Health Policy and Technology最新文献

{"title":"Evaluating progress towards implementation of the European HTA Regulation: Insights generated from the European Access Academy's multi-stakeholder survey","authors":"","doi":"10.1016/j.hlpt.2024.100930","DOIUrl":"10.1016/j.hlpt.2024.100930","url":null,"abstract":"<div><h3>Objectives</h3><div>We conducted a multi-stakeholder survey to assess stakeholders' perceptions of the progress made towards the implementation of the European Regulation on Health Technology Assessment (EU HTA R) and to identify and prioritize the remaining challenges for implementation.</div></div><div><h3>Methods</h3><div>Using two iterative Delphi cycles, an exploratory, semi-quantitative survey was developed to identify how stakeholders 1) experienced preparatory activities of the Regulation, and 2) prioritized remaining challenges for successful implementation. The survey was distributed among the network of the European Access Academy and via social media to ensure coverage of key stakeholders. Descriptive analyses were performed on quantitative response items, and relative importance was calculated for ranking items. Free-text responses supplemented participants' answers to quantitative questions.</div></div><div><h3>Results</h3><div>N = 61 responses were received from N = 15 countries including Global/ EU-wide institutions (Patients and Patients’ representatives: 7; Clinicians’ representatives: 5; Regulators: 3; Health Technology Developers (HTDs): 20; HTA bodies: 10; Payers: 7; Policy Makers: 2; Academic representatives: 7). The majority of respondents were aware of preparatory activities, with 74 % (N = 45) observing the drafting of Guidance Documents and 64 % (N = 39) noting the establishment of the Coordination Group. Respondents ranked the success of preparatory activities neutral with a slight tendency towards a positive ranking. Key challenges were Member States' readiness for Joint Clinical Assessments, HTA capacity/ capability constraints, and the applicability/ feasibility of the methodological framework.</div></div><div><h3>Conclusions</h3><div>This study identified the key remaining challenges for the successful establishment of the EU HTA process. Key findings emphasize the readiness of national systems and procedures as pivotal factors. Balancing operational efficiency with strategic objectives, including the development of a European Value Framework, is imperative for harnessing the full potential of the joint HTA process and enhancing patient access to innovative technologies on a pan-European scale.</div></div><div><h3>Public interest summary</h3><div>In January 2022, the European Union (EU) adopted the European Regulation on Health Technology Assessment (HTA). By harmonizing HTA practices and promoting collaboration across Member States, the joint procedure as set out in the regulation aims to improve efficient use of resources and ensure long-term sustainability of EU-wide HTA cooperation. Close to reaching the half-way mark of the preparation phase in mid-2023, we conducted a multi-stakeholder survey to assess perceptions of the progress made towards implementation of a joint procedure and to prioritize remaining challenges. The responses indicated a neutral to positive perception of the preparatory activitie","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices and systems employed by health professionals toward protection and confidentiality of patient health records in Ghana","authors":"","doi":"10.1016/j.hlpt.2024.100933","DOIUrl":"10.1016/j.hlpt.2024.100933","url":null,"abstract":"<div><h3>Objectives</h3><div>Health information relies on a patient's sensory perceptions as well as objective assessments, diagnoses, and test findings. Ghana's current laws governing the confidentiality of patient health data seems a little pertinent in spite of ongoing conversations on the significance of patient health information and the necessity to protect patient information from improper disclosure. The study therefore investigated the extent of patient confidentiality in Ghana by looking into the guidelines, regulations, and rules that govern patient records.</div></div><div><h3>Methods</h3><div>The interpretive, phenomenological, and narrative methodologies used in qualitative research were employed to study the phenomenon. Twenty (20) participants were interviewed in a semi-structured manner to gather the data needed for the analysis comprising of Doctors, Nurses, Administrative staff, Record Officers, and Information Communication Technology (ICT0 Technicians of five Departments in La General Hospital. The Activity Theory was used as a theoretical foundation for the study</div></div><div><h3>Conclusions</h3><div>The study revealed that healthcare professionals uphold the moral standards relating to patient confidentiality and trust. Again, the findings of the study showed that medical records are safely stored through the use of Electronic Health Record system in the hospital in a manner that wouldn't compromise patient confidentiality. However, the results establishes that health care workers can potentially serve as a conduit for the leak or breach of patient information through negligence and unprofessional practices.</div></div><div><h3>Public interest statement</h3><div>The study investigated systems and practices that are employed by health workers in Ghana to ensure that patient health records are safeguarded in order to build patients confidence in how their health records are protected. Health workers were interviewed in this study and the findings of the study show that there are practices and systems put in place to safeguard patient health records in the hospitals. Although, it was established that EHR systems help in safeguarding patient health records, the study recommends the need for users of the Health Electronic Records to be fully involved in the implementation process and strict enforcement of policies regarding the use of the EHR system to help prevent negligence and unprofessional application of the system.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost effectiveness of esophageal varices screening strategies of cirrhotic patients with portal hypertension","authors":"","doi":"10.1016/j.hlpt.2024.100925","DOIUrl":"10.1016/j.hlpt.2024.100925","url":null,"abstract":"<div><h3>Objectives</h3><div>In France, screening for esophageal varices (EVs) in cirrhotic patients with portal hypertension (PH) is performed by esophagogastroduodenoscopy (EGD). Though proven effective, EGD screening may be unpleasant for some patients. Our study sought to compare the cost-effectiveness of PillCam (Medtronic, Minneapolis, USA) esophageal capsule endoscopy (ECE), a less invasive test, versus EGD, for EV screening, from the perspective of the French national health system (NHS). In secondary objectives we compared the cost-effectiveness of ECE versus no screening for patients not compliant with EGD screening, and the cost-effectiveness of a screening strategy (ECE or EGD) versus no screening strategy at all.</div></div><div><h3>Methods</h3><div>We constructed a Markov model with data from the literature, applying it to two simulated cohorts of adult patients with cirrhosis and PH not previously screened for EVs. These patients were divided into EGD and ECE screening arms and tracked over a virtual 10-year period. Cost-effectiveness was defined as cost (in euros) per quality-adjusted life year (QALY).</div></div><div><h3>Results</h3><div>In the base-case analysis, ECE is more expensive than EGD (€3,606 vs. €3,030) and less effective by 0.0098 QALY (5.2099 vs. 5.2197 QALYs). Probabilistic sensitivity analysis shows that ECE has only a 2.1 % probability of being cost-effective at willingness-to-pay (WTP) of €30,000/QALY.</div></div><div><h3>Conclusions</h3><div>Although patient compliance is apparently higher with ECE, it is not cost-effective at a WTP of €30,000/QALY and should not be considered in all patients with PH. Its cost-effectiveness should be reevaluated in the event of patient refusal of EGD follow-up.</div></div><div><h3>Public Interest Summary</h3><div>Esophagogastroduodenoscopy (EGD) is gold standard to screen cirrhotic patients with portal hypertension for esophageal varices, but its unpleasantness lowers compliance. We evaluated the cost-effectiveness of a more acceptable alternative for patients: the esophageal capsule endoscopy (ECE).</div><div>Our results show that screening by ECE is more expensive and less effective than by EGD from the perspective of the French national health system. It cannot be used as an alternative for all patients suffering from PH in France. Further investigations could be conducted to assess the effectiveness of ECE for the sub population of patients with PH who are totally refractory to EGD and may suffer from inadequate follow-up due to lack of screening.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of emerging technologies on healthcare needs of older people","authors":"","doi":"10.1016/j.hlpt.2024.100935","DOIUrl":"10.1016/j.hlpt.2024.100935","url":null,"abstract":"<div><h3>Background</h3><div>The global elderly population is rapidly increasing resulting in a higher burden on healthcare systems. Emerging technologies may contribute to counteracting the shortage of healthcare workers and to assist the elderly in both healthcare settings and the community.</div></div><div><h3>Objective</h3><div>The study aimed to identify emerging technologies that may have a significant impact on the healthcare and social needs of the elderly, to assess their time to market, and to recommend policy measures intended to overcome entry barriers.</div></div><div><h3>Methods</h3><div>A foresight study was conducted, including horizon scanning, interviews, and a survey of 76 participants who were experts from the fields of health and technology in Europe and Israel.</div></div><div><h3>Results</h3><div>Thirteen emerging technologies were identified and five main areas of needs for the elderly were recognized: mobility, cognition, self-care, social life, and access to healthcare. All the emerging technologies were shown to have a high impact on healthcare needs for the elderly. The most influencing technologies were wearables, artificial intelligence apps and fall prevention devices. The most influential area of need was self-care, while the lowest area was social life. The forecast was that most technologies will reach the market as early as 2024 and will continue to evolve and impact healthcare. The significant barriers were forecasted to be high cost, lack of ease of use, and training.</div></div><div><h3>Conclusions</h3><div>The important policy measures are to increase usability and the availability of solutions, public funding, and training.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on access to imaging digital health records in oncology: A mixed methods systematic review","authors":"","doi":"10.1016/j.hlpt.2024.100915","DOIUrl":"10.1016/j.hlpt.2024.100915","url":null,"abstract":"<div><h3>Background</h3><div>Digital Health Records (DHR) have become essential for managing patient data, including radiology and nuclear medicine reports. The wider adoption of DHR globally presents an opportunity to improve patient engagement and empowerment through effective access and sharing of imaging investigations. This review aims to synthesize literature on views, experiences, expectations, and preferences of oncology patients and healthcare professionals (HCP) when accessing imaging via DHR.</div></div><div><h3>Materials and Methods</h3><div>This review was conducted using recommended Cochrane Handbook databases (registration: CRD42021213808), focusing on English articles published from 2000 onwards. Three experienced reviewers critically appraised selected articles, thematic analysis and narrative synthesis were used to extract data.</div></div><div><h3>Results</h3><div>493 unique articles were identified, with 451 excluded, resulting in 42 articles assessed for eligibility. Nine studies were included, eight from the USA, one from Canada, published between 2010 and 2020. Findings suggest patient portals can positively impact patient and HCP engagement, and patients desire access to their imaging reports. Factors such as timing of access, adequate consultation time, resources for HCP to discuss findings, and format of information are critical considerations that influence both patient and HCP perceptions and preferences.</div></div><div><h3>Conclusion</h3><div>Oncology patients want timely and understandable access to their imaging records. To ensure this, it is crucial to explore the appropriate timing, format, and methods to discuss these findings with patients. By involving all stakeholders in the planning process, we can develop DHR systems that provide personalised support for patients to manage their complex imaging results.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of novel complex integrated care models supported by digital health interventions in European primary settings: a scoping review","authors":"","doi":"10.1016/j.hlpt.2024.100896","DOIUrl":"10.1016/j.hlpt.2024.100896","url":null,"abstract":"<div><h3>Introduction</h3><p>There remains the need to develop comprehensive organisational care models supported by digital health interventions (DHIs) to manage chronic conditions in primary healthcare.</p></div><div><h3>Objective</h3><p>this review aimed to identify and map methods, interventions and outcomes investigated regarding the introduction of novel complex integrated care models supported by DHIs in the European primary care setting, as well as the level of integration achieved.</p></div><div><h3>Methods</h3><p>a scoping review to identify literature from 2013 to 2023 in the European context was conducted across PubMed, Scopus and Web of Science. DHIs description, care models and outcomes were reported using the PRISMA- ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.</p></div><div><h3>Results</h3><p>A total of 53 studies was included. The models introduced, along with a DHI, at least one innovation in their structure or in the modality of care delivery: either a new figure (44%), interprofessional collaboration (37%), new functions like person-centred care (59%) or population stratification (11%). As regarding the DHIs, 56% implemented monitoring/management platforms and apps for chronic conditions. The most frequent combination of care model-DHI was the introduction of an app/platform, supported by phone calls/texts and electronic health records, paired with the introduction of a new healthcare professional/person centred care/ multidisciplinary team. All the studies reaching statistically significant outcomes introduced, along with one or more DHIs, either a new figure or a multidisciplinary team as part of the organizational change to support the technology.</p></div><div><h3>Conclusions</h3><p>novel complex integrated care models are focusing on introducing multidisciplinary perspectives and personalization of care, in line with the complex needs of chronic patients. The predominant development of monitoring/management platforms for patients is a further confirmation of this trend. Future research efforts should focus on the investigation of the effectiveness of current complex integrated care models integrating DHIs.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000595/pdfft?md5=6bf4b87855b7fec46abc3295455a593f&pid=1-s2.0-S2211883724000595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the risk factors of patient safety in internet hospitals: A mixed methods study","authors":"","doi":"10.1016/j.hlpt.2024.100897","DOIUrl":"10.1016/j.hlpt.2024.100897","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to identify key risk factors and their interrelationships for patient safety in internet hospitals from a system perspective, using mixed methods of qualitative and quantitative analysis.</p></div><div><h3>Methods</h3><p>This study constructed a comprehensive indicator system of patient safety risk factors in internet hospitals by qualitative analysis using the Patient Safety Systems (SEIPS) model as a framework. Risk factors were initially identified through a literature review and subsequently refined using a Delphi survey involving 24 experts related to internet hospitals in China. The identified indicators were quantitatively analyzed to determine key risk factors and their influencing mechanism using the Decision Making Trial and Evaluation Laboratory (DEMATEL) and Interpretive Structural Modeling (ISM) methods.</p></div><div><h3>Results</h3><p>The qualitative analysis established a patient safety risk factor indicator system for internet hospitals, comprising 23 elements across six dimensions. Quantitative analysis employing the DEMATEL-ISM approach revealed that risk management has the highest centrality. Among cause factors, task complexity exerts the most significant impact on other factors, while network information security exhibits the highest absolute value among result factors. Risk factors are categorized into three levels: surface, deep, and root factors, with task complexity, legal and regulatory, and guidance policy being the root factors at the foundation of the system.</p></div><div><h3>Conclusions</h3><p>Our study offered a systemic perspective on analyzing risk factors for patient safety in internet hospitals. Policymakers and managers of internet hospitals should take advantage of the interrelationships among these factors to mitigate patient safety risks by effectively controlling key factors.</p></div><div><h3>Public Interest Summary</h3><p>In the rapidly evolving landscape of internet hospitals, ensuring patient safety is paramount. This study aimed to comprehensively identify and understand key risk factors influencing patient safety within these digital healthcare platforms. Using mixed methods of qualitative and quantitative analysis, the study examined the intricate interplay of factors affecting patient safety. Our methodology involved constructing a risk factors indicator system based on the Patient Safety Systems (SEIPS) model. By employing the integrated Decision-Making Trial and Evaluation Laboratory along with the Interpretive Structural Modeling method, we unveiled the core risk factors and their intricate relationships. Recognizing the interconnectivity of these factors allows us to develop effective risk mitigation strategies that enhance patient safety in internet hospitals. This study encourages stakeholders to leverage the dynamic relationships among these factors to ensure safer online healthcare experiences for patients.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on pharmacists’ perceptions about service innovation","authors":"","doi":"10.1016/j.hlpt.2024.100898","DOIUrl":"10.1016/j.hlpt.2024.100898","url":null,"abstract":"<div><h3>Background</h3><p>Expanded services provided at pharmacies show numerous improvements in health outcomes. However, attempts at implementing new services in pharmacies are met with several barriers, among which is the failure to update the pharmacist's role.</p></div><div><h3>Objective</h3><p>This study aimed to explore pharmacists’ perceptions about the role of pharmacies and the effects of, and barriers to, service expansion.</p></div><div><h3>Methods</h3><p>Four focus groups were conducted with pharmacists from across Portugal, and an inductive content analysis was applied to the transcribed sessions.</p></div><div><h3>Results</h3><p>The content analysis results were organized into three main categories: the Role of Pharmacy, Potentialities of Service Innovation, and Service Innovation. The results emphasize the importance of enhancing pharmacists’ training, establishing supportive legal frameworks, prioritizing funding for technological advancements, promoting interprofessional collaboration, and embracing innovative practices to advance healthcare innovation and improve patient outcomes.</p></div><div><h3>Conclusions</h3><p>The identification of several tasks indicates that, in pharmacists’ perspectives, the Role of Pharmacy ranges from dispensing medication to aiding/monitoring patients at various stages of their health conditions. Expanded services were associated with several emergent Potentialities of Service Innovation, namely, enhancement of health outcomes and help to main healthcare facilities dealing with an increased number of patients. For Service Innovation, several factors emerged that need consideration, such as the conditions and the difficulties found associated with new service implementation. These pertain to pharmacists, legislation, and resources.</p></div><div><h3>Public Interest Summary</h3><p>Background: Expanded services provided at pharmacies show numerous improvements in health outcomes. However, several barriers should be addressed. Objective: This study sought to explore pharmacists’ perceptions about the role of pharmacies and the effects of, and barriers to, service expansion. Methods: A content analysis was applied to four focus groups conducted with pharmacists from across Portugal. Results: The three main emerging categories were: The Role of Pharmacy, divided into assessment, referrals, therapy monitoring, educating/informing, prescribing, and registering; Potentialities of Service Innovation, divided into proximity, improvement, and competitiveness; Service Innovation, divided into conditions for implementation, implementation difficulties, activation of the new services, and adherence-promoting factors. Conclusion: The pharmacy role goes beyond dispensing medication. Tied to this expanded role, pharmacists identified several advantages that the services could provide and several barriers to Service Innovation. Factors that promote adherence need more extensive study.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000613/pdfft?md5=11d49cca380593e77280af303b498829&pid=1-s2.0-S2211883724000613-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital approaches in myositis","authors":"","doi":"10.1016/j.hlpt.2024.100906","DOIUrl":"10.1016/j.hlpt.2024.100906","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Experienced-Based Co-Design principles to improve digital health demand management processes in a large metropolitan multi-hospital health system","authors":"","doi":"10.1016/j.hlpt.2024.100905","DOIUrl":"10.1016/j.hlpt.2024.100905","url":null,"abstract":"<div><h3>Objective</h3><p>This study describes the application of Experienced-Based Co-Design (EBCD) principles with an embedded implementation technology framework for improving digital health and informatics demand management processes in a multi-hospital healthcare system. The study identified barriers and enablers within the existing demand management system, proposed interventions to address these challenges and engaged in collaborative co-design with stakeholders.</p></div><div><h3>Methods</h3><p>A multi-method qualitative approach aligning with EBCD principles was used. Framework mapping (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) was applied to barriers and enablers associated with baseline practices. Reflexive thematic mapping and process charts were used to inform stakeholder priorities and co-design. Prototyping was iterative using feedback for continuous improvement with ongoing monitoring.</p></div><div><h3>Results</h3><p>Fragmentation of information was a technological barrier, decentralized processes and service duplication were organizational barriers, and opportunities to improve clarity of governance policies were identified. Solutions were co-generated and prioritised by stakeholders. The co-design and prototyping phase followed an iterative approach which generated two interventions. For centralizing intake and management, a new workflow process was devised. For improving project portfolio visibility and developing a weighted scoring criterion, a single tool to track projects across the lifecycle and a scoring model based on prioritization techniques were created.</p></div><div><h3>Conclusion</h3><p>A novel application of an EBCD approach was used to improve demand management processes in a digital health and informatics service context in a large health system. It highlights the value and agility of EBCD to generate flexible and modular solutions for this digital health context and compares favorably to analogous approaches.</p></div><div><h3>Public interest summary</h3><p>In today's fast-paced digital age, it is vital for hospitals to manage health information innovation efficiently. This study used an Experienced-Based Co-Design design (EBCD) approach to improve how a multi-hospital health system handles and prioritizes digital health projects. We listened to stakeholders, identified challenges, including fragmented information and unclear processes, then co-created solutions. The EBCD produced an implementable streamlined method for managing digital health project requests, including prioritizing and tracking projects from start to finish. This outcome of the exemplar EBCD process is likely to ensure that the most critical health projects are prioritized. For the public, this means better, faster, and more efficient digital health services in the future.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}