Adoption of speech recognition technology in community healthcare nursing

© 2016 IMIA and IOS Press. Adoption of new health information technology is shown to be challenging. However, the degree to which new technology will be adopted can be predicted by measures of usefulness and ease of use. In this work these key determining factors are focused on for design of a wound documentation tool. In the context of wound care at home, consistent with evidence in the literature from similar settings, use of Speech Recognition Technology (SRT) for patient documentation has shown promise. To achieve a user-centred design, the results from a conducted ethnographic fieldwork are used to inform SRT features; furthermore, exploratory prototyping is used to collect feedback about the wound documentation tool from home care nurses. During this study, measures developed for healthcare applications of the Technology Acceptance Model will be used, to identify SRT features that improve usefulness (e.g. increased accuracy, saving time) or ease of use (e.g. lowering mental/physical effort, easy to remember tasks). The identified features will be used to create a low fidelity prototype that will be evaluated in future experiments

Technology and Caregiving: Emerging Interventions and Directions for Research.

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities

Pick-n-mix approaches to technology supply : XML as a standard “glue” linking universalised locals

We report on our experiences in a participatory design project to develop ICTs in a hospital ward working with deliberate self-harm patients. This project involves the creation and constant re-creation of sociotechnical ensembles in which XML-related technologies may come to play vital roles. The importance of these technologies arises from the aim underlying the project of creating systems that are shaped in locally meaningful ways but reach beyond their immediate context to gain wider importance. We argue that XML is well placed to play the role of "glue" that binds multiple such systems together. We analyse the implications of localised systems development for technology supply and argue that inscriptions that are evident in XML-related standards are and will be very important for the uptake of XML technologies

Supernurse:Nurses' workarounds informing the design of interactive technologies for home wound care

The increasing aging population needing homecare is leading to additional clinical work for homecare nurses. Wound care and documentation are substantial components of this work required to monitor patients and make appropriate clinical decisions. However, due to barriers in the systems that nurses are expected to use, and context of their activities, they create and use workarounds to get their job done. In this study, the most common themes of workarounds were identified and used to inform design iterations of a wound documentation application: SuperNurse. The exploratory and experimental design iterations involved homecare nurses, who expressed: curiosity, leading to further reflection; frustration, leading to identifying problems; and surprise, leading to identifying useful and easy to use designs. We found that nurse-centred design, informed by workarounds, led to using mobile, wearable, and speech recognition technology and improving ease of use and usefulness in SuperNurse

Sustainability and Spread of Community-based Initiatives: A case study of Community Cares, a Children’s Hospital’s 16 year effort to serve its community

The sustainability and spread of innovations is often elusive, presenting continuous challenges to clinicians and healthcare leaders. Somewhere between 33 - 70% of all innovations are reportedly not sustained, and even fewer are spread beyond the original team, or to other units within an organization. In plain language, sustainability is defined as locking in progress, while continually building upon that foundation, while spread is the exchange of knowledge and experience to others beyond the original implementing team. The literature supports the concept that sustainability is both multi-dimensional and multi-factorial and has several characteristics and pre-conditions. Tax-exempt, not-for-profit organizations in the USA must provide measurable community benefits to the populations they seek to serve. Many of these community benefits take the form of locating necessary services closer to or directly within the communities being served in order to enhance access. A case study of a 16 year effort to provide a medical home-oriented primary care model to underserved children in Houston, Texas Children’s Pediatrics’ Community Cares, is presented as illustrative of such a community benefit. Many of the characteristics and preconditions essential to a model for sustainability and spread are highlighted and the Community Cares case study is discussed from the standpoint of this framework