New paper published in Journal of Medical Internet Research with Tarricone, Cucciniello, Armeni, Petracca, Hall, and Keefe.
Mobile Health Divide Between Clinicians and Patients in Cancer Care: Results From a Cross-Sectional International Survey
Background: Mobile technologies are increasingly being used to manage chronic diseases, including cancer, with the promise of improving the efficiency and effectiveness of care. Among the myriad of mobile technologies in health care, we have seen an explosion of mobile apps. The rapid increase in digital health apps is not paralleled by a similar trend in usage statistics by clinicians and patients. Little is known about how much and in what ways mobile health (mHealth) apps are used by clinicians and patients for cancer care, what variables affect their use of mHealth, and what patients’ and clinicians’ expectations of mHealth apps are.
Objective: This study aimed to describe the patient and clinician population that uses mHealth in cancer care and to provide recommendations to app developers and regulators to generally increase the use and efficacy of mHealth apps.
Methods: Through a cross-sectional Web-based survey, we explored the current utilization rates of mHealth in cancer care and factors that explain the differences in utilization by patients and clinicians across the United States and 5 different countries in Europe. In addition, we conducted an international workshop with more than 100 stakeholders and a roundtable with key representatives of international organizations of clinicians and patients to solicit feedback on the survey results and develop insights into mHealth app development practices.
Results: A total of 1033 patients and 1116 clinicians participated in the survey. The proportion of cancer patients using mHealth (294/1033, 28.46%) was far lower than that of clinicians (859/1116, 76.97%). Accounting for age and salary level, the marginal probabilities of use at means are still significantly different between the 2 groups and were 69.8% for clinicians and 38.7% for patients using the propensity score–based regression adjustment with weighting technique. Moreover, our analysis identified a gap between basic and advanced users, with a prevalent use for activities related to the automation of processes and the interaction with other individuals and a limited adoption for side-effect management and compliance monitoring in both groups.
Conclusions: mHealth apps can provide access to clinical and economic data that are low cost, easy to access, and personalized. The benefits can go as far as increasing patients’ chances of overall survival. However, despite its potential, evidence on the actual use of mobile technologies in cancer care is not promising. If the promise of mHealth is to be fulfilled, clinician and patient usage rates will need to converge. Ideally, cancer apps should be designed in ways that strengthen the patient-physician relationship, ease physicians’ workload, be tested for validity and effectiveness, and fit the criteria for reimbursement.
Paper available at: https://mhealth.jmir.org/2019/9/e13584/
I am spending the next two weeks in Brazil visiting colleagues and developing research partnerships. I will deliver two research seminars:
Shaping the Future of Autonomous Systems in Society: Research with Impact
Emerging technologies are fundamentally impacting and transforming all aspects of our society. I am particularly concerned with how technological innovations impact 1) the design of our public institutions, 2) the apparatuses through which we shape, implement, and evaluate public policies, and 3) our governance frameworks for public goods. All indications suggest that we are moving toward a world where autonomous systems will dictate how we interface and interact with other agents and objects in our society. We can take advantage of emerging technologies to make our societies more livable, just, resilient, and sustainable. To realize this future, we need active and sustained engagement by scholars across a myriad of disciplines, especially public policy and management.
Public policy and governance scholars have largely been absent when it comes to engineering efforts related to the design and deployment of autonomous systems and policy debates that will shape their impact on our society. In this talk, I will outline why we need active engagement by public policy and management scholars during phases of autonomous systems development and implementation. Examples will be drawn from over a dozen research engagements that have studied emerging technologies in the public sector, from predictive analytic systems to blockchain, social media platforms, and machine learning algorithms. I will outline key governance dilemmas and policy challenges confronting public agencies as they try to keep up with the rapid pace of technological innovations.
Studying complex phenomena requires us to undertake research that 1) draws on multiple disciplines, 2) engages a diverse group of stakeholders, 3) appreciates a plurality of research approaches, and 4) generates actionable solutions. Executing inter-disciplinary research is no easy feat to accomplish. Researchers face daunting challenges from the onset; beginning with the inception of ideas, continuing to the crafting of problem statements, executing the research process, and then communicating the results via publications in academic and practitioner outlets. However, these challenges should not be viewed as an excuse to abandon inter-disciplinary research in favor of narrowly focused research exercises. Opportunities for use-inspired research will be discussed. In addition, I will present a working model for executing inter-disciplinary research that has served me well. I will openly share some of the trials and tribulations that I have encountered along the way.
As artificial intelligence technologies take over larger number of tasks, India will face unique impacts of automation relative to other countries. With its large and young population, advances in AI will affect India in aspects from jobs to quality of life. Incidentally, the Indian economy is currently ill-equipped to face the advent of automation and AI. To read more...
Looking forward to delivering a plenary talk at 2019 PUBSIC Conference in Milan, Italy on Jan 25, 2019.
Mitigating Urban Heat: Developing a Climate Smart Toolkit for Liveable, Sustainable Precincts to Address Environmental Monitoring and Better Building Design
Urban heat islands (UHI) are a major contributor to increasing global warming, which are metropolitan areas that are significantly warmer than their surrounding rural areas. Land temperatures in densely developed city centres can be as much as 10 degrees Celsius higher than the surrounding forested landscape. Besides increased energy needs, UHI effects urge urban planners to reconsider the design and energy assessments of buildings in urban areas due to the storage and release of heat energy. Increasing temperatures also contribute to serious health issues, e.g., through the transmission of infectious diseases, which diminishes the liveability in UHI areas.
We propose to study the mechanisms of UHI and the impact of mitigation strategies on the built environment taking a data-centric approach. We will design a toolkit for the development process using the Northshore Hamilton precinct as our testbed . The toolkit, a Climate Smart Precinct in a Box, will be transferable across multiple precincts and adaptable to local conditions in each precinct. Our goal is to build a scalable model that leverages open source technology, the Internet of Things (IoT), smart sensing environments, data sharing models, and advanced analytics to address the issue of urban heat for more liveable and sustainable communities. To achieve this, we follow a methodology that is divided into two parts, technology and people, and has five components: data collection, data analysis, develop insights, design patterns, and impact.
Methodology to develop a Climate Smart Precinct in a Box
First, we plan to collect sensor data to measure different types of data such as temperature, solar radiation, humidity, and wind speed velocity, which will be realized through the implementation of LoRaWAN-enabled environmental monitoring systems provided by Meshed , an IoT technology provider. Second, we will integrate and analyse data using UrbanPulse, an IoT analytics platform provided by [ui!] . We will employ an open standards approach to design an advanced data visualisation interface. Third, we will develop actionable insights through workshops, focus groups, and interviews with key stakeholders. Fourth, we will leverage the insights in other locations and develop a policy informatics framework through an abstraction of the insights and a development of design patterns. This will help to reiterate the process and share design knowledge. Finally, we will be able to measure and evaluate the impact of the Climate Smart Precinct in a Box as it pertains to reducing UHI effects effectively and efficiently.
Abstract: Cities, like any complex adaptive systems, may become increasingly fragile if not properly managed. To date, the literature has focused primarily on the examination of cities within fragile countries. This has resulted in a dearth of studies that have looked at how developed (or even advanced) cities that operate in relatively stable countries and/or environments might allow unresolved issues to accumulate in the city: degrading its ability to function. Studying fragility in developed cities is a worthwhile undertaking given their economic, social, and political significance. This paper puts forth a conceptual framework to understand the nature of fragile cities in the developed world. Our framework frames fragility as a function of unresolved fractures of social compacts that degrades a city’s ability to function over time and stress exacerbates its effects. Drawing on over two dozen incidents from developed cities, we ground the framework and illustrate its value.
To download a copy of the paper, please visit SSRN.
I am looking forward to participating in the Mechanics for the Future: How Can Governments Transform Themselves? session at the Salzburg Global Forum.
Governments worldwide are under pressure to meet complex needs as populations age, countries urbanize, and technology transforms lives and work. They have lead responsibility to prepare their societies for a radically changing world, yet face shrinking budgets and declining trust in the public sector. The machinery of government has changed, requiring governments to transform themselves, both in terms of the methodology they use and the people needed to implement the change. What is the role of government in driving innovation? How can countries and cities learn from each other? How can governments recruit and retain the best people in public service with the right skills? How can governments better harness the market, and strengthen constructive partnerships with civil society and the private sector? What types of public communication work best to rebuild public trust?
See here for a list of attendees.
As part of the meeting, I will be leading a discussion on the potential for advances in artificial intelligence (AI) to transform how we govern. We will employ a case study that I co-authored with Richard T. Watson (Regents Professor and the J. Rex Fuqua Distinguished Chair for Internet Strategy, University of Georgia). The case study takes place in a country, Intelligensia, and is focused on deploying AI systems to modernize the national healthcare system and improve quality of life outcomes.
I will be spending time at the Università Bocconi during March 2018 as a Visiting Professor. I will deliver several lectures as part of the Innovation and Big Data in the Public Sector course taught by my colleague, Prof. Maria Cucciniello. In addition, I will be working on several research projects with colleagues in Milan.