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Background: This paper discusses the critical importance of epidemic preparedness and innovations in digital health care by examining the transformative impact on speech-language pathology (SLP) services in a specialist outpatient child and adolescent service (CAMHS). Method: This retrospective review analyzes referral data from three periods: pre-pandemic (15 March 2019–14 March 2020), pandemic (15 March 2020–14 March 2021), and post-pandemic (15 March 2021–14 March 2022). Statistical analyses assess trends in referrals and diagnoses during these periods. Feedback was also obtained from Parents of children who received virtual consultations during the pandemic. Results: The results reveal an increase in the demand for SLP services during and after the pandemic, with a surge in referrals (increased from 9.7 to 12.9% when compared pre-pandemic to post-pandemic periods; Chi-Square value 3.33, P = 0.068) for children with social communication challenges and autism spectrum disorder. Phone and video consultations were effectively adopted. Feedback from families shows a positive response (69%–98% of participants responded as strongly agreed and agreed on various items listed in feedback form specifically designed in line with the service objectives) to telehealth interventions, with many parents finding virtual consultations effective and helpful. Conclusions: The study emphasizes the importance of telehealth SLP services in meeting the increasing demand for mental health interventions among children and adolescents. It suggests integrating telehealth into clinical practice beyond the pandemic and highlights the need for long-term evaluation and addressing potential barriers to access. [ABSTRACT FROM AUTHOR]

Background: This scoping review aims to systematically and critically describe the numerous legal challenges brought about by the utilization of digital oral health in the delivery of oral healthcare. Methods: A systematic search was conducted. The following electronic databases were reviewed from inception up to March 2023: MEDLINE, Embase, Scopus, and LILACS. The search included any scientific document and paper in English, Spanish, or Portuguese on legal issues raised using digital health in oral healthcare delivery. Two reviewers conducted the selection process and data extraction. Legal issues raised concerning the adoption of digital health technology were analysed using the modified Mars' framework. Results: Seventeen studies were included. Most of the documents identified and covered generic aspects of delivering digital oral healthcare (n = 11) without explicitly referring to any dental specialty. The most mentioned legal issues were data security (n = 15); liability and malpractice (n = 14); consent (n = 12); and confidentiality (n = 12). To a lower extent, patient-practitioner relationship (n = 11); and license and jurisdiction (n = 11) were also covered. These were followed by privacy of information (n = 10); adequacy of records (n = 9); and e-referrals (n = 8). On the other hand, fewer studies commented on social media use (n = 3), authentication (n = 2); or e-prescriptions (n = 2). Before implementing any digital health solution, practitioners need to be aware of the many legal issues that the introduction of these technologies involves, be clear where the responsibility lies, and apply extreme caution in following national guidelines. Current literature concentrates on a few well-known legal issues. Issues around authentication, use of social media, and e-prescriptions received less attention. [ABSTRACT FROM AUTHOR]

Background: Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange County's (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes. Methods: We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research. Results: Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools. Conclusions: The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts. [ABSTRACT FROM AUTHOR]

Background: Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users' perspectives and emotional states. Methods: The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n = 9), focus group discussions with potential users (n = 42), and two rounds of usability tests between health professionals (n = 9) and users (n = 18). Data were examined using qualitative content analysis. Results: Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals. Conclusions: The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions. [ABSTRACT FROM AUTHOR]

Background: Access to correct and up to date medication information is crucial for effective patient treatment. However, persistent discrepancies exist. This study examines the experiences and challenges health professionals encounter while utilizing current digital solutions in the Norwegian healthcare system to manage patients' medication information. Methods: A cross-sectional descriptive analysis using quantitative survey data was conducted to investigate how health professionals managed patients' medication information. Content analysis was used to analyze free-text responses concerning challenges they encountered when transferring medication information and to identify factors deemed necessary for implementing the Shared Medication List in Norway. Results: A total of 262 doctors and 244 nurses responded to the survey. A higher percentage of doctors (72.2%) expressed concerns regarding obtaining accurate and updated medication lists than nurses (42.9%), particularly for patients with polypharmacy (35.3%) or transitioning between primary and specialist care services (27.6%). The patient's verbal information was the main source for hospital doctors (17%) to obtain an overview of the patient's medication usage, while general practitioners (19%) and nurses (working in both primary and specialist care services, 28% and 27% respectively) predominantly relied on electronic prescriptions. Doctors, in particular general practitioners, reported carrying excessive responsibilities in coordinating with other health actors (84.8%) and managing patients' medication information. The vast majority of both doctors (84.4%) and nurses (82.0%) were in favor of a Shared Medication List. However, about a third of doctors (36.3%) and nurses (29.8%) expressed the need for a more balanced responsibility in updating and managing patients' medication information, while ensuring compatibility with existing digital systems. Conclusions: Fragmented resources for medication information and unclear responsibilities were prevalent concerns among both professional groups. Doctors voiced more concern than nurses about the accuracy of patients' medication list. While both groups are positive about a shared medication list, successful implementation requires proactive training initiatives and clearer role clarification. [ABSTRACT FROM AUTHOR]

Background: Gradually, society has shifted more services online, with COVID-19 highlighting digital inequalities in access to services such as healthcare. Older adults can experience such digital inequalities, yet this group is also more likely to need medical appointments, compared to younger people. With the growing digitalisation of healthcare, it is increasingly important to understand how older people can best use communicative e-health services to interact with healthcare services. This is especially if older adults are to access, and actively interact with health professionals/clinicians due to their general health decline. This review aims to synthesise older adults' experiences and perceptions of communicative e-health services and, in turn, identify barriers and facilitators to using communicative e-health services. Methods: A meta-ethnography was conducted to qualitatively synthesise literature on older adults' experiences of using communicative e-health services. A systematic search, with terms relating to 'older adults', 'e-health', 'technology', and 'communication', was conducted on six international databases between January 2014 and May 2022. The search yielded a total of 10 empirical studies for synthesis. Results: The synthesis resulted in 10 themes that may impact older adults' perceptions and/or experiences of using communicative e-health services. These were: 1) health barriers, 2) support networks, 3) application interface/design, 4) digital literacy, 5) lack of awareness, 6) online security, 7) access to digital devices and the internet, 8) relationship with healthcare provider(s), 9) in-person preference and 10) convenience. These themes interlink with each other. Conclusion: The findings suggest older adults' experiences and perceptions of communicative e-health services are generally negative, with many reporting various barriers to engaging with online services. However, many of these negative experiences are related to limited support networks and low digital literacy, along with complicated application interfaces. This supports previous literature identifying barriers and facilitators in which older adults experience general technology adoption and suggests a greater emphasis is needed on providing support networks to increase the adoption and usage of communicative e-health services. [ABSTRACT FROM AUTHOR]