# Developing a Best Practice Guideline for Clinical Practice in a Digital Health Environment: Systematic Reviews Based on the Grading of Recommendations, Assessment, Development, and Evaluation Approach

## TL;DR

This paper presents a best practice guideline for integrating digital health technologies into clinical practice, based on systematic reviews and expert consensus.

## Contribution

The novel contribution is the development of evidence-based recommendations for digital health adoption using the GRADE approach.

## Key findings

- Four evidence-based recommendations were developed for nurses and health providers on digital health integration.
- One systematic review found insufficient evidence to support a recommendation.
- The GRADE approach ensured alignment with international reporting standards.

## Abstract

Digital health refers to the field of knowledge and practice associated with the development and use of digital technologies to improve clinical practice and health outcomes. Knowledge of digital health technology is becoming essential for all nurses and health providers.

This study aims to present the results of the systematic reviews that were used to inform the recommendations in a best practice guideline (BPG) following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Reviews focused on digital health education for nurses and health providers, peer champion models, and the use of predictive analytics in digital health environments.

The BPG team, in collaboration with a panel of 17 experts, conducted 5 systematic reviews to address 5 recommendation questions. Systematic searches looked for relevant studies published in English from January 2017 to July 2022 from 10 databases. The GRADE approach was used to synthesize and evaluate the quality of evidence, ensuring the guideline aligned with international reporting standards.

A total of 18 articles across 4 systematic reviews met the inclusion criteria. From these reviews, 4 corresponding recommendations were drafted for nurses and health providers. The strength of the recommendations was determined through discussion and consensus by the expert panel using the GRADE approach. Among all, 1 systematic review resulted in no recommendation due to insufficient evidence.

The BPG on digital health provides 4 evidence-based recommendations for nurses and health providers on how to incorporate digital health technologies into clinical practice. This BPG is intended to be used across all health care settings.