Clinical Requirements of Future Patient Monitoring in the Intensive Care Unit: Qualitative Study

BACKGROUND: In the intensive care unit (ICU), continuous patient monitoring is essential to detect critical changes in patients' health statuses and to guide therapy. The implementation of digital health technologies for patient monitoring may further improve patient safety. However, most monitoring devices today are still based on technologies from the 1970s. OBJECTIVE: The aim of this study was to evaluate statements by ICU staff on the current patient monitoring systems and their expectations for future technological developments in order to investigate clinical requirements and barriers to the implementation of future patient monitoring. METHODS: This prospective study was conducted at three intensive care units of a German university hospital. Guideline-based interviews with ICU staff-5 physicians, 6 nurses, and 4 respiratory therapists-were recorded, transcribed, and analyzed using the grounded theory approach. RESULTS: Evaluating the current monitoring system, ICU staff put high emphasis on usability factors such as intuitiveness and visualization. Trend analysis was rarely used; inadequate alarm management as well as the entanglement of monitoring cables were rated as potential patient safety issues. For a future system, the importance of high usability was again emphasized; wireless, noninvasive, and interoperable monitoring sensors were desired; mobile phones for remote patient monitoring and alarm management optimization were needed; and clinical decision support systems based on artificial intelligence were considered useful. Among perceived barriers to implementation of novel technology were lack of trust, fear of losing clinical skills, fear of increasing workload, and lack of awareness of available digital technologies. CONCLUSIONS: This qualitative study on patient monitoring involves core statements from ICU staff. To promote a rapid and sustainable implementation of digital health solutions in the ICU, all health care stakeholders must focus more on user-derived findings. Results on alarm management or mobile devices may be used to prepare ICU staff to use novel technology, to reduce alarm fatigue, to improve medical device usability, and to advance interoperability standards in intensive care medicine. For digital transformation in health care, increasing the trust and awareness of ICU staff in digital health technology may be an essential prerequisite

Integration of Smart Wearable Devices and Cloud Computing in the Kenyan Public Health Care System

The utilization of smart wearable devices and cloud computing in the Kenyan public health care system will facilitate real-time patient monitoring and management. The shortage of certified healthcare professionals and the limited access to quality specialized care for individuals in remote settings has prompted the adoption of wearable devices and cloud computing strategies in Kenya. However, there lacks a clear framework design of integrating the technologies in the public health sector. This article evaluates the current status of healthcare systems in Kenya. It also investigates the existing mobile health and cloud computing services in the country while evaluating the main legal concerns inherent to the utilization of the technologies. The document further outlines a framework design for a mobile application named GB Health. The application incorporates cloud computing and smart wearable devices in the Kenyan public health care system. The design will enhance workflow and patient outcomes in the sector. Keywords: Smart wearable devices, cloud computing, GB Health DOI: 10.7176/IKM/11-4-04 Publication date:June 30th 2021

Integrating home monitoring for transcranial direct current stimulation (tDCS) therapy to professional care environment

Daily management of neurodegenerative diseases is one of the most striking scenarios where an integrated health care system is essential for the continuous assistance to the patient and requires qualification of the caregivers and their training. In particular, patients affected by depression or chronic pain, as well as rehabilitating after stroke, can be treated at home with non-invasive electrical neuromodulation (transcranial Direct Current Stimulation, tDCS) in order to reduce daily travel expenses between home and hospital. Home monitoring of patient undergoing tDCS is essential to (1) optimize the stimulation parameters according to the current health status and to the stimulation outcomes, and (2) assess disease progression. However, monitoring effectiveness depends on the exchange of this information between the patient at home and his/her reference neurologist. Currently, the health IT scenario is composed by two independent environments, one dedicated to healthcare professionals (e.g., Electronic Health Records, EHRs), and one including mobile devices applications dedicated to citizens, caregivers and patients. Safety, communication and interoperability gaps prevented from an effective data exchange between these two environments. The aim of our work is to implement an integrated home monitoring system for tDCS patients, in which a web-based platform for EHR management exchanges data with a patient\u2019s mobile app

Why Smart Watches shouldn\u27t just become a Trend: Using Smart Watches in the Treatment of Diabetes

As mobile technologies have advanced, the idea of using them in health care applications has expanded greatly. In a 2011 paper by Boulos et al, the impact of mobile technology such as smartphones in health care was examined. Numerous benefits of the implementations were noted, such as how smartphones are able to provide a connection between both doctors and patients due to the network access capabilities of the device. Additionally, using the existing monitoring and sensor technologies on a smartphone can eliminate the need for other external devices, thus reducing the maintenance required by the patient. All in all, keeping the system simple for the users, and providing them with little room for error, is the key for succes

IoT And Cloud Server Based Wearable Health Sensors Monitoring System

The healthcare monitoring systems has emerged as one of the most vital system and became technology oriented from the past decade. Humans are facing a problem of unexpected death due to various illness which is because of lack of medical care to the patients at right time. The primary goal was to develop a reliable patient monitoring system using IoT so that the healthcare professionals can monitor their patients, who are either hospitalized or at home using an IoT based integrated healthcare system with the view of ensuring patients are cared for better. A mobile device based wireless healthcare monitoring system was developed which can provide real time online information about physiological conditions of a patient mainly consists of sensors, the data acquisition unit, microcontroller (i.e., Arduino), and programmed with a software (i.e., JAVA). The patient’s temperature, heart beat rate, EEG data are monitored, displayed and stored by the system and sent to the doctor’s mobile containing the application. Thus IOT based monitoring system effectively monitor patient’s health status and save life on time

Patient-oriented computerized clinical guidelines for mobile decision support in gestational diabetes

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients’ self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient’s access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients’ personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients’ acceptance of the whole system

Next-generation care pathways for allergic rhinitis and asthma multimorbidity:a model for multimorbid non-communicable diseases-Meeting Report (Part 1)

International audienceIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system for integrated care with organizational health literacy. MASK (Mobile Airways Sentinel NetworK) (1), a new development of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health) (2), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life integrated care pathways (ICPs) (3)-centred around the patient with rhinitis and using mHealth monitoring of environmental exposure (4).An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018. The aim was to discuss next-generation care pathways: (I) Patient participation, health literacy and self-care through technology-assisted “patient activation”; (II) Implementation of care pathways by pharmacists and (III) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) assessed by mobile technology.The EU (5) and global political agendas are of great importance in supporting health care transformation. MASK has been recognized by DG Santé as a Good Practice (6) in the field of digitally-enabled, integrated, person-centred care.The one-day meeting objectives were clear (Figure 1). The meeting was followed by a workshop. The present paper reports the background of the two-day meeting

Performance study of routing protocols in a mobile patient monitoring network

Patient monitoring and connected medical devices are dramatically changing for providing more care and health services. A WBAN is based on IEEE 802.15.6, allowing near field communication up to one-meter range from the human body. In patient monitoring, the physiological data is sensed by sensor and forward to the medical professional, where the received data is continuously compared with the original data base of a patient. In order to give more care to patients, it is necessary to monitor the patient when they are in motion. This gives a promising way to assist the medical professionals for improving their monitoring abilities. Mobile patient monitoring system detects the patient’s situation when he/she is in motion and allows a patient to roam around the hospital without health professional. For proper communication between the mobile nodes of the patient monitoring system, the IEEE standard WLAN and WPAN are to be implemented. When the patient is moving in the arbitrary trajectory an unpredictable topology and link instability is formed, that make routing protocols a core issue. Different routing protocols such as AODV, DSR, DSDV, and AOMDV have been analysed in NS2 for different types of patient monitoring scenario. Most WLAN are based on IEEE 802.11 and provide wireless connection between the nodes for the communication. This gives users the ability to move around within a local coverage area up to hundred meter range and still be connected to the network. WPAN system is designed under IEEE 802.15.4 standard and provides interconnection of communicating devices. Also it can serve for more specialized purpose such as allowing the surgeon and other team members to communicate during an operation inside the operation theatre. The simulation results shows that IEEE 802.11 is best suited for designed mobile patient monitoring network as it provides more coverage area to the patient