تغییر شیوه عمل جراحی کودکان
Abstract
1. Introduction
2. Theoretical background for social practice theory in the connected health context
3. Materials and methods
4. Results
5. Discussion and conclusions
6. Future research and limitations
Declaration of Competing Interest
Acknowledgements
Appendix 1. Interview template of pediatric surgery professionals' interviews
Appendix 2. Data collection method
Appendix 3. Data analysis
References
Abstract
Purpose: Disruptive connected health technologies, or digitalization, are suggested to tackle the healthcare challenges and transform traditional care models. In Finland, the transformation is manifested by the development of various digital hospitals and citizen-centric care models that foster self-care by utilizing connected health technologies. In this paper we introduce qualitative research that uses social practice theory in order to understand how connected health technologies shape a pediatric day surgery practice in future digital hospitals. Major improvement needs were identified to center on discursive actions (i.e., communication that occurs between health professionals and patients), since hospital IT systems, data exchange, and internal and external communication were found to not support pediatric surgery practice as expected. To improve the current situation, we found out that there is a need to change the patient role to be more active, creating data that health professionals could use through their own patient record systems. Connected health solutions allow this type of interaction between things (i.e., communication through mobile apps, medical devices, etc.) and agents (i.e., health professionals). There is an urgent need to improve communication channels such as Chat, WhatsApp, and mobile applications that gather all necessary information and instructions from patients before and after the surgery. However, these solutions cannot be co-created separately from the clinical decision systems that allow discursive actions among healthcare professionals. These solutions, e.g. mobile applications designed to support patients going through the surgery practice, will also significantly impact and change pediatric surgery practice at hospitals.
Introduction
Healthcare is facing new challenges worldwide due to public health expenditure, ageing populations, increasing chronic illnesses and workforce deficiencies (Suzman and Beard, 2011). The paternalistic and episodic nature of healthcare, where the patient has been a passive recipient of “one size fits all” care, is no longer sustainable (Atanasova et al., 2016; Barello et al., 2012; Coulter and Jenkinson, 2005; Himidan and Kim, 2015; Trappenburg et al., 2013). Digitalized healthcare solutions are assumed to tackle these challenges and enable the much needed transformation of health and social care models. Connected health means connecting technologies, data integration and sharing with patients, their care givers, and medical experts in a way that the integrated technologies can support faster and more efficient decision-making related to patient health and wellbeing (Down et al., 2018). Connected health solutions promote self-care and preventive personalized healthcare providing wider accessibility to services (Kharrazi et al., 2012; Liu et al., 2016; Yoo et al., 2016; Caulfield and Donnelly, 2013; Kvedar et al., 2014; Kreps and Neuhauser, 2010; Schneider, 2001; Barr et al., 2012; Iglehart, 2014). The conceptual model of connected health places a particular focus on connecting patients and health professionals via electronic services and data connected via the Internet-of-Things (IoT) (Yin et al., 2016). In the area of connected health, faster and more efficient decision-making can be supported by user interface technologies such as virtual reality, virtual health stations, communication technologies (such as virtual doctors), mobile health applications, and artificial intelligence (see e.g., Kreps and Neuhauser, 2010; Kvedar et al., 2014; Iglehart, 2014; Dias et al., 2017; Chiang et al., 2017; Barr et al., 2012;).