increase health care access for underserved populations remains an open question. To address this issue, we integrated facilitated telemedicine encounters for the management of hepatitis C virus (HCV), a highly prevalent condition among people with opioid use disorder (OUD), into opioid treatment programs (OTPs). In New York State, OTPs are methadone-dispensing centers that provide patient-centered, evidence-based treatment for OUD. We investigated the integration and impact of facilitated telemedicine into OTP workflows in these settings. OBJECTIVE: This study aims to understand OTP staff experiences with integrating facilitated telemedicine for HCV treatment into OTPs, including best practices and lessons learned. METHODS: We conducted semistructured interviews with 45 OTP staff members (13 clinical, 12 administrative, 6 physicians, and 14 support staff members) at least one year after the implementation of facilitated telemedicine for HCV management. We used hermeneutic phenomenological analysis to understand OTP staff experiences. RESULTS: We identified 4 overarching themes illustrating the successful integration of facilitated telemedicine for HCV care into OTPs. First, integration requires an understanding of the challenges, goals, and values of the OTP. As OTP staff learned about new, highly effective HCV therapies, they valued an HCV cure as a "win" for their patients and were excited about the potential to eliminate a highly prevalent infectious disease. Second, the integration of facilitated telemedicine into OTPs fosters social support and reinforces relationships between patients and OTP staff. OTP staff appreciated the ability to have "eyes on" patients during telemedicine encounters to assess body language, a necessary component of OUD management. Third, participants described high levels of interprofessional collaboration as a care team that included the blurring of lines between disciplines working toward a common goal of improving patient care. Study case managers were integrated into OTP workflows and established communication channels to improve patient outcomes. Fourth, administrators endorsed the sustained and future expansion of facilitated telemedicine to address comorbidities. CONCLUSIONS: OTP staff were highly enthusiastic about facilitated telemedicine for an underserved population. They described high levels of collaboration and integration comparable to relevant integrative frameworks. When situated within OTPs, facilitated telemedicine is a high-value application of telemedicine that provides support for underserved populations necessary for high-quality health care. These experiences support sustaining and scaling facilitated telemedicine in comparable settings and evaluating its ability to address other comorbidities. TRIAL REGISTRATION: ClinicalTrials.gov NCT02933970; https://clinicaltrials.gov/study/NCT02933970.