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

Communication in Healthcare: Opportunities for information technology and concerns for patient safety

Understanding healthcare workflow is fundamental for design and implementation of information systems. Communication and information exchange between healthcare professionals plays a pivotal role in developing smooth workflow within and between healthcare organizations. The study in this thesis analyzes the interaction between Information Technology (IT) and the medication process within and between healthcare organizations. The focus is on the interactions that lead to communication problems and as a result lead to unintended negative consequences on patient safety. The thesis examines several cases of IT intervention to improve intra- and inter-organizational communication. It raises important implications on how to design and implement IT systems that support healthcare processes without jeopardizing patient safety. The author concludes for IT to improve healthcare communication and patient safety, at intra-organizational level, it has to support the highly integrated nature of the shared healthcare work. At inter-organizational level the main challenge is that different pieces of the shared work are not sufficiently integrated

Inter-organisational communication networks in healthcare: centralised versus decentralised approaches

Background: To afford efficient and high quality care, healthcare providers increasingly need to exchange patient data. The existence of a communication network amongst care providers will help them to exchange patient data more efficiently. Information and communication technology (ICT) has much potential to facilitate the development of such a communication network. Moreover, in order to offer integrated care interoperability of healthcare organizations based upon the exchanged data is of crucial importance. However, complications around such a development are beyond technical impediments. Objectives: To determine the challenges and complexities involved in building an Inter-organisational Communication network (IOCN) in healthcare and the appropriations in the strategies. Case study: Interviews, literature review, and document analysis were conducted to analyse the developments that have taken place toward building a countrywide electronic patient record and its challenges in The Netherlands. Due to the interrelated nature of technical and non-technical problems, a socio-technical approach was used to analyse the data and define the challenges. Results: Organisational and cultural changes are necessary before technical solutions can be applied. There are organisational, financial, political, and ethicolegal challenges that have to be addressed appropriately. Two different approaches, one ‘‘centralised’’ and the other ‘‘decentralised’’ have been used by Dutch healthcare providers to adopt the necessary changes and cope with these challenges. Conclusion: The best solutions in building an IOCN have to be drawn from both the centralised and the decentralised approaches. Local communication initiatives have to be supervised and supported centrally and incentives at the organisations’ interest level have to be created to encourage the stakeholder organisations to adopt the necessary changes

A qualitative study of factors influencing ePHR adoption by caregivers and care providers of Alzheimer's patients:An extension of the unified theory of acceptance and use of technology model

Background and AimsAs the nowadays provision of many healthcare services relies on technology, a better understanding of the factors contributing to the acceptance and use of technology in health care is essential. For Alzheimer's patients, an electronic personal health record (ePHR) is one such technology. Stakeholders should understand the factors affecting the adoption of this technology for its smooth implementation, adoption, and sustainable use. So far, these factors have not fully been understood for Alzheimer's disease (AD)-specific ePHR. Therefore, the present study aimed to understand these factors in ePHR adoption based on the perceptions and views of care providers and caregivers involved in AD care. MethodsThis qualitative study was conducted from February 2020 to August 2021 in Kerman, Iran. Seven neurologists and 13 caregivers involved in AD care were interviewed using semi-structured and in-depth interviews. All interviews were conducted through phone contacts amid Covid-19 imposed restrictions, recorded, and transcribed verbatim. The transcripts were coded using thematic analysis based on the unified theory of acceptance and use of technology (UTAUT) model. ATLAS.ti8 was used for data analysis. ResultsThe factors affecting ePHR adoption in our study comprised subthemes under the five main themes of performance expectancy, effort expectancy, social influence, facilitating conditions of the UTAUT model, and the participants' sociodemographic factors. From the 37 facilitating factors and 13 barriers identified for ePHR adoption, in general, the participants had positive attitudes toward the ease of use of this system. The stated obstacles were dependent on the participants' sociodemographic factors (such as age and level of education) and social influence (including concern about confidentiality and privacy). In general, the participants considered ePHRs efficient and useful in increasing neurologists' information about their patients and managing their symptoms in order to provide better and timely treatment. ConclusionThe present study gives a comprehensive insight into the acceptance of ePHR for AD in a developing setting. The results of this study can be utilized for similar healthcare settings with regard to technical, legal, or cultural characteristics. To develop a useful and user-friendly system, ePHR developers should involve users in the design process to take into account the functions and features that match their skills, requirements, and preferences

Monkeypox detection using deep neural networks

BACKGROUND: In May 2022, the World Health Organization (WHO) European Region announced an atypical Monkeypox epidemic in response to reports of numerous cases in some member countries unrelated to those where the illness is endemic. This issue has raised concerns about the widespread nature of this disease around the world. The experience with Coronavirus Disease 2019 (COVID-19) has increased awareness about pandemics among researchers and health authorities.METHODS: Deep Neural Networks (DNNs) have shown promising performance in detecting COVID-19 and predicting its outcomes. As a result, researchers have begun applying similar methods to detect Monkeypox disease. In this study, we utilize a dataset comprising skin images of three diseases: Monkeypox, Chickenpox, Measles, and Normal cases. We develop seven DNN models to identify Monkeypox from these images. Two scenarios of including two classes and four classes are implemented.RESULTS: The results show that our proposed DenseNet201-based architecture has the best performance, with Accuracy = 97.63%, F1-Score = 90.51%, and Area Under Curve (AUC) = 94.27% in two-class scenario; and Accuracy = 95.18%, F1-Score = 89.61%, AUC = 92.06% for four-class scenario. Comparing our study with previous studies with similar scenarios, shows that our proposed model demonstrates superior performance, particularly in terms of the F1-Score metric. For the sake of transparency and explainability, Local Interpretable Model-Agnostic Explanations (LIME) and Gradient-weighted Class Activation Mapping (Grad-Cam) were developed to interpret the results. These techniques aim to provide insights into the decision-making process, thereby increasing the trust of clinicians.CONCLUSION: The DenseNet201 model outperforms the other models in terms of the confusion metrics, regardless of the scenario. One significant accomplishment of this study is the utilization of LIME and Grad-Cam to identify the affected areas and assess their significance in diagnosing diseases based on skin images. By incorporating these techniques, we enhance our understanding of the infected regions and their relevance in distinguishing Monkeypox from other similar diseases. Our proposed model can serve as a valuable auxiliary tool for diagnosing Monkeypox and distinguishing it from other related conditions.</p

Design, Implementation, and Applicability Evaluation of Hip and Knee Arthroplasty Registry

Introduction: Arthroplasty is a major orthopedic operation with an increasing rate. The success of this operation can significantly reduce patients’ pain and disabilities. This study aimed to design a registry system for hip and knee arthroplasties. Method: A comprehensive search was conducted to retrieve minimum data set from articles, guidelines, forms and reports published by orthopedic societies. Then, orthopedists were interviewed and medical records were evaluated for system requirements. After thematic analysis of the qualitative data, the intended system’ requirements were extracted. A system was designed following the "Information System Development Life Cycle and Object-Oriented" approach. The system prototype was developed by Python programming language and PostgreSQL Data Base Management System. Then, the usability of the system and user satisfaction were tested. Quantitative data were analyzed using descriptive statistics and through thematic and quantitative approaches. Results: The required dataset and processes were extracted based on evaluating nine arthroplasty registries of pioneer countries as well as our local needs and requirements. The result was a minimum dataset comprising of 39 elements in 5 groups. They were used for developing the arthroplasty registry forms for hip and knee. The system was considered applicable and useful by potential users. Conclusion: An arthroplasty registry system was developed successfully. This system can provide a ground base for healthcare policymakers as well as the members of orthopedic society for planning a good quality care for arthroplasties