Technical Development and Clinical Evaluation of Intelligent Continence Management System at Nursing Home

International audienceUrinary incontinence and diaper use is common among elderly people with dementia staying at nursing homes. Delays in timely diaper change will cause personal, social and economic ramifications to those elderly as well as to the carers who provide nursing care. In order to alleviate these daily care issues, an intelligent continence management system leveraging on sensors, pervasive sensor network, ambient intelligence and reminders is designed and developed. Clinical trial is conducted with multiple elderly people with dementia at a nursing home to evaluate the applicability and usefulness of the developed system. The analysis of trial outcomes and usability studies proves that this will be a feasible and effective approach to tackle the problems faced in managing incontinence effectively at nursing home

Master of Science

thesisThe Residency Review Committee (RRC) requires that general surgery residents document their Surgical Intensive Care Unit (SICU) experiences. To satisfy these requirements we created a web based intranet log to make it easier for residents to track their patients and determine when these requirements were complete. A premium was put on usability to promote acceptance by surgical residents. A prototype web site was designed with input from an attending general surgeon. Three general surgery residents were selected to participate in the iterative design phase. They went through three iterations using a "think-aloud" method while performing tasks on the prototype web site. Each iteration led to improvements to the web site. In a comparison test, a group of seven medical students performed 14 typical web site tasks using both the prototype and the final versions. They were asked to complete a Questionnaire for User Interaction Satisfaction (QUIS) for each version. The time for completion of these tasks was also recorded. The user interaction satisfaction did not show any improvement (F(1,6)=0.13, p=0.912). Similarly, there was no improvement in times for delete and add tasks ( Delete F(1,5) = 0.949, p=0.375, Add F(1,5)=0.267, p=0.628 ); however, the time to complete edit tasks was faster for the final version of the web site (F (1,5)= 14.3, p=0.013). The primary reason for not detecting other differences between the two web sites is likely that the comparison study did not have sufficient power. This was suggested by the participants whose comments favored the final version over the prototype as well as a trend of consistently higher mean subset scores in the final version. The results indicate that differences may be seen when more complex tasks are completed (editing information) versus the two simpler tasks (adding or deleting a patient record in a web site). Future studies should focus on the impact of navigation strategies on speed and data warehouse approaches to creating the application. This study shows the benefits of using an iterative design approach to create a usable web site and demonstrates the importance of further research in the field of usability

Evaluation methods used on health information systems (HISs) in Iran and the effects of HISs on Iranian healthcare: a systematic review.

Objectives: The most important goal of a health information system (HIS) is improvement of quality, effectiveness and efficiency of health services. To achieve this goal, health care systems should be evaluated continuously. The aim of this paper was to study the impacts of HISs in Iran and the methods used for their evaluation. Methods: We systematically searched all English and Persian papers evaluating health information systems in Iran that were indexed in SID, Magiran, Iran medex, PubMed and Embase databases until June 2013. A data collection form was designed to extract required data such as types of systems evaluated, evaluation methods and tools. Results: In this study, 53 out of 1103 retrieved articles were selected as relevant and reviewed by the authors. This study indicated that 28 studies used questionnaires to evaluate the system and in 27 studies the study instruments were distributed within a research population. In 26 papers the researchers collected the information by means of interviews, observations, heuristic evaluation and the review of documents and records. The main effects of the evaluated systems in health care settings were improving quality of services, reducing time, increasing accessibility to information, reducing costs and decreasing medical errors. Conclusion: Evaluation of health information systems is central to their development and enhancement, and to understanding their effect on health and health services. Despite numerous evaluation methods available, the reviewed studies used a limited number of methods to evaluate HIS. Additionally, the studies mainly discussed the positive effects of HIS on health care services

Evaluation methods used on health information systems (HISs) in Iran and the effects of HISs on Iranian healthcare: a systematic review.

OBJECTIVES: The most important goal of a health information system (HIS) is improvement of quality, effectiveness and efficiency of health services. To achieve this goal, health care systems should be evaluated continuously. The aim of this paper was to study the impacts of HISs in Iran and the methods used for their evaluation. METHODS: We systematically searched all English and Persian papers evaluating health information systems in Iran that were indexed in SID, Magiran, Iran medex, PubMed and Embase databases until June 2013. A data collection form was designed to extract required data such as types of systems evaluated, evaluation methods and tools. RESULTS: In this study, 53 out of 1103 retrieved articles were selected as relevant and reviewed by the authors. This study indicated that 28 studies used questionnaires to evaluate the system and in 27 studies the study instruments were distributed within a research population. In 26 papers the researchers collected the information by means of interviews, observations, heuristic evaluation and the review of documents and records. The main effects of the evaluated systems in health care settings were improving quality of services, reducing time, increasing accessibility to information, reducing costs and decreasing medical errors. CONCLUSION: Evaluation of health information systems is central to their development and enhancement, and to understanding their effect on health and health services. Despite numerous evaluation methods available, the reviewed studies used a limited number of methods to evaluate HIS. Additionally, the studies mainly discussed the positive effects of HIS on health care services

Mobile Health Technologies

Mobile Health Technologies, also known as mHealth technologies, have emerged, amongst healthcare providers, as the ultimate Technologies-of-Choice for the 21st century in delivering not only transformative change in healthcare delivery, but also critical health information to different communities of practice in integrated healthcare information systems. mHealth technologies nurture seamless platforms and pragmatic tools for managing pertinent health information across the continuum of different healthcare providers. mHealth technologies commonly utilize mobile medical devices, monitoring and wireless devices, and/or telemedicine in healthcare delivery and health research. Today, mHealth technologies provide opportunities to record and monitor conditions of patients with chronic diseases such as asthma, Chronic Obstructive Pulmonary Diseases (COPD) and diabetes mellitus. The intent of this book is to enlighten readers about the theories and applications of mHealth technologies in the healthcare domain

Review of state of knowledge regarding the safety, access and usability needs of children with disabilities

Within European countries and the European Union, there is wide recognition that special consideration must be given to the needs of both people with disabilities and to young people. In terms of ergonomics design, consideration needs to be given to access to public buildings, safety in the home, school buildings and educational services, ability to make use of public transport, etc. This research focused on children who also have disabilities, an area that is less well understood and where it is uncertain whether standards or legislation exist. Interviews and discussions with experts were conducted to locate knowledge about design for disabled children in different contexts. This document reports the results of the research sponsored by ANEC (www.anec.org). The study identified relevant standards, legislation or guidelines within Europe and outside which could potentially be employed by the standards bodies within the European Union and promulgated more widely. The report also showed that there are gaps in knowledge indicating a requirement for further research to be carried out to generate suitable guidelines for standards bodies to consider

Health technology assessment for digital health technologies

Health technology assessment (HTA) frameworks used for making public funding decisions on digital health technologies (DHTs) have not been informed by large stakeholder preference studies and rarely cover all nine domains of the widely used EUnetHTA “Core Model”. Our aim was to develop a literature-informed and stakeholder-prioritised checklist of DHT-specific considerations for DHTs that manage chronic disease that extends an internationally established HTA framework. We conducted two systematic reviews to identify: (i) DHT evaluation frameworks and (ii) primary research on DHTs published until 20 March 2020. Stakeholder prioritisation of issues was performed using a best-worst preference study among a broad cross-section of patients, carers, health professionals, and the general population in Australia, Canada, New Zealand, and the UK. Systematic review issues were prioritised and adapted for use as a practical checklist. DHT evaluation content was recommended by 44 identified frameworks for 28 of the 145 issues in the Core Model and for 22 new DHT-specific issues. A coverage assessment of 112 clinical studies of remote treatment and self-management DHTs for patients with cardiovascular disease or diabetes revealed that less than half covered DHT-specific content in all but one domain, or traditional HTA content in clinical effectiveness and ethical analysis. The preference survey of 1,251 stakeholders identified broad agreement on the 12 most important DHT attributes, six of which were related to safety. The most important attribute was “helps health professionals respond quickly when changes in patient care are needed”, which is not a focus of existing DHT HTA frameworks. Using the thesis-developed checklist in conjunction with the Core Model can enable users to perform a DHT-specific and comprehensive HTA on DHTs that manage chronic disease and can assist primary researchers to collect appropriate data to inform this HTA

Development and evaluation of automated ultrasonographic detection of bladder diameter for estimation of bladder urine volume

Bladder urine volume has been estimated using an ellipsoid method based on triaxial measurements of the bladder extrapolated from two-dimensional ultrasound images. This study aimed to automate this process and to determine the accuracy of the automated estimation method for normal and small amounts of urine. A training set of 81 pairs of transverse and longitudinal ultrasound images were collected from healthy volunteers on a tablet-type ultrasound device, and an automatic detection tool was developed using them. The tool was evaluated using paired transverse/longitudinal ultrasound images from 27 other healthy volunteers. After imaging, the participants voided and their urine volume was measured. For determining accuracy, regression coefficients were calculated between estimated bladder volume and urine volume. Further, sensitivity and specificity for 50 and 100 ml bladder volume thresholds were evaluated. Data from 50 procedures were included. The regression coefficient was very similar between the automatic estimation (β = 0.99, R2 = 0.96) and manual estimation (β = 1.05, R2 = 0.97) methods. The sensitivity and specificity of the automatic estimation method were 88.5% and 100.0%, respectively, for 100 ml and were 94.1% and 100.0%, respectively, for 50 ml. The newly-developed automated tool accurately and reliably estimated bladder volume at two different volume thresholds of approximately 50 ml and 100 ml

A Goal-Driven Framework for Individualised Self-Care for Early-Stage Dementia

For people with early or moderate dementia, there are benefits to them continuing to live in their own homes for as long as possible, both in improved quality of life and associated measures such as increased social contact, increased physical activity and lower use of medication, and reduced costs and burden of care. Tools to help extend period of independent living, and to maintain quality of life in this period, are lacking. Systems exist to monitor individuals for problems, e.g. falls or wandering from the home, but there is scope for development of computerised support to help maintain activity in independent living. We aim to monitor achievement of activities, by app and by sensors, and provide recommendations on how to best maintain activities