A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background: Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods: The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results: The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions: The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services

Holistic System Design for Distributed National eHealth Services

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Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

Which electronic health record system should we use? A systematic review

The UK government had intended to introduce a comprehensive EHRs system in England by 2020. These EHRs would run across primary, secondary, and social care linking data in a single digital platform. This systematic review's objectives were to identify studies that compare EHRs in terms of direct comparison between systems and evaluate them using System and Software Quality Requirements and Evaluation (SQuaRE) ISO/IEC 25010. A systematic review was performed by searching EMBASE and Ovid MEDLINE databases between 1974 and April 2021. All original studies that appraised EHR systems and their providers were included. The main outcome measures were EHR system comparison and SQuaRE's eight characteristics: functional suitability, performance efficiency, compatibility, usability, reliability, security, maintainability, and portability. A total of 724 studies were identified using the search criteria. After review of titles and abstracts, this was filtered down to 40 studies as per exclusion and inclusion criteria set out in our study selection. Seven studies compared more than one EHR. The following number of studies looked at the various aspects of the SQuaRE respectively. Nineteen studies addressed functional suitability, n=18 performance efficiency, n=12 compatibility, n=25 usability, n=6 reliability, n=2 security, n=16 maintainability, and n=13 portability. Epic was the most studied EHR system and one of the most implemented vendors in the USA market, and one of the top ten in UK. It is difficult to assess which is the most advantageous EHR system currently available when looking at them in accordance with SQuaRE's eight characteristics for software evaluation

Developing a distributed electronic health-record store for India

The DIGHT project is addressing the problem of building a scalable and highly available information store for the Electronic Health Records (EHRs) of the over one billion citizens of India

Technology Use by Registered Dietitians for Patient Care in an Outpatient Setting

Background Technology use in digital health tools has increased significantly since the COVID-19 pandemic disrupted many in-office patient care services. Although healthcare practices have adopted several technologies, they remain surrounded by a saturated increase in consumer-based wearables and smartphone applications. As a result, attitudes and acceptability toward integrating these technologies for patient care are evolving. Digital health tools is an umbrella term including several technologies utilized among health care providers for the purpose of patient care. The inclusion of digital health tools by Registered Dietitian Nutritionists’ (RDNs) in practice provides a more robust and personalized approach to patients and their health needs. Reasons for decisions about incorporating digital health tools into the RDN practice setting are limited in the professional literature. Methods An exploratory cross-sectional survey design was used. Professionals working as Registered Dietitian Nutritionists (RDNs) were recruited utilizing a snowball sampling approach among several practice settings. Survey compilation included a literature review, identifying and utilizing two surveys otherwise used for different purposes and target audiences. Data collection consists of a 2-step process with a survey pilot test and distribution of a final survey administered via Qualtrics. Data analysis was conducted using SPSS v27.0. Results Sixteen of 20 professionals completed the survey in its entirety: 2 working in employee wellness, 13 in a hospital-based system, and 1 in both employee wellness and community/public health. Quantitative analysis depicted the highest usage of tele-visits/virtual visits and less appreciation for technology in eating disorders. Additionally, RDNs reported heightened chances of adopting a tool if the technology is the standard of care. Qualitative analysis indicated that professionals working in a setting for diabetes had a positive attitude towards wearable or smartphone nutrition applications. Moreover, other practice settings such as dialysis and post-liver transplant, eating disorders, or employee wellness produced either a neutral or negative attitude. Conclusions Registered dietitian nutritionists are highly interested in using digital health tools for patient care. However, it is difficult to conclude the current use of technology in outpatient practice. RDNs understand the potential of technology, such as wearables, in offering patients care concerning their illness or diagnosis. Although RDNs utilize telehealth, other technologies such as wearables and smartphone nutrition apps have yet to be widely adopted. The use of technology among RDNs who practice in an outpatient setting is highly variable, and therefore a presumption cannot be made. Therefore, future research is warranted, focusing on patients with various health conditions and diverse samples

Predictive Analytics in Healthcare: Empowering Consultation with Machine Learning

The Smart Healthcare and Online Consultation initiative intends to offer patients a quick and convenient online platform for seeking medical advice and services. Real-time video consultations, appointment scheduling, prescription administration, and health records management are just a few of the capabilities available on the platform. To deliver individualized and superior healthcare services, the initiative to use cutting-edge such as AI, ML, and data analytics. By giving patients an easy and affordable way to receive healthcare services remotely, the Smart Healthcare and Online Consultation initiative has the potential to completely transform the healthcare sector

A MULTIMODAL ANALYSIS OF HEAR-A MOBILE HEARING SCREENING APPLICATION

Presented here are the results of a series of three studies focused on the need, validation, and improvement of hEAR, a mobile hearing screening application. The first study was a systematic review of 37 peer-reviewed studies to assess the efficacy of different types of audiology mHealth interventions, especially in high-risk populations. Four main modes of technology used to deliver the mHealth intervention were identified, out of which remote computing was found to be most effective. Smartphone applications were found to be as efficacious, but the results were dependent on the population characteristics. The study resulted in demonstrating the need for hEAR in high risk populations. The purpose of the second study was to validate headphone hardware for use with hEAR, when compared to a pure tone audiometric test. Both hEAR and the audiologist’s test used 7 frequencies (independent variable), 125 Hz, 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz and 8000 Hz, and the recorded measurements were sound pressure levels (dependent variable) measured in decibels. Participants (30) from Texas A&M University were recruited based on a screener, and were randomly assigned and counterbalanced to one of two groups, differing in the order the hEAR tests and the audiologist’s test were administered. Data were analyzed using a generalized estimating equation model at α=0.05, which showed that Pioneer headphones, were comparably similar to the audiologist’s test at all frequencies. The third study was a multi-method assessment of hEAR based on user-centered design principles. Six nurses and thirty students from the Bryan Independent School District were recruited and the assessments were conducted at the participants’ schools. Nurses used hEAR to screen their students, after which the nurses filled out two questionnaires: The System Usability Scale and the After-Scenario Questionnaire. The time taken to complete the tasks, as well as the number of errors committed were also observed. The nurses participated in individual in-depth interviews. The result of the assessments revealed 8 problems that the nurses encountered during their use of hEAR, which were then grouped into 4 usability themes to derive user-centered design recommendations for similar mHealth applications