Background: Health interventions delivered by digital platforms are gaining popularity and are evolving to address the needs of patients with chronic diseases. The heterogeneity of chronic diseases requires that digital health platforms vary in their approaches to chronic disease management. Objective: This review aimed to explore the characteristics of digital health platforms and the corresponding digital interventions developed to support patients with chronic diseases. This includes those platforms’ design, development, and the metrics by which any incremental benefits they provide are assessed. Methods: We searched electronic databases including Scopus, Web of Science, PsycINFO, IEEE Xplore, MEDLINE, and Embase. Relevant articles published from January 2013 to November 2024 were extracted. Extracted data were then synthesized using qualitative content analysis and presented in narrative form with relevant tables. Results: In total, we identified 69 digital health platforms supporting the management of 20 chronic diseases. Most platforms were mobile apps (n=22) or a combination of web and mobile apps (n=15). Most of the platforms (n=44) were tailored to support self-management of chronic diseases. These platforms also provided a web-based portal where health care providers could review and manage the information recorded by patients. In 77% (53/69) of the studies, patients reported that the digital interventions delivered by the platform improved their quality of life, their health, and their ability to self-manage their chronic diseases. In addition, health care providers reported positive outcomes, including improved clinical utility and patient communication. While short-term health outcomes of the digital health interventions were largely positive, long-term health outcomes remain unknown. This was because most of the studies were short-term pilots and often formative in nature (n=42). Many had limited sample sizes, limited participant uptake of the digital platforms, and technical issues. In many cases, further personalization of platforms was required to meet patients’ self-management needs. Conclusions: Digital health interventions can be beneficial in the management of chronic disease. The adoption of digital interventions in combination with regular clinical care can improve health outcomes, support self-management, and enhance communication between patients and health care providers. However, long-term user engagement is the major barrier to their long-term success. High dropout rates, often resulting from a lack of motivation or technical issues, testify to the need for adaptive, low-burden interventions that function seamlessly in users’ daily lives. Adopting user-centered and co-design approaches that engage both clinicians and patients in designing digital health platforms may enhance the usability and uptake of such platforms.

Personal Breast Cancer (BC) Risk Assessments (PBCRA) have potential to stratify women into clinically-actionable BC risk categories. As this could involve population-wide genomic testing, women’s attitudes to PBCRA and views on acceptable implementation platforms must be considered to ensure optimal population participation. We explored these issues with 31 women with different BC risk profiles through semi-structured focus group discussions or interviews. Inductive thematic coding of transcripts was performed. Subsequently, women listed factors that would impact on their decision to participate. Participants’ attitudes to PBCRA were positive. Identified themes included that PBCRA acceptance hinges on result actionability. Women value the ability to inform decision-making. Participants reported anxiety, stress, and genetic discrimination as potential barriers. The age at which PBCRA was offered, ease of access, and how results are returned held importance. Most women value the opportunity for PBCRA to inform increased surveillance, while highlighting hesitance to accept reduced surveillance as they find reassurance in regular screening. Women with BRCA pathogenic variants value the potential for PBCRA to identify a lower cancer risk and potentially inform delayed prophylactic surgery. This study highlights complexities in adopting advances in BC early detection, especially for current users who value existing processes as a social good.

Key Points: We evaluated a hub and spoke mainstreaming model to enable nephrologists to order genomic tests independently in their clinic across the state of Victoria. Over 1000 tests were ordered, with the diagnostic yield remaining similar regardless of ordered by local nephrologists or tertiary genomics services. A mainstreaming model proved feasible, scalable, and clinically effective, offering a practical framework for integrating genomics to routine kidney care. Background: Genomic testing has substantial diagnostic and clinical value in nephrology, yet integrating testing into routine care requires service-level changes to ensure timely and equitable access. Methods: We conducted an observational cohort study at four tertiary centers, with a pragmatic, quasi-experimental design to evaluate evidence-informed, service-level interventions to make genomic testing more accessible and routinely embedded within nephrology practice. We implemented a hub and spoke model which provided nephrologists with training, practical resources, and regular case-based discussions, to support test ordering and interpretation within their own clinics. Laboratory audits (June 2021–July 2024) evaluated how public reimbursement and implementation interventions influenced testing patterns. Three periods were compared: prefunding, postfunding, and postintervention. Results: Across the study period, 1028 genomic tests were ordered (63% adults, 37% children; median age 32 years). Results were available for 1014 tests, with an overall diagnostic yield of 34%, which remained stable across all time points. The diagnostic yield was similar regardless of whether testing occurred at tertiary genomics services (249 of 772, 32%) or via local nephrologists (92 of 242, 38%). The number of unique providers ordering tests was higher (T1: 37, T2: 69, T3: 87). The proportion of testing in mainstream nephrology settings rose from 23% to 74%, while absolute testing numbers in multidisciplinary clinics remained consistent over the study period. Conclusion: Mainstreaming genomic testing in nephrology was feasible, scalable, and clinically effective. This model was associated with better access without compromising diagnostic yield and provides a practical framework for integrating genomic medicine into routine kidney care.