Digital health tools may facilitate the continuity of care. Enhancement of digital aid is imperative to prevent information gaps or redundancies, as well as to facilitate support of flexible care plans.
The study presents Health Circuit, an adaptive case management approach that empowers health care professionals and patients to implement personalized evidence-based interventions, thanks to dynamic communication channels and patient-centered service workflows; analyze the health care impact; and determine its usability and acceptability among health care professionals and patients.
From September 2019 to March 2020, the health impact, usability (measured with the system usability scale; SUS), and acceptability (measured with the net promoter score; NPS) of an initial prototype of Health Circuit were tested in a cluster randomized clinical pilot (n=100) in patients with high risk for hospitalization (study 1). From July 2020 to July 2021, a premarket pilot study of usability (with the SUS) and acceptability (with the NPS) was conducted among 104 high-risk patients undergoing prehabilitation before major surgery (study 2).
In study 1, Health Circuit resulted in a reduction of emergency room visits (4/7, 13% vs 7/16, 44%), enhanced patients\' empowerment (P<.001) and showed good acceptability and usability scores (NPS: 31; SUS: 54/100). In study 2, the NPS was 40 and the SUS was 85/100. The acceptance rate was also high (mean score of 8.4/10).
Health Circuit showed potential for health care value generation and good acceptability and usability despite being a prototype system, prompting the need for testing a completed system in real-world scenarios.
ClinicalTrials.gov NCT04056663; https://clinicaltrials.gov/ct2/show/NCT04056663.

BACKGROUND: The aim of this study was to analyze how the reading process of deaf Spanish elementary school students is affected both by those components that explain reading comprehension according to the Simple View of Reading model: decoding and linguistic comprehension (both lexical and grammatical) and by other variables that are external to the reading process: the type of assistive technology used, the age at which it is implanted or fitted, the participant\'s socioeconomic status and school stage.
METHODS: Forty-seven students aged between 6 and 13 years participated in the study; all presented with profound or severe prelingual bilateral deafness, and all used digital hearing aids or cochlear implants. Students\' text comprehension skills, decoding skills and oral comprehension skills (both lexical and grammatical) were evaluated.
RESULTS: Logistic regression analysis indicated that neither the type of assistive technology, age at time of fitting or activation, socioeconomic status, nor school stage could predict the presence or absence of difficulties in text comprehension. Furthermore, logistic regression analysis indicated that neither decoding skills, nor lexical age could predict competency in text comprehension; however, grammatical age could explain 41% of the variance. Probing deeper into the effect of grammatical understanding, logistic regression analysis indicated that a participant\'s understanding of reversible passive object-verb-subject sentences and reversible predicative subject-verb-object sentences accounted for 38% of the variance in text comprehension.
CONCLUSIONS: Based on these results, we suggest that it might be beneficial to devise and evaluate interventions that focus specifically on grammatical comprehension.