Objectives To explore the motivations, barriers and potential solutions from professionals’ perspectives for achieving effective interdisciplinary practice, focusing on communication and collaboration to support work participation and facilitate patients’ return-to-work (RTW).DesignQualitative exploratory interview study using thematic analysis.SettingPrimary and work-focused healthcare.Participants22 healthcare professionals, including occupational physicians (n=5), social insurance physicians (n=5), general practitioners (n=7) and occupational physiotherapists (n=5), were purposively recruited. All participants had at least 1 year of experience and were actively involved in patient care.InterventionsNone.Primary outcome measuresIdentified motivations, experienced barriers and proposed solutions for improving communication and collaboration across disciplines in work-focused healthcare.ResultsParticipating healthcare professionals emphasised the importance of early, proactive and person-centred communication across care domains, particularly in complex or stagnating RTW trajectories. Key barriers included a lack of shared knowledge and common goals, limited understanding of each other’s roles, time constraints, fragmented systems and regulatory restrictions. Proposed solutions focused on clearer coordination of care, improved role clarity and development of a secure, cross-domain digital communication platform to streamline information exchange.ConclusionsEffective work-focused healthcare requires improved interprofessional communication and patient-centred collaboration. This study highlights when collaboration is most valuable, identifies key barriers and outlines feasible practical solutions. Future research should focus on developing and implementing guidelines that clarify communication pathways and coordination mechanisms within interdisciplinary teams.

Introduction – Health digitalization entails a complex array of actors and roles, including healthcare stakeholders and commercial digital-health innovators. The implementation of digital health innovations (DHIs) is notoriously prone to failure. Consequently, many theories, models, and frameworks (TMFs) have been developed to explain or guide the process of health digitalization. Depending on their scholarly origins, these TMFs differ in their perspective, origin, and terminology, leading to knowledge fragmentation and confusion. The aim of this review was to create an overview of the available TMFs, bringing together and clarifying different perspectives of healthcare stakeholders and innovators during the DHI life cycle. Methodology – This study focused on TMFs describing, explaining, predicting, or prescribing parts of the innovation pathway considering influential factors and actors. Three databases (PubMed, EMBASE, and Web of Science) were searched using the aid of an information specialist in February 2025. We identified relevant keywords for the search by extensively reviewing eHealth and health digitalization literature. Studies were eligible for inclusion if they were published after 2000, written in English, and presented a new or significantly adapted TMF empirically tested in healthcare settings involving a commercial DHI. Studies applying only a known TMF without contextual adaptation or a DHI in the prototype phase were excluded. Results – From the 4628 potentially relevant articles, 12 fulfilled the inclusion criteria. The included TMFs came from diverse scholarly disciplines, pointing to the multidisciplinary knowledge needed for health digitalization. Four TMFs focused on behavior change of end users, two TMFs explored organizational adoption of the DHI, and six TMFs dealt with factors that shape innovation design and development. Several constructs were found in two or all of the TMF groups. The actors involved came from diverse backgrounds and differed according to the type of DHI and scope of implementation. Conclusion – The included TMFs synthesized foundational theories and constructs from specific problem areas in health digitalization. Analyzing the reasons for adding certain constructs indicated how actors and researchers in the different groups perceive the landscape of health digitalization and the realities that shape the digitalization process, helping to create a holistic view aiding continuity and outward growth of the digitalization team. Systematic Review Registration – https://www.crd.york.ac.uk/PROSPERO/view/CRD420251027510, PROSPERO CRD420251027510.

Background: Effective collaboration throughout the full cycle of care is essential for value-based health care. In the Netherlands, occupational health care and curative health care traditionally operate as 2 separate sectors. As a consequence, effective communication and robust collaboration between professionals working in these sectors are lacking. Digital collaborative care platforms (ie, digital systems that facilitate communication and collaboration between health care professionals) are recognized as a promising solution to address the fragmentation of work-focused health care (health care that supports people on long-term sick leave in staying at or returning to work). A human-centered design (HCD) approach can help ensure that such platforms align with professionals’ needs by involving them throughout the design process. Objective: This study examines the experiences of (work-focused) health care professionals, including occupational physicians, insurance physicians, medical specialists, and general practitioners, during the design phase of a real-world HCD process for developing a digital platform to support collaborative care. The study specifically focused on understanding how these professionals perceive this collaborative approach. Methods: A mixed method study design was employed, combining observations of 17 design sessions with semistructured interviews with health care professionals as intended users of the platform. Observational data captured session dynamics, while interview data provided deeper insights into professionals’ experiences with the participatory HCD approach. Results: Health care professionals were generally motivated to contribute, driven by professional interest, social encouragement, or a desire to improve practice. They valued the open and informal atmosphere of the design sessions and described their role as actively sharing practical experiences and identifying bottlenecks in current practice. Participants emphasized the importance of clear goals, good preparation, and iterative involvement for meaningful engagement. Barriers identified included limited session time, constraints of virtual interaction, and uncertainty about the commercial context of the platform. Some professionals felt unsure about the relevance of their input or experienced limited interaction, especially when the session’s purpose was unclear. Others noted that the use of a mock-up platform as a conversational foundation, familiarity with similar system interfaces, and well-guided, structured discussions facilitated their input. Positive experiences included a sense of impact through involvement in the design process, note-taking as part of active user engagement, and a safe environment for open and constructive feedback. Participants recommended a clearer explanation of the platform’s broader aims in advance, enhanced participant preparation, and opportunities for multidisciplinary co-creation in future sessions. Conclusions: Health care professionals valued being part of the collaborative design process, but their engagement and perceived contribution were highly dependent on how the design sessions were facilitated. Structuring design sessions with clear expectations, preparatory tools, and opportunities for follow-up can support more effective, foundational co-creation in digital platform development for collaboration among professionals providing work-focused health care.

BACKGROUND: The increasing prevalence of DH applications has outpaced research and practice in digital health (DH) evaluations. Patient experience (PEx) was reported as one of the challenges facing the health system by the World Health Organization. To generate evidence on DH and promote the appropriate integration and use of technologies, a standard evaluation of PEx in DH is required. OBJECTIVE: This study aims to systematically identify evaluation timing considerations (ie, when to measure), evaluation indicators (ie, what to measure), and evaluation approaches (ie, how to measure) with regard to digital PEx. The overall aim of this study is to generate an evaluation guide for further improving digital PEx evaluation. METHODS: This is a 2-phase study parallel to our previous study. In phase 1, literature reviews related to PEx in DH were systematically searched from Scopus, PubMed, and Web of Science databases. Two independent raters conducted 2 rounds of paper screening, including title and abstract screening and full-text screening, and assessed the interrater reliability for 20% (round 1: 23/115 and round 2: 12/58) random samples using the Fleiss-Cohen coefficient (round 1: k1=0.88 and round 2: k2=0.80). When reaching interrater reliability (k>0.60), TW conducted the rest of the screening process, leaving any uncertainties for group discussions. Overall, 38% (45/119) of the articles were considered eligible for further thematic analysis. In phase 2, to check if there were any meaningful novel insights that would change our conclusions, we performed an updated literature search in which we collected 294 newly published reviews, of which 102 (34.7%) were identified as eligible articles. We considered them to have no important changes to our original results on the research objectives. Therefore, they were not integrated into the synthesis of this review and were used as supplementary materials. RESULTS: Our review highlights 5 typical evaluation objectives that serve 5 stakeholder groups separately. We identified a set of key evaluation timing considerations and classified them into 3 categories: intervention maturity stages, timing of the evaluation, and timing of data collection. Information on evaluation indicators of digital PEx was identified and summarized into 3 categories (intervention outputs, patient outcomes, and health care system impact), 9 themes, and 22 subthemes. A set of evaluation theories, common study designs, data collection methods and instruments, and data analysis approaches was captured, which can be used or adapted to evaluate digital PEx. CONCLUSIONS: Our findings enabled us to generate an evaluation guide to help DH intervention researchers, designers, developers, and program evaluators evaluate digital PEx. Finally, we propose 6 directions for encouraging further digital PEx evaluation research and practice to address the challenge of poor PEx.

Economic studies have shown that living in poverty may produce a subjective feeling of scarcity, which affects people's cognitive functions and decision-making. Understanding this mechanism could inform healthcare designers on designing inclusive health interventions by considering the psychological scarcity and limited cognitive resources of impoverished individuals. We conducted a psychological experiment to test the impact of psychological scarcity on cognitive function and health decisions of rural residents in China. We randomly assign participants to two financial scenarios (hard vs. easy) with the technique of priming to induce their immediate financial worries. Then we measure cognitive function using Raven’s Progressive Matrices and uncover their decision-making priorities with a budget allocation task. 301 participants finished the study and 264 were included in the main analysis. The results show that both immediate financial worries and cumulative poverty have negative effects on participants’ cognitive performance. Responses to scarcity could lead to attentional focus on limited resources, thereby neglecting long-term health consequences, particularly for the lower income group. Based on the findings, we suggest a number of human factors design considerations that are critical to successful healthcare design.

BACKGROUND: Value-based healthcare delivery focuses on optimizing care provided by measuring the healthcare outcomes which are most important to the clients relative to the total care costs. However, the understanding of what adds value for clients during work disability assessment is lacking. OBJECTIVE: To explore what medical examiners (MEs) perceive as valuable during the work disability assessment process, by exploring possible: 1) facilitators, 2) barriers and 3) opportunities to add value for the client during the work disability assessment. METHODS: For this explorative qualitative study, 7 semi-structured interviews were conducted with MEs in the Netherlands. Thematic coding was performed for all interviews. RESULTS: A large variety of facilitators (n = 22), barriers (n = 17) and opportunities (n = 11) were identified and inductively subdivided into four main themes: 1) coherent process, including all time related aspects, 2) interdisciplinary collaboration, including all aspects related to the collaboration between the ME and other professionals, 3) client-centred interaction, including all aspects related to the supportive interplay from the ME towards the client, and 4) information provision on all aspects during the work disability assessment process towards the client to ensure a valuable work disability assessment process. CONCLUSIONS: The overview of identified possible facilitators, barriers and opportunities to add value for clients from the perspective of the ME may stimulate improvement in the current work disability assessment practice and to better match the client needs.

Purpose: To explore the experiences and needs concerning work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease based on all facets of person-centred care. Methods: Nineteen patients who experienced or continue to experience problems with work participation due to cardiovascular disease participated in semi-structured interviews preceded by preparatory written assignments. The transcripts were analysed by means of directed qualitative content analysis. Adapted principles of the Picker Institute for Person-Centred Care provided a template for the analysis. Results: 28 experiences and needs emerged and were grouped into the eight principles for person-centred work-focused healthcare. Randomly presenting one theme for each of the eight principles, the themes included: (1) frequent encounters with occupational healthcare professionals; (2) substantive work-related advice; (3) transparency in communication; (4) support for family; (5) information provision on the work-focused healthcare process; (6) personal control during the process; (7) empathy for the personal situation; and (8) tailored work-focused support. Conclusions: The identified experiences and needs for work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease clearly indicate the need to improve the delivery of person-centred work-focused healthcare to better meet the individual needs of patients.

Objective: To assess the added value of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy versus standard counselling alone. Methods: Participants were randomly assigned for additional use of a mobile educative application or standard counselling alone. Main outcome measures were adherence to aspirin measured by two validated questionnaires: Simplified Medication Adherence Questionnaire (SMAQ), Believes and Behaviour Questionnaire (BBQ), and patients reported tablet intake >90%. Results: A total of 174 women with an indication for aspirin during pregnancy were included. The questionnaires were filled in by 126 out of the 174 participants (72.4%). Similar results were found in the app group and the standard counselling groups for both validated questionnaires. Tablet intake >90% was seen in 88.7% and 87.5% (p = 0.834) of the app group and standard counselling group respectively. Subgroup analyses demonstrated a negative effect of BMI and a positive effect of educational level on adherence. Conclusions: Our study revealed no added effect of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy. Tablet intake was equally high in both groups probably explained by our high educated population. Innovation: Future studies should focus on tailored counselling on medication to pregnant women's needs including medication reminders, addressing concerns, adequate health literacy and side effects, offering rewards to further stimulate aspirin adherence in pregnancy with optimal outcome for mother and their neonate.

Background: Risk-based breast cancer (BC) screening raises new questions regarding information provision and risk communication. This study aimed to: 1) investigate women’s beliefs and knowledge (i.e., mental models) regarding BC risk and (risk-based) BC screening in view of implications for information development; 2) develop novel informational materials to communicate the screening result in risk-based BC screening, including risk visualizations of both quantitative and qualitative information, from a Human-Centered Design perspective. Methods: Phase 1: Interviews were conducted (n = 15, 40–50 years, 5 lower health literate) on women’s beliefs about BC risk and (risk-based) BC screening. Phase 2: In three participatory design sessions, women (n = 4–6 across sessions, 40–50 years, 2–3 lower health literate) made assignments and created and evaluated visualizations of risk information central to the screening result. Prototypes were evaluated in two additional sessions (n = 2, 54–62 years, 0–1 lower health literate). Phase 3: Experts (n = 5) and women (n = 9, 40–74 years) evaluated the resulting materials. Two other experts were consulted throughout the development process to ensure that the content of the information materials was accurate. Interviews were transcribed literally and analysed using qualitative thematic analysis, focusing on implications for information development. Notes, assignments and materials from the participatory design sessions were summarized and main themes were identified. Results: Women in both interviews and design sessions were positive about risk-based BC screening, especially because personal risk factors would be taken into account. However, they emphasized that the rationale of risk-based screening and classification into a risk category should be clearly stated and visualized, especially for higher- and lower-risk categories (which may cause anxiety or feelings of unfairness due to a lower screening frequency). Women wanted to know their personal risk, preferably visualized in an icon array, and wanted advice on risk reduction and breast self-examination. However, most risk factors were considered modifiable by women, and the risk factor breast density was not known, implying that information should emphasize that BC risk depends on multiple factors, including breast density. Conclusions: The information materials, including risk visualizations of both quantitative and qualitative information, developed from a Human-Centered Design perspective and a mental model approach, were positively evaluated by the target group.

Design is expanding its influence on shaping future healthcare. Ideally, designers apply human-centered design and human factors that introduce theory, principles, and methods to design to optimize people’s healthcare experiences in both digital and non-digital environments. To discuss and implement experience design in healthcare, consensus about experience design in healthcare is needed. Objectives: Therefore, the purpose of this study is to investigate designers’ views on experience design in health, and to uncover their understanding about three experience design concepts, i.e., user experience (UX), patient experience (PEx), and digital patient experience (dPEx). We conducted online semi-structured interviews study with convenience samples who met the eligibility. We used ATLAS.ti for an in-depth data coding following thematic analysis. 24 international designers of digital health solutions, either in industry or in academia took part in the interviews. We found the similarities and differences mentioned between healthcare design and non-healthcare design relate to (1) design principles, (2) user attributes, and (3) design contexts. Furthermore, the differences between UX, PEx, and dPEx can be mapped on five dimensions: people, contexts, purposes, means, and usage scenarios. These insights can help designers and human factors specialists build a common design language for experience design in healthcare. Our study can also assist designers and human factors specialists with experience design in digital health by pointing out the areas where design thinking generally is appropriate and the places where particular expertise in healthcare design is needed.

Purpose: To identify, appraise, and synthesize qualitative research evidence exploring patients’ needs regarding work-focused healthcare. Methods: A systematic review was conducted in accordance with the PRISMA statement guidelines to identify studies reporting patients’ needs regarding work-focused healthcare. Four databases (MEDLINE, Embase, PsychInfo and Web of Science) were systematically searched from January 2000 until May 2023 and screened in duplicate by pairs of two reviewers. Inclusion criteria were qualitative data collection method, and patients’ perspectives regarding healthcare focusing on work when experiencing work-related problems due to chronic medical conditions. Data extraction and synthesis was executed by means of an inductive thematic analysis approach. The quality of the included studies was assessed using the CASP Qualitative Study checklist. Confidence in the review findings was assessed through the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. Results: Out of 23,677 records, 97 qualitative studies were included. Needs regarding four main themes were identified: (1) Substantive guidance, which comprises the specific content of work-focused healthcare; (2) Clear and continuous process, which comprises clarification and optimization of the work-focused healthcare process; (3) Supportive attitude and behavior, which comprises a positive and supportive attitude and behavior from professionals towards the patients; and (4) Tailored approach, which comprises the delivery of tailored care to the individuals’ needs. 17 subthemes were identified. Conclusion: The broader insight in patients’ needs in work-focused healthcare can help (occupational) healthcare professionals adopt a more patient-centred approach in practice.

Background: To facilitate the maintenance or resumption of participation in work for patients with cardiovascular disease (CVD), there is a need for high-quality work-focused healthcare. According to the concept of value-based healthcare, quality of care can be enhanced by understanding the outcomes that matter most to patients. However, a major challenge in assessing quality of work-focused healthcare in practice is the lack of consensus on which work-related outcomes should be measured. Objective: The objective of this study was to identify a standard set of key work-related outcomes for patients with CVD to be used in practice of work-focused healthcare in the Netherlands, including standardised outcome measures and associated case mix factors. This standard set is intended to assist occupational and other health professionals in delivering work-focused healthcare that meets a patient’s individual needs regarding work participation, and to enhance patients’ engagement in their own work-focused care process. Methods: A 2-round RAND-modified Delphi process was conducted. The process included literature searches, consecutive research team meetings, and several meetings and rounds of voting by a working group. The working group consisted of patients with CVD (n = 6) and health professionals representing different stakeholders (n = 11) involved in work-focused healthcare for this patient population in the Netherlands. Consensus was reached over four phases: (1) establishing the scope of the standard set and defining the population, (2) prioritising and defining the outcome domains, (3) selecting the outcome measures for the most important domains, including clinical data and patient-reported data, and (4) selecting and defining case mix factors. Results: A 23-item patient-reported questionnaire was developed, called the Value@WORK-Q23, including questions on nine work-related outcome domains considered most important for patients with CVD: (1) work participation, (2) physical work ability, (3) mental work ability, (4) suitable work, (5) support from the work environment, (6) flexibility of the work environment, (7) communication with the patient, (8) person-centredness, and (9) interdisciplinary communication. In addition, nine case mix variables was selected, comprising demographic-, disease-, and work factors. Conclusions: The Value@WORK-Q23 provides guidance on measuring the most important work-related outcomes for patients with CVD. Using this work-related set in practice, in addition to existing disease-specific standard sets for CVD may facilitate the provision of high-value work-focused healthcare for this patient population.