Michael Rigby

Keele University · School of Social Science and Public Policy

Despite the renewed interest in Artificial Intelligence-based clinical decision support systems (AI-CDS), there is still a lack of empirical evidence supporting their effectiveness. This underscores the need for rigorous and continuous evaluation and monitoring of processes and outcomes associated with the introduction of health information technol...

Personalized digital health systems (pHealth) bring together in sharp juxtaposition very different yet hopefully complementary moral principles in the shared objectives of optimizing health care and the health status of individual citizens while maximizing the application of robust clinical evidence through harnessing powerful and often complex mod...

UNSTRUCTURED There is an urgent need to incorporate theory-informed health information technology evaluation frameworks into existing and emerging guidelines for the evaluation of Artificial Intelligence. Such frameworks can help developers, implementers, and strategic decision makers to build on existing experience and the existing empirical evide...

Given the requirement to minimize the risks and maximize the benefits of technology applications in health care provision, there is an urgent need to incorporate theory-informed health IT (HIT) evaluation frameworks into existing and emerging guidelines for the evaluation of artificial intelligence (AI). Such frameworks can help developers, impleme...

This study provides a macro-level societal and health system focused analysis of child vaccination rates in 30 European countries, exploring the effect of context on coverage. The importance of demography and health system attributes on health care delivery are recognized in other fields, but generally overlooked in vaccination. The analysis is bas...

Objectives: Patient portals are increasingly implemented to improve patient involvement and engagement. We here seek to provide an overview of ways to mitigate existing concerns that these technologies increase inequity and bias and do not reach those who could benefit most from them. Methods: Based on the current literature, we review the limitati...

Background The ability to successfully transfer knowledge across international boundaries to improve health across the European Region is dependent on an in-depth understanding of the many factors involved in policy creation. Across countries we can observe various approaches to evidence usage in the policy-making process. This study, which was a p...

Background and Objective The COVID-19 pandemic has accelerated digital health applications in multifaceted disease management dimensions. This study aims (1) to identify risk issues relating to the rapid development and redeployment of COVID-19 related e-health systems, in primary care, and in the health ecosystems interacting with it and (2) to su...

Context The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting p...

Context The Models of Child Health Appraised (MOCHA) project was a Horizon 2020 project whose main goal was to appraise the models of primary child health care in each European Union (EU) and European Economic Area (EEA) country. One of the aims of the project was to identify the societal influences on child health care in order to assess contextua...

While children in general are usually seen as a societal priority, many children are disadvantaged by marginalisation, with adverse effects on health and development. Following feasibility studies the European Commission has now adopted a formal Child Guarantee of service access. This paper links the Feasibility Studies to other reports on the need...

Background Low childhood vaccination rates in Europe continue to cause concern and have triggered much policy study. However, regarding children, making immunisation a stand-alone issue cuts across integrated child health services. Most initiatives, including the 10 Action Points from the 2019 European-hosted Global Vaccination Summit, are all laud...

Background Children are dependent on the way in which society provides healthcare, with primary and preventive care being initial components. They also have a generally acclaimed right to health, and to lack of impediment to access to healthcare. In a major initiative, the European Parliament has proposed a Child Guarantee to include free access to...

Background Evidence-based policies should underpin successful implementation of innovations within child health care. The EU-funded Models of Child Health Appraised project enabled research into effective methods to communicate research evidence. The objective of this study was to identify and categorize methods to communicate evidence-based resear...

Background: Population data, such as mortality and morbidity statistics, are essential for many reasons, including giving context for research, supporting action on health determinants, formulation of evidence-based policy for health care and outcome evaluation. However, when considering children, it is difficult to find such data, despite childre...

Background: Children have the Right to health, and countries a duty under the United Nations Convention on the Rights of the Child to facilitate this. The European Union has emphasised the importance of investing in children, but at times this seems more wish than pragmatism. Furthermore, European statistical systems do not provide any relevant da...

To successfully navigate increasing autonomy, independence and health behaviors in adolescence, accessible adolescent health care services (AHS) are essential. AHS comprise all services in primary care that are aimed at the specific needs of adolescents and can be provided in various settings such as public services, private services, schools and h...

Background: Low childhood immunization rates in Europe are causing concern and have triggered several EU initiatives. However, these are counter-factual as they make immunization a stand-alone issue and cut across best practice in integrated child health services. They also focus unduly on 'anti-vax' pressures, generalize 'vaccine hesitancy' and o...

A potentially useful resource for health promotion and guidance is eHealth. However, this field also presents challenges, and one of the most important obstacles is the lack of regulation, without which citizens including young people may be exposed to misleading or risky information and applications. The aim of this study was to investigate the ex...

Immunisation is a key preventive health measure for children. E-health applications have been used for over 50 years, yet still there is no harmonization or standardization, while uncoordinated policy initiatives proliferate. Two EU research projects (Trillium II and MOCHA) have come together with experts and stakeholders, and used EU-wide situatio...

Background and objectives Adolescent sexual and reproductive health and rights (SRHR) are of particular relevance given their potential short-term or long-term health consequences. This study evaluates recommendations and policies regarding access to care in this area in 31 European countries (European Union (EU) plus Iceland, Norway and Switzerlan...

Background The main objective of this study was to explore the contextual determinants of child health policies. Methods The Horizon 2020 Models of Child Health Appraised (MOCHA) project has one Country Agent (CA) in all 30 EU and EEA countries. A questionnaire designed by MOCHA researchers as a semi-structured survey instrument asked CAs to ident...

Good records are vital to joined-up healthcare, ensuring delivery of preventive health, and monitoring public health. In all health spheres, digitisation and e-health are the appropriate new technologies. However, hitherto children have been badly served, and the literature shows minimal recent research in Europe. All European countries are encoura...

Introduction/Background Children are a fifth of Europe’s population; they are citizens, future workers, future parents and carers, and the future elderly population. However they are dependent on society meeting their specific needs for effective primary care, which provides some 90% of all health contact, yet there is little research into how well...

Children’s rights to autonomy of choice are differently expressed throughout Europe. We explored differences regarding expressions of respect for children’s autonomy throughout Europe, using the procedure of human papillomavirus (HPV) vaccination offer as indicator. We used a mixed methods approach, utilizing an expert survey within the frame of “M...

The child is at the centre of all Models of Child Health Appraised researchand indeed all primary care delivery for children. Appraising models of pri-mary care for children is incomplete without ensuring that experiences ofprimary care, design, treatment, management and outcomes are optimalfor the child. However, the principle of child centricity...

Objectives: This paper draws attention to: i) key considerations for evaluating artificial intelligence (AI) enabled clinical decision support; and ii) challenges and practical implications of AI design, development, selection, use, and ongoing surveillance. Method: A narrative review of existing research and evaluation approaches along with expert...

To adopt and implement innovative good practices across the European Union requires developing policies for different political and constitutional contexts. Health policies are mostly decided by national political processes at different levels. To attain effective advice for policy making and good practice exchange, one has to take different models...

Background In the European context the awareness of societal responsibility for children's health has increased with greater attention to children's rights and child empowerment processes. Child health issues are considered particularly sensitive, thus they often provoke strong societal reactions which, as a consequence, influence national health p...

Early recognition, identification and treatment of children with attention deficit hyperactivity disorder (ADHD) can reduce detrimental outcomes and redirect their developmental trajectory. We aimed to describe variations in age of ADHD diagnosis and stimulant prescribing among general practitioner practices in a nationwide network and identify chi...

Objectives Respiratory infections are associated with acute exacerbations of asthma and accompanying morbidity and mortality. In this study we explore inter-practice variations in respiratory infections in children with asthma and study the effect of practice-level factors on these variations. Design Cross-sectional study. Setting We analysed dat...

This Viewpoint presents and discusses the development of the first core principles and standards for effective, personalised care of children living with complex care needs in Europe. These principles and standards emerged from an analysis of data gathered on several areas, including the integration of care for the child at the acute–community inte...

With improvements in neonatal and paediatric care, more children living with complex care needs are surviving beyond infancy into late childhood and adulthood than in the past. We examined the current approach to the management and integration of care of children living with complex care needs in 30 European countries, as well as the implications f...

Issue: It is a core principle that health policy decisions, and appraisal of alternative approaches to service delivery, should be evidence based. Description: As population-wide measures of wellness, morbidity or functioning are scarce, mortality presents itself as a credible condition-orientated outcome measure, and one easily understood by la...

Background: There is no consensus in Europe regarding the ideal model for the child healthcare provision. Similarly, children’s rights to autonomy of choice may also be differently and unequally expressed throughout the European Union (EU). Herewith, we explore differences regarding expressions of respect for children’s developing autonomy througho...

Background: Evidence shows that the implementation of information and communication technologies (ICT) enabled services supporting integrated dementia care represents an opportunity that faces multi-pronged challenges. First, the provision of dementia support is fragmented and often inappropriate. Second, available ICT solutions in this field do n...

Objectives: The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data. Method: A narrative review of existing research...

EHRs are widely seen as a key resource in modern health care. For children not only is primary care vital, but also case-based public health systems can help ensure that all children receive immunisation and other preventive programmes. A European study showed that in 2016 in the 30 EU and EEA countries, 19 countries had widespread use of EHRs in c...

A rising global obesity epidemic in children has implications for an increase in other chronic diseases and a negative social impact, which should not be ignored. A useful resource in this context could be eHealth due to its popularity amongst children. Additionally, telephone guidance is also considered a powerful health promotion tool. The aim of...

Models of child primary health care vary across Europe. There are three categories, primary care paediatricians, general practitioner based, or mixed. This paper describes the metadata schema used in the profiling process of candidate data sources for appraisal for the Models of Child Health Appraised (MOCHA) project using the MOCHA International R...

Assessing National Practice and Preparedness for Integrated Care Delivery Ireland Debbie Keeling, Michael Rigby, Áine Carroll Introduction/Theory/Methods We assess current attitudes, practice and preparedness for Integrated Care (IC) delivery within the publicly-funded health and care services in Ireland. We utilise the framework developed within...

Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data. Method: Working Group review of selected literature and policy approaches. Re...

The MOCHA project will appraise the differing models of child health that are used across Europe. Germany is represented by the research section Child Public Health of the University Medical Center Hamburg-Eppendorf.

Background and aims Primary care is an essential part of paediatric practice and children’s health services in any country. In higher income countries and many middle-income countries e-health and digital records are seen as a key part of an effective and safe health system. The Models Of Child Health Appraised (MOCHA) project (www.childhealthservi...

Background and aims One of the main objectives of the ?Models of Child Health Appraised (MOCHA) project ?(www.?childhealthservicemodels.eu) is to appraise the existing primary child health care system models in 30 European countries. In each country routine screening and physical examinations are used to monitor how a child grows and develops, and...

Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data. Method: Working Group review of selected literature and policy approaches....

Introduction The aim of this paper is to report on the development of surveys to explore integration of care for children living with complex care needs across the European Union (EU) and European Economic Area (EEA). Theory and methods Each survey consists of a vignette and questions adapted from the Standards for Systems of Care for Children and...

Harnessing the power of IT solutions in child primary care requires strategic thought at national level, and good health care delivery needs this support. The aim of this study was to investigate whether children's needs are considered in national e-health strategies in Europe. In 2016, a survey was carried out in all 28 European Member States plus...