Digital health: a path to validation

Aim: This study examines the paradigm shift in India's healthcare sector due to the COVID-19 epidemic, explicitly focusing on adopting digital healthcare. The study explores the innovative initiatives undertaken by both the government and commercial sectors in virtual health and analyzes the long-term benefits of this transition.
 Methodology: The study utilizes a secondary research approach to investigate the development of India's digital healthcare system. Various sources such as reports, surveys, and official documents are reviewed to gather information on implementing digital health solutions. The study examines intelligent devices, telemedicine websites, and platforms like Arogya Setu that have played a crucial role in the digital healthcare revolution. Government programs such as the National Digital Health Mission (NDHM) and the establishment of e-hospitals are also analyzed to understand their impact. The study emphasizes the significance of data mining, the development of digital health records, and the necessary infrastructure to support digital healthcare.
 Results: The results indicate that the COVID-19 pandemic has accelerated the digitization of India's healthcare sector. Adopting digital health solutions, including telemedicine, wearable technology, and artificial intelligence, has gained significant momentum. Initiatives like the NDHM and the establishment of e-hospitals have contributed to the successful implementation of digital healthcare. The study highlights the benefits of digital healthcare, such as improved accessibility, cost-effectiveness, and accuracy of services. The importance of data mining and the development of digital health records are underscored as critical drivers of this transformation.
 Conclusion: To conclude, the COVID-19 pandemic has served as a driving force for the digital transformation of India's healthcare industry. The adoption of digital health solutions and the initiatives taken by the government lay the foundation for a more accessible and patient-centred healthcare future. The study emphasizes the significant implications of digital innovations in healthcare for healthcare organizations, medical device manufacturers, and remote care providers. While acknowledging that in-person treatment is still necessary and that comprehensive digitalization takes time, the study highlights the transformative potential of digitizing healthcare to improve access to care and enhance delivery methods. This digital revolution can potentially revolutionize the healthcare industry and improve healthcare outcomes.

Patient confidentiality has remained a central issue in the current “big data” era of healthcare. Protections such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) exist to ensure that digital personal health information (PHI) are legally secure from threats and breaches that would threaten confidentiality. To be compliant with HIPAA regulations, steps must be taken by health care providers and digital health platforms, and these fall under the Privacy Rule, which outlines appropriate uses and disclosures of PHI, and the Security Rule, which lays out with granularity the steps that must be taken to adhere to the HIPAA regulations. Through deliberate design of secure digital health platforms, we can use technological advances in the collection, measurement, and delivery of health care to advance care and improve patient safety. Renewed efforts to optimize and standardize health care delivery has facilitated the implementation of electronic and digital health solutions that benefit medical and surgical training and efficiency while minimizing harm to patients. Cross-industry innovations such as the OR Black Box® will allow us to accomplish these lofty goals. Finally, we must strive to include patients in this digital health movement, as now more than ever we can create knowledge translation solutions that ensure that patients understand their health in a meaningful way.

Fatigue is the most common symptom in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, impacting patients' quality of life; however, there is currently a lack of evidence-based context-aware tools for fatigue self-management in these populations. This study aimed to (1) address fatigue in ME/CFS and long COVID through the development of digital mobile health solutions for self-management, (2) predict perceived fatigue severity using real-time data, and (3) assess the feasibility and potential benefits of personalized digital mobile health solutions. The MyFatigue project adopts a patient-centered approach within the participatory health informatics domain. Patient representatives will be actively involved in decision-making processes. This study combines inductive and deductive research approaches, using qualitative studies to generate new knowledge and quantitative methods to test hypotheses regarding the relationship between factors like physical activity, sleep behaviors, and perceived fatigue in ME/CFS and long COVID. Co-design methods will be used to develop a personalized digital solution for fatigue self-management based on the generated knowledge. Finally, a pilot study will evaluate the feasibility, acceptance, and potential benefits of the digital health solution. The MyFatigue project opened to enrollment in November 2023. Initial results are expected to be published by the end of 2024. This study protocol holds the potential to expand understanding, create personalized self-management approaches, engage stakeholders, and ultimately improve the well-being of individuals with ME/CFS and long COVID. PRR1-10.2196/50157.

The COVID-19 pandemic has added to the pre-existing challenges of diabetes management in many countries. It has accelerated the wider use of digital health solutions which have tremendous potential to improve health outcomes for people with diabetes. However, little is known about the attributes and the implementation of these solutions. To identify and describe digital health solutions for community-based diabetes management and to highlight their key implementation outcomes. We searched Ovid Medline, CINAHL, Embase, PsycINFO, and Web of Science for relevant articles. A purposive search was also used to identify grey literature. Articles that described digital health solutions that aimed to improve community-based diabetes management were included in this review. We applied a thematic synthesis of evidence to describe the characteristics of digital health solutions, and to summarize their key implementation outcomes. We included 15 articles that reported digital health solutions that primarily focused on community-based diabetes management. Nine of the 15 innovations involved were mobile applications and/or web-based platforms, and five were based on social media platforms. The majority of the digital health solutions were used for diabetes education and support. High engagement, utilization, and satisfaction rates with digital health solutions were observed. The use of digital health solutions was also associated with improvement in self-management, taking medication, and reduction in glycated hemoglobin (HbA1c) levels. COVID-19 triggered digital health solutions have tremendous potential to improve health outcomes for people with diabetes. Further studies are needed to evaluate the sustainability and scale-up of these solutions.

ObjectiveDigital health has been gaining widespread attention but has not been fully integrated into the existing healthcare system. However, it remains unclear whether the new digital health solutions align with users’ needs and wants. This study examines how citizens perceive the functionalities of digital health and how different health risks influence their perception.MethodsUsing an online survey, data are collected from over 4000 Danish citizens. The data are analysed using linear regression models.ResultsThe results show how users’ perceptions of digital health differ significantly. Users are highly interested in data sharing across different healthcare stakeholders but less interested in online health communities. The results also show that the support for digital health is correlated with various health risks, including age, smoking and social network. However, health risks do not have uniform relationship with the perceived value of digital health.ConclusionsWhile developing and implementing new digital health solutions, it is important to consider the perceptions of people who are expected to benefit from such solutions. This study contributes to the literature by deepening the knowledge of how citizens with different risk profiles perceive the multitude of digital health tools being introduced in the healthcare sector.

Digital health education develops an understanding of the pragmatic use of digital technologies, including health apps, artificial intelligence and wearables, in the National Health Service (NHS). Staff should feel confident...

BackgroundDigital health technologies have been proposed to support hospital-to-home transition for older adults. The COVID-19 pandemic and the associated physical distancing guidelines have propelled a shift toward digital health technologies. However, the characteristics of older adults who participated in digital health research interventions to support hospital-to-home transitions remain unclear. This information is needed to assess whether current digital health interventions are generalizable to the needs of the broader older adult population.ObjectiveThis rapid review of the existing literature aimed to identify the characteristics of the populations targeted by studies testing the implementation of digital health interventions designed to support hospital-to-home transitions, identify the characteristics of the samples included in studies testing digital health interventions used to support hospital-to-home transitions, and create recommendations for enhancing the diversity of samples within future hospital-to-home digital health interventions.MethodsA rapid review methodology based on scoping review guidelines by Arksey and O’Malley was developed. A search for peer-reviewed literature published between 2010 and 2021 on digital health solutions that support hospital-to-home transitions for older adults was conducted using MEDLINE, Embase, and CINAHL databases. The data were analyzed using descriptive statistics and qualitative content analysis. The Sex- and Gender-Based Analysis Plus lens theoretically guided the study design, analysis, and interpretation.ResultsA total of 34 studies met the inclusion criteria. Our findings indicate that many groups of older adults were excluded from these interventions and remain understudied. Specifically, the oldest old and those living with cognitive impairments were excluded from the studies included in this review. In addition, very few studies have described the characteristics related to gender diversity, education, race, ethnicity, and culture. None of the studies commented on the sexual orientation of the participants.ConclusionsThis is the first review, to our knowledge, that has mapped the literature focusing on the inclusion of older adults in digital hospital-to-home interventions. The findings suggest that the literature on digital health interventions tends to operationalize older adults as a homogenous group, ignoring the heterogeneity in older age definitions. Inconsistency in the literature surrounding the characteristics of the included participants suggests a need for further study to better understand how digital technologies to support hospital-to-home transitions can be inclusive.

Healthcare has been going through major digital transformations due to the extensive use of information and communication technologies (ICT) in the sector. Many patients lack access to healthcare services due to lack of knowledge of the exitance of the service, physical or mental disability, distance, siege, lockdown and other possible reasons. Access to healthcare services has been impacted by a number of innovations including electronic health record, artificial intelligence, sensors, wearable devices, Internet of (medical) things, Blockchain, big data and other applications. COVID-19 has created new realities in accessing healthcare services through telehealth and telemedicine services as many countries have imposed lockdown and physical distancing. Digital health has been used to empower people, in general and patients in particular, to enable them to access healthcare services at the point of care or remotely. Healthcare professionals have been using digital health to enhance their knowledge, skills and more important to enable them to reach to patients to provide guidance and assistance. Using digital health solutions has a number of challenges which can be legal, ethical, infrastructural, human and material resources, training, education, attitude, cultural, organizational and behavioral. A number of national, regional and international agencies have adopted resolutions and developed strategies to support digital health implementation in countries. This chapter provides few examples to demonstrate how access to healthcare services is being enabled and facilitated by information and communication technology (ICT) through proper national planning of digital health.

BackgroundAboriginal and Torres Strait Islander (Indigenous) peoples living in remote Australia experience a heavy burden of ill health and multiple barriers to accessing health care. Digital health technologies (DHTs) have the potential to help overcome some of these challenges and increase access to comprehensive primary health care (CPHC), thereby improving equity of health outcomes. However, little is known about the community and provider preferences for the use of digital technologies for improving health and wellness.ObjectiveThe study aims to co-design, implement, and evaluate how DHTs can improve access to CPHC in remote Indigenous communities in the Northern Territory (NT), Australia.MethodsThis multiphased project will take a participatory action research approach to co-design and optimize digital health solutions with local community members and health service staff in 2 communities. Our mixed methods approach will include pre- and postimplementation focus group discussions, interviews, quantitative analysis of CPHC utilization administrative data, and surveys administered by Indigenous community-based researchers to understand the use of digital devices and connectivity, eHealth literacy, preferences for different attributes of DHTs using best-worst scaling, and consumer satisfaction and experiences with DHT interventions. Priority DHTs will be selected for implementation based on consumer and health staff preferences. Focus group discussions and interview data will explore community and health service staff preferences, experiences, and satisfaction with implemented DHTs. A realist approach will be taken to identify how DHT interventions work, for whom, and in what circumstances, so that the understanding of why some interventions work while others do not is expanded. Economic analyses will be conducted to calculate the incremental costs and benefits of implemented DHT interventions. The scalability of digital health solutions will be tested in two additional communities. Project partners include key funding, service, and support agencies in the NT and nationally.ResultsAs of November 2024, we have selected two implementation sites. Digital health initiatives are underway at the implementation sites, and evaluation activities are progressing. The initial findings from these sites have informed our scalability assessment in an additional two sites.ConclusionsKnowledge translation is integral to the study design, which involves partnering with consumers, CPHC service providers, and a range of key stakeholders to inform health service providers and policy makers about which DHTs work for which groups of consumers, and under what circumstances, to improve access to CPHC. This unique study will accommodate consumer and provider preferences regarding the use of DHTs to improve CPHC access and address the lack of knowledge about how to deploy digital solutions to best support CPHC in remote Indigenous Australia.International Registered Report Identifier (IRRID)DERR1-10.2196/68892

Advances in digital health technologies have the potential to redesign chronic disease management and enable new directions for better patient outcomes and improved healthcare delivery. The focus here is on congestive heart failure, diabetes mellitus, and opioid use disorder, with an emphasis on the identification of barriers to equitable implementation and to propose research directions to enhance digital health efficacy and scalability. Investing in digital health solutions and innovation makes it possible for the healthcare industry to maintain quality of care, achieve better patient outcomes, and lower the burden of chronic diseases on a healthcare system. This paper explores common challenges and opportunities and proposes future research directions. Unlike earlier reports that focused on implementation barriers and provided an umbrella review of patient experiences, this article uniquely synthesizes evidence across conditions to establish best practices and cross-cutting barriers. In addition, it highlights the growing role of artificial intelligence in digital health—a topic often underexplored in prior works.

In May 2020, in response to the rapidly expanding pandemic caused by the SARS-CoV-2 virus, the National Cancer Institute (NCI) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) together launched a program called “Digital Health Solutions for COVID-19.” The goal of this initiative was to support the development of digital health tools that could leverage multiple data sources, privacy-preserving technologies, and computational tools to assist in managing population health during the COVID-19 pandemic. Seven projects received National Institutes of Health (NIH) support to develop a variety of smartphone apps, wearable devices, and software tools capable of identifying infected individuals, tracking verified COVID-19 test results, and monitoring the health status of infected and potentially infected individuals. The NIH also supported the establishment of a data hub to facilitate the collection and curation of de-identified data generated by these projects, which will be made publicly available in late 2022. This will provide an opportunity for the broader research community to further analyze the data, refine predictive models, and continue to generate new learnings from the data sets. A major focus of the NCI/NIBIB initiative was to define the context of use for various digital health technologies to determine what could be learned from the data and how this could be leveraged to inform decision making during future pandemics. Among these technologies was an artificial intelligence, web-based decision aid, developed by Vibrent Health (Fairfax, Virginia), which can be used to evaluate COVID-19 symptoms of patients at home. Several articles in this issue describe how this system, and potentially others like it, can be extremely useful for both triage decisions and improving accuracy of in-home testing. While these testing improvements have been invaluable during the pandemic, such testing enhancements will become even more critical as COVID-19 shifts to an endemic. It will no longer be acceptable to triage patients based on general symptoms, such as fever and cough, as was done early in the pandemic. As patients return to normal activities and continue striving to make informed health care decisions, they will rightly expect more sophisticated methods to differentiate COVID-19 from other diseases with overlapping symptomatology. Accomplishing this goal will be tremendously complex and will require painstaking deconvolution of symptoms, but this can be achieved with the help of machine learning, as is shown in the Vibrent studies. Despite the fear and uncertainty throughout the COVID-19 pandemic, the public has demonstrated a remarkable willingness to participate in NIH-supported efforts aimed at improving COVID-19 outcomes. Projects supported under the Digital Health Solutions for COVID-19 initiative began in September 2020, just before the beta wave of the pandemic began, and study enrollment was generally high throughout the winter of 2020-2021. Study enrollment decreased somewhat in early 2021 with the rollout of COVID-19 vaccines and falling case numbers, and then steadily increased again during the spread of the delta variant in mid-2021. To successfully navigate these changing dynamics, it was especially important for the NIH-funded teams to establish clear and consistent communication with study participants. The team at Vibrent Health was able to successfully achieve this through targeted outreach campaigns and thoughtful community engagement. Particularly important were their studies aimed at engaging traditionally underserved and underrepresented populations, which showed that digital health tools play an important role in reaching populations that are not well served by current health systems. The Digital Health Solutions for COVID-19 initiative was just one component of a major coordinated effort by the NIH to combat COVID-19. Other programs such as the Rapid Acceleration of Diagnostics (RADx) Tech initiative also played a key role in speeding the development, validation, and commercializaiton of rapid, low-cost, point-of-care, and home-based tests. Importantly, large investments in next-generation testing approaches can only realize their full potential if these new technologies can be easily accessed and operated by the intended end users. The solutions developed by Vibrent Health and the other project teams have clearly demonstrated that digital health tools will play a crucial role in enhancing the use of various physical technologies going forward. In the future, public health officials, clinicians, employers, and the general community will rely heavily on these digital tools as they work to provide individuals with the necessary data to make informed choices about their health. The recent investment by the US government in digital health solutions and other COVID-19 technologies has not only provided clear and immediate benefits but also helped secure a solid foundation and infrastructure for the early detection, prevention, and monitoring of future pandemics. Hopefully, the recent COVID-19 experience will not soon be repeated, but the lessons learned will be invaluable when the next pandemic does occur. —Andrew Kurtz, PhD Program Director Center for Strategic Scientific Initiatives National Cancer Institute Bethesda, Maryland

Digital health solutions are often used to support caregivers in managing acute pain in their children. The aim of this scoping review was to identify, characterize, and synthesize the literature on caregiver-targeted digital health solutions for acute pain management in children as it relates to caregiver, child, and implementation outcomes. Studies must have described a caregiver-targeted digital health solution for acute pain management in children that provides information or support to caregivers of children experiencing acute pain (eg, needle-related procedure, injury, medical procedure). Studies that included caregivers of children 0 to 19 years were eligible. Following the Joanna Briggs Institute scoping review methodology, MEDLINE, Embase, CINAHL, and PsycINFO databases were searched from January 1, 2010 to May 20, 2025. Two reviewers completed screening and data extraction, and a third reviewer resolved disagreements. From 8949 records screened, 33 studies were eligible. From these, there were 15 individual digital health solutions identified. Of the 7,125 caregivers, 95.2% were mothers. More than half of digital health solutions targeted caregivers of newborns (0-1 years, 60.6%), and all except 2 focused on acute pain during needle-related procedures (eg, vaccinations). Overall, 21 studies reported on caregiver outcomes (primarily knowledge), 11 reported on child outcomes (primarily pain and distress), and 28 reported on implementation outcomes (primarily adoption and acceptability). There is a need for (1) standardization in the evaluation of digital health solutions for caregivers, (2) digital health solutions that target acute pain other than needle-related procedures, and (3) increased diversity of caregivers (eg, non-White, non-mothers) and solutions (eg, culturally diverse).

The aging population requires cutting-edge approaches to geriatric care, with digital health technologies playing a crucial part in meeting the challenging demands of healthcare. Current approaches frequently fall short of the goal of providing comprehensive, real-time monitoring and merging contextually complex information for use in the treatment of patients. This paper addresses these limitations by integrating the innovative approaches within the RO-SmartAgeing system and the NeuroPredict platform to boost geriatric-care outcomes. It emphasizes the multifaceted design and development processes of these digital health solutions, emphasizing a multidisciplinary approach and a meticulous choice of decision-making tools. This paper presents the inclusion of decision-making tools, namely the Medical Blackbox and Gaitband, into the RO-SmartAgeing system and the NeuroPredict platform; these tools have been developed for the purpose of gathering complex physiological data and allow for in-depth evaluations of gait patterns and vital health parameters in elderly individuals. The present research emphasizes major breakthroughs in sensing technology and decision-making capabilities, illustrating the manner in which these tools enhance patient outcomes by providing timely, data-driven insights. The results demonstrate that these tailored decision-making tools significantly improve patient outcomes, underscoring the need for such ongoing improvements able to address digital health solutions tailored to the dynamic demands of an increasingly aging population.

Reimbursement is a key challenge for many new digital health solutions, whose importance and value have been highlighted and expanded by the current COVID-19 pandemic. Germany’s new Digital Healthcare Act (Digitale–Versorgung–Gesetz or DVG) entitles all individuals covered by statutory health insurance to reimbursement for certain digital health applications (i.e., insurers will pay for their use). Since Germany, like the United States (US), is a multi-payer health care system, the new Act provides a particularly interesting case study for US policymakers. We first provide an overview of the new German DVG and outline the landscape for reimbursement of digital health solutions in the US, including recent changes to policies governing telehealth during the COVID-19 pandemic. We then discuss challenges and unanswered questions raised by the DVG, ranging from the limited scope of the Act to privacy issues. Lastly, we highlight early lessons and opportunities for other countries.

This research investigates the transformative role of digital health solutions in tackling climate-related health challenges. The study underscores the potential of digital health innovations to empower individuals and communities, fostering resilience and collective action in addressing the health impacts of climate change. By enhancing the accessibility of critical health information and enabling real-time responses, these digital tools not only mitigate immediate risks but also contribute to long-term public health strategies. The findings highlight the importance of integrating digital health solutions into broader climate health initiatives, demonstrating their capacity to bridge gaps in public health infrastructure, especially in vulnerable populations. This research calls for continued investment and innovation in digital health technologies as a vital component of global efforts to combat the growing challenges posed by climate change