The few touch digital diabetes diary : user-involved design of mobile self-help tools for peoplewith diabetes

Paper number 2, 4, 5 and 7 are not available in Munin, due to publishers' restrictions: 2. Årsand E, and Demiris G.: "User-Centered Methods for Designing Patient-Centric Self-Help Tools", Informatics for Health and Social Care, 2008 Vol. 33, No. 3, Pages 158-169 (Informa Healthcare). Available at http://dx.doi.org/10.1080/17538150802457562 4. Årsand E, Olsen OA, Varmedal R, Mortensen W, and Hartvigsen G.: "A System for Monitoring Physical Activity Data Among People with Type 2 Diabetes", pages 173-178 in S.K. Andersen, et.al. (eds.) "eHealth Beyond the Horizon - Get IT There", Proceedings of MIE2008, Studies in Health Technology and Informatics, Volume 136, May 2008, ISBN: 978-1-58603-864-9 5. Årsand E, Tufano JT, Ralston J, and Hjortdahl P.: "Designing Mobile Dietary Management Support Technologies for People with Diabetes", Journal of Telemedicine and Telecare, 2008 Volume 14, Number 7, Pp. 329-332 (Royal Society of Medicine Press). Available at http://dx.doi.org/10.1258/jtt.2008.007001 7. Årsand E, Walseth OA, Andersson N, Fernando R, Granberg O, Bellika JG, and Hartvigsen G.: "Using Blood Glucose Data as an Indicator for Epidemic Disease Outbreaks", pages 199-204 in R. Engelbrecht et.al. (eds.): "Connecting Medical Informatics and Bio-Informatics", Proceedings of MIE2005, Studies in Health Technology and Informatics, Volume 116, August 2005, ISBN: 978-1-58603-549-5. Check availabilityParadoxically, the technological revolution that has created a vast health problem due to a drastic change in lifestyle also holds great potential for individuals to take better care of their own health. The first consequence is not addressed in this dissertation, but the second represents the focus of the work presented, namely utilizing ICT to support self-management of individual health challenges. As long as only 35% of the patients in Norway achieve the International Diabetes Federation‟s goal for blood glucose (HbA1c), actions and activities to improve blood glucose control and related factors are needed. The presented work focuses on the development and integration of alternative sensor systems for blood glucose and physical activity, and a fast and effortless method for recording food habits. Various user-interface concepts running on a mobile terminal constitute a digital diabetes diary, and the total concept is referred to as the “Few Touch application”. The overall aim of this PhD project is to generate knowledge about how a mobile tool can be designed for supporting lifestyle changes among people with diabetes. Applying technologies and methods from the informatics field has contributed to improved insight into this issue. Conversely, addressing the concrete use cases for people with diabetes has resulted in the achievement of ICT designs that have been appreciated by the cohorts involved. Cooperation with three different groups of patients with diabetes over several years and various methods and theories founded in computer science, medical informatics, and telemedicine have been combined in design and research on patient-oriented aids. The blood glucose Bluetooth adapter, the step counter, and the nutrition habit registration system that have been developed were all novel and to my knowledge unique designs at the time they were first tested, and this still applies to the latter two. Whether it can be claimed that the total concept presented, the Few Touch application, will increase quality of life, is up to future research and large-scale tests of the system to answer. However, results from the Type 2 diabetes half-year study showed that several of the participants did adjust their medication, food habits and/or physical activity due to use of the application

Use of a Data-Sharing System During Diabetes Consultations

Patient-gathered self-management data and shared decision-making are touted as the answer to improving an individual’s health situation as well as collaboration between patients and their providers leading to more effective treatment plans. However, there is a gap between this ideal and reality – a lack of data-sharing technology. Here, we present the impact that the FullFlow System for sharing patient-gathered data during diabetes consultations, had on the patient-provider relationship and consultation discussion

Including patient-generated health data in electronic health records – a solution for CGM-data

Patients with diabetes and health personnel do not have an optimal way of interacting. Health personnel must use multiple ICT systems, such as third-party companies’ services, to access health-related data from diverse vendors’ CGM platforms and Electronic Health Record (EHR). Furthermore, other health-related data like physical activities, quality of life or well-being is often discussed but rarely stored inside the EHR system. We propose a future-proof architecture for diabetes medical consultation using the HL7 Fast Healthcare Interoperability Resources (FHIR) standard

Designing, implementing, and testing a modern electronic clinical study management system – the HUBRO system

Clinical trials need to adapt to the rapid development of today’s digital health technologies. The fast phase these technologies are changing today, make the clinical study administration demanding. To meet this challenge, new and more efficient platforms for performing clinical trials in this domain need to be designed. Since the process of following up such trials is very time-consuming, it calls for revisiting several of the methods for performing both randomized, and other clinical trials. We present system for electronic management of clinical studies that addresses many of the time-consuming challenges, which additionally address many of the quality assurance aspects. We also present results from testing the system in two studies with 50 and 8 participants

How mHealth can facilitate collaboration in diabetes care: qualitative analysis of codesign workshops

Background - Individuals with diabetes are using mobile health (mHealth) to track their self-management. However, individuals can understand even more about their diabetes by sharing these patient-gathered data (PGD) with health professionals. We conducted experience-based co-design (EBCD) workshops, with the aim of gathering end-users’ needs and expectations for a PGD-sharing system. Methods - N = 15 participants provided feedback about their experiences and needs in diabetes care and expectations for sharing PGD. The first workshop (2017) included patients with Type 2 Diabetes (T2D) (n = 4) and general practitioners (GPs) (n = 3). The second workshop (2018) included patients with Type 1 Diabetes (T1D) (n = 5), diabetes specialists (n = 2) and a nurse. The workshops involved two sessions: separate morning sessions for patients and healthcare providers (HCPs), and afternoon session for all participants. Discussion guides included questions about end-users’ perceptions of mHealth and expectations for a data-sharing system. Activities included brainstorming and designing paper-prototypes. Workshops were audio recorded, transcribed and translated from Norwegian to English. An abductive approach to thematic analysis was taken. Results Emergent themes were mHealth technologies’ impacts on end-users, and functionalities of a data-sharing system. Within these themes, similarities and differences between those with T1D and T2D, and between HCPs, were revealed. Patients and providers agreed that HCPs could use PGD to provide more concrete self-management recommendations. Participants’ paper-prototypes revealed which data types should be gathered and displayed during consultations, and how this could facilitate shared-decision making. Conclusion The diverse and differentiated results suggests the need for flexible and tailorable systems that allow patients and providers to review summaries, with the option to explore details, and identify an individual’s challenges, together. Participants’ feedback revealed that both patients and HCPs acknowledge that for mHealth integration to be successful, not only must the technology be validated but feasible changes throughout the healthcare education and practice must be addressed. Only then can both sides be adequately prepared for mHealth data-sharing in diabetes consultations. Subsequently, the design and performance of the joint workshop sessions demonstrated that involving both participant groups together led to efficient and concrete discussions about realistic solutions and limitations of sharing mHealth data in consultations

Collecting health-related research data using consumer-based wireless smart scales

Background: Serious public-health concerns such as overweight and obesity are in many cases caused by excess intake of food combined with decreases in physical activity. Smart scales with wireless data transfer can, together with smart watches and trackers, observe changes in the population’s health. They can present us with a picture of our metabolism, body health, and disease risks. Combining body composition data with physical activity measurements from devices such as smart watches could contribute to building a human digital twin. Objective: The objectives of this study were to (1) investigate the evolution of smart scales in the last decade, (2) map status and supported sensors of smart scales, (3) get an overview of how smart scales have been used in research, and (4) identify smart scales for current and future research. Method: We searched for devices through web shops and smart scale tests/reviews, extracting data from the manufacturer’s official website, user manuals when available, and data from web shops. We also searched scientific literature databases for smart scale usage in scientific papers. Result: We identified 165 smart scales with a wireless connection from 72 different manufacturers, released between 2009 and end of 2021. Of these devices, 49 (28%) had been discontinued by end of 2021. We found that the use of major variables such as fat and muscle mass have been as good as constant over the years, and that minor variables such as visceral fat and protein mass have increased since 2015. The main contribution is a representative overview of consumer grade smart scales between 2009 and 2021. Conclusion: The last six years have seen a distinct increase of these devices in the marketplace, measuring body composition with bone mass, muscle mass, fat mass, and water mass, in addition to weight. Still, the number of research projects featuring connected smart scales are few. One reason could be the lack of professionally accurate measurements, though trend analysis might be a more feasible usage scenario

Information and communication technology-based interventions for chronic diseases consultation: Scoping review

Background: Medical consultations are often critical meetings between patients and health personnel to provide treatment, health-management advice, and exchange of information, especially for people living with chronic diseases. The adoption of patient-operated Information and Communication Technologies (ICTs) allows the patients to actively participate in their consultation and treatment. The consultation can be divided into three different phases: before, during, and after the meeting. The difference is identified by the activities in preparation (before), the meeting, conducted either physically or in other forms of non-face-to-face interaction (during), and the follow-up activities after the meeting (after). Consultations can be supported by various ICT-based interventions, often referred to as eHealth, mHealth, telehealth, or telemedicine. Nevertheless, the use of ICTs in healthcare settings is often accompanied by security and privacy challenges due to the sensitive nature of health information and the regulatory requirements associated with storing and processing sensitive information. Objective: This scoping review aims to map the existing knowledge and identify gaps in research about ICT-based interventions for chronic diseases consultations. The review objective is guided by three research questions: (1) which ICTs are used by people with chronic diseases, health personnel, and others before, during, and after consultations; (2) which type of information is managed by these ICTs; and (3) how are security and privacy issues addressed? Methods: We performed a literature search in ACM, IEEE, PubMed, Scopus, and Web of Science and included primary studies published between January 2015 and June 2020 that used ICT before, during, and/or after a consultation for chronic diseases. This review presents and discusses the findings from the included publications structured around the three research questions. Results: Twenty-four studies met the inclusion criteria. Only five studies reported the use of ICTs in all three phases: before, during, and after consultations. The main ICTs identified were smartphone applications, webbased portals, cloud-based infrastructures, and electronic health record systems. Different devices like sensors and wearable devices were used in 23 studies to gather diverse information. Regarding the type of information managed by these ICTs, we identified nine categories: physiological data, treatment information, medical history, consultation media like images or videos, laboratory results, reminders, lifestyle parameters, symptoms, and patient identification. Security issues were addressed in 20 studies, while only eight of the included studies addressed privacy issues. Conclusions: This scoping review highlights the potential for a new model of consultation for patients with chronic diseases. Furthermore, it emphasizes the possibilities for consultations besides physical and remote meetings

Exploring Obese Adults’ Preferences for a Physical Activity Chatbot: Qualitative Study

Social media chatbots could help increase obese adults' physical activity behaviour. The study aims to explore obese adults' preferences for a physical activity chatbot. Individual- and focus group interviews will be conducted in 2023. Identified preferences will inform the development of a chatbot that motivates obese adults to increase their physical activity. The interview guide was tested in a pilot interview

Health research requires efficient platforms for data collection from personal devices

Data from consumer-based devices for collecting personal health-related data could be useful in diagnostics and treatment. This requires a flexible and scalable software and system architecture to handle the data. This study examines the existing mSpider platform, addresses shortcomings in security and development, and suggests a full risk analysis, a more loosely coupled component- based system for long term stability, better scalability, and maintainability. The goal is to create a human digital twin platform for an operational production environment