Effects of Healthcare Technologies on the Promotion of Physical Activities in Older Persons: A Systematic Review.

This study aimed to explore the effects of health technologies on the promotion of health through physical activities of older persons. Following PRISMA guidelines, a systematic review of relevant articles published prior to 2020 was conducted from selected indices such as COCHRANE, PubMed, Science Direct, Proquest, including the use of hand search procedure. Twenty-seven articles were analyzed with significant findings influential to older people nursing: types of health technologies used for promoting physical activity; effects of technology use in promoting physical activity of older person care; and aspects that need to be considered in technology use among older persons. Characteristics of technologies were accuracy, usefulness, reliability, comfort, safety, and relevancy. Most technologies promoting physical activities for older people were wearable technologies that use artificial intelligence. Altogether, these technologies influenced overall healthcare behaviors of older persons. With healthcare technology efficiencies, proficiencies, and dependencies, technology-based healthcare have served older people well. Most technologies for older people care, such as wearables, reliably produce characteristics enhancing dependency and accuracy of bio-behavioral information influencing physical activities of older persons. Health technologies foster the values of physical activities among older persons thereby promoting healthy living.

Utilización del sistema V-Chair, una smart therapeutical surface, en el cuidado de dos pacientes de alta dependencia y movilidad limitada, con discapacidad intelectual en un centro sociosanitario / Use of the V-Chair system, a smart therapeutical surface in the care of two patients with intellectual disabilities with high dependence and limited mobility

Introducción: El cuidado de pacientes de alta dependencia y movilidad limitada, en la práctica representa que estos pasen largos períodos en la cama y surjan importantes retos para ellos mismos y para sus cuidadores en diferentes dimensiones relacionadas con su descanso, ya sea en cama ya sea en sedestación. El encamamiento puede producir problemas en tres grandes dimensiones: dinámica del paciente en la cama, impacto en los cuidadores que atienden a la persona afectada y complicaciones clínicas relacionadas con la estancia prolongada en la cama. Hoy en día existen en el mercado camas con prestaciones especiales (las smart care beds), que facilitan el cuidado de los pacientes encamados y ayudan a disminuir tanto problemas clínicos relacionados con la situación de inmovilidad como sus repercusiones en los cuidadores a la hora de movilizarlos. A lo largo del artículo veremos que la introducción de la robótica aplicada a los movimientos de las camas inteligentes conlleva a una evolución de estas: las smart therapeutical surfaces. Estas proveen de movimientos robóticos únicos, automatizados, programables y personalizables, lo que puede abrir una nueva dimensión en los cuidados a personas encamadas.Metodología:Se presentan 2 casos clínicos correspondientes a la utilización del sistema V-Chair®, una smart therapeutical surface (S.T. Surface®), con la doble funcionalidad de silla de ruedas eléctrica indoor y cama clínica articulada hospitalaria, con movimientos únicos y patentados no existentes en ninguna otra opción de mercado, que permiten incrementar la calidad de vida y la autonomía del paciente encamado de alta dependencia. Las múltiples opciones de movimientos que permite V-Chair® aparentemente facilitan la prevención y la reducción de problemas clínicos derivados del encamamiento...(AU)

Introduction: Caring for patients with high dependency and limited mobility represents in practice that these patients spend long periods of time in bed, arising important challenges for themselves and for their caregivers in different dimensions related to their rest, either in bed or sitting. Bed confinement can cause problems in three broad dimensions: patient dynamics in bed, impact on caregivers caring for the affected person, and clinical complications related to prolonged stay in bed. Today there are beds on the market with special features (smart care beds) which facilitate the care of bedridden patients and help to reduce both clinical problems related to the situation of immobility, as well as its repercussions on caregivers when mobilizing them, but we will see throughout the article that the introduction of robotics applied to the movements of smart beds leads to an evolution of the same: the smart therapeutical surfaces. These provide unique, automatized, programmable and personalized robotic movements, which can lead to a new dimension in the care of bedridden people.Methods:Two clinical cases are presented corresponding to the use of the V-Chair® system, a Smart Therapeutic Surface (S.T. Surface®) with the dual functionality of indoor electric wheelchair and a clinical hospital bed, with unique and patented movements non existing in any other option on the market. Due to nowadays results apparently increasing the quality of life and autonomy of the highly dependent bedridden patient. The multiple movements options provided by V-Chair® facilitates the prevention and reduction of clinical problems resulting from prolonged bed rest, the reduction of the number of nursing staff required during care and handling tasks, while reducing strain and poor posture on the side of the nursing staff...(AU)

Tecnologia gerencial para mediar a consulta de enfermagem a pessoas vivendo com doença de chagas / Management technology to mediate nursing consultation for people living with chagas disease

Objetivo: Construir e validar uma tecnologia gerencial, baseada no referencial teórico de Dorothea Orem, para mediar à consulta de enfermagem ao paciente com doença de chagas no Ambulatório de Cardiopatia Chagásica de uma instituição de ensino no município de Belém/Pa. Método: Pesquisa metodológica do tipo exploratória com abordagem quantitativa, realizada no período de maio a novembro de 2019, constituída em duas fases: elaboração do instrumento; submissão, avaliação e validação do instrumento por juízes especialistas. Resultados: Com exceção de um único item do instrumento, todo este foi validado com concordância de 95,12%. Conclusão: O instrumento validado contribuirá para a implementação da assistência a população. Os princípios da teoria do autocuidado são aplicáveis e pertinentes para planejar e avaliar a assistência aos pacientes que, neste estudo, especificamente, são os que vivem com doença de chagas, assim, este estudo proporciona aos enfermeiros um instrumento baseado em evidências científicas e validado por profissionais qualificados.(AU)

Objective: To construct and validate a management technology, based on Dorothea Orem's theoretical framework, to mediate the nursing consultation with patients with chagas disease at the Chagas Heart Disease Outpatient Clinic of an educational institution in the city of Belém/Pa. Method: Exploratory methodological research with quantitative approach, carried out from May to November 2019, consisting of two phases: elaboration of the instrument; submission, evaluation and validation of the instrument by expert judges. Results: With the exception of a single item of the instrument, the whole of this was validated with agreement of 95.12%. Conclusion: The validated instrument will contribute to the implementation of assistance to the population. The principles of the theory of self-care are applicable and pertinent to plan and evaluate care for patients who, in this study, specifically, are those living with Chagas disease, thus, this study provides nurses with an instrument based on scientific evidence and validated by qualified professionals.(AU)

Objetivo: Construir y validar una tecnología de manejo, basada en el marco teórico de Dorothea Orem, para mediar la consulta de enfermería con pacientes con enfermedad de Chagas en el Ambulatorio de Cardiopatías de Chagas de una institución educativa de la ciudad de Belém/Pa. Método: Investigación metodológica exploratoria con enfoque cuantitativo, realizada de mayo a noviembre de 2019, constituida en dos fases: elaboración del instrumento; presentación, evaluación y validación del instrumento por jueces expertos. Resultados: Con la excepción de un solo ítem del instrumento, el conjunto de este fue validado con concordancia de 95,12%. Conclusión: El instrumento validado contribuirá a la implementación de la asistencia a la población. Los principios de la teoría del autocuidado son aplicables y pertinentes para planificar y evaluar la atención de los pacientes que, en este estudio, específicamente, son los que viven con la enfermedad de Chagas, por lo que este estudio brinda al enfermero un instrumento basado en evidencia científica y validada. por profesionales calificados.(AU)

Weaving Enzymes with Polymeric Shells for Biomedical Applications.

Enzyme therapeutics have received increasing attention due to their high biological specificity, outstanding catalytic efficiency, and impressive therapeutic outcomes. Protecting and delivering enzymes into target cells while retaining enzyme catalytic efficiency is a big challenge. Wrapping of enzymes with rational designed polymer shells, rather than trapping them into large nanoparticles such as liposomes, have been widely explored because they can protect the folded state of the enzyme and make post-functionalization easier. In this review, the methods for wrapping up enzymes with protective polymer shells are mainly focused on. It is aimed to provide a toolbox for the rational design of polymeric enzymes by introducing methods for the preparation of polymeric enzymes including physical adsorption and chemical conjugation with specific examples of these conjugates/hybrid applications. Finally, a conclusion is drawn and key points are emphasized.

How Academic Medical Centers Can Navigate the Pandemic and Its Aftermath: Solutions for 3 Major Issues.

The COVID-19 crisis has seriously affected academic medical centers (AMCs) on multiple levels. Combined with many trends that were already under way pre pandemic, the current situation has generated significant disruption and underscored the need for change within and across AMCs. In this article, the authors explore some of the major issues and propose actionable solutions in 3 areas of concentration. First, the impact on medical students is considered, particularly the trade-offs associated with online learning and the need to place greater pedagogical emphasis on virtual care delivery and other skills that will be increasingly in demand. Solutions described include greater utilization of technology, building more public health knowledge into the curriculum, and partnering with a wide range of academic disciplines. Second, leadership recruiting, vital to long-term success for AMCs, has been complicated by the crisis. Pressures discussed include adapting to the dynamics of competitive physician labor markets as well as attracting candidates with the skill sets to meet the requirements of a shifting AMC leadership landscape. Solutions proposed in this domain include making search processes more focused and streamlined, prioritizing creativity and flexibility as core management capabilities to be sought, and enhancing efforts with assistance from outside advisors. Finally, attention is devoted to the severe financial impact wrought by the pandemic, creating challenges whose resolution is central to planning future AMC directions. Specific challenges include recovery of lost clinical revenue and cash flow, determining how to deal with research funding, and the precarious economic balancing act engendered by the need to continue distance education. A full embrace of telehealth, collaborative policy-making among the many AMC constituencies, and committing fully to being in the vanguard of the transition to value-based care form the solution set offered.

A legal overview of the use of messaging platforms in healthcare.

Medical interventions are becoming more complex day by day. Moreover, compared with the past, more healthcare professionals take part in the same intervention in the field of medicine. The use of technology in medical interventions has also increased. This change in the health sector brings together several legal discussions. In this study, the legal consequences that arise from the treatment processes carried out by the residents and resident educators (registerers / attending physicians), the exchange of information between them, and the usage of some messaging platforms, especially WhatsApp, in this process will be analyzed.

What Factors Influence Clinicians' Use of Technology in Neurorehabilitation? A Multisite Qualitative Study.

OBJECTIVE: Technology is being increasingly used for physical assessment and interventions in health care settings. However, clinical adoption is relatively slow, and the factors affecting use remain underexplored. This study aimed to investigate factors influencing technology use by clinicians working in neurorehabilitation. METHODS: In this qualitative study, 9 physical therapists and 9 occupational therapists (N = 18) were recruited from urban and regional locations in Australia and in Singapore. Three 60-minute focus groups were conducted via video conferencing. Each group comprised 3 physical therapists and 3 occupational therapists working across different neurorehabilitation settings. Participants were asked to discuss which technologies they used in their workplace for physical assessment and treatment and barriers, motivators, and future desires for technology use. Transcripts were analyzed independently using an inductive approach to generate codes and themes. RESULTS: Our results comprised 3 themes and 7 categories. These were encompassed by a single overarching theme, namely "Technology use is influenced by the benefits and challenges of the technology itself, users, and organizational context." Themes showed that technology should promote effective interventions, is preferred if easy to use, and should be dependable. Furthermore, clinical reasoning is important, and users have varying levels of receptivity and confidence in technology use. Also, organizational resources are required, along with supportive cultures and processes, to facilitate technology use. CONCLUSIONS: The themes identified multiple and interlinking factors influencing clinicians' use of technology in neurorehabilitation settings. Clinicians often consider context-specific benefits and challenges when deciding whether to use technology. Although our study found that clinicians generally perceived technology as having a beneficial role in improving health outcomes, there were several challenges raised. Therefore, the characteristics of the technology itself, individual users, and organizational context should be considered. IMPACT: These findings will guide successful technology implementation and future developments.

Validation of the Media Fill Method for Solid Tissue Processing in Good Manufacturing Practice-Compliant Cell Production.

Over the past few years, a large number of clinical studies for advanced therapy medicinal products have been registered and/or conducted for treating various diseases around the world and many have generated very exciting outcomes. Media fill, the validation of the aseptic manufacturing process, is the simulation of medicinal product manufacturing using nutrient media. The purpose of this study is to explain the media fill procedure stepwise in the context of cellular therapy medicinal products. The aseptic preparation of patient individual cellular product is simulated by using tryptic soy broth as the growth medium, and sterile vials as primary packaging materials.

Review of current intracranial aneurysm flow diversion technology and clinical use.

Endovascular treatment of intracranial aneurysms (IAs) has evolved considerably over the past decades. The technological advances have been driven by the experience that coils fail to completely exclude all IAs from the blood circulation, the need to treat the diseased parent vessel segment leading to the aneurysm formation, and expansion of endovascular therapy to treat more complex IAs. Stents were initially developed to support the placement of coils inside wide neck aneurysms. However, early work on stent-like tubular braided structure led to a more sophisticated construct that then later was coined as a flow diverter (FD) and found its way into clinical application. Although FDs were initially used to treat wide-neck large and giant internal carotid artery aneurysms only amenable to surgical trap with or without a bypass or endovascular vessel sacrifice, its use in other types of IAs and cerebrovascular pathology promptly followed. Lately, we have witnessed an explosion in the application of FDs and subsequently their modifications leading to their ubiquitous use in endovascular therapy. In this review we aim to compile the available FD technology, evaluate the devices' peculiarities from the authors' perspective, and analyze the current literature to support initial and expanded indications, recognizing that this may be outdated soon.

Early experience treating intracranial aneurysms using Accero: a novel, fully visible, low profile braided stent with platinum-nitinol composite wire technology.

BACKGROUND: Accero is an innovative, fully visible, self-expanding braided stent with platinum-nitinol composite wire technology, produced by Acandis. OBJECTIVE: To assess the technical success and safety of this new stent by evaluating the intraprocedural behavior and complication rate, and the short-term follow-up results. METHODS: Forty-one consecutive patients suitable for stent-assisted coiling were selected for the use of Accero in an 11-month period. Clinical, procedural, and angiographic data, as well as 30-day morbidity, were recorded. The angiographic results, clinical follow-up at 30 days, and early imaging follow-up at 3 or 6 months were analyzed, when available. RESULTS: Forty-one aneurysms were treated with stent-assisted coiling. All cases were elective, of which 19 were previously untreated aneurysms and 22 were recurrent aneurysms. Aneurysm location was anterior communicating artery complex (16), basilar (12 cases), middle cerebral artery bifurcation (9 cases), and internal cerebral artery (4 cases). The stent was successfully deployed and aneurysm occlusion with coils achieved in 100% of our patients. One case of on table in-stent thrombosis occurred, which resolved after administration of glycoprotein IIB/IIIA inhibitor, with no clinical consequence, and one case of postoperative hematoma at the arteriotomy site, which was managed conservatively. On early follow-up, available for 37 patients, the complete occlusion rate was 76%, with only two recurrences needing further treatment. Satisfactory aneurysm occlusion was therefore achieved in 95% of cases. CONCLUSION: Stent-assisted coiling with the Accero braided stent proved safe and effective.

Technology of deep brain stimulation: current status and future directions.

Deep brain stimulation (DBS) is a neurosurgical procedure that allows targeted circuit-based neuromodulation. DBS is a standard of care in Parkinson disease, essential tremor and dystonia, and is also under active investigation for other conditions linked to pathological circuitry, including major depressive disorder and Alzheimer disease. Modern DBS systems, borrowed from the cardiac field, consist of an intracranial electrode, an extension wire and a pulse generator, and have evolved slowly over the past two decades. Advances in engineering and imaging along with an improved understanding of brain disorders are poised to reshape how DBS is viewed and delivered to patients. Breakthroughs in electrode and battery designs, stimulation paradigms, closed-loop and on-demand stimulation, and sensing technologies are expected to enhance the efficacy and tolerability of DBS. In this Review, we provide a comprehensive overview of the technical development of DBS, from its origins to its future. Understanding the evolution of DBS technology helps put the currently available systems in perspective and allows us to predict the next major technological advances and hurdles in the field.

Suspension Culture of Human Induced Pluripotent Stem Cells in Single-Use Vertical-Wheel™ Bioreactors Using Aggregate and Microcarrier Culture Systems.

Human induced pluripotent stem cells (hiPSCs) have the potential to be used in a variety of biomedical applications, including drug discovery and Regenerative Medicine. The success of these approaches is, however, limited by the difficulty of generating the large quantities of cells required in a reproducible and controlled system. Bioreactors, widely used for industrial manufacture of biological products, constitute a viable strategy for large-scale production of stem cell derivatives. In this chapter, we describe the expansion of hiPSCs using the Vertical-Wheel™ bioreactor, a novel bioreactor configuration specifically designed for the culture of shear-sensitive cells. We provide protocols for the expansion of hiPSCs in suspension, both as floating aggregates and using microcarriers for cell adhesion. These methods may be important for the establishment of a scalable culture of hiPSCs, allowing the manufacturing of industrial- or clinical-scale cell numbers.

Implementation of a paediatric early warning system as a complex health technology intervention.

The national implementation groups of early warning systems in the UK and Ireland have identified a need to understand implementation, adoption and maintenance of these complex interventions. The literature on how to implement, scale, spread and sustain these systems is sparse. We describe a successful adoption and maintenance over 10 years of a paediatric early warning system as a sociotechnical intervention using the Nonadoption, Abandonment, Challenges to the Scale-Up, Spread, and Sustainability Framework for Health and Care Technologies. The requirement for iterative processes within environment, culture, policy, human action and the wider system context may explain the possible reasons for improved outcomes in small-scale implementation and meta-analyses that are not reported in multicentre randomised control trials of early warning systems.

Aplicativos móveis sobre o HIV/aids: uma prospecção tecnológica / Mobile applications on hiv/aids: a technological prospection / Aplicaciones móviles sobre VIH/sida: una prospección tecnológica

Objetivo: identificar aplicativos, disponíveis para a cultura brasileira, que promovam conhecimentos ou informações acercas do HIV/Aids. Método: prospecção tecnológica realizada através de pesquisa documental com abordagem qualitativa. Foi realizada a busca por aplicativos através de acesso as lojas virtuais Apple Store e Google Play em janeiro de 2019. Na estratégia de busca utilizou-se os termos: HIV e aids. A organização dos dados foi realizada a partir de uma listagem com os aplicativos e suas características. Resultados: foram identificados 19 aplicativos na loja virtual Apple Store e 13 na Google Play. Em ambas as lojas virtuais foram identificados aplicativos voltados a população usuária dos sistemas de saúde, profissionais da saúde e população em geral, que promovem o acesso as informações relacionadas ao tema HIV/Aids. Conclusão: os aplicativos apresentam potencial para contribuir no controle no HIV/aids no país através da abordagem a prevenção combinada

Objective: to identify applications, available for brazilian culture, that promote knowledge or information about HIV/AIDS. Method:technological prospecting study carried out through documentary research with a qualitative approach. The search for applications was carried out through access to the Apple Store and Google Play virtual stores in January 2019. The search strategy used the terms: HIV and AIDS. The organization of the data was carried out from a list with the applications and their characteristics. Results: 19 applications were identified in the Apple Store and 13 in Google Play. In both virtual stores, applications were identified aimed at the population using health systems, health professionals and the general population, which promote access to information related to the HIV / AIDS theme. Conclusion: the applications have the potential to contribute to the control of HIV / AIDS in the country through the combined prevention approach

Objetivo: identificar aplicaciones, disponibles para la cultura brasileña, que promuevan el conocimiento o la información sobre el VIH / SIDA. Método:estudio de prospección tecnológica realizado mediante investigación documental con enfoque cualitativo. La búsqueda de aplicaciones se realizó a través del acceso a las tiendas virtuales Apple Store y Google Play en enero de 2019. La estrategia de búsqueda utilizó los términos: VIH y SIDA. La organización de los datos se realizó a partir de una lista con las aplicaciones y sus características. Resultados: se identificaron 19 aplicaciones en Apple Store y 13 en Google Play. En ambas tiendas virtuales, se identificaron aplicaciones dirigidas a la población utilizando sistemas de salud, profesionales de la salud y la población en general, que promueven el acceso a la información relacionada con el tema del VIH / SIDA. Conclusão: las aplicaciones tienen el potencial de contribuir al control del VIH / SIDA en el país a través del enfoque de prevención combinada

Implementation of Mobile Health Technologies in Clinical Trials of Movement Disorders: Underutilized Potential.

Mobile health technologies (mHealth) are patient-worn or portable devices aimed at increasing the granularity and relevance of clinical measurements. The implementation of mHealth has the potential to decrease sample size, duration, and cost of clinical trials. We performed a review of the ClinicalTrials.gov database using a standardized approach to identify adoption in and usefulness of mHealth in movement disorders interventional clinical trials. Trial phase, geographical area, availability of data captured, constructs of interest, and outcome priority were collected. Eligible trials underwent quality appraisal using an ad hoc 5-point checklist to assess mHealth feasibility, acceptability, correlation with patient-centered outcome measures, and clinical meaningfulness. A total of 29% (n = 54/184) registered trials were using mHealth, mainly in Parkinson's disease and essential tremor (59.3% and 27.8%). In most cases, mHealth were used in phase 2 trials (83.3%) as secondary outcome measures (59.3%). Only five phase 3 trials, representing 9.3% of the total, used mHealth (1 as primary outcome measure, 3 as secondary, and 1 as tertiary). Only 3.7% (n = 2/54) of all trials used mHealth for measuring both motor and non-motor symptoms, and 23.1% (n = 12/52) used mHealth for unsupervised, ecologic outcomes. Our findings suggest that mHealth remain underutilized and largely relegated to phase 2 trials for secondary or tertiary outcome measures. Efforts toward greater alignment of mHealth with patient-centered outcomes and development of a universal, common-language platform to synchronize data from one or more devices will assist future efforts toward the integration of mHealth into clinical trials.

Effect of novel technology-enabled multidimensional physical activity feedback in primary care patients at risk of chronic disease - the MIPACT study: a randomised controlled trial.

BACKGROUND: Technological progress has enabled the provision of personalised feedback across multiple dimensions of physical activity that are important for health. Whether this multidimensional approach supports physical activity behaviour change has not yet been examined. Our objective was to examine the effectiveness of a novel digital system and app that provided multidimensional physical activity feedback combined with health trainer support in primary care patients identified as at risk of chronic disease. METHODS: MIPACT was a parallel-group, randomised controlled trial that recruited patients at medium (≥10 and < 20%) or high (≥20%) risk of cardiovascular disease and/or type II diabetes from six primary care practices in the United Kingdom. Intervention group participants (n = 120) received personal multidimensional physical activity feedback using a customised digital system and web-app for 3 months plus five health trainer-led sessions. All participants received standardised information regarding physical activity. Control group participants (n = 84) received no further intervention. The primary outcome was device-based assessment of physical activity at 12 months. RESULTS: Mean intervention effects were: moderate-vigorous physical activity: -1.1 (95% CI, - 17.9 to 15.7) min/day; moderate-vigorous physical activity in ≥10-min bouts: 0.2 (- 14.2 to 14.6) min/day; Physical Activity Level (PAL): 0.00 (- 0.036 to 0.054); vigorous physical activity: 1.8 (- 0.8 to 4.2) min/day; and sedentary time: 10 (- 19.3 to 39.3) min/day. For all of these outcomes, the results showed that the groups were practically equivalent and statistically ruled out meaningful positive or negative effects (>minimum clinically important difference, MCID). However, there was profound physical activity multidimensionality, and only a small proportion (5%) of patients had consistently low physical activity across all dimensions. CONCLUSION: In patients at risk of cardiovascular disease and/or type II diabetes, MIPACT did not increase mean physical activity. Using a sophisticated multidimensional digital approach revealed enormous heterogeneity in baseline physical activity in primary care patients, and practitioners may need to screen for low physical activity across dimensions rather than rely on disease-risk algorithms that are heavily influenced by age. TRIAL REGISTRATION: This trial is registered with the ISRCTN registry ( ISRCTN18008011 ; registration date 31 July 2013).

Digital health technologies: opportunities and challenges in rheumatology.

The past decade in rheumatology has seen tremendous innovation in digital health technologies, including the electronic health record, virtual visits, mobile health, wearable technology, digital therapeutics, artificial intelligence and machine learning. The increased availability of these technologies offers opportunities for improving important aspects of rheumatology, including access, outcomes, adherence and research. However, despite its growth in some areas, particularly with non-health-care consumers, digital health technology has not substantially changed the delivery of rheumatology care. This Review discusses key barriers and opportunities to improve application of digital health technologies in rheumatology. Key topics include smart design, voice enablement and the integration of electronic patient-reported outcomes. Smart design involves active engagement with the end users of the technologies, including patients and clinicians through focus groups, user testing sessions and prototype review. Voice enablement using voice assistants could be critical for enabling patients with hand arthritis to effectively use smartphone apps and might facilitate patient engagement with many technologies. Tracking many rheumatic diseases requires frequent monitoring of patient-reported outcomes. Current practice only collects this information sporadically, and rarely between visits. Digital health technology could enable patient-reported outcomes to inform appropriate timing of face-to-face visits and enable improved application of treat-to-target strategies. However, best practice standards for digital health technologies do not yet exist. To achieve the potential of digital health technology in rheumatology, rheumatology professionals will need to be more engaged upstream in the technology design process and provide leadership to effectively incorporate the new tools into clinical care.