Innovative Diagnostic Tools for Ophthalmology in Low-Income Countries

Globally, there are almost 300 million people blind and visually impaired and over 90% live developing countries. The gross disparity in access to ophthalmologists limits the ability to accurately diagnose potentially blinding conditions like cataract, glaucoma, trachoma, uncorrected refractive error and limits timely initiation of medical and surgical treatment. Since 85% of blindness is preventable, bridging this chasm for care is even more critical in preventing needless blindness. Many low-income countries must rely on community health workers, physician assistants, and cataract surgeons for primary eye care. Ophthalmology in low-income countries (LIC) is further challenging due to complexities brought from tropical climates, frail electric grids, poor road and water infrastructure, limited diagnostic capability and limited treatment options. Vision 2020 set the goal of eliminating preventable blindness by 2020 despite formidable obstacles. Innovative technologies are emerging to test visual acuity, correct refractive error quickly and inexpensively, capture retinal images with portable tools, train cataract surgeons using simulators, capitalize on mHealth, access ophthalmic information remotely. These advancements are allowing nonspecialized ophthalmic practitioners to provide low-cost, high impact eye care in resource-limited regions around the world

Remote Screening And Self-Monitoring For Vision Loss Diseases Based On Smartphone Applications

Remote Healthcare Monitoring System (RHMS) represents remote observing of patient’s well-being and providing therapeutic services. Sensors play an essential part in RHMs. They measure the physical parameters and give continuous information to health organizations, doctors. The presence of Smartphones and other portable devices have allowed us to utilize remote healthcare monitoring system for an assortment of structures. Also, Wireless Sensor Network (WSN) advances considered as one of the critical research factor healthcare application for enhancing the standard of living. In this dissertation, I have presented three tiers operating in the remote healthcare monitoring system; the Body Area Network (BAN), the PAN Coordinator and the Back- Medical End System (BMEsys). The three tiers focused on several patients PAN coordinators include the Wireless Sensor Network. The Wireless Sensor Network can be used at the fixed tale-monitor location and periodic measurements. The Personal Digital Assistant (PDA) can be used in patients own home or community setting with continuous measurements and smartphones can be utilized anywhere with full range parameters, and I have provided a meaningful utilization comparison between Wireless Sensor Network, PDA and smartphone in Remote Healthcare Monitoring System (HRMs) architecture design. Evaluate the approaches of the healthcare monitoring system architecture and investigate the use of advanced technologies enabling the patient vital signs and diagnostic medical team in real-time. This dissertation demonstrates that how a Smartphone can be used for medical treatment in the field of Ophthalmology and discussed how a Smartphone and its technology could be used to diagnose loss of eye vision. Most recent smartphones have been equipped with a featured camera with high megapixels and advanced sensors which can be used to record fundus photographs through a slit lamp or record videos from an operating microscope and display images from optical coherence tomography systems and other high-tech devices. The ophthalmologists can share these images and analyze with their colleagues utilizing media sharing applications and make the optimal diagnostic and therapeutic results to diagnose the low vision of patients. At present, three widely used pocket-sized adapters can improve the magnification and lighting of the camera, which enables the smartphones to capture high-quality images of the eye. These are Portable Eye Examination Kit (PEEK), EyeGo, and D-Eye. Peek Adapter consists of a smartphone application and retina adapter which can be clipped onto the device and synchronized with the peek application for sharing and analyzing the images. This adapter can be used by anyone and anywhere in the world to examine eyes. EyeGo is an adapter intended to allow ophthalmologists and healthcare specialists to capture high-quality images of the eye using an ophthalmic lens. D-Eye Adapter is one of the extensively used adapters which yield excellent results. It consists of a portable eye and retinal system that fits onto a smartphone creating a retinal camera for evaluation and screening of the eye. It uses LED lights as a light source and requires no extra power, making it an ideal solution for portable diagnostics. The medical field has widely accepted these adaptors with the smartphones for diagnosing low vision and eye-related infections. In this dissertation, I also provide a meaningful utilization comparison between the smartphone adapters: D-Eye, EyeGo and Portable Eye Examination Kit (PEEK). In this dissertation, I have developed a new App (Remote Healthcare-Monitoring Mobile App) to help patients who have low vision and who are suffering from the diseases which may cause a vision loss. This app is capable of a process, evaluate, interact and store health data which is continuously measured by (Personal Health Monitors). This App can exchange the information directly to the Smartphone users (patients) and the doctor who allows more security and privacy. The idea of the App consists of the following: A Smartphone Application, a Data Collection Center, and Professionals in Ophthalmology. The patient should be registered in the system, for example, (Retina Michigan Center or Glaucoma Michigan Center). After registration, the patient is instructed on how to take photos of his/her eyes correctly, and then use the Smartphone application. The patient takes photos of his/her eyes and sends them to the data collection center, the specialists get access to these data and help in the treatment according to the analysis. Finally, I completed the development of the Mobile app (including the Skype and Viber links), which can help in exchanging the information between the patient and the doctor

Desarrollo y evaluación de un sistema de ayuda a la decisión médica móvil en iOS para el diagnóstico de enfermedades del polo anterior del ojo

El uso de aplicaciones móviles sigue aumentando año tras año, y este aumento se aprecia aún más en la población adulta, es decir, personas que no son nativas digitales pero que valoran el potencial que tiene el uso de estas herramientas en su vida. Y este aumento no solo se produce en el ámbito personal, sino que los profesionales en su vida laboral cada vez recurren más a la utilización de aplicaciones móviles para desarrollar su actividad profesional. Un sector que basa la mejora del desarrollo de sus actividades en los avances tecnológicos es la medicina. Los profesionales médicos utilizan sistemas en su día a día que les ayudan a desempeñar sus tareas, como son los registros electrónicos de historiales clínicos, gestión de citas médicas, o sistemas de ayuda en el diagnóstico. Estos últimos cada vez son más demandados, ya que una de las tareas principales que desempeñan los médicos es el diagnóstico de enfermedades, y en ciertas ocasiones requieren ayuda externa para poder llevarlo a cabo, sobre todo en casos en que no se es especialista en la materia o en que la dificultad de dominio de la especialidad médica es elevada. Este escenario se plantea en los servicios sanitarios de atención primaria, donde un buen manejo de enfermedades es crucial, tanto para el paciente como para el sistema sanitario. La especialidad de oftalmología es una de las más complicadas, debido a la gran variedad de patologías que se presentan y a la delicadeza de los órganos tratados, ya que estas patologías afectan directamente en la calidad de vida del paciente. El objetivo de este trabajo es el desarrollo de la aplicación móvil OphthalDSS para el sistema operativo iOS basándose en la versión anterior de la aplicación con el mismo nombre, desarrollada para el sistema operativo Android. Esta aplicación pretende ayudar en el diagnóstico de enfermedades oculares del segmento anterior del ojo, además de ofrecer a los usuarios contenido educativo sobre las patologías. Para ello se estudiará el estado del arte en cuanto a literatura y aplicaciones móviles comerciales que dispongan de sistemas de ayuda en la toma de decisiones médicas en el campo de la oftalmología, y se tendrán en cuenta las valoraciones de la calidad de experiencia por parte de los estudiantes de medicina que pudieron probar la versión de OphthalDSS en el sistema operativo Android para el desarrollo de esta nueva versión.Departamento de Teoría de la Señal y Comunicaciones e Ingeniería TelemáticaMáster en Ingeniería de Telecomunicació

Principles in the Design of Mobile Medical Apps: Guidance for Those who Care

The promises of mobile technology in healthcare have led to a great many mobile apps in public app stores that target patients with specific illnesses. Medical experts have criticized the status quo of mobile medical apps owing to the low level of professional medical involvement in mobile app design, leading to weak clinical performance and a poor integration of these tools into clinical practice. Grounded in an action design research study, we build and evaluate a mobile app for elderly patients with age-related macular degeneration. We formalize our learnings and provide a set of design principles to guide the effective and feasible construction of mobile medical apps. Our study systematically develops design knowledge that helps to bridge the current gap between the rapid advances in mobile technology and the specific needs of the healthcare sector

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe