Digital tools in cardiac reperfusion pathways: A systematic review.

With health and surgery increasingly aided by digital technologies, there exists a growing impetus to understand how such tools must integrate into existing clinical pathways to ensure a positive impact on patient and organisational outcomes. Consequently, this study sought to collate evidence on the use of digital technology in cardiac reperfusion surgeries. We systematically searched three scientific databases for relevant articles. In total, 1,092 articles were retrieved, with 126 screened using inclusion/exclusion criteria, and 21 selected for analysis. Articles reported on the use of virtual reality, mHealth and telehealth in cardiovascular reperfusion procedures, ranging from surgical training regimens to postoperative rehabilitation. Here, despite clinical advantages, limitations were highlighted, including cost, ineffective interfaces and extensive training needed to operate novel digital tools. Nevertheless with further development and input from patient stakeholders, many limitations look set to dematerialise and provide tangible improvements to the benefit of patients and hard-pressed health institutions.

Digital health: a neglected part of health curricula?

With growing government investment and a thriving consumer market, digital technologies are rapidly transforming our means of healthcare delivery. These innovations offer increased diagnostic accuracy, greater accessibility and reduced costs compared with conventional equivalents. Despite these benefits, implementing digital health poses challenges. Recent surveys of healthcare professionals (HCPs) have revealed marked inequities in digital literacy across the healthcare service, hampering the use of these new technologies in clinical practice. Furthermore, a lack of appropriate training in the associated ethical considerations risks HCPs running into difficulty when it comes to patient rights. In light of this, and with a clear need for dedicated digital health education, we argue that our focus should turn to the foundation setting of any healthcare profession: the undergraduate curriculum.

Digital tools in neurosurgical pathways: considerations for the future.

With aspects of neurosurgery becoming increasingly digitised, there is a need to understand both the prevalence and impact of digital tools on clinical and organisational outcomes. Consequently, we sought to evaluate evidence of the use of digital tools in neurosurgical settings. We systematically searched three public databases for relevant articles: 283 articles were screened using inclusion/exclusion criteria, with 26 selected for further analysis. Many studies reported on the use of simulation, smartphones, telemedicine and robotics in neurosurgical pathways from education through to postoperative care. Though generally beneficial for both patient and organisational outcomes, a number of considerations were highlighted. Many referred to protection of patient data, cost and requirements to ensure socially disadvantaged groups are not further excluded by the move to digital services. Fortunately, with further innovation, many of these limitations look set to dissipate over coming years, paving the way for a more streamlined neurosurgical pathway.

Patient-initiated follow up as a means of reducing pressures in secondary care.

Outpatient services, largely dedicated to routine follow up, have been under increasing pressure in recent years. The growing and ageing UK population has been a large driver of this pressure, requiring a significant increase in annual outpatient appointments. Many of these appointments, however, may be guided by organisational, rather than clinical need, and as a result, some evidence indicates patient attendance rates have fallen, demonstrating a need for more effective, patient-centred care models. One such model, patient-initiated follow up (PIFU) has shown significant promise, empowering patients while simultaneously reducing appointment numbers and increasing attendance rates. However, for PIFU to be implemented nationwide several key considerations must be made to ensure patients are appropriately engaged, and supported, in directing their own care.

Investigating consultant-led virtual review as a model for implementing 7-day cardiology services in UK clinical practice.

BACKGROUND: Disparities between weekend and weekday care, termed 'the weekend effect', have led to a UK government pledge to provide 7-day services. Despite this, poor outcomes have led to criticism of the programme. This study consequently sought to evaluate consultant-led virtual review as a model for 7-day cardiology services. METHODS: Over 4 weekends, cardiology patients underwent virtual review alongside in-person teams. Outcomes included length of stay, same-day discharge and 30-day mortality rates, as well as duration of ward rounds and change in patient management. Patients were surveyed on attitudes towards virtual review. RESULTS: Statistical analysis revealed no significant difference in clinical outcomes, while virtual review was noted to significantly decrease time taken (p<0.0001). Attitudes towards virtual review were broadly favourable. CONCLUSION: By demonstrating comparable outcomes compared with conventional review, as well as high acceptability, this study identified virtual review as an effective substitute for in-person care.

Barts X as a Model for Teaching Digital Health.

Due to recent technological innovations, digital health is quickly transforming the means of healthcare delivery. Technologies such as artificial intelligence, wearables and virtual consultations are increasingly being integrated into routine clinical care and with careful consideration; these promise to bring improvements to both professional workloads and patient outcomes. We highlight the need for dedicated digital health education in order to ensure appropriate use of patient data, patient safeguarding and the means by which we might incorporate this in a post-covid COVID curriculum. We comment on what can be learnt by Barts X Medicine, the first digital health programme in England to be integrated into the medical curriculum, to improve medical teaching.