eHealth education should be integrated into vocational training and continuous professional development programmes. In this opinion article, we aim to support organisers of Continuing Professional Development (CPD) and teachers delivering medical vocational training by providing recommendations for eHealth education. First, we describe what is required to help primary care professionals and trainees learn about eHealth. Second, we elaborate on how eHealth education might be provided
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Abstract: This case study examines the use of an eHealth application for improving preoperative rehabilitation (prehabilitation). We have analysed healthcare professionals' motivators and drivers for adopting eHealth for a surgical procedure at academic medical facilities. The research focused on when and why healthcare professionals are inclined to adopt eHealth applications in their way of working? For this qualitative study, we selected 12 professionals involved in all levels of the organisation and stages of the medical process and conducted semi-structured interviews. Kotter’s transformational change model and the Technology Acceptance Model were used as analytical frameworks for the identification of the motivation of eHealth adoption. The findings suggest that contrary to Kotter’s change model, which argues that adoption of change is based on perceptions and feelings, the healthcare drivers are rational when it comes to deciding whether or not to adopt eHealth apps. This study further elaborates the observation made by the Dutch expertise centre on eHealth, Nictiz, that when the value of an eHealth pplication is clear for a stakeholder, the adoption process accelerates. Analysis of the motivations and drivers of the healthcare professionals show a strong relationship with an evidence-based grounding of usefulness and the responsibility these professionals have towards their patients. We found that healthcare professionals respond to the primary goal of improving healthcare. This is true if the eHealth application will innovate their work, but mainly when the application will improve the patient care they are responsible for. When eHealth applications are implemented, rational facts need to be collected in a study before deployment of eHealth applications on how these applications will improve the patient's health or wellbeing throughout their so-called medical journey for their treatment. Furthermore, the preference to learn about new eHealth applications from someone who speaks from authority through expertise on the subject matter, suggests adoption by healthcare professionals may be accelerated through peers. The result of this study may provide healthcare management with a different approach to their eHealth strategy. Future research is needed to validate the findings in different medical organisational settings such as regional healthcare facilities or for-profit centers which do not necessarily have an innovation focus but are driven by other strategic drivers.
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Het boek ‘Create Health Ways of Working: Insights from ten eHealth innovation research projects’ presenteert inzichten uit het meta-onderzoeksproject ‘Create & Health Innovation WAys of Working Analysis’, ook wel CHIWAWA genoemd. Binnen dit meta-onderzoeksproject inventariseerden onderzoekers van de Hogeschool Utrecht (Lectoraat Onderzoekend Vermogen en Lectoraat Co-design) het gebruik van creatieve manieren van werken bij innovatieprocessen in de zorg, waarvoor zij tien onderzoeksprojecten van Nederlandse kennisinstellingen volgende in de periode 2018 – 2022. Deze tien onderzoeksprojecten en het meta-onderzoek waren onderdeel van het ZonMw-programma Create Health. Het boek presenteert case-portretten van de tien onderzoeksprojecten naar eHealth innovatie die zich concentreerden rondom de thema’s dementie, eenzaamheid en overgewicht. Vervolgens geeft het boek verdieping met betrekking tot de creatieve manieren van werken in de tien Create Health-onderzoeksprojecten, begrip van relationele processen bij het creëren van kennisuitwisseling en zicht op de impact die een dergelijke samenwerking heeft op de zorg- en welzijnssector en op de creatieve industrie. Het boek bevat aanbevelingen voor toekomstige onderzoeksconsortia, financiers en de praktijk (creatieve industrie, zorgsector en doelgroep) en sluit af met de beschrijving van een tool die gebaseerd is op het Research Pathway Model, dat als instrument gebruikt kan worden om het gesprek tussen stakeholders van innovatieprocessen in de zorg te ondersteunen.
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Inleiding. Gedurende de opleiding Sportkunde leren studenten gezondheidsproblemen signaleren en leefstijlverbeteringen te bedenken. Dit o.a. middels eHealth. eHealth biedt sportkundige extra mogelijkheden voor informatieoverdracht, optimale monitoring en feedback. In het derde jaar ontwikkelen studenten een leefstijl-bevorderende groepsinterventie, met speciale aandacht voor eHealth. Deze module paste een meer digitale aanpak. Een digitale leeromgeving stelt studenten in staat flexibeler en verdiepend te leren en vereenvoudigd het zien van verbanden tussen opdracht, theorie, praktijk. Doelstelling. De ontwikkeling en evaluatie van een blended-onderwijsmodule ‘Gedragsverandering en leefstijlinterventie met behulp van eHealth’ voor de opleiding Sportkunde. Methode. Met een vooronderzoeksfase en ontwerpfase is op systematische wijze gewerkt aan de nieuwe onderwijsmodule over eHealth. In het vooronderzoek zijn zes focusgroepen uitgevoerd met studenten (n=25), docenten (n=6) en professionals (n=10). Hierbij zijn ervaringen, wensen en behoeften rondom eHealth geïnventariseerd en geanalyseerd. Samen met leerdoelen uit de leerlijn zijn de resultaten uit deze inventarisatie gevormd tot een script voor de nieuwe module. In werksessies is de inhoud en vorm bepaald. In de ontwerpfase is dit script omgezet tot een blended-aanpak in de digitale leeromgeving van Inholland: Moodle. Theorie en passende praktijkvoorbeelden, alsook individuele- en groepsopdrachten werden toegevoegd. Om het groepsproces van studenten te monitoren is de TeamTester ingezet. In het tweede semester van studiejaar 2019/2020, is een eerste prototype van de module met 25 derdejaars sportkunde studenten getest en formatief geëvalueerd om verbeterpunten te verzamelen. De nieuwe opzet is geëvalueerd middels een logboek door de docent en een online vragenlijst (halverwege en eind) voor de studenten. Het logboek beschreef geplande taken en doelen per bijeenkomst, aangevuld met ervaringen en eventuele adaptaties tijdens de uitvoer. De anonieme vragenlijsten voor studenten bestond uit stellingen over opzet en inhoud van de module (geheel mee eens – geheel mee oneens), aangevuld met open vragen voor diepgang. Met behulp van deze formatieve evaluatie werd bestudeerd of de aanpak volgens de student relevant, bruikbaar en van meerwaarde was. Stellingen met de hoogst afwijkende scoren of zorgwekkende opmerkingen werden elementen voor aanpassing. Resultaten. Uit de focusgroep gesprekken in de vooronderzoeksfase, bleek dat informatie over en praktische toepassingen van eHealth van toegevoegde waarde zouden zijn voor het werkveld en onderwijs. De centrale opdracht in de module is het ontwikkelen van een eHealth interventie volgens de stappen van Intervention Mapping (IM). In de module worden eHealth theorie en toepassingen getoond en is het IM-proces visueel gemaakt in een tekening (figuur 1a) en deze tekening is met H5P (software voor interactieve content) voorzien van doorklik-links naar bijpassende lesactiviteiten, lesmateriaal, eHealth informatie. De module was opgezet in een blended-vorm, maar door COVID-19 na 6-weken, zonder grote problemen, overgegaan naar een volledige online module. Deze onverwachtse overgang kan een negatief effect hebben gehad op de evaluatie van de module. Desondanks was de evaluatie van studenten positief over opzet en inhoud. Vele studenten zouden de structuur en helderheid van deze opzet vaker terugzien in het onderwijs. Als verbeterpunt werd aangegeven dat ze (meer) weekstructuur en duidelijkheid in de werklijnen wensten. De docent was enthousiast over de toegenomen betrokkenheid van de studenten, maar binnen de digitale omgeving miste zij enkele technische koppelingen in het systeem. Deze veranderingen zijn inmiddels doorgevoerd. Conclusie. De blended module is goed beoordeeld. De aanpak binnen de module draagt bij aan effectief leren en sluit aan op de eHealth informatie behoefte van studenten, docenten en praktijk. De module is reeds geïmplementeerd in het 3e leerjaar van Sportkunde en de eerste mooie interventies zijn ontwikkeld. De opzet en structuur dient nu al als voorbeeld voor vele anderen collega docenten. Ook wordt vanuit Vitale Delta de informatiebehoefte omtrent eHealth bij andere hogescholen bestudeerd.
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To arrive at viable eHealth applications, it is important that future users are involved in research projects. In practice, however, it is difficult to involve potential users and keep them involved. In a multiple-case study, we investigate ten eHealth projects in which design researchers and healthcare researchers worked together. We focus on how they involved potential users and kept them involved. Both domains have a rich tradition of involving potential users and see their involvement of potential (future) users in the early stages of innovation as essential. Therefore it is interesting to investigate projects in which design researchers and healthcare researchers intensively work together. We discovered seven strategies to promote the involvement of potential users in eHealth research projects: (1) use research methods based on building personal relationships; (2) build trust before introducing research methods; (3) facilitate the preconditions around the moments of involvement; (4) facilitate by introducing a prototype as a boundary object; (5) choose the method that fits the research context; (6) integrate the values behind the eHealth tool into the research method; (7) involve proxies instead of the potential users. These strategies may guide future projects where design researchers and healthcare researchers work together with potential users.
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Background: Despite the growing importance of eHealth it is not consistently embedded in the curricula of functional exercise and physical therapy education. Insight in barriers and facilitators for embedding eHealth in education is required for the development of tailored strategies to implement eHealth in curricula. This study aims to identify barriers/facilitators perceived by teachers and students of functional exercise/physical therapy for uptake of eHealth in education. Methods: A qualitative study including six focus groups (two with teachers/four with students) was conducted to identify barriers/facilitators. Focus groups were audiotaped and transcribed in full. Reported barriers and facilitators were identified, grouped and classified using a generally accepted framework for implementation including the following categories: innovation, individual teacher/student, social context, organizational context and political and economic factors. Results: Teachers (n = 11) and students (n = 24) of functional exercise/physical therapy faculties of two universities of applied sciences in the Netherlands participated in the focus groups. A total of 109 barriers/facilitators were identified during the focus groups. Most related to the Innovation category (n = 26), followed by the individual teacher (n = 22) and the organization (n = 20). Teachers and students identified similar barriers/facilitators for uptake of eHealth in curricula: e.g. unclear concept of eHealth, lack of quality and evidence for eHealth, (lack of) capabilities of students/teachers on how to use eHealth, negative/positive attitude of students/teachers towards eHealth. Conclusion: The successful uptake of eHealth in the curriculum of functional exercise/physical therapists needs a systematic multi-facetted approach considering the barriers and facilitators for uptake identified from the perspective of teachers and students. A relatively large amount of the identified barriers and facilitators were overlapping between teachers and students. Starting points for developing effective implementation strategies can potentially be found in those overlapping barriers and facilitators.
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Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: “chronic disease”, “eHealth”, “factors”, and “suggested interventions”. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended
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Abstract Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings. Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients. Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the intervention. Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0.20% before the intervention and 0.27% after the intervention; this difference in slopes was statistically significant (P = 0.027). The decrease of CCQ-mental was 0.97% before the intervention and after the intervention there was an increase of 0.017%; this difference was statistically significant (P = 0.01). No significant difference was found in the slopes of CCQ (P = 0.12) and CCQ-function (P = 0.11) before and after the intervention. Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management. Trial registration: Our study is registered in the Dutch Trial Register (national registration of clinical trails, mandatory for publication) with number NTR4098 and can be found at http://www.trialregister.nl/trial/3936.
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Intensive collaboration between different disciplines is often not without obstacles—healthcare and creative professionals come from different worlds that are not automatically aligned. This study investigates the research question: how do project partners in Create-Health innovation collaborate across boundaries, and how does it add value to interdisciplinary collaboration? It addresses the close collaborations between researchers and practice partners from creative industry and healthcare sector within ten research projects on eHealth innovation. It describes the way that Create-Health collaboration took shape across disciplinary boundaries and provides examples of boundary crossing from the ten projects, with the objective of stimulating learning in the creative and health sectors on creative ways of working on interdisciplinary projects. Findings focus on the way partners from various backgrounds work together across disciplinary boundaries and on the benefits that such collaborations bring for a project.
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Development process of an online educational module on ‘eHealth based lifestyle-interventions’: experiences of teachers
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