Evaluation Study of Australian Telehealth Projects

This paper appeared at the 8th Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2015), Sydney, Australia, January 2015. Conferences in Research and Practice in Information Technology (CRPIT), Vol. 164, Anthony Maeder and Jim Warren, Ed. Reproduction for academic, not-for profit purposes permitted provided this text is included.This paper provides an overview of selected telehealth projects involving pilot or trial implementations, undertaken in Australia in the period since 2000, which have undergone substantial formal evaluations reported in the peer reviewed scientific literature. Barriers and enablers reported for these telehealth projects are identified and the evaluation aspects are presented using a recently proposed generalised evaluation framework

The Potential for Machine Learning Analysis over Encrypted Data in Cloud-based Clinical Decision Support - Background and Review

This paper appeared at the 8th Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2015), Sydney, Australia, January 2015. Conferences in Research and Practice in Information Technology (CRPIT), Vol. 164, Anthony Maeder and Jim Warren, Ed. Reproduction for academic, not-for profit purposes permitted provided this text is includedIn an effort to reduce the risk of sensitive data exposure in untrusted networks such as the public cloud, increasing attention has recently been given to encryption schemes that allow specific computations to occur on encrypted data, without the need for decryption. This relies on the fact that some encryption algorithms display the property of homomorphism, which allows them to manipulate data in a meaningful way while still in encrypted form. Such a framework would find particular relevance in Clinical Decision Support (CDS) applications deployed in the public cloud. CDS applications have an important computational and analytical role over confidential healthcare information with the aim of supporting decision-making in clinical practice. This review paper examines the history and current status of homomoprhic encryption and its potential for preserving the privacy of patient data underpinning cloud-based CDS applications

Monitoring falls in elderly people: Lessons from a community-based project

This article is published online with Open Access by IOS Press and distributed under the terms of the Creative Commons Attribution Non-Commercial License.Objectives. This paper describes an evaluation of a community-based fall-detection project using smart phone based tri-axial accelerometry to identify factors that affect adoption and use of such technology by elderly people. Methods. A mixed methods study using questionnaires and semi-structured interviews was conducted to evaluate attitudes of the elderly people participating, as well as project stakeholders involved in the project. Information registered in a web-based fall management system was analyzed both qualitatively and quantitatively, using an adapted version of Unified Theory of Acceptance and Use of Technology (UTAUT). Results. Adoption rate was 61.7% and attrition rate was 57%, the most common reasons for attrition being health deterioration (50%) and problems with the device and the network (26.2%). Conclusion. We identified a number of challenges that affected the success of this project, including problems with the software, usability issues with the device, coverage of the network, training of participants, an

Trialling a Personal Falls Monitoring System using Smart Phone

Copyright © 2015, Australian Computer Society, Inc. This paper appeared at the 8th Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2015), Sydney, Australia, January 2015. Conferences in Research and Practice in Information Technology (CRPIT), Vol. 164, Anthony Maeder and Jim Warren, Ed. Reproduction for academic, not-for-profit purposes permitted provided this text is included.This paper describes a personal falls monitoring project using smart phone based tri-axial accelerometry, for surveillance of elderly people with falls risk living independently at home. The project relied on collaboration of three parties to achieve its clinical, research and technology aims. The results of data collection during the six month trial period are presented and analysed here. These results indicate a very high rate of false positives (94.7%) which would need to be addressed in future development of the system

Managing chronic disease with home telecare : a system architecture and case study

An overview of the system architecture of a home telecare system (HTS) that was successfully deployed in city and rural Australia Is presented. We describe a case study from a patient with chronic obstructive pulmonary disease who was monitored in her home for a six-month period. A summary of patient and clinician responses to initial and final evaluation questionnaires is presented. There was generally a high level of acceptance of the HTS with both patients and their general practitioners responding favorably on its ease of use, effectiveness and likely impact on improving management of chronic disease.2 page(s

Design of a decision-support architecture for management of remotely monitored patients

Telehealth is the provision of health services at a distance. Typically, this occurs in unsupervised or remote environments, such as a patient’s home. We describe one such telehealth system and the integration of extracted clinical measurement parameters with a decision-support system (DSS). An enterprise application-server framework, combined with a rules engine and statistical analysis tools, is used to analyze the acquired telehealth data, searching for trends and shifts in parameter values, as well as identifying individual measurements that exceed predetermined or adaptive thresholds. An overarching business process engine is used to manage the core DSS knowledge base and coordinate workflow outputs of the DSS. The primary role for such a DSS is to provide an effective means to reduce the data overload and to provide a means of health risk stratification to allow appropriate targeting of clinical resources to best manage the health of the patient. In this way, the system may ultimately influence changes in workflow by targeting scarce clinical resources to patients of most need. A single case study extracted from an initial pilot trial of the system, in patients with chronic obstructive pulmonary disease and chronic heart failure, will be reviewed to illustrate the potential benefit of integrating telehealth and decision support in the management of both acute and chronic disease

Home telecare for chronic disease management

We review the development of an Internet-enabled home clinical workstation for the management of chronic disease, and the implementation of a clinical trial to test the functionality, usability and effectiveness of the system in both a city and a remote country setting. The Home Telecare System integrates with established primary care services to provide a new paradigm of active disease management through the daily collection of clinical data and assessment of functional health status, and the provision of feedback for patient self-management and education. A novel Medications Management module is also implemented to permit on line variation of prescribed medications.4 page(s