P5 eHealth: An Agenda for the Health Technologies of the Future

This open access volume focuses on the development of a P5 eHealth, or better, a methodological resource for developing the health technologies of the future, based on patients’ personal characteristics and needs as the fundamental guidelines for design. It provides practical guidelines and evidence based examples on how to design, implement, use and elevate new technologies for healthcare to support the management of incurable, chronic conditions. The volume further discusses the criticalities of eHealth, why it is difficult to employ eHealth from an organizational point of view or why patients do not always accept the technology, and how eHealth interventions can be improved in the future. By dealing with the state-of-the-art in eHealth technologies, this volume is of great interest to researchers in the field of physical and mental healthcare, psychologists, stakeholders and policymakers as well as technology developers working in the healthcare sector

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Community Physiotherapy and Chronic Disease Self-Management for Rural Community-Dwelling Older Adults

Research problem: The majority of older Canadians live with at least one chronic disease. Exercise has been shown to be an effective means to reducing symptoms, and to improving physical dysfunction in chronically ill populations; and self-management is a nationally advocated approach to dealing with the growing health care issue of chronic disease. Physiotherapists are experts in prescribing therapeutic exercise and promoting chronic disease self-management. Methods: This two-study dissertation explored older adults’ perceptions of exercise as a self-care activity within a chronic disease self-management strategy using focused ethnography; and physiotherapists’ experiences in promoting exercise as a means to chronic disease self-management using hermeneutic phenomenology. Findings: Older adults defined exercise generally, as movement, but did not demonstrate an understanding of the relevance or importance of exercise intensity or specificity to gain health benefits specific to their chronic disease(s). Older adults preferred to participate in exercise they enjoyed doing and was familiar to them. Older adults may not value exercise as a self-care activity in the same way that physiotherapists do. The client’s values with respect to exercise and the structure of the service model significantly impacted the physiotherapists’ ability to promote chronic disease self-management. Physiotherapists described facilitating chronic disease self-management as an important practice role, but physiotherapists were not referred to promote chronic disease self-management. This meant physiotherapists felt constrained by time, as they attempted to both promote chronic disease self-management and address the primary reason for referral. Physiotherapists took on a consultative role described as making connections with the client to build rapport, to help the client understand their chronic disease, and to connect the client with additional community programs, and/or health care practitioners to meet their goals or care needs. Conclusions: Physiotherapists could improve efficiency of their practice by gaining skills to help them understand client’s perceptions about exercise as a means to self-care, and or tailoring interventions to include opportunities to participate in enjoyable and familiar activities. Changes to service model with respect to acknowledging the role of physiotherapists in promoting chronic disease self-management could also facilitate physiotherapists’ efforts to enact this role in community settings

MODEL, FRAMEWORK, AND PLATFORM OF HEALTH PERSUASIVE SOCIAL NETWORK

Persuasive technology (PT) has the potential to support individuals to perform self-management and social support as a part of health behavior change. This has led a few researchers in the intersection of the areas of health behavior change and software engineering to apply behavior change and persuasion theories to software development practices, enabling them to create innovative design principles and development-evaluation frameworks. Unfortunately these are too general for designing and evaluating health PT. Therefore, this dissertation proposes a model, framework, and platform of PT specifically designed for health intervention. The model and framework inform what, why, and how conceptually the suggested and required health behavior change strategies should be transformed into system features; and the platform explains how technically the transformation should be done. The platform includes functional requirements and provides most of the basic and standard computer code to develop the system features of such PT. The model, framework, and platform were designed to work with various health behavior change programs. Nevertheless, in this dissertation, they support health behavior change for physical activity. As an implementation of and tool to evaluate the model, framework, and platform, a technology called Persuasive Social Network for Physical Activity (PersonA) is introduced. PersonA is a combination of automatic input of physical activity data, a smart phone, and social networking. Two systems (SocioPedometer and PAMS) as leverages of PersonA have been developed and evaluated. The model, framework, and platform were evaluated based on the results of SocioPedometer’s usability testing and 4-week trials (n=14) and on PAMS’s usability testing (n=5). The results suggest that the systems were usable and accessible and that users were satisfied and enjoyed using it. Additional evaluations to the model and framework were conducted with the main purpose of eliciting users’ preferences with respect to the characteristics and system features proposed in the model and framework. They rated most of the characteristics as extremely important (average 4.27 of a 5.00 maximum) and most of the system features as very important (average of 4.09). The platform allowed the two systems to be easily developed by customizing the data input and information presented