Trends on integrating framework of applications or data

International audienceA lot of telemedicine applications are nowadays tested in medical situation, but the challenges underlined through the best papers selection deals on the ability of proposing integrative framework for application or data in order to handle efficiency of health and clinical management

Parental evaluation of a telemonitoring service for children with Type 1 Diabetes

Introduction In the past years, we developed a telemonitoring service for young patients affected by Type 1 Diabetes. That service provides data to the clinical staff and offers an important tool to the parents, that are able to oversee in real time their children. The aim of this work was to analyze the parents' perceived usefulness of the service. Methods The service was tested by the parents of 31 children enrolled in a seven-day clinical trial during a summer camp. To study the parents' perception we proposed and analyzed two questionnaires. A baseline questionnaire focused on the daily management and implications of their children's diabetes, while a post-study one measured the perceived benefits of telemonitoring. Questionnaires also included free text comment spaces. Results Analysis of the baseline questionnaires underlined the parents' suffering and fatigue: 51% of total responses showed a negative tendency and the mean value of the perceived quality of life was 64.13 in a 0-100 scale. In the post-study questionnaires about half of the parents believed in a possible improvement adopting telemonitoring. Moreover, the foreseen improvement in quality of life was significant, increasing from 64.13 to 78.39 ( p-value\u2009=\u20090.0001). The analysis of free text comments highlighted an improvement in mood, and parents' commitment was also proved by their willingness to pay for the service (median\u2009=\u2009200\u2009euro/year). Discussion A high number of parents appreciated the telemonitoring service and were confident that it could improve communication with physicians as well as the family's own peace of mind

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

Key Trends In Digital Health And The Future Of Clinical Trials In The Us

With the increasing burden of chronic diseases on the global population, many stakeholders see digital health technologies and devices as potential solutions to improve patient self-management of their disease and offer novel treatment methods. Digital health solutions including mobile apps, web-based programs, texting, and connected devices have been applied to a wide variety of diseases. In recent years, interest in digital health technologies has exploded with almost 200 digital health related articles published in PubMed in 2019 alone. In particular, digital health holds great potential in improving and enhancing the traditional clinical trial by increasing patient recruitment and retention and introducing novel assessment and collection methods that shift clinical trials from the physical site to the patients’ home. Digital health is poised to fundamentally shift how clinical trials are conducted. However, serious challenges from potential regulatory restrictions and data privacy issues will need to be addressed before patients, physicians, and other stakeholders can fully realize the benefits of digital health

A Systems-Based Patient Aid Design Artifact for Active Medication Management in Type 2 Diabetes

In this dissertation, I explore the use of the Abstraction-Decomposition Space (ADS) alongside Hierarchical Task Analysis (HTA) to guide the design of a minimalist patient aid for active medication management in type 2 diabetes. The goal is to address a practical problem, but in addition, this study seeks to address a theoretical problem that is prevalent in design research in Information Systems (IS) today. The practical problem concerns the need for IT-based care delivery models to support patients in the interim period between in-person visits. In this vein, I present a bare-minimum design that focuses on the most essential functionality required to achieve remote insulin titration using the ADS and HTA. The theoretical problem, on the other hand, pertains to the limitations resulting from taking a tool-focused view in design research which inhibits our ability to produce generalized knowledge about IT systems in their contexts. The study proposes an alternative view based on work systems. The overarching thesis is that a work systems view provides for knowledge at a more abstract and generalizable level, yielding contributions beyond mere software packages. Moreover, the study highlights the artifact-building methodology used to delineate the rationale behind the design and to balance evaluation-dominant design research. In this vein, I conducted document analysis and semi-structured interviews with patients and care providers to develop the ADS, then used it alongside HTA to develop and test the usability of twelve user scenarios implemented on a large mobile form factor

ISPAD Clinical Practice Consensus Guidelines 2022: The delivery of ambulatory diabetes care to children and adolescents with diabetes

info:eu-repo/semantics/publishedVersio

Intelligent Remote Monitoring and Management system for Type1 Diabetes

The work presented in this thesis focuses on developing a telemedicine system for better management of type1 diabetes in children and teenagers. The research and development of the system is motivated by the inadequate communication in the current system of management of the disease, which results in non-compliance of patients following the regimen. This non-compliance generally results in uncontrolled blood glucose levels, which can result in hypoglycaemia, hyperglycaemia and later life health complications. This further results in an increase in health care costs. In this context, the thesis presents a novel end-to-end, low cost telemedicine system, WithCare+, developed in close collaboration between the University of Sheffield (Electronics & Electrical Engineering) and Sheffield Children’s Hospital. The system was developed to address the challenges of implementing modern telemedicine in type 1 diabetic care with particular relevance to National Health Service children’s clinics in the United Kingdom, by adopting a holistic care driven approach (involving all stakeholders) based on specific key enabler technologies such as low cost and reconfigurable design. However, one of the major issues with current telemedicine system is non-compliance of the patients due to invasive procedure of the glucose measurement which could be clearly addressed by non-invasive method of glucose measurement. Hence, the thesis also makes a contribution towards non-invasive glucose measurement using Near Infrared spectroscopy in terms of addressing the calibration challenge; two methods are proposed to improve the calibration of the Near Infrared instrument. The first method combines locally weighted regression and partial least square regression and the second method combines digital band pass filtering with support vector regression. The efficacy of the proposed methods is validated in experiments carried out in a non-controlled environment and the results obtained demonstrate that the proposed methods improved the performance of the calibration model in comparison to traditional calibration techniques such as Principal Component Regression and Partial Least Squares regression

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

Antepartum Fetal Monitoring through a Wearable System and a Mobile Application

Prenatal monitoring of Fetal Heart Rate (FHR) is crucial for the prevention of fetal pathologies and unfavorable deliveries. However, the most commonly used Cardiotocographic exam can be performed only in hospital-like structures and requires the supervision of expert personnel. For this reason, a wearable system able to continuously monitor FHR would be a noticeable step towards a personalized and remote pregnancy care. Thanks to textile electrodes, miniaturized electronics, and smart devices like smartphones and tablets, we developed a wearable integrated system for everyday fetal monitoring during the last weeks of pregnancy. Pregnant women at home can use it without the need for any external support by clinicians. The transmission of FHR to a specialized medical center allows its remote analysis, exploiting advanced algorithms running on high-performance hardware able to obtain the best classification of the fetal condition. The system has been tested on a limited set of pregnant women whose fetal electrocardiogram recordings were acquired and classified, yielding an overall score for both accuracy and sensitivity over 90%. This novel approach can open a new perspective on the continuous monitoring of fetus development by enhancing the performance of regular examinations, making treatments really personalized, and reducing hospitalization or ambulatory visits. Keywords: tele-monitoring; wearable devices; fetal heart rate; telemedicin

Success and failure in eHealth

Introduction In the field of eHealth, there seems to be a gap between promising research and clinical reality. This master thesis aims to give insight in patterns that can be found regarding the possible outcome in terms of success and/or failure. An in-depth review of workflow will be done, to get an understanding of the implications of eHealth on workflow. Methods Using a systematic article search, papers have been collected regarding the subject of this thesis. Through multiple search strategies, one final search string has been formulated. This final search string led to 903 papers. These papers have been assessed on relevance using qualitative methods. This resulted in 258 papers, which have been categorised by topic, entity and success or failure. After categorisation, the topic of workflow has been selected for an additional in-depth full-text review. Results The categorisation led to 27 categories. The categories are separated among the following entities: patient, health professional, health system and all. The first three have been separated in terms of success and failure as well. This led to a quantitative overview of different categories, for different actors in terms of success and failure. Workflow appeared to be essential for the possible success or failure of eHealth implementations. It is important to include workflow in the design of the tool as well. Conclusion Different categories show a unique combination in success and failure, and to what entity they belong. The category costs appeared to be mostly based on the health system and is attributed to failure. Therefore it is a pre-requisite for the implementation of eHealth. Other categories like quality healthcare and user expectations seem to target on success. The category legal was smaller than anticipated, which could have been caused by categories that are closely linked to each other