%0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e70594 %T Are Dating App Algorithms Making Men Lonely and Does This Present a Public Health Concern? %A Balki,Eric %+ Faculty of Health and Medicine, Department of Health, Lancaster University, Innovation One, Sir John Fisher Dr, Bailrigg, Lancaster, LA1 4AT, United Kingdom, 44 1524 593763, e.balkhi@lancaster.ac.uk %K dating apps %K mental health %K men %K algorithm %K anxiety %K depression %K loneliness %D 2025 %7 7.4.2025 %9 Viewpoint %J JMIR Form Res %G English %X During the pandemic, dating apps emerged as essential platforms connecting users amid social isolation, experiencing rapid growth in engagement and profile creation. This paper examines the evolution of these apps, highlighting their shift from facilitating offline encounters to promoting match accumulation for revenue. In particular, the study investigates gender disparities, addictive behaviors, and algorithmic match throttling that disproportionately impact men’s psychological well-being. Drawing on evidence linking dating app use to increased depression and anxiety, the analysis calls for regulatory intervention to eliminate pay-for-advantage models and ensure fair, healthy user experiences, thereby mitigating adverse public health outcomes. %M 40193188 %R 10.2196/70594 %U https://formative.jmir.org/2025/1/e70594 %U https://doi.org/10.2196/70594 %U http://www.ncbi.nlm.nih.gov/pubmed/40193188 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e64087 %T Applying Critical Discourse Analysis to Cross-Cultural Mental Health Recovery Research %A Kotera,Yasuhiro %A Daryanani,Riddhi %A Skipper,Oliver %A Simpson,Jonathan %A Takhi,Simran %A McPhilbin,Merly %A Ingall,Benjamin-Rose %A Namasaba,Mariam %A Jepps,Jessica %A Kellermann,Vanessa %A Bhandari,Divya %A Ojio,Yasutaka %A Ronaldson,Amy %A Guerrero,Estefania %A Jebara,Tesnime %A Henderson,Claire %A Slade,Mike %A Vilar-Lluch,Sara %+ Institute of Mental Health, School of Health Sciences, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, United Kingdom, 44 01158231294, yasuhiro.kotera@nottingham.ac.uk %K critical discourse analysis %K cross-cultural mental health recovery research %K linguistic analysis %K social inequality %K mental health %K recovery research %K language %K social inequalities %K qualitative analytical approach %K linguistic expressions %K discourse %K analysis %K framework %K inequalities %K CDA %D 2025 %7 21.2.2025 %9 Viewpoint %J JMIR Form Res %G English %X The purpose of this paper is to demonstrate how critical discourse analysis (CDA) frameworks can be used in cross-cultural mental health recovery research. CDA is a qualitative approach that critically appraises how language contributes to producing and reinforcing social inequalities. CDA regards linguistic productions as reflecting, consciously or unconsciously, the narrators’ understandings of, or attitudes about, phenomena. Mental health recovery research aims to identify and address power differentials, making CDA a potentially relevant approach. However, CDA frameworks have not been widely applied to mental health recovery research. We adapted established CDA frameworks to our cross-cultural mental health recovery study. The adapted methodology comprises (1) selecting discourses that indicate positive changes and (2) considering sociocultural practices informed by relevant cultural characteristics identified in our previous research, without placing value judgments. Our adapted framework can support cross-cultural mental health recovery research that uses CDA. %M 39983121 %R 10.2196/64087 %U https://formative.jmir.org/2025/1/e64087 %U https://doi.org/10.2196/64087 %U http://www.ncbi.nlm.nih.gov/pubmed/39983121 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e65561 %T Development of the Big Ten Academic Alliance Collaborative for Women in Medicine and Biomedical Science: “We Built the Airplane While Flying It” %A Iyer,Maya S %A Moe,Aubrey %A Massick,Susan %A Davis,Jessica %A Ballinger,Megan %A Townsend,Kristy %K collaborative %K gender equity %K women in medicine %K women in science %K biomedical science %K women %K women+ %K gender %K medicine %K university %K faculty %K accessibility %K career %K equity %K networking %K opportunity %K retaining %K programming %K Big Ten Academic Alliance %K BTAA %K academic alliance %D 2025 %7 23.1.2025 %9 %J JMIR Form Res %G English %X Women-identifying and women+ gender faculty (hereto described as women+ faculty) face numerous barriers to career advancement in medicine and biomedical sciences. Despite accumulating evidence that career development programming for women+ is critical for professional advancement and well-being, accessibility of these programs is generally limited to small cohorts, only offered to specific disciplines, or otherwise entirely unavailable. Opportunities for additional, targeted career development activities are imperative in developing and retaining women+ faculty. Our goal was the development of a new collaborative of Big Ten Academic Alliance (BTAA) institutions to support gender equity for women+ faculty in medicine and biomedical sciences, with two initial aims: (1) hosting an inaugural conference and establishing a foundation for rotation of conference hosts across BTAA schools, and (2) creating an infrastructure to develop programming, share resources, conduct environmental scans, and promote networking. In 2022, leaders from The Ohio State University College of Medicine Women in Medicine and Science envisioned, developed, and implemented a collaborative named CommUNITYten: The Big Ten Academic Alliance for Women in Medicine and Biomedical Science. Conference program development occurred through an iterative and collaborative process across external and internal task forces alongside industry partners. We developed a fiscal model to guide registration fees, budget tracking, and solicitation of conference funding from academic and industry sponsors. Attendees completed postconference surveys assessing speaker or workshop effectiveness and suggestions for future events. Finally, we developed an environmental scan survey to assess gender equity needs and existing programming across BTAA institutions. In June 2024, The Ohio State University hosted the inaugural CommUNITYten conference in Columbus, Ohio, featuring 5 keynote presentations, 9 breakout sessions, and networking opportunities across one and a half days of curated programming. Nearly 180 people attended, with representation from 9 BTAA institutions, 6 industry companies, staff, and trainees. Postconference surveys showed 50% (n=27) of respondents were likely to attend another in-person conference and suggested future conference topics. The environmental scan survey launched in October 2024. We successfully established the CommUNITYten collaborative and hosted the inaugural conference. Establishing key stakeholders from each BTAA institution, obtaining sponsorship, and detailed conference planning and partnerships were critical in ensuring realization of this collaborative. The conference brought together leaders, faculty, staff, trainees, and industry partners from across the country and met the initial goal of networking, sharing resources, and building community for women+ faculty. These efforts lay a robust foundation for the BTAA CommUNITYten collaborative to foster ongoing collaboration, innovation, and progress in the years to come. Given the importance of steady improvements, this viewpoint may further guide the efforts of other individuals, groups, and leadership supporting women+ as they consider approaches and strategies advocating for gender equity at the national level. %R 10.2196/65561 %U https://formative.jmir.org/2025/1/e65561 %U https://doi.org/10.2196/65561 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e51319 %T Assessing the Current Limitations of Large Language Models in Advancing Health Care Education %A Kim,JaeYong %A Vajravelu,Bathri Narayan %K large language model %K generative pretrained transformer %K health care education %K health care delivery %K artificial intelligence %K LLM %K ChatGPT %K AI %D 2025 %7 16.1.2025 %9 %J JMIR Form Res %G English %X The integration of large language models (LLMs), as seen with the generative pretrained transformers series, into health care education and clinical management represents a transformative potential. The practical use of current LLMs in health care sparks great anticipation for new avenues, yet its embracement also elicits considerable concerns that necessitate careful deliberation. This study aims to evaluate the application of state-of-the-art LLMs in health care education, highlighting the following shortcomings as areas requiring significant and urgent improvements: (1) threats to academic integrity, (2) dissemination of misinformation and risks of automation bias, (3) challenges with information completeness and consistency, (4) inequity of access, (5) risks of algorithmic bias, (6) exhibition of moral instability, (7) technological limitations in plugin tools, and (8) lack of regulatory oversight in addressing legal and ethical challenges. Future research should focus on strategically addressing the persistent challenges of LLMs highlighted in this paper, opening the door for effective measures that can improve their application in health care education. %R 10.2196/51319 %U https://formative.jmir.org/2025/1/e51319 %U https://doi.org/10.2196/51319 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e60832 %T Promoting Digital Health Data Literacy: The Datum Project %A Powell,Daniel %A Asad,Laiba %A Zavaglia,Elissa %A Ferrari,Manuela %K health data %K digital data %K medical records %K legislation %K ethics %K knowledge dissemination %K learning health system %K data bank %D 2025 %7 3.1.2025 %9 %J JMIR Form Res %G English %X With the increased use of digital health innovations in Canadian health care, educating health care users, professionals, and researchers on the ethical challenges and privacy implications of these tools is essential. The Datum project, funded by the Fondation Barreau du Quebec, was created to help these actors better understand legal and ethical issues regarding the collection, use, and disclosure of digital health data for the purposes of scientific research, thereby enhancing literacy around data privacy. The project consists of a multimedia website divided into legislation and policy documents and narrative-based video content. Users can access the core legislation and policies governing the collection and use of health care data geared toward researchers and health practitioners. Users can also view the narrative-based video content explaining key concepts related to digital health data. The Datum project makes an original contribution to the field of law and ethics in health science research by using novel approaches, such as learning health systems and data banks, to improve equity in health care delivery and by generating multimedia content aimed at encouraging health care users to become better consumers and supporting the collective use of their data. The Datum project also promotes digital literacy as a digital communication tool, which has the significant potential to improve health outcomes, bridge the digital divide, and reduce health inequities. %R 10.2196/60832 %U https://formative.jmir.org/2025/1/e60832 %U https://doi.org/10.2196/60832 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e60368 %T Strategies to Implement a Community-Based, Longitudinal Cohort Study: The Whole Communities-Whole Health Case Study %A Bouchacourt,Lindsay %A Smith,Sarah %A Mackert,Michael %A Almalki,Shoaa %A Awad,Germine %A Barczyk,Amanda %A Bearman,Sarah Kate %A Castelli,Darla %A Champagne,Frances %A de Barbaro,Kaya %A Garcia,Shirene %A Johnson,Karen %A Kinney,Kerry %A Lawson,Karla %A Nagy,Zoltan %A Quiñones Camacho,Laura %A Rodríguez,Lourdes %A Schnyer,David %A Thomaz,Edison %A Upshaw,Sean %A Zhang,Yan %+ Center for Health Communication, The University of Texas at Austin, 300 W Dean Keeton, Austin, TX, 78712, United States, 1 512 471 5775, lindsay.bouchacourt@austin.utexas.edu %K community-based %K longitudinal %K health disparities %K cohort study %K case study %K family health %K child %K children %K families %K child development %K mobile phone %D 2024 %7 5.12.2024 %9 Viewpoint %J JMIR Form Res %G English %X This paper discusses the implementation of the Whole Communities-Whole Health (WCWH) initiative, which is a community-based, longitudinal cohort study. WCWH seeks to better understand the impact of location on family health and child development while also providing support for families participating in the study. Implementing a longitudinal study that is both comprehensive in the data it is collecting and inclusive in the population it is representing is what makes WCWH extremely challenging. This paper highlights the learning process the initiative has gone through to identify effective strategies for implementing this type of research study and work toward building a new model for community-engaged research. Through iterative testing following the Plan-Do-Study-Act model, three main strategies for implementation were identified. These strategies are (1) creating a data collection schedule that balances participant burden and maintains temporality across data types; (2) facilitating multiple opportunities for qualitative and quantitative input from faculty, families, and nonparticipant community members; and (3) establishing an open-door policy for data analysis and interpretation. This paper serves as a guide and provides resources for other researchers wanting to implement a multidisciplinary and community-based cohort study. %M 39636676 %R 10.2196/60368 %U https://formative.jmir.org/2024/1/e60368 %U https://doi.org/10.2196/60368 %U http://www.ncbi.nlm.nih.gov/pubmed/39636676 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e64494 %T Using Extended Reality to Enhance Effectiveness and Group Identification in Remote Group Therapy for Anxiety Disorders: A Critical Analysis %A Bouguettaya,Ayoub %A Aboujaoude,Elias %+ Program of Internet, Health, and Society, Biomedical Sciences, Cedars-Sinai Medical Center, 6500 Wilshire Blvd, Los Angeles, CA, 90048, United States, 1 4152443724, elias.aboujaoude@cshs.org %K group therapy %K psychotherapy %K telepsychiatry %K mental health %K extended reality %K augmented reality %K virtual reality therapy %K anxiety %K cognitive behavioral therapy %D 2024 %7 4.11.2024 %9 Viewpoint %J JMIR Form Res %G English %X Group therapy is a scalable and effective treatment for anxiety disorders. However, when performed online, the reduced ability to identify with group members and the reduced interactivity can limit its appeal and effectiveness. Extended reality (XR) technology, including virtual reality and augmented reality, may help address these limitations, thereby enhancing the reach of online group therapy and the benefits that can be drawn from it. To understand how the incorporation of XR technology may improve online group therapy for anxiety disorders, this viewpoint paper examines evidence related to the treatment of anxiety disorders using offline group therapy, online group therapy, and virtual reality, as well as ways to increase social identification and interactivity with the platform, the therapist, and other users. This viewpoint paper suggests ways to integrate these research streams to leverage the strengths of XR platforms and improve group therapeutic offerings. %M 39496150 %R 10.2196/64494 %U https://formative.jmir.org/2024/1/e64494 %U https://doi.org/10.2196/64494 %U http://www.ncbi.nlm.nih.gov/pubmed/39496150 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e63832 %T Considerations When Designing Inclusive Digital Health Solutions for Older Adults Living With Frailty or Impairments %A Wegener,Emilie Kauffeldt %A Bergschöld,Jenny M %A Bergh,Sverre %A van Berlo,Ad %A Schmidt,Camilla Wong %A Konidari,Afroditi %A Kayser,Lars %+ Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, København K, 1353, Denmark, 45 26202168, emilie.wegener@sund.ku.dk %K digital health services %K frameworks %K sociotechnical ecosystem %K older adults %K co-design %D 2024 %7 21.10.2024 %9 Viewpoint %J JMIR Form Res %G English %X This viewpoint is written by authors with industrial, clinical, and academic backgrounds within medical and social sciences. The purpose is to share our experiences with digital health innovation from a sociotechnical perspective. The audience for the viewpoint is innovators, researchers, service designers, and project managers with little or some experience with theory-informed programs, complex interventions, and implementation or reorganization of sociotechnical ecosystems in health care. In digital health innovation projects, barriers related to traditions and cultures among researchers, clinicians, and industry may arise. Moreover, the final digital solutions may not always fit into existing digital ecosystems and may thus require a reorganization of how health care is provided at horizontal and vertical levels. The collaborating researchers have experience working in the field of digital health innovation for more than a decade, and we have developed and used 4 frameworks and models that are particularly relevant for theory-based complex interventions and can be used to inform inclusive co-design of digital health solutions with a sociotechnical perspective. These are (1) the 4E, a matrix to include, engage, empower, and emancipate marginalized people; (2) the GO-TO model, which can be used as a design navigator; (3) the Epital Care Model, to inform infrastructure; and (4) the Readiness and Enablement Index for Health Technology instrument, to stratify service users. From January 2021 to September 2024, we had the opportunity to apply these into practice in 4 living labs located in Denmark, Norway, the Netherlands, and Canada as a part of a European Union–funded project on “Smart Inclusive Living Environments.” The goal was to cocreate a digital solution and reorganize health care services to reduce social isolation, increase health literacy, and enhance well-being for older adults living with frailty or impairments. Based on our experiences with the Smart Inclusive Living Environments project, we have formed a proposal for how design guidelines for sociotechnical innovation projects can be structured, backed up with reflections based on our experiences. With that, design guidelines should include three areas: (1) a common vocabulary including theories, frameworks, and models; (2) templates and protocols for methods, including detailed guidelines and templates for the planned development of the technologies; and (3) methods to implement and provide education and training of service users and informal and formal caregivers. In the design process, we emphasize the importance of involving relevant stakeholders in the implementation of the created design guidelines to obtain preparedness in the organizations, as well as including putative service users to ensure the likelihood of adoption. Moreover, it is important to align expectations, have a common understanding of the applied frameworks and methods, and have access to the necessary resources to reach successful results. %M 39432894 %R 10.2196/63832 %U https://formative.jmir.org/2024/1/e63832 %U https://doi.org/10.2196/63832 %U http://www.ncbi.nlm.nih.gov/pubmed/39432894 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e50063 %T The Application of a Serious Game Framework to Design and Develop an Exergame for Patients With Heart Failure %A Berglund,Aseel %A Jaarsma,Tiny %A Orädd,Helena %A Fallström,Johan %A Strömberg,Anna %A Klompstra,Leonie %A Berglund,Erik %+ Department of Computer and Information Science, Linköping University, Linköping, Sweden, 46 732703862, aseel.berglund@liu.se %K mobile health apps %K physical activity %K exergames %K player-centered design %K heart failure %K human-computer interaction %K mobile phone %D 2024 %7 7.8.2024 %9 Viewpoint %J JMIR Form Res %G English %X Reducing inactivity in patients with chronic disease is vital since it can decrease the risk of disease progression and mortality. Exergames are an innovative approach to becoming more physically active and positively affecting physical health outcomes. Serious games are designed for purposes beyond entertainment and exergames are serious games for physical activity. However, current commercial exergames might not optimally meet the needs of patients with special needs. Developing tailored exergames is challenging and requires an appropriate process. The primary goal of this viewpoint is to describe significant lessons learned from designing and developing an exergame for patients with chronic heart failure using the player-centered, iterative, interdisciplinary, and integrated (P-III) framework for serious games. Four of the framework’s pillars were used in the design and development of a mobile exergame: player-centered design, iterative development of the game, interdisciplinary teamwork, and integration of play and serious content. The mobile exergame was developed iteratively in 7 iterations by an interdisciplinary team involving users and stakeholders in all iterations. Stakeholders played various roles during the development process, making the team stay focused on the needs of the patients and creating an exergame that catered to these needs. Evaluations were conducted during each iteration by both the team and users or patients according to the player-centered design pillar. Since the exergame was created for a smartphone, the assessments were conducted both on the development computer and on the intended platforms. This required continuous deployment of the exergame to the platforms and smartphones that support augmented reality. Our findings show that the serious game P-III framework needs to be modified in order to be used for the design and development of exergames. In this viewpoint, we propose an updated version of the P-III framework for exergame development including (1) a separate and thorough design of the physical activity and physical interaction, and (2) early and continuous deployment of the exergame on the intended platform to enable evaluations and everyday life testing. %M 39110976 %R 10.2196/50063 %U https://formative.jmir.org/2024/1/e50063 %U https://doi.org/10.2196/50063 %U http://www.ncbi.nlm.nih.gov/pubmed/39110976 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e52566 %T AI Analysis of General Medicine in Japan: Present and Future Considerations %A Aoki,Nozomi %A Miyagami,Taiju %A Saita,Mizue %A Naito,Toshio %+ Department of General Medicine, Juntendo University Faculty of Medicine, 2-1-1Hongo, Tokyo, 113-8421, Japan, 81 3 3813 3111, miya0829gami@gmail.com %K artificial intelligence %K physicians %K hospitalists %K polypharmacy %K sexism %K Japan %K AI %K artificial intelligence %K medicine %K Japan %K gender-biased %K physicians %K physician %K medical care %K gender %K polypharmacy %K women %K Pharmacology %K older adults %K geriatric %K elderly %K Japanese %D 2024 %7 29.3.2024 %9 Viewpoint %J JMIR Form Res %G English %X This paper presents an interpretation of artificial intelligence (AI)–generated depictions of the present and future of general medicine in Japan. Using text inputs, the AI tool generated fictitious images based on neural network analyses. We believe that our study makes a significant contribution to the literature because the direction of general medicine in Japan has long been unclear, despite constant discussion. Our AI analysis shows that Japanese medicine is currently plagued by issues with polypharmacy, likely because of the aging patient population. Additionally, the analysis indicated a distressed female physician and evoked a sense of anxiety about the future of female physicians. It discusses whether the ability to encourage the success of female physicians is a turning point for the future of medicine in Japan. %M 38551640 %R 10.2196/52566 %U https://formative.jmir.org/2024/1/e52566 %U https://doi.org/10.2196/52566 %U http://www.ncbi.nlm.nih.gov/pubmed/38551640 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e52740 %T Decentralizing Health Care: History and Opportunities of Web3 %A Narayan,Aditya %A Weng,Kydo %A Shah,Nirav %+ Clinical Excellence Research Center, 453 Quarry Road, Palo Alto, CA, 94304, United States, 1 7039159597, aditnara@stanford.edu %K Web3 %K health care %K patient-centric %K data ownership %K decentralization %K interoperability %K electronic health record (EHR) %K privacy %K blockchain %K digital transformation %K digital health care %K digital health %K patient %K patients %K technological framework %K security and privacy %K security %K privacy %D 2024 %7 27.3.2024 %9 Viewpoint %J JMIR Form Res %G English %X This paper explores the relationship between the development of the internet and health care, highlighting their parallel growth and mutual influence. It delves into the transition from the early, static days of Web 1.0, akin to siloed physician expertise in health care, to the more interactive and patient-centric era of Web 2.0, which was accompanied by advancements in medical technologies and patient engagement. This paper then focuses on the emerging era of Web3—the decentralized web—which promises a transformative shift in health care, particularly in how patient data are managed, accessed, and used. This shift toward Web3 involves using blockchain technology for decentralized data storage to enhance patient data access, control, privacy, and value. This paper also examines current applications and pilot projects demonstrating Web3’s practical use in health care and discusses key questions and considerations for its successful implementation. %M 38536235 %R 10.2196/52740 %U https://formative.jmir.org/2024/1/e52740 %U https://doi.org/10.2196/52740 %U http://www.ncbi.nlm.nih.gov/pubmed/38536235 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e49759 %T Architecture and Development Framework for a Web-Based Risk Assessment and Management Platform Developed on WordPress to Address Opioid Overdose %A Kazemi,Alireza %A Boyd,Marisha %A Choi,Fiona %A Tai,Andy Man Yeung %A Tsang,Vivian WL %A To,Tam %A Kim,Jane %A Jang,Kerry %A Shams,Farhud %A Schreiter,Stefanie %A Cabanis,Maurice %A Krausz,Reinhard Michael %+ Institute of Mental Health, Department of Psychiatry, University of British Columbia, 4th Floor, Room 430, David Strangway Building, 5950 University Blvd, Vancouver, BC, V6T 1Z3, Canada, 1 236 888 8330, alireza.kazemi@ubc.ca %K software designs %K risks management %K risk assessments %K opioid overdose %K crisis intervention %K substance related disorders %D 2024 %7 11.3.2024 %9 Viewpoint %J JMIR Form Res %G English %X The number of overdose-related fatalities continues to reach historic levels across Canada, despite ongoing efforts by authorities. To reduce mortality, a clinical trajectory ranging from preventative measures to crisis intervention, skill training to treatment, and risk assessment to risk management needs to be supported. The web-based Risk Assessment and Management Platform (RAMP) was developed to realize this concept and to empower people who use drugs through an integrated tool that allows them to better understand and manage their risk of overdose. This paper outlines the architecture and development of RAMP, which is built on the WordPress platform. WordPress components are mapped onto a 3-tier architecture that consists of presentation, application, and database layers. The architecture facilitates the development of a modular software that includes several features that are independent in functionality but interact with each other in an integrated platform. The relatively low coupling and high coherence of the features may reduce the cost of maintenance and increase flexibility of future developments. RAMP’s architecture comprises a user interface, conceptual framework, and backend layers. The RAMP front end effectively uses some of the WordPress’ features such as HTML5, CSS, and JavaScript to create a mobile, friendly, and scalable user interface. The RAMP backend uses several standard and custom WordPress plug-ins to support risk assessment and monitoring, with the goal of mitigating the impacts and eliminating risks together. A rule-based decision support system has been hard-coded to suggest relevant modules and goals to complement each user’s lifestyle and goals based on their risk assessment. Finally, the backend uses the MySQL database management system and communicates with the RAMP framework layer via the data access layer to facilitate a timely and secure handling of information. Overall, RAMP is a modular system developed to identify and manage the risk of opioid overdose in the population of people who use drugs. Its modular design uses the WordPress architecture to efficiently communicate between layers and provide a base for external plug-ins. There is potential for the current system to adopt and address other related fields such as suicide, anxiety, and trauma. Broader implementation will support this concept and lead to the next level of functionality. %M 38466977 %R 10.2196/49759 %U https://formative.jmir.org/2024/1/e49759 %U https://doi.org/10.2196/49759 %U http://www.ncbi.nlm.nih.gov/pubmed/38466977 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e42798 %T Implementation of a Triage Protocol Outside the Hospital Setting for Timely Referral During the COVID-19 Second Wave in Chennai, India %A John,Alby %A M,Jagadeesan %A Rubeshkumar,Polani %A Ganeshkumar,Parasuraman %A Masanam Sriramulu,Hemalatha %A Narnaware,Manish %A Singh Bedi,Gagandeep %A Kaur,Prabhdeep %+ Indian Council of Medical Research-National Institute of Epidemiology, R-127, Second Main Road, Tamil Nadu Housing Board, Ayapakkam, Chennai, 600 077, India, 91 44261336233, kprabhdeep@gmail.com %K COVID-19 %K triage %K low- and middle-income countries %K LMIC %K India %K pulse oximeter %K implementation %K health care system %K self-management %K patient care %K community health %K low income %K health disparity %K low-resource setting %D 2023 %7 18.12.2023 %9 Viewpoint %J JMIR Form Res %G English %X India experienced a surge in COVID-19 cases during the second wave in the period of April-June 2021. A rapid rise in cases posed challenges to triaging patients in hospital settings. Chennai, the fourth largest metropolitan city in India with an 8 million population, reported 7564 COVID-19 cases on May 12, 2021, nearly 3 times higher than the number of cases in the peak of COVID-19 in 2020. A sudden surge of cases overwhelmed the health system. We had established standalone triage centers outside the hospitals in the first wave, which catered to up to 2500 patients per day. In addition, we implemented a home-based triage protocol from May 26, 2021, to evaluate patients with COVID-19 who were aged ≤45 years without comorbidities. Among the 27,816 reported cases between May 26 and June 24, 2021, a total of 16,022 (57.6%) were aged ≤45 years without comorbidities. The field teams triaged 15,334 (55.1%), and 10,917 (39.2%) patients were evaluated at triage centers. Among 27,816 cases, 19,219 (69.1%) were advised to self-isolate at home, 3290 (11.8%) were admitted to COVID-19 care centers, and 1714 (6.2%) were admitted to hospitals. Only 3513 (12.7%) patients opted for the facility of their choice. We implemented a scalable triage strategy covering nearly 90% of the patients in a large metropolitan city during the COVID-19 surge. The process enabled early referral of high-risk patients and ensured evidence-informed treatment. We believe that the out-of-hospital triage strategy can be rapidly implemented in low-resource settings. %M 37235721 %R 10.2196/42798 %U https://formative.jmir.org/2023/1/e42798 %U https://doi.org/10.2196/42798 %U http://www.ncbi.nlm.nih.gov/pubmed/37235721 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e49358 %T Learnings in Digital Health Design: Insights From a Pilot Web App for Structured Note-Taking for Patients With Rheumatoid Arthritis %A Srivastava,Ujwal %A Dasari,Shobha %A Shah,Neha %+ Department of Computer Science, Stanford University, 900 Blake Wilbur Dr Rm W2081 2nd Fl, Stanford, CA, 94305, United States, 1 (650) 723 6961, ujwal@stanford.edu %K digital health %K biodesign %K technology %K software %K web app %K codesign %K patient empowerment %K note-taking %K medical information %K web application %K web-based %K technology engagement %D 2023 %7 28.11.2023 %9 Viewpoint %J JMIR Form Res %G English %X Background: Patients fail to accurately remember 40% to 80% of medical information relayed during doctor appointments, and most standard after-visit summaries fail to effectively help patients comply with behaviors to manage their health conditions. The value of technology to empower and engage patients in their health management has been shown, and here we apply technology to help patients remember and act upon information communicated during their medical appointments. Objective: We describe the development of WellNote, a digital notebook designed for patients to create a customized plan to manage their condition, plan for their appointments, track important actions (eg, medications and labs), and receive reminders for appointments and labs. Methods: For this pilot, we chose to focus on rheumatoid arthritis, a chronic condition that relies on many of these features. The development of WellNote followed a structured method based on design thinking and co-design principles, with the app built in close collaboration with patients and a physician partner to ensure clinical relevance. Our design process consisted of 3 rounds: patient and physician interviews, visual prototypes, and a functional pilot app. Results: Over the course of the design process, WellNote’s features were refined, with the final version being a digital notebook designed for patients with rheumatoid arthritis to manage their health by helping them track medications and labs and plan for appointments. It features several pages, like a dashboard, patient profile, appointment notes, preplanning, medication management, lab tracking, appointment archives, reminders, and a pillbox for medication visualization. Conclusions: WellNote’s active and structured note-taking features allow patients to clearly document the information from their physician without detracting from the conversation, helping the patient to become more empowered and engaged in their health management. The co-design process empowered these stakeholders to share their needs and participate in the development of a solution that truly solves pain points for these groups. This viewpoint highlights the role of digital health tools and the co-design of new health care innovations to empower patients and support clinicians. %M 38015609 %R 10.2196/49358 %U https://formative.jmir.org/2023/1/e49358 %U https://doi.org/10.2196/49358 %U http://www.ncbi.nlm.nih.gov/pubmed/38015609 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e49263 %T A Video Game for Entrepreneurship Learning in Ecuador: Development Study %A Crespo-Martinez,Esteban %A Bueno,Salvador %A Gallego,M Dolores %+ Department of Business Organization and Marketing, Universidad Pablo de Olavide, Carretera Utreras 41089, Seville, 41013, Spain, 34 67 3404321, ecrespo@uazuay.edu.ec %K video game %K computer game %K serious game %K Unity 3D platform %K entrepreneurship %K business simulator %D 2023 %7 11.10.2023 %9 Viewpoint %J JMIR Form Res %G English %X Background: Games have been a part of human life since ancient times and are taught to children and adults who want to simultaneously have fun and learn. Nevertheless, in the third decade of this century, technology invites us to consider using video games to learn topics such as entrepreneurship. However, developing a serious game (SG) is difficult because everyone who forms part of the game development team requires adequate learning resources to acquire the necessary information and improve their game development skills. Objective: This work aimed to detail the experience gained in developing ATIC (Aprende, Trabaja, Innova, Conquista [learn, work, innovate, conquer]), an SG proposed for teaching and learning entrepreneurship. Methods: To develop a videogame, first, we established a game development team formed by professors, professionals, and students who have different roles in this project. Scrum was adopted as a project management method. To create concept art for the video game, designers collected ideas from various games, known as “getting references.” In contrast, narratology considers the life of a recent university graduate immersed in real life, considering locations, characteristics, and representative characters from an essential city of Ecuador Results: In a Unity 3D video game in ATIC, the life of a university student who graduates and ventures into a world full of opportunities, barriers, and risks, where the player needs to make decisions, is simulated. The art of this video game, including sounds and music, is based on the landscape and characteristics of and characters from Cuenca, Ecuador. The game aims to teach entrepreneurs the mechanisms and processes to form their businesses. Thus, we developed the following elements of an SG: (1) world, (2) objects, (3) agents, and (4) events. Conclusions: The narrative, mechanics, and art of video games are relevant. However, project management tools such as leaderboards and appointments are crucial to influencing individuals’ decision to continue to play, or not play, an SG. Developing a serious video game is not an easy task. It was essential to consider many factors, such as the video game audience, needs of learning, context, similarities with the real world, narrative, game mechanics, game art, and game sounds. However, overall, the primary purpose of a serious video game is to transmit knowledge in a fun way and to give adequate and timely feedback to the gamer. Finally, nothing is possible if the members of game development team are not satisfied with the project and not clear about their roles. %M 37819700 %R 10.2196/49263 %U https://formative.jmir.org/2023/1/e49263 %U https://doi.org/10.2196/49263 %U http://www.ncbi.nlm.nih.gov/pubmed/37819700 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e45250 %T The Vinyasa Tool for mHealth Solutions: Supporting Human-Centered Design in Nascent Digital Health Ecosystems %A Thomas,Verghese %A Kalidindi,Bharat %A Waghmare,Abijeet %A Bhatia,Abhishek %A Raj,Tony %A Balsari,Satchit %+ Division of Medical Informatics, St John's Research Institute, 100 Feet Rd, John Nagar, Koramangala, Bangalore, 560034, India, 91 080 4946 7000, verghese.t@sjri.res.in %K community health workers %K digital health %K focus group discussions %K health care workers %K human centered design %K key informant interviews %K LMICs %K low- and middle-income countries %K mHealth %K mobile health %K qualitative research %D 2023 %7 2.10.2023 %9 Viewpoint %J JMIR Form Res %G English %X Background: mHealth (mobile health) systems have been deployed widely in low- and middle-income countries (LMICs) for health system strengthening, requiring considerable resource allocation. However, most solutions have not achieved scale or sustainability. Poor usability and failure to address perceived needs are among the principal reasons mHealth systems fail to achieve acceptance and adoption by health care workers. A human-centered design approach to improving mHealth system use requires an exploration of users’ perceptions of mHealth systems, including the environmental, user-related, and technological aspects of a system. At present, there is a dearth of contextually intelligent tools available to mHealth developers that can guide such exploration before full-scale development and deployment. Objective: To develop a tool to aid optimization of mHealth solutions in LMICs to facilitate human-centered design and, consequently, successful adoption. Methods: We collated findings and themes from key qualitative studies on mHealth deployment in LMICs. We then used the Informatics Stack framework by Lehmann to label, sort, and collate findings and themes into a list of questions that explore the environment, users, artifacts, information governance, and interoperability of mHealth systems deployed in LMICs. Results: We developed the Vinyasa Tool to aid qualitative research about the need and usability of mHealth solutions in LMICs. The tool is a guide for focus group discussions and key informant interviews with community-based health care workers and primary care medical personnel who use or are expected to use proposed mHealth solutions. The tool consists of 71 questions organized in 11 sections that unpack and explore multiple aspects of mHealth systems from the perspectives of their users. These include the wider world and organization in which an mHealth solution is deployed; the roles, functions, workflow, and adoption behavior of a system’s users; the security, privacy, and interoperability afforded by a system; and the artifacts of an information system—the data, information, knowledge, algorithms, and technology that constitute the system. The tool can be deployed in whole or in part, depending on the context of the study. Conclusions: The Vinyasa Tool is the first such comprehensive qualitative research instrument incorporating questions contextualized to the LMIC setting. We expect it to find wide application among mHealth developers, health system administrators, and researchers developing and deploying mHealth tools for use by patients, providers, and administrators. The tool is expected to guide users toward human-centered design with the goal of improving relevance, usability, and, therefore, adoption. %M 37607881 %R 10.2196/45250 %U https://formative.jmir.org/2023/1/e45250 %U https://doi.org/10.2196/45250 %U http://www.ncbi.nlm.nih.gov/pubmed/37607881 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e47486 %T Toward Personalized Medicine Approaches for Parkinson Disease Using Digital Technologies %A Khanna,Amit %A Jones,Graham %+ GDD Connected Health and Innovation Group, Novartis Pharmaceuticals, 1 Health Plaza, East Hanover, NJ, 07936, United States, 1 8572757045, graham.jones@novartis.com %K digital health %K monitoring %K personalized medicine %K Parkinson disease %K wearables %K neurodegenerative disorder %K cognitive impairment %K economic burden %K digital technology %K symptom management %K disease control %K debilitating disease %K intervention %D 2023 %7 27.9.2023 %9 Viewpoint %J JMIR Form Res %G English %X Parkinson disease (PD) is a complex neurodegenerative disorder that afflicts over 10 million people worldwide, resulting in debilitating motor and cognitive impairment. In the United States alone (with approximately 1 million cases), the economic burden for treating and caring for persons with PD exceeds US $50 billion and myriad therapeutic approaches are under development, including both symptomatic- and disease-modifying agents. The challenges presented in addressing PD are compounded by observations that numerous, statistically distinct patient phenotypes present with a wide variety of motor and nonmotor symptomatic profiles, varying responses to current standard-of-care symptom-alleviating medications (L-DOPA and dopaminergic agonists), and different disease trajectories. The existence of these differing phenotypes highlights the opportunities in personalized approaches to symptom management and disease control. The prodromal period of PD can span across several decades, allowing the potential to leverage the unique array of composite symptoms presented to trigger early interventions. This may be especially beneficial as disease progression in PD (alongside Alzheimer disease and Huntington disease) may be influenced by biological processes such as oxidative stress, offering the potential for individual lifestyle factors to be tailored to delay disease onset. In this viewpoint, we offer potential scenarios where emerging diagnostic and monitoring strategies might be tailored to the individual patient under the tenets of P4 medicine (predict, prevent, personalize, and participate). These approaches may be especially relevant as the causative factors and biochemical pathways responsible for the observed neurodegeneration in patients with PD remain areas of fluid debate. The numerous observational patient cohorts established globally offer an excellent opportunity to test and refine approaches to detect, characterize, control, modify the course, and ultimately stop progression of this debilitating disease. Such approaches may also help development of parallel interventive strategies in other diseases such as Alzheimer disease and Huntington disease, which share common traits and etiologies with PD. In this overview, we highlight near-term opportunities to apply P4 medicine principles for patients with PD and introduce the concept of composite orthogonal patient monitoring. %M 37756050 %R 10.2196/47486 %U https://formative.jmir.org/2023/1/e47486 %U https://doi.org/10.2196/47486 %U http://www.ncbi.nlm.nih.gov/pubmed/37756050 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e45694 %T Sustainable Development for Mobile Health Apps Using the Human-Centered Design Process %A An,Qingfan %A Kelley,Marjorie M %A Hanners,Audra %A Yen,Po-Yin %+ Department of Community Medicine and Rehabilitation, Umeå University, Biology Building 3rd floor, Linnaeus väg 9, Umeå, 90736, Sweden, 46 0764550820, qingfan.an@umu.se %K mHealth %K mobile health %K apps %K human-centered design %K sociotechnical %K sustainability %K mobile technology %K speculative design %K mobile phone %D 2023 %7 25.8.2023 %9 Viewpoint %J JMIR Form Res %G English %X Well-documented scientific evidence indicates that mobile health (mHealth) apps can improve the quality of life, relieve symptoms, and restore health for patients. In addition to improving patients’ health outcomes, mHealth apps reduce health care use and the cost burdens associated with disease management. Currently, patients and health care providers have a wide variety of choices among commercially available mHealth apps. However, due to the high resource costs and low user adoption of mHealth apps, the cost-benefit relationship remains controversial. When compared to traditional expert-driven approaches, applying human-centered design (HCD) may result in more useable, acceptable, and effective mHealth apps. In this paper, we summarize current HCD practices in mHealth development studies and make recommendations to improve the sustainability of mHealth. These recommendations include consideration of factors regarding culture norms, iterative evaluations on HCD practice, use of novelty in mHealth app, and consideration of privacy and reliability across the entire HCD process. Additionally, we suggest a sociotechnical lens toward HCD practices to promote the sustainability of mHealth apps. Future research should consider standardizing the HCD practice to help mHealth researchers and developers avoid barriers associated with inadequate HCD practices. %M 37624639 %R 10.2196/45694 %U https://formative.jmir.org/2023/1/e45694 %U https://doi.org/10.2196/45694 %U http://www.ncbi.nlm.nih.gov/pubmed/37624639 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e38938 %T Introduction of a Single Electronic Health Record for Maternity Units in Ireland: Outline of the Experiences of the Project Management Team %A Sheehan,Orla Maria %A Greene,Richard Anthony %A McKernan,Joye %A Murphy,Brendan %A Cahill,Caroline %A Cleary,Brian %A Lawlor,Fiona %A Robson,Michael %A , %+ Department of Obstetrics and Gynaecology, University College Cork, 5th Floor, Cork University Maternity Hospital, Cork, T12 YE02, Ireland, 353 873385218, orla.sheehan1@hse.ie %K baby %K babies %K data management %K data quality %K electronic health record %K health management %K implementation %K information management %K Ireland %K lessons learned %K management system %K maternity %K maternal %K mother %K newborn %K optimization %K planning %K pregnant %K pregnancy %K project management %D 2023 %7 12.5.2023 %9 Viewpoint %J JMIR Form Res %G English %X Electronic health records (EHRs) are being introduced worldwide. The change from paper to electronic records has not always been a seamless or quick process; however, EHRs are viewed as central to updating modern health care, especially organization structures and delivery of sustainable care with the potential for joint decision-making with the patient. The objective of this viewpoint paper is to outline how an EHR is being developed in Ireland. The focus of the Maternal & Newborn Clinical Management System project is the design and implementation of an EHR for all women and babies in the maternity services in the Republic of Ireland. The paper also outlines the lessons learned from the planning to the optimization stage of the project. The paper was developed through discussions with the project management team and their completed reports that outline the lessons they acquired from each project stage. Key lessons learned from each stage of the project are highlighted. This viewpoint paper explains how the national project management team is implementing the EHR and outlines the experiences and lessons learned and the challenges ahead following the phase one introduction. The Maternal & Newborn Clinical Management System is an example of a clinician-led, patient-focused, change management project from its inception to implementation. The introduction of EHRs is essential in modernizing health care and optimizing patient outcomes through the accurate and appropriate use of data. %M 37171841 %R 10.2196/38938 %U https://formative.jmir.org/2023/1/e38938 %U https://doi.org/10.2196/38938 %U http://www.ncbi.nlm.nih.gov/pubmed/37171841 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e42548 %T Do Infrared Thermometers Hold Promise for an Effective Early Warning System for Emerging Respiratory Infectious Diseases? %A Li,Rui %A Shen,Mingwang %A Liu,Hanting %A Bai,Lu %A Zhang,Lei %+ China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, 710061, China, 86 02982655108, lei.zhang1@monash.edu %K respiratory infectious diseases %K early warning %K infrared thermometer %K theoretical framework %K economic burden %K outbreak prevention %K warning system %K community health %K infectious disease %K smartphone device %K digital health surveillance %D 2023 %7 3.5.2023 %9 Viewpoint %J JMIR Form Res %G English %X Background: Major respiratory infectious diseases, such as influenza, SARS-CoV, and SARS-CoV-2, have caused historic global pandemics with severe disease and economic burdens. Early warning and timely intervention are key to suppress such outbreaks. Objective: We propose a theoretical framework for a community-based early warning (EWS) system that will proactively detect temperature abnormalities in the community based on a collective network of infrared thermometer–enabled smartphone devices. Methods: We developed a framework for a community-based EWS and demonstrated its operation with a schematic flowchart. We emphasize the potential feasibility of the EWS and potential obstacles. Results: Overall, the framework uses advanced artificial intelligence (AI) technology on cloud computing platforms to identify the probability of an outbreak in a timely manner. It hinges on the detection of geospatial temperature abnormalities in the community based on mass data collection, cloud-based computing and analysis, decision-making, and feedback. The EWS may be feasible for implementation considering its public acceptance, technical practicality, and value for money. However, it is important that the proposed framework work in parallel or in combination with other early warning mechanisms due to a relatively long initial model training process. Conclusions: The framework, if implemented, may provide an important tool for important decisions for early prevention and control of respiratory diseases for health stakeholders. %M 37133929 %R 10.2196/42548 %U https://formative.jmir.org/2023/1/e42548 %U https://doi.org/10.2196/42548 %U http://www.ncbi.nlm.nih.gov/pubmed/37133929 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e41179 %T Paradigmatic Approach to Support Personalized Counseling With Digital Health (iKNOW) %A Speiser,Dorothee %A Heibges,Maren %A Besch,Laura %A Hilger,Caren %A Keinert,Marie %A Klein,Katharina %A Rauwolf,Gudrun %A Schmid,Christine %A Schulz-Niethammer,Sven %A Stegen,Steffi %A Westfal,Viola %A Witzel,Isabell %A Zang,Benedikt %A Kendel,Friederike %A Feufel,Markus A %+ Department of Gynecology with Breast Center, Hereditary Breast and Ovarian Cancer Center, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany, 49 30 450 664 ext 263, dorothee.speiser@charite.de %K hereditary breast and ovarian cancer %K BRCA %K genetic counseling %K digital health %K online counseling tool %K user-centered design principles %K risk communication %K cancer risk %K hereditary cancer %K breast cancer %K ovarian cancer %D 2023 %7 21.4.2023 %9 Viewpoint %J JMIR Form Res %G English %X iKNOW is the first evidence-based digital tool to support personalized counseling for women in Germany with a hereditary cancer risk. The counseling tool is designed for carriers of pathogenic gBRCA (germline breast cancer gene) variants that increase the lifetime risk of breast and ovarian cancer. Carriers of pathogenic variants are confronted with complex, individualized risk information, and physicians must be able to convey this information in a comprehensible way to enable preference-sensitive health decisions. In this paper, we elaborate on the clinical, regulatory, and practical premises of personalized counseling in Germany. By operationalizing these premises, we formulate 5 design principles that, we suggest, are specific enough to develop a digital tool (eg, iKNOW), yet wide-ranging enough to inform the development of counseling tools for personalized medicine more generally: (1) digital counseling tools should implement the current standard of care (eg, based on guidelines); (2) digital counseling tools should help to both standardize and personalize the counseling process (eg, by enabling the preference-sensitive selection of counseling contents from a common information base); (3) digital counseling tools should make complex information easy to access both cognitively (eg, by using evidenced-based risk communication formats) and technically (eg, by means of responsive design for various devices); (4) digital counseling tools should respect the counselee’s data privacy rights (eg, through strict pseudonymization and opt-in consent); and (5) digital counseling tools should be systematically and iteratively evaluated with the users in mind (eg, using formative prototype testing to ensure a user-centric design and a summative multicenter, randomized controlled trial). On the basis of these paradigmatic design principles, we hope that iKNOW can serve as a blueprint for the development of more digital innovations to support personalized counseling approaches in cancer medicine. %M 37083496 %R 10.2196/41179 %U https://formative.jmir.org/2023/1/e41179 %U https://doi.org/10.2196/41179 %U http://www.ncbi.nlm.nih.gov/pubmed/37083496 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e43009 %T Digital Health at Enterprise Scale: Evaluation Framework for Selecting Patient-Facing Software in a Digital-First Health System %A Shapiro,Martin %A Renly,Sondra %A Maiorano,Ali %A Young,Jerry %A Medina,Eli %A Neinstein,Aaron %A Odisho,Anobel Y %+ Center for Digital Health Innovation, University of California, San Francisco, 550 16th Street Box 1695, San Francisco, CA, 94143, United States, 1 4155022018, anobel.odisho@ucsf.edu %K artificial intelligence %K digital health pathway %K eHealth %K enterprise digital health %K evaluation framework %K framework %K healthcare delivery %K healthcare system %K intelligent care %K intelligent system %K privacy %K security %K service delivery %K systems design %K telehealth %K telemedicine %D 2023 %7 7.4.2023 %9 Viewpoint %J JMIR Form Res %G English %X The digital transformation of our health care system will require not only digitization of existing tools but also a redesign of our care delivery system and collaboration with digital partners. Traditional patient journeys are reactive to symptom presentation and delayed by health care system–centric scheduling, leading to poor experience and avoidable adverse outcomes. Patient journeys will be reimagined to a digital health pathway that seamlessly integrates various care experiences from telemedicine, remote monitoring, to in-person clinic visits. Through centering the care delivery around the patients, they can have more delightful experiences and enjoy the quality of standardized condition pathways and outcomes. To design and implement digital health pathways at scale, enterprise health care systems need to develop capabilities and partnerships in human-centered design, operational workflow, clinical content management, communication channels and mechanisms, reporting and analytics, standards-based integration, security and data management, and scalability. Using a human-centered design methodology, care pathways will be built upon an understanding of the unmet needs of the patients to have a more enjoyable experience of care with improved clinical outcomes. To power this digital care pathway, enterprises will choose to build or partner for clinical content management to operationalize up-to-date, best-in-class pathways. With this clinical engine, this digital solution will engage with patients through multimodal communication modalities, including written, audio, photo, or video, throughout the patient journey. Leadership teams will review reporting and analytics functions to track that the digital care pathways will be iterated to improve patient experience, clinical metrics, and operational efficiency. On the backend, standards-based integration will allow this system to be built in conjunction with the electronic medical record and other data systems to provide safe and efficient use of the digital care solution. For protecting patient information and compliance, a security and data management strategy is critical to derisking breeches and preserving privacy. Finally, a framework of technical scalability will allow digital care pathways to proliferate throughout the enterprise and support the entire patient population. This framework empowers enterprise health care systems to avoid collecting a fragmented series of one-off solutions but develop a sustainable concerted roadmap to the future of proactive intelligent patient care. %M 37027184 %R 10.2196/43009 %U https://formative.jmir.org/2023/1/e43009 %U https://doi.org/10.2196/43009 %U http://www.ncbi.nlm.nih.gov/pubmed/37027184 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e40285 %T A Digital Platform and Smartphone App to Increase Physical Activity in Patients With Type 2 Diabetes: Overview Of a Technical Solution %A Bonn,Stephanie E %A Alexandrou,Christina %A Trolle Lagerros,Ylva %+ Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Maria Aspmans gata 16, Stockholm, 171 76, Sweden, 46 8 517 791 83, stephanie.bonn@ki.se %K methods %K mHealth %K mobile app %K self-management %K smartphone %K digital %K platform %K physical activity %K diabetes %K technical %K engagement %K self-care %K development %K app %K walking %K effective %D 2023 %7 14.3.2023 %9 Viewpoint %J JMIR Form Res %G English %X Mobile Health (mHealth) solutions can be used to increase patients’ engagement in self-care. Descriptions of the technical solutions behind mHealth smartphone apps may guide the development of future apps. Here, we aim to describe the technical background and visual display of the DiaCert system, which was developed to support daily walking among patients with type 2 diabetes. The DiaCert system publishes one application program interface developed for patient devices (ie, smartphone apps running on iOS or Android) and another for web-based health care provider components (ie, administrative components). An individual care plan is created for each patient on the caregiver platform, and data on physical activity (ie, steps), blood samples, and questionnaires are shared between patient and caregiver in the DiaCert system. Technical solutions such as this enable us to reach more individuals at a lower cost compared to traditional health care. An advantage to the DiaCert technical solution is that it is built on a simple architecture and therefore is easily scalable. However, as it is a separate solution, it means adding yet another process for health care personnel to integrate into their work, which must be acknowledged. We hope that the technical description and visual display of the DiaCert system herein can guide researchers in the design and building of new and effective mHealth solutions.International Registered Report Identifier (IRRID): RR2-10.1186/s12889-018-5026-4 %M 36917156 %R 10.2196/40285 %U https://formative.jmir.org/2023/1/e40285 %U https://doi.org/10.2196/40285 %U http://www.ncbi.nlm.nih.gov/pubmed/36917156 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e37784 %T Off-World Mental Health: Considerations for the Design of Well-being–Supportive Technologies for Deep Space Exploration %A Smith,Nathan %A Peters,Dorian %A Jay,Caroline %A Sandal,Gro M %A Barrett,Emma C %A Wuebker,Robert %+ Protective Security and Resilience Centre, Coventry University, Cheetah Road, Coventry, CV1 2TL, United Kingdom, 44 7807045630, nathan.j.smithphd@gmail.com %K long duration space exploration %K astronaut mental health %K countermeasures %K digital design %K human factors %K technology %D 2023 %7 14.2.2023 %9 Viewpoint %J JMIR Form Res %G English %X During future long-duration space exploration missions, humans will be exposed to combinations of extreme physical, psychological, and interpersonal demands. These demands create risks for the safety, performance, health, and well-being of both individuals and crew. The communication latency in deep space means that explorers will increasingly have to operate independently and take responsibility for their own self-care and self-management. At present, several research programs are focused on developing and testing digital technologies and countermeasures that support the effective functioning of deep space crews. Although promising, these initiatives have been stimulated mostly by technological opportunity rather than cogent theory. In this perspective, we argue that digital technologies developed for spaceflight should be informed by well-being–supportive design principles and be cognizant of broader conversations around the development and use of digital health applications, especially pertaining to issues of autonomy, privacy, and trust. These issues are important for designing potentially mission-critical health technologies and may be determining factors in the safe and successful completion of future off-world endeavors. %M 36787162 %R 10.2196/37784 %U https://formative.jmir.org/2023/1/e37784 %U https://doi.org/10.2196/37784 %U http://www.ncbi.nlm.nih.gov/pubmed/36787162 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 12 %P e38003 %T Spotlighting Disability in a Major Electronic Health Record: Michigan Medicine’s Disability and Accommodations Tab %A Halkides,Heather %A James,Tyler G %A McKee,Michael M %A Meade,Michelle A %A Moran,Christa %A Park,Sophia %+ Department of Family Medicine, University of Michigan, 1018 Fuller St, Ann Arbor, MI, 48104, United States, 1 734 998 7120, jamesty@med.umich.edu %K patients with disabilities %K disability accommodations %K electronic health records %K patient-centered care %K Affordable Care Act %K Americans with Disabilities Act %K disability %K disabilities %K affordable care %K EHR %K accommodation %K minority %K equity %K accessibility %K accessible %K inclusive %K inclusivity %K health care %K health service %K environment %K accommodate %K reporting %K data collection %K barrier %D 2022 %7 2.12.2022 %9 Viewpoint %J JMIR Form Res %G English %X People with disabilities represent the largest minority group in the United States and a priority population for health services research. Despite federal civil rights law, people with disabilities face inaccessible health care environments that fail to accommodate their disability. We present Michigan Medicine’s Disability and Accommodations Tab. This patient-facing questionnaire and shared data field in the electronic health record enables the collection and reporting of patient disability-related accommodations. The Disability Tab seeks to address provider- and clinic staff–reported barriers to providing accommodations and fosters an opportunity to redesign health care to meet the needs of people with disabilities. %M 36459406 %R 10.2196/38003 %U https://formative.jmir.org/2022/12/e38003 %U https://doi.org/10.2196/38003 %U http://www.ncbi.nlm.nih.gov/pubmed/36459406 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 9 %P e36759 %T Collaborative Challenges of Multi-Cohort Projects in Pharmacogenetics—Why Time Is Essential for Meaningful Collaborations %A Franchini,Filippo %A Kusejko,Katharina %A Marzolini,Catia %A Tellenbach,Christoph %A Rossi,Simona %A Stampf,Susanne %A Koller,Michael %A Stoyanov,Jivko %A Möller,Burkhard %A Leichtle,Alexander Benedikt %+ University Institute of Clinical Chemistry, Inselspital - Bern University Hospital, University of Bern, Freiburgstrasse 10, Bern, 3010, Switzerland, 41 31 6328330, Alexander.Leichtle@insel.ch %K personalized medicine %K guidelines %K ethical, legal, and social implications %K study %K ethics %K multicentric %D 2022 %7 29.9.2022 %9 Viewpoint %J JMIR Form Res %G English %X Multi-cohort projects in medicine provide an opportunity to investigate scientific questions beyond the boundaries of a single institution and endeavor to increase the sample size for obtaining more reliable results. However, the complications of these kinds of collaborations arise during management, with many administrative hurdles. Hands-on approaches and lessons learned from previous collaborations provide solutions for optimized collaboration models. Here, we use our experience in running PGX-link, a Swiss multi-cohort project, to show the strategy we used to tackle different challenges from project setup to obtaining the relevant permits, including ethics approval. We set PGX-link in an international context because our struggles were similar to those encountered during the SYNCHROS (SYNergies for Cohorts in Health: integrating the ROle of all Stakeholders) project. We provide ad hoc solutions for cohorts, general project management strategies, and suggestions for unified protocols between cohorts that would ease current management hurdles. Project managers are not necessarily familiar with medical projects, and even if they are, they are not aware of the intricacies behind decision-making and consequently, of the time needed to set up multi-cohort collaborations. This paper is meant to be a brief overview of what we experienced with our multi-cohort project and provides the necessary practices for future managers. %M 35976179 %R 10.2196/36759 %U https://formative.jmir.org/2022/9/e36759 %U https://doi.org/10.2196/36759 %U http://www.ncbi.nlm.nih.gov/pubmed/35976179 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 6 %P e32571 %T Antifragile Behavior Change Through Digital Health Behavior Change Interventions %A Kaveladze,Benjamin T %A Young,Sean D %A Schueller,Stephen M %+ Department of Psychological Science, University of California, 4201 Social & Behavioral Sciences Gateway, Irvine, CA, 92697-7085, United States, 1 310 984 9318, bkavelad@uci.edu %K digital health behavior change interventions %K behavior change %K digital health %K self-management %K antifragile %D 2022 %7 3.6.2022 %9 Viewpoint %J JMIR Form Res %G English %X Digital health behavior change interventions (DHBCIs) offer users accessible support, yet their promise to improve health behaviors at scale has not been met. One reason for this unmet potential may be a failure to offer users support that is tailored to their personal characteristics and goals. We apply the concept of antifragility to propose how DHBCIs could be better designed to support diverse users’ behavior change journeys. We first define antifragility as a feature of an individual’s relationship to a particular challenge such that if one is antifragile to a challenge, one is well positioned to benefit from facing that challenge. Second, we introduce antifragile behavior change to describe behavior change processes that leverage person-specific antifragilities to maximize benefits and minimize risk in the behavior change process. While most existing behavior change models focus on improving one’s motivation and ability to face challenges, antifragile behavior change complements these models by helping to select challenges that are most likely to produce desired outcomes. Next, we propose three principles by which DHBCIs can help users to develop antifragile behavior change strategies: providing personalized guidance, embracing variance and exploration in choosing behaviors, and prioritizing user agency. Finally, we offer an example of how a DHBCI could be designed to support antifragile behavior change. %M 35657665 %R 10.2196/32571 %U https://formative.jmir.org/2022/6/e32571 %U https://doi.org/10.2196/32571 %U http://www.ncbi.nlm.nih.gov/pubmed/35657665 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 5 %P e34363 %T Examining the Implementation of Digital Health to Strengthen the COVID-19 Pandemic Response and Recovery and Scale up Equitable Vaccine Access in African Countries %A Olusanya,Olufunto A %A White,Brianna %A Melton,Chad A %A Shaban-Nejad,Arash %+ Department of Pediatrics, The University of Tennessee Health Science Center, 50 N Dunlap, Memphis, TN, 38103, United States, 1 9792043683, oolusan1@uthsc.edu %K COVID-19 %K SARS-CoV-2 %K Africa %K preparedness %K response %K recovery %K digital health %K artificial intelligence %K vaccine equity %D 2022 %7 17.5.2022 %9 Viewpoint %J JMIR Form Res %G English %X The COVID-19 pandemic has profoundly impacted the world, having taken the lives of over 6 million individuals. Accordingly, this pandemic has caused a shift in conversations surrounding the burden of diseases worldwide, welcoming insights from multidisciplinary fields including digital health and artificial intelligence. Africa faces a heavy disease burden that exacerbates the current COVID-19 pandemic and limits the scope of public health preparedness, response, containment, and case management. Herein, we examined the potential impact of transformative digital health technologies in mitigating the global health crisis with reference to African countries. Furthermore, we proposed recommendations for scaling up digital health technologies and artificial intelligence–based platforms to tackle the transmission of the SARS-CoV-2 and enable equitable vaccine access. Challenges related to the pandemic are numerous. Rapid response and management strategies—that is, contract tracing, case surveillance, diagnostic testing intensity, and most recently vaccine distribution mapping—can overwhelm the health care delivery system that is fragile. Although challenges are vast, digital health technologies can play an essential role in achieving sustainable resilient recovery and building back better. It is plausible that African nations are better equipped to rapidly identify, diagnose, and manage infected individuals for COVID-19, other diseases, future outbreaks, and pandemics. %M 35512271 %R 10.2196/34363 %U https://formative.jmir.org/2022/5/e34363 %U https://doi.org/10.2196/34363 %U http://www.ncbi.nlm.nih.gov/pubmed/35512271 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 5 %P e34284 %T The Korean 3T Practice: New Biosurveillance Model Utilizing New Information Technology and Digital Tools %A Kim,HyunJung %+ Barun Information Communications Technology Research Center, Yonsei University, #720 Samsung-Haksulkwan,, 50 Yonsei-ro, Seodaemun-gu,, Seoul, 03722, Republic of Korea, 82 2 2123 6694, hkim76@gmu.edu %K biodefense %K biosurveillance %K public health %K health security %K COVID-19 %K defense %K surveillance %K security %K South Korea %K information technology %K digital health %K pandemic %K testing %K tracing %K treating %K strategy %K privacy %D 2022 %7 16.5.2022 %9 Viewpoint %J JMIR Form Res %G English %X In South Korea, COVID-19 pandemic responses, namely the 3T (testing, tracing, and treating) strategy, emerged as a new biosurveillance regime actively using new information technology (IT) and digital tools. The foundation of the Korean 3T system is epidemiological investigation efforts and clinical practices exploiting the use of new digital and IT tools. Due to these unique features, the Korean 3T system can be referred to as a “contact-based biosurveillance system,” which is an advanced version of the traditional biosurveillance models (indicator-based or event-based models). This article illustrates how the contact-based biosurveillance system originated from the experience with the 2015 Middle East Respiratory Syndrome (MERS) outbreak. The post-MERS Korean biosurveillance regime actively adopted the utility of new digital and IT tools to strengthen not only the ex-ante epidemic intelligence capabilities (by traditional models) but also the ex-post response and recovery capabilities (digital contact tracing and digital health intervention). However, critics claim that the Korean 3T system may violate individuals’ privacy and human rights by addressing the fact that the Korean biosurveillance system would strengthen social surveillance and population control by the government as a “digital big brother” in the cyber age. Nevertheless, 3T biosurveillance promises a positive future direction for digital health practice in the current biosurveillance regimes. %M 35442902 %R 10.2196/34284 %U https://formative.jmir.org/2022/5/e34284 %U https://doi.org/10.2196/34284 %U http://www.ncbi.nlm.nih.gov/pubmed/35442902 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 4 %P e33970 %T Open-Source Clinical Machine Learning Models: Critical Appraisal of Feasibility, Advantages, and Challenges %A Harish,Keerthi B %A Price,W Nicholson %A Aphinyanaphongs,Yindalon %+ Grossman School of Medicine, New York University, 227 East 30th St, 6th Floor, New York, NY, 10016, United States, 1 212 263 9041, yin.a@nyulangone.org %K machine learning %K artificial intelligence %K medical economics %K health policy %K healthcare innovation %D 2022 %7 11.4.2022 %9 Viewpoint %J JMIR Form Res %G English %X Machine learning applications promise to augment clinical capabilities and at least 64 models have already been approved by the US Food and Drug Administration. These tools are developed, shared, and used in an environment in which regulations and market forces remain immature. An important consideration when evaluating this environment is the introduction of open-source solutions in which innovations are freely shared; such solutions have long been a facet of digital culture. We discuss the feasibility and implications of open-source machine learning in a health care infrastructure built upon proprietary information. The decreased cost of development as compared to drugs and devices, a longstanding culture of open-source products in other industries, and the beginnings of machine learning–friendly regulatory pathways together allow for the development and deployment of open-source machine learning models. Such tools have distinct advantages including enhanced product integrity, customizability, and lower cost, leading to increased access. However, significant questions regarding engineering concerns about implementation infrastructure and model safety, a lack of incentives from intellectual property protection, and nebulous liability rules significantly complicate the ability to develop such open-source models. Ultimately, the reconciliation of open-source machine learning and the proprietary information–driven health care environment requires that policymakers, regulators, and health care organizations actively craft a conducive market in which innovative developers will continue to both work and collaborate. %M 35404258 %R 10.2196/33970 %U https://formative.jmir.org/2022/4/e33970 %U https://doi.org/10.2196/33970 %U http://www.ncbi.nlm.nih.gov/pubmed/35404258 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 4 %P e30055 %T The Strategies for Quantitative and Qualitative Remote Data Collection: Lessons From the COVID-19 Pandemic %A Tiersma,Keenae %A Reichman,Mira %A Popok,Paula J %A Nelson,Zoe %A Barry,Maura %A Elwy,A Rani %A Flores,Efrén J %A Irwin,Kelly E %A Vranceanu,Ana-Maria %+ Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, Suite 100, Boston, MA, 02114, United States, 1 6177244977, avranceanu@mgh.harvard.edu %K web-based research %K remote research %K remote data collection %K blended design %K electronic data collection %K mobile phone %D 2022 %7 8.4.2022 %9 Viewpoint %J JMIR Form Res %G English %X The COVID-19 pandemic has necessitated a rapid shift to web-based or blended design models for both ongoing and future clinical research activities. Research conducted virtually not only has the potential to increase the patient-centeredness of clinical research but may also further widen existing disparities in research participation among underrepresented individuals. In this viewpoint, we discuss practical strategies for quantitative and qualitative remote research data collection based on previous literature and our own ongoing clinical research to overcome challenges presented by the shift to remote data collection. We aim to contribute to and catalyze the dissemination of best practices related to remote data collection methodologies to address the opportunities presented by this shift and develop strategies for inclusive research. %M 35394441 %R 10.2196/30055 %U https://formative.jmir.org/2022/4/e30055 %U https://doi.org/10.2196/30055 %U http://www.ncbi.nlm.nih.gov/pubmed/35394441 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 4 %P e29535 %T Digital Health–Enabled Community-Centered Care: Scalable Model to Empower Future Community Health Workers Using Human-in-the-Loop Artificial Intelligence %A Rodrigues,Sarah M %A Kanduri,Anil %A Nyamathi,Adeline %A Dutt,Nikil %A Khargonekar,Pramod %A Rahmani,Amir M %+ Sue & Bill Gross School of Nursing, University of California, 802 W Peltason Drive, Irvine, CA, 92697, United States, 1 949 352 4286, sarahmr@uci.edu %K digital health %K community-centered care %K community health worker %K artificial intelligence %K AI %K AI-enabled health delivery %K eHealth %K individualized delivery %K interventions %K collaborative health %K community health %K social care %K digital empowerment %K mobile phone %D 2022 %7 6.4.2022 %9 Viewpoint %J JMIR Form Res %G English %X Digital health–enabled community-centered care (D-CCC) represents a pioneering vision for the future of community-centered care. D-CCC aims to support and amplify the digital footprint of community health workers through a novel artificial intelligence–enabled closed-loop digital health platform designed for, and with, community health workers. By focusing digitalization at the level of the community health worker, D-CCC enables more timely, supported, and individualized community health worker–delivered interventions. D-CCC has the potential to move community-centered care into an expanded, digitally interconnected, and collaborative community-centered health and social care ecosystem of the future, grounded within a robust and digitally empowered community health workforce. %M 35384853 %R 10.2196/29535 %U https://formative.jmir.org/2022/4/e29535 %U https://doi.org/10.2196/29535 %U http://www.ncbi.nlm.nih.gov/pubmed/35384853 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 3 %P e31342 %T Notes From the Field: A Voice-Activated Video Communication System for Nurses to Communicate With Inpatients With COVID-19 %A Dunn,Mimi %A Landman,Adam %A Cartright,Jennifer %A Bane,Anne %A Brogan,Anne %A Coy,Caroline %A Zhang,Haipeng %+ Brigham Digital Innovation Hub, Brigham and Women's Hospital, Mass General Brigham, 60 Fenwood Road, Boston, MA, 02115, United States, 1 8573075995, mdunn15@bwh.harvard.edu %K Internet of Things %K IoT %K voice assistant %K telehealth %K hospital systems %K COVID-19 %K nurses %K nursing %K public health %K virtual care %D 2022 %7 28.3.2022 %9 Notes From the Field %J JMIR Form Res %G English %X With the relaxing of telehealth regulations through the Health Insurance Portability and Accountability Act (HIPAA) waiver notification for Telehealth Remote Communications during the COVID-19 Nationwide Public Health Emergency, our organization had the opportunity to pilot an innovative virtual care solution using a modified consumer-grade voice-activated video communication system (Amazon Echo Show 8) within one inpatient COVID-19 unit. In this brief report, we describe our experiences with implementing the system and general feedback from clinicians, and discuss areas for future development required to enable future scaling of this solution. Our pilot demonstrates the feasibility of deploying a consumer-grade voice assistant device in COVID-19 patient rooms. We found the devices engaging due to the voice technologies and Alexa functionalities for both clinician and patient entertainment. To enable future deployment at scale, enhancements to the Echo Show and data analytics will need to be further explored. %M 35156929 %R 10.2196/31342 %U https://formative.jmir.org/2022/3/e31342 %U https://doi.org/10.2196/31342 %U http://www.ncbi.nlm.nih.gov/pubmed/35156929 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 2 %P e18539 %T Psychiatry on Twitter: Content Analysis of the Use of Psychiatric Terms in French %A Delanys,Sarah %A Benamara,Farah %A Moriceau,Véronique %A Olivier,François %A Mothe,Josiane %+ Fédération Régionale de Recherche en Psychiatrie et santé mentale d’Occitanie, 134 route d'Espagne, Toulouse, 31000, France, 33 5 61 43 78 52, s.delanys@ch-montauban.fr %K social media analysis %K psychiatric term use %K social stigma %K Twitter %K social media %K mental health %D 2022 %7 14.2.2022 %9 Viewpoint %J JMIR Form Res %G English %X Background: With the advent of digital technology and specifically user-generated contents in social media, new ways emerged for studying possible stigma of people in relation with mental health. Several pieces of work studied the discourse conveyed about psychiatric pathologies on Twitter considering mostly tweets in English and a limited number of psychiatric disorders terms. This paper proposes the first study to analyze the use of a wide range of psychiatric terms in tweets in French. Objective: Our aim is to study how generic, nosographic, and therapeutic psychiatric terms are used on Twitter in French. More specifically, our study has 3 complementary goals: (1) to analyze the types of psychiatric word use (medical, misuse, or irrelevant), (2) to analyze the polarity conveyed in the tweets that use these terms (positive, negative, or neural), and (3) to compare the frequency of these terms to those observed in related work (mainly in English). Methods: Our study was conducted on a corpus of tweets in French posted from January 1, 2016, to December 31, 2018, and collected using dedicated keywords. The corpus was manually annotated by clinical psychiatrists following a multilayer annotation scheme that includes the type of word use and the opinion orientation of the tweet. A qualitative analysis was performed to measure the reliability of the produced manual annotation, and then a quantitative analysis was performed considering mainly term frequency in each layer and exploring the interactions between them. Results: One of the first results is a resource as an annotated dataset. The initial dataset is composed of 22,579 tweets in French containing at least one of the selected psychiatric terms. From this set, experts in psychiatry randomly annotated 3040 tweets that corresponded to the resource resulting from our work. The second result is the analysis of the annotations showing that terms are misused in 45.33% (1378/3040) of the tweets and that their associated polarity is negative in 86.21% (1188/1378) of the cases. When considering the 3 types of term use, 52.14% (1585/3040) of the tweets are associated with a negative polarity. Misused terms related to psychotic disorders (721/1300, 55.46%) were more frequent to those related to depression (15/280, 5.4%). Conclusions: Some psychiatric terms are misused in the corpora we studied, which is consistent with the results reported in related work in other languages. Thanks to the great diversity of studied terms, this work highlighted a disparity in the representations and ways of using psychiatric terms. Moreover, our study is important to help psychiatrists to be aware of the term use in new communication media such as social networks that are widely used. This study has the huge advantage to be reproducible thanks to the framework and guidelines we produced so that the study could be renewed in order to analyze the evolution of term usage. While the newly build dataset is a valuable resource for other analytical studies, it could also serve to train machine learning algorithms to automatically identify stigma in social media. %M 35156925 %R 10.2196/18539 %U https://formative.jmir.org/2022/2/e18539 %U https://doi.org/10.2196/18539 %U http://www.ncbi.nlm.nih.gov/pubmed/35156925 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 1 %P e29333 %T The Applied Data Analytics in Medicine Program: Lessons Learned From Four Years’ Experience With Personalizing Health Care in an Academic Teaching Hospital %A Haitjema,Saskia %A Prescott,Timothy R %A van Solinge,Wouter W %+ Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Room #G.03.551, Utrecht, 3584 CX, Netherlands, 31 088 7550759, s.haitjema@umcutrecht.nl %K digital health %K data-driven care %K multidisciplinarity %K lessons learned %K eHealth %K personalized medicine %K data analytics %K implementation %K collaboration %K hospital %D 2022 %7 28.1.2022 %9 Viewpoint %J JMIR Form Res %G English %X The University Medical Center (UMC) Utrecht piloted a hospital-wide innovation data analytics program over the past 4 years. The goal was, based on available data and innovative data analytics methodologies, to answer clinical questions to improve patient care. In this viewpoint, we aimed to support and inspire others pursuing similar efforts by sharing the three principles of the program: the data analytics value chain (data, insight, action, value), the innovation funnel (structured innovation approach with phases and gates), and the multidisciplinary team (patients, clinicians, and data scientists). We also discussed our most important lessons learned: the importance of a clinical question, collaboration challenges between health care professionals and different types of data scientists, the win-win result of our collaboration with external partners, the prerequisite of available meaningful data, the (legal) complexity of implementation, organizational power, and the embedding of collaborative efforts in the health care system as a whole. %M 35089145 %R 10.2196/29333 %U https://formative.jmir.org/2022/1/e29333 %U https://doi.org/10.2196/29333 %U http://www.ncbi.nlm.nih.gov/pubmed/35089145 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 5 %N 6 %P e27968 %T Using Emerging Telehealth Technology as a Future Model in Vietnam During the COVID-19 Pandemic: Practical Experience From Phutho General Hospital %A Nguyen,Ngoc Huy %A Nguyen,An Quang %A Ha,Van Thi Bich %A Duong,Phuong Xuan %A Nguyen,Thong Van %+ Department of Health, Phutho Province, Tran Phu Str, Viet Tri, 0084, Vietnam, 84 0985179888, ngochuynguyen8888@gmail.com %K telehealth %K telemedicine %K teleconsultation %K COVID-19 %K Vietnam %K digital health %K pandemic %D 2021 %7 22.6.2021 %9 Viewpoint %J JMIR Form Res %G English %X Telehealth has emerged as a model of modern technology for health care services in Vietnam during the COVID-19 pandemic. To actively prevent the outbreak of COVID-19 by using a national digital transformation program, the Vietnamese Ministry of Health launched project 2628/Quyet dinh-Bo y te, which approved a scheme for remote medical examinations and treatments for 2020 to 2025. The project aims to connect 1000 hospitals to strengthen the quality of medical services by using the expertise of central hospitals to support rural areas via provincial hospitals. Phutho General Hospital (PGH) is one of leading provincial hospitals that participated in and applied the early telehealth systems in Vietnam. By using telehealth systems, PGH can offer valuable support to doctors’ activities by streamlining and facilitating their work. Telehealth was demonstrated to be feasible, acceptable, and effective at PGH in Vietnam, and it resulted in considerable improvements in health care outcomes. The COVID-19 pandemic has facilitated the acceleration and enhancement of telehealth in Vietnam. The success of telehealth in Phutho may be a useful reference for other parts of the world. However, this telehealth system focuses on the connectivity among doctors rather than the connectivity between doctors and patients, which is an area that needs further assessment. %M 34078590 %R 10.2196/27968 %U https://formative.jmir.org/2021/6/e27968 %U https://doi.org/10.2196/27968 %U http://www.ncbi.nlm.nih.gov/pubmed/34078590 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 5 %N 3 %P e17456 %T Mind Your Data: Privacy and Legal Matters in eHealth %A Zegers,Catharina M L %A Witteveen,Annemieke %A Schulte,Mieke H J %A Henrich,Julia F %A Vermeij,Anouk %A Klever,Brigit %A Dekker,Andre %+ Institute of Data Science, Maastricht University, Paul-Henri Spaaklaan 1, Maastricht, 6229 ER, Netherlands, 31 43 388 4996, karen.zegers@maastrichtuniversity.nl %K data %K privacy %K eHealth %D 2021 %7 17.3.2021 %9 Viewpoint %J JMIR Form Res %G English %X The health care sector can benefit considerably from developments in digital technology. Consequently, eHealth applications are rapidly increasing in number and sophistication. For successful development and implementation of eHealth, it is paramount to guarantee the privacy and safety of patients and their collected data. At the same time, anonymized data that are collected through eHealth could be used in the development of innovative and personalized diagnostic, prognostic, and treatment tools. To address the needs of researchers, health care providers, and eHealth developers for more information and practical tools to handle privacy and legal matters in eHealth, the Dutch national Digital Society Research Programme organized the “Mind Your Data: Privacy and Legal Matters in eHealth” conference. In this paper, we share the key take home messages from the conference based on the following five tradeoffs: (1) privacy versus independence, (2) informed consent versus convenience, (3) clinical research versus clinical routine data, (4) responsibility and standardization, and (5) privacy versus solidarity. %M 33729163 %R 10.2196/17456 %U https://formative.jmir.org/2021/3/e17456 %U https://doi.org/10.2196/17456 %U http://www.ncbi.nlm.nih.gov/pubmed/33729163 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 3 %P e26718 %T Clinical Trial Data Sharing for COVID-19–Related Research %A Dron,Louis %A Dillman,Alison %A Zoratti,Michael J %A Haggstrom,Jonas %A Mills,Edward J %A Park,Jay J H %+ Department of Experimental Medicine, University of British Columbia, 802-777 West Broadway, Vancouver, BC, V5Z 1J5, Canada, 1 (604) 294 3823, jayhpark1@alumni.ubc.ca %K COVID-19 %K data-sharing %K clinical trials %K data %K research %K privacy %K security %K registry %K feasibility %K challenge %K recruitment %K error %K bias %K assessment %K interoperability %K dataset %K intervention %K cooperation %D 2021 %7 12.3.2021 %9 Viewpoint %J J Med Internet Res %G English %X This paper aims to provide a perspective on data sharing practices in the context of the COVID-19 pandemic. The scientific community has made several important inroads in the fight against COVID-19, and there are over 2500 clinical trials registered globally. Within the context of the rapidly changing pandemic, we are seeing a large number of trials conducted without results being made available. It is likely that a plethora of trials have stopped early, not for statistical reasons but due to lack of feasibility. Trials stopped early for feasibility are, by definition, statistically underpowered and thereby prone to inconclusive findings. Statistical power is not necessarily linear with the total sample size, and even small reductions in patient numbers or events can have a substantial impact on the research outcomes. Given the profusion of clinical trials investigating identical or similar treatments across different geographical and clinical contexts, one must also consider that the likelihood of a substantial number of false-positive and false-negative trials, emerging with the increasing overall number of trials, adds to public perceptions of uncertainty. This issue is complicated further by the evolving nature of the pandemic, wherein baseline assumptions on control group risk factors used to develop sample size calculations are far more challenging than those in the case of well-documented diseases. The standard answer to these challenges during nonpandemic settings is to assess each trial for statistical power and risk-of-bias and then pool the reported aggregated results using meta-analytic approaches. This solution simply will not suffice for COVID-19. Even with random-effects meta-analysis models, it will be difficult to adjust for the heterogeneity of different trials with aggregated reported data alone, especially given the absence of common data standards and outcome measures. To date, several groups have proposed structures and partnerships for data sharing. As COVID-19 has forced reconsideration of policies, processes, and interests, this is the time to advance scientific cooperation and shift the clinical research enterprise toward a data-sharing culture to maximize our response in the service of public health. %M 33684053 %R 10.2196/26718 %U https://www.jmir.org/2021/3/e26718 %U https://doi.org/10.2196/26718 %U http://www.ncbi.nlm.nih.gov/pubmed/33684053 %0 Journal Article %@ 2369-2960 %I JMIR Publications %V 7 %N 2 %P e22581 %T COVID-19 and Black, Asian, and Minority Ethnic Communities: A Complex Relationship Without Just Cause %A Phiri,Peter %A Delanerolle,Gayathri %A Al-Sudani,Ayaat %A Rathod,Shanaya %+ Research & Development Department, Tom Rudd Unit, Moorgreen Hospital, Southern Health NHS Foundation Trust, Research & Development Dept., Clinical Trials Facility, Tom Rudd Unit,, Southampton, SO30 3JB, United Kingdom, 44 02380475112, peter.phiri@southernhealth.nhs.uk %K BAME %K COVID-19 %K ethnicity %K health care professionals %K health care worker %K impact %K inequalities %K minority %K risk %D 2021 %7 1.2.2021 %9 Viewpoint %J JMIR Public Health Surveill %G English %X Emerging evidence has indicated a negative and disproportionate impact of COVID-19 on Black, Asian, and minority ethnic (BAME) communities. Previous studies have already reported that biological and social risk factors increase disease susceptibility, particularly in BAME communities. Despite frontline workers in ethnic minority communities in the United Kingdom’s National Health Service attempting to quell the pandemic, disproportionate numbers of BAME physicians and other health care workers have died of COVID-19. This unprecedented situation highlights ethical and moral implications, which could further augment the impact of the pandemic on their mental health. While the government attempts to mitigate the rate of virus transmission, certain key factors inadvertently augment the negative impact of the pandemic on the mental health and general well-being of BAME communities. This study examined the available literature to explore the association between, and the wider impact of, COVID-19 on BAME communities. Furthermore, this study aims to raise awareness and provide a deeper insight into current scientific discussions. %M 33481752 %R 10.2196/22581 %U https://publichealth.jmir.org/2021/2/e22581 %U https://doi.org/10.2196/22581 %U http://www.ncbi.nlm.nih.gov/pubmed/33481752 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 4 %N 4 %P e17429 %T The Postencounter Form System: Viewpoint on Efficient Data Collection Within Electronic Health Records %A Held,Philip %A Boley,Randy A %A Faig,Walter G %A O'Toole,John A %A Desai,Imran %A Zalta,Alyson K %A Khan,Jawad %A Sims,Shannon %A Brennan,Michael B %A Van Horn,Rebecca %A Glover,Angela C %A Hota,Bala N %A Patty,Brian D %A Rab,S Shafiq %A Pollack,Mark H %A Karnik,Niranjan S %+ Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 325 S Paulina St, Suite 200, Chicago, IL, 60612, United States, 1 312 942 1423, philip_held@rush.edu %K electronic health record %K data collection %K veterans %D 2020 %7 6.4.2020 %9 Viewpoint %J JMIR Form Res %G English %X Electronic health records (EHRs) offer opportunities for research and improvements in patient care. However, challenges exist in using data from EHRs due to the volume of information existing within clinical notes, which can be labor intensive and costly to transform into usable data with existing strategies. This case report details the collaborative development and implementation of the postencounter form (PEF) system into the EHR at the Road Home Program at Rush University Medical Center in Chicago, IL to address these concerns with limited burden to clinical workflows. The PEF system proved to be an effective tool with over 98% of all clinical encounters including a completed PEF within 5 months of implementation. In addition, the system has generated over 325,188 unique, readily-accessible data points in under 4 years of use. The PEF system has since been deployed to other settings demonstrating that the system may have broader clinical utility. %M 32250276 %R 10.2196/17429 %U https://formative.jmir.org/2020/4/e17429 %U https://doi.org/10.2196/17429 %U http://www.ncbi.nlm.nih.gov/pubmed/32250276