Submitted:
25 June 2024
Posted:
26 June 2024
You are already at the latest version
Abstract
Keywords:
1. Introduction
2. Literature Review
3. Digital Health and Public Healthcare
4. Multilayer Networks
5. Multilayer Networks and Public-Driven Digital Health
- a)
- Patient-Centric Data Layers: One layer might include patient-generated health data from wearable devices, mobile health apps, or patient-reported outcomes. This layer empowers patients to actively contribute their health data, making them integral participants in their healthcare management.
- b)
- Community and Social Support Layers: These layers can represent online patient communities, social media platforms, and support groups where patients and caregivers share experiences, advice, and support. Such interactions provide emotional and social support and facilitate the exchange of valuable health-related information and resources.
- c)
- Healthcare Provider Layers: Traditional healthcare provider networks, including hospitals, clinics, and private practices, form another layer. These institutions may engage with patients via digital health platforms, offering virtual consultations, remote monitoring, and digital health assessments.
- d)
- Public Health and Research Layers: Public health initiatives and research projects that engage with the public for data collection, health surveillance, and participatory research studies constitute another crucial layer. These efforts can lead to better-informed public health strategies and more targeted healthcare interventions.
- e)
- Technology and Infrastructure Layers: The backbone of these networks is the underlying technological frameworks that support digital health services, such as cloud computing (Mishra et al., 2019), data analytics platforms, and cybersecurity measures. These frameworks ensure data is securely stored, processed, and accessible to authorized users.
6. Cost/Benefit Analysis
7. Scalable Digital Health Ecosystems
8. Discussion
9. Conclusion
References
- Alami, H.; Gagnon, M.P.; Fortin, J.P. Some multidimensional unintended consequences of telehealth utilization: a multi-project evaluation synthesis. International journal of health policy and management 2019, 8, 337. [Google Scholar] [CrossRef] [PubMed]
- Balram, N.; Tošić, I.; Binnamangalam, H. Digital health in the age of The Infinite Network. APSIPA Transactions on Signal and Information Processing 2016, 5, e5. [Google Scholar] [CrossRef]
- Barabási, L. (2016). Network Science. Cambridge University Press.
- Barabási, A.L.; Albert, R. Emergence of scaling in random networks. Science 1999, 286, 509–512. [Google Scholar] [CrossRef]
- Bianconi, G. (2018). Multilayer Networks. Oxford University Press.
- Bloom, G.; Balasubramaniam, P.; Marin, A.; Nelson, E.; Quak, E.; Husain, L.; Barker, T. (2023). Towards digital transformation for universal health coverage. Institute of Development Studies, Brighton.
- Channi, H.K.; Shrivastava, P.; Chowdhary, C.L. (2022). Digital Transformation in Healthcare Industry: A Survey. In Next Generation Healthcare Informatics (pp. 279-293). Singapore: Springer Nature Singapore.
- Dhaduk, K.; Miller, D.; Schliftman, A.; Athar, A.; Al Aseri, Z.A.; Echevarria, A.; Becker, C. Implementing and optimizing in-patient access to dermatology consultations via telemedicine: an experiential study. Telemedicine and e-Health 2021, 27, 68–73. [Google Scholar] [CrossRef]
- Deloitte. (2015). Accelerating the adoption of connected health. https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-dchs-connected-health.pdf.
- Evers, E.C.; Fritz, S.A.; Colditz, G.A.; Burnham, J.P. Perceptions of telemedicine and costs incurred by a visit to a general infectious diseases’ clinic: a survey. Open Forum Infectious Diseases 2022, 9, ofab661. [Google Scholar] [CrossRef] [PubMed]
- Fareed, M.; Yassin, A.A. A lightweight and secure multilayer authentication scheme for wireless body area networks in healthcare system. International Journal of Electrical and Computer Engineering 2023, 13, 1782. [Google Scholar] [CrossRef]
- Geng, Q.; Chuai, Z.; Jin, J. (2024). An Integrated Healthcare Service System Based on Blockchain Technologies. IEEE Transactions on Computational Social Systems.
- Groom, L.L.; McCarthy, M.M.; Stimpfel, A.W.; Brody, A.A. Telemedicine and telehealth in nursing homes: an integrative review. Journal of the American Medical Directors Association 2021, 22, 1784–1801. [Google Scholar] [CrossRef]
- Haleem, A.; Javaid, M.; Singh, R.P.; Suman, R. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors international 2021, 2, 100117. [Google Scholar] [CrossRef] [PubMed]
- Hallberg, D.; Salimi, N. Qualitative and Quantitative Analysis of Definitions of e-Health and m-Health. Healthcare informatics research 2020, 26, 119–128. [Google Scholar] [CrossRef]
- Hyder, M.A.; Razzak, J. Telemedicine in the United States: an introduction for students and residents. Journal of medical Internet research 2020, 22, e20839. [Google Scholar] [CrossRef]
- Jandoo, T. WHO guidance for digital health: What it means for researchers. Digital Health 2020, 6. [Google Scholar] [CrossRef] [PubMed]
- Kruse, C.S.; Krowski, N.; Rodriguez, B.; Tran, L.; Vela, J.; Brooks, M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open 2017, 7. [Google Scholar] [CrossRef] [PubMed]
- Lamprinakos, G.C.; Asanin, S.; Broden, T.; Prestileo, A.; Fursse, J.; Papadopoulos, K.A.; Venieris, I.S. An integrated remote monitoring platform towards telehealth and telecare services interoperability. Information Sciences 2015, 308, 23–37. [Google Scholar] [CrossRef]
- Leite, H.; Hodgkinson, I.R.; Gruber, T. New development: ‘Healing at a distance’—telemedicine and COVID-19. Public money & management 2020, 40, 483–485. [Google Scholar]
- Loza, O.; Gomez-Lopez, I.; Mikler, A.R. Multi-coaffiliation networks and public health applications. GSTF Journal of BioSciences 2012, 2. [Google Scholar] [CrossRef]
- Mahtta, D.; Daher, M.; Lee, M.T.; Sayani, S.; Shishehbor, M.; Virani, S.S. Promise and perils of telehealth in the current era. Current cardiology reports 2021, 23, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Massaro, A.; Maritati, V.; Savino, N.; Galiano, A.; Convertini, D.; De Fonte, E.; Di Muro, M. A study of a health resources management platform integrating neural networks and DSS telemedicine for homecare assistance. Information 2018, 9, 176. [Google Scholar] [CrossRef]
- McKinsey. (2021). Telehealth: A quarter-trillion-dollar post-COVID-19 reality? https://www.mckinsey.com/industries/healthcare/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality.
- Mishra, S.; Bhutia, S.D.; Akhtar, N.; Dhar, S. (2019). Cloud-Based Multilayer Telemedicine Architecture: A Case Study. Advances in Communication, Devices and Networking: Proceedings of ICCDN 2018. Springer Singapore, 553–561).
- Moro-Visconti, R. Connecting patient-centric blockchains with multilayer P2P networks and digital platforms. Blockchain in Digital Healthcare. Chapman and Hall/CRC 2021, 93–112.
- Moro-Visconti, R.; Martiniello, L. Smart hospitals and patient-centered governance. Corporate Ownership & Control 2019, 16.
- Mutlag, A.A.; Abd Ghani, M.K.; Arunkumar, N.A.; Mohammed, M.A.; Mohd, O. Enabling technologies for fog computing in healthcare IoT systems. Future generation computer systems 2019, 90, 62–78. [Google Scholar] [CrossRef]
- Noorbakhsh-Sabet, N.; Zand, R.; Zhang, Y.; Abedi, V. Artificial intelligence transforms the future of health care. The American journal of medicine 2019, 132, 795–801. [Google Scholar] [CrossRef]
- Osipov, V.S.; Skryl, T.V. (2021). Impact of digital technologies on the efficiency of healthcare delivery. In IoT in Healthcare and Ambient Assisted Living (pp. 243-261). Singapore: Springer Singapore.
- Palanisamy, V.; Thirunavukarasu, R. Implications of big data analytics in developing healthcare frameworks–A review. Journal of King Saud University-Computer and Information Sciences 2019, 31, 415–425. [Google Scholar] [CrossRef]
- Pathinarupothi, R.K.; Ramesh, M.V.; Rangan, E. Multilayer architectures for remote health monitoring. 2016 IEEE 18th International Conference on e-Health Networking, Applications and Services (Healthcom) 2016, 1–6.
- Peyroteo, M.; Ferreira, I.A.; Elvas, L.B.; Ferreira, J.C.; Lapão, L.V. Remote monitoring systems for patients with chronic diseases in primary health care: systematic review. JMIR mHealth and uHealth 2021, 9, e28285. [Google Scholar] [CrossRef] [PubMed]
- Poitras, M.E.; Maltais, M.E.; Bestard-Denommé, L.; Stewart, M.; Fortin, M. What are the effective elements in patient-centered and multimorbidity care? A scoping review. BMC health services research 2018, 18, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Pramanik, P.K.D.; Nayyar, A.; Pareek, G. (2019). WBAN: Driving e-healthcare beyond telemedicine to remote health monitoring: Architecture and protocols. In Telemedicine technologies. Academic Press, 89–119.
- Rahimi NI, M.; Yatya, S.M.; Bakar, N.A.A. Enterprise Architecture: Enabling Digital Transformation for Healthcare Organization. Open International Journal of Informatics 2023, 11, 67–73. [Google Scholar] [CrossRef]
- Rashida, M.M. Predicting Determinants of Telemedicine Adoption in Healthcare: An Artificial Neural Network Approach. International Journal of Engineering Research & Technology 2023, 12.
- Satamraju, K.P. Proof of concept of scalable integration of internet of things and blockchain in healthcare. Sensors 2020, 20, 1389. [Google Scholar] [CrossRef] [PubMed]
- Smith, K.; Ostinelli, E.; Macdonald, O.; Cipriani, A. COVID-19 and telepsychiatry: development of evidence-based guidance for clinicians. JMIR mental health 2020, 7, e21108. [Google Scholar] [CrossRef] [PubMed]
- Snoswell, C.L.; Taylor, M.L.; Comans, T.A.; Smith, A.C.; Gray, L.C.; Caffery, L.J. Determining if telehealth can reduce health system costs scoping review. Journal of medical Internet research 2020, 22. [Google Scholar] [CrossRef]
- Upadhyay, S. Implementation levels of electronic health records and their influence on quality and safety. Online Journal of Nursing Informatics 2023, 26. [Google Scholar]
- van der Weert, G.; Burzynska, K.; Knoben, J. An integrative perspective on interorganizational multilevel healthcare networks: a systematic literature review. BMC health services research 2022, 22, 923. [Google Scholar] [CrossRef] [PubMed]
- Wang, R.; Zhang, J.; He, S.; Guo, H.; Li, T.; Zhong, Q.; He, K. Design and application of a novel telemedicine system jointly driven by multinetwork integration and remote control: Practical experience from PLAGH, China. Healthcare Technology Letters 2023, 10, 113–121. [Google Scholar] [CrossRef]
- Woods, L.; Eden, R.; Canfell, O.J.; Nguyen, K.H.; Comans, T.; Sullivan, C. Show me the money: how do we justify spending health care dollars on digital health? The Medical Journal of Australia 2023, 218, 53. [Google Scholar] [CrossRef]


| Feature | Description | Impact on digital health |
|---|---|---|
| Multiple Layers | Each layer in a multilayer network represents a different type of interaction or relationship. |
|
| Nodes | Depending on the network’s context, nodes in multilayer networks can exist in one or more layers, representing entities such as individuals, organizations, computers, or biological elements. |
|
| Edges | Edges are the connections between nodes. In multilayer networks, edges can exist within (intra-layer edges) or between layers (inter-layer edges), representing within and cross-type interactions. |
|
| Inter-layer Connections | These are what distinguish multilayer networks from other network types. They represent the connections between the same entities (or different entities) across different layers, enabling the model to capture the complexity of interactions in systems where entities can be related in multiple ways. |
|
| Solutions | description | benefits | costs |
|---|---|---|---|
| Integrated Healthcare Services | Multilayer networks enable the integration of various healthcare services, including primary care consultations, specialist referrals, and emergency services across different platforms and technologies. This integration improves patient care coordination and streamlines healthcare delivery. | It enhances patient care continuity, reduces the duplication of services, and improves overall health outcomes. | Initial investment in technology infrastructure and ongoing maintenance costs. |
| Data Sharing and Interoperability | networks facilitate the sharing of patient data across different healthcare systems and providers, including EHRs, lab results, and imaging studies, ensuring that information is readily available when needed. | It improves diagnostic accuracy, reduces unnecessary tests, and speeds up treatment, potentially leading to significant cost savings for healthcare systems. | Requires investments in secure data-sharing technologies and may involve costs related to ensuring privacy and regulation compliance. |
| Remote Patient Monitoring | Utilizing multilayer networks is a sophisticated approach that utilizes interconnected systems to effectively oversee the health status of patients from a distance, using wearable devices and home monitoring equipment. This innovative method is particularly beneficial in managing chronic conditions and providing care to patients after discharge from medical facilities. | Reduces hospital readmissions and allows for early intervention, improving patient outcomes and reducing long-term healthcare costs. | Initial setup costs for remote monitoring devices and platforms and training costs for healthcare providers and patients are also involved. |
| Public Health Surveillance | Use multilayer networks for real-time surveillance of public health data, such as disease outbreaks, vaccination rates, and health trends, to inform public health decisions and interventions. | It enables timely and targeted public health responses, preventing or mitigating health crises and saving on emergency response costs. | Investment in data collection, analysis tools, and potentially increased surveillance infrastructure is required. |
| Patient Engagement and Self-Management | Multilayer networks can support platforms that engage patients in their care, including telehealth apps for health tracking, appointment scheduling, and digital communication tools for patient-provider interactions. | Preventing complications increases patient satisfaction, improves adherence to treatment plans, and can lead to better health outcomes and cost savings. | Development and maintenance of patient engagement platforms and digital literacy programs for some patient populations. |
| Education and Training | Supporting continuous education and training for healthcare professionals through online platforms and virtual reality simulations, ensuring they remain current with medical advancements and best practices. | Improves the quality of care and patient safety, potentially reducing malpractice and associated costs. | Investment in educational content development, technology platforms, and ongoing training programs. |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).