Examining Mental Workload Relating to Digital Health Technologies in Health Care: Systematic Review

BackgroundThe workload in health care is increasing and hence, mental health issues are on the rise among health care professionals (HCPs). The digitization of patient care could be related to the increase in stress levels. It remains unclear whether the health information system or systems and digital health technologies (DHTs) being used in health care relieve the professionals or whether they represent a further burden. The mental construct that best describes this burden of technologies is mental workload (MWL). The measurement methods of MWL are particularly relevant in this sensitive setting. ObjectiveThis review aimed to address 2 different but related objectives: identifying the factors that contribute to the MWL of HCPs when using DHT and examining and exploring the applied assessments for the measurement of MWL with a special focus on eye tracking. MethodsFollowing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement, we conducted a systematic review and processed a literature search in the following databases: MEDLINE (PubMed), Web of Science, Academic Search Premier and CINAHL (EBSCO), and PsycINFO. Studies were eligible if they assessed the MWL of HCPs related to DHT. The review was conducted as per the following steps: literature search, article selection, data extraction, quality assessment (using the Standard Quality Assessment Criteria for Evaluation Primary Research Papers From a Variety of Fields [QualSyst]), data analysis, and data synthesis (narrative and tabular). The process was performed by 2 reviewers (in cases of disagreement, a third reviewer was involved). ResultsThe literature search process resulted in 25 studies that fit the inclusion criteria and examined the MWL of health care workers resulting from the use of DHT in health care settings. Most studies had sample sizes of 10-50 participants, were conducted in the laboratory, and had quasi-experimental or cross-sectional designs. The main results can be grouped into two categories: assessment methods and factors related to DHT that contribute to MWL. Most studies applied subjective methods for the assessment of MWL. Eye tracking did not play a major role in the selected studies. The factors contributing to a higher MWL were clustered into organizational and systemic factors. ConclusionsOur review of 25 papers shows a diverse assessment approach toward the MWL of HCPs related to DHT as well as 2 groups of relevant contributing factors to MWL. Our results are limited in terms of interpretability and causality due to methodological weaknesses of the included studies and may be limited by some shortcomings in the search process. Future research should concentrate on adequate assessments of the MWL of HCPs dependent on the setting, the evaluation of quality criteria, and further assessment of the contributing factors to MWL. Trial RegistrationPROSPERO (International Prospective Register of Systematic Reviews) CRD42021233271; https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD4202123327

3DLC: A Comprehensive Model for Personal Health Records Supporting New Types of Medical Applications

Motivated by the demographic change, many new medical applications are installed in the user's home environment. These applications make use of ambient sensors, enabling new forms of medical care. Personal Health Records (PHRs) are an instrument for the storage, presentation and communication of health related data provided by these applications. But there are still open issues regarding the cooperation between PHRs and the new applications. On the basis of two medical application scenarios, we developed a new model which defines the appropriate level of abstraction of data generated by medical applications to be stored inside the PHR. The model also determines which part of these data is relevant for the clinical decision making process, and how these data should be communicated to physicians. This paper describes the 3DLC model, which uses three dimensions (clinical decision, frequency and context dependence) to determine the type of the data. We further introduce a prototype PHR system that is able to fulfil the requirements of our scenarios

Das Gesundheitsdatennutzungsgesetz und was dies für die Forschung in der Intensiv- und Notfallmedizin bedeutet : Erläuterungen und erste Handlungsempfehlungen

The Health Data Utilization Act (GDNG) is the first nationwide legal basis for the use of healthcare data for research. Particularly relevant for intensive care and emergency medicine is the authorization of non-consensual data use (in-house research), including collaborative research by healthcare facilities. Another change is that there is a cultural shift from preventing unauthorised data use to transparency and control. These changes open up new opportunities for research, but are also associated with obligations. In this article, an interdisciplinary and interprofessional working group from three scientific societies explains the GDNG and formulates initial recommendations for action.Das Gesundheitsdatennutzungsgesetz (GDNG) schafft zum ersten Mal eine bundeseinheitliche Rechtsgrundlage für die Nutzung von Versorgungsdaten für die Forschung. Für die Intensiv- und Notfallmedizin ist besonders der Erlaubnistatbestand einer einwilligungsfreien Datennutzung (Eigenforschung) relevant, einschließlich der Verbundforschung von Gesundheitseinrichtungen. Darüber hinaus gibt es einen Kulturwechsel von der Verhinderung unerlaubter Datennutzung hin zu Transparenz und Kontrolle. Diese Veränderungen eröffnen neue Möglichkeiten für die Forschung, sind aber auch mit Pflichten verbunden. In einer interdisziplinären und interprofessionellen Arbeitsgruppe mit Vertretern von drei Fachgesellschaften wird in diesem Artikel das GDNG erläutert und erste Handlungsempfehlungen formuliert

Augmented Reality-Based Surgery on the Human Cadaver Using a New Generation of Optical Head-Mounted Displays: Development and Feasibility Study

BackgroundAlthough nearly one-third of the world’s disease burden requires surgical care, only a small proportion of digital health applications are directly used in the surgical field. In the coming decades, the application of augmented reality (AR) with a new generation of optical-see-through head-mounted displays (OST-HMDs) like the HoloLens (Microsoft Corp) has the potential to bring digital health into the surgical field. However, for the application to be performed on a living person, proof of performance must first be provided due to regulatory requirements. In this regard, cadaver studies could provide initial evidence. ObjectiveThe goal of the research was to develop an open-source system for AR-based surgery on human cadavers using freely available technologies. MethodsWe tested our system using an easy-to-understand scenario in which fractured zygomatic arches of the face had to be repositioned with visual and auditory feedback to the investigators using a HoloLens. Results were verified with postoperative imaging and assessed in a blinded fashion by 2 investigators. The developed system and scenario were qualitatively evaluated by consensus interview and individual questionnaires. ResultsThe development and implementation of our system was feasible and could be realized in the course of a cadaver study. The AR system was found helpful by the investigators for spatial perception in addition to the combination of visual as well as auditory feedback. The surgical end point could be determined metrically as well as by assessment. ConclusionsThe development and application of an AR-based surgical system using freely available technologies to perform OST-HMD–guided surgical procedures in cadavers is feasible. Cadaver studies are suitable for OST-HMD–guided interventions to measure a surgical end point and provide an initial data foundation for future clinical trials. The availability of free systems for researchers could be helpful for a possible translation process from digital health to AR-based surgery using OST-HMDs in the operating theater via cadaver studies

AAL-Onto: A formal representation of RAALI integration profiles

The integration and commissioning of Ambient Assisted Living (AAL) systems are time consuming and complicated. The lack of interoperability of available AAL system components has to be considered as an obstacle especially for innovative SMEs. In order to ease integration and commissioning of systems, knowledge based methods should be taken into account to enable innovative characteristics such as design automation, self-configuration and self-management. Semantic technologies are suitable instruments for mastering the problems of interoperability of heterogeneous and distributed systems. As an important prerequisite for the emergence of knowledge-based assistance functions a standard for an unambiguous representation of AAL relevant knowledge has to be developed. In this article, the development of an AAL ontology is proposed as a formal basis for knowledge-based system functions. A prototype of an AAL specific ontology engineering process is presented through the modeling example of a formal representation of a sensor block that is part of an AAL Integration Profile proposed by the RAALI project consortium

Die Zukunft sicherheitskritischer Mensch-Computer-Interaktion

Sicherheitskritische Mensch-Computer-Interaktion ist nicht nur derzeit, sondern auch zukünftig ein äußerst relevantes Thema. Hierbei kann ein Lehr- und Fachbuch, wie dieses, immer nur einen punktuellen Stand abdecken. Dennoch kann der Versuch unternommen werden, aktuelle Trends zu identifizieren und einen Ausblick in die Zukunft zu wagen. Genau das möchte dieses Kapitel erreichen: Es sollen zukünftige Entwicklungen vorausgesagt und versucht werden, diese korrekt einzuordnen. Das ist an dieser Stelle nicht nur durch den Herausgeber, sondern durch Abfrage bei zahlreichen am Lehrbuch beteiligten Autoren geschehen. Neben einem Ausblick auf Grundlagen und Methoden werden dementsprechend auch sicherheitskritische interaktive Systeme und sicherheitskritische kooperative Systeme abgedeckt

Die Zukunft sicherheitskritischer Mensch-Computer-Interaktion

Sicherheitskritische Mensch-Computer-Interaktion ist nicht nur derzeit, sondern auch zukünftig ein äußerst relevantes Thema. Hierbei kann ein Lehr- und Fachbuch, wie dieses, immer nur einen punktuellen Stand abdecken. Dennoch kann der Versuch unternommen werden, aktuelle Trends zu identifizieren und einen Ausblick in die Zukunft zu wagen. Genau das möchte dieses Kapitel erreichen: Es sollen zukünftige Entwicklungen vorausgesagt und versucht werden, diese korrekt einzuordnen. Das ist an dieser Stelle nicht nur durch den Herausgeber, sondern durch Abfrage bei zahlreichen am Lehrbuch beteiligten Autoren geschehen. Neben einem Ausblick auf Grundlagen und Methoden werden dementsprechend auch sicherheitskritische interaktive Systeme und sicherheitskritische kooperative Systeme abgedeckt