5,136 research outputs found
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Clinical decision support system for point of care use--ontology-driven design and software implementation
OBJECTIVES: The objective of this research was to design a clinical decision support system (CDSS) that supports heterogeneous clinical decision problems and runs on multiple computing platforms. Meeting this objective required a novel design to create an extendable and easy to maintain clinical CDSS for point of care support. The proposed solution was evaluated in a proof of concept implementation.
METHODS: Based on our earlier research with the design of a mobile CDSS for emergency triage we used ontology-driven design to represent essential components of a CDSS. Models of clinical decision problems were derived from the ontology and they were processed into executable applications during runtime. This allowed scaling applications' functionality to the capabilities of computing platforms. A prototype of the system was implemented using the extended client-server architecture and Web services to distribute the functions of the system and to make it operational in limited connectivity conditions.
RESULTS: The proposed design provided a common framework that facilitated development of diversified clinical applications running seamlessly on a variety of computing platforms. It was prototyped for two clinical decision problems and settings (triage of acute pain in the emergency department and postoperative management of radical prostatectomy on the hospital ward) and implemented on two computing platforms--desktop and handheld computers.
CONCLUSIONS: The requirement of the CDSS heterogeneity was satisfied with ontology-driven design. Processing of application models described with the help of ontological models allowed having a complex system running on multiple computing platforms with different capabilities. Finally, separation of models and runtime components contributed to improved extensibility and maintainability of the system
Pressure Ulcer Prevention System
Pressure ulcers, also known as bedsores, are a widespread but often understated problem. A pressure ulcer is an injury that develops with constant pressure on an area of skin for a long time. They range from bruises to open wounds to even exposed bone. These injuries especially impact bedridden and elderly hospital inpatients, since these people must depend on nursing staff for mobility.
Pressure ulcers can seem to be a solved problem. Solutions that completely eliminate pressure ulcers do exist. These solutions, however, are too expensive for widespread use, at thousands of dollars per bed. Other solutions, such as relying on nursing staff to move all patients is not reliable, and nurses develop chronic back pain from the strain of moving so many patients so often.
The Pressure Ulcer Prevention System is designed specifically to be an affordable solution for these injuries in a hospital or assisted living setting. The system collects data from a gyroscopic sensor and multiple pressure sensors mounted on the patient, and sends an alert to the nurses’ station if a patient is at risk of developing a pressure ulcer, and needs attending. The system does not replace nurse care, nor does it change the most common solution of manually moving patients, but it instead helps nursing staff be more efficient
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Development and Usability Evaluation of an mHealth Application for Symptom Self-Management in Underserved Persons Living with HIV
Effective symptom management is essential to decrease symptom severity and improve health-related quality of life for persons living with HIV (PLWH). A mobile health (mHealth) application (app) has the potential to be an effective delivery mode of an existing paper-based symptom management manual with self-management strategies for underserved PLWH. The quality of the mHealth app requires a thorough understanding of the needs of the intended end-users and ensuring the app’s usability.
The purpose of this study was to translate paper-based health information into an mHealth app for symptom self-management in underserved PLWH, entitled mVIP (mobile Video Information Provider), and assess its usability. To achieve this goal, usability was evaluated rigorously throughout the development process of mVIP. Based on a stratified view of health information technology (IT) usability evaluation framework, usability evaluation was sequentially conducted with the following three levels: 1) user-task, 2) user-task-system, and 3) user-task-system-environment.
At level 1 (user-task), we applied a user-centered design method to guide the information architecture of mVIP. Using a reverse in-person card sorting technique, symptoms and self-management strategies from a paper-based HIV/AIDS symptom management manual were ranked. The rank order of the 13 symptoms and 151 self-management strategies determined the order of appearance to end-users of the mVIP app, with higher-ranked symptoms and strategies appearing first. Based on the findings, we developed a prototype of mVIP as following: 1) once users log in, they are guided by an avatar through a series of 13 symptom questions ascertaining the nature and severity of their symptoms, and 2) the avatar recommends three self-management strategies for each symptom reported. At level 2 (user-task-system), we conducted a usability evaluation of the mVIP prototype in a laboratory setting through end-user usability testing and heuristic evaluation. In end-user usability testing, we used an eye-tracking and retrospective think-aloud method to examine task performance by 20 PLWH. For the heuristic evaluation, five usability experts in informatics assessed the user interface. In the two usability evaluations conducted in a laboratory setting, we found strong user acceptance of the mVIP prototype while identifying a number of usability issues with this prototype. Based on the recommendations from the end-users and heuristic evaluators, we iteratively refined the app’s content, functionality, and interface. We then inserted videos of the finalized symptom self-management strategies into the refined mVIP prototype. At level 3 (user-task-system-environment), the usability of the refined mVIP prototype was evaluated in a real-world setting. Through 10 in-depth interviews and four focus groups conducted at the conclusion of a three-month randomized controlled trial, we explored in-depth understandings of users’ experiences, perceptions, and satisfaction of mVIP use. Findings from the study showed that first, mVIP is useful for HIV-related symptom self-management and has the potential for being used as a communication tool with healthcare providers; and second, mVIP is easy to use to monitor symptom experience over time. At the same time, participants suggested mVIP be more sensitively tailored based on years from initial diagnosis of HIV, an individuals’ age, and conditions. The overall user satisfaction with the mVIP prototype was high, which reflects strong user acceptance of mVIP.
Integral to the findings from the three-level usability evaluation, we assessed the quality of the mVIP prototype in use and found the prototype was highly accepted by PLWH with high user satisfaction. This study will add to the body of literature on translation of evidence-based health information into an mHealth app and its usability assessment, which highlights the importance of the use of mobile technology for PLWH, specifically racial and ethnic minorities and those from low-socioeconomic groups who have limited health literacy and low level of education
Dynamic ePROM mobile application to improve diabetes consultations. Incorporating patient-gathered data into ePROMs
People with diabetes live a life of constant need to monitor and manage their illness. Unfortunately, a large number of people with diabetes suffer from diabetes-related distress and depression. A better diabetes consultation can directly impact the health of people with diabetes, both mentally and physically.
In this thesis, healthcare practices that previous studies have reported lead to a successful diabetes consultation with an improved health outcome are identified through literature review. The findings are used as the inspiration for designing and implementing a dynamic electronic patient-reported outcome measures (ePROM) mobile application.
The application promotes the identified healthcare practices by using the patient-gathered data of each user and tailoring the contents of their questionnaire to them. The application is usability tested with the System Usability Scale is deemed to have good usability (83.75/100) and be a facilitator for better consultations
Automatic Generation of Personalized Recommendations in eCoaching
Denne avhandlingen omhandler eCoaching for personlig livsstilsstøtte i sanntid ved bruk av informasjons- og kommunikasjonsteknologi. Utfordringen er å designe, utvikle og teknisk evaluere en prototyp av en intelligent eCoach som automatisk genererer personlige og evidensbaserte anbefalinger til en bedre livsstil. Den utviklede løsningen er fokusert på forbedring av fysisk aktivitet. Prototypen bruker bærbare medisinske aktivitetssensorer. De innsamlede data blir semantisk representert og kunstig intelligente algoritmer genererer automatisk meningsfulle, personlige og kontekstbaserte anbefalinger for mindre stillesittende tid. Oppgaven bruker den veletablerte designvitenskapelige forskningsmetodikken for å utvikle teoretiske grunnlag og praktiske implementeringer. Samlet sett fokuserer denne forskningen på teknologisk verifisering snarere enn klinisk evaluering.publishedVersio
Front-Line Physicians' Satisfaction with Information Systems in Hospitals
Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe
Be He@lthy - Be Mobile (A handbook on how to implement mAgeing)
The Be He@lthy, Be Mobile initiative is a global
partnership led by the World Health Organization
(WHO) and the International Telecommunication
Union (ITU), representing the United
Nations agencies for health and information
and communications technologies (ICTs). The
initiative supports the scale up of mobile health
technology (mHealth) within national health
systems to help combat noncommunicable diseases
(NCDs) and support healthy ageing.
Mobile health, or mHealth, is defined as "medical
and public health practice supported by mobile
devices, such as mobile phones, patient monitoring
devices, personal digital assistants, and
other wireless devices” (1). The Be Healthy, Be
Mobile initiative uses basic technologies common
in most mobile phones. The BHBM initiative
has overseen the development and implementation
of several mHealth programmes, including
mTobaccoCessation (2), mDiabetes, and mCervicalCancer.
The mHealth programme-specific
handbooks act as aids to policy-makers and
implementers of national or large-scale mHealth
programs. See Annex 1 for further information on
the Be He@lthy, Be Mobile initiative.
mHealth for Ageing, or mAgeing is a new programme
under the initiative, the central objective
of which is to assist older persons (a person
whose age has passed the median life expectancy
at birth) in maintaining functional ability and
living as independently and healthily as possible
through evidence-based self-management and
self-care interventions.
This handbook provides guidance for national
programmes and organizations responsible for
the care of older persons to develop, implement,
monitor, and evaluate an mAgeing programme.
The text messaging communication provided
uses evidence-based behaviour change techniques
to help older persons prevent and manage
early declines in intrinsic capacity and functional
ability. The mAgeing programme is based on
WHO’s Integrated Care for Older People (ICOPE):
Guidelines on community-level interventions to
manage declines in intrinsic capacity (3) which
include interventions to prevent declines in intrinsic
capacity and functional abilities in older
people, namely: mobility loss, malnutrition, visual
impairment and hearing loss; as well as cognitive
impairments and depressive symptoms. The
messages are designed to encourage participation
in activities, and to prevent, reduce, or even
partly reverse, significant losses in capacity. The
content of the mAgeing programme will complement
routine care offered by health care professionals
by supporting self-care and self-management.
All content in this handbook is based on the
WHO ICOPE Guidelines and other relevant WHO
recommendations. The ICOPE Guideline recommendations
were reached by the consensus of
a guideline development group, convened by
WHO, which based its decisions on a summary of
systematic reviews of the best quality evidence
most relevant to community-level care for older
people, as well as the most up-to-date research
on the effectiveness of mHealth
Technology applications
A summary of NASA Technology Utilization programs for the period of 1 December 1971 through 31 May 1972 is presented. An abbreviated description of the overall Technology Utilization Applications Program is provided as a background for the specific applications examples. Subjects discussed are in the broad headings of: (1) cancer, (2) cardiovascular disease, (2) medical instrumentation, (4) urinary system disorders, (5) rehabilitation medicine, (6) air and water pollution, (7) housing and urban construction, (8) fire safety, (9) law enforcement and criminalistics, (10) transportation, and (11) mine safety
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