Mobile Health Applications for Rehabilitation of Musculoskeletal Diseases of the Shoulder: A Systematic Analysis.

Rehabilitation of musculoskeletal diseases (MSD) of the shoulder is a multifaceted long-term process, which is often not transparent to affected patients. Mobile health applications (apps) have the potential to support this complex process by improving patients' self-management skills. However, there seems to be a lack of apps providing a holistic approach to motivate and guide patients during the whole rehabilitation process. Therefore, a systematic analysis of apps on Google Play Store was conducted by two independent reviewers. A total of 3227 apps were identified, of which 64 met the eligibility criteria for the qualitative analysis. The majority of analyzed apps were developed generally for patients with MSD of the shoulder, rarely for specific diseases (individual needs of patients). The majority of apps focus on the provision of information, exercise training, and alternative medicine. Apps for diagnostics, inpatient treatment, and self-management, especially for multiple rehabilitation phases, are rare or even not existent. Game design elements are seldom used. If there are any, then simple to implement ones, e.g. messages and progress bars. The (psychological) effects of individual game design elements on patients seem to be neglected, when selecting and implementing game-components.

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study.

BACKGROUND: Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country. The eHealth indicators focusing on the cross-institutional availability of patient-related information for health care professionals, patients, and care givers are rare. OBJECTIVES: This study aims to present eHealth indicators on cross-institutional availability of relevant patient data for health care professionals, as well as for patients and their caregivers across 14 countries (Argentina, Australia, Austria, Finland, Germany, Hong Kong as a special administrative region of China, Israel, Japan, Jordan, Kenya, South Korea, Sweden, Turkey, and the United States) to compare our indicators and the resulting data for the examined countries with other eHealth benchmarks and to extend and explore changes to a comparable survey in 2017. We defined "availability of patient data" as the ability to access data in and to add data to the patient record in the respective country. METHODS: The invited experts from each of the 14 countries provided the indicator data for their country to reflect the situation on August 1, 2019, as date of reference. Overall, 60 items were aggregated to six eHealth indicators. RESULTS: Availability of patient-related information varies strongly by country. Health care professionals can access patients' most relevant cross-institutional health record data fully in only four countries. Patients and their caregivers can access their health record data fully in only two countries. Patients are able to fully add relevant data only in one country. Finland showed the best outcome of all eHealth indicators, followed by South Korea, Japan, and Sweden. CONCLUSION: Advancement in eHealth depends on contextual factors such as health care organization, national health politics, privacy laws, and health care financing. Improvements in eHealth indicators are thus often slow. However, our survey shows that some countries were able to improve on at least some indicators between 2017 and 2019. We anticipate further improvements in the future.

A Brief Survey on Six Basic and Reduced eHealth Indicators in Seven Countries in 2017.

BACKGROUND: Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-centered) information processing to patient-centered information processing, collecting relevant and timely data for such indicators has been difficult. OBJECTIVES: This article aims to design some basic eHealth indicators, which are easily collected and measure how well information processing supports holistic patient-centered health care, and to evaluate penetrance of patient-centered health as measured by the indicators internationally via an expert survey. METHODS: We identified six basic indicators that measure access of health care professionals, patients, and caregivers to the patient's health record data and the ability of providers, patients, and caregivers to add information in the patient's record. In a survey of international informatics experts, these indicators' penetrance were evaluated for Austria, Finland, Germany, Hong Kong, South Korea, Sweden, and the United States in the summer of 2017. RESULTS: The eHealth status measured by the indicators varied significantly between these seven countries. In Finland, most practices measured by the indicators were fully implemented whereas in Germany only one practice was partially realized. CONCLUSION: Progress in the implementation of practices that support patient-centered care could mainly be observed in those countries where the "political will" focused on achieving patient-centered care as opposed to an emphasis on institution-centered care. The six eHealth indicators seem to be useful for measuring national progress in patient-centered care. Future work will extend the number of countries analyzed.

A literature overview and comparison of driving impairing condition assessment approaches by health enabling technologies.

Due to demographic change, more elderly people have the need to preserve and support mobility by car despite age-related functional limitations. Since accidents by the elderly are primarily caused by age related limitations, and not by careless or irresponsible behavior, it may be beneficial to detect driving impairing conditions. The presented review gives an overview of technologies to detect driving impairing conditions like drowsiness and stress or excessive demand. A comparison of the approaches to detect these conditions suggests that a combination of approaches is the most feasible method. However, there are still few systems that focus on the elderly.

An e-consent-based shared EHR system architecture for integrated healthcare networks.

OBJECTIVES: Virtual integration of distributed patient data promises advantages over a consolidated health record, but raises questions mainly about practicability and authorization concepts. Our work aims on specification and development of a virtual shared health record architecture using a patient-centred integration and authorization model. METHODS: A literature survey summarizes considerations of current architectural approaches. Complemented by a methodical analysis in two regional settings, a formal architecture model was specified and implemented. RESULTS: Results presented in this paper are a survey of architectural approaches for shared health records and an architecture model for a virtual shared EHR, which combines a patient-centred integration policy with provider-oriented document management. An electronic consent system assures, that access to the shared record remains under control of the patient. A corresponding system prototype has been developed and is currently being introduced and evaluated in a regional setting. CONCLUSION: The proposed architecture is capable of partly replacing message-based communications. Operating highly available provider repositories for the virtual shared EHR requires advanced technology and probably means additional costs for care providers. Acceptance of the proposed architecture depends on transparently embedding document validation and digital signature into the work processes. The paradigm shift from paper-based messaging to a "pull model" needs further evaluation.