The factors that impact the adoption and Usage of Telemedicine in Chronic Diseases: Systematic Review

Chronic diseases are one of the most common diseases that pertain to a large number of people. Most people suffer from one or more chronic diseases, such as diabetes, heart failure, rheumatoid arthritis, cancer, and others. According to a recent statistic, 9% of Jordanian have at least one type of chronic disease; it is a high percentage for a country of limited resources. Chronic diseases are costly to manage; the cost is not only associated with the treatment alone but also to monitoring patients, healthcare professionals labor, and continuous lab testing. During the past few years, the world witnessed a significant increase in the number of mobile Health users. This increase also translated into an increase in using Telehealth services. This paper aims to conduct a systematic literature review of the different adoption factors of Telemedicine for chronic diseases. We provide an analysis and a synthesis of recently published research in the past ten years. We follow the methodological literature review proposed by Ramey and Rao to examine and extract related scholarly work. By providing a thematic analysis of relevant literature, we classify the current research into the main themes of the Telehealth in the chronic field. We also develop a taxonomy of positive and negative factors that influence Telehealth. We also highlight the main limitations and gaps in the literature to guide future research

Usability of an Immersive Augmented Reality Based Telerehabilitation System with Haptics (ARTESH) for Synchronous Remote Musculoskeletal Examination

This study describes the features and utility of a novel augmented reality based telemedicine system with haptics that allows the sense of touch and direct physical examination during a synchronous immersive telemedicine consultation and physical examination. The system employs novel engineering features: (a) a new force enhancement algorithm to improve force rendering and overcoming the “just-noticeable-difference” limitation; (b) an improved force compensation method to reduce the delay in force rendering; (c) use of the “haptic interface point” to reduce disparity between the visual and haptic data; and (d) implementation of efficient algorithms to process, compress, decompress, transmit and render 3-D tele-immersion data. A qualitative pilot study (n=20) evaluated the usability of the system. Users rated the system on a 26-question survey using a seven-point Likert scale, with percent agreement calculated from the total users who agreed with a given statement. Survey questions fell into three main categories: (1) ease and simplicity of use, (2) quality of experience, and (3) comparison to in-person evaluation. Average percent agreements between the telemedicine and in-person evaluation were highest for ease and simplicity of use (86%) and quality of experience (85%), followed by comparison to in-person evaluation (58%). Eighty-nine percent (89%) of respondents expressed satisfaction with the overall quality of experience. Results suggest that the system was effective at conveying audio-visual and touch data in real-time across 20.3 miles, and warrants further development.

Effective implementation and monitoring of telehealth and telecare in Ireland: learning from international best practice.

This document synthesises the information provided in a number of papers relating to Telecare/Telehealth commissioned by and developed for the National Disability Authority between 2014 and 2017. The papers in question were developed by researchers in Work Research Centre (WRC), the National Disability Authority and the University of Ulster, and this report has taken key learning and information from each of them to create this composite briefing paper

A Smartphone Application Designed to Engage the Elderly in Home-Based Rehabilitation

As life expectancy increases, it is imperative that the elderly take advantage of the benefits of technology to remain active and independent. Mobile health applications are widely used nowadays as they promote a healthy lifestyle and self-management of diseases, opening new horizons in the interactive health service delivery. However, adapting these applications to the needs and requirements of the elderly is still a challenge. This article presents a smartphone application that is part of a multifactorial intervention to support older people with balance disorders. The application aims to enable users to self-evaluate their activity and progress, to communicate with each other and, through strategically selected motivational features, to engage with the system with undiminished interest for a long period of time. Mock-up interfaces were evaluated in semi-structured focus groups and interviews that were performed across three European countries. Further evaluation in the form of four pilot studies with 160 participants will be performed and qualitative and quantitative measures will be used to process the feedback about the use of the application

Beyond adoption: A new framework for theorising and evaluating Non-adoption, Abandonment and challenges to Scale-up, Spread and Sustainability (NASSS) of health and care technologies

© 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.Background: Many promising technological innovations in health and social care are characterized by nonadoption or abandonment by individuals or by failed attempts to scale up locally, spread distantly, or sustain the innovation long term at the organization or system level. Objective: Our objective was to produce an evidence-based, theory-informed, and pragmatic framework to help predict and evaluate the success of a technology-supported health or social care program. Methods: The study had 2 parallel components: (1) secondary research (hermeneutic systematic review) to identify key domains, and (2) empirical case studies of technology implementation to explore, test, and refine these domains. We studied 6 technology-supported programs—video outpatient consultations, global positioning system tracking for cognitive impairment, pendant alarm services, remote biomarker monitoring for heart failure, care organizing software, and integrated case management via data sharing—using longitudinal ethnography and action research for up to 3 years across more than 20 organizations. Data were collected at micro level (individual technology users), meso level (organizational processes and systems), and macro level (national policy and wider context). Analysis and synthesis was aided by sociotechnically informed theories of individual, organizational, and system change. The draft framework was shared with colleagues who were introducing or evaluating other technology-supported health or care programs and refined in response to feedback. Results: The literature review identified 28 previous technology implementation frameworks, of which 14 had taken a dynamic systems approach (including 2 integrative reviews of previous work). Our empirical dataset consisted of over 400 hours of ethnographic observation, 165 semistructured interviews, and 200 documents. The final nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework included questions in 7 domains: the condition or illness, the technology, the value proposition, the adopter system (comprising professional staff, patient, and lay caregivers), the organization(s), the wider (institutional and societal) context, and the interaction and mutual adaptation between all these domains over time. Our empirical case studies raised a variety of challenges across all 7 domains, each classified as simple (straightforward, predictable, few components), complicated (multiple interacting components or issues), or complex (dynamic, unpredictable, not easily disaggregated into constituent components). Programs characterized by complicatedness proved difficult but not impossible to implement. Those characterized by complexity in multiple NASSS domains rarely, if ever, became mainstreamed. The framework showed promise when applied (both prospectively and retrospectively) to other programs.Peer reviewe

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

E-Health business models prototyping by incremental design

User-Driven Healthcare: Concepts, Methodologies, Tools, and Applications provides a global discussion on the practice of user-driven learning in healthcare and connected disciplines and its influence on learning through clinical problem solving. This book brings together different perspectives for researchers and practitioners to develop a comprehensive framework of user-driven healthcare.Postprint (published version