17,469 research outputs found
`Everyone is a winner, help is just a push of a button away. . . ' : the Telecare Plus service in Malta
This paper reports on a research study
on the role of assistive technologies in later life. Re-
search questions included what is the impact of assistive technologies on the quality of life of older service-users, and to what extent does assistive technology lead
to an improved quality of life for subscribers and in-
formal carers? The chosen method of enquiry was a
case-study of the Telecare Plus service in Malta. A total
of 26 semi-structured interviews were held with a convenience sample of 26 people aged 60-plus about their
use and experience of this particular telecare system.
The Telecare Plus service was found to contribute positively to subscribers' levels of emotional and physical
wellbeing, interpersonal relations and personal develop-
ment, as well as towards the quality of life of informal
carers. However, research also highlighted a range of
challenges that stood in the way of increased adoption
rates of the Telecare Plus service by older people. The
fact that the fi eld of assistive technologies in Malta lacks
effi cient and clear business models constitutes another
barrier towards the take up of such services.peer-reviewe
Patient and provider acceptance of telecoaching in type 2 diabetes : a mixed-method study embedded in a randomised clinical trial
Background: Despite advances in diagnosis and treatment of type 2 diabetes, suboptimal metabolic control persists. Patient education in diabetes has been proved to enhance self-efficacy and guideline-driven treatment, however many people with type 2 diabetes do not have access to or do not participate in self-management support programmes. Tele-education and telecoaching have the potential to improve accessibility and efficiency of care, but there is a slow uptake in Europe. Patient and provider acceptance in a local context is an important precondition for implementation. The aim of the study was to explore the perceptions of patients, nurses and general practitioners (GPs) regarding telecoaching in type 2 diabetes.
Methods: Mixed-method study embedded in a clinical trial, in which a nurse-led target-driven telecoaching programme consisting of 5 monthly telephone sessions of +/- 30 min was offered to 287 people with type 2 diabetes in Belgian primary care. Intervention attendance and satisfaction about the programme were analysed along with qualitative data obtained during post-trial semi-structured interviews with a purposive sample of patients, general practitioners (GPs) and nurses. The perceptions of patients and care providers about the intervention were coded and the themes interpreted as barriers or facilitators for adoption.
Results: Of 252 patients available for a follow-up analysis, 97.5 % reported being satisfied. Interviews were held with 16 patients, 17 general practitioners (GPs) and all nurses involved (n = 6). Themes associated with adoption facilitation were: 1) improved diabetes control; 2) need for more tailored patient education programmes offered from the moment of diagnosis; 3) comfort and flexibility; 4) evidence-based nature of the programme; 5) established cooperation between GPs and diabetes educators; and 6) efficiency gains. Most potential barriers were derived from the provider views: 1) poor patient motivation and suboptimal compliance with "faceless" advice; 2) GPs' reluctance in the area of patient referral and information sharing; 3) lack of legal, organisational and financial framework for telecare.
Conclusions: Nurse-led telecoaching of people with type 2 diabetes was well-accepted by patients and providers, with providers being in general more critical in their reflections. With increasing patient demand for mobile and remote services in healthcare,the findings of this study should support professionals involved in healthcare policy and innovation
An Advanced Conceptual Diagnostic Healthcare Framework for Diabetes and Cardiovascular Disorders
The data mining along with emerging computing techniques have astonishingly
influenced the healthcare industry. Researchers have used different Data Mining
and Internet of Things (IoT) for enrooting a programmed solution for diabetes
and heart patients. However, still, more advanced and united solution is needed
that can offer a therapeutic opinion to individual diabetic and cardio
patients. Therefore, here, a smart data mining and IoT (SMDIoT) based advanced
healthcare system for proficient diabetes and cardiovascular diseases have been
proposed. The hybridization of data mining and IoT with other emerging
computing techniques is supposed to give an effective and economical solution
to diabetes and cardio patients. SMDIoT hybridized the ideas of data mining,
Internet of Things, chatbots, contextual entity search (CES), bio-sensors,
semantic analysis and granular computing (GC). The bio-sensors of the proposed
system assist in getting the current and precise status of the concerned
patients so that in case of an emergency, the needful medical assistance can be
provided. The novelty lies in the hybrid framework and the adequate support of
chatbots, granular computing, context entity search and semantic analysis. The
practical implementation of this system is very challenging and costly.
However, it appears to be more operative and economical solution for diabetes
and cardio patients.Comment: 11 PAGE
Open Source Virtual Worlds and Low Cost Sensors for Physical Rehab of Patients with Chronic Diseases
For patients with chronic diseases, exercise is a key part of rehab to
deal better with their illness. Some of them do rehabilitation at home with telemedicine
systems. However, keeping to their exercising program is challenging
and many abandon the rehabilitation. We postulate that information technologies
for socializing and serious games can encourage patients to keep doing
physical exercise and rehab. In this paper we present Virtual Valley, a low cost
telemedicine system for home exercising, based on open source virtual worlds
and utilizing popular low cost motion controllers (e.g. Wii Remote) and medical
sensors. Virtual Valley allows patient to socialize, learn, and play group based
serious games while exercising
Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications
In the era when the market segment of Internet of Things (IoT) tops the chart
in various business reports, it is apparently envisioned that the field of
medicine expects to gain a large benefit from the explosion of wearables and
internet-connected sensors that surround us to acquire and communicate
unprecedented data on symptoms, medication, food intake, and daily-life
activities impacting one's health and wellness. However, IoT-driven healthcare
would have to overcome many barriers, such as: 1) There is an increasing demand
for data storage on cloud servers where the analysis of the medical big data
becomes increasingly complex, 2) The data, when communicated, are vulnerable to
security and privacy issues, 3) The communication of the continuously collected
data is not only costly but also energy hungry, 4) Operating and maintaining
the sensors directly from the cloud servers are non-trial tasks. This book
chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog
Computing is a service-oriented intermediate layer in IoT, providing the
interfaces between the sensors and cloud servers for facilitating connectivity,
data transfer, and queryable local database. The centerpiece of Fog computing
is a low-power, intelligent, wireless, embedded computing node that carries out
signal conditioning and data analytics on raw data collected from wearables or
other medical sensors and offers efficient means to serve telehealth
interventions. We implemented and tested an fog computing system using the
Intel Edison and Raspberry Pi that allows acquisition, computing, storage and
communication of the various medical data such as pathological speech data of
individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate
estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area
Network, Body Sensor Network, Edge Computing, Fog Computing, Medical
Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment,
Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in
Smart Healthcare (2017), Springe
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
Preventative tele-health supported services for early stage chronic obstructive pulmonary disease: a protocol for a pragmatic randomized controlled trial pilot
Background
Chronic Obstructive Pulmonary Disease (COPD) is a prevalent debilitating long term condition. It is the second most common cause of emergency admission to hospital in the UK and remains one of the most costly conditions to treat through acute care.
Tele-health monitoring offers potential to reduce the rates of re-hospitalisation and emergency department visits and improve quality of life for people with COPD. However, the current evidence base to support technology adoption and implementation is limited and the resource implications for implementing tele-health in practice can be very high. This trial will employ tele-health monitoring in a preventative capacity for patients diagnosed with early stage COPD following discharge from hospital to determine whether it reduces their need for additional health service support or hospital admission and improves their quality of life.
Methods/Design
We describe a pilot study for a two arm, one site randomized controlled trial (RCT) to determine the effect of tele-health monitoring on self-management, quality of life and patient satisfaction. Sixty patients who have been discharged from one acute trust with a primary diagnosis of COPD and who have agreed to receive community clinical support following discharge from acute care will be randomly assigned to one of two groups: (a) Tele-health supported Community COPD Service; or (b) Usual Care. The tele-health supported service involves the patient receiving two home visits with a specialist COPD clinician (nurse or physiotherapist) then participating in daily tele-monitoring over an eight week period. Usual care consists of six home visits to the patient by specialist COPD clinicians again over eight successive weeks. Health status and quality of life data for all participants will be measured at baseline, on discharge from the service and at six months post discharge from the service.
Discussion
The tele-health service under study is a complex service delivered through a collaboration between local authority and health care partners. The implementation of this service demanded significant changes to established working patterns and has been a challenging process requiring considerable planning - a challenge that many providers are likely to face in the future.
Trial registration
Current Controlled Trials ISRCTN6885601
Designing the Health-related Internet of Things: Ethical Principles and Guidelines
The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols
Measuring the 'success' of telehealth interventions
Despite substantial investment over recent years in telehealth there appears to be little consensus regarding what a successful implementation should achieve. However, defining success is often controversial and complex due to differing views from the large number of stakeholders involved, the local environment where telehealth is deployed and the scope, or size, of any planned initiative. Nevertheless, a number of generic measures are proposed in this paper which then provides a framework for the measurement of success. The local context can then be applied to determine the exact emphasis on specific measures, but it is proposed that all of the measures should be included in the holistic measurement of success. Having considered what constitutes success attention is then given to how success should be quantified. Robust evaluation is fundamental and there is much debate as to whether the Ăąïżœïżœgold standardĂąïżœïżœ Randomised Control Trial (RCT) is the most appropriate methodology for telehealth. If the intervention, technology and system, can be maintained in a stable state then the RCT may well provide the most authoritative evidence for decision makers. However, ensuring such stability, in what is still a novel combination of technology and service, is difficult and consequently other approaches may be more appropriate when stability is unlikely to be maintained
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