Smart Glasses in Health Care: A Patient Trust Perspective

Digitization in the health care sector is striving forward. Wearable technologies like smart glasses are being evaluated for providing hands-free and septic-safe access to information systems at the point of care. While smart glasses hold the potential to make service processes more efficient and effective, it is unclear whether patients would opt-in to treatments involving smart glasses. Patients are not active users of smart glasses but are nevertheless affected of outcomes produced by the symbiosis of health care workers and smart glasses. Using an online survey with 437 respondents, we find that it is important to properly explain to patients why smart glasses are being used and to proactively address data privacy concerns. Otherwise, smart glasses can significantly increase risk perceptions, reduce patients’ estimates of health care workers’ abilities, and decrease patients’ willingness to opt-in to medical procedures

CONCEPTUALIZING PASSIVE TRUST: THE CASE OF SMART GLASSES IN HEALTHCARE

In recent years the digitisation of healthcare has been moving forward. Emerging technologies, such as smart glasses, are being tested for allowing healthcare workers information access at the point of care, while being able to work hands-free. Yet it remains unclear how the use of smart glasses will affect the trust relationship between patients and caregivers. The patient is not an active user of the smart glasses but is nevertheless dependent on outcomes influenced by the smart glasses. The patient, therefore, becomes a passive trustor of this technology. Building up-on existing trust research literature, we present a research model and extend it by interviewing 20 patients about their experiences with caregivers and their perceptions regarding the use of smart glasses in healthcare. We find that communication with patients is a key driver of passive trust in technology and trust in caregivers. This research contributes to a better understanding of the trust relationship between patients and caregivers and provides insights into the construct of passive trust in technology. In order to extend the qualitative data analysis, future research should investigate the extent of the acceptance of smart glasses by patients within healthcare facilities

CatCare: Designing a serious game to foster hand hygiene compliance in health care facilities

Lack of proper hand hygiene is often the source of hospital acquired infections. Despite many efforts, on average, health care workers still perform hand hygiene in less than 50% of the occasions in which they must. Serious games have been used successfully to achieve behavioral change in other health care domains. In order to tackle the complex problem of hand hygiene compliance we followed a design science research approach combining the build-phase with three evaluation cycles. In this paper, we present a preliminary design of a serious game to explore the possibilities of achieving better hand hygiene compliance of health care workers

Stray Off Topic to Stay On Topic: Preserving Interaction and Team Morale in a Highly Collaborative Course while at a Distance

The coronavirus disease of 2019 (COVID-19) pandemic has prompted schools and universities to shift their teaching to virtual classrooms from one day to the other. As a unique example, we had to virtualize the second half of a two-semester course on human-centered innovation, which heavily relies on direct interaction with and among students in small groups. In going virtual, we found adapting assignments to be only the tip of the iceberg. Despite being familiar with the students, we faced challenges in preserving high levels of creative interaction and in surveying team morale and status. Reflecting on our experiences, we detail solutions related to the lack of creative interaction by fostering off-topic chit-chat and surveying team morale by introducing more explicit communication and seeking team consent. To help teachers adapt to virtual teaching, we discuss how our mitigation approaches, which we developed in an extreme setting that required close, creative collaboration, may apply to virtual teaching in general

A Human-Centric Approach to Digital Innovation Projects in Health Care: Learnings from Applying Design Thinking

Digital innovation is described to harbor great potential to improve health care. Yet, much of this potential has not been realized. A number of context-specific factors are described to limit implementation of innovative digital solutions. To attenuate these limits in development, we propose a human-centric approach using elements of Design Thinking. We follow a design science research approach using two cases of digital innovation in health care. Based on qualitative and quantitative evaluations performed with care givers we used an iterative prototyping approach to create digital artifacts aimed at improving the underlying health care processes. We detail the research processes of an augmented reality smart glass application for documenting chronic wounds and a smartphone application to support dispensing medication. Based on the exemplary cases, we derive process learnings on applying Design Thinking methods to digital innovation projects in health care

Evaluation of point shear wave elastography using acoustic radiation force impulse imaging for longitudinal fibrosis assessment in patients with HBeAg-negative HBV infection

Background: Accurate assessment of hepatic fibrosis in patients with chronic HBeAg-negative Hepatitis B is of crucial importance not only to predict the long-term clinical course, but also to evaluate antiviral therapy indication. The aim of this study was to prospectively assess the utility of point shear wave elastography (pSWE) for longitudinal non-invasive fibrosis assessment in a large cohort of untreated patients with chronic HBeAg-negative hepatitis B virus (HBV) infection. Methods: 407 consecutive patients with HBeAg-negative HBV infection who underwent pSWE, transient elastography (TE) as well as laboratory fibrosis markers, including fibrosis index based on four factors (FIB-4), aspartate to platelet ratio index (APRI) and FibroTest, on the same day were prospectively followed up for six years. Patients were classified into one of the three groups: inactive carriers (IC; HBV-DNA 40 U/L); grey zone group 2 (GZ-2; HBV-DNA >2000 IU/mL and ALT <40 U/L). Results: pSWE results were significantly correlated with TE (r = 0.29, p < 0.001) and APRI (r = 0.17; p = 0.005). Median pSWE values did not differ between IC, GZ-1 and GZ-2 patients (p = 0.82, p = 0.17, p = 0.34). During six years of follow-up, median pSWE and TE values did not differ significantly over time (TE: p = 0.27; pSWE: p = 0.05). Conclusion: Our data indicate that pSWE could be useful for non-invasive fibrosis assessment and follow-up in patients with HBeAg-negative chronic HBV infection

COVID-19 Induced Acute Respiratory Distress Syndrome — A Multicenter Observational Study

Background: Proportions of patients dying from the coronavirus disease-19 (COVID-19) vary between different countries. We report the characteristics; clinical course and outcome of patients requiring intensive care due to COVID-19 induced acute respiratory distress syndrome (ARDS). Methods: This is a retrospective, observational multicentre study in five German secondary or tertiary care hospitals. All patients consecutively admitted to the intensive care unit (ICU) in any of the participating hospitals between March 12 and May 4, 2020 with a COVID-19 induced ARDS were included. Results: A total of 106 ICU patients were treated for COVID-19 induced ARDS, whereas severe ARDS was present in the majority of cases. Survival of ICU treatment was 65.0%. Median duration of ICU treatment was 11 days; median duration of mechanical ventilation was 9 days. The majority of ICU treated patients (75.5%) did not receive any antiviral or anti-inflammatory therapies. Venovenous (vv) ECMO was utilized in 16.3%. ICU triage with population-level decision making was not necessary at any time. Univariate analysis associated older age, diabetes mellitus or a higher SOFA score on admission with non-survival during ICU stay. Conclusions: A high level of care adhering to standard ARDS treatments lead to a good outcome in critically ill COVID-19 patients

Long-term persistence of HCV resistance-associated substitutions after DAA treatment failure

BACKGROUND & AIMS: Data on the long-term persistence of HCV resistance-associated substitutions (RASs) after treatment with direct-acting antivirals (DAAs) are limited. This study evaluated the persistence of NS3, NS5A, and NS5B RASs for up to 5 years after the end of treatment (EOT). METHODS: We included samples from 678 individuals with an HCV genotype (GT) 1 or 3 infection and virologic DAA treatment failure collected in the European Resistance Database. NS3, NS5A, and NS5B were sequenced, and clinical parameters were evaluated. RESULTS: A total of 242 individuals with HCV GT1a (36%), 237 with GT1b (35%), and 199 (29%) with GT3 and a DAA failure were included. After protease inhibitor failure, the frequencies of NS3 RASs were 40-90% after the EOT. NS3 RASs disappeared rapidly in GT1b and GT3 after follow-up month 3 but were stable (≥60%) in GT1a owing to Q80K. The SOF-resistant NS5B RAS S282T was only found in individuals with GT3a. Non-nucleoside NS5B RASs were frequent in GT1 (56-80%) and decreased to 30% in GT1a but persisted in GT1b. NS5A RASs were very common in all GTs after NS5A inhibitor failure (88-95%), and even after follow-up month 24, their frequency was 65% and higher. However, RASs in GT1b had a stable course, whereas RASs in GT1a and GT3 declined slightly after follow-up month 24 (GT1a, 68%; GT1b, 95%; and GT3, 65%), mainly because of the slow decline of high-level resistant Y93H. CONCLUSIONS: We found that low-to medium-level RASs persisted, whereas high-level resistant RASs disappeared over time. Different patterns of RAS persistence according to HCV subtype could have implications for retreatment with first-generation DAAs and for global HCV elimination goals. IMPACT AND IMPLICATIONS: There are little data on the long-term persistence of HCV resistance-associated substitutions (RASs) after DAA treatment failure, and RASs could have an impact on the efficacy of a rescue treatment. Especially in countries with limited availability of VOX/VEL/SOF or G/P/SOF, different patterns of RAS persistence could have implications for retreatment with first-generation DAAs and for global HCV elimination goals. The different patterns of RAS persistence identified in this study can be used to derive general rules regarding the persistence of RASs after DAA failure that could be applied by physicians in less developed countries to plan individualized HCV retreatment