Abstract
Purpose: The use of digital health technologies (DHT) combined with digital nudging is rapidly growing. Digital nudges have the potential to impact patient treatment, safety, and management. DHTs such as mobile applications in combination with smartwatches and other self-trackers can increase the quality of life of patients. Although digital nudges have been explored and studied in the context of treatment, there is a need to further explore how DHT that rely on digital nudges can be utilized in healthcare settings and if they are effective. Considering that, there is a need for a systematic literature review on the topic. We synthesize research on how digital nudging is utilized to enhance DHTs by addressing the research question: “How can digital nudges be used within digital health technologies in healthcare settings to support patient treatment, safety, and management?” The approach was to systematically analyze the use of digital nudging within the domain of healthcare settings. Methods: A systematic review based on the PRISMA guidelines was conducted by searching the following databases: Scopus, PubMed, ACM Digital Library, Web of Science, and IEEE Xplore. In total, there were 3655 papers after excluding duplicates. Through a selection process, we arrived at 151 peer-reviewed papers that were read after which the last inclusion step in the systematic review yielded 62 papers that were included in the analysis. Results: First, we classified these contributions across established digital nudging categories as well as summarizing the main characteristics of the DHTs. Second, our findings indicated that digital nudging within DHTs were prominently used for patients in the healthcare settings of (i) metabolic and physical activity, (ii) treatment adherence, (iii) addiction disease, (iv) rehabilitation, (v) mental health, and (vi) children’s health. Third, we showed that digital nudges are effective in some healthcare settings when applied to DHTs. They can support the treatment and management of patients where the goal is an improved lifestyle, i.e. more exercise, weight loss, less drinking and smoking. They support documentation and therefore patient safety in the adherence to treatment and mental health interventions. Conclusions: In this paper, we show that digital nudges are used in various ways within DHTs to address patient treatment, safety, and management. There is a need to further explore opportunities for digital nudges for the rehabilitation of patients and successful methods for working with children. There is a need to carefully consider that digital nudges embedded into DHTs are powerful and should be used responsibly with vulnerable users such as patients and children. The main contribution is an in-depth analysis of the literature that engages with the intersection between digital nudging and digital health technologies.
