Challenges and Needs in Digital Health Practice and Nursing Education Curricula: Gap Analysis Study.

Background: Australian nursing programs aim to introduce students to digital health requirements for practice. However, innovation in digital health is more dynamic than education providers' ability to respond. It is uncertain whether what is taught and demonstrated in nursing programs meets the needs and expectations of clinicians with regard to the capability of the nurse graduates. Objective: This study aims to identify gaps in the National Nursing and Midwifery Digital Health Capability Framework , based on the perspectives of clinical nurses, and in nurse educators' confidence and knowledge to teach. The findings will direct a future co-design process. Methods: This study triangulated the findings from 2 studies of the Digital Awareness in Simulated Health project and the National Nursing and Midwifery Digital Capability Framework. The first was a qualitative study that considered the experiences of nurses with digital health technologies during the COVID-19 pandemic, and the second was a survey of nurse educators who identified their confidence and knowledge to teach and demonstrate digital health concepts. Results: The results were categorized by and presented from the perspectives of nurse clinicians, nurse graduates, and nurse educators. Findings were listed against each of the framework capabilities, and omissions from the framework were identified. A series of statements and questions were formulated from the gap analysis to direct a future co-design process with nursing stakeholders to develop a digital health capability curriculum for nurse educators. Conclusions: Further work to evaluate nursing digital health opportunities for nurse educators is indicated by the gaps identified in this study.

Roles and Responsibilities of the Global Specialist Digital Health Workforce: Analysis of Global Census Data.

Background: The Global Specialist Digital Health Workforce Census is the largest workforce survey of the specialist roles that support the development, use, management, and governance of health data, health information, health knowledge, and health technology. Objective: This paper aims to present an analysis of the roles and functions reported by respondents in the 2023 census. Methods: The 2023 census was deployed using Qualtrics and was open from July 1 to August 13, 2023. A broad definition was provided to guide respondents about who is in the specialist digital health workforce. Anyone who self-identifies as being part of this workforce could undertake the survey. The data was analyzed using descriptive statistical analysis and thematic analysis of the functions respondents reported in their roles. Results: A total of 1103 respondents completed the census, with data reported about their demographic information and their roles. The majority of respondents lived in Australia (n=870, 78.9%) or New Zealand (n=130, 11.8%), with most (n=620, 56.3%) aged 35-54 years and identifying as female (n=720, 65.3%). The top four occupational specialties were health informatics (n=179, 20.2%), health information management (n=175, 19.8%), health information technology (n=128, 14.4%), and health librarianship (n=104, 11.7%). Nearly all (n=797, 90%) participants identified as a manager or professional. Less than half (430/1019, 42.2%) had a formal qualification in a specialist digital health area, and only one-quarter (244/938, 26%) held a credential in a digital health area. While two-thirds (502/763, 65.7%) reported undertaking professional development in the last year, most were self-directed activities, such as seeking information or consuming online content. Work undertaken by specialist digital health workers could be classified as either leadership, functional, occupational, or technological. Conclusions: Future specialist digital health workforce capability frameworks should include the aspects of leadership, function, occupation, and technology. This largely unqualified workforce is undertaking little formal professional development to upskill them to continue to support the safe delivery and management of health and care through the use of digital data and technology.

National survey on understanding nursing academics' perspectives on digital health education.

AIM: This study explored the knowledge and confidence levels of nursing academics in teaching both the theories and practical skills of digital health in undergraduate nursing programs. DESIGN: A cross-sectional study. METHODS: A structured online survey was distributed among nursing academics across Australian universities. The survey included two sections: (1) the participants' demographics and their nursing and digital health teaching experience; (2) likert scales asking the participants to rate their knowledge and confidence to teach the theories and practical skills of four main themes; digital health technologies, information exchange, quality and digital professionalism. RESULTS: One hundred and nineteen nursing academics completed part one, and 97 individuals completed part two of the survey. Only 6% (n = 5) of the participants reported having formal training in digital health. Digital health was mainly taught as a module (n = 57, 45.9%), and assessments of theory or practical application of digital health in the nursing curriculum were uncommon, with 79 (69.9%) responding that there was no digital health assessment in their entry to practice nursing programs. Among the four core digital health themes, the participants rated high on knowledge of digital professionalism (22.4% significant knowledge vs. 5.9% no knowledge) but low on information exchange (30% significant knowledge vs. 28.3% no knowledge). Statistically significant (p < .001) associations were found between different themes of digital health knowledge and the level of confidence in teaching its application. Nursing academics with more than 15 years of teaching experience had a significantly higher level of knowledge and confidence in teaching digital health content compared with those with fewer years of teaching experience. CONCLUSION: There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Nursing academics need to upskill in digital health to prepare the future workforce to be capable in digitally enabled health care settings. IMPLICATIONS FOR THE PROFESSION: Nursing academics have a limited level of digital knowledge and confidence in preparing future nurses to work in increasingly technology-driven health care environments. Addressing this competency gap and providing sufficient support for nursing academics in this regard is essential. IMPACT: What problem did the study address? Level of knowledge and confidence among nursing academics to teach digital health in nursing practice. What were the main findings? There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Where and on whom will the research have an impact? Professional nursing education globally. REPORTING METHOD: The STROBE guideline was used to guide the reporting of the study. PATIENT OR PUBLIC CONTRIBUTION: The call for participation from nursing academics across Australia provided an introductory statement about the project, its aim and scope, and the contact information of the principal researcher. A participant information sheet was shared with the call providing a detailed explanation of participation. Nursing academics across Australia participated in the survey through the link embedded in the participation invite.

Understanding Clinician EHR Data Quality for Reuse in Predictive Modelling.

It is imperative to build clinician trust to reuse ever-growing amounts of rich clinical data. Utilising a proprietary, structured electronic health record, we address data quality by assessing the plausibility of chiropractors, physical therapists and osteopaths' data entry to help determine if the data is fit for use in predicting outcomes of work-related musculoskeletal disorders using machine learning. For most variables assessed, individual clinician data entry positively correlated to the clinician group's data entry, indicating data is fit for reuse. However, from the clinician's perspective, there were inconsistencies, which could lead to data mistrust. When assessing data quality in EHR studies, it is crucial to engage clinicians with their deep understanding of EHR use, as improvement suggestions could be made. Clinicians should be considered local knowledge experts.

Insights on the Future of Digital Health: An Analysis of Twitter Posts of IMIA Fellows.

The COVID-19 pandemic has reshaped technology-enhanced services in health and care organizations globally. As the world pivots towards a post-COVID-19 environment, it is essential to examine emerging trends amongst thought leaders in the health information technology sector. This study queried Twitter feeds of IMIA Fellows from 2013 through 2022, utilizing combinations of sentiment analysis, latent dirichlet allocation, and document analysis methods. The results provided a glimpse of positive sentiment year upon year, with the most negative sentiment prevalent in 2020, due to the onset of the pandemic. The findings from this study can be strategically used to analyze emerging trends in digital health, as well as to shape health IT thought leadership in the post-pandemic landscape.

The Australian Health Informatics Competency Framework: Conceptual Design, Framework Development, and Certification Delivery.

The Australian Health Informatics Competency Framework (AHICF) guides the healthcare workforce in identifying the required competencies to perform as a health informatician, and more definitively defines the foundational body of knowledge on which the discipline is based. The aim of this paper is to describe the conceptual foundations in developing the AHICF v1.0, detail the methods used to revise and publish AHICF v2.0, and explore the certification and workforce outcomes achieved. This paper contributes to the competency framework and certification discourse, and knowledge of the increasing importance and recognition of health informaticians through certification. Further, implications for workforce training and education, career advancement and recruitment strategies, are also discussed.

An Exploration of the Certified Health Informatician Australasia (CHIA) Participants.

The Certified Health Informatician Australasian (CHIA) is an assessment of a candidate's capabilities measured using a core set of health informatics competencies. The aim of this paper is to describe the outcomes of the first eight years since the program's launch. This paper contributes to the competency framework and certification discourse, and knowledge of the increasing importance and recognition of health informaticians through certification. An analysis of results and possible contributing factors is discussed.

Are physiotherapists expected to be competent in digital health practice? Meta-synthesis of international physiotherapy practice competency standards.

BACKGROUND: Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging. OBJECTIVE: Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice. METHODS: Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes. RESULTS: Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities. CONCLUSIONS: Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice.

The typing is on the wall: Australia's healthcare future needs a digitally capable workforce.

Digital health technologies are a proposed solution to improve healthcare delivery and reduce pressures on the healthcare system, but these technologies are new to much of the health workforce. This perspective paper highlights lessons learned from the global experience of rapid digital transformation of health workforces, including fostering a culture of learning, ensuring accreditation and recognition, and adopting a transdisciplinary approach. Evidence-based actions are proposed to address recommendations to (1) ensure foundational workforce digital health capability and (2) build specialist digital health career pathways. Australia must take a national approach and strategically leverage strong collaborations across sectors including healthcare, education and government to ensure a consistent, regulated and sustainable digital workforce capability.

Sociotechnical Challenges of Digital Health in Nursing Practice During the COVID-19 Pandemic: National Study.

BACKGROUND: The COVID-19 pandemic has accelerated the use of digital health innovations, which has greatly impacted nursing practice. However, little is known about the use of digital health services by nurses and how this has changed during the pandemic. OBJECTIVE: This study explored the sociotechnical challenges that nurses encountered in using digital health services implemented during the pandemic and, accordingly, what digital health capabilities they expect from the emerging workforce. METHODS: Five groups of nurses, including chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and nurse representatives in government bodies across Australia were interviewed. They were asked about their experience of digital health during the pandemic, their sociotechnical challenges, and their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analyzed based on 8 sociotechnical themes, including technical challenges, nurse-technology interaction, clinical content management, training and human resources, communication and workflow, internal policies and guidelines, external factors, and effectiveness assessment of digital health for postpandemic use. RESULTS: Sixteen participants were interviewed. Human factors and clinical workflow challenges were highly mentioned. Nurses' lack of knowledge and involvement in digital health implementation and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions beyond documentation, such as data analytics and decision-making. CONCLUSIONS: Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts among policy makers, vendors, and clinical and academic industries can leverage digital health capabilities in the nursing workforce.

Perceived quality of online learning during COVID-19 in higher education in Singapore: perspectives from students, lecturers, and academic leaders.

The COVID-19 pandemic has significantly affected the higher education sector in Singapore. Existing tertiary studies seeking to understand the intraperiod response to COVID-19 often focus on single institutions, jurisdictions or stakeholder groups. This study is the first in-depth qualitative multi-stakeholder examination of the higher education environment in Singapore during the COVID-19 pandemic. It explored the perceptions of the quality of digital pedagogy during COVID-19, how universities have adapted because of the pandemic, and how leaders, teaching staff and students have been affected by the management and educational changes via 13 semi-structured interviews across six Singapore higher education institutions. Through purposive sampling, we explore current stakeholder perceptions, structural education changes, and personal learning and teaching impacts of COVID-19. Applying Braun and Clarke's approach to thematic analysis, we inductively uncovered four major themes: the Singapore government's approach to COVID-19 and its effects on delivery; academic leadership approaches; education technology; and well-being. This article is critical as a key foundation to understand how Singapore is responding with unique geopolitical differences. We discuss the practical implications of our research for current university faculty and students during and beyond the pandemic, and outline opportunities for future research.

Prescribing behavior of antidepressants for depressive disorders: A systematic review.

Objective: Guidelines for the prescription of antidepressants for Depressive Disorders (DD) have been in place for a long time. However, there is a lack of systematic information on the prescribing behavior of antidepressants in evidence-based clinical practice in psychopharmacotherapy of depressive disorders. This may suggest a lack of implementation of clinical guidelines by clinicians. Existing literature mainly focuses on specific issues or medications. To provide general information on the prescribing behavior of antidepressants for depressive disorders, a systematic review of available studies since 2013 was conducted. Methods and materials: To ensure a structured and systematic approach for the literature search and subsequent review process, the PRISMA guidelines for systematic reviews were followed. Major medical and health and psychological databases were used for the literature search. These included Ebsco Host, OVID, PubMed, Science Direct, Scopus, and Web of Science. The online application "Covidence" was employed to manage the titles collected and the full articles retrieved from the initial literature search. Upon finalizing the list of selected studies, data extraction was then conducted using a build-in function of the Covidence platform with the required information pre-set on a template for data extraction. The extracted information was tabulated and summarized in a table. Results: Forty-one studies were identified after an extensive search of the literature following the PRISMA guidelines. Of these, 37 quantitative studies providing useful information were systematically reviewed and information extracted. There was a high level of heterogeneity among these studies with different foci or characteristics. Most studies were conducted in or utilized data obtained from hospital and primary healthcare settings. SSRIs were the most commonly prescribed type of antidepressant in the past decade, particularly among younger patients. Among these studies, antidepressants were mainly prescribed by psychiatrists with some by other physicians and general practitioners. This might reflect differences in legislation regarding professional requirements for prescribers or clinical practices. Conclusions: A few themes that would be considered important in terms of the effect of prescription behavior on depression, specifically children/adolescents, special target populations, and off-label prescription. The results highlighted the need for more studies on a community-based approach and the role of GPs in the treatment of DD.

The Impact of Digital Health Transformation Driven by COVID-19 on Nursing Practice: Systematic Literature Review.

BACKGROUND: The COVID-19 pandemic has accelerated the uptake of digital health innovations due to the availability of various technologies and the urgent health care need for treatment and prevention. Although numerous studies have investigated digital health adoption and the associated challenges and strategies during the pandemic, there is a lack of evidence on the impact on the nursing workforce. OBJECTIVE: This study aims to identify the impact of digital health transformation driven by COVID-19 on nurses. METHODS: The online software Covidence was used to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Relevant scientific health and computing databases were searched for papers published from January 2020 to November 2021. Using the 8D sociotechnical approach for digital health in health care systems, the papers were analyzed to identify gaps in applying digital health in nursing practice. RESULTS: In total, 21 papers were selected for content analysis. The analysis identified a paucity of research that quantifies the impact of the digital health transformation on nurses during the pandemic. Most of the initiatives were teleconsultation, followed by tele-intensive care unit (tele-ICU), and only 1 (5%) study explored electronic medical record (EMR) systems. Among the sociotechnical elements, the human-related factor was the most explored and the system measurement was the least studied item. CONCLUSIONS: The review identified a significant gap in research on how implementing digital health solutions has impacted nurses during the COVID-19 pandemic. This gap needs to be addressed by further research to provide strategies for empowering the nursing workforce to be actively involved in digital health design, development, implementation, use, and evaluation.

Patient Expectations: Searching Websites on How to Apply to Access Medical Records.

Patients who want to know how to access their medical records from a health organization's website have certain expectations about what must be included to assist in this process. The purpose of this article is to detail patient expectations of a health care organization website when searching for information on how to apply for access to their medical records. Using expectation confirmation theory, a survey was developed to ask patients, as consumers of health care, about their expectations when accessing websites. The results revealed that patients want websites to be safe and secure and have help available if there are questions about the website or search functionality. In order to improve the patient experience, health care providers need to understand these expectations from the patient perspective about this information-seeking exercise.

The impact of health information management professionals on patient safety: A systematic review.

BACKGROUND: The importance of high-quality health information for patient safety has been established in the literature, yet the impact of the professionals who are the custodians of health information is absent. OBJECTIVES: This article presents the results of a systematic literature review examining the impact of the Health Information Management (HIM) profession on patient safety. METHODS: A PRISMA approach was adopted for the review of selected databases and specific journals. Titles identified as relating to HIM and patient quality were screened using Covidence ® by title and abstract, followed by full text. The quality of selected articles was assessed and thematically analysed. RESULTS: Analysis of the 8 included articles found that the key themes from the non-empirical research were data quality, information governance, corporate governance, skills and knowledge required for HIM professionals. DISCUSSION: Most publications focussed on HIM professional involvement in maintaining standards for data quality and health records, but not the professional qualifications themselves. CONCLUSIONS: There are links between patient safety and health records, and between health records and HIM professional work. More empirical research is needed to demonstrate how qualified HIM professionals contribute to patient safety.

Leading health reform: a critical review of 'leadership' within allied health competency standards.

Objective The study examined if, when and how select allied health professional standards currently articulate the Health LEADS Australia themes. Methods Eighteen allied health professional standards were searched to locate references to leadership. Data were extracted and analysed inductively, deductively and thematically as a meta-synthesis. Frequencies were counted, with subanalysis by professional area, classification level, competency type and level of cognition. Results There were 953 direct and indirect leadership statements. Only two leadership definitions were located, for pharmacists and dentists. The principal theme 'Leadership' only appeared in 18 (2%) statements from the total dataset that made direct references to leadership, which were mostly vague and unclear. The remaining indirect references to leadership are reported as four overarching themes: Self-leadership (n=289 statements; 30%); Leadership With and of Others (n=263; 28%); Improvement and Change Leadership (n=223; 23%); and Health Reform Leadership (n=139; 15%). Conclusion Health leadership was not easily recognisable in the allied health practice standards examined. With some refinement and alignment with a contemporary leadership framework, professional standards could play a critical role in preparing allied health graduates to support the ongoing health system reform required to improve health and well-being outcomes in the future. What is known about the topic? Leadership is essential at all health system levels, and leadership frameworks can usefully guide leadership development. However, little is known about allied health leadership compared with other clinical groups, and their contributions to directional changes in health system reform may be overlooked. What does this paper add? This paper presents results of an analysis of where and how 18 allied health disciplines align with the Australian Health LEADS framework, and where greater clarity or alignment is needed. What are implications for practitioners? Reinstatement of a national health leadership framework, such as the Australian Health LEADS framework, to articulate the need for and capabilities of leadership to enable innovation and support reform across all professional groups working in health care, including medical, nursing and allied health is required. A recognised national leadership framework could guide the revisions to allied health practice standards and coupled with a co-design process involving practitioners and professional associations, further development and incorporation of leadership competencies in a consistent manner would be enabled. Furthermore, alignment of allied health education and professional development with a national health leadership framework may strengthen allied health leadership graduate outcomes.

Factors Influencing Healthcare Professionals' Perception towards EHR/EMR Systems in Gulf Cooperation Council Countries: A Systematic Review.

Electronic health and medical records are widely adopted in many healthcare settings worldwide to improve the quality of care. Users' perception is a significant factor influencing the successful implementation and use of e-health technologies. This systematic review aimed to identify factors influencing the perceptions of healthcare professionals towards the adoption and use of electronic health and medical record systems to improve the quality of healthcare services in the countries of the Gulf Cooperation Council. We identified primary studies evaluating healthcare professionals' perception towards electronic health records and/or electronic medical records in the Gulf region. Seven electronic databases, including Medline, CINAHL, Informit Health Collection, Science Direct, ProQuest, PubMed, and Scopus were used to search for the relevant articles published between January 2007 and December 2016. Thirteen articles met the inclusion criteria and were included in this systematic review. Both individual and system-related factors were found to positively or negatively influence healthcare providers' perceptions towards the systems. Understanding the impact of healthcare professionals' perception of health information technology is important for policymakers involved in the implementation programs to ensure their success. Future studies should evaluate other individual characteristics such as age, gender, and profession of the healthcare providers on their perceptions towards e-health technologies.

A systematic review of online examinations: A pedagogical innovation for scalable authentication and integrity.

Digitization and automation across all industries has resulted in improvements in efficiencies and effectiveness to systems and process, and the higher education sector is not immune. Online learning, e-learning, electronic teaching tools, and digital assessments are not innovations. However, there has been limited implementation of online invigilated examinations in many countries. This paper provides a brief background on online examinations, followed by the results of a systematic review on the topic to explore the challenges and opportunities. We follow on with an explication of results from thirty-six papers, exploring nine key themes: student perceptions, student performance, anxiety, cheating, staff perceptions, authentication and security, interface design, and technology issues. While the literature on online examinations is growing, there is still a dearth of discussion at the pedagogical and governance levels.

SERIES: eHealth in primary care. Part 3: eHealth education in primary care.

BACKGROUND: Education is essential to the integration of eHealth into primary care, but eHealth is not yet embedded in medical education. OBJECTIVES: In this opinion article, we aim to support organisers of Continuing Professional Development (CPD) and teachers delivering medical vocational training by providing recommendations for eHealth education. First, we describe what is required to help primary care professionals and trainees learn about eHealth. Second, we elaborate on how eHealth education might be provided. DISCUSSION: We consider four essential topics. First, an understanding of existing evidence-based eHealth applications and conditions for successful development and implementation. Second, required digital competencies of providers and patients. Third, how eHealth changes patient-provider and provider-provider relationships and finally, understanding the handling of digital data. Educational activities to address these topics include eLearning, blended learning, courses, simulation exercises, real-life practice, supervision and reflection, role modelling and community of practice learning. More specifically, a CanMEDS framework aimed at defining curriculum learning goals can support eHealth education by describing roles and required competencies. Alternatively, Kern's conceptual model can be used to design eHealth training programmes that match the educational needs of the stakeholders using eHealth. CONCLUSION: Vocational and CPD training in General Practice needs to build on eHealth capabilities now. We strongly advise the incorporation of eHealth education into vocational training and CPD activities, rather than providing it as a separate single module. How learning goals and activities take shape and how competencies are evaluated clearly requires further practice, evaluation and study.