BMJ Innovations最新文献

{"title":"Potential of integrated national laboratory information management system in enhancing early HIV care for infants in Malawi: a report.","authors":"Chikondi Chapuma, Precious Bondwe, Geoffrey Singini, Rachel Chamanga, Patricia Nkosi, Efrida Ghobede, Thulani Maphosa","doi":"10.1136/bmjinnov-2025-001428","DOIUrl":"10.1136/bmjinnov-2025-001428","url":null,"abstract":"<p><strong>Background: </strong>Initiating and retaining HIV-exposed infants (HEI) on antiretroviral therapy (ART) before 12 weeks of age remains a pressing public health concern in Malawi and other sub-Saharan African countries. Despite its known benefits in reducing mortality and morbidity, challenges persist, including long turnaround times (TAT) for DNA-PCR results, negative caregiver perspectives, and healthcare-worker barriers. This report discusses the potential of integrating different data collection methods in laboratory information systems to reduce TAT between testing and ART initiation.</p><p><strong>Methods: </strong>To address delays in the Malawi National Laboratory Information Management System (NLIMS), we integrated NLIMS into the electronic medical records(EMRs). We conducted this activity between November 2022 and June 2023 at the Elizabeth Glaser Paediatric Aids Foundation (EGPAF) in Malawi.</p><p><strong>Results: </strong>The integrated NLIMS featured offline capabilities, barcode standardization, and efficient order pulling from previously independent workflows. Electronic transmission to EMRs improved the efficiency of transmitting test statuses online. The average TAT decreased by 65 days (from 77 to 12 days) during months with both lower and higher testing volumes ranging from 2,595 to 5,349 samples.</p><p><strong>Conclusions: </strong>Integrating data collection workflows significantly reduced TAT, demonstrating a non-random variation and overall improvement. Future studies should explore algorithms, workflows, and modules that alert healthcare providers and caregivers of the critical therapeutic point before 12 weeks.</p>","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a peer-led network to overcome the barriers to innovation in the NHS: the case of the NHS InSites Programme.","authors":"Atena Barat, Harry Scarbrough, Jana Schulte, Fiona McKenzie, Hemali Patel, Charitini Stavropoulou","doi":"10.1136/bmjinnov-2025-001509","DOIUrl":"10.1136/bmjinnov-2025-001509","url":null,"abstract":"<p><strong>Background: </strong>The adoption and spread of innovation remain persistent challenges for the English National Health Service (NHS). Traditional top-down approaches provide authority but often fail to account for local context, while bottom-up approaches harness frontline knowledge but fail to overcome systemic inertia. The NHS InSites Programme offers a distinctive alternative that seeks to transcend this dichotomy by combining peer-led learning networks with centralised coordination. We aim to explore the factors that support or hinder the adoption and spread of innovation in the context of the NHS InSites Programme.</p><p><strong>Method: </strong>This qualitative study draws on 25 semistructured interviews with 33 participants, including NHS staff, InSites Hub members and NHS England commissioners. Thematic analysis was conducted to identify key barriers and facilitators to innovation adoption and spread.</p><p><strong>Findings: </strong>Participants generally expressed positive attitudes towards the NHS InSites Programme, viewing it as a valuable catalyst for collaboration, learning and structured innovation support, bridging the limitations of top-down and bottom-up approaches to innovation spread. Four overarching themes influencing innovation adoption were identified: ringfenced financial support; transcending hierarchical structures; harmonising processes to navigate fragmentation and challenging context. Our analysis also showed that the programme's effectiveness relies on relational trust to enhance learning; harmonised processes to allow adaptation and institutional support to transcend hierarchical structures.</p><p><strong>Conclusion: </strong>By providing dedicated resources, harmonising processes and enabling peer-to-peer learning, the NHS InSites Programme addresses several well-documented barriers to spreading innovation. Its long-term contribution will depend on sustained investment, continued policy support and the ability to scale its mechanisms beyond early adopter sites.</p>","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"12 2","pages":"e001509"},"PeriodicalIF":1.6,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of digital health solutions and AI: qualitative interviews with perimenopausal women experiencing health inequalities.","authors":"Claire Mann, Nina Kuypers, Sally Olewe-Richards, Alexandra Perry, Charmaine Daley, Poppy Taylor, Prerita Chawla, Neelam Heera","doi":"10.1136/bmjinnov-2025-001406","DOIUrl":"https://doi.org/10.1136/bmjinnov-2025-001406","url":null,"abstract":"<p><strong>Objectives: </strong>Exploring the acceptability of digital health and artificial intelligence (AI) to perimenopausal women experiencing health inequalities.</p><p><strong>Setting: </strong>We recruited five community leaders representing organisations which support women who experience health inequalities, across the UK. Leaders represented ethnic minority-focused groups as well as groups representing broader disadvantage such as menopause or wellness groups based in areas of deprivation and domestic abuse support groups and were chosen to represent the experience of women in perimenopause who also experienced health inequalities. Data were collected from 84 women via five different community leaders and seven community groups in 24 qualitative datasets, which included 14 focus groups and 10 individual interviews. Inclusion criteria included experience of peri-menopause and membership within the designated group. Women who were beyond their last menstrual period were included to reflect on their experiences during peri-menopause as well as those actively experiencing symptoms. Analysis used the Theoretical Framework of Acceptability domains that influence the acceptability of health interventions.</p><p><strong>Results: </strong>Perimenopausal women expressed fear and distrust towards AI digital health interventions, particularly due to concerns about data privacy and lack of trust of representation of their racial and ethnic backgrounds. AI-driven solutions in women's health faced scepticism due to their perceived lack of relevance and effectiveness.</p><p><strong>Conclusion: </strong>Addressing issues of representation and improving trust in AI technologies are essential to enhance trust, improve engagement and reduce digital health inequalities.</p>","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"12 3","pages":"e001406"},"PeriodicalIF":1.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of in silico research in the development of abdominal and thoracic surgical devices: a systematic review.","authors":"Nikhil Pattani, Jaspinder Sanghera, Emily Mills, Adam Khan, Benoit Jauniaux, William Bolton, Deena Harji, Joshua Richard Burke","doi":"10.1136/bmjinnov-2024-001348","DOIUrl":"10.1136/bmjinnov-2024-001348","url":null,"abstract":"<p><strong>Objective: </strong>Surgical innovation has exponentially improved over the past three decades. However, efficacy assessment of surgical devices through randomised controlled trials requires significant resources. In silico modelling may provide a solution, utilising computational simulations to develop and improve devices. This study aims to evaluate the current use of in silico modelling for devices used in abdominal and thoracic surgery.</p><p><strong>Design: </strong>A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Data resources: </strong>PubMed, MEDLINE and Embase databases from January 2019 to August 2024 were searched.</p><p><strong>Eligibility criteria for selecting studies: </strong>Inclusion criteria were defined as studies using mathematical/computational models to investigate invasive devices implanted or incorporated in abdominal and thoracic surgery.</p><p><strong>Results: </strong>The search strategy yielded 2968 studies, with 42 included in the final analysis. Core themes identified included proof of concept (n=19), device improvement (n=22) and in silico clinical trials with simulated human patients (n=1). Specialities included: general surgery (n=4); hepato-pancreato-biliary (n=2); vascular (n=5); paediatric (n=9) and cardiothoracic (n=22). Most studies were at IDEAL stage 0 (preclinical) and 19 studies validated in silico results with in vitro/in vivo data.</p><p><strong>Conclusion: </strong>In silico modelling can complement preclinical in vitro and in vivo testing for surgical devices. Its applications include simulating rare diseases, modelling diverse patient demographics, and generating early efficacy data for novel or repurposed devices. Standardising methodologies through a core outcome set and credibility framework is essential to reduce inter-study heterogeneity. Global collaboration and clear regulatory guidance are key for its integration into mainstream surgical device research.</p>","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"11 3","pages":"e001348"},"PeriodicalIF":1.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical analysis of delivering chest compressions in virtual reality simulation: preliminary insights into fidelity and validity of virtual reality as a means of delivering life support training","authors":"Aimee Rowe, Matthew A Ellison, Karamveer Narang, Alex Saunders, Steve Furnell, Jagtar Dhanda","doi":"10.1136/bmjinnov-2024-001234","DOIUrl":"https://doi.org/10.1136/bmjinnov-2024-001234","url":null,"abstract":"#### WHAT ARE THE NEW FINDINGS #### HOW MIGHT THIS IMPACT HEALTHCARE IN THE FUTURE Virtual reality (VR) is a promising modality for healthcare education with ample qualitative evaluation.1–3 There is meagre quantitative study of using VR in healthcare training. This study aims to gain quantitative and qualitative insights into the fidelity and validity of cardiopulmonary resuscitation (CPR) training using VR. Good quality, timely chest compressions improve survival outcomes in cardiac arrest.4–6 Traditionally, chest compressions are taught to healthcare professionals (HCPs) as part of resuscitation training using manikin-based simulation.4 Resuscitation bodies, such as The European Resuscitation Council and Resuscitation Council UK, certify trainers to deliver CPR training using scenario-based simulation with manikins. Delivering this training has logistical barriers; accessing space, equipment, staff and time to conduct training. E-learning has been widely adopted in healthcare education, helping to reduce the logistical burden of providing mandatory training to the healthcare workforce.7 Emerging technology such as VR is appealing as it has the flexibility associated with e-learning while offering a more immersive experience,8 along with the potential to increase global accessibility and reduce the environmental impact of in-person training. Novel approaches must be assessed for efficacy before committing resources to their implementation. While there are data exploring VR use for CPR training,9–11 there …","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"24 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"iCount: a human-factors engineered solution to vaginal swab retention – an early-stage innovation report","authors":"Ahmed Nader Elgharably, Kiran Desai, Alan Michael Nevill, Aaron Vance, Jon Lester, Emma Bonfiglio, Colin Rigby, Andrew Forrester, Peter Ogrodnik, Jeffrey Faint, Tom Clutton-Brock, Aditi Desai","doi":"10.1136/bmjinnov-2024-001248","DOIUrl":"https://doi.org/10.1136/bmjinnov-2024-001248","url":null,"abstract":"### WHAT ARE THE NEW FINDINGS #### HOW MIGHT IT IMPACT ON HEALTHCARE IN THE FUTURE Although uncommon, unintentionally retained surgical items remain a persistent and poorly understood medical error with the potential to cause significant harm. They are termed patient safety ‘never events’ and are considered unacceptable and largely preventable.1 The most commonly retained surgical item is the surgical swab, also known as ‘sponge’ in the USA, with the highest rates of swab retention found in the maternity setting. The UK never events database identifies vaginal swabs (used during perineal trauma repair) as the source of the largest number of swab retention events.2 3 NHS England data identifies 338 separate incidents of vaginal swab retention between 2012 and 2022 with evidence of global under-reporting due to the significant reputational impacts of these incidents as well as the difficulty in diagnosis and identification of error.1 3–6 This long-standing problem, also called ‘Gossypiboma’, was first reported in 1884 by the American Obstetrician and Gynaecologist Dr Wilson. …","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"62 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spreading and scaling innovation and improvement: understanding why the differences matter","authors":"Helen Bevan, Diane Ketley, Roseanna Cawthorne, Charitini Stavropoulou, Harry Scarbrough","doi":"10.1136/bmjinnov-2024-001251","DOIUrl":"https://doi.org/10.1136/bmjinnov-2024-001251","url":null,"abstract":"In this paper, we make a distinction between spreading and scaling innovations and spreading and scaling good practices for improvement, as many healthcare change practitioners often feel there is a “muddle” between them. We argue there are multiple factors where the spread and scale factors are similar for innovation and improvement, such as enabling leadership, the capacity and capability for spread and scale, a process of behaviour change, use of data and evidence and system alignment. However, there are multiple characteristics that may be different, including the level of complexity, the nature of the intervention, the approach to fidelity and adaptability, the source of the innovation or improvement and the outcome metrics. These insights enable us to be better equipped to design and deliver successful spread and scale strategies tailored to the specific intervention and situation and realise the full benefits of our change initiatives.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"75 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141862813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of twinnings in scaling up innovative solutions across Europe","authors":"Cláudia Campos, Robbin Kappelhof, Joana Carrilho, Luis Midão, Diogo Henriques, Elísio Costa","doi":"10.1136/bmjinnov-2023-001141","DOIUrl":"https://doi.org/10.1136/bmjinnov-2023-001141","url":null,"abstract":"Introduction Twinnings are cross-border knowledge exchange activities where two or more organisations learn from each other’s experiences and are often used as a scaling up mechanism. Objectives This paper discusses the importance of twinning activities in scaling up by promoting community building, knowledge sharing and innovation transfer among stakeholders in European countries. It explores the role of twinnings in the scaling up model of the European Innovation Partnership on Active and Healthy Ageing) and the Innovation Networks for Scaling Active and Healthy Ageing (IN-4-AHA) project. Methods The study employed a qualitative approach, drawing insights from various sources, including the Scale AHA study (2017), the IN-4-AHA’s scaling up model and twinning reports. Results The findings reveal that twinning activities provide stakeholders with a unique opportunity to learn from the know-how of other like-minded partners, improve the quality of their work and iterate on their innovations. They also highlight that twinnings are particularly relevant for some stages in the scaling up process, such as in the assessment of a network of potential partners and during the evaluation of the environment, the innovation could potentially be transferred to. Conclusion Twinnings are highly regarded as community-building and knowledge-sharing activities with clear advantages for companies and other stakeholder groups. Including twinning activities in the scaling up model has proven benefits for companies and projects that have a strong need for community building and innovation transfer. Data sharing not applicable as no data sets generated and/or analysed for this study.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"1 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140156795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wings of Healing: regulatory landscape, case studies and the Indian prologue of drones in healthcare","authors":"Ankita Sharma, Anju Vijayan, Pavan Ananth, Deepshikha Chhetri, Rahul Konapur, Nachiket Gudi","doi":"10.1136/bmjinnov-2023-001179","DOIUrl":"https://doi.org/10.1136/bmjinnov-2023-001179","url":null,"abstract":"The healthcare sector is among the most rapidly expanding sectors. Drones are increasingly being used to reach the unreached in healthcare. Drones exhibit profound significance by overcoming accessibility challenges and offering versatile solutions. The future of healthcare is in the air, and new government initiatives uncover the country’s rapid market growth. Investments in drone technologies are rising, with research predicting significant drone expansion in the upcoming decade. Since this sector is still in its nascent stage, the time is ripe for stakeholders to collectively work for the effective implementation of drone technology in India. In this context, the paper seeks to bridge existing knowledge gaps by analysing the global regulatory landscape, the evolution of drones in India, used cases in healthcare, and the barriers that constrain their deployment in the healthcare domain. It explores the obstacles that hinder the widespread adoption of drones. Addressing these challenges becomes essential in unlocking the full potential of drone technology in revolutionising healthcare delivery, enhancing patient outcomes and overcoming logistical constraints. The report argues about the potential shift drones can bring to healthcare delivery while underlining the necessity of addressing regulatory concerns and fostering public trust.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"271 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140045281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversational AI facilitates mental health assessments and is associated with improved recovery rates","authors":"Max Rollwage, Johanna Habicht, Keno Juchems, Ben Carrington, Tobias U Hauser, Ross Harper","doi":"10.1136/bmjinnov-2023-001110","DOIUrl":"https://doi.org/10.1136/bmjinnov-2023-001110","url":null,"abstract":"Mental health services across the globe are overburdened due to increased patient need for psychological therapies and a shortage of qualified mental health practitioners. This is unlikely to change in the short-to-medium term. Digital support is urgently needed to facilitate access to mental healthcare while creating efficiencies in service delivery. In this paper, we evaluate the use of a conversational artificial intelligence (AI) solution ( Limbic Access ) to assist both patients and mental health practitioners with referral, triage, and clinical assessment of mild-to-moderate adult mental illness. Assessing this solution in the context of England’s National Health Service (NHS) Talking Therapies services, we demonstrate in a cohort study design that deploying such an AI solution is associated with improved recovery rates. We find that those NHS Talking Therapies services that introduced the conversational AI solution improved their recovery rates, while comparable NHS Talking Therapies services across the country reported deteriorating recovery rates during the same time period. Further, we provide an economic analysis indicating that the usage of this AI solution can be highly cost-effective relative to other methods of improving recovery rates. Together, these results highlight the potential of AI solutions to support mental health services in the delivery of quality care in the context of worsening workforce supply and system overburdening. For transparency, the authors of this paper declare our conflict of interest as employees and shareholders of Limbic Access, the AI solution referred to in this paper. Data available at a dedicated GitHub repository. Code and data supporting this study are available at a dedicated GitHub repository.","PeriodicalId":53454,"journal":{"name":"BMJ Innovations","volume":"72 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140018774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}