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Mobile Technologies and Geographic Information Systems to Improve Health Care Systems : A Literature Review

机译:移动技术和地理信息系统改善医疗保健系统:文献综述

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摘要

Background: A growing body of research has employed mobile technologies and geographic information systems (GIS) for enhancing health care and health information systems, but there is yet a lack of studies of how these two types of systems are integrated together into the information infrastructure of an organization so as to provide a basis for data analysis and decision support. Integration of data and technical systems across the organization is necessary for efficient large-scale implementation. Objective: The aim of this paper is to identify how mobile technologies and GIS applications have been used, independently as well as in combination, for improving health care. Methods: The electronic databases PubMed, BioMed Central, Wiley Online Library, Scopus, Science Direct, and Web of Science were searched to retrieve English language articles published in international academic journals after 2005. Only articles addressing the use of mobile or GIS technologies and that met a prespecified keyword strategy were selected for review. Results: A total of 271 articles were selected, among which 220 concerned mobile technologies and 51 GIS. Most articles concern developed countries (198/271, 73.1%), and in particular the United States (81/271, 29.9%), United Kingdom (31/271, 11.4%), and Canada (14/271, 5.2%). Applications of mobile technologies can be categorized by six themes: treatment and disease management, data collection and disease surveillance, health support systems, health promotion and disease prevention, communication between patients and health care providers or among providers, and medical education. GIS applications can be categorized by four themes: disease surveillance, health support systems, health promotion and disease prevention, and communication to or between health care providers. Mobile applications typically focus on using text messaging (short message service, SMS) for communication between patients and health care providers, most prominently reminders and advice to patients. These applications generally have modest benefits and may be appropriate for implementation. Integration of health data using GIS technology also exhibit modest benefits such as improved understanding of the interplay of psychological, social, environmental, area-level, and sociodemographic influences on physical activity. The studies evaluated showed promising results in helping patients treating different illnesses and managing their condition effectively. However, most studies use small sample sizes and short intervention periods, which means limited clinical or statistical significance. Conclusions: A vast majority of the papers report positive results, including retention rate, benefits for patients, and economic gains for the health care provider. However, implementation issues are little discussed, which means the reasons for the scarcity of large-scale implementations, which might be expected given the overwhelmingly positive results, are yet unclear. There is also little combination between GIS and mobile technologies. In order for health care processes to be effective they must integrate different kinds of existing technologies and data. Further research and development is necessary to provide integration and better understand implementation issues.
机译:背景:越来越多的研究已经采用了移动技术和地理信息系统(GIS)来增强医疗保健和健康信息系统,但是目前还缺乏关于将这两种类型的系统如何集成到医疗机构信息基础架构中的研究。一个组织,以便为数据分析和决策支持提供基础。为了有效地大规模实施,整个组织中的数据和技术系统的集成是必要的。目标:本文的目的是确定如何独立或组合使用移动技术和GIS应用程序来改善医疗保健。方法:检索电子数据库PubMed,BioMed Central,Wiley Online Library,Scopus,Science Direct和Web of Science,以检索2005年以后在国际学术期刊上发表的英语文章。仅涉及使用移动或GIS技术以及符合预定关键字策略的广告被选中进行审核。结果:总共选择了271篇文章,其中220篇涉及移动技术和51篇GIS。大多数文章涉及发达国家(198/271,占73.1%),尤其是美国(81/271,占29.9%),英国(31/271,占11.4%)和加拿大(14/271,占5.2%)。 。移动技术的应用可以分为六个主题:治疗和疾病管理,数据收集和疾病监视,健康支持系统,健康促进和疾病预防,患者与医疗服务提供者之间或提供者之间的交流以及医学教育。 GIS应用程序可以分为四个主题:疾病监视,健康支持系统,健康促进和疾病预防以及与医疗保健提供者或医疗保健提供者之间的通信。移动应用程序通常专注于使用文本消息传递(短信服务,SMS)在患者和医疗保健提供者之间进行通信,最主要的是向患者提供提醒和建议。这些应用程序通常具有适度的好处,可能适合实施。使用GIS技术整合健康数据还显示出适度的好处,例如更好地了解心理,社会,环境,区域级别和社会人口统计学对体育活动影响的相互作用。评估的研究显示出有希望的结果,可以帮助患者治疗各种疾病并有效地控制其病情。但是,大多数研究使用的样本量小且干预期短,这意味着有限的临床或统计学意义。结论:绝大多数论文都报告了积极的结果,包括保留率,对患者的好处以及对医疗保健提供者的经济收益。但是,实施问题很少讨论,这意味着大规模实施的稀缺性的原因尚不清楚,考虑到绝大多数的积极成果,这是可以预料的。 GIS和移动技术之间几乎没有结合。为了使医疗保健流程有效,他们必须集成各种现有技术和数据。为了提供集成并更好地理解实施问题,有必要进行进一步的研究和开发。

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