User involvement in healthcare technology development and assessment: Structured literature review

Purpose – Medical device users are one of the principal stakeholders of medical device technologies. User involvement in medical device technology development and assessment is central to meet their needs. Design/methodology/approach – A structured review of literature, published from 1980 to 2005 in peer-reviewed journals, was carried out from social science perspective to investigate the practice of user involvement in the development and assessment of medical device technologies. This was followed by qualitative thematic analysis. Findings – It is found that users of medical devices include clinicians, patients, carers and others. Different kinds of medical devices are developed and assessed by user involvement. The user involvement occurs at different stages of the medical device technology lifecycle and the degree of user involvement is in the order of design stage > testing and trials stage > deployment stage > concept stage. Methods most commonly used for capturing users’ perspectives are usability tests, interviews and questionnaire surveys. Research limitations/implications – We did not review the relevant literature published in engineering, medical and nursing fields, which might have been useful. Practical implications – Consideration of the users’ characteristics and the context of medical device use is critical for developing and assessing medical device technologies from users’ perspectives. Originality/value – This study shows that users of medical device technologies are not homogeneous but heterogeneous, in several aspects, and their needs, skills and working environments vary. This is important consideration for incorporating users’ perspectives in medical device technologies. Paper type: Literature review

Developing medical device technologies from users' perspectives: A theoretical framework for involving users in the development process

Objectives: The aim of this study was to suggest an acceptable and generic theoretical framework for involving various types of users in the medical device technology (MDT) development process (MDTDP).Methods: The authors propose a theoretical framework suggesting different routes, methods and stages through which various types of medical device users can be involved in the MDTDP.Results: The suggested framework comprises two streams of users' involvement in MDT development, that is, what might be called the end users' stream and the professional users' stream for involving these two groups respectively in the process of developing both simple and more complex and innovative medical devices from conceptualization through to the market deployment. This framework suggests various methods that can be used for users' involvement at different stages of the MDT lifecycle. To illustrate the application of the framework, several MDT development scenarios and device exemplars are presented.Conclusions: Development of medical devices from users' perspectives requires not only the involvement of healthcare professionals but also that of the ultimate end users, that is, patients, people with disabilities and/or special needs, and their caregivers. The evidence shows that such end users quickly discard devices that do not fulfill their personal expectations, even though both manufacturers and healthcare professionals may consider those end users' requirements met. Developers and manufacturers need to recognize this potent potential discrepancy between the parties involved, and involve end users and professional healthcare staff directly in the MDTDP. The framework, the authors contend, is a step forward in helping medical device manufacturers plan and make decisions about users' involvement at different stages of the MDTDP

Multimodal and ubiquitous computing systems: supporting independent-living older users

We document the rationale and design of a multimodal interface to a pervasive/ubiquitous computing system that supports independent living by older people in their own homes. The Millennium Home system involves fitting a resident’s home with sensors – these sensors can be used to trigger sequences of interaction with the resident to warn them about dangerous events, or to check if they need external help. We draw lessons from the design process and conclude the paper with implications for the design of multimodal interfaces to ubiquitous systems developed for the elderly and in healthcare, as well as for more general ubiquitous computing applications

Delivering elder-care environments utilizing TV-channel based mechanisms

In this paper, we present a smart environment for elderly. What makes the development of such system challenging is that the concept of smartness for elderly brings to the extreme the idea of invisibility of the technology. In our experience, elders are well-disposed to new technologies, provided that those will not require significant changes - namely, they are invisible - to their habits. Starting from this consideration, 200 caregivers responses were collected by questionnaire, so as to better understand elders' needs and habits. A system was subsequently developed allowing elders to access a number of "modern web services" as standard TV channels: at channel 43 there is the health status, at channel 45 the photos of the family, at 46 the agenda of the week, just to mention few of the available services. The content of such services is automatically generated by the smart devices in the environment and is managed by the caregivers (e.g., family members) by simple web apps. Fourteen families were asked to install the system in their house. The results of these experiments confirm that the proposed system is considered effective and user-friendly by elders

Commercialisation of eHealth Innovations in the Market of UK Healthcare Sector: A Framework for Sustainable Business Model.

This is the peer reviewed version of the following article: Festus Oluseyi Oderanti, and Feng Li, ‘Commercialization of eHealth innovations in the market of the UK healthcare sector: A framework for a sustainable business model’, Psychology & Marketing, Vol. 35 (2): 120-137, February 2018, which has been published in final form at https://doi.org/10.1002/mar.21074. Under embargo until 10 January 2020. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Demographic trends with extended life expectancy are placing increasing pressures on the UK state-funded healthcare budgets. eHealth innovations are expected to facilitate new avenues for cost-effective and safe methods of care, for enabling elderly people to live independently at their own homes and for assisting governments to cope with the demographic challenges. However, despite heavy investment in these innovations, large-scale deployment of eHealth continues to face significant obstacles, and lack of sustainable business models (BMs) is widely regarded as part of the greatest barriers. Through various empirical methods that include facilitated workshops, case studies of relevant organizations, and user groups, this paper investigates the reasons the private market of eHealth innovations has proved difficult to establish, and therefore it develops a framework for sustainable BMs that could elimiesnate barriers of eHealth innovation commercialization. Results of the study suggest that to achieve sustainable commercialization, BM frameworks and innovation diffusion characteristics should be considered complements but not substitutes.Peer reviewe

Remote Control and Monitoring of Smart Home Facilities via Smartphone with Wi-Fly

Due to the widespread ownership of smartphone devices, the application of mobile technologies to enhance the monitoring and control of smart home facilities has attracted much academic attention. This study indicates that tools already in the possession of the end user can be a significant part of the specific context-aware system in the smart home. The behaviour of the system in the context of existing systems will reflect the intention of the client. This model system offers a diverse architectural concept for Wireless Sensor Actuator Mobile Computing in a Smart Home (WiSAMCinSH) and consists of sensors and actuators in various communication channels, with different capacities, paradigms, costs and degree of communication reliability. This paper focuses on the utilization of end users’ smartphone applications to control home devices, and to enable monitoring of the context-aware environment in the smart home to fulfil the needs of the ageing population. It investigates the application of an iPhone to supervise smart home monitoring and control electrical devices, and through this approach, after initial setup of the mobile application, a user can control devices in the smart home from different locations and over various distances

An Inpatient Rehabilitation Interprofessional Care Pathway for Traumatic Hip Fracture: A Pilot Quality Improvement Project

Background: Each year over 300,000 older adults are hospitalized for hip fracture. The impact of the cost of hip fracture on the US health care system is estimated to be as high as $9 billion, with the typical cost of a hip fracture episode around$30,000. Formalized pathways have been developed and successfully utilized for many patient presentations, including hip fracture, in the acute setting. Although this research is important to the comprehensive care of the elderly hip fracture patient, very little research exists that outlines evidence-based best-practice for patients in the post-acute recovery period. Purpose: The primary aim of this project was to develop an evidence-based, comprehensive, coordinated, and interprofessional care pathway for hip fracture patients in the acute rehabilitation setting to improve the percentage of patients discharging to community settings by 20% from current baseline by the end of the pilot period. Methods: The design of this project was an observational cohort study. Descriptive statistics will be used to compare intervention groups to controls, including frequencies and distributions. Results: The hip fracture tool itself had inconclusive results, the impacts of the effects on team work and enhanced coordination of the care team was realized through reducing institutionalized days for hip fracture patients in acute rehabilitation

A canonical theory of dynamic decision-making

Decision-making behavior is studied in many very different fields, from medicine and eco- nomics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptual- ization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering