The Role of Social Media in Innovative Digital Health

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "TeleHealth and Digital Healthcare".

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 33061

Special Issue Editors


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Guest Editor
Neurosurgery Department, Medical University of Gdansk, 80-952 Gdansk, Poland
Interests: medicine; neurosurgery; neuroscience; health information seeking; spinal cord stimulation
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Guest Editor
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
Interests: neuroimaging and neurovascular surgery; biomedical statistics, social media, YouTube

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Guest Editor
Institute of Medicine, University of Opole, 45-052 Opole, Poland
Interests: disability; meta analysis; scoliosis; aging; spine; clinical microbiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

According to existing research, up to 80% of the global population have used social media at least once. New technologies used both by patients and healthcare professionals facilitate a more equal and comprehensive relationship. Facebook, Twitter, LinkedIn, Instagram, and YouTube are just some examples of the developing channels of communication and providing information. Due to the COVID-19 pandemic, the need for telemedicine has accelerated access provided through digital tools. YouTube channels, both official and unofficial, have become an unexpected market for credible health information.

In this Special Issue, we invite manuscripts concerning the role of various social media platforms in digital health, developing the understanding of innovative tools for digital health possibilities. We are seeking papers investigating various social media platforms and looking for opportunities for emerging platforms, exploring the relationship of social media with healthcare, patient quality of life, treatment options, understanding of diseases, as well as methodological studies.

Prof. Dr. Tomasz Szmuda
Dr. Shan Ali
Prof. Dr. Grzegorz Miękisiak
Guest Editors

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Keywords

  • social media
  • eHealth
  • digital health
  • YouTube
  • telemedicine
  • Twitter
  • Instagram
  • Telegram

Published Papers (12 papers)

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11 pages, 1020 KiB  
Article
Usefulness of YouTube in Sharing Information about New Gene Therapy for Spinal Muscular Atrophy: A Content Analysis
by Kyeong Yeol Kim, Chan Woong Jang, Seok Young Chung, Myungsang Kim, Sung-Rae Cho and Han Eol Cho
Healthcare 2023, 11(1), 147; https://doi.org/10.3390/healthcare11010147 - 03 Jan 2023
Cited by 2 | Viewed by 2187
Abstract
This study aimed to objectively assess YouTube videos’ quality, reliability, and information delivery capability regarding novel spinal muscular atrophy treatments. Using the keywords “nusinersen”, “spinraza”, “ridisplam”, “evrysdi”, “onasemnogene abeparvovec”, and “zolgensma”, we were able to retrieve and screen 360 videos before settling on [...] Read more.
This study aimed to objectively assess YouTube videos’ quality, reliability, and information delivery capability regarding novel spinal muscular atrophy treatments. Using the keywords “nusinersen”, “spinraza”, “ridisplam”, “evrysdi”, “onasemnogene abeparvovec”, and “zolgensma”, we were able to retrieve and screen 360 videos before settling on a final sample of 99 on 25 September 2022. Then, two independent raters used the mDISCERN and GQS instruments to evaluate the videos’ reliability and quality and the Information Delivery Capability (IDC) score to assess the videos’ accuracy and patient-friendliness. The quality, reliability, and information delivery capability of the videos about the new treatment for SMA were quite heterogeneous, with an average mDISCERN, GQS, and IDC score of 3.172 ± 0.899, 2.980 ± 1.025, and 4.141 ± 1.747, respectively. In-depth analysis showed that healthcare expert videos that explained contents while showing infographic supplements had good quality, reliability, and information delivery capability. As YouTube is already a dominant media platform, the public may obtain new information about novel therapeutics for SMA through YouTube. It is necessary to consider how SMA patients and caregivers can choose trusted sources with reliable information on YouTube, and our results can provide clues. Additionally, experts should strive to provide more accurate, reliable, and patient-oriented videos. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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11 pages, 440 KiB  
Article
Online Health (Mis)Information: The Role of Medical Students
by Dalia Y. M. El Kheir, Zainab T. Al Awani, Zainb A. Alrumaih and Majd A. Assad
Healthcare 2023, 11(1), 21; https://doi.org/10.3390/healthcare11010021 - 21 Dec 2022
Viewed by 1352
Abstract
The public perceive social media as a convenient source of health information. Some physicians might use this to enhance their visibility and market value. In this study, we aimed to assess medical students’ awareness of regulations for dispersion of health-related information on social [...] Read more.
The public perceive social media as a convenient source of health information. Some physicians might use this to enhance their visibility and market value. In this study, we aimed to assess medical students’ awareness of regulations for dispersion of health-related information on social media and physicians’ online self-promotional activities. A cross-sectional study was conducted among undergraduate medical students from the 3 largest administrative regions of Saudi Arabia: Central, Western, and Eastern regions. Data was collected between February–July 2020 via online distribution of a self-administered questionnaire. Results showed that: (a) a total of 730 medical students participated; (b) about half of respondents were unsure or unaware of guidelines of both, online posting of medical information and physicians’ online self-promotional activities (343/47% and 385/52.7%, respectively); (c) 610 (83.6%) students supported that healthcare providers report accounts sharing unreliable health information. Physicians’ online promotional activities, and posting about successful cases, might shift physicians’ focus from patient care to becoming more popular online. Care should be taken not to breach essential professional and ethical principles, such as protecting the confidentiality and privacy of patients. Raising awareness among patients and physicians, current and future ones, of the regulations governing these online health related interactions is imperative. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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14 pages, 1119 KiB  
Article
Social Media as a Source of Knowledge about Gene Therapy for Spinal Muscular Atrophy
by Magdalena Tkaczuk, Dawid M. Zakrzewski, Maria Król, Marta Zawadzka, Przemysław M. Waszak and Maria Mazurkiewicz-Bełdzińska
Healthcare 2022, 10(12), 2445; https://doi.org/10.3390/healthcare10122445 - 04 Dec 2022
Cited by 1 | Viewed by 1676
Abstract
Social media is one of the most common sources of medical information. We aimed to evaluate the information contained on websites, including social media and descriptions of fundraisers, in terms of the reliability of knowledge about SMA and gene therapy with onasemnogen abeparvovec. [...] Read more.
Social media is one of the most common sources of medical information. We aimed to evaluate the information contained on websites, including social media and descriptions of fundraisers, in terms of the reliability of knowledge about SMA and gene therapy with onasemnogen abeparvovec. We used a set of available online links found using the Newspointtool. Initially, 1525 texts were included in the study, and after applying the inclusion and exclusion criteria, 112 texts were qualified for analysis using the DISCERN scale and the set of questions prepared by the authors. We observed that most of the texts had poor (48.65%) and medium (27.03%) reliability in the final reliability assessment. All the texts selected for the study were related to gene therapy, although few contained key information about it. In addition, the authors of the entries used various words and phrases that influenced the readers’ perceptions of the text. Of the analyzed sources, 68.8% had an emotional component. Social media is a poor source of information about gene therapy for SMA in Poland. The analyzed texts do not provide a full and complete description of the SMA problem. However, it is important to remember that the Internet is a changing source of information and will hopefully contain more relevant entries in the future. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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10 pages, 751 KiB  
Article
Impact of Social Media on Aesthetic Dentistry: General Practitioners’ Perspectives
by Maria Shakoor Abbasi, Abhishek Lal, Gotam Das, Fatima Salman, Aisha Akram, Abdul Razzaq Ahmed, Afsheen Maqsood and Naseer Ahmed
Healthcare 2022, 10(10), 2055; https://doi.org/10.3390/healthcare10102055 - 17 Oct 2022
Cited by 8 | Viewed by 3586
Abstract
The objective of this study was to investigate general dentists’ observations of various aesthetic dental procedures among social media users. A cross-sectional study was conducted at the Department of Prosthodontics, Altamash Institute of Dental Medicine, over a duration of six months. Data were [...] Read more.
The objective of this study was to investigate general dentists’ observations of various aesthetic dental procedures among social media users. A cross-sectional study was conducted at the Department of Prosthodontics, Altamash Institute of Dental Medicine, over a duration of six months. Data were collected using a well-structured questionnaire comprising 21 predefined responses. The questionnaire was uploaded and disseminated through Google Surveys by forwarding web page links through emails and WhatsApp. The data collected were analysed through Statistical Package for Social Sciences (SPSS-Version 25). The majority (90.7%) of the dental practitioners surveyed believed that there is an increase in the demand for aesthetic dental procedures and social media is a major contributor to it. Moreover, most of the 377 (81.8%) participants agreed that social media is a beneficial platform enabling them to educate, advertise, and communicate with patients. Concerning popular aesthetic procedures, teeth whitening (54.7%), Hollywood smile (17.1%), dental veneers (11.9%), and Invisalign (10.4%) were the most commonly demanded aesthetic procedures. The patients showed desire for these procedures because they were trending on social media platforms. Almost half of the general dental practitioners used social media to post their content related to aesthetic dentistry and to promote their work. They preferred using before and after pictures (48.6%) for advertising their content related to aesthetic dentistry. Within the limitations of the study, it is concluded that the demand for aesthetic dentistry is rapidly growing, and social media is the main driving force behind this revolution as the general population has direct access to the profiles of celebrities and influencers, who all appear to have ‘the perfect smile’. This shift in people’s self-image has created a surge in patients seeking cosmetic treatments. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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8 pages, 249 KiB  
Article
YouTube: Is It a Reliable Source of Nutrition Information on COVID-19 Pandemic?
by Elif Inan-Eroglu and Zehra Buyuktuncer
Healthcare 2022, 10(10), 1911; https://doi.org/10.3390/healthcare10101911 - 29 Sep 2022
Cited by 1 | Viewed by 1345
Abstract
Data on the nutrition-related misinformation about COVID-19 are limited. This study analysed the quality and accuracy of the nutrition information available on YouTube about current COVID-19 pandemic as well as assessed the content of the videos. YouTube was searched using the terms “nutrition [...] Read more.
Data on the nutrition-related misinformation about COVID-19 are limited. This study analysed the quality and accuracy of the nutrition information available on YouTube about current COVID-19 pandemic as well as assessed the content of the videos. YouTube was searched using the terms “nutrition and COVID-19” in Turkish on 1 February 2021. Videos were filtered according to relevancy, and the first 280 videos were analysed. A total of 218 videos were reviewed and classified as “misleading” or “relevant” depending on the information provided. The transparency, utility, reliability, and accuracy of video contents were assessed. The videos attracted a cumulative 6,258,694 views. There were 178 (81.7%) fully relevant and 40 (18.3%) misleading videos. Approximately 80% of the videos shared by health professionals were relevant videos. Government organisations only shared relevant videos. Relevant videos had higher reliability, accuracy, and quality than misleading videos. The nutrition-related content of COVID-19 videos is suboptimal on YouTube. As the COVID-19 pandemic worsens, and nutrition could improve immunity, health professionals and educational and government organisations need to engage more in the spread of nutrition-related COVID-19 information to Internet platforms based on nutrition guidelines and the latest scientific evidence. This will be a practical and immediately implementable public health strategy to effectively spread the right information. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
10 pages, 1839 KiB  
Article
Assessment of the Medical Reliability of Videos on Social Media: Detailed Analysis of the Quality and Usability of Four Social Media Platforms (Facebook, Instagram, Twitter, and YouTube)
by Deniz Gurler and Ismail Buyukceran
Healthcare 2022, 10(10), 1836; https://doi.org/10.3390/healthcare10101836 - 22 Sep 2022
Cited by 7 | Viewed by 2121
Abstract
Introduction: In recent years, the internet and social media have become the primary source for patients to research their medical conditions. Given the billions of links that result from research, it has become increasingly important how medically high quality the priorities of the [...] Read more.
Introduction: In recent years, the internet and social media have become the primary source for patients to research their medical conditions. Given the billions of links that result from research, it has become increasingly important how medically high quality the priorities of the search algorithms are. This study aims to examine the medical quality of videos on social media. Material and Method: A new Gmail account was never used, and Facebook, Instagram, Twitter, and YouTube accounts were opened. The word “knee replacement” was searched via social media. The video duration, daily views, total views, number of likes, source, and shared content were recorded. The parameters were statistically evaluated using the scales JAMA, GQS, DISCERN, and VPI to measure the quality of the medical posts. Results: Correlations were found between JAMA, GQS, and DISCERN. No correlation between the VPI scales with other scales was found. It was found that the promotional content in videos other than Instagram was very high (56–70%). Academics and healthcare workers produced greater quality content than other groups. There is a clear dominance of healthcare practitioners on Instagram. The most shared content was informative, depending on the content. The most frequent users were alternative health practitioners. While YouTube had the highest JAMA, GQC, and DISCERN (2.98, 3.18, 37.5) scores, the lowest VPI (0.761) score was found. Discussion and Conclusions: It has been shown that Instagram and Twitter are not the right places to share videos with medical content. However, everyone should remember that Instagram is the best place to share short but popular videos. YouTube and Facebook are available resources to share videos of better medical quality with a higher score than others. We can say that the most reliable medical sources are Facebook and YouTube videos of physicians and medical staff. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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12 pages, 248 KiB  
Article
Content Analysis of #Postpartumbody Images Posted to Instagram
by Megan L. Gow, Hiba Jebeile, Natalie B. Lister, Heike Roth, Helen Skouteris and Heidi Bergmeier
Healthcare 2022, 10(9), 1802; https://doi.org/10.3390/healthcare10091802 - 19 Sep 2022
Cited by 3 | Viewed by 5250
Abstract
Understanding the imagery on social media targeting postpartum women is an important step in determining the utility of Instagram as a potential avenue for targeting public health messages to this group. This study (1) describes the content of images on Instagram tagged with [...] Read more.
Understanding the imagery on social media targeting postpartum women is an important step in determining the utility of Instagram as a potential avenue for targeting public health messages to this group. This study (1) describes the content of images on Instagram tagged with #postpartumbody and; (2) compares images from ‘Top’ posts (‘trending’ or ‘popular’) with ‘Recent’ posts. 600 images tagged with #postpartumbody (300 ‘Top’ and 300 ‘Recent’) were systematically captured from Instagram and coded using a predefined framework. Images of women were coded for adiposity, muscularity, pose and attire. Chi-square tests were used to compare ‘Top’ and ‘Recent’ posts. Most (n = 409) images were of a woman who generally had low/average adiposity (91%) and little-to-none/some visible muscle definition (93%). Most women (52%) were posing in a non-specific manner, 5% were posing to accentuate a postpartum body feature and 40% were wearing fitness attire. Compared with ‘Recent’, ‘Top’ posts were less likely to be text-focused (p < 0.001), photos of food (p < 0.001) or linked to a product/program (p < 0.001). Women of lower adiposity are more likely to post images of themselves on Instagram tagged with #postpartumbody than women of higher adiposity, which may reflect increased body pride in this group, but could reduce body satisfaction for some viewers. Conveying health information on Instagram may be necessary to interrupt potentially harmful content. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
16 pages, 843 KiB  
Article
Measuring the Impact of Virtual Communities on the Intention to Use Telemedicine Services
by Iustin Priescu and Ionica Oncioiu
Healthcare 2022, 10(9), 1685; https://doi.org/10.3390/healthcare10091685 - 04 Sep 2022
Cited by 1 | Viewed by 1729
Abstract
Digital marketing has given new life to healthcare services by enhancing their visibility in the online space. People choose online healthcare services because they can receive instant answers and communicate with specialists in their comfortable environment at the right time. The purpose of [...] Read more.
Digital marketing has given new life to healthcare services by enhancing their visibility in the online space. People choose online healthcare services because they can receive instant answers and communicate with specialists in their comfortable environment at the right time. The purpose of this study was to understand the impact of virtual communities on the intention to use telemedicine. The model is based on a combination of consumer desire (psychological objective) and loyalty through promotional formats (economic objective), as well as data collected from 442 respondents analyzed using structural equation modeling. The research results show that by analyzing target groups in social networks, content can be individualized, and an accurate measurement of e-patient satisfaction must be conducted in order to improve the experience of future consumers of telemedicine services. The results of this study explain what makes people want to use digital healthcare services and can serve as a guide for people who run virtual communities and help digital healthcare service providers figure out how to market their services. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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10 pages, 807 KiB  
Article
Reliability, Quality, and Educational Suitability of TikTok Videos as a Source of Information about Scoliosis Exercises: A Cross-Sectional Study
by Chan Woong Jang, Myungsang Kim, Seong-Woong Kang and Han Eol Cho
Healthcare 2022, 10(9), 1622; https://doi.org/10.3390/healthcare10091622 - 25 Aug 2022
Cited by 9 | Viewed by 2811
Abstract
This study aimed to systematically assess the informational reliability, quality, and educational suitability of videos introducing scoliosis exercises on TikTok. We retrieved and screened 1904 TikTok videos with the hashtags: “#scoliosis”, “#scoliosisexercise”, and “#scoliosistips”, before collecting a final sample of 171 scoliosis exercises [...] Read more.
This study aimed to systematically assess the informational reliability, quality, and educational suitability of videos introducing scoliosis exercises on TikTok. We retrieved and screened 1904 TikTok videos with the hashtags: “#scoliosis”, “#scoliosisexercise”, and “#scoliosistips”, before collecting a final sample of 171 scoliosis exercises in March 2022. Then, two independent raters assessed the reliability and quality of the videos using the DISCERN instrument and evaluated the educational suitability of the information using “Scoliosis Exercise Education Score” (SEES; exercise cycle, target, effect, precaution, and rationale). None of the videos were rated as excellent or good according to DISCERN. The mean SEES score was 2.02 out of 5. Videos uploaded by health organizations had significantly lower DISCERN and SEES scores than those by general users and healthcare professionals. Regarding the propriety of physiotherapeutic scoliosis-specific exercises (PSSE), DISCERN and SEES scores were significantly higher in the PSSE proper group than in the PSSE non-proper group. Although TikTok has become a popular source of scoliosis-related information, the overall information quality, reliability, and educational suitability of videos on scoliosis exercises in TikTok appear to be low, suggesting that TikTok is not suitable source for obtaining scoliosis exercise information. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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11 pages, 1532 KiB  
Article
YouTube as a Source of Patient Information for Meningiomas: A Content Quality and Audience Engagement Analysis
by Michał Krakowiak, Justyna Fercho, Kaja Piwowska, Rami Yuser, Tomasz Szmuda and Paweł Słoniewski
Healthcare 2022, 10(3), 506; https://doi.org/10.3390/healthcare10030506 - 10 Mar 2022
Cited by 3 | Viewed by 2051
Abstract
YouTube (YT) has become a popular health information reservoir. In this study, we aimed to evaluate the content and quality of YT videos as a source of patient information for meningiomas. A YT search was conducted for the following terms: “meningioma”, “meningiomas”, “meningeal [...] Read more.
YouTube (YT) has become a popular health information reservoir. In this study, we aimed to evaluate the content and quality of YT videos as a source of patient information for meningiomas. A YT search was conducted for the following terms: “meningioma”, “meningiomas”, “meningeal tumor”, and “psammoma”. A total of 119 videos were examined by five independent raters, using validated quality criteria, including the Quality Criteria for Consumer Health Information (DISCERN), the Journal of the American Medical Association instrument (JAMA), and the Global Quality Score (GQS). The mean DISCERN score was 35.6 points, while the mean GQS and JAMA scores were 2.4 and 1.8, respectively. The majority of the videos were produced in the United States (37.82%). Moreover, 47.9% of the evaluated videos were graded as “poor” and only 9.24% were “good”. Statistically higher scores in all three scoring systems were associated with the following information: tumor localization, clinical manifestations, indications for surgery, treatment options, risks, adjuvant therapies, results, follow up, diagrams, and those that featured a doctor as the speaker. Misleading information was presented in 35 productions. Our findings show that the overall quality of YT on the topic of meningiomas is defective, and requires further improvement and evaluation. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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8 pages, 364 KiB  
Article
Can Social Media Profiles Be a Reliable Source of Information on Nutrition and Dietetics?
by Paweł Kabata, Dorota Winniczuk-Kabata, Piotr Maciej Kabata, Janusz Jaśkiewicz and Karol Połom
Healthcare 2022, 10(2), 397; https://doi.org/10.3390/healthcare10020397 - 20 Feb 2022
Cited by 9 | Viewed by 3630
Abstract
Background: Social media are growing worldwide platforms for unlimited exchange of various content. Owing to their accessibility and short form, they can be utilized as usable, wide-range communication and information tools for companies, scientific communities, patient advocacy organizations, and special interest groups. This [...] Read more.
Background: Social media are growing worldwide platforms for unlimited exchange of various content. Owing to their accessibility and short form, they can be utilized as usable, wide-range communication and information tools for companies, scientific communities, patient advocacy organizations, and special interest groups. This study aimed to investigate whether Instagram® profiles can be reliable sources of information and knowledge about nutrition and dietetics. Materials and Methods: Random identification of nutrition-related posts was performed using a built-in website search engine. Posts were searched by five popular hashtags: #nutrition, #nutritionist, #instadiet, #diet, and #dietitian, 250 newest posts of each. Advertisement posts were discarded. Each eligible post was then categorized (dietetics, fitness, motivation, other) and assessed with regard to the quality of nutrition information provided (five levels from none to good quality), popularity (number of followers, likes, and comments), and engagement measures (like, comment, and engagement ratio). Results: A total of 1189 posts were reviewed. The overall quality of the content regarding nutritional knowledge was extremely low (93.9% of all posts), also when divided into categories. Among all posts, 63.8% were categorized as “nutrition and dietetics”, while “fitness”, “motivation”, and “other” categories comprised 8.2%, 4.8%, and 23.2% of the posts, respectively. Posts recognized as dietetics were the most liked (mean n = 116 likes per post) and of the highest quality. However, those motivational raised the greatest degree of engagement (32.7%). Posts with cooking recipes were the most commented. Conclusions: Random post search cannot provide viewers with valuable nutrition information. A dedicated search for high-quality professional profiles is preferred to obtain quality information. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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10 pages, 415 KiB  
Systematic Review
Technology-Based (Mhealth) and Standard/Traditional Maternal Care for Pregnant Woman: A Systematic Literature Review
by Tatik Kusyanti, Firman Fuad Wirakusumah, Fedri Ruluwedrata Rinawan, Abdul Muhith, Ayi Purbasari, Fitriana Mawardi, Indriana Widya Puspitasari, Afina Faza and Alyxia Gita Stellata
Healthcare 2022, 10(7), 1287; https://doi.org/10.3390/healthcare10071287 - 12 Jul 2022
Cited by 9 | Viewed by 3238
Abstract
The world of health has changed significantly since the advent of smartphones. Smartphones have been widely known to facilitate the search for health information in the mobile Health (mHealth) system, which is used to improve the quality of life for patients, such as [...] Read more.
The world of health has changed significantly since the advent of smartphones. Smartphones have been widely known to facilitate the search for health information in the mobile Health (mHealth) system, which is used to improve the quality of life for patients, such as communication between doctors and patients. This systematic literature review aims to identify the use of mHealth as a digital communication tool for pregnant women by comparing technology-based and standard-based pregnancy care. The method used is a systematic review of articles related to pregnancy care that utilize mHealth for pregnant women. The articles were obtained from the database based on the PICO framework; we searched articles using seven databases. The selection was adjusted to the inclusion criteria, data extraction, study quality evaluation, and results from synthesis. From the disbursement, 543 articles were obtained and 10 results were obtained after the screening. After a critical appraisal was carried out, four articles were obtained. Advantages can be in the form of increasing knowledge of pregnant women who use mHealth due to the availability of information needed by pregnant women in the mHealth application. mHealth also provides information about their babies, so the impact of mHealth is not only for mothers. mHealth is a promising solution in pregnancy care compared to the standard of maternal care. Full article
(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)
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