Exploring end-user perceptions towards mandated deployment of PDA-based health information systems within Ambulatory Care

The impact of many well intentioned technology integration projects has not always been viewed favourably. In fact, many projects are destined to fail from the outset by not considering fundamental IT system inves tment risks (technical failure, data failure, user failure, organizational failure) [Lyytinen & Hirschiem, 1987]. With any new technology ‘an element of uncertainty exists in the minds of decision makers with respect to the successful adoption of them’ [Bagozzi et al, 1992]. Uncertainty towards adopting new technologies is not solely the domain of decision makers. Apart from chief technology and information officers, system administrators and help desk personnel, those who ultimately feel the greatest impac t and transformation upon work practices from any newly adopted technology application or process are end-users. In mandated technology integration environments, impressions may exist whereby any form of consultative input from end-users is inherently removed, leaving end-users disillusioned with the mandated technology. This research uses an adapted version of Kline’s Groupware Adoption Scale [Kline, 2001] in a preliminary study to ascertain end-user perceptions towards the proposed mandated implementation of a PDA-based point-of-care information system (ePOC) in The Ambulatory Care Team (TACT), Northern Illawarra, South Eastern Sydney Illawarra Health Service

Wireless body sensor networks for health-monitoring applications

This is an author-created, un-copyedited version of an article accepted for publication in Physiological Measurement. The publisher is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at http://dx.doi.org/10.1088/0967-3334/29/11/R01

Enhancing User Acceptance of Mandated Technology Implementation in a Mobile Healthcare Setting: A Case Study

A paradigm shift is underway towards the acceptance and utility of Personal Digital Assistant (PDA) systems within mobile-based healthcare environments. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a ‘best fit’ with end user needs. It is envisaged this research will lead to the development of a framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a proposed mandated electronic point-of-care (ePOC) information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented

Optimising User Acceptance of Mandated Mobile Health Systems (MHS): The ePOC (Electronic Point-of-Care) Project Experience

From a clinical perspective, the use of mobile technologies such as Personal Digital Assistants (PDAs) within hospital environments is not new. A paradigm shift however, is underway towards the acceptance and utility of such systems within community-based healthcare environments. Notwithstanding, introducing new technologies and associated work practices has intrinsic risks which must be addressed. In situations where end-users of a system are traditionally averse to technology through entrenched paper-based work practices (for example, community health workers), the process of managing change bears considerable determination in system implementation success. The authors propose a novel approach to end user acceptance within the context of a mandated mobile health system in a community health setting. The ePOC (electronic point-of-care) project is used to demonstrate how higher levels of user acceptance are achievable in these implementation environments where traditionally low levels of technology acceptance and use are common

The INCA System: A Further Step Towards a Telemedical Artificial Pancreas

Biomedical engineering research efforts have accomplished another level of a ldquotechnological solutionrdquo for diabetes: an artificial pancreas to be used by patients and supervised by healthcare professionals at any time and place. Reliability of continuous glucose monitoring, availability of real-time programmable insulin pumps, and validation of safe and efficient control algorithms are critical components for achieving that goal. Nevertheless, the development and integration of these new technologies within a telemedicine system can be the basis of a future artificial pancreas. This paper introduces the concept, design, and evaluation of the ldquointelligent control assistant for diabetes, INCArdquo system. INCA is a personal digital assistant (PDA)-based personal smart assistant to provide patients with closed-loop control strategies (personal and remote loop), based on a real-time continuous glucose sensor (Guardian RT, Medtronic), an insulin pump (D-TRON, Disetronic Medical Systems), and a mobile general packet radio service (GPRS)-based telemedicine communication system. Patient therapeutic decision making is supervised by doctors through a multiaccess telemedicine central server that provides to diabetics and doctors a Web-based access to continuous glucose monitoring and insulin infusion data. The INCA system has been technically and clinically evaluated in two randomized and crossover clinical trials showing an improvement on glycaemic control of diabetic patients

Wearable feedback systems for rehabilitation

In this paper we describe LiveNet, a flexible wearable platform intended for long-term ambulatory health monitoring with real-time data streaming and context classification. Based on the MIT Wearable Computing Group's distributed mobile system architecture, LiveNet is a stable, accessible system that combines inexpensive, commodity hardware; a flexible sensor/peripheral interconnection bus; and a powerful, light-weight distributed sensing, classification, and inter-process communications software architecture to facilitate the development of distributed real-time multi-modal and context-aware applications. LiveNet is able to continuously monitor a wide range of physiological signals together with the user's activity and context, to develop a personalized, data-rich health profile of a user over time. We demonstrate the power and functionality of this platform by describing a number of health monitoring applications using the LiveNet system in a variety of clinical studies that are underway. Initial evaluations of these pilot experiments demonstrate the potential of using the LiveNet system for real-world applications in rehabilitation medicine

Mobihealth: mobile health services based on body area networks

In this chapter we describe the concept of MobiHealth and the approach developed during the MobiHealth project (MobiHealth, 2002). The concept was to bring together the technologies of Body Area Networks (BANs), wireless broadband communications and wearable medical devices to provide mobile healthcare services for patients and health professionals. These technologies enable remote patient care services such as management of chronic conditions and detection of health emergencies. Because the patient is free to move anywhere whilst wearing the MobiHealth BAN, patient mobility is maximised. The vision is that patients can enjoy enhanced freedom and quality of life through avoidance or reduction of hospital stays. For the health services it means that pressure on overstretched hospital services can be alleviated

A Mobile ECG Monitoring System with Context Collection

An objective of a health process is one where patients can stay healthy with the support of expert medical advice when they need it, at any location and any time. An associated aim would be the development of a system which places increased emphasis on preventative measures as a first point of contact with the patient. This research is a step along the road towards this type of preventative healthcare for cardiac patients. It seeks to develop a smart mobile ECG monitoring system that requests and records context information about what is happening around the subject when an arrhythmia event occurs. Context information about the subject’s activities of daily living will, it is hoped, provide an enriched data set for clinicians and so improve clinical decision making. As a first step towards a mobile cardiac wellness guidelines system, the focus of this work is to develop a system that can receive bio-signals wirelessly, analyzing and storing the bio-signal in a handheld device and can collect context information when there are significant changes in bio-signs. For this purpose the author will use a low cost development environment to program a state of the art wireless prototype on a handheld computer that detects and responds to changes in the heart rate as calculated form the interval between successive heart beats. Although the general approach take in this work could be applied to a wide range of bio-signals, the research will focus on ECG signals. The pieces of the system are, A wireless receiver, data collection and storage module An efficient real time ECG beat detection algorithm A rule based (Event-Condition-Action) interactive system A simple user interface, which can request additional information form the user. A selection of real-time ECG detection algorithms have been investigated and one algorithm was implemented in MATLAB [110] and then in Java [142] for this project. In order to collect ECG signals (and in principle any signals) the generalised data collection architecture has also been developed utilizing Java [142] and Bluetooth [5] technology. This architecture uses an implementation of the abstract factory pattern [91] to ensure that the communication channel can be changed conveniently. Another core part of this project is a “wellness” guideline based on Event-Condition-Action (E-C-A) [68] production rule approach that originated in active databases. The work also focuses on design of a guideline based expert system which an E-C-A based implementation will be fully event driven using the Java programming language. Based on the author’s experience and the literature review, some important issues in mobile healthcare along with the corresponding reasons, consequences and possible solutions will be presented

Impact of Mobile and Wireless Technology on Healthcare Delivery services

Modern healthcare delivery services embrace the use of leading edge technologies and new scientific discoveries to enable better cures for diseases and better means to enable early detection of most life-threatening diseases. The healthcare industry is finding itself in a state of turbulence and flux. The major innovations lie with the use of information technologies and particularly, the adoption of mobile and wireless applications in healthcare delivery [1]. Wireless devices are becoming increasingly popular across the healthcare field, enabling caregivers to review patient records and test results, enter diagnosis information during patient visits and consult drug formularies, all without the need for a wired network connection [2]. A pioneering medical-grade, wireless infrastructure supports complete mobility throughout the full continuum of healthcare delivery. It facilitates the accurate collection and the immediate dissemination of patient information to physicians and other healthcare care professionals at the time of clinical decision-making, thereby ensuring timely, safe, and effective patient care. This paper investigates the wireless technologies that can be used for medical applications, and the effectiveness of such wireless solutions in a healthcare environment. It discusses challenges encountered; and concludes by providing recommendations on policies and standards for the use of such technologies within hospitals

The Use of Information Systems in Health Care Practice

Information systems are now the basis of the operation of each unit in health care. This paper describes the objectives and benefits of the introduction of new technologies in information systems and examples of practical use of the systems in Poland and worldwide. In the paper chosen programs used to monitor patient's health status and their usefulness to professionals have been described. The inherent savings, which are brought by the computerization of healthcare facilities, have been pointed out as well as the contribution of European Union funds in financing the programs.Systemy informacyjne stanowią obecnie podstawę funkcjonowania każdej jednostki w ochronie zdrowia. W pracy opisano cele i korzyści z wprowadzania nowych technologii w systemach informacyjnych oraz przykłady praktycznego wykorzystanie systemów w Polsce i na świecie. Opisano wybrane programy monitorujące stan zdrowia pacjenta oraz ich przydatność dla profesjonalistów. Wskazano na oszczędności, jakie niesie ze sobą informatyzacja placówek ochrony zdrowia oraz udział środków z Unii Europejskiej w finansowaniu programów