A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP)

<p>Abstract</p> <p>Background</p> <p>Cardiac rehabilitation programs offer effective means to prevent recurrence of a cardiac event, but poor uptake of current programs have been reported globally. Home based models are considered as a feasible alternative to avoid various barriers related to care centre based programs. This paper sets out the study design for a clinical trial seeking to test the hypothesis that these programs can be better and more efficiently supported with novel Information and Communication Technologies (ICT).</p> <p>Methods/Design</p> <p>We have integrated mobile phones and web services into a comprehensive home- based care model for outpatient cardiac rehabilitation. Mobile phones with a built-in accelerometer sensor are used to measure physical exercise and WellnessDiary software is used to collect information on patients' physiological risk factors and other health information. Video and teleconferencing are used for mentoring sessions aiming at behavioural modifications through goal setting. The mentors use web-portal to facilitate personal goal setting and to assess the progress of each patient in the program. Educational multimedia content are stored or transferred via messaging systems to the patients phone to be viewed on demand. We have designed a randomised controlled trial to compare the health outcomes and cost efficiency of the proposed model with a traditional community based rehabilitation program. The main outcome measure is adherence to physical exercise guidelines.</p> <p>Discussion</p> <p>The study will provide evidence on using mobile phones and web services for mentoring and self management in a home-based care model targeting sustainable behavioural modifications in cardiac rehabilitation patients.</p> <p>Trial registration</p> <p>The trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with number ACTRN12609000251224.</p

A Software Architecture and Data Model for Community-Based Healthcare Environments

Abstract — Major changes in healthcare delivery are needed to ease the pressures caused by global increase in ageing population and prevalence of chronic diseases. Recent care initiatives address these problems by delivering care in community-based settings, away from hospitals. The community care model requires that a patient’s health condition is also monitored in the home environment to allow assessment and follow-up of the health status. Our work presented in this paper aims to design a system architecture and data model that would provide efficient means to perform essential information management for ambulatory monitoring in a home health care setting. We describe a general purpose architecture and data model that is designed for collecting ambulatory data from various existing devices and systems, as well as for analyzing, storing and presenting clinically significant information to the care personnel. I

Can a mobile phone be used as a pedometer in an outpatient cardiac rehabilitation program?

Our aim is to evaluate the use of a mobile phone as a step counter in cardiovascular disease patients, to measure daily walking activity through the course of an outpatient cardiac rehabilitation program. A conventional Omron pedometer (HJ-7201TE) and a mobile phone inbuilt step counter (Nokia StepCounter Beta V0.26) were used in the study. Firstly, we conducted a laboratory trial with 11 normal healthy subjects to investigate the performance of the two devices over different step rates during walking. Secondly, we collected and analysed 141 daily step count records from 18 patients wearing the two devices during a clinical trial. The laboratory study revealed that both devices maintain an accuracy of less than 2% error rate within step rates of between 85 and 125 steps/min but tend to degrade outside this step rate range. During the clinical trial, patients carried the mobile phone as well as the Omron pedometer in a free living environment. The results of this study showed that despite the underperformance of these devices during the slow walk, the reliability of the mobile phone ((error 10%+/-30%) was better than the Omron pedometer (20.5%+/30% error) and accounted reliable assessment of 84% of the patients. This demonstrates the feasibility of using the inbuilt step counter as an integral solution of the mobile phone for delivery an ICT-based home care CR program

Improving the use, analysis and integration of patient health data

Health Information Technologies (HIT) are being deployed world- wide to improve access to individual patient information. Primarily this is through the development of electronic health records (EHR) and electronic medical records (EMR). While the proper collection of this data has reached a high level of maturity, the use and analysis of it is only in its infancy. This data contains information which can potentially improve treatment for the individual patient and for the cohort of patients suffering a similar disease. The data can also provide valuable information for broader research purposes. In this paper we discuss the research contributions we are making in improving the use and analysis of patient data. Our projects include the analysis of physiological data, the extraction of information from multi-modal data types, the linking of data stored in heterogeneous data sources and the semantic integration of data. Through these projects we are providing new ways of using health data to improve health care delivery and provide support for medical research