Telehealth and Mobile Health Applied To IntegratedBehavioral Care: OpportunitiesFor Progress In New Hampshire

This paper is an accompanying document to a webinar delivered on May 16, 2017, for the New Hampshire Citizens Health Initiative (Initiative). As integrated behavioral health efforts in New Hampshire gain traction, clinicians, administrators, payers, and policy makers are looking for additional efficiencies in delivering high quality healthcare. Telehealth and mobile health (mHealth) have the opportunity to help achieve this while delivering a robust, empowered patient experience. The promise of video-based technology was first made in 1964 as Bell Telephone shared its Picturephone® with the world. This was the first device with audio and video delivered in an integrated technology platform. Fast-forward to today with Skype, FaceTime, and webinar tools being ubiquitous in our personal and business lives, but often slow to be adopted in the delivery of medicine. Combining technology-savvy consumers with New Hampshire’s high rate of electronic health record (EHR) technology adoption, a fairly robust telecommunications infrastructure, and a predominately rural setting, there is strong foundation for telehealth and mHealth expansion in New Hampshire’s integrated health continuum

Integrating digital Health services : the role of the government and the challenge of cost allocation

eHealth, mHealth and eCare services are growing in numbers at a fast pace. This is mainly driven by technology and the societal challenges of an aging and more chronically burdened population while pressure on both human and financial resources increases. Though the adoption of these digital health services is challenging and experience difficulties. This work focusses on the main barriers that cause a 'gap' in the value network. Via case research following barriers are identified: 1) low willingness to pay, 2) unbalanced cost/benefit ratios of the actors or unfair cost allocation and 3) negative impacted business models. Furthermore the several roles of the government within the value network of digital health services are discussed and reflections and guidelines for digital health service developers are foreseen

MyAirCoach: The use of home-monitoring and mHealth systems to predict deterioration in asthma control and the occurrence of asthma exacerbations; Study protocol of an observational study

© Published by the BMJ Publishing Group Limited. Introduction Asthma is a variable lung condition whereby patients experience periods of controlled and uncontrolled asthma symptoms. Patients who experience prolonged periods of uncontrolled asthma have a higher incidence of exacerbations and increased morbidity and mortality rates. The ability to determine and to predict levels of asthma control and the occurrence of exacerbations is crucial in asthma management. Therefore, we aimed to determine to what extent physiological, behavioural and environmental data, obtained by mobile healthcare (mHealth) and home-monitoring sensors, as well as patient characteristics, can be used to predict episodes of uncontrolled asthma and the onset of asthma exacerbations. Methods and analysis In an 1-year observational study, patients will be provided with mHealth and home-monitoring systems to record daily measurements for the first-month (phase I) and weekly measurements during a follow-up period of 11 months (phase II). Our study population consists of 150 patients, aged ≥18 years, with a clinician's diagnosis of asthma, currently on controller medication, with uncontrolled asthma and/or minimally one exacerbation in the past 12 months. They will be enrolled over three participating centres, including Leiden, London and Manchester. Our main outcomes are the association between physiological, behavioural and environmental data and (1) the loss of asthma control and (2) the occurrence of asthma exacerbations. Ethics This study was approved by the Medical Ethics Committee of the Leiden University Medical Center in the Netherlands and by the NHS ethics service in the UK. Trial registration number NCT02774772

Private Enterprise for Public Health: Opportunities for Business to Improve Women's and Children's Health

This guide, developed by FSG and published by the Innovation Working Group in support of the global Every Woman, Every Child effort, explores how companies can create shared value in women's and children's health. The document sets out opportunities for multiple different industries to develop new product and services, improve delivery systems and strengthen health systems that can support global efforts to save 16 million women's and children's lives between now and 2015. It particularly notes that companies need not wait for health services to "catch up" with their economic model, but rather they can work proactively to help accelerate change, by partnering with other industries, civil society and the public sector to create collective impact in a specific location. The aim of the guide is to catalyze these transformative partnerships

Influence of Smartphone Diabetic Messaging on HbA1c

Associated personal, financial, and societal costs of a diagnosis of Type 2 Diabetes Mellitus impacted over 22 million Americans at a cost of over $245 billion in 2012. The project provided evidence-based outcomes that demonstrated improved HbA1c levels in the intervention group and positive feedback on diabetes related text messages. Ongoing opportunities are available to expand text messaging within the physician network; the potential for replication studies; and the feasibility and effectiveness of text messaging for improving engagement in managing people with T2DM health are also findings within the study

Holistic System Design for Distributed National eHealth Services

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Personalized Pain Study Platform Using Evidence-Based Continuous Learning Tool

With the increased accessibility to mobile technologies, research utilizing mobile technologies in medical and public health area has also increased. The efficiency and effectiveness of healthcare services are also improved by introduction of mobile technologies. Effective pain treatment requires regular and continuous pain assessment of the patients. Mobile Health or mHealth has been an active interdisciplinary research area for more than a decade to research pain assessment through different software research tools. Different mHealth support systems are developed to assess pain level of patient using different techniques. Close attention to participant’s self- reported pain along with data mining based pain level detection could help the healthcare industry and researchers to deliver effective health services in pain treatment. Pain expression recognition can be a good way for data mining based approach though pain expression recognition itself may utilize different approach based on the research study scope. Most of the pain research tools are study or disease specific. Some of the tools are pain specific (lumber pain, cancer pain etc) and some are patient group specific (neonatal, adult, woman etc). This results in recurrent but potentially avoidable costs such as time, money, and workforce to develop similar service or software research tools for each research study. Based on the pain study research characteristics, it is possible to design and implement a customizable and extensible generic pain research tool. In this thesis, we have proposed, designed, and implemented a customizable personalized pain study platform tool following a micro service architecture. It has most of the common software research modules that are needed for a pain research study. These include real-time data collection, research participant management, role based access control, research data anonymization etc. This software research tool is also used to investigate pain level detection accuracy using evidence-based continuous learning from facial expression which yielded about 71% classification accuracy. This tool is also HIPAA compliant and platform independent which makes it device independent, privacy-aware, and security-aware

mHealth Support System for Researchers and Participants

With the proliferation of mobile technologies, there is a significant increase of research using mobile devices in the medical and public health area. Mobile technology has improved the efficiency of healthcare delivery effectively. Mobile Health or mHealth is an interdisciplinary research area which has been active for more than a decade. Much research has been conducted and many software research tools (mHealth Support System) have been developed. Despite the time length, there is a significant gap in the mHealth research area regarding software research tools. Individual research groups are developing their own software research tool though there is a significant similarity among them. Most of the research tools are study or disease specific. Some of the tools are device specific (desktop/laptop, mobile phone, and tablet) and some are platform specific (web, android, iOS, and windows). This costs each research study their precious time, money, and workforce to develop similar service or software research tools. Based on the mHealth research characteristics, it is possible to design and implement a customizable generic software research tool. In this thesis, we have proposed, designed, and implemented a customizable generic mHealth software research tool. It has most of the common software research modules that are needed for an mHealth research study. These include real-time data collection, research participant management, research staff management, role based access control, research data anonymization, customizable surveys, report generation, study forum, and activity tracking. This software research tool is responsive and HIPAA compliant which makes it device independent, privacy-aware, and security-aware