Use of m-Health Technology for Preventive Interventions to Tackle Cardiometabolic Conditions and Other Non-Communicable Diseases in Latin America- Challenges and Opportunities

In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation.Fil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Diez Canseco, Francisco. Universidad Peruana Cayetano Heredia; PerúFil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Miranda, Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Ramirez Zea, Manuel. Institute of Nutrition of Central America and Panama; GuatemalaFil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Using Smartphone Technology to Enhance Self-Management Support in Adults with Type 2 Diabetes in Primary Care

Background: Self-care is a crucial component in the management of Type 2 Diabetes Mellitus (T2DM). The literature shows that frequent feedback on blood sugar recordings together with reminders can lead to improvements in patient’s glucose control and diabetic self-care. The Chronic Care Model developed by Wagner emphasizes the importance of patient participation in the management of their chronic diseases. Purpose: To explore the possibility of using smartphone technology to help adults with T2DM better manage this chronic disease in a primary care clinic in New England. Methods: A smartphone application (App) OnTrack Diabetes (OnTrack) and text messaging were used to enhance communication between the patient and the provider. After receiving facility and IRB waivers, participants were recruited and trained on the downloaded App. Data was generated through text messages, the App and DNP student journaling, which was evaluated for patient and provider satisfaction with the App. Results: This project lasted about five months with five out of the seven participants recruited actually completing the project. Many (60%) of the participants found the App useful, 80% followed through with the instructions in the text messages and 60% intend to continue to use the App. Three out of five providers liked the App and intend to continue to use it. Most (80%) of the participants noticed a decrease in blood sugar, hemoglobin A1C and weight. Conclusion: This project confirms that an App and text messaging may be a useful tool for primary care providers to enhance self management in patients with T2DM and that frequent communication with the patient in between face to face office visits keeps them engaged and more compliant with diabetes management

Remote Screening And Self-Monitoring For Vision Loss Diseases Based On Smartphone Applications

Remote Healthcare Monitoring System (RHMS) represents remote observing of patient’s well-being and providing therapeutic services. Sensors play an essential part in RHMs. They measure the physical parameters and give continuous information to health organizations, doctors. The presence of Smartphones and other portable devices have allowed us to utilize remote healthcare monitoring system for an assortment of structures. Also, Wireless Sensor Network (WSN) advances considered as one of the critical research factor healthcare application for enhancing the standard of living. In this dissertation, I have presented three tiers operating in the remote healthcare monitoring system; the Body Area Network (BAN), the PAN Coordinator and the Back- Medical End System (BMEsys). The three tiers focused on several patients PAN coordinators include the Wireless Sensor Network. The Wireless Sensor Network can be used at the fixed tale-monitor location and periodic measurements. The Personal Digital Assistant (PDA) can be used in patients own home or community setting with continuous measurements and smartphones can be utilized anywhere with full range parameters, and I have provided a meaningful utilization comparison between Wireless Sensor Network, PDA and smartphone in Remote Healthcare Monitoring System (HRMs) architecture design. Evaluate the approaches of the healthcare monitoring system architecture and investigate the use of advanced technologies enabling the patient vital signs and diagnostic medical team in real-time. This dissertation demonstrates that how a Smartphone can be used for medical treatment in the field of Ophthalmology and discussed how a Smartphone and its technology could be used to diagnose loss of eye vision. Most recent smartphones have been equipped with a featured camera with high megapixels and advanced sensors which can be used to record fundus photographs through a slit lamp or record videos from an operating microscope and display images from optical coherence tomography systems and other high-tech devices. The ophthalmologists can share these images and analyze with their colleagues utilizing media sharing applications and make the optimal diagnostic and therapeutic results to diagnose the low vision of patients. At present, three widely used pocket-sized adapters can improve the magnification and lighting of the camera, which enables the smartphones to capture high-quality images of the eye. These are Portable Eye Examination Kit (PEEK), EyeGo, and D-Eye. Peek Adapter consists of a smartphone application and retina adapter which can be clipped onto the device and synchronized with the peek application for sharing and analyzing the images. This adapter can be used by anyone and anywhere in the world to examine eyes. EyeGo is an adapter intended to allow ophthalmologists and healthcare specialists to capture high-quality images of the eye using an ophthalmic lens. D-Eye Adapter is one of the extensively used adapters which yield excellent results. It consists of a portable eye and retinal system that fits onto a smartphone creating a retinal camera for evaluation and screening of the eye. It uses LED lights as a light source and requires no extra power, making it an ideal solution for portable diagnostics. The medical field has widely accepted these adaptors with the smartphones for diagnosing low vision and eye-related infections. In this dissertation, I also provide a meaningful utilization comparison between the smartphone adapters: D-Eye, EyeGo and Portable Eye Examination Kit (PEEK). In this dissertation, I have developed a new App (Remote Healthcare-Monitoring Mobile App) to help patients who have low vision and who are suffering from the diseases which may cause a vision loss. This app is capable of a process, evaluate, interact and store health data which is continuously measured by (Personal Health Monitors). This App can exchange the information directly to the Smartphone users (patients) and the doctor who allows more security and privacy. The idea of the App consists of the following: A Smartphone Application, a Data Collection Center, and Professionals in Ophthalmology. The patient should be registered in the system, for example, (Retina Michigan Center or Glaucoma Michigan Center). After registration, the patient is instructed on how to take photos of his/her eyes correctly, and then use the Smartphone application. The patient takes photos of his/her eyes and sends them to the data collection center, the specialists get access to these data and help in the treatment according to the analysis. Finally, I completed the development of the Mobile app (including the Skype and Viber links), which can help in exchanging the information between the patient and the doctor

A Cloud Mobile-Based Information Retrieval and Optimal Route Service Delivery System for Aiding the Treatment of Diabetic Patients in Nigeria

Diabetes is considered as one of the most incurable diseases in the world. Studies have shown that at least fourteen million, four hundred and six thousand Nigerians are currently living with the incurable disease. Several researchers have proposed the use of mobile technology to aid diabetes treatment, but challenges such as time taken for physicians to attend to patients due to unavailable Information and problems associated with location of hospitals are recurrent. This research approached these challenges by developing a cloud mobile-based Information retrieval and optimal route service delivery system for aiding the treatment of diabetic patients in Nigeria

eHealth interventions for people with chronic kidney disease

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to look at the benefits and harms of using eHealth interventions in the CKD population

A Cloud Mobile-Based Information Retrieval and Optimal Route Service Delivery System for Aiding the Treatment of Diabetic Patients in Nigeria

Diabetes is considered as one of the most incurable diseases in the world. Studies have shown that at least fourteen million, four hundred and six thousand Nigerians are currently living with the incurable disease. Several researchers have proposed the use of mobile technology to aid diabetes treatment, but challenges such as time taken for physicians to attend to patients due to unavailable Information and problems associated with location of hospitals are recurrent. This research approached these challenges by developing a cloud mobile-based Information retrieval and optimal route service delivery system for aiding the treatment of diabetic patients in Nigeria

Novel Health Mobile Technology as an Emerging Strategy in Diabetes Management

Advances in mobile phone technology and its applications coupled with equally robust growth of telecommunication technology can serve to give patients a better access to the healthcare. More and more healthcare providers and patients started using these applications. Mobile applications are useful in handling various aspects of healthcare namely, health promotion and disease prevention, diagnosis, treatment, monitoring and supporting health services. Clinical studies evaluating mobile applications often come up with mixed results. In this chapter, application of mobile health technology or mHealth in diabetes management is presented as a case study. We have reviewed 25 articles from pubmed database that fulfilled our selection criteria which included original clinical studies that evaluated mobile health technology in the management of diabetes mellitus. Most studies (88%) reported positive outcomes after use of the mobile health applications in various aspects of diabetes treatment such as disease management, behavioural monitoring and patient education. Educational SMS were effective but inferior to Smartphone Apps or teleconsultations. User-friendliness of the systems influenced patient compliance and outcomes. Smartphone/web applications offer significant benefits for patient care, education and behavioural modifications. As providing continuous patient support would require adequate infrastructure and personnel, cost effectiveness of such interventions need to be studied

Diabetes Management System for a New Type 2 Diabetes Geriatric Cohort: Improve the Interaction of Self-management

abstract: According to the ADA (American Diabetes Association), diabetes mellitus is one of the chronic diseases with the highest mortality rate. In the US, 25 million are known diabetics, which may double in the next decade, and another seven million are undiagnosed. Among these patients, older adults are a very special group with varying physical capabilities, cognitive functions and life expectancies. Because they run an increased risk for geriatric conditions, Type 2 diabetes treatments for them must be both realistic and systematic. In fact, some researchers have explored older adults’ experiences of diabetes, and how they manage their diabetes with new technological devices. However, little research has focused on their emotional experiences of medical treatment technology, such as mobile applications, tablets, and websites for geriatric diabetes. This study will address both elderly people's experiences and reactions to devices and their children's awareness of diabetes. It aims to find out how to improve the diabetes treatment and create a systematic diabetes mobile application that combines self-initiated and assisted care together.Dissertation/ThesisMasters Thesis Design 201