Metaverse: Evolving role in healthcare delivery and implications.

Metaverse, or the immersive internet, is touted as the next considerable technology-led disruption on the horizon, which can potentially disrupt clinician-patient interactions, patient experience, innovation and research and development processes. Metaverse is still in the evolution phase, and its firm definition framework is a work in progress. Surgical training allows the trainees to mimic procedures and simulate cross-collaborations within time and space, shortening the learning cycles. Similarly, patient experiences can be built by creating unique experiences replicating the real world without constraints. At the same time, the care providers can foster greater empathy while serving the patients with regular or special specific needs per disease conditions.

Musculoskeletal care - at the confluence of data science, sensors, engineering, and computation.

Data has always been integral to modern medicine in almost all aspects of patient care and the recent proliferation of data has opened up innumerable opportunities for all the stakeholders in trying to improve the quality of care and health outcomes including quality of life and rehabilitation. Greater usage and adoption of digital technologies have led to the convergence of health data in different forms - clinical, self-reported, electronic health records social media, etc. The application and utilization of patient data set continue to get broadened each day with greater availability and access. These are empowering newer cutting-edge solutions such as connected care and artificial intelligence, 3D printing and real-life mimicking prosthetics. The availability of data at micro and macro levels has the potential to act as a catalyst for personalized care based on behavioral, cultural, genetic, and psychological needs for patients with musculoskeletal disorders. Realistic algorithms coupled with biomarkers which can identify relevant interventions and alert the care providers regarding any deterioration. Although in the nascent stage currently, 3D printing, exoskeletons, and virtual rehabilitation hold tremendous potential of cost-effective, precise interventions for the patients.

Harnessing of real-world data and real-world evidence using digital tools: utility and potential models in rheumatology practice.

The diversity of diseases in rheumatology and variability in disease prevalence necessitates greater data parity in disease presentation, treatment responses including adverse events to drugs and various comorbidities. Randomized controlled trials are the gold standard for drug development and performance evaluation. However, when the drug is applied outside the controlled environment, the outcomes may differ in patient populations. In this context, the need to understand the macro and micro changes involved in disease evolution and progression becomes important and so is the need for harvesting and harnessing the real-world data from various resources to use them in generating real-world evidence. Digital tools with potential relevance to rheumatology can potentially be leveraged to obtain greater patient insights, greater information on disease progression and disease micro processes and even in the early diagnosis of diseases. Since the patients spend only a minuscule portion of their time in hospital or in a clinic, using modern digital tools to generate realistic, bias-proof, real-world data in a non-invasive patient-friendly manner becomes critical. In this review we have appraised different digital mediums and mechanisms for collecting real-world data and proposed digital care models for generating real-world evidence in rheumatology.

Electronic health records: a critical appraisal of strengths and limitations.

Electronic health record (EHR) was hailed as a major step towards making healthcare more transparent and accountable. All the developed nations digitised their health records which were meant to be safe, secure and could be accessed on demand. This was intended to benefit all stakeholders. However, the jury is still out if the EHR has been worth it. There have been incidences of data breaches despite cybersecurity checks and of manipulation compromising clinicians' integrity and patients' safety. EHRs have also been blamed for doctor burnout in overloading them with a largely avoidable administrative burden. The lack of interoperability amongst various EHR software systems is creating obstacles in seamless workflow. Artificial intelligence is now being used to overcome deficiencies of the EHR. Emerging data from real-world usage of EHR is providing useful inputs which would be helpful in making it a better system. This review critically appraises the current status and issues with the EHR and provides an overview of the key innovations which are being implemented to make the system more efficient for health care providers leading to a reduction in their administrative burden.

Emerging role of eHealth in the identification of very early inflammatory rheumatic diseases.

Digital health or eHealth technologies, notably pervasive computing, robotics, big-data, wearable devices, machine learning, and artificial intelligence (AI), have opened unprecedented opportunities as to how the diseases are diagnosed and managed with active patient engagement. Patient-related data have provided insights (real world data) into understanding the disease processes. Advanced analytics have refined these insights further to draw dynamic algorithms aiding clinicians in making more accurate diagnosis with the help of machine learning. AI is another tool, which, although is still in the evolution stage, has the potential to help identify early signs even before the clinical features are apparent. The evolving digital developments pose challenges on allowing access to health-related data for further research but, at the same time, protecting each patient's privacy. This review focuses on the recent technological advances and their applications and highlights the immense potential to enable early diagnosis of rheumatological diseases.

Digital health: a new dimension in rheumatology patient care.

The new digital health innovations have opened up several opportunities to help the clinicians, patients and other caregivers of rheumatology healthcare system in maximizing efficiencies resulting in better patient outcomes. In the global context, digital health technology has the potential to bridge the distance gap between all the key stakeholders involved in rheumatology health care. In this review, we update on the recent advances in the field of digital health and highlight unique features of these technologies which would help in routine care. Application of technology in any form to enable, facilitate or enhance the quality of care is the foundation of digitised care. The components could be smartphone apps, sensors, video, social media platforms or messenger platforms, wearables or a combination of these enabling healthcare delivery and overcoming the constraints of distance, location and time. Digital therapeutics have started evolving and an important step in this direction is the involvement of FDA in the approval process. Speciality specific apps, personalised patient education as per disease status, remote specialist consultations or virtual health coach to guide on lifestyle modifications are some of the developments which have been facilitated by increased digitization in all walks of life. Assisted care with the help of robots rendering care in the hospitals or an intelligent robot guiding a patient by voice and visual sense at home are already at the threshold of entering the mainstream of patient care. Wearable devices equipped with powerful sensors are coming handy in keeping a watch on patient symptoms all the time and providing useful insights on disease progression, clinical response or complications. In chronic care such as rheumatology the implications, possibilities and benefits seem unprecedented. Real time data analytics and artificial intelligence are helping the clinicians, healthcare systems and policy makers optimise the resources and improve patient outcomes. Digitization of healthcare has gained momentum in the recent years and it is envisaged that it could be a catalyst to change, bridge the quality of care and most important democratise the healthcare access across the globe. However, more data, efficacy and objective results are needed which would be fulfilled by ongoing observational studies, clinical trials, systematic review and meta-analysis to further establish the role of digital health in the realms of patient care.