BackgroundTelemedicine use surged due to its capacity to deliver safe, remote care. As the public health crisis subsides, evaluating the interplay among various tools, such as video, audio, and text, becomes critical to sustained use. With health care shifting back to in-person models, understanding whether telemedicine tools complement or compete provides valuable insights for future technology design and usage strategies. ObjectiveThis study investigates whether different types of telemedicine technology tools complement or compete while physicians deliver health care services through them. A clear understanding of the relationships between telemedicine technology tools, physicians’ satisfaction, evaluation of care quality, and patient visit percentages is crucial for the design of new telemedicine technology platforms and ensuring quality of care services through technology platforms. MethodsTo fulfill our objective, we analyzed data from the 2021 National Electronic Health Records Survey. We used ordered logit and probit regression models to evaluate the effects of telemedicine technology tools on physicians’ overall satisfaction, quality of health care evaluation, and the percentage of patient visits via telemedicine. ResultsA total of 1875 office-based physicians in the United States completed the survey. Three main outcomes were assessed, including physician satisfaction (n=1614), evaluation of health care quality (n=1617), and the percentage of patient visits conducted via telemedicine (n=1558). Ordered logit and probit regression analyses revealed that the aggravated use of telemedicine tools had a significant impact on improvements in all 3 outcomes. A unit increase in telemedicine tools was associated with a 4.2 percentage point increase in the predicted probability of physicians being “very satisfied” (P<.001) and a 5.2 percentage point increase in evaluating telemedicine quality as “to a great extent” (P<.001). For patient visits, a unit increase in telemedicine tools was associated with a 1.8 percentage point increase in the likelihood of reporting “≥75% of visits via telemedicine” (P<.001). Disaggregated analysis indicated that all individual tools were positively associated with physician satisfaction and quality evaluation (P<.05). Bundle models revealed patterns consistent with complementarity (several bundles exceeded their constituent tools) and competition (some significant bundles were smaller than at least one constituent tool), aligning with the presence of both reinforcing and overlapping functionalities. ConclusionsOur study demonstrates that telemedicine tools interact in ways that can be either complementary or competitive, depending on how their functionalities align within physicians’ workflows. Videoconferencing tools, especially when integrated with electronic health record platforms, act as a central complementary component that enhances physicians’ satisfaction and evaluation of care quality. In contrast, combinations lacking video capability or involving multiple nonintegrated platforms fragment workflows and increase cognitive burden. These findings emphasize the importance of designing telemedicine tool bundles that align media capabilities with clinical communication needs, thereby improving satisfaction and supporting sustainable, high-quality telemedicine practice.

A more equal and sustainable digital future depends on the inclusion of digitally marginalized communities in the socioeconomic opportunities created by digital technologies. Digital inclusion is a complex process that involves all stages of digital innovation, including development, adoption, use, and maintenance. However, past research has largely approached digital inclusion as an adoption and use challenge. In this paper, we develop a view of digital inclusion as a design challenge. We focus on the activities of requirements elicitation (RE) as a critical element of the design process and draw on a design-based interpretive study involving the design of two mobile apps for agricultural communities in India and China. We analyze how the conditions of digital inequality underlying the digital marginalization of these communities affect their sensemaking as they participate in RE activities. We conceptualize these challenges as limitations on the emergence of technology affordances. Our findings reveal various shifts, or translations, in the emerging affordances, which enabled the RE activities to be more generative and consequently more inclusive. These affordance translations manifested along three main dimensions: specificity, temporality, and collectivity. We discuss the implications of these findings for the inclusion of marginalized communities in the design of new technologies.

Objective The objective of our study is to investigate the impacts of telemedicine technology and its specific tools on physicians’ overall satisfaction, quality of care, and percentage of patient visits in ambulatory care settings after the COVID-19 lockdowns. Materials and methods Data for our analysis was sourced from the 2021 annual National Electronic Health Records Survey (NEHRS), which included 1,875 complete questionnaire responses from physicians in the 2021 NEHRS. We used regression models to test the effects of telemedicine on physicians’ overall satisfaction, quality of care, and percentage of patients’ visits. Results We report that telemedicine technology has significant positive effects on physicians’ satisfaction with telemedicine and quality of care evaluation, both at an aggregate level and at the disaggregate levels of individual telemedicine features, and partially significant effects on patients’ telemedicine visits. Discussion Telemedicine features that contributed significantly to physician satisfaction and quality of care evaluation were telephone, videoconferencing, standalone telemedicine platform, and telemedicine platform integrated with EHR, while only telephone and integrated telemedicine platform contributed significantly to patients’ telemedicine visits. Conclusion For telemedicine research and practice, this study confirms that telemedicine improves physician satisfaction and quality of care perceptions and will therefore be preferred by physicians. However, telemedicine has a mixed impact on percentage of patient visits, which suggests that providers may have to work harder to regularize telemedicine acceptance among patients in the post-COVID era.

Generative artificial intelligence (GenAI) is revolutionizing digital health by enhancing diagnostic accuracy, predicting health risks, and reducing wait times and costs. This study adopts an inductive approach to analyze user experiences with GenAI through social media comments. We construct a conceptual framework and find that users, including physicians and patients/general users, have varying needs that need to be met using different GenAI types. Our conceptual framework also reveals the interactions among the characteristics of GenAI, users, and users' tasks. This research advances the field of Information Systems by bridging the gap between technology and user behavior in digital health. We also offer insights for future research to explore the influence of GenAI on users' behavior efficiently and how to effectively integrate GenAl tools into their clinical workflows, enhancing patient care and operational efficiency.

Digitizing healthcare is a major aim of healthcare policy, with efforts aimed at increasing adoption of electronic health records (EHRs). We study the capability use for EHRs through the lens of normalisation process theory to assess whether these barriers to adoption also remain barriers to sustained use. We focus on health information exchange (HIE), which is one of the most challenging capabilities identified in the literature. We analyse the National Electronic Health Records Survey data, in which physicians were asked whether known HIE adoption barriers remain in place, and how frequently they use HIE capabilities. Though we expect that adoption barriers reported to be less problematic will be associated with greater capability use, we found that adoption barriers perceived to be more (less) problematic were not necessarily those that predicted less (greater) capability use. This study contributes through a critical examination of the process of normalization of EHR capabilities.

Government-imposed lockdowns and shelter-in-place orders during COVID-19 have accelerated the adoption of telemedicine for remote patient monitoring, consultation, diagnosis, and care. However, healthcare providers' utilization of and satisfaction with telemedicine technologies could have a significant impact on the quality of care provided to patients during COVID-19. The objective of our study is to investigate the impacts of telemedicine technology tools and perceived barriers on physicians' overall satisfaction and continued usage intention of telemedicine in office-based ambulatory care settings. With the help of task-technology fit model we develop a set of hypotheses and then assess those hypotheses empirically with the help of National Electronic Health Records Survey (NEHRS) response data. While we find significant impacts of telemedicine technology tools on physicians' satisfaction and continued usage intention, perceived barriers only significantly impact physicians' satisfaction but not the continued usage intention. Our research has significant implications for both theory and practice.

Controversies surrounding the role of AI in sustainable development may be due to a missing dimension from the sustainability concept. We propose to add technical sustainability to the existing socioeconomic and environmental dimensions of sustainability. Further, adopting a constructionist ontology, we analyzed academic publications on AI and sustainability (2010-2024), and found that various AI techniques and tools have been developed and used to affect the socioeconomic, environmental, and technical sustainability of ecosystems. Meanwhile, an organizing vision has been created in a multi-disciplinary community to help members interpret, legitimize, and mobilize the application of AI for sustainability. While serving these functions, the organizing vision encodes knowledge regarding what, why, how, when, and where sustainable goals can be achieved by employing AI. Our ecological view of sustainability, digital sustainability, and ecosystems is conducive to multi-disciplinary collaborations. The constructionist lens can help foster a constructive discourse that will shape our shared future.

PURPOSE:The aim of this study was to evaluate the effects of a mobile health (mHealth) intervention, HerBeat, compared with educational usual care (E-UC) for improving exercise capacity (EC) and other patient-reported outcomes at 3 mo among women with coronary heart disease. METHODS:Women were randomized to the HerBeat group (n = 23), a behavior change mHealth intervention with a smartphone, smartwatch, and health coach or to the E-UC group (n = 24) who received a standardized cardiac rehabilitation workbook. The primary endpoint was EC measured with the 6-min walk test (6MWT). Secondary outcomes included cardiovascular disease risk factors and psychosocial well-being. RESULTS:A total of 47 women (age 61.2 ± 9.1 yr) underwent randomization. The HerBeat group significantly improved on the 6MWT from baseline to 3 mo ( P = .016, d = .558) while the E-UC group did not ( P = .894, d =-0.030). The between-group difference of 38 m at 3 mo was not statistically significant. From baseline to 3 mo, the HerBeat group improved in anxiety ( P = .021), eating habits confidence ( P = .028), self-efficacy for managing chronic disease ( P = .001), diastolic blood pressure ( P = .03), general health perceptions ( P = .047), perceived bodily pain ( P = .02), and waist circumference ( P = .008) while the E-UC group showed no improvement on any outcomes. CONCLUSIONS:The mHealth intervention led to improvements in EC and several secondary outcomes from baseline to 3 mo while the E-UC intervention did not. A larger study is required to detect small differences between groups. The implementation and outcomes evaluation of the HerBeat intervention was feasible and acceptable with minimal attrition.

Though primary school enrolment in developing countries is growing, dropout rates remain quite high. This leads to significant wastage of economic resources that could otherwise be deployed to productive ends. While information and communication technologies (ICTs) have been viewed as a potent tool to transform education and make it efficient and sustainable, in this paper, we examine whether ICT can help reduce dropouts in primary education. Using structuration theory and capability approach, we propose a conceptual framework illustrating that process by which ICT can improve retention and quality of learning through teacher empowerment and capability improvement. Our study deviates from the prior literature by (1) focusing on the role of teachers in the education process, and (2) elaborating the process of empowerment and capability development by which ICT may influence education outcomes. Theoretical and practical contributions expected from our study are discussed.

While the number of women with Coronary Heart Disease requiring cardiac rehabilitation (CR) continues to increase, lack of access and other barriers to center-based CR present significant challenges. A mobile phone and wearable device-based technological system can offer home-based secondary prevention program for CHD. We have designed a women-specific digital health intervention system for use in a home-based CR program. The system that we have proposed combines human-expert intelligence with machine intelligence to enhance the decision-making capability of a health coach. We have evaluated the prototype of our system with eight women with CHD for over 13 weeks. The evaluation has shown a significant positive impact of preprogrammed intervention messages on participants’ walking performance on the same and the next day. Since increased walking activities directly improve heart health, we can directly infer that our proposed system is beneficial as a tool for secondary prevention among women with CHD.

Pervasive usage of smart phones and smart watches create immense opportunities for deploying the Ecological Momentary Assessment (EMA) method as a research tool by providing access to individuals in their natural environment. Though EMA method establish itself as a substitution of more conventional methods (e.g. retrospective surveys) because of its higher ecological validity, creation of decision rules for just-in-time adaptive interventions based on patients EMA responses are still quite rare. We propose a novel method of creating and triggering behavior change interventions based on the decision rules developed in response to EMA surveys, particularly for patients with coronary heart disease (CHD).

Background: Coronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care. Objective: The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants. Methods: Using a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants' ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment. Results: All 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04). Conclusions: The mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.

Most mhealth applications send motivational messages without regard to the individual's current physical or emotional context. Ecological Momentary Assessments (EMA), in contrast, allow for real-time self-reports that can guide more timely and appropriate behavioral interventions. However, many mhealth assessments suffer from poor user adherence. We hypothesize that EMA survey interfaces with appropriate level of media richness improve user adherence and reduce cognitive load. Guided by Media Richness Theory and Cognitive Load Theory, a 3-group (n=90), 12-week randomized experiment will evaluate user engagement and cognitive load of 3 sets of EMA survey interfaces representing 3 different levels of media richness. Our study will determine the effect of media richness on the user engagement and cognitive load in the context of EMA surveys. Insights generated by our study can help interface designers' in choosing the appropriate media for designing superior EMA survey interfaces.

Population Stereotype tells interaction designers just one-half of the complete story. It informs them only about the level of general consensus regarding each representation generated by different participants. It does not provide answers to those questions, which ask how the representation is to be achieved. Identification of different representation strategies adopted by different participants can reveal the rest of the story. In the presence of more than one or no strong contenders (population stereotype), adoption of the right representation strategy can be really beneficial. As most of the representational strategies are complementary to each other, the combination of different representational strategies can lead towards a more representative icon development.