Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review.

Autor:	Singh H; Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.; March of Dimes Canada, Toronto, ON, Canada.; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada., Tang T; Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.; Department of Medicine, University of Toronto, Toronto, ON, Canada., Steele Gray C; Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Kokorelias K; St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Thombs R; Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada., Plett D; Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Heffernan M; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada., Jarach CM; Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy., Armas A; March of Dimes Canada, Toronto, ON, Canada.; Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada., Law S; Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Cunningham HV; Gerstein Science Information Centre, University of Toronto, Toronto, ON, Canada., Nie JX; Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada., Ellen ME; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.; Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Thavorn K; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada., Nelson M; March of Dimes Canada, Toronto, ON, Canada.; Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Jazyk:	angličtina
Zdroj:	JMIR aging [JMIR Aging] 2022 May 19; Vol. 5 (2), pp. e35929. Date of Electronic Publication: 2022 May 19.
DOI:	10.2196/35929
Abstrakt:	Background: Older adults experience a high risk of adverse events during hospital-to-home transitions. Implementation barriers have prevented widespread clinical uptake of the various digital health technologies that aim to support hospital-to-home transitions. Objective: To guide the development of a digital health intervention to support transitions from hospital to home (the Digital Bridge intervention), the specific objectives of this review were to describe the various roles and functions of health care providers supporting hospital-to-home transitions for older adults, allowing future technologies to be more targeted to support their work; describe the types of digital health interventions used to facilitate the transition from hospital to home for older adults and elucidate how these interventions support the roles and functions of providers; describe the lessons learned from the design and implementation of these interventions; and identify opportunities to improve the fit between technology and provider functions within the Digital Bridge intervention and other transition-focused digital health interventions. Methods: This 2-phase rapid review involved a selective review of providers' roles and their functions during hospital-to-home transitions (phase 1) and a structured literature review on digital health interventions used to support older adults' hospital-to-home transitions (phase 2). During the analysis, the technology functions identified in phase 2 were linked to the provider roles and functions identified in phase 1. Results: In phase 1, various provider roles were identified that facilitated hospital-to-home transitions, including navigation-specific roles and the roles of nurses and physicians. The key transition functions performed by providers were related to the 3 categories of continuity of care (ie, informational, management, and relational continuity). Phase 2, included articles (n=142) that reported digital health interventions targeting various medical conditions or groups. Most digital health interventions supported management continuity (eg, follow-up, assessment, and monitoring of patients' status after hospital discharge), whereas informational and relational continuity were the least supported. The lessons learned from the interventions were categorized into technology- and research-related challenges and opportunities and informed several recommendations to guide the design of transition-focused digital health interventions. Conclusions: This review highlights the need for Digital Bridge and other digital health interventions to align the design and delivery of digital health interventions with provider functions, design and test interventions with older adults, and examine multilevel outcomes. International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2020-045596. (©Hardeep Singh, Terence Tang, Carolyn Steele Gray, Kristina Kokorelias, Rachel Thombs, Donna Plett, Matthew Heffernan, Carlotta M Jarach, Alana Armas, Susan Law, Heather V Cunningham, Jason Xin Nie, Moriah E Ellen, Kednapa Thavorn, Michelle LA Nelson. Originally published in JMIR Aging (https://aging.jmir.org), 19.05.2022.)
Databáze:	MEDLINE
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