WorldWideScience

Sample records for technology savvy patient

  1. Technology Leadership Is Just Good Leadership: Dispositions of Tech Savvy Superintendents

    Science.gov (United States)

    Richardson, Jayson W.; McLeod, Scott; Sauers, Nick

    2015-01-01

    This study describes core dispositions of school district superintendents who have been identified as technology savvy leaders by a prominent educational technology newspaper. The superintendents in this study described how they accomplished their technology initiatives and offered suggestions for other superintendents who aspire to be more…

  2. Adapting qualitative research strategies to technology savvy adolescents.

    Science.gov (United States)

    Mason, Deanna Marie; Ide, Bette

    2014-05-01

    To adapt research strategies involving adolescents in a grounded theory qualitative research study by conducting email rather than face-to-face interviews. Adolescent culture relies heavily on text-based communication and teens prefer interactions mediated through technology. Traditional qualitative research strategies need to be rethought when working with adolescents. Adapting interviewing strategies to electronic environments is timely and relevant for researching adolescents. Twenty three adolescents (aged 16-21) were interviewed by email. A letter of invitation was distributed. Potential participants emailed the researcher to convey interest in participating. If the inclusion criteria were met, email interviews were initiated. Participants controlled the interviews through their rate of response to interview questions. A grounded theory methodology was employed. Initial contact with participants reiterated confidentiality and the ability to withdraw from the study at any time. Interviews began with the collection of demographic information and a broad opening based on a semi-structured interview guide. All data were permissible, including text, photos, music, videos or outside media, for example YouTube. The participant was allowed to give direction to the interview after initial questions were posed. Email interviews continued until saturation was reached in the data. Participants were enthusiastic about email interviewing. Attrition did not occur. Email interviewing gave participants more control over the research, decreased power differentials between the adolescent and researcher, allowed the study to be adapted to cultural, linguistic and developmental needs, and maintained confidentiality. As participants said that email communication was slow and they preferred instant messaging, replication in faster-paced media is recommended. Repetition in face-to-face settings is warranted to evaluate how technology may have influenced the findings. Implications for

  3. Student Characteristics and E-Textbook Experiences: The Direct and Moderating Effects of Technology Savvy and Gender

    Science.gov (United States)

    Sun, Jun; Flores, Javier

    2013-01-01

    The adoption of e-textbooks in universities by the majority of students has yet to materialize, requiring a better understanding of the differences among users to cater for their different needs. The main focus of this study is to examine the role of technology savvy in terms of the experiences, skills and self-efficacy of students in using…

  4. Future Savvy

    DEFF Research Database (Denmark)

    Gordon, Adam

    -tank forecasts, consultant reports, and stock-market guides. These resources are crucial, but they are also of very mixed quality. How can decision-makers know which predictions to take seriously, which to be wary of, and which to throw out entirely? Future Savvy provides analytical filters to judging predictive......There's no shortage of predictions available to organizations looking to anticipate and profit from future events or trends. Apparently helpful forecasts are ubiquitous in everyday communications such as newspapers and business magazines, and in specialized sources such as government and think...... material of all types, including providing a battery of critical tests to apply to any forecast to assess its validity, and judge how to fit it into everyday management thinking. The book synthesizes information assessment skills and future studies tools into a single template that allows managers to apply...

  5. Consumer Savvy: Conceptualisation and Measurement.

    OpenAIRE

    Macdonald, Emma K.; Uncles, Mark D.

    2007-01-01

    The notion of savvy consumers increasingly appears in the e-marketing and e-management literatures, usually in discussions about the importance of consumer-centricity. A synthesis of the literature identifies six broad characteristics of these savvy consumers: they are enabled by competencies in relation to technological sophistication, interpersonal networking, online networking and marketing/advertising literacy, and they are empowered by consumer self-efficacy and by their expectations of ...

  6. Tech-Savvy Science Education? Understanding Teacher Pedagogical Practices for Integrating Technology in K-12 Classrooms

    Science.gov (United States)

    Hechter, Richard; Vermette, Laurie Anne

    2014-01-01

    This paper examines the technology integration practices of Manitoban K-12 inservice science educators based on the Technological, Pedagogical, and Content knowledge (TPACK) framework. Science teachers (n = 433) completed a 10-item online survey regarding pedagogical beliefs about technology integration, types of technology used, and how often…

  7. Technology in Today's Classroom: Are You a Tech-Savvy Teacher?

    Science.gov (United States)

    Hicks, Stephanie Diamond

    2011-01-01

    Technology has changed the way the world functions on a day-to-day basis, but what about education? Education has been directly affected by the increase of technology in the United States. This change has not been well accepted by some members of the educational community, thus leaving the realm of education behind in the technology era. This…

  8. The Savvy Caregiver Program: A Probe Multicenter Randomized Controlled Pilot Trial in Caregivers of Patients Affected by Alzheimer's Disease.

    Science.gov (United States)

    Sepe-Monti, Micaela; Vanacore, Nicola; Bartorelli, Luisa; Tognetti, Alessandra; Giubilei, Franco

    2016-10-04

    Alzheimer's disease (AD) is a major cause of disability in the elderly, leading to a considerable burden on caregivers and high costs to society. Psycho-education programs such as the Savvy Caregiver Program (SCP) are reported to be a successful means of reducing caregivers' distress through various intervention strategies. The aim of the present study was to assess the efficacy of the SCP in reducing the burden and psychological symptoms in caregivers of AD patients and to analyze the coping strategies adopted by the caregivers. The study was designed as a multicenter, randomized, controlled, pilot clinical trial. One hundred and sixty-four caregivers of patients with probable AD were randomized. The SCP was structured in six, weekly, two-hour sessions. All the clinical scales were administered before treatment, two weeks and six months after treatment. Caregivers in the SCP group displayed better coping strategies adopted to positive attitudes, and they tended to be less anxious and less depressed than those in the control group. However, caregiver burden levels were not reduced in SCP caregivers. The patients of SCP caregivers received a lower number of new prescriptions of neuroleptics during the 6 months of follow-up than the patients of control caregivers and apathy was the neuropsychiatric symptom that improved most as a result of the SCP. The results of this study suggest that the SCP may improve coping strategies of caregivers of people affected by AD, influencing their psychological symptoms and those of their patients.

  9. Do gender and personality traits (BFI-10) influence self-perceived tech savviness?

    DEFF Research Database (Denmark)

    Sudzina, Frantisek

    2015-01-01

    Nowadays, it is necessary to use technology in various everyday activities. A certain level of what used to be called high-tech savviness is needed to access certain services. The aim of this paper is to analyze if gender and personality traits (Big Five Inventory-10) influence self-perceived tech...

  10. Impact of gender and personality traits (BFI-10) on tech savviness

    DEFF Research Database (Denmark)

    Pavlicek, Antonin; Sudzina, Frantisek; Malinova, Ludmila

    2017-01-01

    Nowadays, it is necessary to use technology in various everyday activities. A certain level of what used to be called high-tech savviness is needed to access almost all modern services. The aim of this paper is to analyze if gender and personality traits (Big Five Inventory-10) influence self...

  11. Impact of gender and personality traits (BFI-10) on tech savviness

    DEFF Research Database (Denmark)

    Pavlicek, Antonin; Sudzina, Frantisek; Malinova, Ludmila

    2017-01-01

    Nowadays, it is necessary to use technology in various everyday activities. A certain level of what used to be called high-tech savviness is needed to access almost all modern services. The aim of this paper is to analyze if gender and personality traits (Big Five Inventory-10) influence self-per...

  12. It savvy what top executives must know to go from pain to gain

    CERN Document Server

    Weill, Peter; Ross, Jeanne

    2009-01-01

    Digitization of business interactions and processes is advancing full bore. But in many organizations, returns from IT investments are flatlining, even as technology spending has skyrocketed. These challenges call for new levels of IT savvy: the ability of all managers-IT or non-IT-to transform their company's technology assets into operational efficiencies that boost margins. Companies with IT-savvy managers are 20 percent more profitable than their competitors. In IT Savvy, Peter Weill and Jeanne Ross-two of the world's foremost authorities on using IT in business-explain how non-IT executives can acquire this savvy. Concise and practical, the book describes the practices, competencies, and leadership skills non-IT managers need to succeed in the digital economy. You'll discover how to: -Define your firm's operating model-how IT can help you do business -Revamp your IT funding model to support your operating model -Build a digitized platform of business processes, IT systems, and data to execute on the mode...

  13. IT savvy what top executives must know to go from pain to gain

    CERN Document Server

    Weill, Peter; Ross, Jeanne

    2009-01-01

    Digitization of business interactions and processes is advancing full bore. But in many organizations, returns from IT investments are flatlining, even as technology spending has skyrocketed. These challenges call for new levels of IT savvy: the ability of all managers-IT or non-IT-to transform their company's technology assets into operational efficiencies that boost margins. Companies with IT-savvy managers are 20 percent more profitable than their competitors. In IT Savvy, Peter Weill and Jeanne Ross-two of the world's foremost authorities on using IT in business-explain how non-IT executives can acquire this savvy. Concise and practical, the book describes the practices, competencies, and leadership skills non-IT managers need to succeed in the digital economy. You'll discover how to: -Define your firm's operating model-how IT can help you do business -Revamp your IT funding model to support your operating model -Build a digitized platform of business processes, IT systems, and data to execute on the mode...

  14. Media work as public affairs: moving beyond media savvy

    DEFF Research Database (Denmark)

    Trapp, Leila; Laursen, Bo

    . The interviews reveal that media work is considered an effective, though potentially risky, form of public affairs. Indeed, media work is said to damage, or even ruin, an organization’s lobbying efforts or relationships with political actors. The study’s key finding is that in order to deal with these risks......, professional press contact staff acquire a great deal of political savvy in addition to the well-known forms of media savvy. The interviewees describe intricate media tactics used to minimize the risks, and even strengthen relationships to political actors. These include flattery, praise, self...

  15. Custom Formula-Based Visualizations for Savvy Designers"

    DEFF Research Database (Denmark)

    Kuhail, Mohammad Amin

    Despite their usefulness in many domains (e.g. healthcare, finance, etc.), custom visualizations remain tedious and hard to implement. It would be advantageous if savvy designers (designers with end-user development skills and much domain knowledge) could refine visualizations to their needs...

  16. Is eLearning only for the tech savvy and the lazy? : A survey study to determine what characterizes students who enroll in internet based classes

    NARCIS (Netherlands)

    Rhee, van der B.; Verma, R.; Plaschka, G.

    2005-01-01

    More and more Business Schools are offering classes using a mix of face-to-face and online elements. We conducted a large scale survey to determine whether only students who are technology savvy would enroll in these mixed classes and whether there exists a participation bias such that students with

  17. How To: Be VoIP-Savvy

    Science.gov (United States)

    Branzburg, Jeffrey

    2005-01-01

    Cablevision, Comcast, Verizon, and many other high-speed broadband Internet providers are now also offering telephone services through "Voice over Internet Protocol" (VoIP). This technology sends ordinary telephone calls over the Internet rather than over telephone lines. While impractical without the use of a broadband Internet connection, with…

  18. Gender and personality traits' (BFI-10) effect on self-perceived tech savviness

    DEFF Research Database (Denmark)

    Olexova, Cecilia; Kirchner, Kathrin; Sudzina, Frantisek

    2017-01-01

    Today's students are considered as digital natives that grew up digitally. They use smartphones and services like social media on a regular basis. The aim of this paper is to analyze if gender and personality traits (Big Five Inventory-10) influence self-perceived tech savviness of Slovak business...... features of tech devices. Moreover, self-perceived tech savviness in eyes of others is significantly influenced also by gender, i.e. men consider themselves more tech savvy....

  19. Gender and personality traits' (BFI-10) effect on self-perceived tech savviness

    DEFF Research Database (Denmark)

    Olexova, Cecilia; Kirchner, Kathrin; Sudzina, Frantisek

    2017-01-01

    Today's students are considered as digital natives that grew up digitally. They use smartphones and services like social media on a regular basis. The aim of this paper is to analyze if gender and personality traits (Big Five Inventory-10) influence self-perceived tech savviness of Slovak business...... students. The tech savviness is investigated in two dimensions - in one's own opinion and in the eyes of others. In both cases, neuroticism significantly influences self-perceived tech savviness, and the relationship is negative. It may be because more neurotic people are more afraid of using various new...

  20. App Savvy Turning Ideas into iPad and iPhone Apps Customers Really Want

    CERN Document Server

    Yarmosh, Ken

    2010-01-01

    How can you make your iPad or iPhone app stand out in the highly competitive App Store? While many books simply explore the technical aspects of iPad and iPhone app design and development, App Savvy also focuses on the business, product, and marketing elements critical to pursuing, completing, and selling your app -- the ingredients for turning a great idea into a genuinely successful product. Whether you're a designer, developer, entrepreneur, or just someone with a unique idea, App Savvy explains every step in the process, with guidelines for planning a solid concept, engaging customers ea

  1. SAVVY vaginal gel (C31G for prevention of HIV infection: a randomized controlled trial in Nigeria.

    Directory of Open Access Journals (Sweden)

    Paul J Feldblum

    2008-01-01

    Full Text Available The objective of this trial was to determine the effectiveness of 1.0% C31G (SAVVY in preventing male-to-female vaginal transmission of HIV infection among women at high risk.This was a Phase 3, double-blind, randomized, placebo-controlled trial. Participants made up to 12 monthly follow-up visits for HIV testing, adverse event reporting, and study product supply. The study was conducted between September 2004 and December 2006 in Lagos and Ibadan, Nigeria, where we enrolled 2153 HIV-negative women at high risk of HIV infection. Participants were randomized 1 ratio 1 to SAVVY or placebo. The effectiveness endpoint was incidence of HIV infection as indicated by detection of HIV antibodies in oral mucosal transudate (rapid test or blood (ELISA, and confirmed by Western blot or PCR testing. We observed 33 seroconversions (21 in the SAVVY group, 12 in the placebo group. The Kaplan-Meier estimates of the cumulative probability of HIV infection at 12 months were 0.028 in the SAVVY group and 0.015 in the placebo group (2-sided p-value for the log-rank test of treatment effect 0.121. The point estimate of the hazard ratio was 1.7 for SAVVY versus placebo (95% confidence interval 0.9, 3.5. Because of lower-than-expected HIV incidence, we did not observe the required number of HIV infections (66 for adequate power to detect an effect of SAVVY. Follow-up frequencies of adverse events, reproductive tract adverse events, abnormal pelvic examination findings, chlamydial infections and vaginal infections were similar in the study arms. No serious adverse event was attributable to SAVVY use.SAVVY did not reduce the incidence of HIV infection. Although the hazard ratio was higher in the SAVVY than the placebo group, we cannot conclude that there was a harmful treatment effect of SAVVY.

  2. Learning from Cyber-Savvy Students: How Internet-Age Kids Impact Classroom Teaching.

    Science.gov (United States)

    Hird, Anne

    This book describes what happens when cyber-savvy students enter classrooms wired to the Internet. It offers a preview of challenges teachers will face as they become connected to the Internet. Information comes from 6 months spent observing an 8th- grade class at Cityview School, a 4-8 school that was wired to the Internet. Participants were 34…

  3. Information technology for patient empowerment in healthcare

    CERN Document Server

    Grando, Maria Adela; Bates, David

    2015-01-01

    The authors explore novel information-based mechanisms that are changing the way patients are involved in their own health care. The book covers models, frameworks and technologies to improve patient-to-provider communication, patient interaction with information technologies, patient education and involvement in health care decision processes, and patient access, understanding and control over their clinical data.

  4. Development and Implementation of Tele-Savvy for Dementia Caregivers: A Department of Veterans Affairs Clinical Demonstration Project.

    Science.gov (United States)

    Griffiths, Patricia C; Whitney, M Kate; Kovaleva, Mariya; Hepburn, Kenneth

    2016-02-01

    To test fidelity and preliminary efficacy of Tele-Savvy, an internet-based version of the in-person, evidence-based psychoeducation Savvy Caregiver Program (SCP) for dementia caregivers. Tele-Savvy used synchronous (tele-conferences) and asynchronous components (video modules) to provide program access to caregivers in their homes. SCP experts were surveyed to evaluate Tele-Savvy's fidelity to SCP. A convenience sample of 30 dementia caregivers from the Atlanta VA Medical Center enrolled in the Tele-Savvy clinical demonstration program. Twenty-two caregivers completed both pre- and postprogram evaluations, which included measures of caregiver stress and competence and behavioral and psychological symptoms of dementia (BPSD). Expert review confirmed Tele-Savvy's fidelity with and, in certain domains, improvement on the original. Participants demonstrated moderately high initial levels of burden, anxiety, and depressive symptoms all of which decreased significantly postprogram in an intention to treat analysis. Similar reductions were seen in care recipients' BPSD and caregivers' reactions to them. Marginally significant increases in caregiver competence were observed. Caregiver and expert panel evaluations of program quality were enthusiastic. An effective online caregiver psychoeducation program could provide greatly expanded access for caregivers who cannot attend in person for reasons of distance, transportation limitations, and caregiving responsibilities. Further testing in a controlled trial is needed to establish program efficacy. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  5. Does Not Compute: The High Cost of Low Technology Skills in the U.S.--and What We Can Do about It. Vital Signs: Reports on the Condition of STEM Learning in the U.S.

    Science.gov (United States)

    Change the Equation, 2015

    2015-01-01

    Although American millennials are the first generation of "digital natives"--that is, people who grew up with computers and the internet--they are not very tech savvy. Using technology for social networking, surfing the web, or taking selfies is a far cry from using it to solve complex problems at work or at home. Truly tech savvy people…

  6. Technology innovation for patients with kidney disease.

    Science.gov (United States)

    Mitsides, Nicos; Keane, David F; Lindley, Elizabeth; Mitra, Sandip

    2014-01-01

    The loss of kidney function is a life-changing event leading to life-long dependence on healthcare. Around 5000 people are diagnosed with kidney failure every year. Historically, technology in renal medicine has been employed for replacement therapies. Recently, a lot of emphasis has been placed on technologies that aid early identification and prevent progression of kidney disease, while at the same time empowering affected individuals to gain control over their chronic illness. There is a shift in diversity of technology development, driven by collaborative innovation initiatives such the National Institute's for Health Research Healthcare Technology Co-operative for Devices for Dignity. This has seen the emergence of the patient as a key figure in designing technologies that are fit for purpose, while business involvement has ensured uptake and sustainability of these developments. An embodiment of this approach is the first successful Small Business Research Initiative in the field of renal medicine in the UK.

  7. Overcoming Barriers to Classroom Technology Integration

    Science.gov (United States)

    Kelly, Daniel P.

    2015-01-01

    Technology-savvy teachers are often the "go to" staff members in schools for their colleagues' technology issues. These teachers are seen as leaders within their schools with respect to technology and often do not understand their peers' difficulties when bringing technology into the classroom. Understanding both the reasons teachers may…

  8. Patient safety and technology-driven medication

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Keinicke Fabricius, Pia

    2015-01-01

    BACKGROUND: The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26-38% of in-hospital cases. This points to the need for new...... ways of educating nursing students in today's medication administration. AIM: To explore nursing students' experiences and competences with the technology-driven medication administration process. METHODS: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... and confidence in using technology, but were fearful of committing serious medication errors. From the nursing students' perspective, experienced nurses deviate from existing guidelines, leaving them feeling isolated in practical learning situations. CONCLUSION: Having an unclear nursing role model...

  9. A technology-enhanced patient case workshop.

    Science.gov (United States)

    Pai, Vinita B; Kelley, Katherine A; Bellebaum, Katherine L

    2009-08-28

    To assess the impact of technology-based changes on student learning, skill development, and satisfaction in a patient-case workshop. A new workshop format for a course was adopted over a 3-year period. Students received and completed patient cases and obtained immediate performance feedback in class instead of preparing the case prior to class and waiting for instructors to grade and return their cases. The cases were designed and accessed via an online course management system. Student satisfaction was measured using end-of-course surveys. The impact of the technology-based changes on student learning, problem-solving, and critical-thinking skills was measured and compared between the 2 different course formats by assessing changes in examination responses. Three advantages to the new format were reported: real-life format in terms of time constraint for responses, a team learning environment, and expedient grading and feedback. Students overwhelmingly agreed that the new format should be continued. Students' examination scores improved significantly under the new format. The change in delivery of patient-case workshops to an online, real-time system was well accepted and resulted in enhanced learning, critical thinking, and problem-solving skills.

  10. Ventilator Technologies Sustain Critically Injured Patients

    Science.gov (United States)

    2012-01-01

    Consider this scenario: A soldier has been critically wounded in a sudden firefight in a remote region of Afghanistan. The soldier s comrades attend to him and radio for help, but the soldier needs immediate medical expertise and treatment that is currently miles away. The connection between medical support for soldiers on the battlefield and astronauts in space may not be immediately obvious. But when it comes to providing adequate critical care, NASA and the military have very similar operational challenges, says Shannon Melton of NASA contractor Wyle Integrated Science and Engineering. Melton works within Johnson Space Center s Space Medicine Division, which supports astronaut crew health before, during, and after flight. In space, we have a limited number of care providers, and those providers are not always clinicians with extensive medical training. We have limited room to provide care, limited consumables, and our environment is not like that of a hospital, she says. The Space Medicine Division s Advanced Projects Group works on combining the expertise of both clinicians and engineers to develop new capabilities that address the challenges of medical support in space, including providing care to distant patients. This field, called telemedicine, blends advanced communications practices and technologies with innovative medical devices and techniques to allow caregivers with limited or no medical experience to support a patient s needs. NASA, just by its nature, has been doing remote medicine since the beginning of the Space Program, says Melton, an engineer in the Advanced Projects Group. Since part of NASA s mandate is to transfer the results of its technological innovation for the benefit of the public, the Agency has worked with doctors and private industry to find ways to apply the benefits of space medicine on Earth. In one such case, a NASA partnership has resulted in new technologies that may improve the quality of emergency medicine for wounded

  11. SAVVY (C31G gel for prevention of HIV infection in women: a Phase 3, double-blind, randomized, placebo-controlled trial in Ghana.

    Directory of Open Access Journals (Sweden)

    Leigh Peterson

    2007-12-01

    Full Text Available The objective of this trial was to determine the effectiveness of 1.0% C31G (SAVVY in preventing male-to-female vaginal transmission of HIV infection among women at high risk.This was a Phase 3, double-blind, randomized, placebo-controlled trial. Participants made up to 12 monthly visits for HIV testing, adverse event reporting, and study product supply. The study was conducted between March 2004 and February 2006 in Accra and Kumasi, Ghana. We enrolled 2142 HIV-negative women at high risk of HIV infection, and randomized them to SAVVY or placebo gel. Main outcome measures were the incidence of HIV-1 and HIV-2 infection as determined by detection of HIV antibodies from oral mucosal transudate specimens and adverse events. We accrued 790 person-years of follow-up in the SAVVY group and 772 person-years in the placebo group. No clinically significant differences in the overall frequency of adverse events, abnormal pelvic examination findings, or abnormal laboratory results were seen between treatment groups. However, more participants in the SAVVY group reported reproductive tract adverse events than in the placebo group (13.0% versus 9.4%. Seventeen HIV seroconversions occurred; eight in participants randomized to SAVVY and nine in participants receiving placebo. The Kaplan-Meier estimates of the cumulative probability of HIV infection through 12 months were 0.010 in the SAVVY group and 0.011 in the placebo group (p = 0.731, with a hazard ratio (SAVVY versus placebo of 0.88 (95% confidence interval 0.33, 2.27. Because of a lower-than-expected HIV incidence, we were unable to achieve the required number of HIV infections (66 to obtain the desired study power.SAVVY was not associated with increased adverse events overall, but was associated with higher reporting of reproductive adverse events. Our data are insufficient to conclude whether SAVVY is effective at preventing HIV infection relative to placebo.ClinicalTrials.gov NCT00129532.

  12. Through the Looking Glass: Examining Technology Integration in School Librarianship

    Science.gov (United States)

    Green, Lucy Santos

    2014-01-01

    The school library profession has begun to develop a reputation for tech-savviness. Several school librarians are nationally recognized technology leaders and present at conferences where instructional technology is at the forefront. Unfortunately, while school librarians have done a wonderful job of marketing their technological expertise in the…

  13. M-Learning Systems Design--Technology and Pedagogy Aspects

    Science.gov (United States)

    Gourova, Elissaveta; Asenova, Asya; Dulev, Pavlin

    2013-01-01

    Technology developments face universities with many challenges--to integrate technologies in educational processes, design new electronic materials, change teaching styles, and better meet the demands of the technology-savvy generation. The paper considers problems of m-learning adoption in Bulgaria at one Faculty of the Technical…

  14. The impact of health information technology on patient safety.

    Science.gov (United States)

    Alotaibi, Yasser K; Federico, Frank

    2017-12-01

    Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety.  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient's safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

  15. Patient Safety Technology Gap: Minimizing Errors in Healthcare through Technology Innovation

    Directory of Open Access Journals (Sweden)

    Deborah Carstens

    2005-04-01

    Full Text Available In a world of ever increasing technological advances, users of technology are at risk for exceeding human memory limitations. A gap analysis was conducted through reviewing literature in the field of human error or specifically transition errors in emergency room (ER operations to identify the current state of technology available. The gap analysis revealed the technological needs of ER healthcare workers. The findings indicate the need for technology such as knowledge management or decision support systems in ERs to reduce the potential for error, enhance patient safety, and improve the overall quality of care for the patient.

  16. Integrating Technology into the Classroom: How Does It Impact Student Achievement?

    Science.gov (United States)

    Harvey-Woodall, Antionette

    2009-01-01

    As an educator during the 21st century, it is important to note that technology is becoming more and more dominant in society. Many teachers have become very knowledgeable of how technologically-savvy students have become. In the field of technology, everyday upgrades are being made and new innovations are being discovered. As a result, the…

  17. Contactless Patient Monitoring for General Wards: A Systematic Technology Review.

    Science.gov (United States)

    Naziyok, Tolga P; Zeleke, Atinkut A; Röhrig, Rainer

    2016-01-01

    Sudden, serious life-threatening situations happen even on general wards. Current technologies are working with sensors which are attached to every patient, which is a source of failures and false alarms. The goal of this review was to assess the state of the art of potential techniques for contactless patient monitoring in general wards. The MEDLINE database was used for literature retrieval. 453 unique references screened, 34 research articles met inclusion criteria. Ballistocardiography, Radar and Thermography technologies are the most widely tested techniques. The Majority of the studies are done in a laboratory setting. No study shows the feasibility of one contactless monitoring technology over the distance required for monitoring rooms. Today no technology is feasible. A combination of technologies may become feasible in 10 or more years, until then we have to think about ethical and privacy issues of these pervasive technologies.

  18. [Application of patient card technology to health care].

    Science.gov (United States)

    Sayag, E; Danon, Y L

    1995-03-15

    The potential benefits of patient card technology in improving management and delivery of health services have been explored. Patient cards can be used for numerous applications and functions: as a means of identification, as a key for an insurance payment system, and as a communication medium. Advanced card technologies allow for the storage of data on the card, creating the possibility of a comprehensive and portable patient record. There are many types of patient cards: paper or plastic cards, microfilm cards, bar-code cards, magnetic-strip cards and integrated circuit smart-cards. Choosing the right card depends on the amount of information to be stored, the degree of security required and the cost of the cards and their supporting infrastructure. Problems with patient cards are related to storage capacity, backup and data consistency, access authorization and ownership and compatibility. We think it is worth evaluating the place of patient card technology in the delivery of health services in Israel.

  19. An Inch Deep and a Mile Wide: Electronic Tools for Savvy Administrators

    Directory of Open Access Journals (Sweden)

    Deborah Jolly

    1999-01-01

    Full Text Available Texas school administrators often lack vital knowledge of technology trends, issues and skills; therefore, they are not as effective leaders of technology introduction, integration, and management as are needed. This lack comes from three sources: 1 school administrator preparatory programs have not and do not provide technology-related courses; 2 there are few technology-related in-service training course available to administrators; and 3 many Texas administrators are geographically isolated and thus have less opportunity to interact with colleagues and less opportunity to receive training. This article presents and explains web-based resources for: 1 standards development for administrator, teacher and student technology skills and knowledge; 2 standards development for accessibility, connectivity, and software; and 3 national and state resources such as diagnostic tools, school data/statistics, and other technology-related information.

  20. European pharmacy students' experience with virtual patient technology.

    Science.gov (United States)

    Cavaco, Afonso Miguel; Madeira, Filipe

    2012-08-10

    To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education.

  1. Technology Experience of Solid Organ Transplant Patients and Their Overall Willingness to Use Interactive Health Technology.

    Science.gov (United States)

    Vanhoof, Jasper M M; Vandenberghe, Bert; Geerts, David; Philippaerts, Pieter; De Mazière, Patrick; DeVito Dabbs, Annette; De Geest, Sabina; Dobbels, Fabienne

    2018-03-01

    The use of interactive health technology (IHT) is a promising pathway to tackle self-management problems experienced by many chronically ill patients, including solid organ transplant (Tx) patients. Yet, to ensure that the IHT is accepted and used, a human-centered design process is needed, actively involving end users in all steps of the development process. A first critical, predevelopment step involves understanding end users' characteristics. This study therefore aims to (a) select an IHT platform to deliver a self-management support intervention most closely related to Tx patients' current use of information and communication technologies (ICTs), (b) understand Tx patients' overall willingness to use IHT for self-management support, and investigate associations with relevant technology acceptance variables, and (c) explore Tx patients' views on potential IHT features. We performed a cross-sectional, descriptive study between October and December 2013, enrolling a convenience sample of adult heart, lung, liver, and kidney Tx patients from the University Hospitals Leuven, Belgium. Broad inclusion criteria were applied to ensure a representative patient sample. We used a 35-item newly designed interview questionnaire to measure Tx patients' use of ICTs, their overall willingness to use IHT, and their views on potential IHT features, as well as relevant technology acceptance variables derived from the Unified Theory of Acceptance and Use of Technology and a literature review. Descriptive statistics were used as appropriate, and an ordinal logistic regression model was built to determine the association between Tx patients' overall willingness to use IHT, the selected technology acceptance variables, and patient characteristics. Out of 139 patients, 122 agreed to participate (32 heart, 30 lung, 30 liver, and 30 kidney Tx patients; participation rate: 88%). Most patients were male (57.4%), married or living together (68%), and had a mean age of 55.9 ± 13.4 years

  2. User-Centered Design and Interactive Health Technologies for Patients

    Science.gov (United States)

    De Vito Dabbs, Annette; Myers, Brad A.; Mc Curry, Kenneth R.; Dunbar-Jacob, Jacqueline; Hawkins, Robert P.; Begey, Alex; Dew, Mary Amanda

    2010-01-01

    Despite recommendations that patients be involved in the design and testing of health technologies, few reports describe how to involve patients in systematic and meaningful ways to ensure that applications are customized to meet their needs. User-centered design (UCD) is an approach that involves end-users throughout the development process so that technology support tasks, are easy to operate, and are of value to users. In this paper we provide an overview of UCD and use the development of Pocket Personal Assistant for Tracking Health (Pocket PATH), to illustrate how these principles and techniques were applied to involve patients in the development of this interactive health technology. Involving patient-users in the design and testing ensured functionality and usability, therefore increasing the likelihood of promoting the intended health outcomes. PMID:19411947

  3. Technologies of Compliance? : Telecare technologies and self-management of COPD patients

    NARCIS (Netherlands)

    Maathuis, Ivo; Oudshoorn, Nelly E.J.

    2016-01-01

    In current healthcare discourses self-management has been articulated as one of the major aims of telecare technologies for chronic patients. This article investigates what forms of self-management are inscribed during the design of a telecare system for patients with COPD (Chronic Obstructive

  4. Millennial Learners and Net-Savvy Teens? Examining Internet Use among Low-Income Students

    Science.gov (United States)

    Greenhow, Christine; Walker, J. D.; Kim, Seongdok

    2010-01-01

    This paper discusses access and use of information and communication technologies among urban high school students from low-income families, a topic of great interest to teacher educators, educational policymakers, and others concerned with digital literacy instruction. Recent reports from national digital learning initiatives have portrayed…

  5. Cloud computing and patient engagement: leveraging available technology.

    Science.gov (United States)

    Noblin, Alice; Cortelyou-Ward, Kendall; Servan, Rosa M

    2014-01-01

    Cloud computing technology has the potential to transform medical practices and improve patient engagement and quality of care. However, issues such as privacy and security and "fit" can make incorporation of the cloud an intimidating decision for many physicians. This article summarizes the four most common types of clouds and discusses their ideal uses, how they engage patients, and how they improve the quality of care offered. This technology also can be used to meet Meaningful Use requirements 1 and 2; and, if speculation is correct, the cloud will provide the necessary support needed for Meaningful Use 3 as well.

  6. Leveraging Interactive Patient Care Technology to Improve Pain Management Engagement.

    Science.gov (United States)

    Rao-Gupta, Suma; Kruger, David; Leak, Lonna D; Tieman, Lisa A; Manworren, Renee C B

    2017-12-15

    Most children experience pain in hospitals; and their parents report dissatisfaction with how well pain was managed. Engaging patients and families in the development and evaluation of pain treatment plans may improve perceptions of pain management and hospital experiences. The aim of this performance improvement project was to engage patients and families to address hospitalized pediatric patients' pain using interactive patient care technology. The goal was to stimulate conversations about pain management expectations and perceptions of treatment plan effectiveness among patients, parents, and health care teams. Plan-Do-Study-Act was used to design, develop, test, and pilot new workflows to integrate the interactive patient care technology system with the automated medication dispensing system and document actions from both systems into the electronic health record. The pediatric surgical unit and hematology/oncology unit of a free-standing, university-affiliated, urban children's hospital were selected to pilot this performance improvement project because of the high prevalence of pain from surgeries and hematologic and oncologic diseases, treatments, and invasive procedures. Documentation of pain assessments, nonpharmacologic interventions, and evaluation of treatment effectiveness increased. The proportion of positive family satisfaction responses for pain management significantly increased from fiscal year 2014 to fiscal year 2016 (p = .006). By leveraging interactive patient care technologies, patients and families were engaged to take an active role in pain treatment plans and evaluation of treatment outcomes. Improved active communication and partnership with patients and families can effectively change organizational culture to be more sensitive to patients' pain and patients' and families' hospital experiences. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  7. Touch and technology: Two paradigms of patient care.

    Science.gov (United States)

    Gadow, S

    1984-03-01

    Technology violates human dignity only to the extent that its use reduces persons to the moral status of objects. The prevalence of technology in health care is an extension of the scientific paradigm, in which the body is reduced to an object void of subjectivity. The empathie paradigm, in contrast, is based upon the moral primacy of subjectivity. Empathic touch-as distinct from instrumental and philanthropic touch-establishes a clinical relation of intersubjectivity, affirming in patients the dignity and worth that morally distinguish persons from objects.

  8. Utilizing information technologies for lifelong monitoring in diabetes patients.

    Science.gov (United States)

    Capozzi, Davide; Lanzola, Giordano

    2011-01-01

    Information and communication technologies have long been acknowledged to support information sharing along the whole chain of care, from the clinic to the homes of patients and their relatives. Thus they are increasingly being considered for improving the delivery of health care services also in light of clinical and technological achievements that propose new treatments requiring a tighter interaction among patients and physicians. The multiagent paradigm has been utilized within an architecture for delivering telemedicine services to chronic outpatients at their domiciles and enforcing cooperation among patients, caregivers, and different members of the health care staff. The architecture sees each communication device such as a palmtop, smart phone, or personal digital assistant as a separate agent upon which different services are deployed, including telemetry, reminders, notifications, and alarms. Decoupling services from agents account for a highly configurable environment applicable to almost any context that can be customized as needed. The architecture has been used for designing and implementing a prototypical software infrastructure, called LifePhone, that runs on several communication devices. A basic set of services has been devised with which we were able to configure two different applications that address long-term and short-term monitoring scenarios for diabetes patients. The long-term scenario encompasses telemetry and reminder services for patients undergoing peritoneal dialysis, which is a treatment for chronic renal failure, a diabetes complication. The short-term scenario incorporates telemetry and remote alarms and is applicable for training patients to use an artificial pancreas. Our experiments proved that an infrastructure such as LifePhone can be used successfully for bridging the interaction gap that exists among all the components of a health care delivery process, improving the quality of service and possibly reducing the overall

  9. Understanding the role of patient organizations in health technology assessment.

    Science.gov (United States)

    Moreira, Tiago

    2015-12-01

    The involvement of patient representatives in health technology assessment is increasingly seen by policy makers and researchers as key for the deployment of patient-centred health care, but there is uncertainty and a lack of theoretical understanding regarding the knowledge and expertise brought by patient representatives and organisations to HTA processes. To propose a conceptually-robust typological model of the knowledge and expertise held by patient organisations. The study followed a case-study design. Data were collected within an international research project on patient organisations' engagement with knowledge, and included archival and documentary data, in-depth interviews with key members of the organisation and participant observation. Data analysis followed standard procedure of qualitative analysis anchored in an analytic induction approach. Analysis identified three stages in the history of the patient organisation under analysis - Alzheimer's Society. In a first period, the focus is on 'caring knowledge' and an emphasis on its volunteer membership. In a transition stage, a combination of experiential, clinical and scientific knowledge is proposed in an attempt to expand its field of activism into HTA. In the most recent phase, there is a deepening of its network of associations to secure its role in the production of evidence. Analysis identified an important relationship between the forms of knowledge deployed by patient organisations and the networks of expertise and policy they mobilise to pursue their activities. A model of this relationship is outlined, for the use of further research and practice on patient involvement. © 2014 John Wiley & Sons Ltd.

  10. Improving patient access to novel medical technologies in Europe.

    LENUS (Irish Health Repository)

    Kearney, Peter

    2012-02-03

    The European Society of Cardiology (ESC) organized a one-day workshop with clinicians, health economic experts, and health technology appraisal experts to discuss the equity of patient access to novel medical technologies in Europe. Two index technologies were considered: implantable cardioverter defibrillators (ICDs) and drug-eluting stents (DES). The use of ICDs range from 35 implants\\/million population in Portugal to 166 implants\\/million population in Germany, whereas for implants of DES (as percentage of total stents) it is lowest in Germany at 14% and high in Portugal at 65%. These differences can in part be explained by a lack of structured implementation of guidelines, the direct cost in relation to the overall healthcare budget, and to differences in procedures and models applied by Health Technology Assessment (HTA) agencies in Europe. The workshop participants concluded that physicians need to be involved in a more structured way in HTA and need to become better acquainted with its methods and terminology. Clinical guidelines should be systematically translated, explained, disseminated, updated, and adopted by cardiologists in Europe. Clinically appropriate, consistent and transparent health economic models need to be developed and high-quality international outcome and cost data should be used. A process for funding of a technology should be developed after a positive recommendation from HTA agencies. Both the ESC and the national cardiac societies should build-up health economic expertise and engage more actively in discussions with stakeholders involved in the provision of healthcare.

  11. The Effects of Technology Instruction on the Academic Achievement of Fifth Grade Students

    Science.gov (United States)

    Davis, Karen Cortina

    2012-01-01

    A digital native is an individual born between 1981 and 2001, and children born after 2001 are called millennials. Educators are expected to meet the needs of today's technologically savvy students. Some researchers assert that an academic "moral panic" is taking place that lacks the empirical and theoretical knowledge to support…

  12. Radio Frequency Identification (RFID) technology and patient safety

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad

    2013-01-01

    Background: Radio frequency identification (RFID) systems have been successfully applied in areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services to name a few. However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers of healthcare organizations. The aim of this study was to express and display the role of RFID technology in improving patient safety and increasing the impact of it in healthcare. Materials and Methods: This study was non-systematical review, which the literature search was conducted with the help of libraries, books, conference proceedings, PubMed databases and also search engines available at Google, Google scholar in which published between 2004 and 2013 during Febuary 2013. We employed the following keywords and their combinations; RFID, healthcare, patient safety, medical errors, and medication errors in the searching areas of title, keywords, abstract, and full text. Results: The preliminary search resulted in 68 articles. After a careful analysis of the content of each paper, a total of 33 papers was selected based on their relevancy. Conclusion: We should integrate RFID with hospital information systems (HIS) and electronic health records (EHRs) and support it by clinical decision support systems (CDSS), it facilitates processes and reduce medical, medication and diagnosis errors. PMID:24381626

  13. Radio Frequency Identification (RFID technology and patient safety

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2013-01-01

    Full Text Available Background: Radio frequency identification (RFID systems have been successfully applied in areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services to name a few. However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers of healthcare organizations. The aim of this study was to express and display the role of RFID technology in improving patient safety and increasing the impact of it in healthcare. Materials and Methods: This study was non-systematical review, which the literature search was conducted with the help of libraries, books, conference proceedings, PubMed databases and also search engines available at Google, Google scholar in which published between 2004 and 2013 during Febuary 2013. We employed the following keywords and their combinations; RFID, healthcare, patient safety, medical errors, and medication errors in the searching areas of title, keywords, abstract, and full text. Results: The preliminary search resulted in 68 articles. After a careful analysis of the content of each paper, a total of 33 papers was selected based on their relevancy. Conclusion: We should integrate RFID with hospital information systems (HIS and electronic health records (EHRs and support it by clinical decision support systems (CDSS, it facilitates processes and reduce medical, medication and diagnosis errors.

  14. Radio Frequency Identification (RFID) technology and patient safety.

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad

    2013-09-01

    Radio frequency identification (RFID) systems have been successfully applied in areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services to name a few. However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers of healthcare organizations. The aim of this study was to express and display the role of RFID technology in improving patient safety and increasing the impact of it in healthcare. This study was non-systematical review, which the literature search was conducted with the help of libraries, books, conference proceedings, PubMed databases and also search engines available at Google, Google scholar in which published between 2004 and 2013 during Febuary 2013. We employed the following keywords and their combinations; RFID, healthcare, patient safety, medical errors, and medication errors in the searching areas of title, keywords, abstract, and full text. The preliminary search resulted in 68 articles. After a careful analysis of the content of each paper, a total of 33 papers was selected based on their relevancy. We should integrate RFID with hospital information systems (HIS) and electronic health records (EHRs) and support it by clinical decision support systems (CDSS), it facilitates processes and reduce medical, medication and diagnosis errors.

  15. Stock Market Savvy.

    Science.gov (United States)

    Okula, Susan

    2003-01-01

    This issue of Keying In, the newsletter of the National Business Education Association, focuses upon teaching young adults how to develop both investment strategies and an understanding of the stock market. The first article, "Sound Investing Know-How: A Must for Today's Young Adults," describes how young adults can plan for their own…

  16. Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology.

    Science.gov (United States)

    Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M B

    2015-01-01

    This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

  17. Effect of health information technology expenditure on patient level cost.

    Science.gov (United States)

    Lee, Jinhyung; Dowd, Bryan

    2013-09-01

    This study investigate the effect of health information technology (IT) expenditure on individual patient-level cost using California Office of Statewide Health Planning and Development (OSHPD) data obtained from 2000 to 2007. We used a traditional cost function and applied hospital fixed effect and clustered error within hospitals. We found that a quadratic function of IT expenditure best fit the data. The quadratic function in IT expenditure predicts a decrease in cost of up to US$1,550 of IT labor per bed, US$27,909 of IT capital per bed, and US$28,695 of all IT expenditure per bed. Moreover, we found that IT expenditure reduced costs more quickly in medical conditions than surgical diseases. Interest in health IT is increasing more than ever before. Many studies examined the effect of health IT on hospital level cost. However, there have been few studies to examine the relationship between health IT expenditure and individual patient-level cost. We found that IT expenditure was associated with patient cost. In particular, we found a quadratic relationship between IT expenditure and patient-level cost. In other word, patient-level cost is non-linearly (or a polynomial of second-order degree) related to IT expenditure.

  18. Patient innovation: an analysis of patients' designs of digital technology support for everyday living with diabetes.

    Science.gov (United States)

    Kanstrup, Anne Marie; Bertelsen, Pernille; Nohr, Christian

    The aim of this paper is to identify characteristics of patients' contributions to innovation in health information technology (HIT). The paper outlines a theoretical definition of patient innovation and presents an analysis of four digital prototypes and 22 low-fidelity mock-ups designed by people affected by the chronic illness diabetes mellitus. Seventeen families (a total of 60 people) with one or more diabetic family members participated in design activities in a four-year research project focused on the design of digital support for everyday living with diabetes. Our analysis documented the originality of the analysed patient designs and identified three characteristics of patients' designs: socio-technical networks, objects with associated personal meanings and technology supporting the expression of identity. The paper concludes that patient innovation is defined by what is perceived as new by patients and/or others within the social system of adaptation. The analysed patient designs are original (as distinct from replications of or improvements on known products), and their characteristics are innovative contributions to the social system of everyday living with diabetes (i.e. they are perceived as new to the patients in the research study). The results of the analysis contribute to the credentials of patients as key actors in HIT innovation and call for participatory approaches in health informatics.

  19. Patient priorities and the doorknob phenomenon in primary care: Can technology improve disclosure of patient stressors?

    Science.gov (United States)

    Wittink, Marsha N; Walsh, Patrick; Yilmaz, Sule; Mendoza, Michael; Street, Richard L; Chapman, Benjamin P; Duberstein, Paul

    2018-02-01

    Patients with multiple chronic conditions face many stressors (e.g. financial, safety, transportation stressors) that are rarely prioritized for discussion with the primary care provider (PCP). In this pilot randomized controlled trial we examined the effects of a novel technology-based intervention called Customized Care on stressor disclosure. The main outcomes were stressor disclosure, patient confidence and activation, as assessed by self-report and observational methods (transcribed and coded audio-recordings of the office visit). Sixty patients were enrolled. Compared with care as usual, intervention patients were 6 times more likely to disclose stressors to the PCP (OR=6.16, 95% CI [1.53, 24.81], p=0.011) and reported greater stressor disclosure confidence (exp[B]=1.06, 95% CI [1.01, 1.12], p=0.028). No differences were found in patient activation or the length of the office visit. Customized Care improved the likelihood of stressor disclosure without affecting the length of the PCP visit. Brief technology-based interventions, like Customized Care could be made available through patient portals, or on smart phones, to prime patient-PCP discussion about difficult subjects, thereby improving the patient experience and efficiency of the visit. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Patient educational technologies and their use by patients diagnosed with localized prostate cancer.

    Science.gov (United States)

    Baverstock, Richard J; Crump, R Trafford; Carlson, Kevin V

    2015-09-29

    Two urology practices in Calgary, Canada use patient educational technology (PET) as a core component of their clinical practice. The purpose of this study was to determine how patients interact with PET designed to inform them about their treatment options for clinically localized prostate cancer. A PET library was developed with 15 unique prostate-related educational modules relating to diagnosis, treatment options, and potential side effects. The PET collected data regarding its use, and those data were used to conduct a retrospective analysis. Descriptive analyses were conducted and comparisons made between patients' utilization of the PET library during first and subsequent access; Pearson's Chi-Square was used to test for statistical significance, where appropriate. Every patient (n = 394) diagnosed with localized prostate cancer was given access to the PET library using a unique identifier. Of those, 123 logged into the library and viewed at least one module and 94 patients logged into the library more than once. The average patient initially viewed modules pertaining to their diagnosis. Viewing behavior significantly changed in subsequent logins, moving towards modules pertaining to treatment options, decision making, and post-surgical information. As observed through the longitudinal utilization of the PET library, information technology offers clinicians an opportunity to provide an interactive platform to meet patients' dynamic educational needs. Understanding these needs will help inform the development of more useful PETs. The informational needs of patients diagnosed with clinically localized prostate cancer changed throughout the course of their diagnosis and treatment.

  1. Technology-based assessment in patients with disorders of consciousness

    Directory of Open Access Journals (Sweden)

    Carol Di Perri

    2014-09-01

    Full Text Available Introduction. A number of studies highlight the difficulty in forming a diagnosis for patients with disorders of consciousness when this is established merely on behavioral assessments. Background. Positron emission tomography (PET, functional magnetic resonance imaging (fMRI, diffusion tensor imaging (DTI, and electroencephalography combined with transcranial magnetic stimulation (TMS-EEG techniques are promoting the clinical characterization of this challenging population. With such technology-based "objective" tools, patients are also differentially able to follow simple commands and in some cases even communicate through modified brain activity. Consequently, the vegetative state and minimally conscious state have been revised and new nosologies have been proposed, namely the unresponsive wakefulness syndrome, the minimally conscious state plus and minus, and the functional locked-in syndrome. Aim. To our mind, an integration of different technical modalities is important to gain a holistic vision of the underlying pathophysiology of disorders of consciousness in general and to promote single-patient medical management in particular.

  2. Robotic Technologies and Rehabilitation: New Tools for Stroke Patients' Therapy

    Science.gov (United States)

    Poli, Patrizia; Morone, Giovanni; Rosati, Giulio; Masiero, Stefano

    2013-01-01

    Introduction. The role of robotics in poststroke patients' rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords “robot AND stroke AND rehabilitation.” Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. Conclusions. In the field of robotic technologies for stroke patients' rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient's characteristics to be successfully enrolled to this treatment. PMID:24350244

  3. Effects of Patient Care Unit Design and Technology on Nurse and Patient Care Technician Communication.

    Science.gov (United States)

    Beck, Mary S; Doscher, Mindy

    2018-04-01

    The current study described RN and patient care technician (PCT) communication in centralized and hybrid decentralized workstation designs using hands-free communication technology and infrared locator badge technology to facilitate communication. New construction of an oncology unit provided the opportunity to compare staff communication in two different workstation designs. Observations and questionnaires compared nurse and PCT communication in the two-unit designs. Descriptive statistics were used to analyze the differences. The hybrid decentralized unit had increased use of hands-free communication technology and hallway communication by nurses and PCTs, and increased patient room communication by nurses. Perceptions of communication between nurses and PCTs and congruency of priorities for care were similar for both units. The locator badge technology had limited adoption. Replacement of nurse workstations with new construction or remodeling impact staff communication patterns, necessitating that nurse leaders understand the impact of design and technology on communication. [Journal of Gerontological Nursing, 44(4), 17-22.]. Copyright 2018, SLACK Incorporated.

  4. Characterization of Patient Interest in Provider-Based Consumer Health Information Technology: Survey Study.

    Science.gov (United States)

    Featherall, Joseph; Lapin, Brittany; Chaitoff, Alexander; Havele, Sonia A; Thompson, Nicolas; Katzan, Irene

    2018-04-19

    Consumer health information technology can improve patient engagement in their health care and assist in navigating the complexities of health care delivery. However, the consumer health information technology offerings of health systems are often driven by provider rather than patient perspectives and inadequately address patient needs, thus limiting their adoption by patients. Consideration given to patients as stakeholders in the development of such technologies may improve adoption, efficacy, and consumer health information technology resource allocation. The aims of this paper were to measure patient interest in different health system consumer health information technology apps and determine the influence of patient characteristics on consumer health information technology interest. Patients seen at the Cleveland Clinic Neurological Institute were electronically surveyed on their interest in using different consumer health information technology apps. A self-efficacy scale, Patient Health Questionnaire-9 depression screen, and EuroQol 5 dimensions health-related quality of life scale were also completed by patients. Logistic regression was used to determine the influence of patient characteristics on interest in consumer health information technology in the categories of self-management, education, and communication. The majority of 3852 patient respondents had an interest in all technology categories assessed in the survey. The highest interest was in apps that allow patients to ask questions of providers (3476/3852, 90.24%) and to schedule appointments (3211/3839, 83.64%). Patient interest in consumer health information technology was significantly associated with greater depression symptoms, worse quality of life, greater health self-efficacy, and smartphone ownership (Pinformation technology development and their perspectives should consistently guide development efforts. Health systems should consider focusing on consumer health information technologies

  5. Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology

    Directory of Open Access Journals (Sweden)

    Om Prakash Singh

    2015-01-01

    Full Text Available This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620 followed by signal conditioning circuit with the operation amplifier (lm741. Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

  6. Using Digital Technology to Engage and Communicate with Patients: A Survey of Patient Attitudes.

    Science.gov (United States)

    Jenssen, Brian P; Mitra, Nandita; Shah, Anand; Wan, Fei; Grande, David

    2016-01-01

    As primary care moves toward a system of population health management, providers will need to engage patients outside traditional office-based interactions. We assessed patient attitudes regarding technology use to communicate with their primary care team or to engage with other patients outside typical office settings. Design/Participants/Main Measures We conducted a national survey using GfK KnowledgePanel(®) to examine attitudes on the use of digital technology (email, text messaging, and social media such as Facebook and Twitter) to communicate with primary care teams about health behavior goals and test results. We also assessed attitudes toward the use of digital technologies to engage with other patients in activities such as peer coaching. Of the 5119 panel members invited to participate, 3336 completed the survey (response rate, 65.2 %). Among respondents, more than half (58 %) reported using Facebook, and nearly two-thirds (64.1 %) used text messaging. Overall, few participants were willing to communicate about health goals via social media (3.1 %) or text messaging (13.3 %), compared to email (48.8 %) or phone (75.5 %) (results were similar for communication about test results). Among those that used text messaging, race/ethnicity was the only factor independently associated with greater support for text messaging [African American (OR 1.44; 95 % CI, 1.01-2.06) and Hispanic (OR 1.8; 95 % CI, 1.25-2.59)] in multivariate models. Participants interested in engaging in peer coaching through Facebook (11.7 %) were more likely to be younger (p tools for communicating with their physicians' practice. Participants were most supportive of using email for communication. Contrary to previous studies, among users of technology, low socioeconomic status and racial/ethnic minorities were equally or more likely to support use.

  7. Ocular disease, knowledge and technology applications in patients with diabetes.

    Science.gov (United States)

    Threatt, Jennifer; Williamson, Jennifer F; Huynh, Kyle; Davis, Richard M

    2013-04-01

    An estimated 25.8 million children and adults in the United States, approximately 8.3% of the population, have diabetes. Diabetes prevalence varies by race and ethnicity. African Americans have the highest prevalence (12.6%), followed closely by Hispanics (11.8%), Asian Americans (8.4%) and whites (7.1%). The purpose of this article was to discuss the ocular complications of diabetes, the cultural and racial differences in diabetes knowledge and the role of telemedicine as a means to reach the undeserved who are at risk of complications. Information on the pathophysiology of ocular disease in patients with diabetes and the role of telemedicine in diabetes care was derived from a literature review. National Institutes of Health online resources were queried to present data on the racial and cultural understandings of diabetes and diabetes-related complications. The microvascular ocular complications of diabetes are discussed for retinopathy, cataracts, glaucoma and ocular surface disease. Racial and cultural differences in knowledge of recommended self-care practices are presented. These differences, in part, may explain health disparities and the increased risk of diabetes and its complications in rural minority communities. Finally, advances in telemedicine technology are discussed that show improvements in metabolic control and cardiovascular risk in adults with type 2 diabetes. Improving provider and patient understanding of diabetes complications may improve management and self-care practices that are important for diabetes control. Telemedicine may improve access to diabetes specialists and may improve self-management education and diabetes control particularly in rural and underserved communities.

  8. Constructing a Patient Education System: A Performance Technology Project

    Science.gov (United States)

    Bell, Edith E.

    2009-01-01

    The purpose of the patient education system described here was to distribute patient education material to and within medical practices managed by a small medical practice management company. The belief was that patient education opportunities improved health care outcomes and increased patient participation in health care decisions and compliance…

  9. Patients' Acceptance of Smartphone Health Technology for Chronic Disease Management: A Theoretical Model and Empirical Test.

    Science.gov (United States)

    Dou, Kaili; Yu, Ping; Deng, Ning; Liu, Fang; Guan, YingPing; Li, Zhenye; Ji, Yumeng; Du, Ningkai; Lu, Xudong; Duan, Huilong

    2017-12-06

    Chronic disease patients often face multiple challenges from difficult comorbidities. Smartphone health technology can be used to help them manage their conditions only if they accept and use the technology. The aim of this study was to develop and test a theoretical model to predict and explain the factors influencing patients' acceptance of smartphone health technology for chronic disease management. Multiple theories and factors that may influence patients' acceptance of smartphone health technology have been reviewed. A hybrid theoretical model was built based on the technology acceptance model, dual-factor model, health belief model, and the factors identified from interviews that might influence patients' acceptance of smartphone health technology for chronic disease management. Data were collected from patient questionnaire surveys and computer log records about 157 hypertensive patients' actual use of a smartphone health app. The partial least square method was used to test the theoretical model. The model accounted for .412 of the variance in patients' intention to adopt the smartphone health technology. Intention to use accounted for .111 of the variance in actual use and had a significant weak relationship with the latter. Perceived ease of use was affected by patients' smartphone usage experience, relationship with doctor, and self-efficacy. Although without a significant effect on intention to use, perceived ease of use had a significant positive influence on perceived usefulness. Relationship with doctor and perceived health threat had significant positive effects on perceived usefulness, countering the negative influence of resistance to change. Perceived usefulness, perceived health threat, and resistance to change significantly predicted patients' intentions to use the technology. Age and gender had no significant influence on patients' acceptance of smartphone technology. The study also confirmed the positive relationship between intention to use

  10. Leaving patients to their own devices? Smart technology, safety and therapeutic relationships.

    Science.gov (United States)

    Ho, Anita; Quick, Oliver

    2018-03-06

    This debate article explores how smart technologies may create a double-edged sword for patient safety and effective therapeutic relationships. Increasing utilization of health monitoring devices by patients will likely become an important aspect of self-care and preventive medicine. It may also help to enhance accurate symptom reports, diagnoses, and prompt referral to specialist care where appropriate. However, the development, marketing, and use of such technology raise significant ethical implications for therapeutic relationships and patient safety. Drawing on lessons learned from other direct-to-consumer health products such as genetic testing, this article explores how smart technology can also pose regulatory challenges and encourage overutilization of healthcare services. In order for smart technology to promote safer care and effective therapeutic encounters, the technology and its utilization must be safe. This article argues for unified regulatory guidelines and better education for both healthcare providers and patients regarding the benefits and risks of these devices.

  11. Patient monitoring in Polish assisted reproductive technology centres

    Directory of Open Access Journals (Sweden)

    Anna Krawczak

    2016-12-01

    Full Text Available In 2014, the Polish non-governmental patient association ‘Our Stork’ (Nasz Bocian introduced the ‘Patient monitoring in ART centres’ research project to gather previously unrecorded information on the situation of infertile people and the provision of assisted reproductive treatment in Poland. When the research project began, assisted reproductive treatment centres were unregulated by the state, a situation that had existed for more than 28 years following the birth of the first Polish test-tube baby in 1987. Patients signed civil contracts, remaining unprotected in terms of safety of treatment and recognition of their rights, and their presumed social position was described by doctors as ‘disciplined patients’ – a reflection of what Michele Foucault described as biopolitics. The research project comprised patient questionnaires (responses from 722 patients provided the basis for the document ‘Patient Recommendations in Infertility Treatment’, analysis of civil contracts and their accuracy in the context of patients’ legal rights in Poland, and in-depth interviews with assisted reproductive treatment centres’ owners, doctors, midwives, and patients to explore patient care. The data reveal that there is a lack of patient-centred care among doctors and medical staff in Poland and that following the passing into law of the 2015 Infertility Act, which introduced state regulation of assisted reproductive treatment centres, the situation for patients worsened.

  12. Empowering Patients with COPD Using Tele-Homecare Technology

    DEFF Research Database (Denmark)

    Huniche, Lotte

    2010-01-01

    Abstract. This paper describes how a tele-rehabilitation program using home tele-monitoring empowers patients with COPD. The paper is based on findings from an ongoing research and innovation project, called “Telehomecare, chronic patients and the integrated healthcare system” (the TELEKAT project......) that employs triple interventions related to patients, professionals, and the organisation of care. The ways COPD patients utilize home tele-monitoring in the TELEKAT project points to the relevance of empowerment, as rooted in ideologies of social action, and focusing on the improvement of both personal...

  13. Ophthalmic patients' utilization of technology and social media: an assessment to improve quality of care.

    Science.gov (United States)

    Aleo, Chelsea L; Hark, Lisa; Leiby, Benjamin; Dai, Yang; Murchison, Ann P; Martinez, Patricia; Haller, Julia A

    2014-10-01

    E-health tools have the potential to improve the quality of care for ophthalmic patients, many of whom have chronic conditions. However, little research has assessed ophthalmic patients' use or acceptance of technological devices and social media platforms for health-related purposes. The present study evaluated utilization of technological devices and social media platforms by eye clinic patients, as well as their willingness to receive health reminders through these technologies. A 31-item paper questionnaire was administered to eye clinic patients (n=843) at an urban, tertiary-care center. Questions focused on technology ownership, comfort levels, frequency of use, and preferences for receiving health reminders. Demographic data were also recorded. Eye clinic patients most commonly owned cellular phones (90%), landline phones (81%), and computers (80%). Overall, eye clinic patients preferred to receive health reminders through phone calls and e-mail and used these technologies frequently and with a high level of comfort. Less than 3% of patients preferred using social networking to receive health reminders. In addition, age was significantly associated with technology ownership, comfort level, and frequency of use (p<0.05). The majority of patients 18-45 years of age preferred to receive appointment reminders via text message (57%) and e-mail (53%). This age group also used these technologies more frequently and with a higher comfort level (p<0.001). These data support the proposal that e-mail and text-messaging e-health tools are likely to be immediately adopted by eye clinic patients and therefore have the greatest potential to improve health outcomes and increase quality of care. Eye clinic patients are interested in these technologies for appointment reminders, general eye and vision health information, asking urgent medical questions, and requesting prescription refills. Future controlled trials could further explore the efficacy of e-health tools for these

  14. Distributed Computing and Monitoring Technologies for Older Patients

    DEFF Research Database (Denmark)

    Klonovs, Juris; Haque, Mohammad Ahsanul; Krueger, Volker

    This book summarizes various approaches for the automatic detection of health threats to older patients at home living alone. The text begins by briefly describing those who would most benefit from healthcare supervision. The book then summarizes possible scenarios for monitoring an older patient...

  15. Effectiveness of educational technology to improve patient care in pharmacy curricula.

    Science.gov (United States)

    Smith, Michael A; Benedict, Neal

    2015-02-17

    A review of the literature on the effectiveness of educational technologies to teach patient care skills to pharmacy students was conducted. Nineteen articles met inclusion criteria for the review. Seven of the articles included computer-aided instruction, 4 utilized human-patient simulation, 1 used both computer-aided instruction and human-patient simulation, and 7 utilized virtual patients. Educational technology was employed with more than 2700 students at 12 colleges and schools of pharmacy in courses including pharmacotherapeutics, skills and patient care laboratories, drug diversion, and advanced pharmacy practice experience (APPE) orientation. Students who learned by means of human-patient simulation and virtual patients reported enjoying the learning activity, whereas the results with computer-aided instruction were mixed. Moreover, the effect on learning was significant in the human-patient simulation and virtual patient studies, while conflicting data emerged on the effectiveness of computer-aided instruction.

  16. CSIR ScienceScope: Science and technology in support of small, medium and micro enterprises

    CSIR Research Space (South Africa)

    CSIR

    2017-01-01

    Full Text Available generation of small-scale farmers with business savvy 34 Diversifying the product range of the Tshivhase Tea Estate 36 Supporting the creation of substantive township economic activity 38 CSIR technology stimulating the media and broadcast... and natural remedies. The cooperative is supported by the Department of Rural Development and Land Reform, which contracted the CSIR as an implementation agent for the production facility. See articles on page 28-31 44 54 ENTERPRISE AND SUPPLIER...

  17. Heart failure patients' perceptions and use of technology to manage disease symptoms.

    Science.gov (United States)

    Hall, Amanda K; Dodd, Virginia; Harris, Amy; McArthur, Kara; Dacso, Clifford; Colton, Lara M

    2014-04-01

    Technology use for symptom management is beneficial for both patients and physicians. Widespread acceptance of technology use in healthcare fuels continued development of technology with ever-increasing sophistication. Although acceptance of technology use in healthcare by medical professionals is evident, less is known about the perceptions, preferences, and use of technology by heart failure (HF) patients. This study explores patients' perceptions and current use of technology for managing HF symptoms (MHFS). A qualitative analysis of in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Fifteen participants (mean age, 64.43 years) with HF were recruited from hospitals, cardiology clinics, and community groups. All study participants reported use of a home monitoring device, such as an ambulatory blood pressure device or bathroom scale. The majority of participants reported not accessing online resources for additional MHFS information. However, several participants stated their belief that technology would be useful for MHFS. Participants reported increased access to care, earlier indication of a worsening condition, increased knowledge, and greater convenience as potential benefits of technology use while managing HF symptoms. For most participants financial cost, access issues, satisfaction with current self-care routine, mistrust of technology, and reliance on routine management by their current healthcare provider precluded their use of technology for MHFS. Knowledge about HF patients' perceptions of technology use for self-care and better understanding of issues associated with technology access can aid in the development of effective health behavior interventions for individuals who are MHFS and may result in increased compliance, better outcomes, and lower healthcare costs.

  18. Introducing the patient's perspective in hospital health technology assessment (HTA): the views of HTA producers, hospital managers and patients.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Desmartis, Marie; Gagnon, Johanne; St-Pierre, Michèle; Gauvin, François-Pierre; Rhainds, Marc; Lepage-Savary, Dolorès; Coulombe, Martin; Dipankui, Mylène Tantchou; Légaré, France

    2014-12-01

    The recent establishment of health technology assessment (HTA) units in University hospitals in the Province of Quebec (Canada) provides a unique opportunity to foster increased participation of patients in decisions regarding health technologies and interventions at the local level. However, little is known about factors that influence whether the patient's perspective is taken into consideration when such decisions are made. To explore the practices, perceptions and views of the various HTA stakeholders concerning patient involvement in HTA at the local level. Data were collected using semi-structured interviews with 24 HTA producers and hospital managers and two focus groups with a total of 13 patient representatives. Patient representatives generally showed considerable interest in being involved in HTA. Our findings support the hypothesis that the patient perspective contributes to a more accurate and contextualized assessment of health technologies and produces HTA reports that are more useful for decision makers. They also suggest that participation throughout the assessment process could empower patients and improve their knowledge. Barriers to patient involvement in HTA at the local level are also discussed as well as potential strategies to overcome them. This study contributes to knowledge that could guide interventions in favour of patient participation in HTA activities at the local level. Experimenting with different patient involvement strategies and assessing their impact is needed to provide evidence that will inform future interventions of this kind. © 2012 John Wiley & Sons Ltd.

  19. Hemodialysis Key Features Mining and Patients Clustering Technologies

    Directory of Open Access Journals (Sweden)

    Tzu-Chuen Lu

    2012-01-01

    Full Text Available The kidneys are very vital organs. Failing kidneys lose their ability to filter out waste products, resulting in kidney disease. To extend or save the lives of patients with impaired kidney function, kidney replacement is typically utilized, such as hemodialysis. This work uses an entropy function to identify key features related to hemodialysis. By identifying these key features, one can determine whether a patient requires hemodialysis. This work uses these key features as dimensions in cluster analysis. The key features can effectively determine whether a patient requires hemodialysis. The proposed data mining scheme finds association rules of each cluster. Hidden rules for causing any kidney disease can therefore be identified. The contributions and key points of this paper are as follows. (1 This paper finds some key features that can be used to predict the patient who may has high probability to perform hemodialysis. (2 The proposed scheme applies k-means clustering algorithm with the key features to category the patients. (3 A data mining technique is used to find the association rules from each cluster. (4 The mined rules can be used to determine whether a patient requires hemodialysis.

  20. A comparative review of patient safety initiatives for national health information technology

    DEFF Research Database (Denmark)

    Magrabi, Farah; Aarts, Jos; Nøhr, Christian

    2013-01-01

    OBJECTIVE: To collect and critically review patient safety initiatives for health information technology (HIT). METHOD: Publicly promulgated set of advisories, recommendations, guidelines, or standards potentially addressing safe system design, build, implementation or use were identified by sear...

  1. Poster COHERENT EFFORT FOR COPD PATIENTS  WITH A SPECIAL FOCUS ON WELFARE TECHNOLOGY

    DEFF Research Database (Denmark)

    Vestergaard*, Kitt; Bagger, Bettan; Bech, Lone

    and consistency of treatment programs for patients with COPD this project seeks to explore: Experiences among patients with COPD and health professionals of implementation of technology regarding own competences for using the technologies as well as its impact on the quality of care. Method: The study...... own illness leading to prevention of hospitalizations (3, 4). Technologies therefore are assumed to enhance the quality and consistency of treatment programs for patients with COPD. Prior to implementation of welfare technology in the Region of Zealand, Denmark, University College Zealand and COPD......, as one expressed “what gives me knowledge, give me security“. Thus from the raw data it seems that the patients with COPD find the knowledge will impact quality in the care pathways and daily life, but it is individual how they prefer to have it. The health professionals generally pointed out...

  2. COHERENT EFFORT FOR COPD PATIENTS  WITH A SPECIAL FOCUS ON WELFARE TECHNOLOGY

    DEFF Research Database (Denmark)

    Vestergaard*, Kitt; Bagger, Bettan; Jensen, Lars Heegaard

    and consistency of treatment programs for patients with COPD this project seeks to explore: Experiences among patients with COPD and health professionals of implementation of technology regarding own competences for using the technologies as well as its impact on the quality of care. Method: The study...... own illness leading to prevention of hospitalizations (3, 4). Technologies therefore are assumed to enhance the quality and consistency of treatment programs for patients with COPD. Prior to implementation of welfare technology in the Region of Zealand, Denmark, University College Zealand and COPD......, as one expressed “what gives me knowledge, give me security“. Thus from the raw data it seems that the patients with COPD find the knowledge will impact quality in the care pathways and daily life, but it is individual how they prefer to have it. The health professionals generally pointed out...

  3. Organization-and-technological model of medical care delivered to patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Popova Y.V.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with coronary heart disease based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  4. Organization-and-technological model of medical care delivered to patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Kiselev A.R.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with arterial hypertension based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  5. Organization-and-technological model of medical care delivered to patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Kiselev A.R.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with chronic heart failure based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  6. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi).

    NARCIS (Netherlands)

    Elwyn, G.; O'Connor, A.M.; Bennett, C.; Newcombe, R.G.; Politi, M.; Durand, M.A.; Drake, E.; Joseph-Williams, N.; Khangura, S.; Saarimaki, A.; Sivell, S.; Stiel, M.; Bernstein, S.J.; Col, N.; Coulter, A.; Eden, K.; Harter, M.; Rovner, M.H.; Moumjid, N.; Stacey, D.; Thomson, R.; Whelan, T.; Weijden, G.D.E.M. van der; Edwards, A.

    2009-01-01

    OBJECTIVES: To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids). DESIGN: Scale development study, involving construct, item and scale development, validation and reliability testing.

  7. Teleheath Technology as E-Learning: Learning and Practicing Interprofessional Patient Care

    Science.gov (United States)

    Shortridge, Ann; Ross, Heather; Randall, Ken; Ciro, Carrie; Loving, Gary

    2018-01-01

    Teaching team-based patient competencies to health sciences students has proven to be a challenging endeavor. This paper describes two hands-on learning experiences and their subsequent evaluation. In both of these experiences telehealth technology served as both a distance education e-learning technology, as well as a medium to provide patient…

  8. The Role of Technology in Medication Safety Incidents: Interpretative Analysis of Patient Safety Incidents Data.

    Science.gov (United States)

    Lichtner, Valentina; Gerrett, David; Slee, Ann; Gul, Noreen; Cornford, Tony

    2017-01-01

    This is a study of medication safety incidents reported to the NHS in England (UK) associated with the use of digital technology. An interpretative analysis of 888 incidents reports offers insight into uses and features of this technology associated with medication errors and potential patient harm.

  9. The Role of Technology in Medication Safety Incidents: Interpretative Analysis of Patient Safety Incidents Data

    OpenAIRE

    Lichtner, V.; Gerrett, D.; Slee, A.; Gul, N.; Cornford, T.

    2017-01-01

    This is a study of medication safety incidents reported to the NHS in England (UK) associated with the use of digital technology. An interpretative analysis of 888 incidents reports offers insight into uses and features of this technology associated with medication errors and potential patient harm.

  10. Online self-management interventions for chronically ill patients: cognitive impairment and technology issues.

    Science.gov (United States)

    Archer, Norm; Keshavjee, Karim; Demers, Catherine; Lee, Ryan

    2014-04-01

    As the fraction of the population with chronic diseases continues to grow, methods and/or technologies must be found to help the chronically ill to take more responsibility to self-manage their illnesses. Internet based and/or mobile support for disease self-management interventions have often proved effective, but patients with chronic illnesses may have co-occurring cognitive impairment, making it more difficult for them to cope with technologies. Many older patients are also not familiar with technologies or they may have cognitive disabilities or dementia that reduce their ability to self-manage their healthcare. On-line solutions to the needs of chronically ill patients must be investigated and acted upon with care in an integrated manner, since resources invested in these solutions will be lost if patients do not adopt and continue to use them successfully. To review the capabilities of online and mobile support for self-management of chronic illnesses, and the impacts that age and disease-related issues have on these interventions, including cognitive impairment and lack of access or familiarity with Internet or mobile technologies. This study includes a review of the co-occurrence of cognitive impairment with chronic diseases, and discusses how cognitive impairment, dyadic caregiver patient support, patient efficacy with technology, and smart home technologies can impact the effectiveness and sustainability of online support for disease self-management. Disease self-management interventions (SMIs) using online patient centered support can often enable patients to manage their own chronic illnesses. However, our findings show that cognitive impairment often co-occurs in patients with chronic disease. This, along with age-related increases in multiple chronic illnesses and lack of technology efficacy, can be obstacles to Internet and mobile support for chronic disease self-management. Patients with chronic diseases may have greater than expected difficulties

  11. Effect of Internet technology on extended care in elderly patients with diabetic feet

    OpenAIRE

    Xian Zang; Jiao-Jiao Bai; Jiao Sun; Yue Ming; Li Ji

    2017-01-01

    Objective: To evaluate the effect of Internet technology on continuing nursing in elderly patients with diabetic feet. Method: From January 2015 to July 2016, 12 elderly patients with diabetic foot ulcers were enrolled from the Endocrinology Department in our hospital. We used “WeChat”, “E nursing” and other Internet technologies to perform remote extended care and to observe the foot ulcer outcomes. Results: All foot ulcers healed with a wound healing time between 38 and 73 days (avera...

  12. Patients' and carers' experiences of interacting with home haemodialysis technology: implications for quality and safety.

    Science.gov (United States)

    Rajkomar, Atish; Farrington, Ken; Mayer, Astrid; Walker, Diane; Blandford, Ann

    2014-12-11

    Little is known about patients' and carers' experiences of interacting with home haemodialysis (HHD) technology, in terms of user experience, how the design of the technology supports safety and fits with home use, and how the broader context of service provision impacts on patients' use of the technology. Data were gathered through ethnographic observations and interviews with 19 patients and their carers associated with four different hospitals in the UK, using five different HHD machines. All patients were managing their condition successfully on HHD. Data were analysed qualitatively, focusing on themes of how individuals used the machines and how they managed their own safety. Findings are organised by three themes: learning to use the technology, usability of the technology, and managing safety during dialysis. Home patients want to live their lives fully, and value the freedom and autonomy that HHD gives them; they adapt use of the technology to their lives and their home context. They also consider the machines to be safe; nevertheless, most participants reported feeling scared and having to learn through mistakes in the early months of dialysing at home. Home care nurses and technicians provide invaluable support. Although participants reported on strategies for anticipating problems and keeping safe, perceived limitations of the technology and of the broader system of care led some to trade off safety against immediate quality of life. Enhancing the quality and safety of the patient experience in HHD involves designing technology and the broader system of care to take account of how individuals manage their dialysis in the home. Possible design improvements to enhance the quality and safety of the patient experience include features to help patients manage their dialysis (e.g. providing timely reminders of next steps) and features to support communication between families and professionals (e.g. through remote monitoring).

  13. Classifying Health Information Technology patient safety related incidents – an approach used in Wales

    OpenAIRE

    Warm, D.; Edwards, P.

    2012-01-01

    Interest in the field of patient safety incident reporting and analysis with respect to Health Information Technology (HIT) has been growing over recent years as the development, implementation and reliance on HIT systems becomes ever more prevalent. One of the rationales for capturing patient safety incidents is to learn from failures in the delivery of care and must form part of a feedback loop which also includes analysis; investigation and monitoring. With the advent of new technologies a...

  14. Home care for patients in need of advanced care and technology : a challenge for patients and their caregivers

    OpenAIRE

    Swedberg, Lena

    2014-01-01

    Background and aim: There is an ongoing trend of advanced care ‘moving out’ from hospitals and into patients' homes. In Sweden, caregivers with limited training, employed by municipalities or private agencies take 24-hour responsibility for patient care with limited support from healthcare professionals. The aim of this thesis was to explore and gain new and broadened understanding of 24-hour home care for patients in need of advanced care and technology. Material and methods: A multi ...

  15. New technologies in treatment of atrial fibrillation in cardiosurgical patients

    Science.gov (United States)

    Evtushenko, A. V.; Evtushenko, V. V.; Bykov, A. N.; Sergeev, V. S.; Syryamkin, V. I.; Kistenev, Yu. V.; Anfinogenova, Ya. D.; Smyshlyaev, K. A.; Kurlov, I. O.

    2015-11-01

    The article is devoted to the evaluation of the results of clinical application of penetrating radiofrequency ablation techniques on atrial myocardium. Total operated on 241 patients with valvular heart disease and coronary heart disease complicated with atrial fibrillation. All operations were performed under cardiopulmonary bypass and cardioplegia. The main group consists of 141 patients which were operated using penetrating technique radiofrequency exposure. The control group consisted of 100 patients who underwent surgery with the use of "classical" monopolar RF-ablation technique. Both groups were not significantly different on all counts before surgery. Patients with previous heart surgery were excluded during the selection of candidates for the procedure, due to the presence of adhesions in the pericardium, that do not allow good visualization of left atrium, sufficient to perform this procedure. Penetrating technique has significantly higher efficiency compared to the "classic" technique in the early and long-term postoperative periods. In the early postoperative period, its efficiency is 93%, and in the long term is 88%. The efficacy of "classical" monopolar procedure is below: 86% and 68% respectively.

  16. Impact of gender on patient preferences for technology-based behavioral interventions.

    Science.gov (United States)

    Kim, David J; Choo, Esther K; Ranney, Megan L

    2014-08-01

    Technology-based interventions offer an opportunity to address high-risk behaviors in the emergency department (ED). Prior studies suggest behavioral health strategies are more effective when gender differences are considered. However, the role of gender in ED patient preferences for technology-based interventions has not been examined. The objective was to assess whether patient preferences for technology-based interventions varies by gender. This was a secondary analysis of data from a systematic survey of adult (≥18 years of age), English-speaking patients in a large urban academic ED. Subjects were randomly selected during a purposive sample of shifts. The iPad survey included questions on access to technology, preferences for receiving health information, and demographics. We defined "technology-based" as web, text message, e-mail, social networking, or DVD; "non-technology-based" was defined as in-person, written materials, or landline. We calculated descriptive statistics and used univariate tests to compare men and women. Gender-stratified multivariable logistic regression models were used to examine associations between other demographic factors (age, race, ethnicity, income) and technology-based preferences for information on specific risky behaviors. Of 417 participants, 45.1% were male. There were no significant demographic differences between men and women. Women were more likely to use computers (90.8% versus 81.9%; p=0.03), Internet (66.8% versus 59.0%; p=0.03), and social networks (53.3% versus 42.6%; p=0.01). 89% of men and 90% of women preferred technology-based formats for at least type of health information; interest in technology-based for individual health topics did not vary by gender. Concern about confidentiality was the most common barrier to technology-based use for both genders. Multivariate analysis showed that for smoking, depression, drug/alcohol use, and injury prevention, gender modified the relationship between other demographic

  17. Being in front of the patient. Nurse-patient interaction and use of technology in emergency services

    Directory of Open Access Journals (Sweden)

    Yeimy Yesenia Granados-Pembertty

    2013-12-01

    Full Text Available Objective. This study sought to describe how the use of technology intervenes in the nurse-patient relationship, from the nurse's point of view. Methodology. This was a qualitative research with tools from grounded theory. Twenty semi-structured interviews were conducted with nurses working in emergency services in three municipalities of Colombia. Results. Four categories emerged: 1 direct care, the maximum interaction or being in front of the patient; 2 fairly direct care; 3 indirect care, institutional management; and 4 minimum interaction; technology as facilitator of the interaction and awareness of the necessity for interaction. Conclusion. This study shows the irreplaceable nature of the nurse and the fundamental necessity of technology. The dual mediations of technology constitute a paradoxical matter that reveals the importance of placing it as a means; warning on the danger of converting it an end in and of itself.

  18. Purchasing medical innovation the right technology, for the right patient, at the right price

    CERN Document Server

    Robinson, James C

    2015-01-01

    Innovation in medical technology generates a remarkable supply of new drugs, devices, and diagnostics that improve health, reduce risks, and extend life. But these technologies are too often used on the wrong patient, in the wrong setting, or at an unaffordable price. The only way to moderate the growth in health care costs without undermining the dynamic of medical innovation is to improve the process of assessing, pricing, prescribing, and using new technologies. Purchasing Medical Innovation analyzes the contemporary revolution in the purchasing of health care technology, with a focus on th

  19. Blurring the boundaries: technology and the nurse-patient relationship.

    Science.gov (United States)

    Aylott, Marion

    Nurses, like the rest of the world's population are increasingly participating in online social media. Nurses must be mindful to avoid situations that could ultimately compromise past, present and future patient health and wellbeing, as well as their professional identities and reputations and that of the nursing profession. Unprofessional uses of social networking tools are common. This article aims to inform nurses of the public accessibility to professionally inappropriate online behaviour and activities. It asks nurses to carefully consider the risks posed by online social media with a focus on boundary crossing in an e-society. Forethought is required to ensure that private information stays private and that the nature of the professional relationship between nurse and patient continues to be respected.

  20. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approache......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work....

  1. Impact of Gender on Patient Preferences for Technology-Based Behavioral Interventions

    Directory of Open Access Journals (Sweden)

    David J. Kim

    2014-08-01

    Full Text Available Introduction: Technology-based interventions offer an opportunity to address high-risk behaviors in the emergency department (ED. Prior studies suggest behavioral health strategies are more effective when gender differences are considered. However, the role of gender in ED patient preferences for technology-based interventions has not been examined. The objective was to assess whether patient preferences for technology-based interventions varies by gender. Methods: This was a secondary analysis of data from a systematic survey of adult (18 years of age, English-speaking patients in a large urban academic ED. Subjects were randomly selected during a purposive sample of shifts. The iPad survey included questions on access to technology, preferences for receiving health information, and demographics. We defined ‘‘technology-based’’ as web, text message, e-mail, social networking, or DVD; ‘‘non-technology-based’’ was defined as in-person, written materials, or landline. We calculated descriptive statistics and used univariate tests to compare men and women. Gender-stratified multivariable logistic regression models were used to examine associations between other demographic factors (age, race, ethnicity, income and technology-based preferences for information on specific risky behaviors. Results: Of 417 participants, 45.1% were male. There were no significant demographic differences between men and women. Women were more likely to use computers (90.8% versus 81.9%; p¼0.03, Internet (66.8% versus 59.0%; p¼0.03, and social networks (53.3% versus 42.6%; p¼0.01. 89% of men and 90% of women preferred technology-based formats for at least type of health information; interest in technology-based for individual health topics did not vary by gender. Concern about confidentiality was the most common barrier to technology-based use for both genders. Multivariate analysis showed that for smoking, depression, drug/alcohol use, and injury

  2. Coherent efforts in relation to COPD patients with special emphasis on the quality and technological solutions

    DEFF Research Database (Denmark)

    Bagger, Bettan; Vestergaard*, Kitt; Andresen, Mette

    patients and health professionals. - To qualify patient care in pathways between sectors for the COPD patient Population COPD patients with long term experience living with COPD (N=20) and health professionals involved in e.g. care, treatment, rehabilitation (N=12) will be included. COPD Competence Center......Keywords: COPD, quality, clinical pathways, daily life, competences, welfare technology Background: Focus in Health Service moves towards quality and hence focus is on results that create quality in healthcare services. Technologies are assumed to promote more consistent quality in health care...... with respect to COPD patients. National Board of Health has produced series of recommendations to ensure quality based among others on The Chronic Care Model. But how do COPD patients and health professionals define quality themselves in daily life? University College Zealand and COPD Competence Center...

  3. Interaction Between Nurse Anesthetists and Patients in a Highly Technological Environment.

    Science.gov (United States)

    Aagaard, Karin; Laursen, Birgitte Schantz; Rasmussen, Bodil Steen; Sørensen, Erik Elgaard

    2017-10-01

    To explore the specific interactions between patients and nurse anesthetists in the highly technological environment of anesthesia nursing, focusing on the time interval between patient entrance into the operating room and induction of general anesthesia. Focused ethnography was used for data collection. Participant observation and interview of 13 hospitalized patients being admitted for major or minor surgical procedures and 13 nurse anesthetists in charge of their patients and anesthetic procedures. Photographs were taken of specific situations and technological objects in the observation context. The analysis was inspired by grounded theory. A core variable of creating emotional energy is presented, and two subcore variables are delineated: instilling trust and performing embodied actions. Creating emotional energy has an important impact on the interaction between patients and nurse anesthetists. Furthermore, the motives underpinning nurse anesthetists' interactions with patients are a central constituent in developing anesthesia care. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  4. Technology for long-term care.

    Science.gov (United States)

    Tak, Sunghee H; Benefield, Lazelle E; Mahoney, Diane Feeney

    2010-01-01

    Severe staff shortages in long-term care (LTC) make it difficult to meet the demands of the growing aging population. Further, technology-savvy Baby Boomers are expected to reshape the current institutional environments toward gaining more freedom and control in their care and lives. Voices from business, academia, research, advocacy organizations, and government bodies suggest that innovative technological approaches are the linchpin that may prepare society to cope with these projected demands. In this article, we review the current state of aging-related technology, identify potential areas for efficacy testing on improving the quality of life of LTC residents in future research, and discuss barriers to implementation of LTC technology. Finally, we present a vision of future technology use that could transform current care practices. Copyright 2010, SLACK Incorporated.

  5. New information and communication technologies to communicate with patients: text messaging

    OpenAIRE

    Nagberi, Augustina Edisemi

    2008-01-01

    New information and communication technologies such as cell phone communication hold great potential for improvements in health care access and delivery. This paper addresses the use of text messaging for patient communication. It includes a case study that is one of the first to examine the use of text messaging to notify patients of STD results. Findings from 2 focus groups with 15 participants from an urban STD clinic show patients reacted positively regarding the use of text messages. Rea...

  6. Health information technologies in systemic lupus erythematosus: focus on patient assessment.

    Science.gov (United States)

    Tani, Chiara; Trieste, Leopoldo; Lorenzoni, Valentina; Cannizzo, Sara; Turchetti, Giuseppe; Mosca, Marta

    2016-01-01

    Recent advances in health information technologies (HIT) in systemic lupus erythematosus have included electronic databases and registries, computerised clinical charts for patient monitoring, computerised diagnostic tools, computerised prediction rules and, more recently, disease-specific applications for mobile devices for physicians, health care professionals, and patients. Traditionally, HIT development has been oriented primarily to physicians and public administrators. However, more recent development of patient-centered Apps could improve communication and empower patients in the daily management of their disease. Economic advantages could also result from the use of HIT, including these Apps by collecting real life data that could be used in both economic analyses and to improve patient care.

  7. [The contribution of Web 2.0 technologies to the empowerment of active patients].

    Science.gov (United States)

    Oliver-Mora, Martí; Iñiguez-Rueda, Lupicinio

    2017-03-01

    The Spanish health system has recently been marked by the emergence of more active patients who are characterized as being better informed about their disease, having a more participatory attitude, wanting to have a greater influence in making decisions about their health and asserting their rights as patients. Therefore, this article aims to report on how the introduction of Web 2.0 technologies can contribute to the empowering of more active patients. To achieve this, 14 semi-structured interviews were conducted with patients and representatives of patient associations who have used Web 2.0 technologies to interact with other patients or to communicate with health professionals. From the results obtained, we highlight the fact that Web 2.0 technologies provide greater access to health-related information, improve communication between patients and health professionals, and enable the creation of new spaces of interaction among patients. All of the facts above contribute to the formation of a more active role on the part of patients.

  8. Mobile Technology Use Across Age Groups in Patients Eligible for Cardiac Rehabilitation: Survey Study.

    Science.gov (United States)

    Gallagher, Robyn; Roach, Kellie; Sadler, Leonie; Glinatsis, Helen; Belshaw, Julie; Kirkness, Ann; Zhang, Ling; Gallagher, Patrick; Paull, Glenn; Gao, Yan; Partridge, Stephanie Ruth; Parker, Helen; Neubeck, Lis

    2017-10-24

    Emerging evidence indicates mobile technology-based strategies may improve access to secondary prevention and reduce risk factors in cardiac patients. However, little is known about cardiac patients' use of mobile technology, particularly for health reasons and whether the usage varies across patient demographics. This study aimed to describe cardiac patients' use of mobile technology and to determine variations between age groups after adjusting for education, employment, and confidence with using mobile technology. Cardiac patients eligible for attending cardiac rehabilitation were recruited from 9 hospital and community sites across metropolitan and rural settings in New South Wales, Australia. Participants completed a survey on the use of mobile technology devices, features used, confidence with using mobile technology, willingness and interest in learning, and health-related use. The sample (N=282) had a mean age of 66.5 (standard deviation [SD] 10.6) years, 71.9% (203/282) were male, and 79.0% (223/282) lived in a metropolitan area. The most common diagnoses were percutaneous coronary intervention (33.3%, 94/282) and myocardial infarction (22.7%, 64/282). The majority (91.1%, 257/282) used at least one type of technology device, 70.9% (200/282) used mobile technology (mobile phone/tablet), and 31.9% (90/282) used all types. Technology was used by 54.6% (154/282) for health purposes, most often to access information on health conditions (41.4%, 117/282) and medications (34.8%, 98/282). Age had an important independent association with the use of mobile technology after adjusting for education, employment, and confidence. The youngest group (mobile technology than the oldest (>69 years) age group (odds ratio [OR] 4.45, 95% CI 1.46-13.55), 5 times more likely to use mobile apps (OR 5.00, 95% CI 2.01-12.44), and 3 times more likely to use technology for health-related reasons (OR 3.31, 95% CI 1.34-8.18). Compared with the older group, the middle age group (56

  9. Empowering Patients through Healthcare Technology and Information? The Challenge of becoming a Patient 2.0

    DEFF Research Database (Denmark)

    Brodersen, Søsser Grith Kragh; Lindegaard, Hanne

    2015-01-01

    at patient empowerment (e.g., pamphlets, training instructions) change how patients are framed in established networks; the emergent chronic patient frame challenges the traditional functioning of established patient-doctor relationships. Theoretically, we draw on the concepts of discipline (Foucault, 1975......), and domestication (Silverstone, 1989; Lie and S Keywords: patient empowerment; Patient 2.0; self-management; future healthcare system; change in healthcare practices; chronic/treated challenges...

  10. USE OF TECHNOLOGIES OF PLASTIC AND RECONSTRUCTIVE MICROSURGERY IN TREATMENT OF PATIENTS WITH PATHOLOGY OF KNEE

    Directory of Open Access Journals (Sweden)

    L. A. Rodomanova

    2012-01-01

    Full Text Available Analysis of the results of surgical treatment of 63 patients with knee-joint pathology who were treated in Vreden’s Scientific-research Institute of traumatology and orthopaedics (Saint-Petersburg, Russia within the period from 2000 to 2011. All the patients had pedicled flap transfer or free tissue transfer. 53 patients (84,1% had additionally various orthopedic operations on the knee joint: 42 patients had primary or revision total knee arthroplasty, 6 patients had resections of bony tumors and total knee arthroplasty, 4 - knee arthrodesis, 1 - open reduction and internal fixation of patella. The results of treatment were estimated according to WOMAC knee score. 4 patients had total necrosis of flap what demanded repeated reconstructive microsurgical operation. 6 patients had knee arthroplasty surgical site infection, 1 patient had recidive of osteoblastic sarcoma and he was made leg amputation. 65,7% of patients had good results according to WOMAC knee score, 28,6% patients had satisfactory results. Microsurgical operations in patients with pathology of knee-joint mainly aim to correct various pathological changes of tissues located in this particular area. In cases of scarry deformations and defects of tissues located in the area of knee-joint microsurgical technologies increase the opportunities for fulfilling total knee arthroplasty and improve its results as well as results of other orthopedical operations. At the same time microsurgical technologies may be used as preparative operations, single-step maneuvers and operations fulfilled in case of development of local infectious complications.

  11. Moving beyond the rhetoric of patient input in health technology assessment deliberations.

    Science.gov (United States)

    Wortley, Sally; Wale, Janet; Grainger, David; Murphy, Peter

    2017-05-01

    At a health system level, the importance of patient and public input into healthcare decision making is well recognised. Patient and public involvement not only provides a mechanism to legitimise decisions, but also contributes to improved translation of these decisions into practice, ultimately leading to better patient outcomes. Recent reviews in the health technology assessment space have identified the need for, and increased use of, patient input through systematic methodologies. Yet, what does this mean in practical terms? This paper outlines both short- and longer-term options for strengthening patient input into health technology assessment deliberations. This is particularly important given the planned reforms in this area and the commitment to public consultation as part of the reform process.

  12. Qualitative Research for Patient Safety Using ICTs: Methodological Considerations in the Technological Age.

    Science.gov (United States)

    Yee, Kwang Chien; Wong, Ming Chao; Turner, Paul

    2017-01-01

    Considerable effort and resources have been dedicated to improving the quality and safety of patient care through health information systems, but there is still significant scope for improvement. One contributing factor to the lack of progress in patient safety improvement especially where technology has been deployed relates to an over-reliance on purely objective, quantitative, positivist research paradigms as the basis for generating and validating evidence of improvement. This paper argues the need for greater recognition and accommodation of evidence of improvement generated through more subjective, qualitative and pragmatic research paradigms to aid patient safety especially where technology is deployed. This paper discusses how acknowledging the role and value of more subjective ontologies and pragmatist epistemologies can support improvement science research. This paper illustrates some challenges and benefits from adopting qualitative research methods in patient safety improvement projects, particularly focusing challenges in the technological era. While adopting methods that can more readily capture, analyse and interpret direct user experiences, attitudes, insights and behaviours in their contextual settings, patient safety can be enhanced 'on the ground' and errors reduced and/or mitigated, challenges of using these methods with the younger "technologically-centred" healthcare professionals and patients needs to recognised.

  13. Continuous glucose monitoring technology for personal use: an educational program that educates and supports the patient.

    Science.gov (United States)

    Evert, Alison; Trence, Dace; Catton, Sarah; Huynh, Peter

    2009-01-01

    The purpose of this article is to describe the development and implementation of an educational program for the initiation of real-time continuous glucose monitoring (CGM) technology for personal use, not 3-day CGMS diagnostic studies. The education program was designed to meet the needs of patients managing their diabetes with either diabetes medications or insulin pump therapy in an outpatient diabetes education center using a team-based approach. Observational research, complemented by literature review, was used to develop an educational program model and teaching strategies. Diabetes educators, endocrinologists, CGM manufacturer clinical specialists, and patients with diabetes were also interviewed for their clinical observations and experience. The program follows a progressive educational model. First, patients learn in-depth about real-time CGM technology by attending a group presensor class that provides detailed information about CGM. This presensor class facilitates self-selection among patients concerning their readiness to use real-time CGM. If the patient decides to proceed with real-time CGM use, CGM initiation is scheduled, using a clinic-centered protocol for both start-up and follow-up. Successful use of real-time CGM involves more than just patient enthusiasm or interest in a new technology. Channeling patient interest into a structured educational setting that includes the benefits and limitations of real-time CGM helps to manage patient expectations.

  14. The role of information technology and informatics research in the dentist-patient relationship.

    Science.gov (United States)

    Kirshner, M

    2003-12-01

    A high-value doctor-patient relationship is based on a set of parameters which include the interpersonal relationship between the patient and the doctor. Based on the Primary Care Assessment Survey model, measures of the interpersonal relationship are associated with communication, interpersonal care, contextual knowledge of the patient, and trust. Despite the proven value of the doctor-patient relationship, current trends indicate that the quality of these relationships is on the decline. The advent of communication and information technologies has greatly affected the way in which health care is delivered and the relationship between doctors and patients. The convergence of communication and information technology with biomedical informatics offers an opportunity to affect the character of the doctor-patient relationship positively. This paper examines the intersection of the key features of the doctor-patient relationship and a variety of Internet-based, clinical, and administrative applications used in dental practice. This paper discusses the role of dental informatics research vis-à-vis the doctor-patient relationship and explores how it may inform the next generation of information technologies used in dental practice.

  15. Patient Outcomes as Transformative Mechanisms to Bring Health Information Technology Industry and Research Informatics Closer Together.

    Science.gov (United States)

    Krive, Jacob

    2015-01-01

    Despite the fast pace of recent innovation within the health information technology and research informatics domains, there remains a large gap between research and academia, while interest in translating research innovations into implementations in the patient care settings is lacking. This is due to absence of common outcomes and performance measurement targets, with health information technology industry employing financial and operational measures and academia focusing on patient outcome concerns. The paper introduces methodology for and roadmap to introduction of common objectives as a way to encourage better collaboration between industry and academia using patient outcomes as a composite measure of demonstrated success from health information systems investments. Along the way, the concept of economics of health informatics, or "infonomics," is introduced to define a new way of mapping future technology investments in accordance with projected clinical impact.

  16. Data-Savvy School Systems

    Science.gov (United States)

    Zavadsky, Heather

    2013-01-01

    A team of 4th-grade teachers in California's Sacramento City Unified School District collaboratively examines student writing products using a rubric that outlines elements in high-quality persuasive writing. The teachers analyze how they taught and assigned the written work in relationship to what the students produced. They focus on what a few…

  17. Development of the PRE-HIT instrument: patient readiness to engage in health information technology.

    Science.gov (United States)

    Koopman, Richelle J; Petroski, Gregory F; Canfield, Shannon M; Stuppy, Julie A; Mehr, David R

    2014-01-28

    Technology-based aids for lifestyle change are becoming more prevalent for chronic conditions. Important "digital divides" remain, as well as concerns about privacy, data security, and lack of motivation. Researchers need a way to characterize participants' readiness to use health technologies. To address this need, we created an instrument to measure patient readiness to engage with health technologies among adult patients with chronic conditions. Initial focus groups to determine domains, followed by item development and refinement, and exploratory factor analysis to determine final items and factor structure. The development sample included 200 patients with chronic conditions from 6 family medicine clinics. From 98 potential items, 53 best candidate items were examined using exploratory factor analysis. Pearson's Correlation for Test/Retest reliability at 3 months. The final instrument had 28 items that sorted into 8 factors with associated Cronbach's alpha: 1) Health Information Need (0.84), 2) Computer/Internet Experience (0.87), 3) Computer Anxiety (0.82), 4) Preferred Mode of Interaction (0.73), 5) Relationship with Doctor (0.65), 6) Cell Phone Expertise (0.75), 7) Internet Privacy (0.71), and 8) No News is Good News (0.57). Test-retest reliability for the 8 subscales ranged from (0.60 to 0.85). The Patient Readiness to Engage in Health Internet Technology (PRE-HIT) instrument has good psychometric properties and will be an aid to researchers investigating technology-based health interventions. Future work will examine predictive validity.

  18. Technology acceptance perception for promotion of sustainable consumption.

    Science.gov (United States)

    Biswas, Aindrila; Roy, Mousumi

    2018-03-01

    Economic growth in the past decades has resulted in change in consumption pattern and emergence of tech-savvy generation with unprecedented increase in the usage of social network technology. In this paper, the technology acceptance value gap adapted from the technology acceptance model has been applied as a tool supporting social network technology usage and subsequent promotion of sustainable consumption. The data generated through the use of structured questionnaires have been analyzed using structural equation modeling. The validity of the model and path estimates signifies the robustness of Technology Acceptance value gap in adjudicating the efficiency of social network technology usage in augmentation of sustainable consumption and awareness. The results indicate that subjective norm gap, ease-of-operation gap, and quality of green information gap have the most adversarial impact on social network technology usage. Eventually social networking technology usage has been identified as a significant antecedent of sustainable consumption.

  19. Treatment of rosacea patients with broadband pulse light emission using smooth pulse and photon recirculation technologies

    Directory of Open Access Journals (Sweden)

    A. A. Kubanova

    2015-01-01

    Full Text Available Goal of the study. To assess the efficacy and safety of using broadband pulse light emission with smooth pulse and photon recirculation technologies in the treatment of patients suffering from erythematous and papulous subtypes of rosacea. Materials and methods. Sixty rosacea patients (21 male and 39 female at the age of 25-65 including 38 patients with erythematous and 22 patients with papulous subtypes of rosacea underwent treatment using broadband pulse light emission (5-8 treatment sessions. Results. After one month of treatment with broadband pulse light emission using smooth pulse and photon recirculation technologies: 68.4% of patients with the erythematous subtype had clinical recovery, and 31.6% - improvement; 27.2% of patients with the papulous subtype - clinical recovery, 54.5% - improvement, and 18.3% had no effect. After 5 months of treatment most of the patients still had a positive effect of the therapy, yet 21.1% of patients with the erythematous subtype and 11% of patients with the papulous subtype had single telangiectasias, increased erythema and single papules. After 10 months of treatment 44.7% of patients with the erythematous subtype of rosacea had an increase in the number of enlarged vessels, and 18.3% of patients with the papulous subtype had signs of a recurrence of the disease. Conclusion. The use of broadband pulse light emission with smooth pulse and photon recirculation technologies has a multiple, painless and significant effect on large lesions in the treatment of patients suffering from erythematous and papulous subtypes of rosacea.

  20. Designing a patient monitoring system for bipolar disorder using Semantic Web technologies.

    Science.gov (United States)

    Thermolia, Chryssa; Bei, Ekaterini S; Petrakis, Euripides G M; Kritsotakis, Vangelis; Tsiknakis, Manolis; Sakkalis, Vangelis

    2015-01-01

    The new movement to personalize treatment plans and improve prediction capabilities is greatly facilitated by intelligent remote patient monitoring and risk prevention. This paper focuses on patients suffering from bipolar disorder, a mental illness characterized by severe mood swings. We exploit the advantages of Semantic Web and Electronic Health Record Technologies to develop a patient monitoring platform to support clinicians. Relying on intelligently filtering of clinical evidence-based information and individual-specific knowledge, we aim to provide recommendations for treatment and monitoring at appropriate time or concluding into alerts for serious shifts in mood and patients' non response to treatment.

  1. Does applying technology throughout the medication use process improve patient safety with antineoplastics?

    Science.gov (United States)

    Bubalo, Joseph; Warden, Bruce A; Wiegel, Joshua J; Nishida, Tess; Handel, Evelyn; Svoboda, Leanne M; Nguyen, Lam; Edillo, P Neil

    2014-12-01

    Medical errors, in particular medication errors, continue to be a troublesome factor in the delivery of safe and effective patient care. Antineoplastic agents represent a group of medications highly susceptible to medication errors due to their complex regimens and narrow therapeutic indices. As the majority of these medication errors are frequently associated with breakdowns in poorly defined systems, developing technologies and evolving workflows seem to be a logical approach to provide added safeguards against medication errors. This article will review both the pros and cons of today's technologies and their ability to simplify the medication use process, reduce medication errors, improve documentation, improve healthcare costs and increase provider efficiency as relates to the use of antineoplastic therapy throughout the medication use process. Several technologies, mainly computerized provider order entry (CPOE), barcode medication administration (BCMA), smart pumps, electronic medication administration record (eMAR), and telepharmacy, have been well described and proven to reduce medication errors, improve adherence to quality metrics, and/or improve healthcare costs in a broad scope of patients. The utilization of these technologies during antineoplastic therapy is weak at best and lacking for most. Specific to the antineoplastic medication use system, the only technology with data to adequately support a claim of reduced medication errors is CPOE. In addition to the benefits these technologies can provide, it is also important to recognize their potential to induce new types of errors and inefficiencies which can negatively impact patient care. The utilization of technology reduces but does not eliminate the potential for error. The evidence base to support technology in preventing medication errors is limited in general but even more deficient in the realm of antineoplastic therapy. Though CPOE has the best evidence to support its use in the

  2. Information technology to support patient engagement: where do we stand and where can we go?

    Science.gov (United States)

    Walker, Daniel M; Sieck, Cynthia J; Menser, Terri; Huerta, Timothy R; Scheck McAlearney, Ann

    2017-11-01

    Given the strong push to empower patients and make them partners in their health care, we evaluated the current capability of hospitals to offer health information technology that facilitates patient engagement (PE). Using an ontology mapping approach, items from the American Hospital Association Information Technology Supplement were mapped to defined levels and categories within the PE Framework. Points were assigned for each health information technology function based upon the level of engagement it encompassed to create a PE-information technology (PE-IT) score. Scores were divided into tertiles, and hospital characteristics were compared across tertiles. An ordered logit model was used to estimate the effect of characteristics on the adjusted odds of being in the highest tertile of PE-IT scores. Thirty-six functions were mapped to specific levels and categories of the PE Framework, and adoption of each item ranged from 23.5 to 96.7%. Hospital characteristics associated with being in the highest tertile of PE-IT scores included medium and large bed size (relative to small), nonprofit (relative to government nonfederal), teaching hospital, system member, Midwest and South regions, and urban location. Hospital adoption of PE-oriented technology remains varied, suggesting that hospitals are considering how technology can create partnerships with patients. However, PE functionalities that facilitate higher levels of engagement are lacking, suggesting room for improvement. While hospitals have reached modest levels of adoption of PE technologies, consistent monitoring of this capacity can identify opportunities to use technology to facilitate engagement. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. Hospital based patient coordination for ethnic minority patients - a health technology assessment

    DEFF Research Database (Denmark)

    Sodemann, Morten

    A cross diciplinary, cross specialty, cross sectoral hospital based approach to cultural management of ethnic minority patients is effective in creating more approprite patient flows, better quality of care and increases functional level of patients. Surprisingly the aggregated effect saves...... especially on public medicine expenses and social services. Ethnic minority patients can achieve increased empowerment & Equity in type and quality of hospital care through cross dicplinary cross specialty cultural case management & support between hospital departments and primary sectors...

  4. Influence of co-payment levels on patient and surgeon acceptance of advanced technology intraocular lenses.

    Science.gov (United States)

    Carones, Francesco; Knorz, Michael C; Jackson, Daniel; Samiian, Ali

    2014-04-01

    To investigate patients' willingness to pay for advanced technology intraocular lenses and surgeons' willingness to recommend them. In this study, 370 cataract surgeons and 700 patients undergoing cataract surgery from seven countries underwent online interviews in which they were shown unbranded profiles of three advanced technology intraocular lenses (ie, biconvex toric aspheric optic, symmetric biconvex diffractive optic, and biconvex diffractive aspheric toric) and asked to indicate their willingness to accept (for patients) or suggest (for surgeons) each lens. Acceptance was assessed assuming there was either no co-payment or co-payments of €500 to €1,500 +15%. All three lenses were widely accepted by patients, with 68% to 99% indicating acceptance when there was no co-payment. In contrast, surgeons' willingness to suggest them was markedly lower (20% to 43%). Both patients' acceptance of the lenses and surgeons' willingness to suggest them decreased with increasing co-payment levels to 19% to 74% (patients) and 5% to 31% (surgeons) at the highest co-payment levels. There is a marked discrepancy between patients' acceptance of the three lenses and surgeons' willingness to suggest them. Although patients' acceptance is high, it decreases with increasing out-of-pocket expenditure. Manufacturers should communicate the relative benefits and costs of their lenses to both surgeons and patients. Copyright 2014, SLACK Incorporated.

  5. Analysis of Nutrition Care Chronic Renal Failure Patients with Health Technology Assessment

    OpenAIRE

    Yani, Ahmad; Nugraha, Gaga Irwan; DH, Dewi Marhaeni

    2017-01-01

    Declined in nutritional status of hospitalized Chronic Renal Failure (CRF) patients were due to nutrient intake inadequate which required special attention from the Hospital Nutrition Service Team. This study analyzed the nutritional service on hospitalized CRF patients in Dr. Hasan Sadikin Hospital, Bandung using Health Technology Assessment. The study was conducted in 2014. The study design mixed method with concurrent embedded strategies. The hospital management, nutritionist and hospitali...

  6. Pressure map technology for pressure ulcer patients: can we handle the truth?

    Science.gov (United States)

    Pompeo, Matthew Q

    2013-02-01

    Objective. The purpose of this study was to trial new pressure mapping technology for patients with pressure ulcers. Pressure mapping data was recorded during 3 phases of technology implementation, as nurses became increasingly familiar with pressuremapping technology in a 55-bed, long-term acute care (LTAC) facility in North Texas. Forty-three patients with pressure ulcers were selected for the study. Patients with pressure ulcers, or who were considered at high risk for developing pressure ulcers based on a Braden score of ≤ 12, were selected to utilize a pressure-sensing device system. Turning timeliness improved greatly from the baseline phase to the last phase. The average turning after the 2-hour alarm decreased from 120 minutes to 44 minutes, and the median time to turning decreased from 39 minutes to 17 minutes. If time past 2 hours is considered the most damaging time to tissue, these reductions (average and median) represented 63% and 56% less potential tissue damage. Pressure mapping technology is in its infancy and this paper discusses implications for the future, including barriers to implementation and potential advanced applications. While only changes in nursing practice were measured in this study, the changes observed suggest the technology can be instrumental in reducing hospital-acquired pressure ulcers and improving the healing of pressure wounds in the future. .

  7. Harnessing Information Technology to Inform Patients Facing Routine Decisions: Cancer Screening as a Test Case.

    Science.gov (United States)

    Krist, Alex H; Woolf, Steven H; Hochheimer, Camille; Sabo, Roy T; Kashiri, Paulette; Jones, Resa M; Lafata, Jennifer Elston; Etz, Rebecca S; Tu, Shin-Ping

    2017-05-01

    Technology could transform routine decision making by anticipating patients' information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use such a decision module and its impact on care, using 3 cancer screening decisions as test cases. Twelve practices with 55,453 patients using a patient portal participated in this prospective observational cohort study. Participation was open to patients who might face a cancer screening decision: women aged 40 to 49 who had not had a mammogram in 2 years, men aged 55 to 69 who had not had a prostate-specific antigen test in 2 years, and adults aged 50 to 74 overdue for colorectal cancer screening. Data sources included module responses, electronic health record data, and a postencounter survey. In 1 year, one-fifth of the portal users (11,458 patients) faced a potential cancer screening decision. Among these patients, 20.6% started and 7.9% completed the decision module. Fully 47.2% of module completers shared responses with their clinician. After their next office visit, 57.8% of those surveyed thought their clinician had seen their responses, and many reported the module made their appointment more productive (40.7%), helped engage them in the decision (47.7%), broadened their knowledge (48.1%), and improved communication (37.5%). Many patients face decisions that can be anticipated and proactively facilitated through technology. Although use of technology has the potential to make visits more efficient and effective, cultural, workflow, and technical changes are needed before it could be widely disseminated. © 2017 Annals of Family Medicine, Inc.

  8. Evolution of human factors research and studies of health information technologies: the role of patient safety

    NARCIS (Netherlands)

    Beuscart-Zéphir, M. C.; Borycki, E.; Carayon, P.; Jaspers, M. W. M.; Pelayo, S.

    2013-01-01

    The objective of this survey paper is to present and explain the impact of recent regulations and patient safety initiatives (EU, US and Canada) on Human Factors (HF)/Usability studies and research focusing on Health Information Technology (HIT). The authors have selected the most prominent of these

  9. Clinical trials of health information technology interventions intended for patient use: unique issues and considerations.

    Science.gov (United States)

    DeVito Dabbs, Annette; Song, Mi-Kyung; Myers, Brad; Hawkins, Robert P; Aubrecht, Jill; Begey, Alex; Connolly, Mary; Li, Ruosha; Pilewski, Joseph M; Bermudez, Christian A; Dew, Mary Amanda

    2013-01-01

    Despite the proliferation of health information technology (IT) interventions, descriptions of the unique considerations for conducting randomized trials of health IT interventions intended for patient use are lacking. Our purpose is to describe the protocol to evaluate Pocket PATH (Personal Assistant for Tracking Health), a novel health IT intervention, as an exemplar of how to address issues that may be unique to a randomized controlled trial (RCT) to evaluate health IT intended for patient use. An overview of the study protocol is presented. Unique considerations for health IT intervention trials and strategies are described to maintain equipoise, to monitor data safety and intervention fidelity, and to keep pace with changing technology during such trials. The sovereignty granted to technology, the rapid pace of changes in technology, ubiquitous use in health care, and obligation to maintain the safety of research participants challenge researchers to address these issues in ways that maintain the integrity of intervention trials designed to evaluate the impact of health IT interventions intended for patient use. Our experience evaluating the efficacy of Pocket PATH may provide practical guidance to investigators about how to comply with established procedures for conducting RCTs and include strategies to address the unique issues associated with the evaluation of health IT for patient use.

  10. Patient and public involvement in scope development for a palliative care health technology assessment in europe

    NARCIS (Netherlands)

    Brereton, L.; Goyder, E.; Ingleton, C.; Gardiner, C.; Chilcott, J.; Wilt, G.J. van der; Oortwijn, W.; Mozygemba, K.; Lysdahl, K.B.; Sacchini, D.; Lepper, W.

    2014-01-01

    BACKGROUND: Patient and Public Involvement (PPI) helps to ensure that study findings are useful to end users but is under-developed in Health Technology Assessment (HTA). "INTEGRATE-HTA, (a co-funded European Union project -grant agreement 30614) is developing new methods to assess complex health

  11. Technology.

    Science.gov (United States)

    Online-Offline, 1998

    1998-01-01

    Focuses on technology, on advances in such areas as aeronautics, electronics, physics, the space sciences, as well as computers and the attendant progress in medicine, robotics, and artificial intelligence. Describes educational resources for elementary and middle school students, including Web sites, CD-ROMs and software, videotapes, books,…

  12. Enabling Patient Control of Personal Electronic Health Records Through Distributed Ledger Technology.

    Science.gov (United States)

    Cunningham, James; Ainsworth, John

    2017-01-01

    The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.

  13. Simulated human patients and patient-centredness: The uncanny hybridity of nursing education, technology, and learning to care.

    Science.gov (United States)

    Ireland, Aileen V

    2017-01-01

    Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman. © 2016 John Wiley & Sons Ltd.

  14. A Technological Review of the Instrumented Footwear for Rehabilitation with a Focus on Parkinson's Disease Patients.

    Science.gov (United States)

    Maculewicz, Justyna; Kofoed, Lise Busk; Serafin, Stefania

    2016-01-01

    In this review article, we summarize systems for gait rehabilitation based on instrumented footwear and present a context of their usage in Parkinson's disease (PD) patients' auditory and haptic rehabilitation. We focus on the needs of PD patients, but since only a few systems were made with this purpose, we go through several applications used in different scenarios when gait detection and rehabilitation are considered. We present developments of the designs, possible improvements, and software challenges and requirements. We conclude that in order to build successful systems for PD patients' gait rehabilitation, technological solutions from several studies have to be applied and combined with knowledge from auditory and haptic cueing.

  15. Of vigilance and invisibility--being a patient in technologically intense environments.

    Science.gov (United States)

    Almerud, Sofia; Alapack, Richard J; Fridlund, Bengt; Ekebergh, Margaretha

    2007-01-01

    Equipment and procedures developed during the past several decades have made the modern intensive care unit (ICU) the hospital's most technologically advanced environment. In terms of patient care, are these advances unmitigated gains? This study aimed to develop a knowledge base of what it means to be critically ill or injured and cared for in technologically intense environments. A lifeworld perspective guided the investigation. Nine unstructured interviews with intensive care patients comprise its data. The qualitative picture uncovered by a phenomenological analysis shows that contradiction and ambivalence characterized the entire care episode. The threat of death overshadows everything and perforates the patient's existence. Four inter-related constituents further elucidated the patients' experiences: the confrontation with death, the encounter with forced dependency, an incomprehensible environment and the ambiguity of being an object of clinical vigilance but invisible at the personal level. Neglect of these issues lead to alienating 'moments' that compromised care. Fixed at the end of a one-eyed clinical gaze, patients described feeling marginalized, subjected to rituals of power, a stranger cared for by a stranger. The roar of technology silences the shifting needs of ill people, muffles the whispers of death and compromises the competence of the caregivers. This study challenges today's caregiving system to develop double vision that would balance clinical competence with a holistic, integrated and comprehensive approach to care. Under such vision, subjectivity and objectivity would be equally honoured, and the broken bonds re-forged between techne, 'the act of nursing', and poesis, 'the art of nursing'.

  16. Acceptability of robotic technology in neuro-rehabilitation: preliminary results on chronic stroke patients.

    Science.gov (United States)

    Mazzoleni, Stefano; Turchetti, Giuseppe; Palla, Ilaria; Posteraro, Federico; Dario, Paolo

    2014-09-01

    During the last decade, different robotic devices have been developed for motor rehabilitation of stroke survivors. These devices have been shown to improve motor impairment and contribute to the understanding of mechanisms underlying motor recovery after a stroke. The assessment of the robotic technology for rehabilitation assumes great importance. The aim of this study is to present preliminary results on the assessment of the acceptability of the robotic technology for rehabilitation on a group of thirty-four chronic stroke patients. The results from questionnaires on the patients' acceptability of two different robot-assisted rehabilitation scenarios show that the robotic approach was well accepted and tolerated by the patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Validation and Assessment of a Technology Familiarity Score in Patients Attending a Symptomatic Breast Clinic.

    Science.gov (United States)

    O'Brien, C; Kelly, J; Lehane, E A; Livingstone, V; Cotter, B; Butt, A; Kelly, L; Corrigan, M A

    2015-10-01

    New media technologies (computers, mobile phones and the internet) have the potential to transform the healthcare information needs of patients with breast disease (Ferlay et al. in Eur J Cancer 49:1374-1403, 2013). However, patients' current level of use and their willingness to accept new media for education and communication remain unknown. This was a single-centre clinic-based prospective cross-sectional study. A previously developed instrument was modified, validated and tested on patients attending a symptomatic breast clinic. The instrument was evaluated on 200 symptomatic breast patients. The commonest outlets for education were staff (95 %), leaflets (69 %) and websites (59 %). Websites are more likely to be consulted by younger patients (new to the clinic were more likely to find text messaging and emailing useful (n messages, apps, websites and email useful (p messaging, apps, websites and email as useful media (p new media technology use among breast patients is expanding as expected along generational trends. As such its' further integration into healthcare systems can potentially ameliorate patient education and communication.

  18. Community pharmacy patient perceptions of a pharmacy-initiated mobile technology app to improve adherence.

    Science.gov (United States)

    DiDonato, Kristen L; Liu, Yifei; Lindsey, Cameron C; Hartwig, David Matthew; Stoner, Steven C

    2015-10-01

    To determine patient perceptions of using a demonstration application (app) of mobile technology to improve medication adherence and to identify desired features to assist in the management of medications. A qualitative study using key informant interviews was conducted in a community pharmacy chain for patients aged 50 and older, on statin therapy and owning a smart device. Three main themes emerged from 24 interviews at four pharmacy locations, which included benefits, barriers and desired features of the app. Benefits such as accessibility, privacy, pros of appearance and beneficiaries were more likely to lead to usage of the app. Barriers that might prevent usage of the app were related to concerns of appearance, the burden it might cause for others, cost, privacy, motivation and reliability. Specific features patients desired were categorized under appearance, customization, communication, functionality, input and the app platform. Patients provided opinions about using a mobile app to improve medication adherence and assist with managing medications. Patients envisioned the app within their lifestyle and expressed important considerations, identifying benefits to using this technology and voicing relevant concerns. App developers can use patient perceptions to guide development of a mobile app addressing patient medication-related needs. © 2015 Royal Pharmaceutical Society.

  19. Patient-Driven Innovation for Mobile Mental Health Technology: Case Report of Symptom Tracking in Schizophrenia.

    Science.gov (United States)

    Torous, John; Roux, Spencer

    2017-07-06

    This patient perspective piece presents an important case at the intersection of mobile health technology, mental health, and innovation. The potential of digital technologies to advance mental health is well known, although the challenges are being increasingly recognized. Making mobile health work for mental health will require broad collaborations. We already know that those who experience mental illness are excited by the potential technology, with many actively engaged in research, fundraising, advocacy, and entrepreneurial ventures. But we don't always hear their voice as often as others. There is a clear advantage for their voice to be heard: so we can all learn from their experiences at the direct intersection of mental health and technology innovation. The case is cowritten with an individual with schizophrenia, who openly shares his name and personal experience with mental health technology in order to educate and inspire others. This paper is the first in JMIR Mental Health's patient perspective series, and we welcome future contributions from those with lived experience. ©John Torous, Spencer Roux. Originally published in JMIR Mental Health (http://mental.jmir.org), 06.07.2017.

  20. A technology selection framework for supporting delivery of patient-oriented health interventions in developing countries.

    Science.gov (United States)

    Chan, Connie V; Kaufman, David R

    2010-04-01

    Health information technologies (HIT) have great potential to advance health care globally. In particular, HIT can provide innovative approaches and methodologies to overcome the range of access and resource barriers specific to developing countries. However, there is a paucity of models and empirical evidence informing the technology selection process in these settings. We propose a framework for selecting patient-oriented technologies in developing countries. The selection guidance process is structured by a set of filters that impose particular constraints and serve to narrow the space of possible decisions. The framework consists of three levels of factors: (1) situational factors, (2) the technology and its relationship with health interventions and with target patients, and (3) empirical evidence. We demonstrate the utility of the framework in the context of mobile phones for behavioral health interventions to reduce risk factors for cardiovascular disease. This framework can be applied to health interventions across health domains to explore how and whether available technologies can support delivery of the associated types of interventions and with the target populations. Published by Elsevier Inc.

  1. Using technology to engage hospitalised patients in their care: a realist review.

    Science.gov (United States)

    Roberts, Shelley; Chaboyer, Wendy; Gonzalez, Ruben; Marshall, Andrea

    2017-06-06

    Patient participation in health care is associated with improved outcomes for patients and hospitals. New technologies are creating vast potential for patients to participate in care at the bedside. Several studies have explored patient use, satisfaction and perceptions of health information technology (HIT) interventions in hospital. Understanding what works for whom, under what conditions, is important when considering interventions successfully engaging patients in care. This realist review aimed to determine key features of interventions using bedside technology to engage hospital patients in their care and analyse these in terms of context, mechanisms and outcomes. A realist review was chosen to explain how and why complex HIT interventions work or fail within certain contexts. The review was guided by Pawson's realist review methodology, involving: clarifying review scope; searching for evidence; data extraction and evidence appraisal; synthesising evidence and drawing conclusions. Author experience and an initial literature scope provided insight and review questions and theories (propositions) around why interventions worked were developed and iteratively refined. A purposive search was conducted to find evidence to support, refute or identify further propositions, which formed an explanatory model. Each study was 'mined' for evidence to further develop the propositions and model. Interactive learning was the overarching theme of studies using technology to engage patients in their care. Several propositions underpinned this, which were labelled: information sharing; self-assessment and feedback; tailored education; user-centred design; and support in use of HIT. As studies were mostly feasibility or usability studies, they reported patient-centred outcomes including patient acceptability, satisfaction and actual use of HIT interventions. For each proposition, outcomes were proposed to come about by mechanisms including improved communication, shared

  2. Nurse adoption of continuous patient monitoring on acute post-surgical units: managing technology implementation.

    Science.gov (United States)

    Jeskey, Mary; Card, Elizabeth; Nelson, Donna; Mercaldo, Nathaniel D; Sanders, Neal; Higgins, Michael S; Shi, Yaping; Michaels, Damon; Miller, Anne

    2011-10-01

    To report an exploratory action-research process used during the implementation of continuous patient monitoring in acute post-surgical nursing units. Substantial US Federal funding has been committed to implementing new health care technology, but failure to manage implementation processes may limit successful adoption and the realisation of proposed benefits. Effective approaches for managing barriers to new technology implementation are needed. Continuous patient monitoring was implemented in three of 13 medical/surgical units. An exploratory action-feedback approach, using time-series nurse surveys, was used to identify barriers and develop and evaluate responses. Post-hoc interviews and document analysis were used to describe the change implementation process. Significant differences were identified in night- and dayshift nurses' perceptions of technology benefits. Research nurses' facilitated the change process by evolving 'clinical nurse implementation specialist' expertise. Health information technology (HIT)-related patient outcomes are mediated through nurses' acting on new information but HIT designed for critical care may not transfer to acute care settings. Exploratory action-feedback approaches can assist nurse managers in assessing and mitigating the real-world effects of HIT implementations. It is strongly recommended that nurse managers identify stakeholders and develop comprehensive plans for monitoring the effects of HIT in their units. © 2011 Blackwell Publishing Ltd.

  3. Developing next-generation telehealth tools and technologies: patients, systems, and data perspectives.

    Science.gov (United States)

    Ackerman, Michael J; Filart, Rosemarie; Burgess, Lawrence P; Lee, Insup; Poropatich, Ronald K

    2010-01-01

    The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth?

  4. Using digital technologies to engage with medical research: views of myotonic dystrophy patients in Japan.

    Science.gov (United States)

    Coathup, Victoria; Teare, Harriet J A; Minari, Jusaku; Yoshizawa, Go; Kaye, Jane; Takahashi, Masanori P; Kato, Kazuto

    2016-08-24

    As in other countries, the traditional doctor-patient relationship in the Japanese healthcare system has often been characterised as being of a paternalistic nature. However, in recent years there has been a gradual shift towards a more participatory-patient model in Japan. With advances in technology, the possibility to use digital technologies to improve patient interactions is growing and is in line with changing attitudes in the medical profession and society within Japan and elsewhere. The implementation of an online patient engagement platform is being considered by the Myotonic Dystrophy Registry of Japan. The aim of this exploratory study was to understand patients' views and attitudes to using digital tools in patient registries and engagement with medical research in Japan, prior to implementation of the digital platform. We conducted an exploratory, cross-sectional, self-completed questionnaire with a sample of myotonic dystrophy (MD) patients attending an Open Day at Osaka University, Japan. Patients were eligible for inclusion if they were 18 years or older, and were diagnosed with MD. A total of 68 patients and family members attended the Open Day and were invited to participate in the survey. Of those, 59 % submitted a completed questionnaire (n = 40). The survey showed that the majority of patients felt that they were not receiving the information they wanted from their clinicians, which included recent medical research findings and opportunities to participate in clinical trials, and 88 % of patients indicated they would be willing to engage with digital technologies to receive relevant medical information. Patients also expressed an interest in having control over when and how they received this information, as well as being informed of how their data is used and shared with other researchers. Overall, the findings from this study suggest that there is scope to develop a digital platform to engage with patients so that they can receive

  5. A technology-based quality innovation to identify undiagnosed hypertension among active primary care patients.

    Science.gov (United States)

    Rakotz, Michael K; Ewigman, Bernard G; Sarav, Menaka; Ross, Ruth E; Robicsek, Ari; Konchak, Chad W; Gavagan, Thomas F; Baker, David W; Hyman, David J; Anderson, Kenneth P; Masi, Christopher M

    2014-07-01

    The goal of this study was to develop a technology-based strategy to identify patients with undiagnosed hypertension in 23 primary care practices and integrate this innovation into a continuous quality improvement initiative in a large, integrated health system. In phase 1, we reviewed electronic health records (EHRs) using algorithms designed to identify patients at risk for undiagnosed hypertension. We then invited each at-risk patient to complete an automated office blood pressure (AOBP) protocol. In phase 2, we instituted a quality improvement process that included regular physician feedback and office-based computer alerts to evaluate at-risk patients not screened in phase 1. Study patients were observed for 24 additional months to determine rates of diagnostic resolution. Of the 1,432 patients targeted for inclusion in the study, 475 completed the AOBP protocol during the 6 months of phase 1. Of the 1,033 at-risk patients who remained active during phase 2, 740 (72%) were classified by the end of the follow-up period: 361 had hypertension diagnosed, 290 had either white-coat hypertension, prehypertension, or elevated blood pressure diagnosed, and 89 had normal blood pressure. By the end of the follow-up period, 293 patients (28%) had not been classified and remained at risk for undiagnosed hypertension. Our technology-based innovation identified a large number of patients at risk for undiagnosed hypertension and successfully classified the majority, including many with hypertension. This innovation has been implemented as an ongoing quality improvement initiative in our medical group and continues to improve the accuracy of diagnosis of hypertension among primary care patients. © 2014 Annals of Family Medicine, Inc.

  6. Technology

    Directory of Open Access Journals (Sweden)

    Xu Jing

    2016-01-01

    Full Text Available The traditional answer card reading method using OMR (Optical Mark Reader, most commonly, OMR special card special use, less versatile, high cost, aiming at the existing problems proposed a method based on pattern recognition of the answer card identification method. Using the method based on Line Segment Detector to detect the tilt of the image, the existence of tilt image rotation correction, and eventually achieve positioning and detection of answers to the answer sheet .Pattern recognition technology for automatic reading, high accuracy, detect faster

  7. Pregnancy outcome of assisted reproductive technology cycle in patients with hypogonadotropic hypogonadism.

    Science.gov (United States)

    Pandurangi, Monna; Tamizharasi, M; Reddy, N Sanjeeva

    2015-01-01

    Ovulation induction in patients with hypogonadotropic hypogonadism (HH) is a challenge to the treating physician. The threshold for ovarian response in HH may differ substantially from that of normal patients. To reach that threshold levels of follicle stimulating hormone, in a step-up protocol longer duration of stimulation is required in some cases so as to prevent multiple pregnancy and to eliminate the risk of ovarian hyperstimulation syndrome. To evaluate the duration of stimulation, quality of oocytes, and embryo, and the pregnancy outcome in the assisted reproductive technology (ART) cycles in patients with HH. Over the period of 4 years, we had 14 patients with HH in whom 21 cycles of ovulation induction were done. Of these 7 patients underwent oocyte retrieval and intracytoplasmic sperm injection (ICSI). We present a retrospective study of these 7 patients who underwent ART to evaluate the duration of stimulation, quality of oocytes and embryo, and the pregnancy outcome. In the study group on ovulation induction with gonadotropins, only one patient had the duration of stimulation of the standard 12 days, the remaining 6 patients took ≥12 days to respond to stimulation (maxium being 54 days). Mean ET in these patients was 8.9 mm. Six patients had >70% good quality MII oocytes. One patient responded poorly and had only 2 good quality MII oocytes (50%). After ICSI procedure, resultant embryos were of grade 1 and 2 in all the patients irrespective of the duration of stimulation. Fertilization rate in these patients was 85% (except in one 50% fertilization rate), and the cumulative pregnancy rate was 68.6%. In the patients with HH the quality of oocytes and embryos, and the pregnancy rate is not affected even if the duration of stimulation is prolonged.

  8. Internet-based technologies to improve cancer care coordination: current use and attitudes among cancer patients.

    Science.gov (United States)

    Girault, Anne; Ferrua, Marie; Lalloué, Benoît; Sicotte, Claude; Fourcade, Aude; Yatim, Fatima; Hébert, Guillaume; Di Palma, Mario; Minvielle, Etienne

    2015-03-01

    The uses of internet-based technologies (e.g. patient portals, websites and applications) by cancer patients could be strong drive for change in cancer care coordination practices. The goal of this study was to assess the current utilisation of internet-based technologies (IBT) among cancer patients, and their willingness to use them for their health, as well as analyse the influence of socio-demographics on both aspects. A questionnaire-based survey was conducted in June 2013, over seven non-consecutive days within seven outpatient departments of Gustave Roussy, a comprehensive cancer centre (≈160,000 consultations yearly), located just outside Paris. We computed descriptive statistics and performed correlation analysis to investigate patients' usage and attitudes in correspondence with age, gender, socioeconomic status, social isolation, and place of living. We then conducted multinomial logistic regressions using R. The participation level was 85% (n=1371). The median age was 53.4. 71% used a mobile phone everyday and 93% had access to Internet from home. Age and socioeconomic status were negatively associated with the use of IBT (puse in health care, and especially, the possibility to enhance communication with providers. 84% of patients reported feeling comfortable with the use of such technologies but age and socioeconomic status had a significant influence. Most patients used IBTs every day. Overall, patients advocated for an extended use of IBT in oncology. Differences in perceived ease of use corresponding to age and socioeconomic status have to be addressed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Evaluating Patient Empowerment in Association With eHealth Technology: Scoping Review.

    Science.gov (United States)

    Risling, Tracie; Martinez, Juan; Young, Jeremy; Thorp-Froslie, Nancy

    2017-09-29

    The prioritization of sustainable patient-centered care in contemporary health care has resulted in an increased focus on patient empowerment, which in turn is considered to facilitate patient independence, self-management, and self-efficacy. However, a definitional consensus of empowerment remains elusive, impeding efforts to translate the conceptual ideals of empowerment into a measurable entity associated with changes in health care behavior or outcomes. The rapid integration of technology in health care serves to add another layer of complexity in the measurability and operationalization of empowerment and helps to create a specific context in which this conceptual entity should be further examined. The primary objective of this scoping review was to explore the concept of patient empowerment within the electronic health (eHealth) context. A further focus on the association or measurement of this concept in conjunction with tethered patient portal use was also employed. In this scoping review, a six-step framework was used to guide the search and paper selection process. The review was initiated with two broad research questions, which are as follows: (1) What is the relationship between empowerment and the use of eHealth technologies from a patient perspective? (2) How is patient empowerment (and/or engagement or activation) influenced by accessing personal health information through a tethered patient portal? Multiple databases were employed in a comprehensive search strategy, and papers were primarily evaluated and selected for inclusion by 2 review authors, and a third author was consulted to resolve any issues in reaching consensus. From an initial count of 1387 publications, this review returned nine systematic or literature review papers and 19 empirical studies that pertained to patient empowerment (and/or engagement and activation) in relation to the use of tethered patient portals providing access to electronic health records (EHRs). Of the 19

  10. Healthcare model with use of information and communication technology for patients with chronic disease.

    Science.gov (United States)

    Lisiecka-Biełanowicz, Mira; Wawrzyniak, Zbigniew

    2016-07-15

    The healthcare system is positioned in the patient's environment and works with other determinants of the treatment. Patient care requires a whole system compatible to the needs of organizational and technical solutions. The purpose of this study is to present a new model of patient-oriented care, in which the use of information and communication technology (ICT) can improve the effectiveness of healthcare for patients with chronic diseases. The study material is the process of healthcare for chronically ill patients. Knowledge of the circumstances surrounding ecosystem and of the patients' needs, taking into account the fundamental healthcare goals allows us to build a new models of care, starting with the economic assumptions. The method used is modeling the construction of efficient healthcare system with the patient-centered model using ICT tools. We present a new systemic concept of building patient's environment in which he is the central figure of the healthcare organization - so called patient centered system. The use of ICT in the model of chronic patient's healthcare can improve the effectiveness of this kind of care. The concept is a vision to making wide platform of information management in chronic disease in a real environment ecosystem of patient using ICT tools. On the basis of a systematic approach to the model of chronic disease, and the knowledge of the patient itself, a model of the ecosystem impacts and interactions through information feedback and the provision of services can be constructed. ICT assisted techniques will increase the effectiveness of patient care, in which nowadays information exchange plays a key role.

  11. Utilization of communication technology by patients enrolled in substance abuse treatment.

    Science.gov (United States)

    McClure, Erin A; Acquavita, Shauna P; Harding, Emily; Stitzer, Maxine L

    2013-04-01

    Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39-45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Analysis of the concept of nursing educational technology applied to the patient

    Directory of Open Access Journals (Sweden)

    Aline Cruz Esmeraldo Áfio

    2014-04-01

    Full Text Available It is aimed at analyzing the concept of educational technology, produced by nursing, applied to the patient. Rodgers´ Evolutionary Method of Concept Analysis was used, identifying background, attributes and consequential damages. 13 articles were selected for analysis in which the background was identified: knowledge deficiency, shortage of nursing professionals' time, to optimize nursing work, the need to achieve the goals of the patients. Attributes: tool, strategy, innovative approach, pedagogical approach, mediator of knowledge, creative way to encourage the acquisition of skills, health production instrument. Consequences: to improve the quality of life, encouraging healthy behavior, empowerment, reflection and link. It emphasizes the importance of educational technologies for the care in nursing, to boost health education activities.

  13. 3D Modelling and Printing Technology to Produce Patient-Specific 3D Models.

    Science.gov (United States)

    Birbara, Nicolette S; Otton, James M; Pather, Nalini

    2017-11-10

    A comprehensive knowledge of mitral valve (MV) anatomy is crucial in the assessment of MV disease. While the use of three-dimensional (3D) modelling and printing in MV assessment has undergone early clinical evaluation, the precision and usefulness of this technology requires further investigation. This study aimed to assess and validate 3D modelling and printing technology to produce patient-specific 3D MV models. A prototype method for MV 3D modelling and printing was developed from computed tomography (CT) scans of a plastinated human heart. Mitral valve models were printed using four 3D printing methods and validated to assess precision. Cardiac CT and 3D echocardiography imaging data of four MV disease patients was used to produce patient-specific 3D printed models, and 40 cardiac health professionals (CHPs) were surveyed on the perceived value and potential uses of 3D models in a clinical setting. The prototype method demonstrated submillimetre precision for all four 3D printing methods used, and statistical analysis showed a significant difference (pprinted models, particularly using multiple print materials, were considered useful by CHPs for preoperative planning, as well as other applications such as teaching and training. This study suggests that, with further advances in 3D modelling and printing technology, patient-specific 3D MV models could serve as a useful clinical tool. The findings also highlight the potential of this technology to be applied in a variety of medical areas within both clinical and educational settings. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  14. Ethical perspectives on recommending digital technology for patients with mental illness.

    Science.gov (United States)

    Bauer, Michael; Glenn, Tasha; Monteith, Scott; Bauer, Rita; Whybrow, Peter C; Geddes, John

    2017-12-01

    The digital revolution in medicine not only offers exciting new directions for the treatment of mental illness, but also presents challenges to patient privacy and security. Changes in medicine are part of the complex digital economy based on creating value from analysis of behavioral data acquired by the tracking of daily digital activities. Without an understanding of the digital economy, recommending the use of technology to patients with mental illness can inadvertently lead to harm. Behavioral data are sold in the secondary data market, combined with other data from many sources, and used in algorithms that automatically classify people. These classifications are used in commerce and government, may be discriminatory, and result in non-medical harm to patients with mental illness. There is also potential for medical harm related to poor quality online information, self-diagnosis and self-treatment, passive monitoring, and the use of unvalidated smartphone apps. The goal of this paper is to increase awareness and foster discussion of the new ethical issues. To maximize the potential of technology to help patients with mental illness, physicians need education about the digital economy, and patients need help understanding the appropriate use and limitations of online websites and smartphone apps.

  15. Using continuous motion monitoring technology to determine patient's risk for development of pressure ulcers.

    Science.gov (United States)

    Zimlichman, Eyal; Shinar, Zvika; Rozenblum, Ronen; Levkovich, Shiraz; Skiano, Sarit; Szyper-Kravitz, Martine; Altman, Arie; Amital, Howard; Shoenfeld, Yehuda

    2011-12-01

    To perform initial validation of a continuous motion monitoring technology that can potentially be used as a risk assessment tool to determine risk for developing pressure ulcers (PUs). We have used the EverOn system (Earlysense LTD, Ramat Gan, Israel) as a bed movement and activity monitor. The EverOn is a contactless continuous measurement system based on a piezoelectric sensor that is placed under the patient's mattress. The study was a noninterventional study performed in 2 medical departments in 2 medical centers. Recorded movement data from enrolled patients were retrospectively analyzed, and patients were assigned a motion level score. Motion scores for the first night of hospitalization were correlated with the Norton scale as calculated per patient on admission. Overall, 116 patients were included in the study from the 2 sites. Motion score was significantly different between the PU risk groups as determined by the Norton scale (10.7 ± 6.2 for low, 5.4 ± 4.9 for intermediate, and 1.6 ± 3.2 for high risk; P risk for developing PU (≤14), the sensitivity of the motion score was 85%, and the specificity was 93%. With regard to individual risk components, we found that activity, mobility, physical condition, and incontinence correlated highly with motion level. The high correlation between the EverOn motion score and the calculated Norton scale indicates the potential of this technology to serve as a risk assessment tool for the development of PUs.

  16. [Application of gene capture technology on mutation screening of RB1 gene in retinoblastoma patients].

    Science.gov (United States)

    Meng, Q Y; Huang, L Z; Wang, B; Li, X X; Liang, J H

    2017-06-11

    Objectives: To analyze RB1 gene mutation in retinoblastoma (RB) patients using gene capture technology. Methods: Experimental research. The clinical data of 17 RB patients were collected at Department of Ophthalmology, Peking University People's Hospital from June 2010 to Jun 2014. Peripheral blood samples of seventeen RB patients and their parents were collected and genomic DNA were extracted. DNA library from RB patients was mixed with designed gene capture probe of RB1 exons and its flanking sequences. The data were analyzed using bioinformatics software. To avoid the false positive, the abnormal sites were verified using the Sanger sequencing method. Results: Totally, there were 17 RB patients, including 12 males and 5 females, from 0.5 to 23 years old, average ages were (3.2±5.2) years old. Both eyes were involved in 6 patients. The other 11 cases were only one eye was attacked. Four RB patients were found to have germline mutations, among whom 2 had bilateral tumors and 2 had unilateral tumors. 2 novel missense mutations were identified, including 15(th) exon c.1408A>T (p. Ile470Phe) and c.1960G>C (p. Val654Leu) at 19(th) exon. No RB1 mutation was identified in any of their parents. We also identified 2 mutations reported previously. One is c.1030C>T termination mutation at 10(th) exon in a bilateral RB patients and his father, who was diagnosed with unilateral RB. The other is c.371-372delTA frame shift mutation at 3(rd) exon. No mutation was found in their parents. Conclusions: Two novel germline RB1 mutations were found using gene capture technology, which enriched RB1 mutations library. (Chin J Ophthalmol, 2017, 53: 455-459) .

  17. New technologies in radiation therapy: ensuring patient safety, radiation safety and regulatory issues in radiation oncology.

    Science.gov (United States)

    Amols, Howard I

    2008-11-01

    New technologies such as intensity modulated and image guided radiation therapy, computer controlled linear accelerators, record and verify systems, electronic charts, and digital imaging have revolutionized radiation therapy over the past 10-15 y. Quality assurance (QA) as historically practiced and as recommended in reports such as American Association of Physicists in Medicine Task Groups 40 and 53 needs to be updated to address the increasing complexity and computerization of radiotherapy equipment, and the increased quantity of data defining a treatment plan and treatment delivery. While new technology has reduced the probability of many types of medical events, seeing new types of errors caused by improper use of new technology, communication failures between computers, corrupted or erroneous computer data files, and "software bugs" are now being seen. The increased use of computed tomography, magnetic resonance, and positron emission tomography imaging has become routine for many types of radiotherapy treatment planning, and QA for imaging modalities is beyond the expertise of most radiotherapy physicists. Errors in radiotherapy rarely result solely from hardware failures. More commonly they are a combination of computer and human errors. The increased use of radiosurgery, hypofractionation, more complex intensity modulated treatment plans, image guided radiation therapy, and increasing financial pressures to treat more patients in less time will continue to fuel this reliance on high technology and complex computer software. Clinical practitioners and regulatory agencies are beginning to realize that QA for new technologies is a major challenge and poses dangers different in nature than what are historically familiar.

  18. Implementing health information technology in a patient-centered manner: patient experiences with an online evidence-based lifestyle intervention.

    Science.gov (United States)

    Lyden, Jennifer R; Zickmund, Susan L; Bhargava, Tina D; Bryce, Cindy L; Conroy, Molly B; Fischer, Gary S; Hess, Rachel; Simkin-Silverman, Laurey R; McTigue, Kathleen M

    2013-01-01

    The patient-centered care (PCC) model and the use of health information technology (HIT) are major initiatives for improving U.S. healthcare quality and delivery. A lack of published data on patient perceptions of Internet-based care makes patient-centered implementation of HIT challenging. To help ascertain patients' perceptions of an online intervention, patients completing a 1-year web-based lifestyle intervention were asked to complete a semistructured interview. We used qualitative methodology to determine frequency and types of interview responses. Overall satisfaction with program features was coded on a Likert-type scale. High levels of satisfaction were seen with the online lifestyle coaching (80%), self-monitoring tools (57%), and structured lesson features (54%). Moderated chat sessions and online resources were rarely used. Frequently identified helpful aspects were those that allowed for customized care and shared decision-making consistent with the tenets of PCC. Unhelpful program aspects were reported less often. Findings suggest that despite challenges for communicating effectively in an online forum, the personalized support, high-tech data management capabilities, and easily followed evidence-based curricula afforded by HIT may be a means of providing PCC and improving healthcare delivery and quality. © 2013 National Association for Healthcare Quality.

  19. Patient Perceptions of Wearable Face-Mounted Computing Technology and the Effect on the Doctor-Patient Relationship.

    Science.gov (United States)

    Prochaska, Micah T; Press, Valerie G; Meltzer, David O; Arora, Vineet M

    2016-10-12

    Wearable face-mounted computers such as Google Glass™ , Microsoft HoloLens™, and Oculus' Rift ® , are increasingly being tested in hospital care. These devices challenge social etiquette, raise privacy issues, and may disrupt the intimacy of the doctor patient relationship. We aimed to determine patients' perception of and their privacy concerns with an archetype of wearable face-mounted computer devices, Google Glass. Hospitalized inpatients were asked about their familiarity with Glass, how comfortable they would be and if they would be concerned about privacy if their physician wore Glass, if the use of Glass would affect their trust in their physician, and if they would want their physician to wear Glass if it improved their care. Most (73%) respondents were unfamiliar with Glass, though 64% would be comfortable if their doctor wore Glass. Under half (46%) of respondents were concerned about privacy with the use of Glass. Seventy-six percent (76%) of respondents stated their doctor wearing Glass would not affect their trust in their doctor. Patients concerned about their privacy were less likely to trust their doctor if their doctor wore Glass (17% vs. 0%, ptechnology. While some patients expressed concerns about privacy, patients were much less concerned about wearable technologies affecting the trust they have in their physician.

  20. EVALUATION OF PATIENT AND PUBLIC INVOLVEMENT INITIATIVES IN HEALTH TECHNOLOGY ASSESSMENT: A SURVEY OF INTERNATIONAL AGENCIES.

    Science.gov (United States)

    Weeks, Laura; Polisena, Julie; Scott, Anna Mae; Holtorf, Anke-Peggy; Staniszewska, Sophie; Facey, Karen

    2017-01-01

    Although there is increased awareness of patient and public involvement (PPI) among health technology assessment (HTA) organizations, evaluations of PPI initiatives are relatively scarce. Our objective as members of Health Technology Assessment International's (HTAi's) Patient and Citizen Involvement Group (PCIG) was to advance understanding of the range of evaluation strategies adopted by HTA organizations and their potential usefulness. In March 2016, a survey was sent to fifty-four HTA organizations through the International Network of Agencies for Health Technology Assessment (INAHTA) and contacts of members of HTAi's PCIG. Respondents were asked about their organizational structure; how patients and members of the public are involved; whether and how PPI initiatives have been evaluated, and, if so, which facilitators and challenges to evaluation were found and how results were used and disseminated. Fifteen (n = 15) programs from twelve countries responded (response rate 27.8 percent) that involved patients (14/15) and members of the public (10/15) in HTA activities. Seven programs evaluated their PPI activities, including participant satisfaction (5/7), process (5/7) and impact evaluations (4/7). Evaluation results were used to improve PPI activities, identify education and training needs, and direct strategic priorities. Facilitators and challenges revolved around the need for stakeholder buy-in, sufficient resources, senior leadership, and including patients in evaluations. A small but diverse set of HTA organizations evaluate their PPI activities using a range of strategies that reflect the range of rationales and approaches to PPI in HTA. It will be important for HTA organizations to draw on evaluation theories and methods.

  1. Patients welcome the Sickle Cell Disease Mobile Application to Record Symptoms via Technology (SMART).

    Science.gov (United States)

    Shah, Nirmish; Jonassaint, Jude; De Castro, Laura

    2014-01-01

    The widespread use of mobile phones among patients provides a unique opportunity for the development of mobile health intervention designed specifically for sickle cell disease, which will improve self-management as well as health care delivery. Our objective was to determine the receptiveness of patients with sickle cell disease to technology and a mobile application (app) designed for sickle cell disease. Phase I included 100 patients who completed a survey inquiring about receptiveness to technology and use of mobile devices to self-manage and communicate with providers. Phase II surveyed 17 additional patients who tested a newly developed sickle cell disease app, to report its usability and utility. In Phase I, on a 0-10 Likert scale where 0 is not comfortable, and 10 is extremely comfortable, 87.0% of participants reported >5 comfort level using a mobile device for health care management. Participants were comfortable with texting (81.0%) and emailing (77.0%) but not with social media (40.0%). Most participants (84.0%) owned computer devices (desktops, laptops, tablets, or iPads), and 92.0% owned mobile devices. In Phase II, participants reported that the app tested was useful to track pain (88.0%), and 94.0% reported that it was easy to use, practical, and useful for health self-management. All reported that the app was useful to help one communicate with providers. Following the use of our app, patients found it an extremely valuable tool for tracking pain, health management, and communicating with providers. We conclude that mobile technology might provide an appropriate venue for sickle cell disease healthcare management.

  2. Doing it my way: old women, technology and wellbeing.

    Science.gov (United States)

    Loe, Meika

    2010-02-01

    This article focuses on women in their nineties (nonagenarians) who are ageing in place - or ageing at home - in upstate New York. I analyse these old women's use of everyday technological tools to care for themselves and construct meaning. I argue that despite what we may expect, nonagenarian women can be and are technogenarians in their active and creative uses of everyday technologies. Old women utilise lifelong care work repertoires to identify, adjust, use and reject old and new technologies for their own everyday mobility, communication, nourishment, and physiological health. Perhaps most importantly techno-savvy elders can maintain and achieve health and wellbeing, associated here with bodily comfort, social networks, self-efficacy and intellectual life, in and beyond their homes. In these ways, nonagenarians can teach us how household technologies can be health and ageing technologies; instruments of continuity and control; or just the opposite.

  3. Effect of Etanercept on the Success of Assisted Reproductive Technology in Patients with Endometrioma.

    Science.gov (United States)

    Önalan, Göğşen; Tohma, Yusuf Aytaç; Zeyneloğlu, Hulusi Bülent

    2017-11-24

    To determine the effects of a tumor necrosis factor inhibitor (etanercept) on pregnancy outcomes in patients with endometrioma who were treated with assisted reproductive technology. Sixty-eight infertile patients who had endometrioma were included in our retrospective case-control study. We administered etanercept (Enbrel, 50 mg in 1 mL intramuscularly) to 19 patients on the second day of their previous menstrual cycle. All patients were treated with assisted reproductive technology. Pregnancy and live birth rates (LBR) were documented. When all other parameters (age, body mass index, infertility) are supposed to be constant, the clinical pregnancy rate was significantly higher in patients who used etanercept in an antagonist protocol than in patients who did not use etanercept (χ2 = 5.547; p = 0.019) but LBR did not reach a statistical significance (χ2 = 3.179; p = 0.075). The use of etanercept had an OR of 4.17 (95% CI 1.23-14.14) compared with not using etanercept for clinical pregnancy rate. The use of etanercept increased the rate of pregnancy (χ2 = 6.55; p = 0.01). The pregnancy rate with the use of etanercept had an OR of 4.23 (95% CI 1.35-13.25) compared with patients who did not use etanercept. In the same way, the use of etanercept increased LBR twofold, but it is not significant in the border line (χ2 = 3.771; p = 0.052). Etanercept may be a new non-hormonal therapy that may be an adjunct to treatment of infertile women with endometrioma. However, the safety of etanercept on embryos and fetuses has not been fully clarified. © 2017 S. Karger AG, Basel.

  4. Application of RFID technology in patient tracking and medication traceability in emergency care.

    Science.gov (United States)

    Martínez Pérez, María; Cabrero-Canosa, Mariano; Vizoso Hermida, José; Carrajo García, Lino; Llamas Gómez, Daniel; Vázquez González, Guillermo; Martín Herranz, Isabel

    2012-12-01

    One of the most important factors that directly affects the quality of health care is patient safety. Minimize the occurrence of adverse events is one of the main challenges for health professionals. This requires continuous tracking of the patient by different areas and services, a process known as traceability and proper patient identification and medication prescribed. This article presents an information system for patient tracking and drugs developed for the Emergency Department of Hospital A Coruña. The systems use RFID technology to perform various tasks: (1) locate patients in different areas; (2) measure patient care times and waiting times; (3) identify unitary doses of medication; and (4) ensure the correct matching between the patient and the medication prescribed by the doctor. The hardware infrastructure as well as the optimal configuration of devices interconnected via a wireless network was determined by conducting a detailed coverage study. To support all the functionality needed, specific tools were designed and integrated with proprietary software applications. The RFID system was evaluated positively by staff from different professional profiles involved in its development or subsequent implementation.

  5. Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance.

    Science.gov (United States)

    Lazard, Allison J; Watkins, Ivan; Mackert, Michael S; Xie, Bo; Stephens, Keri K; Shalev, Heidi

    2016-04-01

    This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal's PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model - simplicity evaluations had a significant positive effect on PEU. This study provides evidence that aesthetic evaluations - specifically regarding simplicity - function as a significant antecedent variable to patients' use of patient portals and should influence patient portal design strategies. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. The effect of health information technology implementation in Veterans Health Administration hospitals on patient outcomes.

    Science.gov (United States)

    Spetz, Joanne; Burgess, James F; Phibbs, Ciaran S

    2014-03-01

    The impact of health information technology (HIT) in hospitals is dependent in large part on how it is used by nurses. This study examines the impact of HIT on the quality of care in hospitals in the Veterans Health Administration (VA), focusing on nurse-sensitive outcomes from 1995 to 2005. Data were obtained from VA databases and original data collection. Fixed-effects Poisson regression was used, with the dependent variables measured using the Agency for Healthcare Research and Quality Inpatient Quality Indicators and Patient Safety Indicators software. Dummy variables indicated when each facility began and completed implementation of each type of HIT. Other explanatory variables included hospital volume, patient characteristics, nurse characteristics, and a quadratic time trend. The start of computerized patient record implementation was associated with significantly lower mortality for two diagnoses but significantly higher pressure ulcer rates, and full implementation was associated with significantly more hospital-acquired infections. The start of bar-code medication administration implementation was linked to significantly lower mortality for one diagnosis, but full implementation was not linked to any change in patient outcomes. The commencement of HIT implementation had mixed effects on patient outcomes, and the completion of implementation had little or no effect on outcomes. This longitudinal study provides little support for the perception of VA staff and leaders that HIT has improved mortality rates or nurse-sensitive patient outcomes. Future research should examine patient outcomes associated with specific care processes affected by HIT. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. PUBLIC AND PATIENT INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT: A FRAMEWORK FOR ACTION.

    Science.gov (United States)

    Abelson, Julia; Wagner, Frank; DeJean, Deirdre; Boesveld, Sarah; Gauvin, Franςois-Pierre; Bean, Sally; Axler, Renata; Petersen, Stephen; Baidoobonso, Shamara; Pron, Gaylene; Giacomini, Mita; Lavis, John

    2016-01-01

    As health technology assessment (HTA) organizations in Canada and around the world seek to involve the public and patients in their activities, frameworks to guide decisions about whom to involve, through which mechanisms, and at what stages of the HTA process have been lacking. The aim of this study was to describe the development and outputs of a comprehensive framework for involving the public and patients in a government agency's HTA process. The framework was informed by a synthesis of international practice and published literature, a dialogue with local, national and international stakeholders, and the deliberations of a government agency's public engagement subcommittee in Ontario, Canada. The practice and literature synthesis failed to identify a single, optimal approach to involving the public and patients in HTA. Choice of methods should be considered in the context of each HTA stage, goals for incorporating societal and/or patient perspectives into the process, and relevant societal and/or patient values at stake. The resulting framework is structured around four actionable elements: (i) guiding principles and goals for public and patient involvement (PPI) in HTA, (ii) the establishment of a common language to support PPI efforts, (iii) a flexible array of PPI approaches, and (iv) on-going evaluation of PPI to inform adjustments over time. A public and patient involvement framework has been developed for implementation in a government agency's HTA process. Core elements of this framework may apply to other organizations responsible for HTA and health system quality improvement.

  8. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts.

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-12-01

    The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed.

  9. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-01-01

    Background The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. Objective To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. Materials and methods We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. Results We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. Conclusions This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed. PMID:23934950

  10. Information technology and hospital patient safety: a cross-sectional study of US acute care hospitals.

    Science.gov (United States)

    Appari, Ajit; Johnson, Eric M; Anthony, Denise L

    2014-11-01

    To determine whether health information technology (IT) systems are associated with better patient safety in acute care settings. In a cross-sectional retrospective study, data on hospital patient safety performance for October 2008 to June 2010 were combined with 2007 information technology systems data. The sample included 3002 US non-federal acute care hospitals. Electronic health record (EHR) system was coded as a composite dichotomous variable based on the presence of 10 major clinical and administrative applications that (if in use) could potentially meet stage 1 "meaningful use" objectives. The surgical IT system was measured as a dichotomous variable if a hospital used at least 1 of the perioperative, preoperative, or postoperative information systems. Hospital patient safety performance was measured by risk-standardized estimated rates per 1000 admissions. Statistical analyses were conducted using an estimated dependent variable methodology with gamma-log link-based weighted generalized linear models, adjusting for hospital characteristics, historical composite process quality, and propensity for EHR adoption. We found that the use of surgical IT systems was associated with 7% to 26% lower rates for 7 of 8 patient safety indicators (incidence rate ratio [IRR] range from 0.74 to 0.93; all P values hospitals. However, the cross-sectional design limits our ability to make causal conclusions.

  11. Examination of wireless technology to improve nurse communication, response time to bed alarms, and patient safety.

    Science.gov (United States)

    Guarascio-Howard, Linda

    2011-01-01

    A medical-surgical unit in a southwestern United States hospital examined the results of adding wireless communication technology to assist nurses in identifying patient bed status changes and enhancing team communication. Following the addition of wireless communication, response time to patient calls and the number of nurse-initiated communications were compared to pre-wireless calls and response time sampling period. In the baseline study, nurse-initiated communications and response time to patient calls were investigated for a team nursing model (Guarascio-Howard & Malloch, 2007). At this time, technology consisted of a nurse call system and telephones located at each decentralized nurse station and health unit coordinator (HUC) station. For this follow-up study, a wireless device was given to nurses and their team members following training on device use and privacy issues. Four registered nurses (RNs) were shadowed for 8 hours (32 hours total) before and after the introduction of the wireless devices. Data were collected regarding patient room visits, number of patient calls, bed status calls, response time to calls, and the initiator of the communication episodes. Follow-up study response time to calls significantly decreased (t-test p = .03). RNs and licensed practical nurses responded to bed status calls in less than 1 minute-62% of the 37 calls. Communication results indicated a significant shift (One Proportion Z Test) in RN-initiated communications, suggesting an enhanced ability to communicate with team members and to assist in monitoring patient status. Patient falls trended downward, although not significantly (p > .05), for a 6-month period of wireless technology use compared to the same period the previous year. The addition of a wireless device has advantages in team nursing, namely increasing communication with staff members and decreasing response time to patient and bed status calls. Limitations of the study included a change in caregiver team

  12. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi.

    Directory of Open Access Journals (Sweden)

    Glyn Elwyn

    Full Text Available To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids.Scale development study, involving construct, item and scale development, validation and reliability testing.There has been increasing use of decision support technologies--adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation.Scale development study, involving construct, item and scale development, validation and reliability testing.Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi. In the fourth Stage (reliability study, eight raters assessed thirty randomly selected decision support technologies.IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100 for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30, enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68. Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items was also developed that had very similar mean scores to IPDASi and high correlation between short score and overall score 0.87 (CI 0.79 to 0.92.This work

  13. Enabling technologies promise to revitalize the role of nursing in an era of patient safety.

    Science.gov (United States)

    Ball, Marion J; Weaver, Charlotte; Abbott, Patricia A

    2003-01-01

    The application of information technology (IT) in health care has the potential to transform the delivery of care, as well as the health care work environment, by streamlining processes, making procedures more accurate and efficient, and reducing the risk of human error. For nurses, a major aspect of this transformation is the refocusing of their work on direct patient care and away from being a conduit of information and communication among departments. Several of the technologies discussed, such as physician order entry and bar code technology, have existed for years as standalone systems. Many others are just being developed and are being integrated into complex clinical information systems (CISs) with clinical decision support at their core. While early evaluation of these systems shows positive outcome measurements, financial, technical, and organizational hurdles to widespread implementation still remain. One major issue is defining the role nurses, themselves, will play in the selection and implementation of these systems as they become more steeped in the knowledge of nursing informatics. Other challenges revolve around issues of job satisfaction and the attraction and retention of nursing staff in the midst of a serious nursing shortage. Despite these concerns, it is expected that, in the long run, the creation of an electronic work environment with systems that integrate all functions of the health care team will positively impact cost-effectiveness, productivity, and patient safety while helping to revitalize nursing practice. Copyright 2002 Elsevier Science Ireland Ltd.

  14. Transforming Patient Care in Adventist Health (West) Through Use of Information Technology

    Energy Technology Data Exchange (ETDEWEB)

    Huff, Wynelle J.; Bancarz, Gloria P.

    2009-07-01

    In 2002, Adventist Health(West) embarked upon a major project to better serve its communities by enhancing the safety, quality and clinical outcomes of the patients served by its 20 hospitals, i.e. the transformation of patient care through the use of information technology. The project is the implementation of the Cerner Millenium clinical information system (CIS) entitled Project IntelliCare. Budgeted allocations will go toward the training of 'super users' in 5-7 California Sites scheduled for installation and go-live of Phases I and II in 2005 and early 2006. Numerous super users in each hospital must be educated to provide support for every shift, every unit/department throughout the hospital. The hospitals experience significant costs associated with training these super users to thoroughly understand the CIS software, to train clinical users, to support the 'go-live' installations, and be there as a 'cheerleader to encourage and support all clinical users, and most importantly help guide users to transform their work processes using this information technology to provide the safest, highest quality care possible. Indeed, super users are critical to the success of Project IntelliCare. The 'super users' contributed significantly to the success of the 'go-live' impementations as well as ongoing support. Care has been transformed through clinicians use of information technology.

  15. Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance

    Science.gov (United States)

    Watkins, Ivan; Mackert, Michael S; Xie, Bo; Stephens, Keri K; Shalev, Heidi

    2016-01-01

    Objective This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. Methods A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. Results The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal’s PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model – simplicity evaluations had a significant positive effect on PEU. Conclusion This study provides evidence that aesthetic evaluations – specifically regarding simplicity – function as a significant antecedent variable to patients’ use of patient portals and should influence patient portal design strategies. PMID:26635314

  16. Patient satisfaction concerning assisted reproductive technology treatments in moderate to severe endometriosis.

    Science.gov (United States)

    van der Houwen, Lisette E E; Schreurs, Anneke M F; Schats, Roel; Lambalk, Cornelis B; Hompes, Peter G A; Mijatovic, Velja

    2014-11-01

    A prospective observational cohort study was performed to examine patient satisfaction after one Assisted Reproductive Technology (ART) treatment cycle in moderate to severe endometriosis patients. From May 2012 till September 2013, 25 patients with surgically proven endometriosis stage III-IV were included per group and received intrauterine insemination (IUI), in vitro fertilization (IVF) or IVF preceded by long-term pituitary down-regulation (IVF-ultralong). The median patient satisfaction scores were 8.3, 7.9 and 8.0 in patients receiving IUI (n = 22), IVF (n = 24) and IVF-ultralong (n = 23), respectively (p = 0.89). Both deterioration in pain and quality-of-life could not be identified as determinants of decreased patient satisfaction scores. Satisfaction was higher in women receiving their first ART treatment attempt (p = 0.002), after treatment accomplishment (p = 0.04) and after a positive pregnancy test (p = 0.04). A median satisfaction score concerning preceding long term pituitary down-regulation of 6.1 (IVF-ultralong n = 25, IUI n = 8) was reported. Only three patients would refrain from this preceding therapy in a next treatment attempt. We concluded that patient satisfaction scores were comparable between the three different ART treatments. Since patient satisfaction was in particular dependent on treatment outcomes, it is recommended to compare those three ART treatments in a randomized controlled trial investigating the efficacy, safety and cost-effectiveness.

  17. Patients' perspectives on high-tech home care: a qualitative inquiry into the user-friendliness of four technologies.

    Science.gov (United States)

    Lehoux, Pascale

    2004-10-05

    The delivery of technology-enhanced home care is growing in most industrialized countries. The objective of our study was to document, from the patient's perspective, how the level of user-friendliness of medical technology influences its integration into the private and social lives of patients. Understanding what makes a technology user-friendly should help improve the design of home care services. Four home care interventions that are frequently used and vary in their technical and clinical features were selected: Antibiotic intravenous therapy, parenteral nutrition, peritoneal dialysis and oxygen therapy. Our qualitative study relied on the triangulation of three sources of data: 1) interviews with patients (n = 16); 2) interviews with carers (n = 6); and 3) direct observation of nursing visits of a different set of patients (n = 16). Participants of varying socioeconomic status were recruited through primary care organizations and hospitals that deliver home care within 100 km of Montreal, the largest urban area in the province of Quebec, Canada. The four interventions have both a negative and positive effect on patients' lives. These technologies were rarely perceived as user-friendly, and user-acceptance was closely linked to user-competence. Compared with acute I.V. patients, who tended to be passive, chronic patients seemed keener to master technical aspects. While some of the technical and human barriers were managed well in the home setting, engaging in the social world was more problematic. Most patients found it difficult to maintain a regular job because of the high frequency of treatment, while some carers found their autonomy and social lives restricted. Patients also tended to withdraw from social activities because of social stigmatization and technical barriers. While technology contributes to improving the patients' health, it also imposes significant constraints on their lives. Policies aimed at developing home care must clearly integrate

  18. Realization of a universal patient identifier for electronic medical records through biometric technology.

    Science.gov (United States)

    Leonard, D C; Pons, Alexander P; Asfour, Shihab S

    2009-07-01

    The technology exists for the migration of healthcare data from its archaic paper-based system to an electronic one, and, once in digital form, to be transported anywhere in the world in a matter of seconds. The advent of universally accessible healthcare data has benefited all participants, but one of the outstanding problems that must be addressed is how the creation of a standardized nationwide electronic healthcare record system in the United States would uniquely identify and match a composite of an individual's recorded healthcare information to an identified individual patients out of approximately 300 million people to a 1:1 match. To date, a few solutions to this problem have been proposed that are limited in their effectiveness. We propose the use of biometric technology within our fingerprint, iris, retina scan, and DNA (FIRD) framework, which is a multiphase system whose primary phase is a multilayer consisting of these four types of biometric identifiers: 1) fingerprint; 2) iris; 3) retina scan; and 4) DNA. In addition, it also consists of additional phases of integration, consolidation, and data discrepancy functions to solve the unique association of a patient to their medical data distinctively. This would allow a patient to have real-time access to all of their recorded healthcare information electronically whenever it is necessary, securely with minimal effort, greater effectiveness, and ease.

  19. Ecuadorian Cancer Patients' Preference for Information and Communication Technologies: Cross-Sectional Study.

    Science.gov (United States)

    Cherrez Ojeda, Ivan; Vanegas, Emanuel; Torres, Michell; Calderón, Juan Carlos; Calero, Erick; Cherrez, Annia; Felix, Miguel; Mata, Valeria; Cherrez, Sofia; Simancas, Daniel

    2018-02-20

    The instantaneous spread of information, low costs, and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, patient communication, and medical interventions in cancer treatment. There is little information available in Latin America about the level of usage of ICTs for and by cancer patients. Our study attempts to fill this gap. The aim of this study was to assess the level of ICT use and patterns of preferences among cancer patients. We conducted an anonymous cross-sectional survey study in 500 Ecuadorian cancer patients. This questionnaire consisted of 22 items about demographic and clinical data, together with the preferences of people who use ICTs. Chi-square, crude, and adjusted logistic regressions were performed. Of the total, 43.2% (216/500) of participants reported that they had access to the Internet, and 25.4% (127/500) reported that they neither owned a cell phone nor did they have access to the Internet. The Internet constituted the highest usage rate as a source of information about malignant diseases (74.3%, 162/218) regardless of age (PWhatsApp (66.5%, 145/218) and short message service (SMS) text messaging (61.0%, 133/218) were widely reported as interesting communication channels. Similarly, WhatsApp (72.0%, 157/218) followed by SMS (63.8%, 139/218) were reported as the preferred ICTs through which patients would like to ask physicians about diseases. Adjusted regression analysis showed that patients aged between 40 and 64 years were more likely to be interested in receiving information through SMS (odds ratio, OR 5.09, 95% CI 1.92-13.32), as well as for asking questions to physicians through this same media (OR 9.78, CI 3.45-27.67) than the oldest group. WhatsApp, SMS, and email are effective and widely used ICTs that can promote communication between cancer patients and physicians. According to age range, new ICTs such as Facebook are still emerging. Future studies should

  20. Effects of health information technology on patient outcomes: a systematic review.

    Science.gov (United States)

    Brenner, Samantha K; Kaushal, Rainu; Grinspan, Zachary; Joyce, Christine; Kim, Inho; Allard, Rhonda J; Delgado, Diana; Abramson, Erika L

    2016-09-01

    To systematically review studies assessing the effects of health information technology (health IT) on patient safety outcomes. The authors employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement methods. MEDLINE, Cumulative Index to Nursing Allied Health (CINAHL), EMBASE, and Cochrane Library databases, from 2001 to June 2012, were searched. Descriptive and comparative studies were included that involved use of health IT in a clinical setting and measured effects on patient safety outcomes. Data on setting, subjects, information technology implemented, and type of patient safety outcomes were all abstracted. The quality of the studies was evaluated by 2 independent reviewers (scored from 0 to 10). A total of 69 studies met inclusion criteria. Quality scores ranged from 1 to 9. There were 25 (36%) studies that found benefit of health IT on direct patient safety outcomes for the primary outcome measured, 43 (62%) studies that either had non-significant or mixed findings, and 1 (1%) study for which health IT had a detrimental effect. Neither the quality of the studies nor the rate of randomized control trials performed changed over time. Most studies that demonstrated a positive benefit of health IT on direct patient safety outcomes were inpatient, single-center, and either cohort or observational trials studying clinical decision support or computerized provider order entry. Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care settings. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Isokinetic dynamometry as a technologic assessment tool for trunk rigidity in Parkinson's disease patients.

    Science.gov (United States)

    Cano-de-la-Cuerda, Roberto; Vela-Desojo, Lydia; Miangolarra-Page, Juan Carlos; Macías-Macías, Yolanda

    2014-01-01

    Rigidity is a cardinal symptom of Parkinson's disease (PD). There are few studies that have assessed rigidity with objective tools in PD patients. This study aimed to develop an objective measurement to quantify trunk rigidity in PD patients with a technology device and to investigate the relationship between this objective assessment and to examine its relationship with disease severity (Hoehn and Yahr staging score and the Unified Parkinson's Disease Rating Scale III) disease duration, functional status (Schwab & England activities of daily living scale) and health related quality of life (European Quality of Life-5 Dimensions and Parkinson's Disease Questionnaire-39 items) in patients with mild to moderate PD. An isokinetic dynamometer Biodex System 3 was employed to assess trunk rigidity in 36 PD patients. Passive trunk flexion and extension at 3 angular velocities, 30°/s, 45°/s and 60°/s were applied and resistive torques were recorded as trunk flexor and extensors rigidity. Significant correlations between trunk flexors-extensors tone and clinical status, disease duration and functional status at 30°/s, 45°/s and 60°/s were obtained. No correlations were found among trunk muscle tone assessed with the isokinetic dynamometer and the EuroQoL-5D. Trunk rigidity was correlated with the HRQoL assessed with the mobility, cognition and stigma PDQ-39 domains and the total PDQ-39 scores. Our results suggest that the 30°/s, 45°/s and 60°/s angular velocities of this objective technology method were a valid assessment for trunk rigidity and were correlated with disease severity, disease duration, functional status and HRQoL in PD patients.

  2. Technology-enhanced practice for patients with chronic cardiac disease: home implementation and evaluation.

    Science.gov (United States)

    Brennan, Patricia Flatley; Casper, Gail R; Burke, Laura J; Johnson, Kathy A; Brown, Roger; Valdez, Rupa S; Sebern, Marge; Perez, Oscar A; Sturgeon, Billie

    2010-01-01

    This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home-care nursing model, referred to as technology-enhanced practice (TEP). Nurses using TEP augmented the usual care with a web-based resource (HeartCareII) that provided patients with self-management information, self-monitoring tools, and messaging services. Patients exposed to TEP demonstrated better quality of life and self-management of chronic heart disease during the first 4 weeks, and were no more likely than patients in usual care to make unplanned visits to a clinician or hospital. Both groups demonstrated the same long-term symptom management and achievements in health status. This project provides new evidence that the purposeful creation of patient-tailored web resources within a hospital portal is possible; that nurses have difficulty with modifying their practice routines, even with a highly-tailored web resource; and that the benefits of this intervention are more discernable in the early postdischarge stages of care. Copyright © 2010 Elsevier Inc. All rights reserved.

  3. Speckle technologies and measurement of retinal visual acuity in cataract patients

    Science.gov (United States)

    Akchurin, Garif G.; Bakutkin, Valery V.; Radchenko, Elena Y.; Tuchin, Valery V.; Akchurin, Alexander G.

    2001-01-01

    Special features of speckle-modulated laser fields arising at in vitro measurements of different types of human cataractous lenses have been investigated experimentally. Computer analysis of digital images has allowed for estimation of destruction of the spatial coherence of a laser beam scattered by a turbid lens. Applied speckle-technologies have permitted the range of retinal angular resolution to be estimated with the help of laser retinometer at the stage of preoperative cataract diagnosis. An extent of laser retinometry at measuring visual acu9ity in patients with any type of cataract, and an incorrectness of its estimation by means of opto types charts have been set up.

  4. AN ASSESSMENT OF PATIENT NEED FOR A TECHNOLOGY-ENABLED REMOTE EXERCISE REHABILITATION PROGRAMME AMONG A CHRONIC ILLNESS POPULATION

    Directory of Open Access Journals (Sweden)

    Deirdre Walsh

    2015-10-01

    Conclusion: This study provides evidence of patient desire for a technology-enabled remote exercise rehabilitation programme. Further to this, the current study provides promising preliminary evidence for both the high level of technology use and capability among a cohort of people with chronic illness.

  5. A network meta-analysis on the effects of information technology application on preoperative knowledge of patients.

    Science.gov (United States)

    Lai, Yi-Horng

    2015-01-01

    The application of information technology in health education plan in Taiwan has existed for a long time. The purpose of this study is to explore the relationship between information technology application in health education and patients' preoperative knowledge by synthesizing existing researches that compare the effectiveness of information technology application and traditional instruction in the health education plan. In spite of claims regarding the potential benefits of using information technology in health education plan, results of previous researches were conflicting. This study is carried out to examine the effectiveness of information technology by using network meta-analysis, which is a statistical analysis of separate but similar studies in order to test the pooled data for statistical significance. Information technology application in health education discussed in this study include interactive technology therapy (person-computer), group interactive technology therapy (person-person), multimedia technology therapy and video therapy. The result has shown that group interactive technology therapy is the most effective, followed by interactive technology therapy. And these four therapies of information technology are all superior to the traditional health education plan (leaflet therapy).

  6. Readiness for meaningful use of health information technology and patient centered medical home recognition survey results.

    Science.gov (United States)

    Shin, Peter; Sharac, Jessica

    2013-01-01

    Determine the factors that impact HIT use and MU readiness for community health centers (CHCs). The HITECH Act allocates funds to Medicaid and Medicare providers to encourage the adoption of electronic health records (EHR), in an effort to improve health care quality and patient outcomes, and to reduce health care costs. We surveyed CHCs on their Readiness for Meaningful Use (MU) of Health Information Technology (HIT) and Patient Centered Medical Home (PCMH) Recognition, then we combined responses with 2009 Uniform Data System data to determine which factors impact use of HIT and MU readiness. Nearly 70% of CHCs had full or partial EHR adoption at the time of survey. Results are presented for centers with EHR adoption, by the length of time that their EHR systems have been in operation.

  7. Multilayer flow modulator stent technology: a treatment revolution for US patients?

    Science.gov (United States)

    Sultan, Sherif; Hynes, Niamh

    2015-05-01

    Thoracoabdominal aortic repair is a high-risk procedure in most experienced centers, not only because of anatomical complexity but also due to the fragility of the patients in whom these aneurysms occur. Such repairs are complex, time-consuming and impose a systemic injury upon the patients, regardless of whether the repair is performed by open surgery or via a fenestrated/branched technique. The substantive risks associated with such repairs include death, dialysis and paralysis. The multilayer flow modulator (MFM) is a disruptive technology which promises a minimally invasive reproducible treatment option, with clinical results demonstrating physiological modulation of the aortic sac with abolition of spinal injury. The mode of action of MFM forces us to completely rethink aneurysm pathogenesis and, consequently, it has been met with much cynicism. We aim to uncloak some of the mystery surrounding the MFM, clarify its mode of action and explore the truth behind its clinical effectiveness.

  8. [The early rehabilitation of the patients with shoulder impingement syndrome using robotic technologies].

    Science.gov (United States)

    Tsvetkova, E M

    2013-01-01

    The objective of the present study was to develop a complex of rehabilitative measures for the treatment of the patients presenting with shoulder impingement syndrome including the combined application of the robotic technology based on the Multi-Joint System (Italy) in conjunction with physical therapy and massage. In addition, we estimated dynamics of the "American assessment shoulder and elbow surgery" test, the shoulder score index, the range of motion in the shoulder joint on the affected side with the help of the Multi-Joint System. It is concluded that the early use of the Multi-Joint System in combination with physical therapy and massage techniques provides the highly efficacious tool for the management of the patients suffering impingement syndrome.

  9. The oxygen reactivity index and its relation to sensor technology in patients with severe brain lesions.

    Science.gov (United States)

    Dengler, Julius; Frenzel, Christin; Vajkoczy, Peter; Horn, Peter; Wolf, Stefan

    2013-08-01

    The oxygen reactivity index (ORx) has been introduced to assess the status of cerebral autoregulation after traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). Currently, there is some controversy about whether the ORx depends on the type of PbrO2-sensor technology used for its calculation. To examine if the probe technology does matter, we compared the ORx and the resulting optimal cerebral perfusion pressures (CPPopt) of simultaneously implanted Licox (CC1.SB, Integra Neuroscience, France) and Neurovent-PTO (Raumedic, Germany) probes in patients after aneurysmal SAH or severe TBI. Licox and Raumedic probes were implanted side by side in 11 patients after TBI or SAH. ORx and CPPopt were recorded continuously. The equivalence of both probes was examined using Bland-Altman analyses. The mean difference in ORx was 0.1, with Licox producing higher values. The limits of agreement regarding ORx ranged from -0.6 to +0.7. When both probes' ORx values were compared in each patient, no specific pattern in their relationship was seen. The mean difference in CPPopt was 0 mmHg with limits of agreement between -16.5 and +16.4 mmHg. Owing to the rather limited number of patients, we view the results of this study as preliminary. The main result is that Licox and Raumedic showed consistent differences in ORx and CPPopt. Therefore, ORx values of both probes cannot be interchanged and should not be viewed as equivalent. This should be taken into consideration when discussing ORx data generated by different PbrO2 probe types.

  10. [Innovative patient access schemes for the adoption of new technology: risk-sharing agreements].

    Science.gov (United States)

    Espín, Jaime; Oliva, Juan; Rodríguez-Barrios, José Manuel

    2010-01-01

    The incorporation of new treatments, procedures and technologies into the services' portfolio of healthcare providers should aim to improve three areas equally: patient access to innovative solutions, the sustainability of the health system and compensation for innovation. However, traditional schemes based on fixed prices that fail to consider the product's appropriate use or its results in terms of effectiveness may lead to inefficient decision-making processes. Recently, risk-sharing agreements have appeared as new access schemes based on results that aim to reduce the uncertainty of the distinct health care players involved in reaching an agreement on new health technology financing and conditions of use. Key elements in the debate on these instruments are the huge variety of instruments available (especially those based on results), the implications for different players involved in their design and supervision, and their possible implementation in Spain. Our main conclusion is that risk-sharing agreements should be used in highly limited cases when standard conditions of access cannot be applied due to uncertainty about long-term effectiveness. These measures are aimed not only at regulating price but also at acting on the appropriate use of new technology. However, because international experience is limited, drawing a solid conclusion on the final results of the application of risk-sharing agreements would be premature. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Hardwiring patient blood management: harnessing information technology to optimize transfusion practice.

    Science.gov (United States)

    Dunbar, Nancy M; Szczepiorkowski, Zbigniew M

    2014-11-01

    This review will describe recent applications of computerized provider order entry (CPOE) with clinical decision support systems (CDSS) in transfusion medicine and other novel ways information technology is being applied to support patient blood management (PBM) efforts. CPOE with CDSS can be used to encourage appropriate transfusion practices as part of an institutional PBM program. The impact of CPOE with CDSS is enhanced when the laboratory information system (LIS) can be linked to the electronic medical record (EMR) to enable adaptive alerts that query transfusion orders against current laboratory and/or clinical data to ensure provider ordering practice is consistent with institutional guidelines. Additional current applications of healthcare information technology to transfusion medicine include creation of electronic reports to support order auditing, assessment of blood product utilization and compliance monitoring. Application of healthcare information technology to transfusion medicine will expand, as more institutions embrace PBM and utilize their EMR and LIS to 'hardwire' appropriate transfusion practice. The impact of implementation of CPOE with CDSS is variable and influenced by multiple factors including existing practice patterns, provider receptiveness and system configuration.

  12. Impact of Hearing Aid Technology on Outcomes in Daily Life I: The Patients' Perspective.

    Science.gov (United States)

    Cox, Robyn M; Johnson, Jani A; Xu, Jingjing

    2016-01-01

    difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. It could reasonably be asserted that the patient's perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the present research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient's point of view. All of the research hearing aids were substantially, but equally, helpful. Further research is needed on this topic with other hearing aids and other manufacturers. In the meantime, providers should insist on scientifically credible independent evidence to support effectiveness claims for any hearing help devices.

  13. The agency of patients and carers in medical care and self-care technologies for interacting with doctors.

    Science.gov (United States)

    Nunes, Francisco; Andersen, Tariq; Fitzpatrick, Geraldine

    2017-06-01

    People living with Parkinson's disease engage in self-care for most of the time but, two or three times a year, they meet with doctors to re-evaluate the condition and adjust treatment. Patients and (informal) carers participate actively in these encounters, but their engagement might change as new patient-centred technologies are integrated into healthcare infrastructures. Drawing on a qualitative study that used observations and interviews to investigate consultations, and digital ethnography to understand interactions in an online community, we describe how patients and carers living with Parkinson's participate in the diagnosis and treatment decisions, engage in discussions to learn about certain topics, and address inappropriate medication. We contrast their engagement with a review of self-care technologies that support interactions with doctors, to investigate how these artefacts may influence the agency of patients and carers. Finally, we discuss design ideas for improving the participation of patients and carers in technology-mediated scenarios.

  14. Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology.

    Science.gov (United States)

    Robbins, Reuben N; Mellins, Claude A; Leu, Cheng-Shiun; Rowe, Jessica; Warne, Patricia; Abrams, Elaine J; Witte, Susan; Stein, Dan J; Remien, Robert H

    2015-06-01

    Multimedia technologies offer powerful tools to increase capacity of health workers to deliver standardized, effective, and engaging antiretroviral medication adherence counseling. Masivukeni-is an innovative multimedia-based, computer-driven, lay counselor-delivered intervention designed to help people living with HIV in resource-limited settings achieve optimal adherence. This pilot study examined medication adherence and key psychosocial outcomes among 55 non-adherent South African HIV+ patients, on antiretroviral therapy (ART) for at least 6 months, who were randomized to receive either Masivukeni or standard of care (SOC) counseling for ART non-adherence. At baseline, there were no significant differences between the SOC and Masivukeni groups on any outcome variables. At post-intervention (approximately 5-6 weeks after baseline), -clinic-based pill count adherence data available for 20 participants (10 per intervention arm) showed a 10 % improvement for-participants and a decrease of 8 % for SOC participants. Masivukeni participants reported significantly more positive attitudes towards disclosure and medication social support, less social rejection, and better clinic-patient relationships than did SOC participants. Masivukeni shows promise to promote optimal adherence and provides preliminary evidence that multimedia, computer-based technology can help lay counselors offer better adherence counseling than standard approaches.

  15. Use of mobile technologies in patients with psychosis: A systematic review.

    Science.gov (United States)

    Bonet, Lucia; Izquierdo, Clara; Escartí, Maria Jose; Sancho, José Vicente; Arce, David; Blanquer, Ignacio; Sanjuan, Julio

    There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Impact of video technology on efficiency of pharmacist-provided anticoagulation counseling and patient comprehension.

    Science.gov (United States)

    Moore, Sarah J; Blair, Elizabeth A; Steeb, David R; Reed, Brent N; Hull, J Heyward; Rodgers, Jo Ellen

    2015-06-01

    Discharge anticoagulation counseling is important for ensuring patient comprehension and optimizing clinical outcomes. As pharmacy resources become increasingly limited, the impact of informational videos on the counseling process becomes more relevant. To evaluate differences in pharmacist time spent counseling and patient comprehension (measured by the Oral Anticoagulation Knowledge [OAK] test) between informational videos and traditional face-to-face (oral) counseling. This prospective, open, parallel-group study at an academic medical center randomized 40 individuals-17 warfarin-naïve ("New Start") and 23 with prior warfarin use ("Restart")-to receive warfarin discharge education by video or face-to-face counseling. "Teach-back" questions were used in both groups. Although overall pharmacist time was reduced in the video counseling group (P counseling method (P = 0.012) suggests the difference between counseling methods was smaller in New Start participants. Following adjustment, mean total time was reduced 8.71 (95% CI = 5.15-12.26) minutes (adjusted P counseling. Postcounseling OAK test scores did not differ. Age, gender, socioeconomic status, and years of education were not predictive of total time or OAK test score. Use of informational videos coupled with teach-back questions significantly reduced pharmacist time spent on anticoagulation counseling without compromising short-term patient comprehension, primarily in patients with prior warfarin use. Study results demonstrate that video technology provides an efficient method of anticoagulation counseling while achieving similar comprehension. © The Author(s) 2015.

  17. Classifying Health Information Technology patient safety related incidents – an approach used in Wales

    Science.gov (United States)

    Warm, D.; Edwards, P.

    2012-01-01

    Interest in the field of patient safety incident reporting and analysis with respect to Health Information Technology (HIT) has been growing over recent years as the development, implementation and reliance on HIT systems becomes ever more prevalent. One of the rationales for capturing patient safety incidents is to learn from failures in the delivery of care and must form part of a feedback loop which also includes analysis; investigation and monitoring. With the advent of new technologies and organizational programs of delivery the emphasis is increasingly upon analyzing HIT incidents. This thematic review had two objectives, to test the applicability of a framework specifically designed to categorize HIT incidents and to review the Welsh incidents as communicated via the national incident reporting system in order to understand their implications for healthcare. The incidents were those reported as IT/ telecommunications failure/ overload. Incidents were searched for within a national reporting system using a standardized search strategy for incidents occurring between 1st January 2009 and 31st May 2011. 149 incident reports were identified and classified. The majority (77%) of which were machine related (technical problems) such as access problems; computer system down/too slow; display issues; and software malfunctions. A further 10% (n = 15) of incidents were down to human-computer interaction issues and 13% (n = 19) incidents, mainly telephone related, could not be classified using the framework being tested. On the basis of this review of incidents, it is recommended that the framework be expanded to include hardware malfunctions and the wrong record retrieved/missing data associated with a machine output error (as opposed to human error). In terms of the implications for clinical practice, the incidents reviewed highlighted critical issues including the access problems particularly relating to the use of mobile technologies. PMID:23646074

  18. Classifying health information technology patient safety related incidents - an approach used in Wales.

    Science.gov (United States)

    Warm, D; Edwards, P

    2012-01-01

    Interest in the field of patient safety incident reporting and analysis with respect to Health Information Technology (HIT) has been growing over recent years as the development, implementation and reliance on HIT systems becomes ever more prevalent. One of the rationales for capturing patient safety incidents is to learn from failures in the delivery of care and must form part of a feedback loop which also includes analysis; investigation and monitoring. With the advent of new technologies and organizational programs of delivery the emphasis is increasingly upon analyzing HIT incidents. This thematic review had two objectives, to test the applicability of a framework specifically designed to categorize HIT incidents and to review the Welsh incidents as communicated via the national incident reporting system in order to understand their implications for healthcare. The incidents were those reported as IT/ telecommunications failure/ overload. Incidents were searched for within a national reporting system using a standardized search strategy for incidents occurring between 1(st) January 2009 and 31(st) May 2011. 149 incident reports were identified and classified. The majority (77%) of which were machine related (technical problems) such as access problems; computer system down/too slow; display issues; and software malfunctions. A further 10% (n = 15) of incidents were down to human-computer interaction issues and 13% (n = 19) incidents, mainly telephone related, could not be classified using the framework being tested. On the basis of this review of incidents, it is recommended that the framework be expanded to include hardware malfunctions and the wrong record retrieved/missing data associated with a machine output error (as opposed to human error). In terms of the implications for clinical practice, the incidents reviewed highlighted critical issues including the access problems particularly relating to the use of mobile technologies.

  19. The influence of assistive technology on occupational performance and satisfaction of leprosy patients with grade 2 disabilities

    Directory of Open Access Journals (Sweden)

    Lucas da Silva Muniz

    Full Text Available Abstract INTRODUCTION: We aimed to investigate the feasibility of assistive technology (AT devices to improve leprosy patients' occupational performances and satisfaction. METHODS: This is a pretest-posttest design study. The Canadian Occupational Performance Measure was used to assess the occupational performance and satisfaction of five leprosy participants with grade 2 disabilities before and after ten 45-minute interventions using assistive technology devices. RESULTS: The data showed a statistically significant 7-point average improvement (p<0.05 in participants' post-intervention performance and satisfaction scores. CONCLUSIONS: Assistive technology devices may be useful therapeutic tools to enhance autonomy/independence and satisfaction of leprosy patients with grade 2 disabilities.

  20. Identifying patient safety problems associated with information technology in general practice: an analysis of incident reports.

    Science.gov (United States)

    Magrabi, Farah; Liaw, Siaw Teng; Arachi, Diana; Runciman, William; Coiera, Enrico; Kidd, Michael R

    2016-11-01

    To identify the categories of problems with information technology (IT), which affect patient safety in general practice. General practitioners (GPs) reported incidents online or by telephone between May 2012 and November 2013. Incidents were reviewed against an existing classification for problems associated with IT and the clinical process impacted. 87 GPs across Australia. Types of problems, consequences and clinical processes. GPs reported 90 incidents involving IT which had an observable impact on the delivery of care, including actual patient harm as well as near miss events. Practice systems and medications were the most affected clinical processes. Problems with IT disrupted clinical workflow, wasted time and caused frustration. Issues with user interfaces, routine updates to software packages and drug databases, and the migration of records from one package to another generated clinical errors that were unique to IT; some could affect many patients at once. Human factors issues gave rise to some errors that have always existed with paper records but are more likely to occur and cause harm with IT. Such errors were linked to slips in concentration, multitasking, distractions and interruptions. Problems with patient identification and hybrid records generated errors that were in principle no different to paper records. Problems associated with IT include perennial risks with paper records, but additional disruptions in workflow and hazards for patients unique to IT, occasionally affecting multiple patients. Surveillance for such hazards may have general utility, but particularly in the context of migrating historical records to new systems and software updates to existing systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

    Science.gov (United States)

    Singh, Hardeep; Sittig, Dean F

    2016-04-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  2. Information and communication technology in patient education and support for people with schizophrenia.

    Science.gov (United States)

    Välimäki, Maritta; Hätönen, Heli; Lahti, Mari; Kuosmanen, Lauri; Adams, Clive E

    2012-10-17

    Poor compliance with treatment often means that many people with schizophrenia or other severe mental illness relapse and may need frequent and repeated hospitalisation. Information and communication technology (ICT) is increasingly being used to deliver information, treatment or both for people with severe mental disorders. To evaluate the effects of psychoeducational interventions using ICT as a means of educating and supporting people with schizophrenia or related psychosis. We searched the Cochrane Schizophrenia Group Trials Register (2008, 2009 and September 2010), inspected references of identified studies for further trials and contacted authors of trials for additional information. All clinical randomised controlled trials (RCTs) comparing ICT as a psychoeducational and supportive tool with any other type of psychoeducation and supportive intervention or standard care. We selected trials and extracted data independently. For homogenous dichotomous data we calculated fixed-effect risk ratios (RR) with 95% confidence intervals (CI). For continuous data, we calculated mean differences (MD). We assessed risk of bias using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions. We included six trials with a total of 1063 participants. We found no significant differences in the primary outcomes (patient compliance and global state) between psychoeducational interventions using ICT and standard care.Technology-mediated psychoeducation improved mental state in the short term (n = 84, 1 RCT, RR 0.75, 95% CI 0.56 to 1.00; n = 30, 1 RCT, MD -0.51, 95% CI -0.90 to -0.12) but not global state (n = 84, 1 RCT, RR 1.07, 95% CI 0.82 to 1.42). Knowledge and insight were not effected (n = 84, 1 RCT, RR 0.89, 95% CI 0.68 to 1.15; n = 84, 1 RCT, RR 0.77, 95% CI 0.58 to 1.03). People allocated to technology-mediated psychoeducation perceived that they received more social support than people allocated to the standard care group (n = 30, 1 RCT, MD

  3. Toward a model for field-testing patient decision-support technologies: a qualitative field-testing study.

    NARCIS (Netherlands)

    Evans, R.; Elwyn, G.; Edwards, A.; Watson, E.; Austoker, J.; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: Field-testing is a quality assurance criterion in the development of patient decision-support technologies (PDSTs), as identified in the consensus statement of the International Patient Decision Aids Standards Collaboration. We incorporated field-testing into the development of a

  4. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model,…

  5. Self-reported "communication technology" usage in patients attending a cardiology outpatient clinic in a remote regional hospital.

    Science.gov (United States)

    Gandiya, Tariro; Dua, Anahita; King, Gerry; Mazzocco, Thomas; Hussain, Amir; Leslie, Stephen J

    2012-04-01

    This study assessed the perceived usage of, and attitudes toward, communication technologies (mobile phone and texting, e-mail, and the World Wide Web) in patients attending a cardiology clinic with a view to guiding future health service redesign. This was performed in a remote regional hospital serving both urban and rural populations. A self-completion questionnaire was completed by a convenience sample of 221 patients attending a general cardiology clinic. The questions asked about patients' access to and use of technology at home. Data collected also included age, gender, travel time to the clinic, mode of travel, and whether the respondent was accompanied to the clinic. Appropriate statistical tests were used with significance taken at the 0.05 level. Age was the strongest predictor of use of communication technologies, with younger patients more likely to use e-mail, Web, mobile phone, and texting. However, frequency of use of e-mail was not related to age. It is encouraging that over 99% of patients used at least one communication technology. This study has highlighted that there may be several potential barriers to the widespread implementation of communication technologies in general cardiology patients. Cognizance should be taken of these findings when attempting service redesign.

  6. Changes of brain structure in Parkinson's disease patients with mild cognitive impairment analyzed via VBM technology.

    Science.gov (United States)

    Gao, Yuyuan; Nie, Kun; Huang, Biao; Mei, Mingjin; Guo, Manli; Xie, Sifen; Huang, Zhiheng; Wang, Limin; Zhao, Jiehao; Zhang, Yuhu; Wang, Lijuan

    2017-09-29

    To analyze changes in cerebral grey matter volume and white matter density in non-dementia Parkinson's disease patients using voxel-based morphometry (VBM) technology; to investigate features of brain structure changes in Parkinson's disease patients with mild cognitive impairment (PD-MCI), and reveal their intrinsic pathological changes. Based on the diagnostic criteria of PD-MCI, 23 PD-MCI patients, 23 Parkinson's disease patients with normal cognition (PD-NC), and 21 age- and gender-matched healthy people were recruited for the study. Scans were performed on all subjects on a 3.0T MR scanner to obtain brain structural magnetic resonance images. Images were preprocessed using the VBM8 tool from SPM8 software package on the Matlab R2008a platform, and data were then analyzed using the SPM statistical software package to compare the differences of grey matter volume and white matter density between groups, and to evaluate the brain structural changes corresponding to the overall cognitive function. Compared to the control group, the PD-NC group suffered from grey matter atrophy, mainly found in the prefrontal lobe, limbic lobe and left temporal gyrus. The PD-MCI group suffered from grey matter atrophy found in the frontal lobe, limbic lobe, basal ganglia and cerebellum. Compared to the PD-NC group, the PD-MCI group suffered from grey matter atrophy found in the left-side middle temporal gyrus, inferior temporal gyrus and frontal lobe. The grey matter regions correlated with MMSE score (mainly memory related) including the right cingulate gyrus and the limbic lobe. The grey matter regions correlated with MoCA score (mainly non-memory related) including the frontal lobe, basal ganglia, parahippocampal gyrus, occipital lobe and the cerebellum. Additionally, overall cognitive function in non-dementia PD was mainly located in the frontal and limbic system, and was dominated by subcortical atrophy. Structural changes in PD-MCI patients are associated with overall

  7. Educating patients about warfarin therapy using information technology: A survey on healthcare professionals’ perspectives

    Directory of Open Access Journals (Sweden)

    Mullan J

    2012-06-01

    Full Text Available Objective: To explore healthcare professionals’ views about the benefits and challenges of using information technology (IT resources for educating patients about their warfarin therapy.Methods: A cross-sectional survey of both community and hospital-based healthcare professionals (e.g., doctors, pharmacists and nurses involved using a purpose-designed questionnaire. The questionnaires were distributed using a multi-modal approach to maximise response rates.Results: Of the total 300 questionnaires distributed, 109 completed surveys were received (43.3% response rate. Over half (53.2% of the healthcare participants were aged between 40-59 years, the majority (59.5% of whom were female. Fifty nine (54.1% participants reported having had no access to warfarin-specific IT-based patient education resources, and a further 19 (38.0% of the participants who had IT-access reported that they never used such resources. According to the healthcare participants, the main challenges associated with educating their patients about warfarin therapy included: patient-related factors, such as older age, language barriers, cognitive impairments and/or ethnic backgrounds or healthcare professional factors, such as time constraints. The healthcare professionals reported that there were several aspects about warfarin therapy which they found difficult to educate their patients about which is why they identified computers and interactive touch screen kiosks as preferred IT devices to deliver warfarin education resources in general practices, hospital-based clinics and community pharmacies. At the same time, the healthcare professionals also identified a number of facilitators (e.g., to reinforce warfarin education, to offer reliable and easily comprehensible information and barriers (e.g., time and costs of using IT resources, difficulty in operating the resources that could impact on the effective implementation of these devices in educating patients about their

  8. [Design and development of a new information technology platform for patients with dementia].

    Science.gov (United States)

    Osváth, Péter; Vörös, Viktor; Kovács, Attila; Boda-Jörg, Adrienn; Fekete, Szabolcs; Jankovics, Réka; Tényi, Tamás; Fekete, Sándor

    2017-01-01

    As dementia, including Alzheimer's disease is a major public health issue worldwide, there are many efforts at European level to promote active and healthy ageing. University of Pecs joined the ICT4Life project - supported by the European Union H2020 programme - in 2016. The aim of this three-years project is to improve qualityof- life and autonomy of patients with mild or moderate dementia with developing a new Information and Communication Technology (ICT) platform, which may provide help for patients, caregivers and professionals. The ICT4Life research is conducted among patients with cognitive decline, their relatives, caregivers, and professionals involved in their care. The needs of the different actors are assessed with semi-structured interviews and clinical scales (cognitive and affective scales, quality-of-life measurements, functionality, caregiver burden), which help to develop a user-friendly, adaptive and personalized platform. Using the integrated ICT platform (bio-sensors, smart TV, tablet, mobile, bracelet) may contribute to monitor (physical, psycho-motor and emotional states) elderly with cognitive decline and to provide better and personalized care for them. The platform includes cognitive enhancement with gamification, and focuses also on the decrease of professional and caregiver burden. Here we report on the ICT4Life programme, which develops an ICT solution for individuals with early stage cognitive impairment while contributing in a user-friendly way to extending their independence and improve their quality-of-life.

  9. Communication technology access, use, and preferences among primary care patients: from the Residency Research Network of Texas (RRNeT).

    Science.gov (United States)

    Hill, Jason H; Burge, Sandra; Haring, Anna; Young, Richard A

    2012-01-01

    The digital revolution is changing the manner in which patients communicate with their health care providers, yet many patients still lack access to communication technology. We conducted this study to evaluate access to, use of, and preferences for using communication technology among a predominantly low-income patient population. We determined whether access, use, and preferences were associated with type of health insurance, sex, age, and ethnicity. In 2011, medical student researchers administered questionnaires to patients of randomly selected physicians within 9 primary care clinics in the Residency Research Network of Texas. Surveys addressed access to and use of cell phones and home computers and preferences for communicating with health care providers. In this sample of 533 patients (77% response rate), 448 (84%) owned a cell phone and 325 (62%) owned computers. Only 48% reported conducting Internet searches, sending and receiving E-mails, and looking up health information on the Internet. Older individuals, those in government sponsored insurance programs, and individuals from racial/ethnic minority groups had the lowest levels of technology adoption. In addition, more than 60% of patients preferred not to send and receive health information over the Internet, by instant messaging, or by text messaging. Many patients in this sample did not seek health information electronically nor did they want to communicate electronically with their physicians. This finding raises concerns about the vision of the patient-centered medical home to enhance the doctor-patient relationship through communication technology. Our patients represent some of the more vulnerable populations in the United States and, as such, deserve attention from health care policymakers who are promoting widespread use of communication technology.

  10. Access to Mobile Communication Technology and Willingness to Participate in Automated Telemedicine Calls Among Chronically Ill Patients in Honduras

    Science.gov (United States)

    Mendoza-Avelares, Milton O.; Milton, Evan C.; Lange, Ilta; Fajardo, Roosevelt

    2010-01-01

    Abstract Objectives: Patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support. Materials and Methods: 624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management. Results: Participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p 80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures. Conclusions: Even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries. PMID:21062234

  11. Radiation dose in neuroangiography using image noise reduction technology: a population study based on 614 patients

    Energy Technology Data Exchange (ETDEWEB)

    Soederman, Michael; Andersson, Tommy; Holmin, Staffan [Karolinska University Hospital - Solna, Department of Clinical Neuroscience, Karolinska Institute and Department of Neuroradiology, Stockholm (Sweden); Mauti, Maria; Boon, Sjirk; Hoornaert, Bart [Philips Healthcare, Best (Netherlands); Omar, Artur; Marteinsdottir, Maria [Karolinska University Hospital, Department of Medical Physics, Section of Imaging Physics, Stockholm (Sweden)

    2013-11-15

    The purpose of this study was to quantify the reduction in patient radiation dose by X-ray imaging technology using image noise reduction and system settings for neuroangiography and to assess its impact on the working habits of the physician. Radiation dose data from 190 neuroangiographies and 112 interventional neuroprocedures performed with state-of-the-art image processing and reference system settings were collected for the period January-June 2010. The system was then configured with extra image noise reduction algorithms and system settings, which enabled radiation dose reduction without loss of image quality. Radiation dose data from 174 neuroangiographies and 138 interventional neuroprocedures were collected for the period January-June 2012. Procedures were classified as diagnostic or interventional. Patient radiation exposure was quantified using cumulative dose area product and cumulative air kerma. Impact on working habits of the physician was quantified using fluoroscopy time and number of digital subtraction angiography (DSA) images. The optimized system settings provided significant reduction in dose indicators versus reference system settings (p<0.001): from 124 to 47 Gy cm{sup 2} and from 0.78 to 0.27 Gy for neuroangiography, and from 328 to 109 Gy cm{sup 2} and from 2.71 to 0.89 Gy for interventional neuroradiology. Differences were not significant between the two systems with regard to fluoroscopy time or number of DSA images. X-ray imaging technology using an image noise reduction algorithm and system settings provided approximately 60% radiation dose reduction in neuroangiography and interventional neuroradiology, without affecting the working habits of the physician. (orig.)

  12. Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America

    Directory of Open Access Journals (Sweden)

    Juan Calderón

    2017-07-01

    Full Text Available Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%. The most used ICT was the short message service (SMS (69.9%. SMS and E-mail are useful tools for communicating (i.e. receiving and seeking information with all asthma patients, irrespective of their age. WhatsApp (61.5% and Facebook (32.0% were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient.

  13. Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America.

    Science.gov (United States)

    Calderón, Juan; Cherrez, Annia; Ramón, Germán Darío; Lopez Jove, Orlando; Baptist, Alan; Matos, Edgar; Morfín Maciel, Blanca; Calero, Erick; Sanchez-Borges, Mario; Cherrez, Sofia; Simancas-Racines, Daniel; Cherrez Ojeda, Ivan

    2017-07-01

    Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%). The most used ICT was the short message service (SMS) (69.9%). SMS and E-mail are useful tools for communicating ( i.e. receiving and seeking information) with all asthma patients, irrespective of their age. WhatsApp (61.5%) and Facebook (32.0%) were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient.

  14. The patient perspective on the use of information and communication technologies and e-health in rehabilitation.

    Science.gov (United States)

    Wentink, M M; Prieto, E; de Kloet, A J; Vliet Vlieland, T P M; Meesters, J J L

    2017-07-31

    Success of e-health relies on the extent to which the related technology, such as the electronic device, is accepted by its users. However, there has been limited research on the patients' perspective on use of e-health-related technology in rehabilitation care. To explore the usage of common electronic devices among rehabilitation patients with access to email and investigate their preferences regarding their usage in rehabilitation. Adult patients who were admitted for inpatient and/or outpatient rehabilitation and were registered with an email address were invited to complete an electronic questionnaire regarding current and preferred use of information and communication technologies in rehabilitation care. 190 out of 714 invited patients completed the questionnaire, 94 (49%) female, mean age 49 years (SD 16). 149 patients (78%) used one or more devices every day, with the most frequently used devices were: PC/laptop (93%), smartphone (57%) and tablet (47%). Patients mostly preferred to use technology for contact with health professionals (mean 3.15, SD 0.79), followed by access to their personal record (mean 3.09, SD 0.78) and scheduling appointments with health professionals (mean 3.07, SD 0.85). Most patients in rehabilitation used one or more devices almost every day and wish to use these devices in rehabilitation. Implications for Rehabilitation In a sample of 190 patients in rehabilitation with access to email, almost all patients used one or more electronic devices almost every day of the week, with the most frequently used devices were: a PC/laptop, smartphone and tablet. Most of the patients wish to incorporate electronic devices in their rehabilitation process and prefer to use those devices to have insight in their health record, communication with peers and scheduling appointments with health professionals. To better assist patients with e-health in rehabilitation care in the future, preferences could be implemented in rehabilitation care by using

  15. Patients' perspectives on high-tech home care: a qualitative inquiry into the user-friendliness of four technologies

    Directory of Open Access Journals (Sweden)

    Lehoux Pascale

    2004-10-01

    Full Text Available Abstract Background The delivery of technology-enhanced home care is growing in most industrialized countries. The objective of our study was to document, from the patient's perspective, how the level of user-friendliness of medical technology influences its integration into the private and social lives of patients. Understanding what makes a technology user-friendly should help improve the design of home care services. Methods Four home care interventions that are frequently used and vary in their technical and clinical features were selected: Antibiotic intravenous therapy, parenteral nutrition, peritoneal dialysis and oxygen therapy. Our qualitative study relied on the triangulation of three sources of data: 1 interviews with patients (n = 16; 2 interviews with carers (n = 6; and 3 direct observation of nursing visits of a different set of patients (n = 16. Participants of varying socioeconomic status were recruited through primary care organizations and hospitals that deliver home care within 100 km of Montreal, the largest urban area in the province of Quebec, Canada. Results The four interventions have both a negative and positive effect on patients' lives. These technologies were rarely perceived as user-friendly, and user-acceptance was closely linked to user-competence. Compared with acute I.V. patients, who tended to be passive, chronic patients seemed keener to master technical aspects. While some of the technical and human barriers were managed well in the home setting, engaging in the social world was more problematic. Most patients found it difficult to maintain a regular job because of the high frequency of treatment, while some carers found their autonomy and social lives restricted. Patients also tended to withdraw from social activities because of social stigmatization and technical barriers. Conclusions While technology contributes to improving the patients' health, it also imposes significant constraints on their lives

  16. The Impact of Health Information Technology on the Doctor-Patient Relationship in Child and Adolescent Psychiatry.

    Science.gov (United States)

    Krishna, Rajeev

    2017-01-01

    As health information technology continues to expand and permeate medicine, there is increasing concern for the effect on the therapeutic relationship between patient and psychiatrist. This article explores this impact, seeking wisdom from adult psychiatry and more broadly from general medical disciplines to draw conclusions regarding how the child psychiatry encounter may be affected. Several proposed strategies to mitigate potential negative impacts of health information technology on the therapeutic relationship across practice settings are offered. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The influence of assistive technology on occupational performance and satisfaction of leprosy patients with grade 2 disabilities.

    Science.gov (United States)

    Muniz, Lucas da Silva; Amaral, Irmara Géssica Santos; Dias, Thiago da Silva; Rodrigues, Jorge Lopes

    2016-01-01

    We aimed to investigate the feasibility of assistive technology (AT) devices to improve leprosy patients' occupational performances and satisfaction. This is a pretest-posttest design study. The Canadian Occupational Performance Measure was used to assess the occupational performance and satisfaction of five leprosy participants with grade 2 disabilities before and after ten 45-minute interventions using assistive technology devices. The data showed a statistically significant 7-point average improvement (pgrade 2 disabilities.

  18. Patient self-management and chronic illness: evaluating outcomes and impacts of information technology.

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2009-01-01

    Chronic illness is increasing in Australia and throughout the world. It is proving to be a large burden upon health systems. In response, a number of approaches are being tried including the introduction of self-management programmes to assist people in improving their health outcomes. There are also claims that the introduction of information and communications technology (ICT) tools can improve the management of these chronic conditions.This paper investigates the influence of ICT on the health outcomes and experiences of patients with chronic obstructive pulmonary disease (COPD) participating in a mentored self-management programme. It utilises a combined quantitative and qualitative methodology and introduces the use of triad interviews to provide a broader evaluation of the experiences of individuals within a controlled trial. Two sub-groups of participants within the controlled trial were examined, both received mentoring but one sub-group was also supported with access to an ICT symptom monitoring tool. This research highlights the need for more holistic perspectives on patients and towards the use of a variety of methodological approaches in designing and evaluating e-health projects. Critically, this research highlights the need to expand our understanding of participant's outcomes beyond conventional clinical or cohort based measures.

  19. Impact of new X-ray technology on patient dose in pacemaker and implantable cardioverter defibrillator (ICD) implantations.

    Science.gov (United States)

    van Dijk, Joris D; Ottervanger, Jan Paul; Delnoy, Peter Paul H M; Lagerweij, Martine C M; Knollema, Siert; Slump, Cornelis H; Jager, Pieter L

    2017-01-01

    New X-ray technology providing new image processing techniques may reduce radiation exposure. The aim of this study was to quantify this radiation exposure reduction for patients during pacemaker and implantable cardioverter defibrillator (ICD) implantation. In this retrospective study, 1185 consecutive patients who had undergone de novo pacemaker or ICD implantation during a 2-year period were included. All implantations in the first year were performed using the reference technology (Allura Xper), whereas in the second year, the new X-ray technology (AlluraClarity) was used. Radiation exposure, expressed as the dose area product (DAP), was compared between the two time periods to determine the radiation exposure reduction for pacemaker and ICD implantations without cardiac resynchronization therapy (CRT) and with CRT. Procedure duration and contrast volume were used as measures to compare complexity and image quality. The study population consisted of 591 patients who had undergone an implantation using the reference technology, and 594 patients with the new X-ray technology. The two groups did not differ in age, gender, or body mass index. The DAP decreased with 69 % from 16.4 ± 18.5 to 5.2 ± 6.6 Gy cm 2 for the non-CRT implantations (p technology (p = 0.09 and p = 0.20, respectively). Introduction of new X-ray technology resulted in a radiation exposure reduction of more than 69 % for patients during pacemaker and ICD implantation while image quality was unaffected.

  20. Ascertaining the Place of Social Media and Technology for Bariatric Patient Support: What Do Allied Health Practitioners Think?

    Science.gov (United States)

    Graham, Yitka N H; Hayes, Catherine; Mahawar, Kamal K; Small, Peter K; Attala, Anita; Seymour, Keith; Woodcock, Sean; Ling, Jonathan

    2017-07-01

    There is an increasing presence of patient-led social media, mobile apps and patient support technology, but little is known about the role of these in the support of bariatric surgery patients in the UK. This study aimed to seek the views of allied health professionals (AHPs) working in bariatric surgical teams to understand their current perceptions of the role of social media, mobile apps and patient-support technology within bariatric surgery in the UK. A confidential, printed survey was distributed to the AHPs at the British Obesity and Metabolic Surgery Society (BOMSS) 7th Annual Scientific Conference in January 2016. An email to AHPs who did not attend the conference was sent requesting voluntary participation in the same survey online through Survey Monkey® within 2 weeks of the conference. A total of 95 responses were received, which was a 71% response rate (n = 134). Responses were from nurses (34%, n = 46), dietitians (32%, n = 32), psychologists (16%, n = 12) and 1 nutritionist, 1 physiotherapist, 1 patient advocate, 1 surgeon and 9 respondents did not fill in their title. The use of social media and mobile apps by patients is increasing, with AHPs concerned about misinformation; advice may differ from what is given in clinic. Technologies, e.g. telehealth and videoconferencing are not widely used in bariatric surgery in the UK. AHPs are unclear about the role of technologies for bariatric surgical patient support. Further discussions are needed to understand the potential of technology with AHPs supporting/facilitating patients as this becomes more commonplace.

  1. Mobile technology supporting trainee doctors’ workplace learning and patient care: an evaluation

    Directory of Open Access Journals (Sweden)

    Hardyman Wendy

    2013-01-01

    Full Text Available Abstract Background The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks. Methods Data on trainee doctors’ (Foundation Year 2 workplace information seeking practice was collected by questionnaire in 2011 (n = 260. iDoc baseline questionnaires (n = 193 collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117 detail specific instances of Smartphone use. Results Most frequently (daily used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline; peers (70%; 58%; and other medical/nursing team staff (53% both datasets. Smartphones were used more frequently by males (p  Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based, complex (problem-based clinical questions and clinical procedures (skills-based scenarios. From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making. Conclusion A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge. By

  2. Patterns of technology use in patients attending a cardiopulmonary outpatient clinic: a self-report survey.

    Science.gov (United States)

    Disler, Rebecca T; Inglis, Sally C; Newton, Phillip J; Currow, David C; Macdonald, Peter S; Glanville, Allan R; Donesky, DorAnne; Carrieri-Kohlman, Virginia; Davidson, Patricia M

    2015-03-06

    Self-management education for cardiopulmonary diseases is primarily provided through time-limited, face-to-face programs, with access limited to a small percentage of patients. Telecommunication tools will increasingly be an important component of future health care delivery. The purpose of this study was to describe the patterns of technology use in patients attending a cardiopulmonary clinic in an academic medical center. A prevalence survey was developed to collect data on participant demographics (age in years, sex, and socioeconomic status); access to computers, Internet, and mobile phones; and use of current online health support sites or programs. Surveys were offered by reception staff to all patients attending the outpatient clinic. A total of 123 surveys were collected between March and April 2014. Technological devices were a pervasive part of everyday life with respondents engaged in regular computer (102/123, 82.9%), mobile telephone (115/117, 98.3%), and Internet (104/121, 86.0%) use. Emailing (101/121, 83.4%), researching and reading news articles (93/121, 76.9%), social media (71/121, 58.7%), and day-to-day activities (65/121, 53.7%) were the most common telecommunication activities. The majority of respondents reported that access to health support programs and assistance through the Internet (82/111, 73.9%) would be of use, with benefits reported as better understanding of health information (16/111, 22.5%), avoidance of difficult travel requirements and time-consuming face-to-face appointments (13/111, 18.3%), convenient and easily accessible help and information (12/111, 16.9%), and access to peer support and sharing (9/111, 12.7%). The majority of patients did not have concerns over participating in the online environment (87/111, 78.4%); the few concerns noted related to privacy and security (10/15), information accuracy (2/15), and computer literacy and access (2/15). Chronic disease burden and long-term self-management tasks provide a

  3. Technology in the OR: AORN Members' Perceptions of the Effects on Workflow Efficiency and Quality Patient Care.

    Science.gov (United States)

    Sipes, Carolyn; Baker, Joy Don

    2015-09-01

    This collaborative study sought to describe technology used by AORN members at work, inclusive of radio-frequency identification or barcode scanning (RFID), data collection tools (DATA), workflow or dashboard management tools (DASHBOARD), and environmental services/room decontamination technologies (ENVIRON), and to identify the perceived effects of each technology on workflow efficiency (WFE) and quality patient care (QPC). The 462 respondents to the AORN Technology in the OR survey reported use of technology (USE) in all categories. Eleven of 17 RFID items had a strong positive correlation between the designated USE item and the perceived effect on WFE and QPC. Five of the most-used technology items were found in the DATA category. Two of the five related to Intraoperative Nursing Documentation and the use of the Perioperative Nursing Data Set. The other three related to Imaging Integration for Radiology Equipment, Video Camera Systems, and Fiber-optic Systems. All three elements explored in the DASHBOARD category (ie, Patient Update, OR Case, OR Efficiency) demonstrated approximately 50% or greater perceived effectiveness in WFE and QPC. There was a low reported use of ENVIRON technologies, resulting in limited WFE and QPC data for this category. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  4. Using information and communication technologies to consult with patients in Victorian primary care: the views of general practitioners.

    Science.gov (United States)

    Hanna, Lisa; Fairhurst, Karen

    2013-01-01

    Information and communication technologies such as email, text messaging and video messaging are commonly used by the general population. However, international research has shown that they are not used routinely by GPs to communicate or consult with patients. Investigating Victorian GPs' perceptions of doing so is timely given Australia's new National Broadband Network, which may facilitate web-based modes of doctor-patient interaction. This study therefore aimed to explore Victorian GPs' experiences of, and attitudes toward, using information and communication technologies to consult with patients. Qualitative telephone interviews were carried out with a maximum variation sample of 36GPs from across Victoria. GPs reported a range of perspectives on using new consultation technologies within their practice. Common concerns included medico-legal and remuneration issues and perceived patient information technology literacy. Policy makers should incorporate GPs' perspectives into primary care service delivery planning to promote the effective use of information and communication technologies in improving accessibility and quality of general practice care.

  5. Evaluation of hyperspectral imaging technology in patients with peripheral vascular disease.

    Science.gov (United States)

    Chiang, Nathaniel; Jain, Jitendra K; Sleigh, Jamie; Vasudevan, Thodur

    2017-10-01

    Hyperspectral imaging technology is a novel method of using transcutaneous measurement of oxyhemoglobin (HT-Oxy) and deoxyhemoglobin (HT-Deoxy) concentrations to create a two-dimensional, color-coded "oxygen map." The aims of this study were to compare the use of a hyperspectral imaging device with the transcutaneous oxygen measurement (TCOM), ankle-brachial index (ABI), and severity of peripheral vascular disease (PVD) and to assess their correlations. This prospective study recruited 294 participants divided into three distinct groups composed of healthy volunteers and patients with PVD. Patients underwent measurements of lower limbs at a standardized point over the head of the first metatarsal on the plantar aspect using the hyperspectral imaging device, generating four outputs including HT-Oxy, HT-Deoxy, oxygen saturation (HT-Sat), and skin temperature, and the TCOM system, generating transcutaneous partial pressure of oxygen (TcpO 2 ) and carbon dioxide (TcpCO 2 ). Demographic data, severity of PVD, ABI, and other pertinent information were obtained from both the participants and medical records. Interoperator reliability ranged from 86% to 94% across the four hyperspectral imaging device outputs, whereas intraoperator reliability ranged from 92% to 94%. The HT-Oxy, HT-Sat, TcpCO 2 , and ABI of the diseased limb correlated significantly with the severity of PVD. HT-Sat significantly correlated with TcpO 2 (R = 0.19), TcpCO 2 (R = -0.26), ABI (R = 0.42), and skin temperature (R = 0.56). HT-Deoxy also correlated with TcpCO 2 (R = 0.27). This study demonstrates the reliability of hyperspectral imaging in comparison to TCOM, ABI, skin temperature, and severity of PVD in a series of patients. Its correlation to other established modalities and low interoperator and intraoperator variability could enable this modality to be a useful screening tool in PVD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  6. Hurdles overcome in technology transfer for AIET and Positive outcome in Indian patients

    Directory of Open Access Journals (Sweden)

    Dedeepiya V

    2012-01-01

    Full Text Available Introduction Cell based immunotherapies have been in practice in Japan for the past two decades with established clinical trials on its efficacy in both solid tumours and hematological malignancies including gastric cancer, ovarian cancer , lung cancer and liver cancer. [1,2,3,4] In India, NCRM has been providing Autologous Immune Enhancement Therapy (AIET using autologous Natural Killer (NK cells and activated T Lymphocytes for Cancer since 2005 following the established protocols practiced by the Biotherapy Institute of Japan. Significant outcome achieved after AIET in advanced pancreatic cancer, Acute Myeloid leukemia (AML in Indian patients have already been reported. [5, 6] Here we report our experience in few more patients and present the hurdles overcome and lessons learned in translating the technology from Japan to India Case Details: Case 1: A 54 year-old female presented with Stage IV recurrent ovarian malignancy in 2010 with a history of previous surgery and chemotherapy for ovarian malignancy in June 2009. The CA-125 level of 243 U/ml. CT scan revealed lesions in the liver, spleen, along the greater curvature of body of stomach and in the perisplenic region, between the medial aspect of liver and stomach and in the right inguinal region. She was suggested six cycles of chemotherapy with Doxorubicin (50 mg and Carboplatin (450 mg along with AIET. After proper informed consent, the peripheral blood was withdrawn and the in vitro expansion of the NK cells, activated T Lymphocytes from the peripheral blood was performed using the protocol reported earlier. [7] Average cell count after the in vitro expansion was 1.2 X 108 cells. Six transfusions of the in vitro expanded NK cells and activated T lymphocytes were administered following which the CA-125 decreased to 4.7 U/mL. CT scan taken in December 2010 showed a regression of the lesions in the spleen and perisplenic peritoneal deposits, stable hepatic lesions and resolution of

  7. Rhodopsin in plasma from patients with diabetic retinopathy - development and validation of digital ELISA by Single Molecule Array (Simoa) technology

    DEFF Research Database (Denmark)

    Petersen, Eva Rabing Brix; Olsen, Dorte Aalund; Christensen, Henry

    2017-01-01

    was therefore to develop and validate a Rhodopsin assay by employing digital ELISA technology, and to investigate whether Rhodopsin concentrations in diabetes patients with DR are elevated compared with diabetes patients without DR. METHODS: A digital ELISA assay using a Simoa HD-1 Analyzer (Quanterix...... patients with or without DR, but significantly increased number of DR patients having concentrations above the LOD. CONCLUSION: We developed and validated a digital ELISA method for quantification of Rhodopsin in plasma but found no statistically significant difference in the plasma concentration...

  8. Assessment of the reliability of active radiofrequency identification technology for patient tracking in the pediatric emergency department.

    Science.gov (United States)

    Hung, Geoffrey R; Doan, Quynh

    2013-02-01

    Radiofrequency identification (RFID) technology has been used in other emergency department settings but has not been assessed in a pediatric emergency department setting for its reliability in its application as a patient tracking system. The goal of this study was to assess the accuracy, precision, and reliability of the technology in a simulated pediatric emergency department setting to collect patient tracking information. A simulated pediatric emergency department clinical assessment room was developed to serve as a test room to collect patient tracking information. This information included the interaction times between simulated patients, parents, physicians, and nurses. Direct observation of these interaction times were recorded by an observer. A patient tracking system based on active RFID technology recorded interaction times between models wearing RFID devices and recorded this information in a computerized data log. Comparison between the direct observation record and the data log was used to determine accuracy, precision, and reliability. A total of 152 directly observed interactions were recorded. Data extraction from the data log yielded 152 sensor-recorded interactions, resulting in a reliability of 1.0. Data pair comparison on all events resulted in a mean difference of 2.88 seconds. Active RFID-based patient tracking systems are a precise and reliable means of recording patient interaction events in the pediatric emergency department.

  9. How technology in care at home affects patient self-care and self-management: a scoping review.

    Science.gov (United States)

    Peeters, José M; Wiegers, Therese A; Friele, Roland D

    2013-10-29

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients' role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients' self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits.

  10. Information and Communication Technologies for the Activities of Daily Living in Older Patients with Dementia: A Systematic Review.

    Science.gov (United States)

    D'Onofrio, Grazia; Sancarlo, Daniele; Ricciardi, Francesco; Panza, Francesco; Seripa, Davide; Cavallo, Filippo; Giuliani, Francesco; Greco, Antonio

    2017-01-01

    Significant innovations have been introduced in recent years in the application of information and communication technologies (ICTs) to support healthcare for patients with dementia. In the present systematic review, our goal is to keep track of ICT concepts and approaches to support the range of activities of daily living for people with dementia and to provide a snapshot of the effect that technology is having on patients' self-reliance. We reviewed the literature and identified systematic reviews of cohort studies and other authoritative reports. Our selection criteria included: (1) activities of daily living, (2) ICT, and (3) dementia. We identified 56 studies published between 2000 and 2015, of which 26 met inclusion criteria. The present systematic review revealed many ICT systems that could purportedly support the range of activities of daily living for patients with dementia. The results showed five research bodies: 1) technologies used by patients with dementia, 2) technologies used by caregivers, 3) monitoring systems, 4) ambient assistive living with ICTs, and 5) tracking and wayfinding. There is a potential for ICTs to support dementia care at home and to improve quality of life for caregivers, reducing healthcare costs and premature institutional care for these patients.

  11. The secret to health information technology's success within the diabetes patient population: a comprehensive privacy and security framework.

    Science.gov (United States)

    Pandya, Sheel M

    2010-05-01

    Congress made an unprecedented investment in health information technology (IT) when it passed the American Recovery and Reinvestment Act in February 2009. Health IT provides enormous opportunities to improve health care quality, reduce costs, and engage patients in their own care. But the potential payoff for use of health IT for diabetes care is magnified given the prevalence, cost, and complexity of the disease. However, without proper privacy and security protections in place, diabetes patient data are at risk of misuse, and patient trust in the system is undermined. We need a comprehensive privacy and security framework that articulates clear parameters for access, use, and disclosure of diabetes patient data for all entities storing and exchanging electronic data. (c) 2010 Diabetes Technology Society.

  12. Beyond Volume: Hospital-Based Healthcare Technology for Better Outcomes in Cerebrovascular Surgical Patients Diagnosed With Ischemic Stroke

    OpenAIRE

    Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Lee, Tae-Hyun; Jang, Sung-In

    2016-01-01

    Abstract We examined whether the level of hospital-based healthcare technology was related to the 30-day postoperative mortality rates, after adjusting for hospital volume, of ischemic stroke patients who underwent a cerebrovascular surgical procedure. Using the National Health Insurance Service-Cohort Sample Database, we reviewed records from 2002 to 2013 for data on patients with ischemic stroke who underwent cerebrovascular surgical procedures. Statistical analysis was performed using Cox ...

  13. Beyond volume: hospital-based healthcare technology as a predictor of mortality for cardiovascular patients in Korea.

    Science.gov (United States)

    Kim, Jae-Hyun; Lee, Yunhwan; Park, Eun-Cheol

    2016-06-01

    To examine whether hospital-based healthcare technology is related to 30-day postoperative mortality rates after adjusting for hospital volume of cardiovascular surgical procedures.This study used the National Health Insurance Service-Cohort Sample Database from 2002 to 2013, which was released by the Korean National Health Insurance Service. A total of 11,109 cardiovascular surgical procedure patients were analyzed. The primary analysis was based on logistic regression models to examine our hypothesis.After adjusting for hospital volume of cardiovascular surgical procedures as well as for all other confounders, the odds ratio (OR) of 30-day mortality in low healthcare technology hospitals was 1.567-times higher (95% confidence interval [CI] = 1.069-2.297) than in those with high healthcare technology. We also found that, overall, cardiovascular surgical patients treated in low healthcare technology hospitals, regardless of the extent of cardiovascular surgical procedures, had the highest 30-day mortality rate.Although the results of our study provide scientific evidence for a hospital volume-mortality relationship in cardiovascular surgical patients, the independent effect of hospital-based healthcare technology is strong, resulting in a lower mortality rate. As hospital characteristics such as clinical pathways and protocols are likely to also play an important role in mortality, further research is required to explore their respective contributions.

  14. BARRIERS AND MOTIVATORS IN ENGAGING WITH TECHNOLOGY-ENABLED CARDIAC REHABILITATION: A PATIENT AND HEALTH PROFESSIONAL PERSPECTIVE.

    Directory of Open Access Journals (Sweden)

    Deirdre Walsh

    2015-10-01

    This formative work has outlined key patient and stakeholder concerns regarding engagement with a technology enabled behavior change intervention in CR. Factors that inhibit and promote engagement have been explored using the COM-B framework. Motivational factors related to social interaction were deemed one of the integral aspects for engagement and adherence to PATHway. In terms of capability factors, technology ease- of-use was highlighted among patient and stakeholders as important for uptake and continued use. This project has received funding from the European Union’s Horizon 2020 Framework Programme for Research and Innovation Action under Grant Agreement no. 643491. PATHway: Technology enabled behavioural change as a pathway towards better self-management of CVD (www.pathway2health.eu

  15. Technology to engage hospitalised patients in their nutrition care: a qualitative study of usability and patient perceptions of an electronic foodservice system.

    Science.gov (United States)

    Roberts, S; Marshall, A P; Gonzalez, R; Chaboyer, W

    2017-10-01

    Active patient involvement in nutrition care may improve dietary intakes in hospital. Our team is developing an innovative programme allowing patients to self-assess and self-monitor their nutrition at the bedside. The present study aimed to assess usability and patient perceptions of an electronic foodservice system (EFS) for participating in nutrition care. This qualitative study was conducted in an Australian tertiary hospital. Participants were sampled purposively and included patients who were able to provide informed consent and communicate in English. Patient interviews were conducted at the bedside and consisted of: (i) usability testing of the EFS using 'Think Aloud' technique and (ii) questioning using a semi-structured interview guide to understand perceptions of the EFS. Interview data were analysed using inductive content analysis. Thirty-two patients were interviewed. Their perceptions of using the EFS to participate in nutrition care were expressed in five categories: (i) Familiarity with technology can affect confidence and ability but is not essential to use EFS; (ii) User interface design significantly impacts EFS usability; (iii) Identifying benefits to technology increases its acceptance; (iv) Technology enables participation, which occurs to varying extents; and (v) Degree of participation depends on perceived importance of nutrition. Patients found the EFS acceptable and acknowledged benefits to its use. Several factors appeared to influence usability, acceptability and willingness to engage with the system, such as user interface design and perceived ease of use, benefits and importance. The present study provides important insights into designing technology-based interventions for engaging inpatients in their nutrition care. © 2017 The British Dietetic Association Ltd.

  16. Digital technology influence on patient dose in the radiological examination of the upper digestive apparatus

    International Nuclear Information System (INIS)

    Nunez, E.; Pifarre, X.; Ruiz, J.; Escalada, C.; Paredes, M.C.

    2001-01-01

    The radiological study of the superior digestive apparatus (oesophagus, stomach and duodenum) throughout the barium contrast is a kind of exploration which provides medium-high dosage levels for patients. In these studies the fluoroscopy and the acquisition of images for the diagnosis are shared. The acquisition of images, up until a few years ago, was accomplished through radiographic film and chemical processing; nowadays, the new generation of image-intensifier tube incorporates a new utility to digitally capture the images. This new capturing method, with higher sensitivity, allows us to obtain images with a mAs 5 times smaller than the classical system of radiological film (reduction of the dosage up to 80%). This leads us to expect very important reductions in dosage in the studies conducted with this new technology. Nonetheless, these expectations haven't been reflected in the dosimetric samples that our work team has conducted in several centers of the community of Madrid these past years. In this work, the reasons for this phenomenon are analyzed. (author)

  17. GnRH antagonist, cetrorelix, for pituitary suppression in modern, patient-friendly assisted reproductive technology.

    Science.gov (United States)

    Tur-Kaspa, Ilan; Ezcurra, Diego

    2009-10-01

    Gonadotropin-releasing hormone (GnRH) analogues are used routinely to prevent a premature luteinizing hormone (LH) surge in women undergoing assisted reproductive technology (ART) treatments. In contrast to GnRH agonists, antagonists produce rapid and reversible suppression of LH with no initial flare effect. To review the role of cetrorelix, the first GnRH antagonist approved for the prevention of premature LH surges during controlled ovarian stimulation in modern ART. A review of published literature on cetrorelix. Both multiple- and single-dose cetrorelix protocols were shown to be at least as effective as long GnRH agonist regimens for pituitary suppression in Phase II/III clinical trials. Furthermore, cetrorelix co-treatment resulted in similar live birth rates but a shorter duration of gonadotropin stimulation, a lower total gonadotropin dose requirement and lower incidence of ovarian hyperstimulation syndrome compared with long agonist regimens. A single-dose cetrorelix protocol further decreased the number of injections required. Preliminary studies have also produced promising data on the use of cetrorelix in modified ART protocols, such as frozen embryo transfer and donor oocyte recipient cycles. Cetrorelix offers a potential therapeutic alternative to GnRH agonists during controlled ovarian stimulation and has become an integral part of modern, patient-friendly reproductive medicine.

  18. What can be expected of information and communication technologies in terms of patient empowerment in health?

    Science.gov (United States)

    Lemire, Marc

    2010-01-01

    Implementing information and communication technologies (ICT) is often mentioned as a strategy that can foster public involvement and responsibility in health. The purpose of this paper is to provide a better understanding of the possibilities and issues afforded by the social uses of ICT for personal empowerment in health. The paper discusses evidence from four case studies that characterize current computerization and networking processes in health. The studies shared a global framework comprising four interpretative paradigms of personal empowerment: the professional, technocratic, consumerist and democratic paradigms. The results show the coexistence of four empowerment logics in ICT use. Two trends proved dominant: a strengthening of the control and standardization processes tied to the typical power relationships in health, and a reinforcement of personal autonomy and self-assertion processes, either through commercial relationships or through the social relationships that are also present. The paper supports the argument that in order to understand the opportunities for personal empowerment offered by ICT the logic underlying user practices in their respective contexts must be examined. The paper uses data from four case studies to illustrate the contradictory logics shaping the personal empowerment process. Under these logics, an ICT user may play roles as patient, client, consumer, or citizen.

  19. Social representations of nurses about professional autonomy and the use of technologies in the care of patients with wounds.

    Science.gov (United States)

    Dos Santos, Érick Igor; Grativol Aguiar Dias de Oliveira, Jéssica

    2016-06-01

    To identify the social representations by nurses about professional autonomy in the care of patients with wounds and analyze their interfaces with the constant incorporation of technologies in this care. This is a qualitative research, outlined from the Theory and method of social representations in its procedural approach and performed with 31 nurses. The interviews were submitted to thematic content analysis software NVivo instrumentalized by 10. The representational content on autonomy is linked mainly to the level of knowledge, power of decision, vocational training and institutional factors. The subjects are positioned favorably to the incorporation of care technologies in professional practice, which involves elements such as cost-effective structure, training, and other resources. It is concluded that autonomy is configured as a prerequisite for the full use of technology and technology is configured as a facilitator for nurses to become more autonomous.

  20. The International Safeguards Technology Base: How is the Patient Doing? An Exploration of Effective Metrics

    Energy Technology Data Exchange (ETDEWEB)

    Schanfein, Mark J; Gouveia, Fernando S

    2010-07-01

    The term “Technology Base” is commonly used but what does it mean? Is there a common understanding of the components that comprise a technology base? Does a formal process exist to assess the health of a given technology base? These are important questions the relevance of which is even more pressing given the USDOE/NNSA initiatives to strengthen the safeguards technology base through investments in research & development and human capital development. Accordingly, the authors will establish a high-level framework to define and understand what comprises a technology base. Potential goal-driven metrics to assess the health of a technology base will also be explored, such as linear demographics and resource availability, in the hope that they can be used to better understand and improve the health of the U.S. safeguards technology base. Finally, through the identification of such metrics, the authors will offer suggestions and highlight choices for addressing potential shortfalls.

  1. The International Safeguards Technology Base: How is the Patient Doing? An Exploration of Effective Metrics

    International Nuclear Information System (INIS)

    Schanfein, Mark J.; Gouveia, Fernando S.

    2010-01-01

    The term 'Technology Base' is commonly used but what does it mean? Is there a common understanding of the components that comprise a technology base? Does a formal process exist to assess the health of a given technology base? These are important questions the relevance of which is even more pressing given the USDOE/NNSA initiatives to strengthen the safeguards technology base through investments in research and development and human capital development. Accordingly, the authors will establish a high-level framework to define and understand what comprises a technology base. Potential goal-driven metrics to assess the health of a technology base will also be explored, such as linear demographics and resource availability, in the hope that they can be used to better understand and improve the health of the U.S. safeguards technology base. Finally, through the identification of such metrics, the authors will offer suggestions and highlight choices for addressing potential shortfalls.

  2. MO-H-19A-03: Patient Specific Bolus with 3D Printing Technology for Electron Radiotherapy

    International Nuclear Information System (INIS)

    Zou, W; Swann, B; Siderits, R; McKenna, M; Khan, A; Yue, N; Zhang, M; Fisher, T

    2014-01-01

    Purpose: Bolus is widely used in electron radiotherapy to achieve desired dose distribution. 3D printing technologies provide clinicians with easy access to fabricate patient specific bolus accommodating patient body surface irregularities and tissue inhomogeneity. This study presents the design and the clinical workflow of 3D printed bolus for patient electron therapy in our clinic. Methods: Patient simulation CT images free of bolus were exported from treatment planning system (TPS) to an in-house developed software package. Bolus with known material properties was designed in the software package and then exported back to the TPS as a structure. Dose calculation was carried out to examine the coverage of the target. After satisfying dose distribution was achieved, the bolus structure was transferred in Standard Tessellation Language (STL) file format for the 3D printer to generate the machine codes for printing. Upon receiving printed bolus, a quick quality assurance was performed with patient resimulated with bolus in place to verify the bolus dosimetric property before treatment started. Results: A patient specific bolus for electron radiotherapy was designed and fabricated in Form 1 3D printer with methacrylate photopolymer resin. Satisfying dose distribution was achieved in patient with bolus setup. Treatment was successfully finished for one patient with the 3D printed bolus. Conclusion: The electron bolus fabrication with 3D printing technology was successfully implemented in clinic practice

  3. Digital health technology for use in patients with serious mental illness: a systematic review of the literature.

    Science.gov (United States)

    Batra, Sonal; Baker, Ross A; Wang, Tao; Forma, Felicia; DiBiasi, Faith; Peters-Strickland, Timothy

    2017-01-01

    As the capabilities and reach of technology have expanded, there is an accompanying proliferation of digital technologies developed for use in the care of patients with mental illness. The objective of this review was to systematically search published literature to identify currently available health technologies and their intended uses for patients with serious mental illness. The Medline, Embase, and BIOSIS Previews electronic databases were searched to identify peer-reviewed English language articles that reported the use of digital, mobile, and other advanced technology in patients with schizophrenia/schizoaffective disorder, bipolar disorder, and major depressive disorder. Eligible studies were systematically reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eighteen studies that met the inclusion criteria were identified. Digital health technologies (DHTs) assessed in the selected studies included mobile applications (apps), digital medicine, digital personal health records, and an electronic pill container. Smartphone apps accounted for the largest share of DHTs. The intended uses of DHTs could be broadly classified as monitoring to gain a better understanding of illness, clinical assessment, and intervention. Overall, studies indicated high usability/feasibility and efficacy/effectiveness, with several reporting validity against established clinical scales. Users were generally engaged with the DHT, and mobile assessments were deemed helpful in monitoring disease symptoms. Rapidly proliferating digital technologies seem to be feasible for short-term use in patients with serious mental illness; nevertheless, long-term effectiveness data from naturalistic studies will help demonstrate their usefulness and facilitate their adoption and integration into the mental health-care system.

  4. Time, space and technology in radiotherapy departments: how do these factors impact on patients' experiences of radiotherapy?

    Science.gov (United States)

    Merchant, S; O'Connor, M; Halkett, G

    2017-03-01

    Radiation therapists (RTs) plan and deliver radiotherapy treatment for patients diagnosed with cancer. They need to communicate regularly with their patients and may have a role to play in reducing patient anxiety and distress. The objectives were to explore how the environment of radiotherapy departments supports or inhibits communication generally and information giving and supportive care provision in particular. An ethnographic approach was used to gather rich descriptive data through observations and interviews conducted in two Australian radiotherapy centres. Time, space and a technology driven culture was found to negatively affect the quality of interaction that occurred between RTs and their patients. This research has shown design/modification of spaces is needed in the radiotherapy environment to reflect a patient care centred culture and to enhance opportunities for RTs to provide supportive care for their patients. © 2015 John Wiley & Sons Ltd.

  5. Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients

    Directory of Open Access Journals (Sweden)

    María Martínez Pérez

    2016-07-01

    Full Text Available This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication. RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient.

  6. Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients.

    Science.gov (United States)

    Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

    2016-07-28

    This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient.

  7. Mechanical Thrombectomy in Patients With Acute Ischemic Stroke: A Health Technology Assessment

    Science.gov (United States)

    2016-01-01

    Background In Ontario, current treatment for eligible patients who have an acute ischemic stroke is intravenous thrombolysis (IVT). However, there are some limitations and contraindications to IVT, and outcomes may not be favourable for patients with stroke caused by a proximal intracranial occlusion. An alternative is mechanical thrombectomy with newer devices, and a number of recent studies have suggested that this treatment is more effective for improving functional independence and clinical outcomes. The objective of this health technology assessment was to evaluate the clinical effectiveness and cost-effectiveness of new-generation mechanical thrombectomy devices (with or without IVT) compared to IVT alone (if eligible) in patients with acute ischemic stroke. Methods We conducted a systematic review of the literature, limited to randomized controlled trials that examined the effectiveness of mechanical thrombectomy using stent retrievers and thromboaspiration devices for patients with acute ischemic stroke. We assessed the quality of the evidence using the GRADE approach. We developed a Markov decision-analytic model to assess the cost-effectiveness of mechanical thrombectomy (with or without IVT) versus IVT alone (if eligible), calculated incremental cost-effectiveness ratios using a 5-year time horizon, and conducted sensitivity analyses to examine the robustness of the estimates. Results There was a substantial, statistically significant difference in rate of functional independence (GRADE: high quality) between those who received mechanical thrombectomy (with or without IVT) and IVT alone (odds ratio [OR] 2.39, 95% confidence interval [CI] 1.88–3.04). We did not observe a difference in mortality (GRADE: moderate quality) (OR 0.80, 95% CI 0.60–1.07) or symptomatic intracerebral hemorrhage (GRADE: moderate quality) (OR 1.11, 95% CI 0.66–1.87). In the base-case cost-utility analysis, which had a 5 year time horizon, the costs and effectiveness for

  8. Effects of combining CBCT technology with visual root canal recurrence in treatment of elderly patients with dental pulp disease.

    Science.gov (United States)

    Cui, J-J; Peng, B; Lin, W

    2017-03-01

    The aim of this study is to analyze the effects of combining cone beam computed tomography (CBCT) technology with visual root canal recurrence in the treatment of elderly patients with dental pulp disease. 56 cases of elderly patients with dental pulp disease were contiguously selected, and randomly divided into the control group (70 teeth from 27 patients) and the observation group (77 teeth from the rest 29 patients). We adopted CBCT technology combined with conventional root canal therapy in control group and CBCT technology combined with visual root canal recurrence in observation group to compare the clinical effects. It was found that there was no statistical difference in duration of operation between the two groups (p>0.05). The operation times and the VAS during and after operation of the observation group were significantly less than that of the control group (ptechnology combined with visual root canal recurrence can significantly improve the near and long-term treatment effects of elderly patients with dental pulp disease.

  9. Psychosocial interventions for patients and caregivers in the age of new communication technologies: opportunities and challenges in cancer care.

    Science.gov (United States)

    Badr, Hoda; Carmack, Cindy L; Diefenbach, Michael A

    2015-01-01

    Interactive health communication technologies (IHCTs) present a new opportunity and challenge for cancer control researchers who focus on couple- and family-based psychosocial interventions. In this article, the authors first present findings from a systematic review of 8 studies that used IHCTs in psychosocial interventions with cancer patients and their caregivers. Although this research area is still in its infancy, studies suggest that it is feasible to incorporate IHCTs in such interventions, that IHCTs are generally well accepted by patients and caregivers, and that the choice of technology is largely dependent on intervention target (i.e., patient, caregiver, or both) and outcomes (e.g., decision making, symptom management, lifestyle behaviors). A major research gap has been the lack of integration of Web 2.0 technologies (e.g., social media), despite the fact that social support and communication are frequently targeted components of interventions that involve cancer patients and their caregivers. Given this, the authors next present findings from a qualitative study that they conducted to describe the different needs and preferences of 13 cancer survivors and 12 caregivers with regard to social media use. Last, the authors discuss some of the opportunities and challenges of using IHCTs in psychosocial interventions for cancer patients and their caregivers and propose directions for future research.

  10. [Effect of Kiken-Yochi training (KYT) induction on patient safety at the department of radiological technology].

    Science.gov (United States)

    Yasuda, Mitsuyoshi; Kato, Kyoichi; Uchiyama, Yushi; Sakiyama, Koshi; Shibata, Masako; Sanbe, Takeyuki; Sasaki, Haruaki; Yoshikawa, Kohki; Nakazawa, Yasuo

    2013-07-01

    In this report, we evaluated whether radiological technologists' (RTs') awareness of patient safety would improve and what kind of effects would be seen at the department of radiological technology by introducing KYT [K: kiken (hazard), Y: yochi (prediction), T: (training)]. KYT was carried out by ten RTs based on a KYT sheet for the department of radiological technology. To evaluate the effects of KYT, we asked nine questions each to ten participants before and after KYT enforcement with regard to their attitude to patient safety and to operating procedures for working safely. Significant improvements after KYT enforcement were obtained in two items concerning medical safety: It is important for any risk to be considered by more than one person; The interest in preventive measures against medical accident degree conducted now) and one concerning operating procedures (It is necessary to have a nurse assist during testing with the mobile X-ray apparatus) (peffective for patients.

  11. Mount Sinai leverages smartphone technology, aiming to boost care, coordination of ED patients while also trimming costs.

    Science.gov (United States)

    2015-05-01

    Mount Sinai Hospital in New York, NY, is using smartphone technology to enhance follow-up calls to senior patients who have visited the ED, and to help provide acute-level care to select patients in their own homes. Investigators are hoping to show that these approaches can improve care and coordination while trimming costs, and they expect that patients will approve of these new approaches as well. While senior patients are still in the ED, nurse coordinators will work with them to load a HIPAA-compliant application to their smartphones so they can conduct face-to-face follow-up calls that meet HIPAA standards. Nurses say the face-to-face communications enhance their ability to assess how patients are doing following their ED visit. The hospital is also testing a program that enables some ED patients who meet inpatient criteria to receive this care in the home setting through the use of a mobile acute care team (MACT). In the case of emergencies, the MACT team relies on community paramedics who will visit the patients' homes and provide care under the direction of MACT physicians who are linked in to these visits via smartphone technology.

  12. Evaluating the impact of mobile telephone technology on type 2 diabetic patients' self-management: the NICHE pilot study.

    Science.gov (United States)

    Faridi, Zubaida; Liberti, Lauren; Shuval, Kerem; Northrup, Veronika; Ali, Ather; Katz, David L

    2008-06-01

    Utilizing information technology, such as Internet and cellphones, holds great promise in enhancing diabetic care. Yet few studies have examined the impact of cellphone technology on type 2 diabetics' self-care. The primary aim of the study is to examine the feasibility of utilizing this technology to assist with diabetes self-care in a clinic population as well as its impact on clinical outcomes. Thirty patients with a diagnosis of type 2 diabetes at two Community Health Centers were randomized to intervention or control. Intervention patients participated in a brief intervention and received tailored daily messages via cellphone prompting them to enhance their diabetic self-care behaviour. Patients at the control site continued with their standard diabetes self-management. A mean improvement in HbA1c levels was apparent (-0.1, SD = 0.3%; P = 0.1534) in the intervention group, compared with a mean deterioration in the control (0.3, SD = 1.0%; P = 0.3813), yet without statistical significance. Self-efficacy scores improved significantly in the intervention group (-0.5, SD = 0.6; P = 0.0080) compared with no improvement in the control (0.0, SD = 1.0; P = 0.9060). Participants encountered numerous technological barriers when attempting to adhere to the intervention protocol. The results indicate the intervention had a positive impact on some clinical outcome and self-efficacy. Although the technology appears feasible in a clinical setting technology must be made more user-friendly before a larger phase II trial is conducted.

  13. Differences in blood pressure by measurement technique in neurocritically ill patients: A technological assessment.

    Science.gov (United States)

    Lele, Abhijit V; Wilson, Daren; Chalise, Prabhakar; Nazzaro, Jules; Krishnamoorthy, Vijay; Vavilala, Monica S

    2018-01-01

    Blood pressure data may vary by measurement technique. We performed a technological assessment of differences in blood pressure measurement between non-invasive blood pressure (NIBP) and invasive arterial blood pressure (ABP) in neurocritically ill patients. After IRB approval, a prospective observational study was performed to study differences in systolic blood pressure (SBP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) values measured by NIBP arm, ABP at level of the phlebostatic axis (ABP heart) and ABP at level of the external auditory meatus (ABP brain) at 30 and 45-degree head of bed elevation (HOB) using repeated measure analysis of covariance and correlation coefficients. Overall, 168 patients were studied with median age of 57 ± 15 years, were mostly female (57%), with body mass index ≤30 (66%). Twenty-three percent (n = 39) had indwelling intracranial pressure monitors, and 19.7% (n = 33) received vasoactive agents. ABP heart overestimated ABP brain for SBP (11.5 ± 2.7 mmHg, p < .001), MAP (mean difference 13.3 ± 0.5 mmHg, p < .001) and CPP (13.4 ± 3.2 mmHg, p < .001). ABP heart overestimated NIBP arm for SBP (8 ± 1.5 mmHg, p < .001), MAP (mean difference 8.6 ± 0.8 mmHg, p < .001), and CPP (mean difference 9.8 ± 3.2 mmHg, p < .001). Regardless of HOB elevation, ABP heart overestimates MAP compared to ABP brain and NIBP arm. Using ABP heart data overestimates CPP and may be responsible for not achieving SBP, MAP or CPP targets aimed at the brain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. iPod™ technology for teaching patients about anticoagulation: a pilot study of mobile computer-assisted patient education.

    Science.gov (United States)

    Denizard-Thompson, Nancy R; Singh, Sonal; Stevens, Sheila R; Miller, David P; Wofford, James L

    2012-01-01

    To determine whether an educational strategy using a handheld, multimedia computer (iPod™) is practical and sustainable for routine office-based patient educational tasks. With the limited amount of time allotted to the office encounter and the growing number of patient educational tasks, new strategies are needed to improve the efficiency of patient education. Education of patients anticoagulated with warfarin is considered critical to preventing complications. Despite the dangers associated with the use of warfarin, educational practices are variable and often haphazard. During a four-month period, we examined the implementation of a three-part series of iPod™-based patient educational modules delivered to anticoagulated patients at the time of routine INR (International Normalized Ratio) blood tests for outpatients on the anticoagulation registry at an urban community health center. A total of 141 computer module presentations were delivered to 91 patients during the four-month period. In all, 44 patients on the registry had no INR checkups, and thus no opportunity to view the modules, and 32 patients had at least three INR checkups but no modules were documented. Of the 130 patients with at least one INR performed during the study period, 22 (16.9%) patients completed all three modules, 91 (70.0%) patients received at least one module, and nine (7.6%) patients refused to view at least one module. Neither of the two handheld computers was lost or stolen, and no physician time was used in this routine educational activity. Patients reported that the audio and visual quality was very good, (9.0/10); the educational experience of the patient was helpful (7.4/10) compared with the patient's previous warfarin education (6.3/10), and the computer strategy extended the INR visit duration by 1-5 min at most. The computer-assisted patient educational strategy was well received by patients, and uptake of the intervention by the clinic was successful and durable. The i

  15. Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study.

    Science.gov (United States)

    Lee, Heesun; Park, Jun-Bean; Choi, Sae Won; Yoon, Yeonyee E; Park, Hyo Eun; Lee, Sang Eun; Lee, Seung-Pyo; Kim, Hyung-Kwan; Cho, Hyun-Jai; Choi, Su-Yeon; Lee, Hae-Young; Choi, Jonghyuk; Lee, Young-Joon; Kim, Yong-Jin; Cho, Goo-Yeong; Choi, Jinwook; Sohn, Dae-Won

    2017-10-02

    Despite the advances in the diagnosis and treatment of heart failure (HF), the current hospital-oriented framework for HF management does not appear to be sufficient to maintain the stability of HF patients in the long term. The importance of self-care management is increasingly being emphasized as a promising long-term treatment strategy for patients with chronic HF. The objective of this study was to evaluate whether a new information communication technology (ICT)-based telehealth program with voice recognition technology could improve clinical or laboratory outcomes in HF patients. In this prospective single-arm pilot study, we recruited 31 consecutive patients with chronic HF who were referred to our institute. An ICT-based telehealth program with voice recognition technology was developed and used by patients with HF for 12 weeks. Patients were educated on the use of this program via mobile phone, landline, or the Internet for the purpose of improving communication and data collection. Using these systems, we collected comprehensive data elements related to the risk of HF self-care management such as weight, diet, exercise, medication adherence, overall symptom change, and home blood pressure. The study endpoints were the changes observed in urine sodium concentration (uNa), Minnesota Living with Heart Failure (MLHFQ) scores, 6-min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as surrogate markers for appropriate HF management. Among the 31 enrolled patients, 27 (87%) patients completed the study, and 10 (10/27, 37%) showed good adherence to ICT-based telehealth program with voice recognition technology, which was defined as the use of the program for 100 times or more during the study period. Nearly three-fourths of the patients had been hospitalized at least once because of HF before the enrollment (20/27, 74%); 14 patients had 1, 2 patients had 2, and 4 patients had 3 or more previous HF hospitalizations. In the total study

  16. Screening diabetic and hypertensive patients for ocular pathology using telemedicine technology in rural West Virginia: a retrospective chart review.

    Science.gov (United States)

    Ahmed, Rezwan; Petrany, Stephen; Fry, Russell; Krasnow, Michael

    2013-01-01

    There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia. A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and reports from the screenings were returned with instruction for follow-up care or specialist referral when indicated. A retrospective chart review of 643 patients with diabetes or hypertension who were screened for ocular problems from October 2003 to December 2009 was completed. 44.8% of patients who were screened in the primary care center were identified as having 1 of 34 types of eye pathology that were previously unknown, of which 33% of patients were recommended to seek prompt attention by a retina consultant or glaucoma specialist for suspected ocular pathology. Our review demonstrates the actual benefits of telemedicine in the effective screening of diabetic and hypertensive patients for eye pathology, and our experience suggests that using distance medicine and telemedicine technologies is valuable for screening rural populations.

  17. The use of information and communication technology to meet chronically ill patients' needs when living at home.

    Science.gov (United States)

    Skär, Lisa; Söderberg, Siv

    2011-01-01

    The aim of the study was to describe influences, benefits, and limitations in using information and communication technology to meet chronically ill patients' needs when living at home. The study is a descriptive, exploratory designed pilot study and the intervention was performed using an electronic communication program enabling communication between ill persons and the district nurse in real time by web cam pictures and sound. The participant used the programme once or twice a week from February to August 2008. Data were collected by means of repeated interviews and logbook notes, and were subjected to qualitative content analysis. The results showed that all participants appreciated being able to communicate regardless of time and place and their experiences of using information and communication technology revealed that it created feelings of safety and security. The information and communication technology became a tool in their communication and improved nursing care among seriously chronically ill persons living at home.

  18. Managing Psychiatrist-Patient Relationships in the Digital Age: a Summary Review of the Impact of Technology-enabled Care on Clinical Processes and Rapport.

    Science.gov (United States)

    Parish, Michelle Burke; Fazio, Sarina; Chan, Steven; Yellowlees, Peter M

    2017-10-27

    Participatory medicine and the availability of commercial technologies have given patients more options to view and track their health information and to communicate with their providers. This shift in the clinical process may be of particular importance in mental healthcare where rapport plays a significant role in the therapeutic process. In this review, we examined literature related to the impact of technology on the clinical workflow and patient-provider rapport in the mental health field between January 2014 and June 2017. Thirty three relevant articles, of 226 identified articles, were summarized. The use of technology clinically has evolved from making care more accessible and efficient to leveraging technology to improve care, communication, and patient-provider rapport. Evidence exists demonstrating that information and communication technologies may improve care by better connecting patients and providers and by improving patient-provider rapport, although further research is needed.

  19. Enhancing mHealth Technology in the Patient-Centered Medical Home Environment to Activate Patients With Type 2 Diabetes: A Multisite Feasibility Study Protocol.

    Science.gov (United States)

    Gimbel, Ronald; Shi, Lu; Williams, Joel E; Dye, Cheryl J; Chen, Liwei; Crawford, Paul; Shry, Eric A; Griffin, Sarah F; Jones, Karyn O; Sherrill, Windsor W; Truong, Khoa; Little, Jeanette R; Edwards, Karen W; Hing, Marie; Moss, Jennie B

    2017-03-06

    The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys. Each of these tools, used alone or in combination, have demonstrated varying degrees of effectiveness. Some of the more promising results have been demonstrated using regular collection of biometric devices, SMS text messaging, secure email communication with clinical teams, and regular reporting of quality-of-life variables. In this study, we seek to incorporate several of the most promising mHealth capabilities in a patient-centered medical home (PCMH) workflow. We aim to address underlying technology needs and gaps related to the use of mHealth technology and the activation of patients living with type 2 diabetes. Stated differently, we enable supporting technologies while seeking to influence patient activation and self-care activities. This is a multisite phased study, conducted within the US Military Health System, that includes a user-centered design phase and a PCMH-based feasibility trial. In phase 1, we will assess both patient and provider preferences regarding the enhancement of the enabling technology capabilities for type 2 diabetes chronic care management. Phase 2 research will be a single-blinded 12-month feasibility study that incorporates randomization principles. Phase 2 research will seek to improve patient activation and self-care activities through the use of the Mobile Health Care Environment with tailored behavioral messaging. The primary outcome measure is the Patient Activation Measure scores. Secondary outcome measures are Summary of

  20. [The informational technologies for the comprehensive rehabilitation of the patients presenting with juvenile cerebral palsy (a review)].

    Science.gov (United States)

    Legkaya, E F; Khodasevich, L S; Polyakova, A V

    2016-01-01

    This article is devoted to the application of the up-to-date technologies for the treatment and rehabilitation of the children presenting with juvenile cerebral palsy (JCP). It is shown that the use of computer classes, play therapy toys, and robotic exercise machines collectively make up a promising tool for the correction of limb movements in the JCP patients. Lessons with the use of modified technical devices make it possible to develop the creative capacities of the children, improve memory, attention, coordination and precision of the movements of their extremities. One of the important components of the comprehensive rehabilitation of the patients suffering from juvenile cerebral palsy is teaching. It is concluded that the informational technologies provide a powerful tool for remote learning to enable the invalid children to receive education in the future.

  1. Identifying and Coordinating Care for Complex Patients: Findings from the Leading Edge of Analytics and Health Information Technology.

    Science.gov (United States)

    Rudin, Robert S; Gidengil, Courtney A; Predmore, Zachary; Schneider, Eric C; Sorace, James; Hornstein, Rachel

    2017-06-01

    In the United States, a relatively small proportion of complex patients---defined as having multiple comorbidities, high risk for poor outcomes, and high cost---incur most of the nation's health care costs. Improved care coordination and management of complex patients could reduce costs while increasing quality of care. However, care coordination efforts face multiple challenges, such as segmenting populations of complex patients to better match their needs with the design of specific interventions, understanding how to reduce spending, and integrating care coordination programs into providers' care delivery processes. Innovative uses of analytics and health information technology (HIT) may address these challenges. Rudin and colleagues at RAND completed a literature review and held discussions with subject matter experts, reaching the conclusion that analytics and HIT are being used in innovative ways to coordinate care for complex patients but that the capabilities are limited, evidence of their effectiveness is lacking, and challenges are substantial, and important foundational work is still needed.

  2. A communication and information technology infrastructure for real time monitoring and management of type 1 diabetes patients.

    Science.gov (United States)

    Skevofilakas, Marios; Mougiakakou, Stavroula G; Zarkogianni, Konstantia; Aslanoglou, Erika; Pavlopoulos, Sotiris A; Vazeou, Andriani; Bartsocas, Christos S; Nikita, Konstantina S

    2007-01-01

    This paper is focused on the integration of state-of-the-art technologies in the fields of telecommunications, simulation algorithms, and data mining in order to develop a Type 1 diabetes patient's semi to fully-automated monitoring and management system. The main components of the system are a glucose measurement device, an insulin delivery system (insulin injection or insulin pumps), a mobile phone for the GPRS network, and a PDA or laptop for the Internet. In the medical environment, appropriate infrastructure for storage, analysis and visualizing of patients' data has been implemented to facilitate treatment design by health care experts.

  3. Requirements of a new communication technology for handover and the escalation of patient care: a multi-stakeholder analysis.

    Science.gov (United States)

    Johnston, Maximilian J; King, Dominic; Arora, Sonal; Cooper, Kerri; Panda, Neha Aparajita; Gosling, Rebecca; Singh, Kaushiki; Sanders, Bradley; Cox, Benita; Darzi, Ara

    2014-08-01

    In order to enable safe and efficient information transfer between health care professionals during clinical handover and escalation of care, existing communication technologies must be updated. This study aimed to provide a user-informed guide for the development of an application-based communication system (ABCS), tailored for use in patient handover and escalation of care. Current methods of inter-professional communication in health care along with information system needs for communication technology were identified through literature review. A focus group study was then conducted according to a topic guide developed by health innovation and safety researchers. Fifteen doctors and 11 nurses from three London hospitals participated in a mixture of homogeneous and heterogeneous sessions. The sessions were recorded and transcribed verbatim before being subjected to thematic analysis. Seventeen information system needs were identified from the literature review. Participants identified six themes detailing user perceptions of current communication technology, attitudes to smartphone technology and anticipated requirements of an application produced for handover and escalation of care. Participants were in favour of an ABCS over current methods and expressed enthusiasm for a system with integrated patient information and group-messaging functions. Despite concerns regarding confidentiality and information governance a robust guide for development and implementation of an ABCS was produced, taking input from multiple stakeholders into account. Handover and escalation of care are vital processes for patient safety and communication within these must be optimized. An ABCS for health care professionals would be a welcome innovation and may lead to improvements in patient safety. © 2014 John Wiley & Sons, Ltd.

  4. Beyond volume: hospital-based healthcare technology as a predictor of mortality for cardiovascular patients in Korea

    OpenAIRE

    Kim, Jae-Hyun; Lee, Yunhwan; Park, Eun-Cheol

    2016-01-01

    Abstract To examine whether hospital-based healthcare technology is related to 30-day postoperative mortality rates after adjusting for hospital volume of cardiovascular surgical procedures. This study used the National Health Insurance Service?Cohort Sample Database from 2002 to 2013, which was released by the Korean National Health Insurance Service. A total of 11,109 cardiovascular surgical procedure patients were analyzed. The primary analysis was based on logistic regression models to ex...

  5. Using Telemedicine and Wireless Technology to Improve Diabetic Outcomes in Poorly Controlled Patients

    National Research Council Canada - National Science Library

    Vigersky, Robert

    2002-01-01

    Diabetes mellitus is a condition that lends itself to the use of telemedicine and technology because its management relies heavily on the collection, sharing, and interpretation of blood glucose data...

  6. Engaging Patients in Online Self-Care Technologies for Chronic Disease Management.

    Science.gov (United States)

    Picton, Peter; Wiljer, David; Urowitz, Sara; Cafazzo, Joseph A

    2016-01-01

    A common perception is that the use of Internet-based self-care systems is best suited for a younger, tech-proficient population, and that these systems will increase the burden on patients with complex chronic conditions. The study stratified patients with diabetes into three regimens of use of an Internet-based diabetes self-care portal. Results show that patients were more likely to adhere to a diurnal regimen than a variable regimen, and older patients, over the age of 60, were more adherent than younger patients, regardless of regimen. This suggests that common misconceptions should be reconsidered when prescribing Internet-based interventions for patients with chronic illness.

  7. Impact of Information Technology, Clinical Resource Constraints, and Patient-Centered Practice Characteristics on Quality of Care

    Directory of Open Access Journals (Sweden)

    JongDeuk Baek

    2015-02-01

    Full Text Available Objective: Factors in the practice environment, such as health information technology (IT infrastructure, availability of other clinical resources, and financial incentives, may influence whether practices are able to successfully implement the patient-centered medical home (PCMH model and realize its benefits. This study investigates the impacts of those PCMH-related elements on primary care physicians’ perception of quality of care. Methods: A multiple logistic regression model was estimated using the 2004 to 2005 CTS Physician Survey, a national sample of salaried primary care physicians (n = 1733. Results: The patient-centered practice environment and availability of clinical resources increased physicians’ perceived quality of care. Although IT use for clinical information access did enhance physicians’ ability to provide high quality of care, a similar positive impact of IT use was not found for e-prescribing or the exchange of clinical patient information. Lack of resources was negatively associated with physician perception of quality of care. Conclusion: Since health IT is an important foundation of PCMH, patient-centered practices are more likely to have health IT in place to support care delivery. However, despite its potential to enhance delivery of primary care, simply making health IT available does not necessarily translate into physicians’ perceptions that it enhances the quality of care they provide. It is critical for health-care managers and policy makers to ensure that primary care physicians fully recognize and embrace the use of new technology to improve both the quality of care provided and the patient outcomes.

  8. Impact of Information Technology, Clinical Resource Constraints, and Patient-Centered Practice Characteristics on Quality of Care.

    Science.gov (United States)

    Baek, JongDeuk; Seidman, Robert L

    2015-01-01

    Factors in the practice environment, such as health information technology (IT) infrastructure, availability of other clinical resources, and financial incentives, may influence whether practices are able to successfully implement the patient-centered medical home (PCMH) model and realize its benefits. This study investigates the impacts of those PCMH-related elements on primary care physicians' perception of quality of care. A multiple logistic regression model was estimated using the 2004 to 2005 CTS Physician Survey, a national sample of salaried primary care physicians (n = 1733). The patient-centered practice environment and availability of clinical resources increased physicians' perceived quality of care. Although IT use for clinical information access did enhance physicians' ability to provide high quality of care, a similar positive impact of IT use was not found for e-prescribing or the exchange of clinical patient information. Lack of resources was negatively associated with physician perception of quality of care. Since health IT is an important foundation of PCMH, patient-centered practices are more likely to have health IT in place to support care delivery. However, despite its potential to enhance delivery of primary care, simply making health IT available does not necessarily translate into physicians' perceptions that it enhances the quality of care they provide. It is critical for health-care managers and policy makers to ensure that primary care physicians fully recognize and embrace the use of new technology to improve both the quality of care provided and the patient outcomes.

  9. Implementation of the concept of home hospitalisation for heart patients by means of telehomecare technology: integration of clinical tasks

    Directory of Open Access Journals (Sweden)

    Birthe Dinesen

    2007-05-01

    Full Text Available Purpose: To explore how the implementation of the concept ‘Home hospitalisation of heart patients’ by means of telehomecare technology influences the integration of clinical tasks across healthcare sectors. Theory: Inter-organisational theory. Methods: The case study approach was applied. Triangulations of data collection techniques were used: documentary materials, participant observation, qualitative and focus group interviews. Results: The clinical decision-making and task solving became multidisciplinary and integrated with the implementation of telehomecare and, therefore, complex in terms of the prescription and adjustment of patient medicine. Workflows between healthcare professionals across sectors changed from sequential to collective client flows. Pre-existing procedures for patient care, treatment, and responsibility were challenged. In addition, the number of tasks for the district nurses increased. Integration in the clinical task-solving area increases fragmentation in the knowledge technologies in a network perspective. Conclusions: Implementing the concept of ‘Home hospitalisation of heart patients’ by means of telehomecare technology will result in a more integrated clinical task-solving process that involves healthcare professionals from various sectors. Overall, the integration of clinical tasks between hospital and district nursing will result in a direct benefit for the heart patients.

  10. Implementation of the concept of home hospitalisation for heart patients by means of telehomecare technology: integration of clinical tasks

    Science.gov (United States)

    Dinesen, Birthe; Gustafsson, Jeppe; Nøhr, Christian; Andersen, Stig Kjær; Sejersen, Holger; Toft, Egon

    2007-01-01

    Purpose To explore how the implementation of the concept ‘Home hospitalisation of heart patients’ by means of telehomecare technology influences the integration of clinical tasks across healthcare sectors. Theory Inter-organisational theory. Methods The case study approach was applied. Triangulations of data collection techniques were used: documentary materials, participant observation, qualitative and focus group interviews. Results The clinical decision-making and task solving became multidisciplinary and integrated with the implementation of telehomecare and, therefore, complex in terms of the prescription and adjustment of patient medicine. Workflows between healthcare professionals across sectors changed from sequential to collective client flows. Pre-existing procedures for patient care, treatment, and responsibility were challenged. In addition, the number of tasks for the district nurses increased. Integration in the clinical task-solving area increases fragmentation in the knowledge technologies in a network perspective. Conclusions Implementing the concept of ‘Home hospitalisation of heart patients’ by means of telehomecare technology will result in a more integrated clinical task-solving process that involves healthcare professionals from various sectors. Overall, the integration of clinical tasks between hospital and district nursing will result in a direct benefit for the heart patients. PMID:17627299

  11. Lean systems approaches to health technology assessment: a patient-focused alternative to cost-effectiveness analysis.

    Science.gov (United States)

    Bridges, John F P

    2006-12-01

    Many countries now use health technology assessment (HTA) to review new and emerging technologies, especially with regard to reimbursement, pricing and/or clinical guidelines. One of the common, but not universal, features of these systems is the use of economic evaluation, normally cost-effectiveness analysis (CEA), to confirm that new technologies offer value for money. Many have criticised these systems as primarily being concerned with cost containment, rather than advancing the interests of patients or innovators. This paper calls into question the underlying principles of CEA by arguing that value in the healthcare system may in fact be unconstrained. It is suggested that 'lean management principles' can be used not only to trim waste from the health system, but as a method of creating real incentives for innovation and value creation. Following the lean paradigm, this value must be defined purely from the patients' perspective, and the entire health system needs to work towards the creation of such value. This paper offers as a practical example a lean approach to HTA, arguing that such an approach would lead to better incentives for innovation in health, as well as more patient-friendly outcomes in the long run.

  12. Health information technology and physician-patient interactions: impact of computers on communication during outpatient primary care visits.

    Science.gov (United States)

    Hsu, John; Huang, Jie; Fung, Vicki; Robertson, Nan; Jimison, Holly; Frankel, Richard

    2005-01-01

    The aim of this study was to evaluate the impact of introducing health information technology (HIT) on physician-patient interactions during outpatient visits. This was a longitudinal pre-post study: two months before and one and seven months after introduction of examination room computers. Patient questionnaires (n = 313) after primary care visits with physicians (n = 8) within an integrated delivery system. There were three patient satisfaction domains: (1) satisfaction with visit components, (2) comprehension of the visit, and (3) perceptions of the physician's use of the computer. Patients reported that physicians used computers in 82.3% of visits. Compared with baseline, overall patient satisfaction with visits increased seven months after the introduction of computers (odds ratio [OR] = 1.50; 95% confidence interval [CI]: 1.01-2.22), as did satisfaction with physicians' familiarity with patients (OR = 1.60, 95% CI: 1.01-2.52), communication about medical issues (OR = 1.61; 95% CI: 1.05-2.47), and comprehension of decisions made during the visit (OR = 1.63; 95% CI: 1.06-2.50). In contrast, there were no significant changes in patient satisfaction with comprehension of self-care responsibilities, communication about psychosocial issues, or available visit time. Seven months post-introduction, patients were more likely to report that the computer helped the visit run in a more timely manner (OR = 1.76; 95% CI: 1.28-2.42) compared with the first month after introduction. There were no other significant changes in patient perceptions of the computer use over time. The examination room computers appeared to have positive effects on physician-patient interactions related to medical communication without significant negative effects on other areas such as time available for patient concerns. Further study is needed to better understand HIT use during outpatient visits.

  13. Cyber Savvy: Embracing Digital Safety and Civility

    Science.gov (United States)

    Willard, Nancy

    2012-01-01

    Concerns about children's online safety have evolved from protecting them to focusing on encouraging positive social norms, transmitting effective skills, and encouraging students to be helpful allies. In fact, federal law now requires schools that receive funding to educate students about cyber safety. Nancy Willard integrates her expertise in…

  14. Help Your Kids Be Savvy about Sunglasses.

    Science.gov (United States)

    PTA Today, 1994

    1994-01-01

    Children need to protect their eyes from the sun's harmful rays. Sunglasses with ultraviolet (UV) protection can help enhance the eye's ability to filter out damaging rays, but sunglasses without such protection may allow in more harmful rays. The article presents guidelines to help parents select safe, appropriate sunglasses for their children.…

  15. 10 Budget-Savvy Content Management Strategies

    Science.gov (United States)

    Hillis, David J.

    2004-01-01

    Facing an overall budget reduction of 10 percent, most colleges or universities would postpone investing in a Web content management system. However, for California State University Monterey Bay (CSUMB), a large budget cut made Web content management even more important. CSUMB found an innovative way to purchase and implement a new Content…

  16. Patient Portals as a Means of Information and Communication Technology Support to Patient-Centric Care Coordination – the Missing Evidence and the Challenges of Evaluation

    Science.gov (United States)

    Georgiou, Andrew; Hyppönen, Hannele; Ammenwerth, Elske; de Keizer, Nicolette; Magrabi, Farah; Scott, Philip

    2015-01-01

    Summary Objectives To review the potential contribution of Information and Communication Technology (ICT) to enable patient-centric and coordinated care, and in particular to explore the role of patient portals as a developing ICT tool, to assess the available evidence, and to describe the evaluation challenges. Methods Reviews of IMIA, EFMI, and other initiatives, together with literature reviews. Results We present the progression from care coordination to care integration, and from patient-centric to person-centric approaches. We describe the different roles of ICT as an enabler of the effective presentation of information as and when needed. We focus on the patient’s role as a co-producer of health as well as the focus and purpose of care. We discuss the need for changing organisational processes as well as the current mixed evidence regarding patient portals as a logical tool, and the reasons for this dichotomy, together with the evaluation principles supported by theoretical frameworks so as to yield robust evidence. Conclusions There is expressed commitment to coordinated care and to putting the patient in the centre. However to achieve this, new interactive patient portals will be needed to enable peer communication by all stakeholders including patients and professionals. Few portals capable of this exist to date. The evaluation of these portals as enablers of system change, rather than as simple windows into electronic records, is at an early stage and novel evaluation approaches are needed. PMID:26123909

  17. [Effects of application of pulse contour cardiac output monitoring technology in early treatment of patients with large area burns].

    Science.gov (United States)

    Wang, D Y; Xie, W G; Xi, M M; Li, Z; Wang, B

    2018-01-20

    Objective: To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period. Methods: Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours. The fluid infusion coefficients of patients at the first and second 24 hours post injury were calculated. The blood lactic acid values of patients from PID 1 to 7 were also recorded. The correlations among PCCI, SVRI, and GEDVI as well as the correlation between SVRI and blood lactic acid of these 18 patients were analyzed. Prognosis of patients were recorded. Data were processed with one-way analysis of variance, single sample t test and Bonferroni correction, Pearson correlation analysis, and Spearman rank correlation analysis. Results: (1) There was statistically significant difference in PCCI value of patients from post injury hour (PIH) 4 to 168 ( F =7.428, P 0.05). (2) There was statistically significant difference in SVRI value of patients from PIH 4 to 168 ( F =7.863, P 0.05). (3) There was no statistically significant difference in the GEDVI values of patients from PIH 4 to 168 ( F =0.704, P >0.05). The GEDVI values of patients at PIH 8, 12, 16, 20, and 24 were significantly lower than normal value ( t =-3.112, -3.554, -2.969, -2.450, -2.476, P 0.05). (4) There was statistically significant difference in EVLWI value of patients from PIH 4 to 168 ( F =1.859, P 0.05). (5) The fluid infusion

  18. Prejudices and perceptions: patient acceptance of mobile technology use in health care.

    Science.gov (United States)

    Alexander, S M; Nerminathan, A; Harrison, A; Phelps, M; Scott, K M

    2015-11-01

    mHealth is transforming health care, yet few studies have evaluated patient and carer perceptions of the use of smartphones at the patient bedside. In this study, 70 patients and carers answered a short survey on health professionals' use of mobile devices. Half the participants were tolerant of doctors using such devices if it was work-related; others believed it was a distraction and not beneficial to patient care. Changes in practice and patient education may be needed to enable effective use of mobile devices in health. © 2015 Royal Australasian College of Physicians.

  19. The Impact of Information Technology on Patient Engagement and Health Behavior Change: A Systematic Review of the Literature.

    Science.gov (United States)

    Sawesi, Suhila; Rashrash, Mohamed; Phalakornkule, Kanitha; Carpenter, Janet S; Jones, Josette F

    2016-01-21

    Advancements in information technology (IT) and its increasingly ubiquitous nature expand the ability to engage patients in the health care process and motivate health behavior change. Our aim was to systematically review the (1) impact of IT platforms used to promote patients' engagement and to effect change in health behaviors and health outcomes, (2) behavior theories or models applied as bases for developing these interventions and their impact on health outcomes, (3) different ways of measuring health outcomes, (4) usability, feasibility, and acceptability of these technologies among patients, and (5) challenges and research directions for implementing IT platforms to meaningfully impact patient engagement and health outcomes. PubMed, Web of Science, PsycINFO, and Google Scholar were searched for studies published from 2000 to December 2014. Two reviewers assessed the quality of the included papers, and potentially relevant studies were retrieved and assessed for eligibility based on predetermined inclusion criteria. A total of 170 articles met the inclusion criteria and were reviewed in detail. Overall, 88.8% (151/170) of studies showed positive impact on patient behavior and 82.9% (141/170) reported high levels of improvement in patient engagement. Only 47.1% (80/170) referenced specific behavior theories and only 33.5% (57/170) assessed the usability of IT platforms. The majority of studies used indirect ways to measure health outcomes (65.9%, 112/170). In general, the review has shown that IT platforms can enhance patient engagement and improve health outcomes. Few studies addressed usability of these interventions, and the reason for not using specific behavior theories remains unclear. Further research is needed to clarify these important questions. In addition, an assessment of these types of interventions should be conducted based on a common framework using a large variety of measurements; these measurements should include those related to motivation

  20. Patients' and Health Professionals' Experiences of Using Virtual Reality Technology for Upper Limb Training after Stroke: A Qualitative Substudy.

    Science.gov (United States)

    Pallesen, Hanne; Andersen, Mette Brændstrup; Hansen, Gunhild Mo; Lundquist, Camilla Biering; Brunner, Iris

    2018-01-01

    In recent years, virtual reality (VR) therapy systems for upper limb training after stroke have been increasingly used in clinical practice. Therapy systems employing VR technology can enhance the intensity of training and can also boost patients' motivation by adding a playful element to therapy. However, reports on user experiences are still scarce. A qualitative investigation of patients' and therapists' perspectives on VR upper limb training. Semistructured face-to-face interviews were conducted with six patients in the final week of the VR intervention. Therapists participated in two focus group interviews after the completion of the intervention. The interviews were analyzed from a phenomenological perspective emphasizing the participants' perceptions and interpretations. Five key themes were identified from the patients' perspectives: (i) motivational factors, (ii) engagement, (iii) perceived improvements, (iv) individualization, and (v) device malfunction. The health professionals described the same themes as the patients but less positively, emphasizing negative technical challenges. Patients and therapists mainly valued the intensive and motivational character of VR training. The playful nature of the training appeared to have a significant influence on the patients' moods and engagement and seemed to promote a "gung-ho" spirit, so they felt that they could perform more repetitions.

  1. Information and communication technology to support self-management of patients with mild acquired cognitive impairments: systematic review.

    Science.gov (United States)

    Eghdam, Aboozar; Scholl, Jeremiah; Bartfai, Aniko; Koch, Sabine

    2012-11-19

    Mild acquired cognitive impairment (MACI) is a new term used to describe a subgroup of patients with mild cognitive impairment (MCI) who are expected to reach a stable cognitive level over time. This patient group is generally young and have acquired MCI from a head injury or mild stroke. Although the past decade has seen a large amount of research on how to use information and communication technology (ICT) to support self-management of patients with chronic diseases, MACI has not received much attention. Therefore, there is a lack of information about what tools have been created and evaluated that are suitable for self-management of MACI patients, and a lack of clear direction on how best to proceed with ICT tools to support self-management of MACI patients. This paper aims to provide direction for further research and development of tools that can support health care professionals in assisting MACI patients with self-management. An overview of studies reporting on the design and/or evaluation of ICT tools for assisting MACI patients in self-management is presented. We also analyze the evidence of benefit provided by these tools, and how their functionality matches MACI patients' needs to determine areas of interest for further research and development. A review of the existing literature about available assistive ICT tools for MACI patients was conducted using 8 different medical, scientific, engineering, and physiotherapy library databases. The functionality of tools was analyzed using an analytical framework based on the International Classification of Functioning, Disability and Health (ICF) and a subset of common and important problems for patients with MACI created by MACI experts in Sweden. A total of 55 search phrases applied in the 8 databases returned 5969 articles. After review, 7 articles met the inclusion criteria. Most articles reported case reports and exploratory research. Out of the 7 articles, 4 (57%) studies had less than 10 participants, 5

  2. Effect of Kiken-Yochi training (KYT) induction on patient safety at the department of radiological technology

    International Nuclear Information System (INIS)

    Yasuda, Mitsuyoshi; Uchiyama, Yushi; Sakiyama, Koshi; Shibata, Masako; Sasaki, Haruaki; Kato, Kyoichi; Nakazawa, Yasuo; Sanbe, Takeyuki; Yoshikawa, Kohki

    2013-01-01

    In this report, we evaluated whether radiological technologists' (RTs') awareness of patient safety would improve and what kind of effects would be seen at the department of radiological technology by introducing KYT [K: kiken (hazard), Y: yochi (prediction), T: (training)]. KYT was carried out by ten RTs based on a KYT sheet for the department of radiological technology. To evaluate the effects of KYT, we asked nine questions each to ten participants before and after KYT enforcement with regard to their attitude to patient safety and to operating procedures for working safely. Significant improvements after KYT enforcement were obtained in two items concerning medical safety: It is important for any risk to be considered by more than one person; The interest in preventive measures against medical accident degree conducted now) and one concerning operating procedures (It is necessary to have a nurse assist during testing with the mobile X-ray apparatus) (p<0.05). Performing KYT resulted in improved awareness of the importance of patient safety. KYT also enabled medical staffers to evaluate objectively whether the medical safety measures currently performed would be effective for patients. (author)

  3. Early Patient Access to Medicines: Health Technology Assessment Bodies Need to Catch Up with New Marketing Authorization Methods.

    Science.gov (United States)

    Leyens, Lada; Brand, Angela

    National and international medicines agencies have developed innovative methods to expedite promising new medicines to the market and facilitate early patient access. Some of these approval pathways are the conditional approval and the adaptive pathways by the European Medicines Agency (EMA); the Promising Innovative Medicine (PIM) designation and the Early Access to Medicines Scheme (EAMS) by the Medicines and Healthcare Products Regulatory Agency (MHRA), as well as the Fast Track, Breakthrough or Accelerated Approval methods by the Food and Drug Administration (FDA). However, at least in Europe, these methods cannot achieve the goal of improving timely access for patients to new medicines on their own; the reimbursement process also has to become adaptive and flexible. In the past 2 years, the effective access (national patient access) to newly approved oncology drugs ranged from 1 to 30 months, with an extremely high variability between European countries. The goal of early patient access in Europe can only be achieved if the national health technology assessment bodies, such as NICE (ENG), HAS (FR), G-BA (DE) or AIFA (IT), provide harmonized, transparent, flexible, conditional and adaptive methods that adopt the level of evidence accepted by the medicines agencies. The efforts from medicines agencies are welcome but will be in vain if health technology assessments do not follow with similar initiatives, and the European 'postcode' lottery will continue. © 2016 S. Karger AG, Basel.

  4. Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols.

    Science.gov (United States)

    Schutt, Suann Cirigliano; Tarver, Christine; Pezzani, Michelle

    2018-01-01

    The study aim was to evaluate if continual patient position monitoring, taking into account self-turns and clinician-assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. While patient turning has clinical benefits, current models to help staff remember to turn patients, such as "turn clocks" and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2-hr windows (such as turning on "even" hours) rather than on individual patient activity, including self-turns. This is a first inpatient, non-randomized, pre-/postintervention study. Data collection occurred from May 2013-February 2014 on a 39-bed medical unit in a community hospital. Baseline patient turning data were recorded by a sensor; however, the patient data were not displayed at the nurses' station to establish compliance with the hospital's turning protocol. Postintervention, patient position information was wirelessly displayed on nurses' station computer monitors in real time. A Student t test was used to compare baseline to postintervention "mean time in compliance." Data from 138 patients ( N  =   7,854 hr of monitoring) were collected. The baseline phase yielded 4,322 hr of position monitoring data and the postintervention phase yielded 3,532 hr of data. Statistically significant improvement was demonstrated in the percentage of time a patient's position changed at least every 2 hr from baseline to postintervention.

  5. Patients' use and views of real-time feedback technology in general practice.

    Science.gov (United States)

    Wright, Christine; Davey, Antoinette; Elmore, Natasha; Carter, Mary; Mounce, Luke; Wilson, Ed; Burt, Jenni; Roland, Martin; Campbell, John

    2017-06-01

    There is growing interest in real-time feedback (RTF), which involves collecting and summarizing information about patient experience at the point of care with the aim of informing service improvement. To investigate the feasibility and acceptability of RTF in UK general practice. Exploratory randomized trial. Ten general practices in south-west England and Cambridgeshire. All patients attending surgeries were eligible to provide RTF. Touch screens were installed in waiting areas for 12 weeks with practice staff responsible for encouraging patients to provide RTF. All practices received fortnightly feedback summaries. Four teams attended a facilitated reflection session. RTF 'response rates' among consulting patients were estimated, and the representativeness of touch screen users were assessed. The frequency of staff-patient interactions about RTF (direct observation) and patient views of RTF (exit survey) were summarized. Associated costs were collated. About 2.5% consulting patients provided RTF (range 0.7-8.0% across practices), representing a mean of 194 responses per practice. Patients aged above 65 were under-represented among touch screen users. Receptionists rarely encouraged RTF but, when this did occur, 60% patients participated. Patients were largely positive about RTF but identified some barriers. Costs per practice for the twelve-week period ranged from £1125 (unfacilitated team-level feedback) to £1887 (facilitated team ± practitioner-level feedback). The main cost was the provision of touch screens. Response rates for RTF were lower than those of other survey modes, although the numbers of patients providing feedback to each practice were comparable to those achieved in the English national GP patient survey. More patients might engage with RTF if the opportunity were consistently highlighted to them. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  6. Older patients' use of technology for a post-discharge nutritional intervention - A mixed-methods feasibility study.

    Science.gov (United States)

    Lindhardt, T; Nielsen, M H

    2017-01-01

    Malnutrition is frequent in older people and a precursor for morbidity and hospitalisation; furthermore low intake and weight loss during and after hospitalisation is well-described. Such patients are often excluded from technology projects on account of lack of skills. This is a barrier for their access to many current and future health care offers. To test the acceptability, feasibility and preliminary efficacy of technology-supported energy- and protein-enforced homedelivered meals for older patients discharged from hospital. Mixed method design including a quasi-experimental controlled feasibility trial and embedded qualitative interviews. Older medical patients (mean age 79.4 years; women 66.7%) at nutritional risk and discharged to own home were included consecutively to first the control group (n=18) and later the intervention group (n=18). Nine intervention and 16 control group patients completed the project. Intervention: group received: 1) enriched meals delivered to participants' homes 12 weeks after discharge, and 2) a tablet computer combining goal setting for intake with self-monitoring and feedback. Control group were treated as usual. Data collection was done at baseline, and at six and 12 weeks follow-up. Feasibility evaluation focused on 1) inclusion and retention and 2) acceptability and functionality of the intervention. Efficacy primary endpoint: Muscle strength and BMI. Secondary: Health related quality of life (HRQoL), depression; readmissions, mortality. Technology challenges were related to immaturity of the out-of hospital app version; however, participants were motivated and capable of using the device. Inclusion and retention was challenged by the acceptability of the nutritional intervention and exhaustion among patients. Mortality was high. Although weaker at baseline the intervention group increased their muscle strength more consistently than did the control group: Handgrip strength with 2.5kg vs 0.9kg and chairto-stand-test with 3

  7. Bridging medicine and biomedical technology: enhance translation of fundamental research to patient care.

    Science.gov (United States)

    Raff, Adam B; Seiler, Theo G; Apiou-Sbirlea, Gabriela

    2017-12-01

    The 'Bridging medicine and biomedical technology' special all-congress session took place for the first time at the OSA Biophotonics Congress: Optics in Life Sciences in 2017 (http://www.osa.org/enus/meetings/osa_meetings/optics_in_the_life_sciences/bridging_medicine_and_biomedical_technology_specia/). The purpose was to identify key challenges the biomedical scientists in academia have to overcome to translate their discoveries into clinical practice through robust collaborations with industry and discuss best practices to facilitate and accelerate the process. Our paper is intended to complement the session by providing a deeper insight into the concept behind the structure and the content we developed.

  8. Capturing patient-reported area of knee pain: a concurrent validity study using digital technology in patients with patellofemoral pain.

    Science.gov (United States)

    Matthews, Mark; Rathleff, Michael S; Vicenzino, Bill; Boudreau, Shellie A

    2018-01-01

    Patellofemoral pain (PFP) is often reported as a diffuse pain at the front of the knee during knee-loading activities. A patient's description of pain location and distribution is commonly drawn on paper by clinicians, which is difficult to quantify, report and compare within and between patients. One way of overcoming these potential limitations is to have the patient draw their pain regions using digital platforms, such as personal computer tablets. To assess the validity of using computer tablets to acquire a patient's knee pain drawings as compared to paper-based records in patients with PFP. Patients ( N = 35) completed knee pain drawings on identical images (size and colour) of the knee as displayed on paper and a computer tablet. Pain area expressed as pixel density, was calculated as a percentage of the total drawable area for paper and digital records. Bland-Altman plots, intraclass correlation coefficient (ICC), Pearson's correlation coefficients and one-sample tests were used in data analysis. No significant difference in pain area was found between the paper and digital records of mapping pain area ( p = 0.98), with the mean difference = 0.002% (95% CI [-0.159-0.157%]). A very high agreement in pain area between paper and digital pain drawings (ICC = 0.966 (95% CI [0.93-0.98], F = 28.834, df = 31, p digital drawings. Pain drawings as acquired using paper and computer tablet are equivalent in terms of total area of reported knee pain. The advantages of digital recording platforms, such as quantification and reporting of pain area, could be realized in both research and clinical settings.

  9. Development and application of the informational and communication technologies in quality standards of health care management for patients with arterial hypertension.

    Science.gov (United States)

    Smііanov, V; Smiianova, O; Tarasenko, S

    2014-01-01

    Mobile health technologies improve the quality of health care service. The information and communication technology is developed and applied to remind patients with arterial hypertension to follow medical recommendations. The feedback system from general practitioners was developed (the reminder system for patients sending the feedbacks). It helped to supervise follow-up patients online. Suggested system provides for forming the database for summarized analysis of online survey of the patients, who receive medical care at health care institution, to take managerial decisions concerning the improvements of medical services quality. Evaluation of efficiency of the applied technology assured that the number of patients, who checked regularly his/her arterial pressure, increased by 31.00%. The number of patients, who visited doctors for preventive purpose two or more times during given year, rose by 18.24%. The number of patients with target pressure grew by 24.51% and composed 38.55±4.26%.

  10. Aging and technology in medical care: using the example of patient controllers in deep brain stimulation.

    Science.gov (United States)

    Kaiser, Iris; Oppenauer-Meerskraut, Claudia; Kryspin-Exner, Ilse; Czech, Thomas; Alesch, François

    2010-11-01

    Deep brain stimulation is a neurosurgical therapy for patients with advanced movement disorders (e.g., Parkinson's disease). This therapy involves the use of a patient controller for home-use. So far, there are four different patient controllers available on the European market. However, use and acceptance of the patient controller is relatively low. The main end-user group is patients above the age of 60 years. This article compares the design of the different interfaces, with a special focus on gerotechnological aspects (display, acoustic signals, coloring, lettering, cognitive load and haptics). We suggest strategies to optimize the use and acceptance of these devices, which have already entered the market. Moreover, future directions of deep brain stimulation and the usability of patient controllers are discussed.

  11. Coevolution of patients and hospitals: how changing epidemiology and technological advances create challenges and drive organizational innovation.

    Science.gov (United States)

    Lega, Federico; Calciolari, Stefano

    2012-01-01

    Over the last 20 years, hospitals have revised their organizational structures in response to new environmental pressures. Today, demographic and epidemiologic trends and recent technological advances call for new strategies to cope with ultra-elderly frail patients characterized by chronic conditions, high-severity health problems, and complex social situations. The main areas of change surround new ways of managing emerging clusters of patients whose needs are not efficiently or effectively met within traditional hospital organizations. Following the practitioner and academic literature, we first identify the most relevant clusters of new kinds of patients who represent an increasingly larger share of the hospital population in developed countries. Second, we propose a framework that synthesizes the major organizational innovations adopted by successful organizations around the world. We conclude by substantiating the trends of and the reasoning behind the prospective pattern of hospital organizational development.

  12. A preliminary field study of patient flow management in a trauma center for designing information technology*

    OpenAIRE

    Gurses, Ayse P.; Hu, Peter; Gilger, Sheila; Dutton, Richard P.; Trainum, Therese; Ross, Kathy; Xiao, Yan

    2006-01-01

    We described the information transfer and communication activities of nurse coordinators (NCO), who lead patient flow management in a major trauma center. A field study was conducted to identify information sources and information tools used, leading purposes of communication, and the information types NCOs need for patient flow management. In addition to verbal communication, NCOs frequently used a combination of patient-oriented and process-oriented information tools.

  13. Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols

    OpenAIRE

    Schutt, Suann Cirigliano; Tarver, Christine; Pezzani, Michelle

    2017-01-01

    Abstract Aim The study aim was to evaluate if continual patient position monitoring, taking into account self‐turns and clinician‐assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. Background While patient turning has clinical benefits, current models to help staff remember to turn patients, such as “turn clocks” and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2‐hr windo...

  14. Technological aided assessment of the acutely ill patient - The case of postoperative complications

    DEFF Research Database (Denmark)

    Haahr-Raunkjær, C.; Meyhoff, C. S.; Sørensen, H. B.D.

    2017-01-01

    complications.Several wireless systems are being developed for monitoring vital parameters, but many of these are not yet validated for critically ill patients. The ultimate goal with patient monitoring and detect of events is to prevent postoperative complications, death and costs in the health care system....... A few studies indicate that monitoring systems detect deteriorating patients earlier than the nurses, and this was associated with less clinical instability.An important caveat of future devices is to assess their effect in relevant patient populations and not only in healthy test...

  15. Accuracy of patient's turnover time prediction using RFID technology in an academic ambulatory surgery center.

    Science.gov (United States)

    Marchand-Maillet, Florence; Debes, Claire; Garnier, Fanny; Dufeu, Nicolas; Sciard, Didier; Beaussier, Marc

    2015-02-01

    Patients flow in outpatient surgical unit is a major issue with regards to resource utilization, overall case load and patient satisfaction. An electronic Radio Frequency Identification Device (RFID) was used to document the overall time spent by the patients between their admission and discharge from the unit. The objective of this study was to evaluate how a RFID-based data collection system could provide an accurate prediction of the actual time for the patient to be discharged from the ambulatory surgical unit after surgery. This is an observational prospective evaluation carried out in an academic ambulatory surgery center (ASC). Data on length of stay at each step of the patient care, from admission to discharge, were recorded by a RFID device and analyzed according to the type of surgical procedure, the surgeon and the anesthetic technique. Based on these initial data (n = 1520), patients were scheduled in a sequential manner according to the expected duration of the previous case. The primary endpoint was the difference between actual and predicted time of discharge from the unit. A total of 414 consecutive patients were prospectively evaluated. One hundred seventy four patients (42%) were discharged at the predicted time ± 30 min. Only 24% were discharged behind predicted schedule. Using an automatic record of patient's length of stay would allow an accurate prediction of the discharge time according to the type of surgery, the surgeon and the anesthetic procedure.

  16. The Use of Assistive Technology to Promote Care of the Self and Social Inclusion in Patients with Sequels of Leprosy

    Science.gov (United States)

    2016-01-01

    Background This study is about the contribution of occupational therapy inside a rehabilitation group, and we focus on the autonomy of patients with disabilities due to leprosy. There are few studies on the use of assistive technology by leprosy patients; to our knowledge, none of them aim to have a subjective approach of care. Our purpose was to analyze the repercussions of assistive technology on autonomy of care of the self in patients with sequels of leprosy. Methods A qualitative, descriptive exploratory study with a semi-structured interview and a field observation as a research method was conducted between November 2014 and February 2015 at a University Hospital in Rio de Janeiro. Findings Eight patients from the service of Occupational Therapy were interviewed, and 44 hours of observation were performed. Interviews followed a semi-structured script and a field journal was used to take notes. Analysis was conducted by the hermeneutic approach. Costs were obtained after a global cost analysis of the fixed and variable expenses and direct and indirect costs to the manufactured products with an amount of 100 dollars. Results were grouped according to the following categories: contribution of the adapted devices for the care of the self and feelings and sensations provoked by the use of self-help devices. The reports revealed feelings, perceptions and meaningful contents about the social, familiar and individual dimensions, also the stigma coupled with leprosy. However, forms of re-signification were elaborated. Conclusions Assistive technology empowers the subject to perform care of the self and promotes social inclusion. PMID:27124408

  17. Barriers to the use of e-health technology in nurse practitioner_patient consultations

    Directory of Open Access Journals (Sweden)

    Ann Adams

    2007-06-01

    Conclusions Study NPs had received only very limited information technology (IT training, but nevertheless were enthusiastic about computer use. This suggests that with further training they could adapt their practice to embrace more EHT, which would enhance their ability to be more autonomous and to base their practice on sound clinical evidence.

  18. Comparison Between Infrared Optical and Stereoscopic X-Ray Technologies for Patient Setup in Image Guided Stereotactic Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tagaste, Barbara, E-mail: tagaste@cnao.it [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Riboldi, Marco [Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Spadea, Maria F. [TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Department of Experimental and Clinical Medicine, Universita degli Studi Magna Graecia, Catanzaro (Italy); Bellante, Simone [TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Baroni, Guido [Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Cambria, Raffaella; Garibaldi, Cristina [Medical Physics, European Institute of Oncology, Milano (Italy); Ciocca, Mario [Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Medical Physics, European Institute of Oncology, Milano (Italy); Catalano, Gianpiero [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Unit of Radiotherapy, Multimedica Holding Clinical Institute, Castellanza (Italy); Alterio, Daniela [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Orecchia, Roberto [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Department of Science and Biomedical Technologies, Universita di Milano, Milano (Italy)

    2012-04-01

    Purpose: To compare infrared (IR) optical vs. stereoscopic X-ray technologies for patient setup in image-guided stereotactic radiotherapy. Methods and Materials: Retrospective data analysis of 233 fractions in 127 patients treated with hypofractionated stereotactic radiotherapy was performed. Patient setup at the linear accelerator was carried out by means of combined IR optical localization and stereoscopic X-ray image fusion in 6 degrees of freedom (6D). Data were analyzed to evaluate the geometric and dosimetric discrepancy between the two patient setup strategies. Results: Differences between IR optical localization and 6D X-ray image fusion parameters were on average within the expected localization accuracy, as limited by CT image resolution (3 mm). A disagreement between the two systems below 1 mm in all directions was measured in patients treated for cranial tumors. In extracranial sites, larger discrepancies and higher variability were observed as a function of the initial patient alignment. The compensation of IR-detected rotational errors resulted in a significantly improved agreement with 6D X-ray image fusion. On the basis of the bony anatomy registrations, the measured differences were found not to be sensitive to patient breathing. The related dosimetric analysis showed that IR-based patient setup caused limited variations in three cases, with 7% maximum dose reduction in the clinical target volume and no dose increase in organs at risk. Conclusions: In conclusion, patient setup driven by IR external surrogates localization in 6D featured comparable accuracy with respect to procedures based on stereoscopic X-ray imaging.

  19. Electronic health information technology as a tool for improving quality of care and health outcomes for HIV/AIDS patients.

    Science.gov (United States)

    Virga, Patricia H; Jin, Bongguk; Thomas, Jesse; Virodov, Sergey

    2012-10-01

    This paper presents research on the interplay of health information technology (HIT), quality improvement and progression of health status. The purpose of the research was to determine whether electronic exchange of health information impacts quality of care and, by extension, health outcomes of patients with HIV/AIDS. The research was supported as a demonstration project under the Information Technology Networks of Care Initiative sponsored by the U.S. Health Resources and Services Administration, HIV/AIDS Bureau, Special Projects of National Significance (SPNS). The City of Paterson, New Jersey, Department of Health and Human Services administered the project as the grant recipient, secured and managed through the City of Paterson's Ryan White Part A Program of Bergen and Passaic Counties. We implemented a web-based health information support system, e2, to facilitate rigorous quality improvement activities associated with care and treatment of HIV/AIDS patients. We used e2 to monitor patient care in the clinic setting. We observed five quality and two health status indicators relating to the care of 263 HIV/AIDS medical patients at three HIV/AIDS medical clinics from 2008 to 2010. The quality indicators conformed to HIV/AIDS Bureau (HAB) Groups 1 and 2 definitions of two or more CD4 T-cell counts performed in the measurement year, AIDS patients prescribed HAART, two or more medical visits in the measurement year, PCP prophylaxis administered to AIDS patients with CD4 T-cell counts quality management activities, leading to improved quality of care and health status of HIV/AIDS patients across all three clinics. Significant improvements were observed in three of the five quality indicators and in both of the two health status indicators. We conclude that health information technology as a tool for rigorous application of quality improvement methods can positively impact quality of care and health outcomes. We found that health outcomes improved over time when

  20. A Framework for Incorporating Patient Preferences Regarding Benefits and Risks into Regulatory Assessment of Medical Technologies.

    Science.gov (United States)

    Ho, Martin; Saha, Anindita; McCleary, K Kimberly; Levitan, Bennett; Christopher, Stephanie; Zandlo, Kristen; Braithwaite, R Scott; Hauber, A Brett

    In response to 2012 guidance in which the US Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) stated the importance of patient-centric measures in regulatory benefit-risk assessments, the Medical Device Innovation Consortium (MDIC) initiated a project. The project was used to develop a framework to help the Food and Drug Administration (FDA) and industry sponsors understand how patient preferences regarding benefit and risk might be integrated into the review of innovative medical devices. A public-private partnership of experts from medical device industry, government, academia and non-profits collaborated on development of the MDIC patient centered benefit-risk framework. The MDIC Framework examines what patient preference information is and the potential use and value of patient preference information in the regulatory process and across the product development life cycle. The MDIC Framework also includes a catalog of patient preference assessment methods and an agenda for future research to advance the field. This article discusses key concepts in patient preference assessment of particular importance for regulators and researchers that are addressed in the MDIC Framework for patient centered benefit-risk assessment as well as the unique public-private collaboration that led its development. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Diagnosis at a distance: the invisible work of patients and healthcare professionals in cardiac telemonitoring technology

    NARCIS (Netherlands)

    Oudshoorn, Nelly E.J.

    2008-01-01

    Although patients are often absent in discourses on telemedicine, many telemonitoring applications constitute a new medical practice in which patients are expected to play an active role. The paper is based on a study of the use of one specific telemonitoring device, an ambulatory ECG recorder

  2. Electronic-nose technology using sputum samples in diagnosis of patients with tuberculosis

    NARCIS (Netherlands)

    Kolk, A.; Hoelscher, M.; Maboko, L.; Jung, J.; Kuijper, S.; Cauchi, M.; Bessant, C.; van Beers, S.; Dutta, R.; Gibson, T.; Reither, K.

    2010-01-01

    We investigated the potential of two different electronic noses (EN; code named "Rob" and "Walter") to differentiate between sputum headspace samples from tuberculosis (TB) patients and non-TB patients. Only samples from Ziehl-Neelsen stain (ZN)- and Mycobacterium tuberculosis culture-positive

  3. Gluten, pills and talk : assessing emergent technologies from a patients'perspective

    NARCIS (Netherlands)

    Veen, M.

    2011-01-01

    How can research in the area of celiac disease take patients into account? Celiac disease is an intolerance for gluten, for which a lifelong gluten-free diet is the only treatment currently available. The aim of this thesis is to gain insight into the everyday life of patients, so as to better align

  4. Enhancement of Cognitive Processing by Multiple Sclerosis Patients Using Liquid Cooling Technology: A Case Study

    Science.gov (United States)

    Montgomery, Leslie D.; Montgomery, Richard W.; Ku, Yu-Tsuan; Luna, Bernadette (Technical Monitor)

    1997-01-01

    Cognitive dysfunction is a common symptom in patients with multiple sclerosis (MS). This can have a significant impact on the quality of life of both the patient and of their primary care giver. This case study explores the possibility that liquid cooling therapy may be used to enhance the cognitive processing of MS patients in the same way that it provides temporary relief of some physical impairment. Two MS patients were presented a series of pattern discrimination tasks before and after being cooled with a liquid cooling garment for a one hour period. The subject whose ear temperature was reduced during cooling showed greater electroencephalographic (EEG) activity and scored much better on the task after cooling. The patient whose ear temperature was unaffected by cooling showed less EEG activity and degraded performance after the one hour cooling period.

  5. Bedside patient data viewer using RFID and e-Ink technology.

    Science.gov (United States)

    Nikodijevic, Aleksandar; Pichler, Patrick; Forjan, Mathias; Sauermann, Stefan

    2014-01-01

    In the daily routine of hospitals, which work with paper based medical records, the staff has to find the appropriate patient file if it needs information about the patient. With the introduction of ELGA the Austrian hospitals have to use specific standards for their clinical documentation. These structured documents can be used to feed an e-Ink reader with information about every patient in a hospital. Combined with RFID and security measures, the clinical staff is supported during the patient file searching process. The developed experimental setup of the Bedside Patient Data Viewer demonstrates a prototype of such a system. An Amazon Kindle Paperwhite is used to display processed data, supplied by a Raspberry Pi with an attached RFID module for identification purposes. Results show that such a system can be implemented, however a lot of organizational and technical issues remain to be solved.

  6. Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial

    DEFF Research Database (Denmark)

    Jacobsen, Anna Svarre; Laursen, Lars C; Østergaard, Birte

    2013-01-01

    phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional...... hospital treatment measured according to first treatment failure, which is defined as readmission due to COPD within 30 days after discharge.......Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable...

  7. A methodology for incorporating web technologies into a computer-based patient record, with contributions from cognitive science.

    Science.gov (United States)

    Webster, Charles

    2002-12-18

    Cognitive science is a rich source of insight for creative use of new Web technologies by medical informatics workers. I outline a project to Web-enable an existing computer-based patient record (CPR) in the context of ideas from philosophy, linguistics, artificial intelligence, and cognitive psychology. Web prototypes play an important role (a) because Web technology lends itself to rapid prototype development, and (b) because prototypes help team members bridge among disparate medical, computing, and business ontologies. Six Web-enabled CPR prototypes were created and ranked. User scenarios were generated using a user communication matrix. Resulting prototypes were compared according to the degree to which they satisfied medical, computing, and business constraints. In a different organization, or at different time, candidate prototypes and their ranking might have been different. However, prototype generation and comparison are fundamentally influenced by factors usefully understood in a cognitive science framework.

  8. Could we offer mitochondrial donation or similar assisted reproductive technology to South African patients with mitochondrial DNA disease?

    Science.gov (United States)

    Meldau, Surita; Riordan, Gillian; Van der Westhuizen, Francois; Elson, Joanna L; Smuts, Izelle; Pepper, Michael S; Soodyall, Himla

    2016-02-02

    The decision of the UK House of Commons in 2015 to endorse the use of pioneering in vitro fertilisation techniques to protect future generations from the risk of mitochondrial DNA (mtDNA) disease has sparked worldwide controversy and debate. The availability of such technologies could benefit women at risk of transmitting deleterious mutations. MtDNA disease certainly occurs in South Africa (SA) in all population groups. However, diagnostic strategies and practices for identifying individuals who would benefit from technologies such as IVF have in the past been suboptimal in this country. New developments in the molecular diagnostic services available to SA patients, as well as better education of referring clinicians and the implementation of more structured, population-appropriate diagnostic strategies, may open the floor to this debate in SA.

  9. Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application

    Directory of Open Access Journals (Sweden)

    Philipp Honigmann

    2018-01-01

    Full Text Available Additive manufacturing (AM is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI are well-established processes in the surgical fields. Polyetheretherketone (PEEK has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a “biomimetic” design.

  10. Pilot implementation of a technologically advanced system for the optimization of pre-hospital, trauma patient care.

    Science.gov (United States)

    Vagianos, Constantine E; Dimopoulou, Efi; Tsiftsis, Dimitrios; Spyropoulos, Charalambos; Spyrakopoulos, Panagiotis; Vagenas, Konstantinos

    2010-07-01

    Cooperation between medical informatics, wireless communication and pre-hospital emergency services is essential for the optimal pre-hospital patient treatment. The use of technological innovations improves medical care in the pre-hospital setting with regard to the organization of an integrated center, which coordinates all parties involved for the patient's best interest. A dispatch center was developed in the city of Patras, in southwestern Greece, equipped with a Geographic Information System (GIS), which immediately points out the location of emergency vehicles (EVs) on a digital map depicting the city plan. Additionally, three ambulances of the National Center of Immediate Aid (NCIA) were equipped with a decentralized traffic management system for the vehicle's traffic priority at signaled junctions. The system consisted of a cellular-based (GSM) telemedicine module, a Global Positioning System (GPS) and a web camera system in the vehicle cabin. The aforementioned system provided considerable assistance to the pre-hospital treatment first by selecting the ambulance closest to the accident's location and then by pinpointing the optimum route to the hospital, thus significantly reducing the overall transportation time. The project's objective to coordinate emergency hospital departments involved in the treatment of trauma patients with other emergency services by utilizing high technology was achieved within this interdisciplinary effort.

  11. Understanding the digital divide in the clinical setting: the technology knowledge gap experienced by US safety net patients during teleretinal screening.

    Science.gov (United States)

    George, Sheba; Moran, Erin; Fish, Allison; Ogunyemi, Lola

    2013-01-01

    Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 African-American and 4 Latino) were conducted with patients who received teleretinal screenings in U.S. urban safety-net settings. Findings indicate that patients' "knowledge gap" is primarily produced at three points: (1) when patients' preexisting personal barriers to care became exacerbated in the clinical setting; (2) through encounters with technology during screening; and (3) in doctor-patient follow-up. This "knowledge gap" can produce confusion and fear, potentially affecting patients' confidence in quality of care and limiting their disease management ability. In rethinking the digital divide to include the consequences of this knowledge gap faced by patients in the clinical setting, we suggest that patient education focus on both their disease and specific telehealth technologies deployed in care delivery.

  12. The use of information technology to enhance patient safety and nursing efficiency.

    Science.gov (United States)

    Lee, Tso-Ying; Sun, Gi-Tseng; Kou, Li-Tseng; Yeh, Mei-Ling

    2017-10-23

    Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this. The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan. This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, bar code scanning, shift handover, and information and communication integration. Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34). Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment.

  13. CAD/CAM technologies in the surgical and prosthetic treatment of the edentulous patient with biomymetic individualized approach.

    Science.gov (United States)

    Pozzi, A; Gargari, M; Barlattani, A

    2008-04-01

    The advent of modern endosseous implant design and improved surface technology has allowed the development of new restorative techniques that decrease patient's total treatment time. Utilizing the latest scanning, CAD/CAM and manufacturing technolgies we are able to manufacture individualized dental restoration with high accuracy and a perfect precision of fit. This report describes the rehabilitation of a completely edentulous patient utilizing a CT-based implant planning with computer-assisted surgical design, simultaneous CAD/CAM fabrication of a surgical template, a flapless surgical placement of the implants, and a prefabricated fixed complete denture for an immediately loaded restoration according to Nobel Biocare's Teeth-in-an-Hour™ (Nobel Biocare Goteborg, Sweden) protocol. This systematic approach to full mouth rehabilitation reduces the time necessary for an edentulous patient to go from severely atrophic alveolar support to implant retained prosthetic restoration. These aspects of minimally invasive and simplified surgery, along with reducing the treatment time and postsurgical discomfort, are beneficial to the patient, and allowing for rehabilitation with the same level of success as in flap surgery. The Teeth-in-an-Hour protocol is a unique solution made possible by the Procera System. With the aid of the CT scans and a virtual planning software, a custom fabricated precision drill guide and a pre-manufactured prosthesis can be made before surgery. The execution of implant placement is performed with a flapless procedure that results in minimal surgical intervention. This results in a short and non-traumatic surgery with a minimum of postoperative complications, allowing the patient to leave the chair with a fixed prosthesis. Utilizing the latest scanning, CAD/CAM and manufacturing technologies the dental team is able to develop individualized zirconia full arch framework with high accuracy and precision of fit.

  14. Wearable cardioverter defibrillators for the prevention of sudden cardiac arrest: a health technology assessment and patient focus group study

    Directory of Open Access Journals (Sweden)

    Ettinger S

    2017-11-01

    Full Text Available Sabine Ettinger,1 Michal Stanak,1 Piotr Szymański,2 Claudia Wild,1 Romana Tandara Haček,3 Darija Erčević,3 Renata Grenković,3 Mirjana Huić3 1Ludwig Boltzmann Institute for Health Technology Assessment, Vienna, Austria; 2Institute of Cardiology, Warsaw, Poland; 3Department for Development, Research and Health Technology Assessment, Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, Croatia Aim: To summarize the evidence on clinical effectiveness and safety of wearable cardioverter defibrillator (WCD therapy for primary and secondary prevention of sudden cardiac arrest in patients at risk. Methods: We performed a systematic literature search in databases including MEDLINE via OVID, Embase, the Cochrane Library, and CRD (DARE, NHS-EED, HTA. The evidence obtained was summarized according to GRADE methodology. A health technology assessment (HTA was conducted using the HTA Core Model® for rapid relative effectiveness assessment. Primary outcomes for the clinical effectiveness domain were all-cause and disease-specific mortality. Outcomes for the safety domain were adverse events (AEs and serious adverse events (SAEs. A focus group with cardiac disease patients was conducted to evaluate ethical, organizational, patient, social, and legal aspects of the WCD use. Results: No randomized- or non-randomized controlled trials were identified. Non-comparative studies (n=5 reported AEs including skin rash/itching (6%, false alarms (14%, and palpitations/light-headedness/fainting (9% and discontinuation due to comfort/lifestyle issues (16–22%, and SAEs including inappropriate shocks (0–2%, unsuccessful shocks (0–0.7%, and death (0–0.3%. The focus group results reported that experiencing a sense of security is crucial to patients and that the WCD is not considered an option for weeks or even months due to expected restrictions in living a “normal” life. Conclusion: The WCD appears to be relatively safe for short

  15. Hybrid technologies in surgical treatment of patients with concomitant atherosclerotic lesions of carotid and coronary arteries

    Directory of Open Access Journals (Sweden)

    А. М. Чернявский

    2015-10-01

    Full Text Available Cardiovascular diseases, which have their origins in atherosclerosis, are the "leaders" in morbidity and mortality among the population in many countries. Given the increase of elderly people in the population, it is important to choose the best strategy for surgical treatment of patients with combined atherosclerotic lesions of several arteries (coronary arteries, carotid arteries, peripheral arteries of the lower extremities, atherosclerosis visceral branches of the abdominal aorta. Currently, there is yet no common approach to the timing and sequence of revascularization surgery in this group of patients. The rapid development of endovascular techniques enables us to carry out the so-called hybrid procedures in patients with atherosclerotic lesions of several arteries. In this article we analyze different strategies that are used to manage patients with both coronary and carotid arteries atherosclerotic lesions.

  16. Continuous remote monitoring of COPD patients-justification and explanation of the requirements and a survey of the available technologies.

    Science.gov (United States)

    Tomasic, Ivan; Tomasic, Nikica; Trobec, Roman; Krpan, Miroslav; Kelava, Tomislav

    2018-04-01

    Remote patient monitoring should reduce mortality rates, improve care, and reduce costs. We present an overview of the available technologies for the remote monitoring of chronic obstructive pulmonary disease (COPD) patients, together with the most important medical information regarding COPD in a language that is adapted for engineers. Our aim is to bridge the gap between the technical and medical worlds and to facilitate and motivate future research in the field. We also present a justification, motivation, and explanation of how to monitor the most important parameters for COPD patients, together with pointers for the challenges that remain. Additionally, we propose and justify the importance of electrocardiograms (ECGs) and the arterial carbon dioxide partial pressure (PaCO 2 ) as two crucial physiological parameters that have not been used so far to any great extent in the monitoring of COPD patients. We cover four possibilities for the remote monitoring of COPD patients: continuous monitoring during normal daily activities for the prediction and early detection of exacerbations and life-threatening events, monitoring during the home treatment of mild exacerbations, monitoring oxygen therapy applications, and monitoring exercise. We also present and discuss the current approaches to decision support at remote locations and list the normal and pathological values/ranges for all the relevant physiological parameters. The paper concludes with our insights into the future developments and remaining challenges for improvements to continuous remote monitoring systems. Graphical abstract ᅟ.

  17. Patients' views and experiences of technology based self-management tools for the treatment of hypertension in the community: A qualitative study.

    Science.gov (United States)

    Glynn, Liam; Casey, Monica; Walsh, Jane; Hayes, Patrick S; Harte, Richard P; Heaney, David

    2015-09-09

    Patients with hypertension in the community frequently fail to meet treatment goals. The optimal way to organize and deliver care to hypertensive patients has not been clearly identified. The powerful on-board computing capacity of mobile devices, along with the unique relationship individuals have with newer technologies, suggests that they have the potential to influence behaviour. However, little is known regarding the views and experiences of patients using such technology to self-manage their hypertension and associated lifestyle behaviours. The aim of this study was to explore patients' views and experiences of using technology based self-management tools for the treatment of hypertension in the community. This focus group study was conducted with known hypertensive patients over 45 years of age who were recruited in a community setting in Ireland. Taped and transcribed semi-structured interviews with a purposeful sample involving 50 participants in six focus groups were used. Framework analysis was utilized to analyse the data. Four key inter-related themes emerged from the analysis: individualisation; trust; motivation; and communication. The globalisation of newer technologies has triggered many substantial and widespread behaviour changes within society, yet users are unique in their use and interactions with such technologies. Trust is an ever present issue in terms of its potential impact on engagement with healthcare providers and motivation around self-management. The potential ability of technology to influence motivation through carefully selected and tailored messaging and to facilitate a personalised flow of communication between patient and healthcare provider was highlighted. Newer technologies such as mobile devices and the internet have been embraced across the globe despite technological challenges and concerns regarding privacy and security. In the design and development of technology based self-management tools for the treatment of

  18. Individualised controlled ovarian stimulation (iCOS: maximising success rates for assisted reproductive technology patients

    Directory of Open Access Journals (Sweden)

    Bosch Ernesto

    2011-06-01

    Full Text Available Abstract Background In the last two decades, pregnancy rates for patients undergoing in-vitro fertilisation (IVF have significantly increased. Some of the major advances responsible for this improvement were the introduction of controlled ovarian stimulation (COS for the induction of multiple follicle development, and the utilisation of mid-luteal gonadotropin-releasing hormone agonists to achieve pituitary down-regulation and full control of the cycle. As a result, a combination of a gonadotropin-releasing hormone agonist with high doses (150-450 IU/day of recombinant follicle-stimulating hormone has become the current standard approach for ovarian stimulation. However, given the heterogeneity of patients embarking on IVF, and the fact that many different drugs can be used alone or in different combinations (generating multiple potential protocols of controlled ovarian stimulation, we consider the need to identify special populations of patients and adapt treatment protocols accordingly, and to implement a more individualised approach to COS. Discussion Studies on mild, minimal and natural IVF cycles have yielded promising results, but have focused on fresh embryo transfers and included relatively young patient populations who generally have the potential for more favourable outcomes. The efficacy of these protocols in patients with a poorer prognosis remains to be tested. When comparing protocols for COS, it is important to think beyond current primary endpoints, and to consider the ideal quality and quantity of oocytes and embryos being produced per stimulated patient, in order to achieve a pregnancy. We should also focus on the cumulative pregnancy rate, which is based on outcomes from fresh and frozen embryos from the same cycle of stimulation. Individualised COS (iCOS determined by the use of biomarkers to test ovarian reserve has the potential to optimise outcomes and reduce safety issues by adapting treatment protocols according to each

  19. Wireless Patient Monitoring System Using Point to Multi Point Zigbee Technology

    Directory of Open Access Journals (Sweden)

    Aung Soe Phyo

    2015-06-01

    Full Text Available ABSTRACT A ZigBee sensor network for data acquisition and monitoring is presented in this paper. A ZigBee module is connected via a USB interface to a Microsoft Windows PC which works as a base station in the network. Data collected by sensor devices are sent to the base station PC which is set as Wireless sensorNetwork WSN. ZigBee is low power consumption built-in security method and ratified specifications make it very suitable to be used with medical sensor devices.This application of Zigbee based network consists of two transmitter sections and a receiver section.Each transmitter section consists of heartbeat sensor body temperature sensor microcontroller Zigbee and LCD module.In the proposed system the patients health is continuously monitored and theacquired data is analyzed at a personal computer using Graphical User InterfaceGUI. If a particular patients health parameter is higher or lower the threshold values an alarm system is used to alert the doctor. The aim of this system is to know the condition of patients health by the doctor immediately and to reduce the load of the staff taking care of the patient in the hospitals. In this paper wireless point to multipoint system is used between doctor and patient.

  20. Querying phenotype-genotype relationships on patient datasets using semantic web technology: the example of Cerebrotendinous xanthomatosis.

    Science.gov (United States)

    Taboada, María; Martínez, Diego; Pilo, Belén; Jiménez-Escrig, Adriano; Robinson, Peter N; Sobrido, María J

    2012-07-31

    Semantic Web technology can considerably catalyze translational genetics and genomics research in medicine, where the interchange of information between basic research and clinical levels becomes crucial. This exchange involves mapping abstract phenotype descriptions from research resources, such as knowledge databases and catalogs, to unstructured datasets produced through experimental methods and clinical practice. This is especially true for the construction of mutation databases. This paper presents a way of harmonizing abstract phenotype descriptions with patient data from clinical practice, and querying this dataset about relationships between phenotypes and genetic variants, at different levels of abstraction. Due to the current availability of ontological and terminological resources that have already reached some consensus in biomedicine, a reuse-based ontology engineering approach was followed. The proposed approach uses the Ontology Web Language (OWL) to represent the phenotype ontology and the patient model, the Semantic Web Rule Language (SWRL) to bridge the gap between phenotype descriptions and clinical data, and the Semantic Query Web Rule Language (SQWRL) to query relevant phenotype-genotype bidirectional relationships. The work tests the use of semantic web technology in the biomedical research domain named cerebrotendinous xanthomatosis (CTX), using a real dataset and ontologies. A framework to query relevant phenotype-genotype bidirectional relationships is provided. Phenotype descriptions and patient data were harmonized by defining 28 Horn-like rules in terms of the OWL concepts. In total, 24 patterns of SWQRL queries were designed following the initial list of competency questions. As the approach is based on OWL, the semantic of the framework adapts the standard logical model of an open world assumption. This work demonstrates how semantic web technologies can be used to support flexible representation and computational inference mechanisms

  1. Predicting 30- to 120-Day Readmission Risk among Medicare Fee-for-Service Patients Using Nonmedical Workers and Mobile Technology.

    Science.gov (United States)

    Ostrovsky, Andrey; O'Connor, Lori; Marshall, Olivia; Angelo, Amanda; Barrett, Kelsy; Majeski, Emily; Handrus, Maxwell; Levy, Jeffrey

    2016-01-01

    Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice. The objective of this study is to show how mobile technology can use the observations of nonmedical workers to stratify patients on the basis of their hospital readmission risk. An area agency on aging in Massachusetts implemented a quality improvement project with the aim of reducing 30-day hospital readmission rates using a modified care transition intervention supported by mobile predictive analytics technology. Proprietary readmission risk prediction algorithms were used to predict 30-, 60-, 90-, and 120-day readmission risk. The risk score derived from the nonmedical workers' observations had a significant association with 30-day readmission rate with an odds ratio (OR) of 1.12 (95 percent confidence interval [CI], 1 .09-1.15) compared to an OR of 1.25 (95 percent CI, 1.19-1.32) for the risk score using nurse observations. Risk scores using nurse interpretation of nonmedical workers' observations show that patients in the high-risk category had significantly higher readmission rates than patients in the baseline-risk and mild-risk categories at 30, 60, 90, and 120 days after discharge. Of the 1,064 elevated-risk alerts that were triaged, 1,049 (98.6 percent) involved the nurse care manager, 804 (75.6 percent) involved the patient, 768 (72.2 percent) involved the health coach, 461 (43.3 percent) involved skilled nursing, and 235 (22.1 percent) involved the outpatient physician in the coordination of care in response to the alert. The predictive nature of the 30-day readmission risk scores is influenced

  2. The digital divide in adoption and use of mobile health technology among caregivers of pediatric surgery patients.

    Science.gov (United States)

    Hamilton, Emma C; Saiyed, Faiez; Miller, Charles C; Eguia, Arturo; Fonseca, Alexandra C; Baum, George P; Tsao, KuoJen; Austin, Mary T

    2017-09-01

    The purpose of this study was to identify mobile Health (mHealth) technology utilization among caregivers of pediatric surgery patients. We provided a modified version of the 2012 mobile health survey from the Pew Research Center to English and Spanish-speaking caregivers of children aged <18years presenting to pediatric surgical outpatient clinics from June to July of 2016. A total of 171 caregivers completed the survey and included 57 (34%) whites, 30 (18%) blacks, 75 (44%) Hispanics, and 6 (4%) other races. Among these, 160 (94%) were smartphone owners. mHealth users were identified as individuals who used their phone to look up health information online, receive text updates from healthcare providers or pharmacists, or use any health-related smartphone applications. On univariate ordered logistic regression, race/ethnicity, primary language, education level, and income quartile were associated with level of mHealth technology use. The majority of responders (n=126, 76%) said that they would be very or moderately interested in trying a new smartphone app related to management of their child's health. While the majority of pediatric caregivers are smartphone owners, there are significant racial and socioeconomic differences in mHealth usage. Understanding these differences may be important in identifying barriers to adoption of mHealth technology. Level IV case series with no comparison group. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Taking care of suicidal patients with new technologies and reaching-out means in the post-discharge period.

    Science.gov (United States)

    Falcone, Giulia; Nardella, Adele; Lamis, Dorian A; Erbuto, Denise; Girardi, Paolo; Pompili, Maurizio

    2017-09-22

    Suicide is a global public health problem with over one million people dying by suicide each year worldwide. Research efforts have focused on developing and testing novel suicide prevention strategies employing recent technological advances. In order to provide a review regarding the role of new technologies ( e.g ., postcards/letters, text messages, crisis cards, telephone contacts, online interventions) in suicide prevention, we searched PubMed, ScienceDirect, ResearchGate, and Crisis to identify all papers in English from 1977 to 2016. Our results indicated that brief contact interventions show promise in reducing the number of episodes of repeated self-harm and/or suicide attempts following discharge from the Emergency Department or psychiatric units. Innovative methods of contact ( e.g ., text messages) are easily implemented by clinicians and received by patients in the period of post discharge and have been shown to be beneficial. However, more research employing randomized clinical trials investigating the potential benefits of these novel suicide prevention methods is warranted. Future researchers should continue improving and testing new technologies in the prevention of suicide.

  4. Feasibility of combining e-health for patients with e-learning for students using synchronous technologies.

    Science.gov (United States)

    Jones, Ray; Skirton, Heather; McMullan, Miriam

    2006-10-01

    This paper is a report of a project to introduce and evaluate methods for using information and communication technologies to involve academic staff, students, and patients in a common synchronous e-learning environment. Although there is no strong evidence for this, there may be benefits in 'efficiency' and for patients and students from shared e-learning. Asynchronous e-learning methods in nursing education are well-established, but synchronous methods have received less attention. However, if feasible, because they are more akin to face-to-face contact, they may be more suitable for patients and may provide a quicker development path for e-learning. We evaluated three synchronous technologies: (1) non-commercial satellite interactive television (TV); (2) Internet videoconferencing; and (3) webcasting, through feasibility studies of 'TV-style' panel discussions on health topics and seminars with interaction with viewers by e-mail, inter-site research meetings with face-to-face interaction, user surveys and literature reviews. Interactive satellite TV required the booking of rooms with specialized receiving equipment. This limited accessibility contributed to the high cost per participant. Videoconferencing proved acceptable for cross-site research meetings and is proposed for joint meetings for doctoral students with overseas centres but has the same access issues as interactive satellite TV. Webcasting is accessible to most users with Internet access and provides a feasible means of delivery of synchronous interactive material. Reported live webcasts have had audiences of thousands. Presentation formats: panel discussions with mixed patient-professional membership and mixed patient-professional audiences were acceptable to participants but engaging academic staff and students was problematic. This may be overcome with webcasting but there may still be barriers such as timetabling and students' concerns about learning in the same 'live' environment as patients

  5. Data collection using open access technology in multicentre operational research involving patient interviews.

    Science.gov (United States)

    Shewade, H D; Chadha, S S; Gupta, V; Tripathy, J P; Satyanarayana, S; Sagili, K; Mohanty, S; Bera, O P; Pandey, P; Rajeswaran, P; Jayaraman, G; Santhappan, A; Bajpai, U N; Mamatha, A M; Maiser, R; Naqvi, A J; Pandurangan, S; Nath, S; Ghule, V H; Das, A; Prasad, B M; Biswas, M; Singh, G; Mallick, G; Jeyakumar Jaisingh, A J; Rao, R; Kumar, A M V

    2017-03-21

    Conducting multicentre operational research is challenging due to issues related to the logistics of travel, training, supervision, monitoring and troubleshooting support. This is even more burdensome in resource-constrained settings and if the research includes patient interviews. In this article, we describe an innovative model that uses open access tools such as Dropbox, TeamViewer and CamScanner for efficient, quality-assured data collection in an ongoing multicentre operational research study involving record review and patient interviews. The tools used for data collection have been shared for adaptation and use by other researchers.

  6. The use of drug-free technologies in patients with chronic toxicochemical bronchitis

    Directory of Open Access Journals (Sweden)

    Illarionov V.E.

    2014-12-01

    Full Text Available Aim: development and scientific substantiation of a complex application halo-inhaled and flutter-kinesiotherapy in patients with chronic obstructive toxic chemical bronchitis. Material and methods. There was an examination and treatment of 125 patients with chronic obstructive toxic chemical bronchitis at the age from 32 to 65 years (average age 52.2+3,1 with industrial experience from 5 to 27 years (average age 15.9+3,9. Results. Comparative analysis revealed an advantage of an integrated application halo-inhaled and flutter-kinesiotherapy in patients with chronic obstructive toxic chemical bronchitis as in the I, and that is especially important at the II stage of the disease, which is confirmed by the regression of the main clinical symptoms, a significant decrease in the intensity index of inflammation, recovery to normal values of factors of local immunity broncho-pulmonary system. Conclusion. Developed a comprehensive program including halo-inhaled and flutter-kinesiotherapy in patients with chronic obstructive toxic chemical bronchitis has a pronounced anti-inflammatory, antibacterial and immunocorrection effect, improves bronchodilating function and bronchial obstruction in bronchial tubes of large, medium and small caliber. The absence of exacerbations in the past year proves that this method is highly effective secondary prevention of lung disease.

  7. [Value of anti-Müllerian hormone in predicting pregnant outcomes of polycystic ovary syndrome patients undergone assisted reproductive technology].

    Science.gov (United States)

    Li, Y; Tan, J Q; Mai, Z Y; Yang, D Z

    2018-01-25

    Objective: Explore the value of anti-Müllerian hormone (AMH) in predicting pregnant outcomes of polycystic ovary syndrome (PCOS) patients undergone assisted reproductive technology. Methods: The study totally recruited 1 697 patients who underwent the first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle in Sun Yat-sen Memorial Hospital from the January 2014 to December 2015. The patients were divided into two groups based on the age<35 ( n= 758) and ≥35 years old ( n= 939) , compare the basic data and pregnant outcomes of controlled ovarian hyerstimulation. Spearman correlation method was conducted to analyze the relations between AMH and clinical outcomes. The logistic regression method and partial correlation analysis were used to judge the main factors which determine pregnancy outcomes by controlled the confounding factors. The receiver operating characteristic curve (ROC) was used to evaluate the predictive sensitivity and specificity of AMH. Results: In the group of PCOS patient younger than 35 years, AMH were correlated with the number of antral follicles ( r= 0.388) and retrieved oocytes ( r= 0.235) . When the effect of total dosage and starting dosage of gonadotropin were controlled, AMH was still significantly associated with the number of retrieved oocytes ( P< 0.05) . AMH had no predictive value for the clinical pregnancy of PCOS patient younger than 35 years (area under ROC curve=0.481, P= 0.768) . In the group of PCOS patient≥35 years old, AMH were correlated with the number of antral follicles ( r= 0.450) , retrieved oocytes ( r= 0.399) , available embryo ( r= 0.336) and high quality embryo ( r= 0.235) . When the effect of total dosage and starting dosage of gonadotropin were controlled, the correlations were still significant between those indexes (all P< 0.05) . AMH had no predictive value for the clinical pregnancy of PCOS patient ≥35 years old (area under ROC curve=0.535, P= 0.560) . However, the clinical

  8. Estimating the Value of New Technologies That Provide More Accurate Drug Adherence Information to Providers for Their Patients with Schizophrenia.

    Science.gov (United States)

    Shafrin, Jason; Schwartz, Taylor T; Lakdawalla, Darius N; Forma, Felicia M

    2016-11-01

    Nonadherence to antipsychotic medication among patients with schizophrenia results in poor symptom management and increased health care and other costs. Despite its health impact, medication adherence remains difficult to accurately assess. New technologies offer the possibility of real-time patient monitoring data on adherence, which may in turn improve clinical decision making. However, the economic benefit of accurate patient drug adherence information (PDAI) has yet to be evaluated. To quantify how more accurate PDAI can generate value to payers by improving health care provider decision making in the treatment of patients with schizophrenia. A 3-step decision tree modeling framework was used to measure the effect of PDAI on annual costs (2016 U.S. dollars) for patients with schizophrenia who initiated therapy with an atypical antipsychotic. The first step classified patients using 3 attributes: adherence to antipsychotic medication, medication tolerance, and response to therapy conditional on medication adherence. The prevalence of each characteristic was determined from claims database analysis and literature reviews. The second step modeled the effect of PDAI on provider treatment decisions based on health care providers' survey responses to schizophrenia case vignettes. In the survey, providers were randomized to vignettes with access to PDAI and with no access. In the third step, the economic implications of alternative provider decisions were identified from published peer-reviewed studies. The simulation model calculated the total economic value of PDAI as the difference between expected annual patient total cost corresponding to provider decisions made with or without PDAI. In claims data, 75.3% of patients with schizophrenia were found to be nonadherent to their antipsychotic medications. Review of the literature revealed that 7% of patients cannot tolerate medication, and 72.9% would respond to antipsychotic medication if adherent. Survey responses by

  9. Patient-centered applications: use of information technology to promote disease management and wellness. A white paper by the AMIA knowledge in motion working group.

    Science.gov (United States)

    Demiris, George; Afrin, Lawrence B; Speedie, Stuart; Courtney, Karen L; Sondhi, Manu; Vimarlund, Vivian; Lovis, Christian; Goossen, William; Lynch, Cecil

    2008-01-01

    Advances in information technology (IT) enable a fundamental redesign of health care processes based on the use and integration of electronic communication at all levels. New communication technologies can support a transition from institution centric to patient-centric applications. This white paper defines key principles and challenges for designers, policy makers, and evaluators of patient-centered technologies for disease management and prevention. It reviews current and emerging trends; highlights challenges related to design, evaluation, reimbursement and usability; and reaches conclusions for next steps that will advance the domain.

  10. Perceptions of pharmacy students, faculty members, and administrators on the use of technology in the classroom.

    Science.gov (United States)

    DiVall, Margarita V; Hayney, Mary S; Marsh, Wallace; Neville, Michael W; O'Barr, Stephen; Sheets, Erin D; Calhoun, Larry D

    2013-05-13

    To gather and evaluate the perceptions of students, faculty members, and administrators regarding the frequency and appropriateness of classroom technology use. Third-year pharmacy students and faculty members at 6 colleges and schools of pharmacy were surveyed to assess their perceptions about the type, frequency, and appropriateness of using technology in the classroom. Upper-level administrators and information technology professionals were also interviewed to ascertain overall technology goals and identify criteria used to adopt new classroom technologies. Four hundred sixty-six students, 124 faculty members, and 12 administrators participated in the survey. The most frequently used and valued types of classroom technology were course management systems, audience response systems, and lecture capture. Faculty members and students agreed that faculty members appropriately used course management systems and audience response systems. Compared with their counterparts, tech-savvy, and male students reported significantly greater preference for increased use of classroom technology. Eighty-six percent of faculty members reported having changed their teaching methodologies to meet student needs, and 91% of the students agreed that the use of technology met their needs. Pharmacy colleges and schools use a variety of technologies in their teaching methods, which have evolved to meet the needs of the current generation of students. Students are satisfied with the appropriateness of technology, but many exhibit preferences for even greater use of technology in the classroom.

  11. Mobile Health Technology for Atrial Fibrillation Management Integrating Decision Support, Education, and Patient Involvement: mAF App Trial.

    Science.gov (United States)

    Guo, Yutao; Chen, Yundai; Lane, Deirdre A; Liu, Lihong; Wang, Yutang; Lip, Gregory Y H

    2017-12-01

    Mobile Health technology for the management of patients with atrial fibrillation is unknown. The simple mobile AF (mAF) App was designed to incorporate clinical decision-support tools (CHA 2 DS 2 -VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes Mellitus, Prior Stroke or TIA, Vascular disease, Age 65-74 years, Sex category], HAS-BLED [Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly], SAMe-TT 2 R 2 [Sex, Age App vs usual care) in a cluster randomized design pilot study. Patients' knowledge, quality of life, drug adherence, and anticoagulation satisfaction were evaluated at baseline, 1 month, and 3 months. Usability, feasibility, and acceptability of the mAF App were assessed at 1 month. A total of 113 patients were randomized to mAF App intervention (mean age, 67.4 years; 57.5% were male; mean follow-up, 69 days), and 96 patients were randomized to usual care (mean age, 70.9 years; 55.2% were male; mean follow-up, 95 days). More than 90% of patients reported that the mAF App was easy, user-friendly, helpful, and associated with significant improvements in knowledge compared with the usual care arm (P values for trend App versus usual care (all P App arm versus usual care, with anxiety and depression reduced (all P App, integrating clinical decision support, education, and patient-involvement strategies, significantly improved knowledge, drug adherence, quality of life, and anticoagulation satisfaction. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study

    Science.gov (United States)

    Fábregas Escurriola, Mireia; Lozano Moreno, Maribel; Burón Leandro, Raquel; Gomez Quintero, Ana María; Ballve, Jose Luis; Clemente Jiménez, María Lourdes; Puigdomènech Puig, Elisa; Casas More, Ramón; Garcia Rueda, Beatriz; Casajuana, Marc; Méndez-Aguirre, Marga; Garcia Bonias, David; Fernández Maestre, Soraya; Sánchez Fondevila, Jessica

    2015-01-01

    Background The use of information and communication technologies (ICTs) in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking. Objectives To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose. Methods A qualitative, descriptive–interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer’s notes. Data were analyzed with the ATLAS TI 6.0 programme. Results Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers. Conclusions Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations

  13. Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Jose Manuel Trujillo Gómez

    Full Text Available The use of information and communication technologies (ICTs in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking.To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose.A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme.Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers.Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not

  14. Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

    Science.gov (United States)

    Trujillo Gómez, Jose Manuel; Díaz-Gete, Laura; Martín-Cantera, Carlos; Fábregas Escurriola, Mireia; Lozano Moreno, Maribel; Burón Leandro, Raquel; Gomez Quintero, Ana María; Ballve, Jose Luis; Clemente Jiménez, María Lourdes; Puigdomènech Puig, Elisa; Casas More, Ramón; Garcia Rueda, Beatriz; Casajuana, Marc; Méndez-Aguirre, Marga; Garcia Bonias, David; Fernández Maestre, Soraya; Sánchez Fondevila, Jessica

    2015-01-01

    The use of information and communication technologies (ICTs) in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking. To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose. A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme. Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers. Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not substitute personal

  15. [Completion technology of pelvic surgery accompanying with cystectomy in elderly and senile patients].

    Science.gov (United States)

    Krest'ianinov, S S; Kostiuk, I P; Shestaev, A Iu; Shostka, K G; Vasil'ev, L A; Kheĭfets, V Kh; Pavlenko, A N; Kagan, O F

    2014-01-01

    Results of treatment of 204 elderly and senile patients who underwent cystprostatectomy or anterior pelvic exenteration are analyzed. A comparative analysis of two groups of patients whose operation ended with the traditional drainage through the anterior abdominal wall (n = 100), and bilateral perineal drainage (n = 104) is presented. Bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy in conjunction with the restoration of the peritoneum lateral pelvic walls, improves postoperative recovery of intestinal peristalsis, promotes an earlier reduction in the intensity of pain and morbidity in the early postoperative period. Perineal installation of drains is a simple in design and safe procedure. We recommend bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy.

  16. Heart failure analysis dashboard for patient's remote monitoring combining multiple artificial intelligence technologies.

    Science.gov (United States)

    Guidi, G; Pettenati, M C; Miniati, R; Iadanza, E

    2012-01-01

    In this paper we describe an Heart Failure analysis Dashboard that, combined with a handy device for the automatic acquisition of a set of patient's clinical parameters, allows to support telemonitoring functions. The Dashboard's intelligent core is a Computer Decision Support System designed to assist the clinical decision of non-specialist caring personnel, and it is based on three functional parts: Diagnosis, Prognosis, and Follow-up management. Four Artificial Intelligence-based techniques are compared for providing diagnosis function: a Neural Network, a Support Vector Machine, a Classification Tree and a Fuzzy Expert System whose rules are produced by a Genetic Algorithm. State of the art algorithms are used to support a score-based prognosis function. The patient's Follow-up is used to refine the diagnosis.

  17. Patient-facing Technology for Identification of COPD in Primary Care

    Directory of Open Access Journals (Sweden)

    David Kevin Ahern

    2016-07-01

    to share and discuss their results with their providers. Results from the semistructured interviews indicated that participants perceived the Lung Age app as intuitive and easy to use. These results demonstrate that tablet computers and mHealth apps can be used to deploy acceptable and useable electronic risk assessments in primary care settings. Future research focused on the impact and outcomes of patient-centered, mHealth apps for risk screening in primary care is warranted.

  18. DoD/VA Health Information Technology (IT) Data Sharing to Benefit Our Patients

    Science.gov (United States)

    2011-01-25

    GRISCOM. MISS Q Oemograpi-Ocs -U~H:::: Alergy Wetness l lrnrru1izations V•ol Signs Review PKC Couplers Readineu Patient Questionnaires l =~otes...Authorization Act (NDAA) FY 2008, Section 1635 required DoD and VA to “ develop and implement electronic health record (EHR) systems or... developed and funded 36 2011 MHS Conference 37 Recruitment Accession/Training Routine Care Readiness/ Pre-Deployment Deployed/Theater CareCare in

  19. Conditional associative learning examined in a paralyzed patient with amyotrophic lateral sclerosis using brain-computer interface technology

    Directory of Open Access Journals (Sweden)

    Birbaumer N

    2008-11-01

    Full Text Available Abstract Background Brain-computer interface methodology based on self-regulation of slow-cortical potentials (SCPs of the EEG (electroencephalogram was used to assess conditional associative learning in one severely paralyzed, late-stage ALS patient. After having been taught arbitrary stimulus relations, he was evaluated for formation of equivalence classes among the trained stimuli. Methods A monitor presented visual information in two targets. The method of teaching was matching to sample. Three types of stimuli were presented: signs (A, colored disks (B, and geometrical shapes (C. The sample was one type, and the choice was between two stimuli from another type. The patient used his SCP to steer a cursor to one of the targets. A smiley was presented as a reward when he hit the correct target. The patient was taught A-B and B-C (sample – comparison matching with three stimuli of each type. Tests for stimulus equivalence involved the untaught B-A, C-B, A-C, and C-A relations. An additional test was discrimination between all three stimuli of one equivalence class presented together versus three unrelated stimuli. The patient also had sessions with identity matching using the same stimuli. Results The patient showed high accuracy, close to 100%, on identity matching and could therefore discriminate the stimuli and control the cursor correctly. Acquisition of A-B matching took 11 sessions (of 70 trials each and had to be broken into simpler units before he could learn it. Acquisition of B-C matching took two sessions. The patient passed all equivalence class tests at 90% or higher. Conclusion The patient may have had a deficit in acquisition of the first conditional association of signs and colored disks. In contrast, the patient showed clear evidence that A-B and B-C training had resulted in formation of equivalence classes. The brain-computer interface technology combined with the matching to sample method is a useful way to assess various

  20. Conditional associative learning examined in a paralyzed patient with amyotrophic lateral sclerosis using brain-computer interface technology.

    Science.gov (United States)

    Iversen, Ih; Ghanayim, N; Kübler, A; Neumann, N; Birbaumer, N; Kaiser, J

    2008-11-24

    Brain-computer interface methodology based on self-regulation of slow-cortical potentials (SCPs) of the EEG (electroencephalogram) was used to assess conditional associative learning in one severely paralyzed, late-stage ALS patient. After having been taught arbitrary stimulus relations, he was evaluated for formation of equivalence classes among the trained stimuli. A monitor presented visual information in two targets. The method of teaching was matching to sample. Three types of stimuli were presented: signs (A), colored disks (B), and geometrical shapes (C). The sample was one type, and the choice was between two stimuli from another type. The patient used his SCP to steer a cursor to one of the targets. A smiley was presented as a reward when he hit the correct target. The patient was taught A-B and B-C (sample - comparison) matching with three stimuli of each type. Tests for stimulus equivalence involved the untaught B-A, C-B, A-C, and C-A relations. An additional test was discrimination between all three stimuli of one equivalence class presented together versus three unrelated stimuli. The patient also had sessions with identity matching using the same stimuli. The patient showed high accuracy, close to 100%, on identity matching and could therefore discriminate the stimuli and control the cursor correctly. Acquisition of A-B matching took 11 sessions (of 70 trials each) and had to be broken into simpler units before he could learn it. Acquisition of B-C matching took two sessions. The patient passed all equivalence class tests at 90% or higher. The patient may have had a deficit in acquisition of the first conditional association of signs and colored disks. In contrast, the patient showed clear evidence that A-B and B-C training had resulted in formation of equivalence classes. The brain-computer interface technology combined with the matching to sample method is a useful way to assess various cognitive abilities of severely paralyzed patients, who are

  1. Evaluation of a Tracking System for Patients and Mixed Intravenous Medication Based on RFID Technology.

    Science.gov (United States)

    Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

    2016-11-30

    At present, one of the primary concerns of healthcare professionals is how to increase the safety and quality of the care that patients receive during their stay in hospital. This is particularly important in the administration of expensive and high-risk medicines with which it is fundamental to minimize the possibility of adverse events in the process of prescription-validation-preparation/dosage-dispensation-administration of intravenous mixes. This work is a detailed analysis of the evaluation, carried out by the health personnel involved in the Radiofrequency Identification (RFID) system developed in the Day Hospital and Pharmacy services of the Complejo Hospitalario Universitario A Coruña (CHUAC). The RFID system is evaluated by analyzing surveys completed by said health personnel, since their questions represent the key indicators of the patient care process (safety, cost, adequacy with the clinical practice). This work allows us to conclude, among other things, that the system tracks the patients satisfactorily and that its cost, though high, is justified in the context of the project context (use of dangerous and costly medication).

  2. Evaluation of a Tracking System for Patients and Mixed Intravenous Medication Based on RFID Technology

    Directory of Open Access Journals (Sweden)

    María Martínez Pérez

    2016-11-01

    Full Text Available At present, one of the primary concerns of healthcare professionals is how to increase the safety and quality of the care that patients receive during their stay in hospital. This is particularly important in the administration of expensive and high-risk medicines with which it is fundamental to minimize the possibility of adverse events in the process of prescription-validation-preparation/dosage-dispensation-administration of intravenous mixes. This work is a detailed analysis of the evaluation, carried out by the health personnel involved in the Radiofrequency Identification (RFID system developed in the Day Hospital and Pharmacy services of the Complejo Hospitalario Universitario A Coruña (CHUAC. The RFID system is evaluated by analyzing surveys completed by said health personnel, since their questions represent the key indicators of the patient care process (safety, cost, adequacy with the clinical practice. This work allows us to conclude, among other things, that the system tracks the patients satisfactorily and that its cost, though high, is justified in the context of the project context (use of dangerous and costly medication.

  3. Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies

    Directory of Open Access Journals (Sweden)

    Stiebel M

    2014-04-01

    Full Text Available Matthew Stiebel,1 Larry E Miller,2,3 Jon E Block3 1Palm Beach Sports Medicine, West Palm Beach, FL, USA; 2Miller Scientific Consulting, Inc, Asheville, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Abstract: Traumatic knee injury is common in young adults and strongly contributes to premature development of knee osteoarthritis (OA. Post-traumatic knee OA poses a therapeutic dilemma to the physician, since no known therapy has an acceptable safety profile, effectively relieves joint pain, and enjoys reasonable patient acceptance. Consequently, these young patients will ultimately be faced with the decision to either undergo surgical intervention, despite prosthesis durability concerns, or to continue with ineffective nonsurgical treatment. Emerging therapies, such as biologics, disease-modifying drugs, partial joint resurfacings, and minimally invasive joint-unloading implants are currently being studied to fill this therapeutic void in the young patient with post-traumatic knee OA. Keywords: injury, knee, osteoarthritis, post-traumatic, implant, joint unloading, KineSpring, minimally invasive

  4. Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care

    NARCIS (Netherlands)

    Nijland, N.; van Gemert-Pijnen, Julia E.W.C.; Boer, Hendrik; Steehouder, M.F.; Seydel, E.R.

    2008-01-01

    Background: Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is

  5. Identification of human papillomavirus (HPV) subtype in oral cancer patients through microarray technology.

    Science.gov (United States)

    Kim, Soung Min; Kwon, Ik Jae; Myoung, Hoon; Lee, Jong Ho; Lee, Suk Keun

    2018-02-01

    Human papilloma virus (HPV) is the main source of cervical cancer. Many recent studies have revealed the prevalence and prognosis of HPV associated with oropharyngeal squamous cell carcinoma, but fewer reports have evaluated HPV in oral squamous cell carcinoma (OSCC). The purpose of this study was to determine the prevalence and prognosis of HPV associated with OSCC according to HPV and tumor types. We used a DNA chip kit (MY-HPV chip kit ® , Mygene Co., Korea) to detect high-risk HPV subtypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 54, 56, 58) and low-risk subtypes (6, 11, 34, 40, 42, 43, 44) among 187 patients. The prevalence was determined by Chi-square and Fisher's exact tests, and the prognosis was calculated by the Kaplan-Meier method and the log-rank test. The overall prevalence of HPV in OSCC was 7.0% for all HPV positives and 4.3% for high-risk HPV positives. The prevalence of HPV was significantly higher in individuals under 65 years old and in those with tumors in the tongue and gum regions. The prognosis did not differ between the HPV-positive and -negative groups. Although the prevalence of HPV-positive cases in OSCC was low (7.0, 4.3%) and the prognosis did not depend on HPV positivity, HPV-associated OSCC should be considered in the evaluation and treatment of oral cancer patients. In addition, separating high- and low-risk groups based on the HPV status of other body parts might not be appropriate. The DNA microarray method can accurately detect known HPV subtypes simultaneously, but has limitations in detecting new subtypes. Vaccines can also be used to prevent HPV-associated OSCC in patients, so further studies on the prognosis and efficacy of vaccines should be undertaken.

  6. Proprioception rehabilitation training system for stroke patients using virtual reality technology.

    Science.gov (United States)

    Kim, Sun I; Song, In-Ho; Cho, Sangwoo; Kim, In Young; Ku, Jeonghun; Kang, Youn Joo; Jang, Dong Pyo

    2013-01-01

    We investigated a virtual reality (VR) proprioceptive rehabilitation system that could manipulate the visual feedback of upper-limb during training and could do training by relying on proprioception feedback only. Virtual environments were designed in order to switch visual feedback on/off during upper-limb training. Two types of VR training tasks were designed for evaluating the effect of the proprioception focused training compared to the training with visual feedback. In order to evaluate the developed proprioception feedback virtual environment system, we recruited ten stroke patients (age: 54.7± 7.83years, on set: 3.29± 3.83 years). All patients performed three times PFVE task in order to check the improvement of proprioception function just before training session, after one week training, and after all training. In a comparison between FMS score and PFVE, the FMS score had a significant relationship with the error distance(r = -.662, n=10, p = .037) and total movement distance(r = -.726, n=10, p = .018) in PFVE. Comparing the training effect between in virtual environment with visual feedback and with proprioception, the click count, error distance and total error distance was more reduced in PFVE than VFVE. (Click count: p = 0.005, error distance: p = 0.001, total error distance: p = 0.007). It suggested that the proprioception feedback rather than visual feedback could be effective means to enhancing motor control during rehabilitation training. The developed VR system for rehabilitation has been verified in that stroke patients improved motor control after VR proprioception feedback training.

  7. Problems with health information technology and their effects on care delivery and patient outcomes: a systematic review.

    Science.gov (United States)

    Kim, Mi Ok; Coiera, Enrico; Magrabi, Farah

    2017-03-01

    To systematically review studies reporting problems with information technology (IT) in health care and their effects on care delivery and patient outcomes. We searched bibliographic databases including Scopus, PubMed, and Science Citation Index Expanded from January 2004 to December 2015 for studies reporting problems with IT and their effects. A framework called the information value chain, which connects technology use to final outcome, was used to assess how IT problems affect user interaction, information receipt, decision-making, care processes, and patient outcomes. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of the 34 studies identified, the majority ( n  = 14, 41%) were analyses of incidents reported from 6 countries. There were 7 descriptive studies, 9 ethnographic studies, and 4 case reports. The types of IT problems were similar to those described in earlier classifications of safety problems associated with health IT. The frequency, scale, and severity of IT problems were not adequately captured within these studies. Use errors and poor user interfaces interfered with the receipt of information and led to errors of commission when making decisions. Clinical errors involving medications were well characterized. Issues with system functionality, including poor user interfaces and fragmented displays, delayed care delivery. Issues with system access, system configuration, and software updates also delayed care. In 18 studies (53%), IT problems were linked to patient harm and death. Near-miss events were reported in 10 studies (29%). The research evidence describing problems with health IT remains largely qualitative, and many opportunities remain to systematically study and quantify risks and benefits with regard to patient safety. The information value chain, when used in conjunction with existing classifications for health IT safety problems, can enhance

  8. A technology-enabled adherence enhancement system for people with bipolar disorder: results from a feasibility and patient acceptance analysis

    Directory of Open Access Journals (Sweden)

    Sajatovic M

    2015-06-01

    Full Text Available Martha Sajatovic,1 Michael S Davis,2 Kristin A Cassidy,3 Joseph Nestor,2 Johnny Sams,3 Edna Fuentes-Casiano3 1Department of Psychiatry and Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, OH, USA; 2MedicaSafe, New York, NY, USA; 3Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA Objective: As poor medication adherence is common in bipolar disorder (BD, technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods: This prospective study tested the system in five BD patients over a 15-day period. System components included: 1 an automated pill cap with remote monitoring sensor; 2 a multimedia adherence enhancement program; and 3 a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale, knowledge (treatment knowledge test [TKT], and symptoms (internal state scale [ISS]. Results: Mean age of the sample was 62 years, 4/5 (80% Caucasian, and 4/5 (80% single/divorced or widowed. Most participants (4/5, 80% were on a single BD medication. Participants had BD for an average of 21 years. Challenges included attaching the pill sensor to standard pharmacy bottles for individuals using very large pill containers or those with multiday pill boxes. Three of five (60% individuals completed the full 15-day period. Usability scores were high overall. Mean Morisky scores improved. Means on all four subscales of the ISS were all in the direction of improvement. On the TKT, there was a 40% increase in mean scores. Conclusion: A multicomponent technology-assisted BD

  9. [Results of complex treatment of patients with squamous cell carcinoma of the anal canal using advanced radiotherapy technologies].

    Science.gov (United States)

    Glebovskaya, V V; Tkachev, S I; Rasulov, A O; Tsaryuk, V F; Gordeev, S S; Fedyanin, M Yu; Aliev, V A; Mamedly, Z Z; Kuzmichev, D V; Trofimova, O P; Borisova, T N; Yazhgunovich, I P

    2015-01-01

    During recent decades radiotherapy is the basis, on which it is built a medical complex that is the first-line treatment of patients with squamous cell carcinoma of the anal canal. An increase of overall and disease-free survival and quality of life of patients with squamous cell carcinoma of the anal canal at the present stage of development of a comprehensive medical treatment is largely due to the improvement of technical equipment of radiotherapy departments of oncology clinics. The use of modem linear electron accelerators and systems of computer dosimetric planning to create a 3D program of isodose distribution, diagnostic devices (computed tomography and magnetic resonance imaging) as well as a number of other conditions permit accurate summarizing of proposed dose, reducing of absorbed dose to critical structures, diminishing unplanned interruptions in chemoradiotherapy course by means of modern technologies of conformal radiotherapy (3D CRT, IMRT, VMAT). The paper presents the preliminary results of a comprehensive medical treatment of 14 patients with squamous cell carcinoma of the anal canal.

  10. A systematic review and meta-analysis of metformin among patients with polycystic ovary syndrome undergoing assisted reproductive technology procedures.

    Science.gov (United States)

    Huang, Xiaman; Wang, Pin; Tal, Reshef; Lv, Fang; Li, Yuanyuan; Zhang, Xiaomei

    2015-11-01

    Metformin is used among patients with polycystic ovary syndrome (PCOS), but findings for its effects on outcomes of assisted reproductive technology (ART) have been conflicting. To compare ART outcomes among women with PCOS who were and were not given metformin. Databases were searched for reports published in English between 2002 and 2013, using combinations of the terms "polycystic ovary syndrome," "PCOS," "insulin-sensitizing," and "metformin." Randomized controlled trials of metformin versus placebo among women with PCOS undergoing ART were included if they assessed rates of pregnancy, live birth, spontaneous abortion, multiple pregnancy, and/or ovarian hyperstimulation syndrome (OHSS). Data were extracted from included studies. The Mantel-Haenzel random-effects model was used for meta-analyses. Twelve studies (1516 participants) were included. No significant differences were recorded between metformin and placebo groups for rates of pregnancy (risk ratio [RR] 1.11, 95% CI 0.92-1.33), live birth (RR 1.12, 0.92-1.36), spontaneous abortion (RR 1.00, 0.60-1.67), or multiple pregnancy (RR 0.96, 0.47-1.96). However, OHSS rate was significantly lower among patients who received metformin than among those who received placebo (RR 0.44, 0.26-0.77). Metformin does not improve ART outcomes among patients with PCOS, but does significantly reduce their risk of OHSS. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

  11. Accessibility to surgical robot technology and prostate-cancer patient behavior for prostatectomy.

    Science.gov (United States)

    Sugihara, Toru; Yasunaga, Hideo; Matsui, Hiroki; Nagao, Go; Ishikawa, Akira; Fujimura, Tetsuya; Fukuhara, Hiroshi; Fushimi, Kiyohide; Ohori, Makoto; Homma, Yukio

    2017-07-01

    To examine how surgical robot emergence affects prostate-cancer patient behavior in seeking radical prostatectomy focusing on geographical accessibility. In Japan, robotic surgery was approved in April 2012. Based on data in the Japanese Diagnosis Procedure Combination database between April 2012 and March 2014, distance to nearest surgical robot and interval days to radical prostatectomy (divided by mean interval in 2011: % interval days to radical prostatectomy) were calculated for individual radical prostatectomy cases at non-robotic hospitals. Caseload changes regarding distance to nearest surgical robot and robot introduction were investigated. Change in % interval days to radical prostatectomy was evaluated by multivariate analysis including distance to nearest surgical robot, age, comorbidity, hospital volume, operation type, hospital academic status, bed volume and temporal progress. % Interval days to radical prostatectomy became wider for distance to nearest surgical robot robot emerged within 30 and 10 km, the prostatectomy caseload in non-robot hospitals reduced by 13 and 18% within 6 months, respectively, while the robot hospitals gained +101% caseload (P robotic minimally invasive radical prostatectomies in 483 non-robot hospitals revealed a significant inverse association between distance to nearest surgical robot and % interval days to radical prostatectomy (B = -17.3% for distance to nearest surgical robot ≥30 km and -11.7% for 10-30 km versus distance to nearest surgical robot Robotic surgery accessibility within 30 km would make patients less likely select conventional surgery. The nearer a robot was, the faster the caseload reduction was. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Addressing Cancer Disparities Among American Indians through Innovative Technologies and Patient Navigation: The Walking Forward Experience

    International Nuclear Information System (INIS)

    Petereit, Daniel G.; Guadagnolo, B. Ashleigh; Wong, Rosemary; Coleman, C. Norman

    2011-01-01

    Purpose/Objective(s): American Indians (AIs) present with more advanced stages of cancer and, therefore, suffer from higher cancer mortality rates compared to non-AIs. Under the National Cancer Institute (NCI) Cancer Disparities Research Partnership (CDRP) Program, we have been researching methods of improving cancer treatment and outcomes since 2002, for AIs in Western South Dakota, through the Walking Forward (WF) Program. Materials/Methods: This program consists of (a) a culturally tailored patient navigation program that facilitated access to innovative clinical trials in conjunction with a comprehensive educational program encouraging screening and early detection, (b), surveys to evaluate barriers to access, (c) clinical trials focusing on reducing treatment length to facilitate enhanced participation using brachytherapy and intensity modulated radiotherapy (IMRT) for breast and prostate cancer, as AIs live a median of 140 miles from the cancer center, and (d) a molecular study (ataxia telangiectasia mutated) to address whether there is a specific profile that increases toxicity risks. Results: We describe the design and implementation of this program, summary of previously published results, and ongoing research to influence stage at presentation. Some of the critical outcomes include the successful implementation of a community-based research program, development of trust within tribal communities, identification of barriers, analysis of nearly 400 navigated cancer patients, clinical trial accrual rate of 10%, and total enrollment of nearly 2,500 AIs on WF research studies. Conclusion: This NCI funded pilot program has achieved some initial measures of success. A research infrastructure has been created in a community setting to address new research questions and interventions. Efforts underway to promote cancer education and screening are presented, as well as applications of the lessons learned to other health disparity populations – both nationally and

  13. Information Technology in Critical Care: Review of Monitoring and Data Acquisition Systems for Patient Care and Research

    Science.gov (United States)

    De Georgia, Michael A.; Kaffashi, Farhad; Jacono, Frank J.; Loparo, Kenneth A.

    2015-01-01

    There is a broad consensus that 21st century health care will require intensive use of information technology to acquire and analyze data and then manage and disseminate information extracted from the data. No area is more data intensive than the intensive care unit. While there have been major improvements in intensive care monitoring, the medical industry, for the most part, has not incorporated many of the advances in computer science, biomedical engineering, signal processing, and mathematics that many other industries have embraced. Acquiring, synchronizing, integrating, and analyzing patient data remain frustratingly difficult because of incompatibilities among monitoring equipment, proprietary limitations from industry, and the absence of standard data formatting. In this paper, we will review the history of computers in the intensive care unit along with commonly used monitoring and data acquisition systems, both those commercially available and those being developed for research purposes. PMID:25734185

  14. Information Technology in Critical Care: Review of Monitoring and Data Acquisition Systems for Patient Care and Research

    Directory of Open Access Journals (Sweden)

    Michael A. De Georgia

    2015-01-01

    Full Text Available There is a broad consensus that 21st century health care will require intensive use of information technology to acquire and analyze data and then manage and disseminate information extracted from the data. No area is more data intensive than the intensive care unit. While there have been major improvements in intensive care monitoring, the medical industry, for the most part, has not incorporated many of the advances in computer science, biomedical engineering, signal processing, and mathematics that many other industries have embraced. Acquiring, synchronizing, integrating, and analyzing patient data remain frustratingly difficult because of incompatibilities among monitoring equipment, proprietary limitations from industry, and the absence of standard data formatting. In this paper, we will review the history of computers in the intensive care unit along with commonly used monitoring and data acquisition systems, both those commercially available and those being developed for research purposes.

  15. Learning computer technology in the development of educational practice «Care for surgical patients»

    Directory of Open Access Journals (Sweden)

    Dyabkin E.V.

    2017-01-01

    Full Text Available this article deals with the problem of implementation in the educational process of new computer technologies. Modern students of medical educational institutions need computer programs, which encourage them to absorb necessary educational material and stimulate cognitive interest in the subject. This training flash program is recommended for implementation in the educational process in educational practice and it consists of «Care for surgical patients» module. The computer program includes educational material, revealing the structure and equipment of the surgical department with the use of animation clip. In order to check the quality of learning, the student must pass a test and solve situational problems. This article is devoted to the indicated problem.

  16. endoscope-i: an innovation in mobile endoscopic technology transforming the delivery of patient care in otolaryngology.

    Science.gov (United States)

    Mistry, N; Coulson, C; George, A

    2017-11-01

    Digital and mobile device technology in healthcare is a growing market. The introduction of the endoscope-i, the world's first endoscopic mobile imaging system, allows the acquisition of high definition images of the ear, nose and throat (ENT). The system combines the e-i Pro camera app with a bespoke engineered endoscope-i adaptor which fits securely onto the iPhone or iPod touch. Endoscopic examination forms a salient aspect of the ENT work-up. The endoscope-i therefore provides a mobile and compact alternative to the existing bulky endoscopic systems currently in use which often restrict the clinician to the clinic setting. Areas covered: This article gives a detailed overview of the endoscope-i system together with its applications. A review and comparison of alternative devices on the market offering smartphone adapted endoscopic viewing systems is also presented. Expert commentary: The endoscope-i fulfils unmet needs by providing a compact, highly portable, simple to use endoscopic viewing system which is cost-effective and which makes use of smartphone technology most clinicians have in their pocket. The system allows real-time feedback to the patient and has the potential to transform the way that healthcare is delivered in ENT as well as having applications further afield.

  17. Using Information and Communication Technology in Home Care for Communication between Patients, Family Members, and Healthcare Professionals: A Systematic Review

    Science.gov (United States)

    Lindberg, Birgitta; Nilsson, Carina; Zotterman, Daniel; Söderberg, Siv; Skär, Lisa

    2013-01-01

    Introduction. Information and communication technology (ICT) are becoming a natural part in healthcare both for delivering and giving accessibility to healthcare for people with chronic illness living at home. Aim. The aim was to review existing studies describing the use of ICT in home care for communication between patients, family members, and healthcare professionals. Methods. A review of studies was conducted that identified 1,276 studies. A selection process and quality appraisal were conducted, which finally resulted in 107 studies. Results. The general results offer an overview of characteristics of studies describing the use of ICT applications in home care and are summarized in areas including study approach, quality appraisal, publications data, terminology used for defining the technology, and disease diagnosis. The specific results describe how communication with ICT was performed in home care and the benefits and drawbacks with the use of ICT. Results were predominated by positive responses in the use of ICT. Conclusion. The use of ICT applications in home care is an expanding research area, with a variety of ICT tools used that could increase accessibility to home care. Using ICT can lead to people living with chronic illnesses gaining control of their illness that promotes self-care. PMID:23690763

  18. Technology and Social Media Use Among Patients Enrolled in Outpatient Addiction Treatment Programs: Cross-Sectional Survey Study

    Science.gov (United States)

    Lynch, Kevin; Curtis, Brenda

    2018-01-01

    /259), and nearly half (49.1%, 127/259) expressed an interest in receiving support by allowing social media accounts to be monitored as a relapse prevention technique. Conclusions To our knowledge, this is the first and largest study examining the online behavior and preferences regarding technology-based substance use disorder treatment interventions in a population of patients enrolled in community outpatient treatment programs. Patients were generally receptive to using relapse prevention apps and text messaging interventions and a substantial proportion supported social media surveillance tools. However, the design of technology-based interventions remains as many participants have monthly telephone plans which may limit continuity. PMID:29510968

  19. Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?

    Science.gov (United States)

    Gordon, James A; Hayden, Emily M; Ahmed, Rami A; Pawlowski, John B; Khoury, Kimberly N; Oriol, Nancy E

    2010-02-01

    Flexner wanted medical students to study at the patient bedside-a remarkable innovation in his time-so that they could apply science to clinical care under the watchful eye of senior physicians. Ever since his report, medical schools have reserved the latter years of their curricula for such an "advanced" apprenticeship, providing clinical clerkship experiences only after an initial period of instruction in basic medical sciences. Although Flexner codified the segregation of preclinical and clinical instruction, he was committed to ensuring that both domains were integrated into a modern medical education. The aspiration to fully integrate preclinical and clinical instruction continues to drive medical education reform even to this day. In this article, the authors revisit the original justification for sequential preclinical-clinical instruction and argue that modern, technology-enhanced patient simulation platforms are uniquely powerful for fostering simultaneous integration of preclinical-clinical content in a way that Flexner would have applauded. To date, medical educators tend to focus on using technology-enhanced medical simulation in clinical and postgraduate medical education; few have devoted significant attention to using immersive clinical simulation among preclinical students. The authors present an argument for the use of dynamic robot-mannequins in teaching basic medical science, and describe their experience with simulator-based preclinical instruction at Harvard Medical School. They discuss common misconceptions and barriers to the approach, describe their curricular responses to the technique, and articulate a unifying theory of cognitive and emotional learning that broadens the view of what is possible, feasible, and desirable with simulator-based medical education.

  20. A needs assessment of health information technology for improving care coordination in three leading patient-centered medical homes.

    Science.gov (United States)

    Richardson, Joshua E; Vest, Joshua R; Green, Cori M; Kern, Lisa M; Kaushal, Rainu

    2015-07-01

    We investigated ways that patient-centered medical homes (PCMHs) are currently using health information technology (IT) for care coordination and what types of health IT are needed to improve care coordination. A multi-disciplinary team of researchers conducted semi-structured telephone interviews with 28 participants from 3 PCMHs in the United States. Participants included administrators and clinicians from PCMHs, electronic health record (EHR) and health information exchange (HIE) representatives, and policy makers. Participants identified multiple barriers to care coordination using current health IT tools. We identified five areas in which health IT can improve care coordination in PCMHs: 1) monitoring patient populations, 2) notifying clinicians and other staff when specific patients move across care settings, 3) collaborating around patients, 4) reporting activities, and 5) interoperability. To accomplish these tasks, many participants described using homegrown care coordination systems separate from EHRs. The participants in this study have resources, experience, and expertise with using health IT for care coordination, yet they still identified multiple areas for improvement. We hypothesize that focusing health IT development in the five areas we identified can enable more effective care coordination. Key findings from this work are that homegrown systems apart from EHRs are currently used to support care coordination and, also, that reporting tools are key components of care coordination. New health IT that enables monitoring, notifying, collaborating, reporting, and interoperability would enhance care coordination within PCMHs beyond what current health IT enables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. A Role for Semantic Web Technologies in Patient Record Data Collection

    Science.gov (United States)

    Ogbuji, Chimezie

    Business Process Management Systems (BPMS) are a component of the stack of Web standards that comprise Service Oriented Architecture (SOA). Such systems are representative of the architectural framework of modern information systems built in an enterprise intranet and are in contrast to systems built for deployment on the larger World Wide Web. The REST architectural style is an emerging style for building loosely coupled systems based purely on the native HTTP protocol. It is a coordinated set of architectural constraints with a goal to minimize latency, maximize the independence and scalability of distributed components, and facilitate the use of intermediary processors.Within the development community for distributed, Web-based systems, there has been a debate regarding themerits of both approaches. In some cases, there are legitimate concerns about the differences in both architectural styles. In other cases, the contention seems to be based on concerns that are marginal at best. In this chapter, we will attempt to contribute to this debate by focusing on a specific, deployed use case that emphasizes the role of the Semantic Web, a simple Web application architecture that leverages the use of declarative XML processing, and the needs of a workflow system. The use case involves orchestrating a work process associated with the data entry of structured patient record content into a research registry at the Cleveland Clinic's Clinical Investigation department in the Heart and Vascular Institute.

  2. Turning Techno-Savvy into Info-Savvy: Authentically Integrating Information Literacy into the College Curriculum

    Science.gov (United States)

    Brown, Cecelia; Murphy, Teri J.; Nanny, Mark

    2003-01-01

    It is no longer effective to provide information literacy instruction that is thought to be "good for" college students, but rather, instruction must focus on the learning styles and preferences of the target population. This case study reports a series of hands-on/minds-on information literacy activities that dissolve student's misconception that…

  3. The never-ending digital journey creating new consumer experiences through technology

    CERN Document Server

    Angelani, Andres; Migoya, Martin

    2016-01-01

    The Never-Ending Digital Journey provides readers with the concepts and steps needed to create successful user experiences. The authors look ahead and explore digital scenarios of the future. They probe how technology is changing the way users interact with brands, and they address today's digital challenges with new ways of surprising consumers, integrating design and engineering. The authors leverage knowledge gleaned from working with renowned global companies to describe the recipe needed to build a Digital Journey. With a strong focus on Agile Pods, they dive into technolo- gies, processes, team building, motivation, and met- rics that enable businesses to construct and nurture the dynamic ecosystems necessary in this digital era to foster success. Over the last several years, customers, employees, and partners have become tech-savvy users whose expectations of “Give me more and deliver it faster" require manageable solutions. The desire to interact with digital ecosystems anywhere, anytime demands that...

  4. Bridging burn care education with modern technology, an integration with high fidelity human patient simulation.

    Science.gov (United States)

    Reeves, Patrick T; Borgman, Matthew A; Caldwell, Nicole W; Patel, Leela; Aden, James; Duggan, John P; Serio-Melvin, Maria L; Mann-Salinas, Elizabeth A

    2018-03-10

    The Advanced Burn Life Support (ABLS) program is a burn-education curriculum nearly 30 years in the making, focusing on the unique challenges of the first 24h of care after burn injury. Our team applied high fidelity human patient simulation (HFHPS) to the established ABLS curriculum. Our hypothesis was that HFHPS would be a feasible, easily replicable, and valuable adjunct to the current curriculum that would enhance learner experience. This prospective, evidenced-based practice project was conducted in a single simulation center employing the American Burn Association's ABLS curriculum using HFHPS. Participants managed 7 separate simulated polytrauma and burn scenarios with resultant clinical complications. After training, participants completed written and practical examinations as well as satisfaction surveys. From 2012 to 2013, 71 students participated in this training. Simulation (ABLS-Sim) participants demonstrated a 2.5% increase in written post-test scores compared to traditional ABLS Provider Course (ABLS Live) (p=0.0016). There was no difference in the practical examination when comparing ABLS-Sim versus ABLS Live. Subjectively, 60 (85%) participants completed surveys. The Educational Practice Questionnaire showed best practices rating of 4.5±0.7; with importance of learning rated at 4.4±0.8. The Simulation Design Scale rating for design was 4.6±0.6 with an importance rating of 4.4±0.8. Overall Satisfaction and Self-Confidence with Learning were 4.4±0.7 and 4.5±0.7, respectfully. Integrating HFHPS with the current ABLS curriculum led to higher written exam scores, high levels of confidence, satisfaction, and active learning, and presented an evidenced-based model for education that is easily employable for other facilities nationwide. Copyright © 2018. Published by Elsevier Ltd.

  5. Transcatheter aortic valve replacement in patients with severe aortic stenosis who are at high risk for surgical complications: summary assessment of the California Technology Assessment Forum.

    Science.gov (United States)

    Tice, Jeffrey A; Sellke, Frank W; Schaff, Hartzell V

    2014-08-01

    The California Technology Assessment Forum is dedicated to assessment and public reporting of syntheses of available data on medical technologies. In this assessment, transcatheter aortic valve replacement (TAVR) was evaluated for patients with severe aortic stenosis (AS) who are at high risk for complications. In this assessment, 5 criteria were used: Regulatory approval, sufficient scientific evidence to allow conclusions on effectiveness, evidence that the technology improves net health outcomes, evidence that the technology is as beneficial as established methods, and availability of the technology outside investigational settings. In this assessment, all 5 criteria were judged to have been met. The primary benefit of TAVR is the ability to treat AS in patients who would otherwise be ineligible for surgical aortic valve replacement. It may also be useful for patients at high surgical risk by potentially reducing periprocedural complications and avoiding the morbidity and recovery from undergoing heart surgery. Potential harms include the need for conversion to an open procedure, perioperative death, myocardial infarction, stroke, bleeding, valve embolization, aortic regurgitation, heart block that requires a permanent pacemaker, renal failure, pulmonary failure, and major vascular complications such as cardiac perforation or arterial dissection. Potential long-term harms include death, stroke, valve failure or clotting, and endocarditis. As highlighted at the February 2012 California Technology Assessment Forum meeting, the dispersion of this technology to new centers across the United States must proceed with careful thought given to training and proctoring multidisciplinary teams to become new centers of excellence. TAVR is a potentially lifesaving procedure that may improve quality of life for patients at high risk for surgical AVR. However, attention needs to be paid to appropriate patient selection, their preoperative evaluation, surgical techniques, and

  6. [Internal medicine and the holistic approach to the patient between globalization and advanced technologies].

    Science.gov (United States)

    Dammacco, Franco

    2012-06-01

    Although Internal Medicine (IM) has played for many years a crucial role in the medical education and in the diagnostic framing of the most common diseases, starting from the beginning of the 70's the knowledge explosion, the recognition of the multidisciplinary nature of IM and the consequent impossibility for the Internist to master an ever growing array of notions have resulted in the development of specialized disciplines restricted to pathologies of single organs or apparatus. The parcelling out of medical knowledge has thus induced the onset of a number of specializations stemmed from IM and, as a direct consequence, an identity crisis of the same IM. Social transformations and variations in the epidemiology of several diseases have contributed to such crisis, including aging, frailty and disability, polypathology and chronicity. In the last few years, however, IM has regained a central role in medicine, in that the Internist is an expert of "medicine of complexity" and the only specialist able to envisage an holistic approach to the patient. The development of biotechnologies, characterized on one side by nanotechnologies and on the other by the instruments of diagnostic imaging, has provided an important contribution to make clinical medicine more and more precise and reliable. The genomic analysis of novel pharmacological targets has opened new therapeutic horizons, especially in the oncology field. A striking aspect of modern medicine, again based on unreasonable expectations of improvement and recovery, is the progressive increment of malpractice claims leading to an indemnity payment. Defensive medicine has been the answer to face this growing problem: physicians are in fact induced to prescribe a much higher number of often unnecessary examinations and laboratory tests, that result in a wasting rise of health costs. In view of the rapidly changing reality, it seems fair to ask the question as to whether in our country the medical education is abreast

  7. Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: a scoping review.

    Science.gov (United States)

    Gentles, Stephen James; Lokker, Cynthia; McKibbon, K Ann

    2010-06-18

    Pediatric patients with health conditions requiring follow-up typically depend on a caregiver to mediate at least part of the necessary two-way communication with health care providers on their behalf. Health information technology (HIT) and its subset, information communication technology (ICT), are increasingly being applied to facilitate communication between health care provider and caregiver in these situations. Awareness of the extent and nature of published research involving HIT interventions used in this way is currently lacking. This scoping review was designed to map the health literature about HIT used to facilitate communication involving health care providers and caregivers (who are usually family members) of pediatric patients with health conditions requiring follow-up. Terms relating to care delivery, information technology, and pediatrics were combined to search MEDLINE, EMBASE, and CINAHL for the years 1996 to 2008. Eligible studies were selected after three rounds of duplicate screening in which all authors participated. Data regarding patient, caregiver, health care provider, HIT intervention, outcomes studied, and study design were extracted and maintained in a Microsoft Access database. Stage of research was categorized using the UK's Medical Research Council (MRC) framework for developing and evaluating complex interventions. Quantitative and qualitative descriptive summaries are presented. We included 104 eligible studies (112 articles) conducted in 17 different countries and representing 30 different health conditions. The most common conditions were asthma, type 1 diabetes, special needs, and psychiatric disorder. Most studies (88, 85%) included children 2 to 12 years of age, and 73 (71%) involved home care settings. Health care providers operated in hospital settings in 96 (92%) of the studies. Interventions featured 12 modes of communication (eg, Internet, intranets, telephone, video conferencing, email, short message service [SMS], and

  8. An ambient assisted living approach in designing domiciliary services combined with innovative technologies for patients with Alzheimer's disease: a case study.

    Science.gov (United States)

    Cavallo, Filippo; Aquilano, Michela; Arvati, Marco

    2015-02-01

    Alzheimer's disease (AD) is one of the most disabling diseases to affect large numbers of elderly people worldwide. Because of the characteristics of this disease, patients with AD require daily assistance from service providers both in nursing homes and at home. Domiciliary assistance has been demonstrated to be cost effective and efficient in the first phase of the disease, helping to slow down the course of the illness, improve the quality of life and care, and extend independence for patients and caregivers. In this context, the aim of this work is to demonstrate the technical effectiveness and acceptability of an innovative domiciliary smart sensor system for providing domiciliary assistance to patients with AD which has been developed with an Ambient Assisted Living (AAL) approach. The design, development, testing, and evaluation of the innovative technological solution were performed by a multidisciplinary team. In all, 15 sociomedical operators and 14 patients with AD were directly involved in defining the end-users' needs and requirements, identifying design principles with acceptability and usability features and evaluating the technological solutions before and after the real experimentation. A modular technological system was produced to help caregivers continuously monitor the health status, safety, and daily activities of patients with AD. During the experimentation, the acceptability, utility, usability, and efficacy of this system were evaluated as quite positive. The experience described in this article demonstrated that AAL technologies are feasible and effective nowadays and can be actively used in assisting patients with AD in their homes. The extensive involvement of caregivers in the experimentation allowed to assess that there is, through the use of the technological system, a proven improvement in care performance and efficiency of care provision by both formal and informal caregivers and consequently an increase in the quality of life of

  9. Clinical and economic benefits of integrated pump/CGM technology therapy in patients with type 1 diabetes in Colombia.

    Science.gov (United States)

    Gomez, Ana Maria; Alfonso-Cristancho, Rafael; Orozco, John Jairo; Lynch, Peter Matthew; Prieto, Diana; Saunders, Rhodri; Roze, Stephane; Valencia, Juan Esteban

    2016-11-01

    To assess the long-term clinical and economic impact of integrated pump/CGM technology therapy as compared to multiple daily injections (MDI), for the treatment of type 1 diabetes (T1D) in Colombia. The CORE Diabetes Model was used to simulate a hypothetical cohort of patients with T1D. Mean baseline characteristics were taken from a clinical study conducted in Colombia and a healthcare payer perspective was adopted, with a 5% annual discount rate applied to both costs and outcomes. The integrated pump/CGM improved mean life expectancy by 3.51 years compared with MDI. A similar increase occurred in mean quality-adjusted life expectancy with an additional 3.81 quality-adjusted life years (QALYs). Onset of diabetes-related complications was also delayed as compared to MDI, and mean survival time free of complication increased by 1.74 years with integrated pump/CGM. Although this increased treatment costs of diabetes as compared to MDI, savings were achieved thanks to reduced expenditure on diabetes-related complications. The estimated incremental cost-effectiveness ratio (ICER) for SAP was Colombian Pesos (COP) 44,893,950 (approximately USD$23,200) per QALY gained. Improved blood glucose control associated to integrated pump/CGM results in a decreased incidence of diabetes-related complications and improves life expectancy as compared to MDI. Using recommended thresholds from the World Health Organization and previous coverage decisions about health technologies in Colombia, it is a cost-effective alternative to MDI for the treatment of type 1 diabetes in Colombia. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment – Web-SP

    Directory of Open Access Journals (Sweden)

    Boberg Jonas

    2006-02-01

    Full Text Available Abstract Background The Web-based Simulation of Patients (Web-SP project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines. Results The Web-SP system was constructed to support easy authoring, management and presentation of virtual patient cases. The case authoring environment was found to facilitate for teachers to create full-fledged patient cases without the assistance of computer specialists. Web-SP was successfully implemented at several universities by taking into account key factors such as cost, access, security, scalability and flexibility. Pilot evaluations in medical, dentistry and pharmacy courses shows that students regarded Web-SP as easy to use, engaging and to be of educational value. Cases adapted for all three disciplines were judged to be of significant educational value by the course leaders. Conclusion The Web-SP system seems to fulfil the aim of providing a common generic platform for creation, management and evaluation of web-based virtual patient cases. The responses regarding the authoring environment indicated that the system might be user-friendly enough to appeal to a majority of the academic staff. In terms of implementation strengths, Web-SP seems to fulfil most needs from course directors and teachers from various educational

  11. Technology and Social Media Use Among Patients Enrolled in Outpatient Addiction Treatment Programs: Cross-Sectional Survey Study.

    Science.gov (United States)

    Ashford, Robert D; Lynch, Kevin; Curtis, Brenda

    2018-03-06

    equal percentage reported being exposed to recovery information on social media. There was a significant difference in rates of reporting viewing recovery information on social media across the 3 age groups with Baby Boomers reporting higher rates than Millennials (Psocial media accounts to be monitored as a relapse prevention technique. To our knowledge, this is the first and largest study examining the online behavior and preferences regarding technology-based substance use disorder treatment interventions in a population of patients enrolled in community outpatient treatment programs. Patients were generally receptive to using relapse prevention apps and text messaging interventions and a substantial proportion supported social media surveillance tools. However, the design of technology-based interventions remains as many participants have monthly telephone plans which may limit continuity. ©Robert D Ashford, Kevin Lynch, Brenda Curtis. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.03.2018.

  12. Assessing the use of BreatheSmart® mobile technology in adult patients with asthma: a remote observational study.

    Science.gov (United States)

    Melvin, Emilie; Cushing, Anna; Tam, Anne; Kitada, Ruri; Manice, Melissa

    2017-01-01

    Non-adherence to asthma daily controller medications is a common problem, reported to be responsible for 60% of asthma-related hospitalisations. The mean level of adherence for asthma medications is estimated to be as low as 22%. Therefore, objective measurements of adherence to medicine are necessary. This virtual observational study is designed to measure the usability of an electronic monitoring device platform that measures adherence. Understanding how patients use the BreatheSmart mobile technology at home is essential to assess its feasibility as a solution to improve medication adherence. We anticipate this approach can be applied to real-world environments as a cost-effective solution to improve medication adherence. This is a virtual 6-month observational study of 100 adults (≥18 years) with an asthma diagnosis, using inhaled corticosteroids for at least 3 months. Participants will be recruited in the USA through ad placements online. All participants receive wireless Bluetooth-enabled inhaler sensors that track medication usage and an mSpirometer TM capable of clinical-grade lung function measurements, and download the BreatheSmart mobile application that transmits data to a secure server. All analyses are based on an intention-to-treat. Usability is assessed by patient questionnaires and question sessions. Simple paired t-test is used to assess significant change in Asthma Control Test score, quality of life (EuroQol-5D questionnaire) and lung function. No ethical or safety concerns pertain to the collection of these data. Results of this research are planned to be published as soon as available. NCT03103880.

  13. Empowerment of diabetic patients through mHealth technologies and education: development of a pilot self-management application

    Science.gov (United States)

    Gustin, G.; Macq, B.; Gruson, D.; Kieffer, S.

    2017-11-01

    Diabetes is a major, global and increasing condition that occurs when the insulin-glucagon regulatory mechanism is affected, leading to uncontrolled hyper- and hypoglycaemia events that may be life-threatening. However, it has been shown that through daily monitoring, appropriate patient-specific empowerment, lifestyle behavior of diabetics can be positively influenced and the associated and costly diabetes complications significantly reduced. As personal face-to-face coaching is costly and hard to scale, mobile applications and services have now become a key driver of mobile Health (mHealth) deployment, especially as a helpful way for self-management. Despite the huge mHealth market, a major limitation of many diabetes apps is that they do not use inputted data to help patients determine their daily insulin doses. On the other hand, the majority of existing insulin dose calculator apps provide no protection against - or even may actively contribute to - incorrect or inappropriate dose recommendations that put users at risk. Besides, there is clear evidence that lack of education on insulinotherapy and carbohydrate counting is associated with higher blood glucose variability with type 1 diabetes. Hence, there is a need for an accurate modelling of glucose-insulin dynamics together as well as providing adequate educational support. The aims of this paper are: a) to highlight the usefulness of mHealth technologies in chronic disease management; b) to describe and discuss the development of an insulin bolus calculator integrated into a pilot mHealth app; c) to underline the importance of diabetes self-management education.

  14. Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis: a systematic review and meta-analysis.

    Science.gov (United States)

    Gasparri, Maria Luisa; Nirgianakis, Konstantinos; Taghavi, Katayoun; Papadia, Andrea; Mueller, Michael D

    2018-03-30

    Recent evidence suggests that assisted reproductive technology (ART) increases the risk of adverse pregnancy outcomes, including placental disorders. Similarly, endometriosis resulted detrimental on placenta previa. However, up to 50% of women with endometriosis suffer from infertility, thus requiring ART. The aim of our metanalysis is to compare women with and without endometriosis undergoing ART in terms of placenta disorders events, to establish if ART itself or endometriosis, as an indication to ART, increases the risk of placenta previa. Literature searches were conducted in January 2018 using electronic databases (PubMed, Medline, Scopus, Embase, Science Direct, and the Cochrane Library Scopus). Series comparing pregnancy outcome after ART in women with and without endometriosis were screened and data on placenta previa and placental abruption were extracted. Five retrospective case-control studies met the inclusion criteria. The meta-analysis revealed that endometriosis is associated with an increased risk of placenta previa in pregnancies achieved through ART (OR 2.96 (95% CI 1.25-7.03); p = 0.01, I 2  =69%, random-effect model). No differences in placental abruption incidence were found (OR 0.44 (95% CI 0.10-1.87); p = 0.26, I 2  = 0%, fixed-effect model). Patients with endometriosis undergoing ART may have additional risk of placenta previa. Despite the inability to determine if endometriosis alone or endometriosis plus ART increase the risk, physicians should be aware of the potential additional risk that endometriosis patients undergoing ART harbor.

  15. User-Centered Design Groups to Engage Patients and Caregivers with a Personalized Health Information Technology Tool.

    Science.gov (United States)

    Maher, Molly; Kaziunas, Elizabeth; Ackerman, Mark; Derry, Holly; Forringer, Rachel; Miller, Kristen; O'Reilly, Dennis; An, Larry C; Tewari, Muneesh; Hanauer, David A; Choi, Sung Won

    2016-02-01

    Health information technology (IT) has opened exciting avenues for capturing, delivering and sharing data, and offers the potential to develop cost-effective, patient-focused applications. In recent years, there has been a proliferation of health IT applications such as outpatient portals. Rigorous evaluation is fundamental to ensure effectiveness and sustainability, as resistance to more widespread adoption of outpatient portals may be due to lack of user friendliness. Health IT applications that integrate with the existing electronic health record and present information in a condensed, user-friendly format could improve coordination of care and communication. Importantly, these applications should be developed systematically with appropriate methodological design and testing to ensure usefulness, adoption, and sustainability. Based on our prior work that identified numerous information needs and challenges of HCT, we developed an experimental prototype of a health IT tool, the BMT Roadmap. Our goal was to develop a tool that could be used in the real-world, daily practice of HCT patients and caregivers (users) in the inpatient setting. Herein, we examined the views, needs, and wants of users in the design and development process of the BMT Roadmap through user-centered Design Groups. Three important themes emerged: 1) perception of core features as beneficial (views), 2) alerting the design team to potential issues with the user interface (needs); and 3) providing a deeper understanding of the user experience in terms of wider psychosocial requirements (wants). These findings resulted in changes that led to an improved, functional BMT Roadmap product, which will be tested as an intervention in the pediatric HCT population in the fall of 2015 (ClinicalTrials.govNCT02409121). Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  16. Applying Task-Technology Fit Model to the Healthcare Sector: a Case Study of Hospitals' Computed Tomography Patient-Referral Mechanism.

    Science.gov (United States)

    Chen, Ping-Shun; Yu, Chun-Jen; Chen, Gary Yu-Hsin

    2015-08-01

    With the growth in the number of elderly and people with chronic diseases, the number of hospital services will need to increase in the near future. With myriad of information technologies utilized daily and crucial information-sharing tasks performed at hospitals, understanding the relationship between task performance and information system has become a critical topic. This research explored the resource pooling of hospital management and considered a computed tomography (CT) patient-referral mechanism between two hospitals using the information system theory framework of Task-Technology Fit (TTF) model. The TTF model could be used to assess the 'match' between the task and technology characteristics. The patient-referral process involved an integrated information framework consisting of a hospital information system (HIS), radiology information system (RIS), and picture archiving and communication system (PACS). A formal interview was conducted with the director of the case image center on the applicable characteristics of TTF model. Next, the Icam DEFinition (IDEF0) method was utilized to depict the As-Is and To-Be models for CT patient-referral medical operational processes. Further, the study used the 'leagility' concept to remove non-value-added activities and increase the agility of hospitals. The results indicated that hospital information systems could support the CT patient-referral mechanism, increase hospital performance, reduce patient wait time, and enhance the quality of care for patients.

  17. Rapid and Sensitive Detection of Breast Cancer Cells in Patient Blood with Nuclease-Activated Probe Technology

    Directory of Open Access Journals (Sweden)

    Sven Kruspe

    2017-09-01

    Full Text Available A challenge for circulating tumor cell (CTC-based diagnostics is the development of simple and inexpensive methods that reliably detect the diverse cells that make up CTCs. CTC-derived nucleases are one category of proteins that could be exploited to meet this challenge. Advantages of nucleases as CTC biomarkers include: (1 their elevated expression in many cancer cells, including cells implicated in metastasis that have undergone epithelial-to-mesenchymal transition; and (2 their enzymatic activity, which can be exploited for signal amplification in detection methods. Here, we describe a diagnostic assay based on quenched fluorescent nucleic acid probes that detect breast cancer CTCs via their nuclease activity. This assay exhibited robust performance in distinguishing breast cancer patients from healthy controls, and it is rapid, inexpensive, and easy to implement in most clinical labs. Given its broad applicability, this technology has the potential to have a substantive impact on the diagnosis and treatment of many cancers. Keywords: cancer, circulating tumor cells, diagnostic nucleic acids, nucleases, diagnostic markers, breast cancer, liquid biopsy

  18. Integrated Technologies Like Noninvasive Brain Stimulation (NIBS for Stroke Rehabilitation; New Hopes for Patients, Neuroscientists, and Clinicians in Iran

    Directory of Open Access Journals (Sweden)

    Shahid Bashir

    2010-08-01

    Full Text Available A B S T R A C TThe applications of neurophysiological therapy techniques range far and few in the realm of modern day medicine. However, the concept of electromagnetic stimulation, the basis for many noninvasive brain stimulation (NIBS techniques today, has been of interest to the scientific community since the late nineteenth century. Recently, transcranial direct current stimulation (tDCS and transcranial magnetic stimulation (TMS, two noninvasive neurostimulation techniques, have begun to gain popularity and acceptance in the clinical neurophysiology, neurorehabilitaion, neurology, neuroscience, and psychiatry has spread widely, mostly in research applications, but increasingly with clinical aims in mind. These two neurophysiological techniques have proven to be valuable assets in not only the diagnosis, but also the treatment of many neurological disorders (post-stroke motor deficits, tinnitus, fibromyalgia, depression, epilepsy, autism, ageing and parkinson’s disease. Its effects can be modulated by combination with pharmacological treatment that has undergone resurgence in recent years. In this review we discuss how these integrated technology like NIBS for evaluation in the clinical evidence to date and what mechanism it work for stroke rehabilitation particularly. Then, we will review the current situation of stroke rehabilitation in Iran and new hopes that NIBS could bring for clinicians and patients in this nationally prioritized field.

  19. Obstetric and perinatal outcomes in subfertile patients who conceived following low technology interventions for fertility enhancement: a comprehensive review.

    Science.gov (United States)

    Palomba, Stefano; Santagni, Susanna; Daolio, Jessica; Gibbins, Karen; Battaglia, Francesco Antonino; La Sala, Giovanni Battista; Silver, Robert M

    2018-01-01

    Low technology interventions for fertility enhancement (LTIFE) are strategies that avoid retrieval, handling, and manipulation of female gametes. The definition of LTIFE is yet to be widely accepted and clarified, but they are commonly used in milder cases of infertility and subfertility. Based on these considerations, the aim of the present study was comprehensively to review and investigate the obstetric and perinatal outcomes in subfertile patients who underwent LTIFE. A literature search up to May 2017 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science, and Google Scholar. An evidence-based hierarchy was used according to The Oxford Centre for Evidence-Based Medicine to determine which articles to include and analyze, and to provide a level of evidence of each association between intervention and outcome. This analysis identified preliminary and low-grade evidence on the influence of LTIFE on obstetric and perinatal outcomes in subfertile women. LTIFE women should deserve major consideration from Clinicians/Researchers of Reproductive Medicine, because these treatments could be potentially responsible for mothers' and babies' complications. So far, the lack of well-designed and unbiased studies makes further conclusions difficult to be drawn.

  20. A systematic review on the effect of serious games and wearable technology used in rehabilitation of patients with traumatic bone and soft tissue injuries

    NARCIS (Netherlands)

    Meijer, Henriëtte A. W.; Graafland, Maurits; Goslings, J. Carel; Schijven, Marlies P.

    2017-01-01

    To determine the effects on functional outcomes and treatment adherence of wearable technology and serious games (i.e., interactive computer applications with specific purposes useful in the 'real world') currently applied in physical rehabilitation of patients after traumatic bone and soft tissue

  1. The effect of sodium profiling and feedback technologies on plasma conductivity and ionic mass balance: a study in hypotension-prone dialysis patients.

    NARCIS (Netherlands)

    Moret, K.; Aalten, J.; Wall Bake, A.W. van den; Gerlag, P.G.G.; Beerenhout, C.; Sande, F. van der; Leunissen, K.; Kooman, J.

    2006-01-01

    BACKGROUND: Sodium profiling improves haemodynamic tolerance in haemodialysis (HD) patients but may also influence sodium homeostasis. Changes in blood volume and plasma conductivity (PC) during HD can be modelled by feedback technology, but their effects on sodium homeostasis are not widely

  2. Patient safety and technology-driven medication e A qualitative study on how graduate nursing students navigate through complex medication administration

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Fabricius, Pia

    2014-01-01

    Background: The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26e38% of in-hospital cases. This points to the need for new...... ways of educating nursing students in today's medication administration. Aim: To explore nursing students' experiences and competences with the technology-driven medication administration process. Methods: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... and confidence in using technology, but were fearful of committing serious medication errors. From the nursing students' perspective, experienced nurses deviate from existing guidelines, leaving them feeling isolated in practical learning situations. Conclusion: Having an unclear nursing role model...

  3. Health care's 100 most wired.

    Science.gov (United States)

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key."

  4. Exploring physical activity behaviour - needs for and interest in a technology-delivered, home-based exercise programme among patients with intermittent claudication.

    Science.gov (United States)

    Cornelis, Nils; Buys, Roselien; Fourneau, Inge; Dewit, Tijl; Cornelissen, Véronique

    2018-02-01

    Supervised walking is a first line therapy in peripheral arterial disease (PAD) with complaints of intermittent claudication. However, uptake of supervised programmes is low. Home-based exercise seems an appealing alternative; especially since technological advances, such as tele-coaching and tele-monitoring, may facilitate the process and support patients when adopting a physically active lifestyle. To guide the development of such an intervention, it is important to identify barriers of physical activity and the needs and interests for technology-enabled exercise in this patient group. PAD patients were recruited at the vascular centre of UZ Leuven (Belgium). A questionnaire assessing PA (SF-International Physical Activity Questionnaire), barriers to PA, and interest in technology-supported exercise (Technology Usage Questionnaire) was completed. Descriptive and correlation analyses were performed. Ninety-nine patients (76 men; mean age 69 years) completed the survey. Physical activity levels were low in 48 %, moderate in 29 %, and high in 23 %. Intermittent claudication itself is the most important barrier for enhanced PA, with most patients reporting pain (93 %), need for rest (92 %), and obstacles worsening their pain (74 %) as barriers. A total of 93 % participants owned a mobile phone; 76 % had Internet access. Eighty-seven reported the need for an exercise programme, with 67 % showing interest in tele-coaching to support exercise. If technology was available, three-quarter stated they would be interested in home-based tele-coaching using the Internet (preferably e-mails, 86 %); 50 % via mobile phone, 87 % preferred text messages. Both were inversely related to age (rpb = 0.363 and rpb = 0.255, p exercise, offering opportunities to develop a guided home-based exercise programme.

  5. Prospective Evaluation of a Multifaceted Intervention to Improve Outcomes in Intensive Care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study.

    Science.gov (United States)

    Dykes, Patricia C; Rozenblum, Ronen; Dalal, Anuj; Massaro, Anthony; Chang, Frank; Clements, Marsha; Collins, Sarah; Donze, Jacques; Fagan, Maureen; Gazarian, Priscilla; Hanna, John; Lehmann, Lisa; Leone, Kathleen; Lipsitz, Stuart; McNally, Kelly; Morrison, Conny; Samal, Lipika; Mlaver, Eli; Schnock, Kumiko; Stade, Diana; Williams, Deborah; Yoon, Catherine; Bates, David W

    2017-08-01

    Studies comprehensively assessing interventions to improve team communication and to engage patients and care partners in ICUs are lacking. This study examines the effectiveness of a patient-centered care and engagement program in the medical ICU. Prospective intervention study. Medical ICUs at large tertiary care center. Two thousand one hundred five patient admissions (1,030 before and 1,075 during the intervention) from July 2013 to May 2014 and July 2014 to May 2015. Structured patient-centered care and engagement training program and web-based technology including ICU safety checklist, tools to develop shared care plan, and messaging platform. Patient and care partner access to online portal to view health information, participate in the care plan, and communicate with providers. Primary outcome was aggregate adverse event rate. Secondary outcomes included patient and care partner satisfaction, care plan concordance, and resource utilization. We included 2,105 patient admissions, (1,030 baseline and 1,075 during intervention periods). The aggregate rate of adverse events fell 29%, from 59.0 per 1,000 patient days (95% CI, 51.8-67.2) to 41.9 per 1,000 patient days (95% CI, 36.3-48.3; p communication and patient engagement program in the ICU was associated with a reduction in adverse events and improved patient and care partner satisfaction.

  6. Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy.

    Science.gov (United States)

    Yu, Shui; Li, Hengjin

    2016-01-01

    The current study aimed to assess the value of microplasma radiofrequency technology combined with triamcinolone for the therapy of Chinese patients with hypertrophic scar. A total of 120 participants with hypertrophic scars were enrolled in the current study. Participants were divided into two groups based on sex, and then randomly and evenly divided into four groups (Groups A, B, C, and D). Participants in Group A received microplasma radiofrequency technology combined with triamcinolone. Participants in Group B received microplasma radiofrequency technology combined with normal saline. Participants in Groups C and D received triamcinolone (40 and 10 mg/mL) injected directly into scar. Experienced physicians evaluated the condition of scars according to the Vancouver Scar Scale 1 month before and after the therapy. There was no difference in age, sex, area, height and location of scars, and Vancouver Scar Scale scores before the therapy between any groups (P>0.05 for all). Vancouver Scar Scale scores after the therapy were significantly lower than those before the therapy in all groups (P0.05 for all). Incidences of tissue atrophy after the therapy were significantly lower in Groups A and B than in Group C (P0.05 for all). Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy compared with the use of either microplasma radiofrequency technology or triamcinolone injection alone.

  7. Adopting information technology to drive improvements in patient safety: lessons from the Agency for Healthcare Research and Quality health information technology grantees.

    Science.gov (United States)

    Damberg, Cheryl L; Ridgely, M Susan; Shaw, Rebecca; Meili, Robin C; Sorbero, Melony E S; Bradley, Lily A; Farley, Donna O

    2009-04-01

    To document and assess the experiences of 104 Agency for Healthcare Research and Quality (AHRQ)-funded health information technology (health IT) grantees in planning and implementing health IT systems. Grant proposals and interviews with the AHRQ health IT grantees. Extracted descriptive data from the health IT grant proposals; conducted telephone interviews with principal investigators. AHRQ funding of the health IT projects provided important support for health IT development work in various health care settings. Successful implementation required commitment from top management, dedicated staff and financial resources, an open process to encourage buy-in and enthusiasm by end users, and sheer persistence. Technologies required tailoring to the specific organization's needs. Grantees felt their projects could be replicated by others, if organizations had ample IT expertise and resources. Evaluating the value of health IT was hampered by the absence of validated instruments and measures, organizational demands that competed with data collection, and lack of evaluation expertise among health IT implementers. Experiences of the health IT grantees provide rich information for use by health care providers, AHRQ, and other policy makers to help strengthen future health IT development efforts, including the need to improve evaluation design and standards to assess impact.

  8. A New Classification of Three-Dimensional Printing Technologies: Systematic Review of Three-Dimensional Printing for Patient-Specific Craniomaxillofacial Surgery.

    Science.gov (United States)

    Jacobs, Carly A; Lin, Alexander Y

    2017-05-01

    Three-dimensional printing technology has been advancing in surgical applications. This systematic review examines its patient-specific applications in craniomaxillofacial surgery. Terms related to "three-dimensional printing" and "surgery" were searched on PubMed on May 4, 2015; 313 unique articles were returned. Inclusion and exclusion criteria concentrated on patient-specific surgical applications, yielding 141 full-text articles, of which 33 craniomaxillofacial articles were analyzed. Thirty-three articles included 315 patients who underwent three-dimensional printing-assisted operations. The most common modeling software was Mimics, the most common printing software was 3D Systems, the average time to create a printed object was 18.9 hours (range, 1.5 to 96 hours), and the average cost of a printed object was $1353.31 (range, $69.75 to $5500). Surgical procedures were divided among 203 craniofacial patients (205 three-dimensional printing objects) and 112 maxillofacial patients (137 objects). Printing technologies could be classified as contour models, guides, splints, and implants. For craniofacial patients, 173 contour models (84 percent), 13 guides (6 percent), two splints (1 percent), and 17 implants (8 percent) were made. For maxillofacial patients, 41 contour models (30 percent), 48 guides (35 percent), 40 splints (29 percent), and eight implants (6 percent) were made. These distributions were significantly different (p technology in craniomaxillofacial surgery can be classified into contour models (type I), guides (type II), splints (type III), and implants (type IV). These four methods vary in their use between craniofacial and maxillofacial surgery, reflecting their different goals. This understanding may help advance and predict three-dimensional printing applications for other types of plastic surgery and beyond.

  9. Assisted Reproductive Technology (ART)

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print Assisted Reproductive Technology (ART) ART refers to treatments and procedures that ... American Society for Reproductive Medicine. (2015). Assisted reproductive technologies: A guide for patients . Retrieved May 31, 2016, ...

  10. Based Real Time Remote Health Monitoring Systems: A Review on Patients Prioritization and Related "Big Data" Using Body Sensors information and Communication Technology.

    Science.gov (United States)

    Kalid, Naser; Zaidan, A A; Zaidan, B B; Salman, Omar H; Hashim, M; Muzammil, H

    2017-12-29

    The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.

  11. Adoption of Radiation Technology Among Privately Insured Nonelderly Patients With Cancer in the United States, 2008 to 2014: A Claims-Based Analysis.

    Science.gov (United States)

    Pan, Hubert Y; Jiang, Jing; Shih, Ya-Chen Tina; Smith, Benjamin D

    2017-08-01

    Despite enthusiasm for advanced radiation technologies, understanding of their adoption in recent years is limited. The aim of this study was to elucidate utilization trends of conventional radiation, intensity-modulated radiotherapy (IMRT), brachytherapy, proton radiotherapy, stereotactic body radiotherapy (SBRT), and stereotactic radiosurgery (SRS) using a large convenience sample of irradiated patients with cancer identified from private insurance claims in the United States. The unit of analysis was a claim corresponding to a fraction of delivered radiotherapy from 2008 to 2014. Each claim was assigned a disease site on the basis of the diagnosis code and a radiation technology on the basis of the procedure code. In 2014, conventional radiation and IMRT constituted 56% and 39% of all radiation treatment claims, respectively, while brachytherapy constituted 2%, proton radiotherapy 1%, SBRT 1%, and SRS technologies from 2008 to 2014, while SBRT showed the most robust growth over the study period. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Towards a framework for teaching about information technology risk in health care: Simulating threats to health data and patient safety

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Borycki

    2015-09-01

    Full Text Available In this paper the author describes work towards developing an integrative framework for educating health information technology professionals about technology risk. The framework considers multiple sources of risk to health data quality and integrity that can result from the use of health information technology (HIT and can be used to teach health professional students about these risks when using health technologies. This framework encompasses issues and problems that may arise from varied sources, including intentional alterations (e.g. resulting from hacking and security breaches as well as unintentional breaches and corruption of data (e.g. resulting from technical problems, or from technology-induced errors. The framework that is described has several levels: the level of human factors and usability of HIT, the level of monitoring of security and accuracy, the HIT architectural level, the level of operational and physical checks, the level of healthcare quality assurance policies and the data risk management strategies level. Approaches to monitoring and simulation of risk are also discussed, including a discussion of an innovative approach to monitoring potential quality issues. This is followed by a discussion of the application (using computer simulations to educate both students and health information technology professionals about the impact and spread of technology-induced and related types of data errors involving HIT.

  13. The application of wearable technology in surgery: ensuring the positive impact of the wearable revolution on surgical patients.

    Science.gov (United States)

    Slade Shantz, Jesse Alan; Veillette, Christian J H

    2014-01-01

    Wearable technology has become an important trend in consumer electronics in the past year. The miniaturization and mass production of myriad sensors have made possible the integration of sensors and output devices in wearable platforms. Despite the consumer focus of the wearable revolution some surgical applications are being developed. These fall into augmentative, assistive, and assessment functions and primarily layer onto current surgical workflows. Some challenges to the adoption of wearable technologies are discussed and a conceptual framework for understanding the potential of wearable technology to revolutionize surgical practice are presented.

  14. Innovation Practice Using Pervasive Mobile Technology Solutions to Improve Population Health Management: A Pilot Study of Gestational Diabetes Patient Care in Australia.

    Science.gov (United States)

    Wickramasinghe, Nilmini; Gururajan, Raj

    2016-01-01

    Healthcare service delivery is moving forward from individual care to population health management, because of the fast growth of health records. However, to improve population health performance, it is necessary to leverage relevant data and information using new technology solutions, such as pervasive diabetes mobile technology solution of Inet International Inc., which offers the potential to facilitate patient empowerment with gestational diabetic care. Hence, this article examines the pilot study outcomes of a small clinical trial focusing on pregnant patients affected by gestational diabetes mellitus, in an Australian not for profit healthcare context. The aims include establishing proof of concept and also assessing the usability, acceptability, and functionality of this mobile solution and thereby generate hypotheses to be tested in a large-scale confirmatory clinical trial.

  15. The adoption of a new diagnostic technology for tuberculosis in two Brazilian cities from the perspective of patients and healthcare workers: a qualitative study.

    Science.gov (United States)

    de Camargo, Kenneth R; Guedes, Carla R; Caetano, Rosângela; Menezes, Alexandre; Trajman, Anete

    2015-07-21

    This article presents the qualitative component linked to a larger study of implementation of the Xpert™ MTB/Rif technology in two Brazilian cities. Despite intrinsic advantages of new health technologies, its introduction can be disruptive to existing routines, and it is thus important to understand how these innovations are perceived by the different groups involved in its regular use. This study was based on semi-structured interviews with patients, lab technicians, health care workers and managers involved with diagnosis and care of Tuberculosis (TB). The interviews had their content analyzed in order to abstract the different perspectives for the various actors. For patients the changes were not perceived as significant, since their greatest concerns were related to treatment and the stigma associated with TB. The professionals in general welcomed the new technique, which dramatically decreases the workload, time and reliability of diagnosis, in their view. However, we noted difficulties with the concomitant implementation of new IT technology for recording and reporting test results, which negatively impacted the time necessary to get lab diagnosis to physicians. Through this analysis we detected some bottlenecks in the surrounding environment, not necessarily linked to the technology itself but which could hamper considerably its advantages.

  16. Support needs for medication use and the suitability of eHealth technologies to address these needs: a focus group study of older patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mathijssen EGE

    2018-03-01

    Full Text Available Elke GE Mathijssen,1 Johanna E Vriezekolk,1 Agnes MM Eijsbouts,1 Frank HJ van den Hoogen,1,2 Bart JF van den Bemt3 1Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands; 2Department of Rheumatology, Radboud University Medical Centre, Nijmegen, the Netherlands; 3Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands Objective: The objectives of this study were to explore the needs of patients with rheumatoid arthritis (RA regarding support for medication use and to gain insight into their perspective on the suitability of eHealth technologies to address these needs.Methods: Three focus groups were conducted with 28 patients with RA. Audio recordings made during the focus groups were transcribed verbatim. Two researchers independently performed an inductive, thematic analysis on the data (ie, the transcripts and field notes.Results: The following three themes that described support needs of patients with RA for medication use were identified in the data: 1 informational support; 2 practical support; and 3 emotional support. Informational support reflected the provision of information and facts, including advice, suggestions, and feedback from health care providers. Practical support included the reinforcement of practical skills as well as the provision of medication aids and pharmacy services. Emotional support reflected a trusted patient–health care provider relationship, characterized by good communication. Although potential advantages of eHealth technologies to address the patients’ support needs were recognized, concerns over matters such as personal interaction with health care providers, privacy and data security, and the quality and reliability of online information were prevalent.Conclusion: Patients with RA have informational, practical, and emotional support needs for medication use. Informational support seems to be most important. From the patients’ perspective, eHealth technologies may

  17. Using multimedia technology to help combat the negative effects of protective isolation on patients: the Open Window project--an engineering challenge.

    LENUS (Irish Health Repository)

    Hegarty, F

    2012-02-01

    The Open Window project was established with the aim of creating a "virtual window" for each patient who is confined to protective isolation due to treatment for illness. This virtual window as developed provides a range of media or experiences. This paper describes the approach taken to the system design and discusses initial experiences with implementing such a system in a critical care setting. The system design was predicated on two guiding principles. Firstly it should be intuitive to use and the technology used to create the virtual window hidden from patient view. Secondly the system must be able to be installed at the point of care in a way that delivers the experience under the patient\\'s control, without compromising the function or safety of the clinical environment. Patient acceptance of the system is being measured as part of an on-going trial and at this interim phase of data analysis 100% (n=55) of participants in the intervention group have reported that the technology was easy to use. We conclude that the system as designed and installed is an effective, robust and reliable system upon which to base a multimedia interventions in a critical care room.

  18. Technologies to better serve the millions of diabetic patients: a holistic, interactive and persuasive ICT model to facilitate self care, in extremely poor rural zones of Central America.

    Science.gov (United States)

    Vargas-Lombardo, Miguel; Jipsion, Armando; Vejarano, Rafael; Camargo, Ismael; Alvarez, Humberto; Mora, Elena Villalba; Ruíz, Ernestina Menasalva

    2012-04-01

    Health indicators express remarkable gaps between health systems at a world-wide level. Countries of the entire world are overflowed by the need of new strategies, methodologies and technologies to better serve the millions of patients, who demand better medical attention. The present archaic and ephemerally systematized systems widen the gap even more than the quality of medical services that should be provided for the millions of diabetic patients. It is therefore necessary to develop highly familiar environments with diabetic patients and their care needs. A Holistic, Interactive and Persuasive ICT model to facilitate self care of patients with diabetes (hIPAPD), is proposed as an innovative technological development in Panama to health optimized treatment for diabetic patients. Three health centers located in the District of Aguadulce, Province of Cocle, located on Panama's Pacific Coast, were selected to validate the model; the area presents extremely poor population, mostly with one daily meal, without any health insurance and with a high illiteracy rate. A series of experiences in the application and validation process are presented and analyzed in order to confirm the application, value and contribution of ICTs in health care in poor regions of Central America.

  19. Dental care providers' and patients' perceptions of the effect of health information technology in the dental care setting.

    Science.gov (United States)

    Asan, Onur; Ye, Zhan; Acharya, Amit

    2013-09-01

    The use of electronic health records (EHRs) in dental care and their effect on dental care provider-patient interaction have not been studied sufficiently. The authors conducted a study to explore dental care providers' interactions with EHRs during patient visits, how these interactions influence dental care provider-patient communication, and the providers' and patients' perception of EHR use in the dental clinic setting during patient visits. The authors collected survey and interview data from patients and providers at three dental clinics in a health care system. The authors used qualitative and quantitative methods to analyze data obtained from patients and dental care providers. The provider survey results showed significant differences in perceptions of EHR use in patient visits across dental care provider groups (dentists, dental hygienists and dental assistants). Patient survey results indicated that some patients experienced a certain level of frustration and distraction because of providers' use of EHRs during the visit. The provider survey results indicated that there are different perceptions across provider groups about EHRs and the effect of computer use on communication with patients. Dental assistants generally reported more negative effects on communication with patients owing to computer use. Interview results also indicated that dental care providers may not feel comfortable interacting with the EHR without having any verbal or eye contact with patients during the patient's dental visit. A new design for dental operatories and locations of computer screens within the operatories should be undertaken to prevent negative nonverbal communication such as loss of eye contact or forcing the provider and patient to sit back to back, as well as to enhance patient education and information sharing.

  20. Evaluation of internet-based technology for supporting self-care: problems encountered by patients and caregivers when using self-care applications.

    Science.gov (United States)

    Nijland, Nicol; van Gemert-Pijnen, Julia; Boer, Henk; Steehouder, Michaël F; Seydel, Erwin R

    2008-05-15

    Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care. The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care. We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice. Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients' health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients' needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of secure email consultation

  1. What kind of information and communication technologies do patients with COPD prefer to use? A cross-sectional study in Latin America.

    Science.gov (United States)

    Cherrez Ojeda, Ivan; Calderon, J C; Jove, O López; Guerreros, A; Plaza, Karin J; Cano, Jose A; Vanegas, E; Felix, M; Mata, V; Calero, E; Cherrez, A; Simancas-Racines, D

    2017-01-01

    The aim of the present study was to assess the frequency of uses and preferences of information and communication technologies (ICTs) among Latin American chronic obstructive pulmonary disease (COPD) patients. We conducted an anonymous cross-sectional survey study on Latin American COPD patients. The adapted version of the Michigan questionnaire was employed in eligible outpatients in different cities of Latin America. We categorized age and educational levels into three groups. The time passed since COPD diagnosis was categorized as ≤5 years and >5 years. χ 2 and crude and adjusted logistic regressions were performed. A total of 256 patients were enrolled with a mean age of 68.7 years old. The most recurrently used ICTs were short message service (SMS; 47.1%) and WhatsApp (30.7%) for receiving COPD information. Moreover, SMS (85.8%) and Facebook (36.1%) were rated as useful for asking physicians information about COPD. Regression analysis showed that the best predictor for patients using ICTs, for any purpose, was higher education (undergraduate or graduate school). Understanding the preferences of ICTs among COPD patients could help improve patient's outcomes through developing applications in response to specific requirements of each patient.

  2. Using multimedia technology to help combat the negative effects of protective isolation on patients: the Open Window project--an engineering challenge.

    Science.gov (United States)

    Hegarty, F; Roche, D; McCabe, C; McCann, S

    2009-01-01

    The Open Window project was established with the aim of creating a "virtual window" for each patient who is confined to protective isolation due to treatment for illness. This virtual window as developed provides a range of media or experiences. This paper describes the approach taken to the system design and discusses initial experiences with implementing such a system in a critical care setting. The system design was predicated on two guiding principles. Firstly it should be intuitive to use and the technology used to create the virtual window hidden from patient view. Secondly the system must be able to be installed at the point of care in a way that delivers the experience under the patient's control, without compromising the function or safety of the clinical environment. Patient acceptance of the system is being measured as part of an on-going trial and at this interim phase of data analysis 100% (n=55) of participants in the intervention group have reported that the technology was easy to use. We conclude that the system as designed and installed is an effective, robust and reliable system upon which to base a multimedia interventions in a critical care room.

  3. Can information and communication technologies support patient engagement? A review of opportunities and challenges in health social work.

    Science.gov (United States)

    Craig, Shelley L; Calleja Lorenzo, Maria Victoria

    2014-10-01

    Despite becoming a prerequisite for participation in an information-based society, the use of information communication technologies (ICT) within social work and health care remains in its infancy. Currently, there is a push to adopt newer technologies to enhance practice. This article aims to highlight some of the innovative ways in which ICT have been adopted and adapted to augment social work practice. The need for social workers to become proficient in the use of newer technologies, opportunities for implementing ICT within a health care setting, and potential challenges at the professional, ethical, and systemic level are explored. Using the available literature as a guide, recommendations and strategies to strengthen implementation of ICTs into health social work are provided.

  4. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine').

    Science.gov (United States)

    Orth, Matthias; Averina, Maria; Chatzipanagiotou, Stylianos; Faure, Gilbert; Haushofer, Alexander; Kusec, Vesna; Machado, Augusto; Misbah, Siraj A; Oosterhuis, Wytze; Pulkki, Kari; Twomey, Patrick J; Wieland, Eberhard

    2017-12-22

    The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts-exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction undergoing emergent PCI.

    Science.gov (United States)

    Yang, Wu-Xiao; Lai, Chun-Lin; Chen, Fu-Heng; Wang, Ji-Rong; Ji, You-Rui; Wang, Dong-Xia

    2017-06-01

    The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function. Anticoagulant therapy selected was of low molecular weight heparin calcium perioperatively, intraoperative unfractionated heparin, and clopidogrel (75 mg) combined with aspirin enteric-coated tablets (100 mg) as antiplatelet drugs. The therapy was administered in accordance with blood coagulation results. The blood coagulation time, postoperative creatine kinase isoenzyme MB, cardiac troponin I and B-type natriuretic peptide levels in the observation group are significantly lower than those in the control group (P0.05). The incidence of recurrent myocardial infarction, microembolism, acute and subacute thrombosis and bleeding events in the observation group are significantly lower than those in the control group (P0.05). Whereas, in the observation group, there is significant difference in coagulation indexes of the patients with thrombosis events or bleeding events or no event (P<0.05). In conclusion, Sonoclot detection technology instructs emergent PCI treatment in AMI patients to shorten the detection time of blood coagulation, reduce the degree of myocardial injury, reduce the incidence of perioperative thrombosis and bleeding events. Furthermore, it has great value in guiding the clinical medication of anticoagulation and

  6. Magnetic resonance imaging-guided focused ultrasound treatment of symptomatic uterine fibroids: impact of technology advancement on ablation volumes in 115 patients.

    Science.gov (United States)

    Trumm, Christoph G; Stahl, Robert; Clevert, Dirk-André; Herzog, Peter; Mindjuk, Irene; Kornprobst, Sabine; Schwarz, Christina; Hoffmann, Ralf-Thorsten; Reiser, Maximilian F; Matzko, Matthias

    2013-06-01

    The aim of this study was to assess the impact of the advanced technology of the new ExAblate 2100 system (Insightec Ltd, Haifa, Israel) for magnetic resonance imaging (MRI)-guided focused ultrasound surgery on treatment outcomes in patients with symptomatic uterine fibroids, as measured by the nonperfused volume ratio. This is a retrospective analysis of 115 women (mean age, 42 years; range, 27-54 years) with symptomatic fibroids who consecutively underwent MRI-guided focused ultrasound treatment in a single center with the new generation ExAblate 2100 system from November 2010 to June 2011. Mean ± SD total volume and number of treated fibroids (per patient) were 89 ± 94 cm and 2.2 ± 1.7, respectively. Patient baseline characteristics were analyzed regarding their impact on the resulting nonperfused volume ratio. Magnetic resonance imaging-guided focused ultrasound treatment was technically successful in 115 of 123 patients (93.5%). In 8 patients, treatment was not possible because of bowel loops in the beam pathway that could not be mitigated (n = 6), patient movement (n = 1), and system malfunction (n = 1). Mean nonperfused volume ratio was 88% ± 15% (range, 38%-100%). Mean applied energy level was 5400 ± 1200 J, and mean number of sonications was 74 ± 27. No major complications occurred. Two cases of first-degree skin burn resolved within 1 week after the intervention. Of the baseline characteristics analyzed, only the planned treatment volume had a statistically significant impact on nonperfused volume ratio. With technological advancement, the outcome of MRI-guided focused ultrasound treatment in terms of the nonperfused volume ratio can be enhanced with a high safety profile, markedly exceeding results reported in previous clinical trials.

  7. Improving quality of fall prevention and management in elderly patients using information technology: The impact of computerized decision support

    NARCIS (Netherlands)

    Askari, M.

    2014-01-01

    This thesis explores the role of information technology (IT) for prevention and management of falls in both general practice and hospital settings. Specifically, we address the question of how disease management concepts, process modeling, prognostic models and computerized decision support systems

  8. Patient Portals as a Means of Information and Communication Technology Support to Patient- Centric Care Coordination - the Missing Evidence and the Challenges of Evaluation. A joint contribution of IMIA WG EVAL and EFMI WG EVAL.

    Science.gov (United States)

    Rigby, M; Georgiou, A; Hyppönen, H; Ammenwerth, E; de Keizer, N; Magrabi, F; Scott, P

    2015-08-13

    To review the potential contribution of Information and Communication Technology (ICT) to enable patient-centric and coordinated care, and in particular to explore the role of patient portals as a developing ICT tool, to assess the available evidence, and to describe the evaluation challenges. Reviews of IMIA, EFMI, and other initiatives, together with literature reviews. We present the progression from care coordination to care integration, and from patient-centric to person-centric approaches. We describe the different roles of ICT as an enabler of the effective presentation of information as and when needed. We focus on the patient's role as a co-producer of health as well as the focus and purpose of care. We discuss the need for changing organisational processes as well as the current mixed evidence regarding patient portals as a logical tool, and the reasons for this dichotomy, together with the evaluation principles supported by theoretical frameworks so as to yield robust evidence. There is expressed commitment to coordinated care and to putting the patient in the centre. However to achieve this, new interactive patient portals will be needed to enable peer communication by all stakeholders including patients and professionals. Few portals capable of this exist to date. The evaluation of these portals as enablers of system change, rather than as simple windows into electronic records, is at an early stage and novel evaluation approaches are needed.

  9. What Kind of Information and Communication Technologies Do Patients with Type 2 Diabetes Mellitus Prefer? An Ecuadorian Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Iván Chérrez-Ojeda

    2018-01-01

    Full Text Available Purpose. The purpose of this study is to assess the frequency of use of information and communication technologies and patterns of preference among Ecuadorian patients with diabetes. Methods. We conducted an anonymous cross-sectional survey on type 2 diabetes mellitus. A chi-square test for association and adjusted regression analyses were performed. Results. 248 patients were enrolled, with a mean sample age of 57.7 years. SMS was the most used ICT (66.0%. The Internet was used by 45.2% of patients to obtain information about diabetes. SMS and email were rated as the most useful ICTs for receiving information (64.5% and 28.1%, resp. and asking physicians about diabetes (63.8% and 26.1%, resp.. Patients were also interested in receiving disease information (82.4% and asking physicians about diabetes (84.7% through WhatsApp. Adjusted logistic regressions revealed that individuals aged 55 years or younger, those with superior degree level, and those with long diabetes history preferred email for receiving information and asking physicians about diabetes compared to those above 55 years, those with low education level, and those with short diabetes history, respectively. Conclusion. Understanding preferences of ICTs among patients with diabetes could facilitate application development targeted towards specific requirements from patients.

  10. Using tablet-based technology in patient education about systemic therapy options for early-stage breast cancer: a pilot study.

    Science.gov (United States)

    Morgan, E R; Laing, K; McCarthy, J; McCrate, F; Seal, M D

    2015-10-01

    Patient education in early-stage breast cancer has been shown to improve patient well-being and quality of life, but it poses a challenge given the increasingly complex regimens and time constraints in clinical practice. Technology-aided teaching in the clinic could help to improve the understanding of adjuvant systemic therapy for patients. In this prospective pilot study, we used a clinician-administered, tablet-based teaching aid to teach patients with early-stage breast cancer about adjuvant systemic therapy. Participation was offered to newly diagnosed patients with early-stage breast cancer presenting for their first medical oncology visit at a provincial cancer centre. Participants were shown a tablet-based presentation describing procedures, rationales, risks, and benefits of adjuvant systemic therapy as an adjunct to a discussion with the medical oncologist. After the clinic visit, participants completed a questionnaire measuring satisfaction with the visit and knowledge of the treatment plan discussed. The 25 patients recruited for the study had a mean age of 57 years. An offer of upfront chemotherapy alone was made to 12 participants (48%), chemotherapy with trastuzumab to 4 (16%), and hormonal therapy to 9 (36%). Correct answers to all questions related to treatment knowledge were given by 22 patients (88%). Satisfaction with the clinic visit was high (mean satisfaction score: 4.53 ± 0.1 of a possible 5). We found that a tablet-based presentation about adjuvant systemic therapy was satisfactory to patients with early-stage breast cancer and that knowledge retention after the clinic visit was high. Tablet-based teaching could be a feasible and effective way of educating patients in the breast oncology clinic and warrants further investigation in randomized studies.

  11. [Mini-invasive technologies in treatment of acute cholecystitis in patients with high operational and anesthetic risk].

    Science.gov (United States)

    Ermolov, A S; Guliaev, A A; Ivanov, P A; Samsonov, V T; Rogal', M L; Timerbaev, V Kh; Trofimova, E Iu; Kudriashova, N E; Tlibekova, M A

    2014-01-01

    The treatment results of 769 patients with acute calculous cholecystitis and high operational and anesthetic risk at admission are presented in the retrospective study. High risk was determined by expressed comorbidities, diseases' terms, the complications of acute cholecystitis, age, which was more than 60 years in most cases. The patients were divided into 2 groups depending on the severity of comorbidity and the possible effects of its correction. The first group included 617 perspective patients for cholecystectomy. And the second group included 152 patients unpromising for this. Concept of stage treatment was used in the first group including primary decompression of the gallbladder by using of percutaneous transhepatic micro-cholecystostomy under ultrasound guidance. Cholecystectomy was performed after correction of comorbidities, complications of acute cholecystitis, and readjustment of extrahepatic bile ducts by endoscopy if necessary. Laparoscopic cholecystectomy was successfully performed in 587 patients. There was open cholecystectomy in 11 cases. Cholecystectomy was done in 19 patients as a result of conversion. Cholecystostomy from minimal access with extraction of stones under local anesthesia was performed in the second group for decompression and as definitive treatment. There was not observed deaths in patients with high operational and anesthetic risk as a result of such tactics. Postoperatively 1.7% of patients had complications that were successfully resolved.

  12. Information and Communication Technologies in the Care of the Elderly: Systematic Review of Applications Aimed at Patients With Dementia and Caregivers

    Science.gov (United States)

    2016-01-01

    Background The interest in applying information and communications technology (ICT) in older adult health care is frequently promoted by the increasing and unsustainable costs of health care services. In turn, the unprecedented growth of the elderly population around the globe has urged institutions, companies, industries, and governments to respond to older adults’ medical needs. Objective The aim of this review is to systematically identify the opportunities that ICT offers to health services, specifically for patients with dementia and their families. Methods A systematic review of the literature about ICT applications that have been developed to assist patients with Alzheimer’s disease (AD) and their primary caregivers was conducted. The bibliographic search included works published between January 2005 and July 2015 in the databases Springer Link, Scopus, and Google Scholar. Of the published papers, 902 were obtained in the initial search, of which 214 were potentially relevant. Included studies fulfilled the following inclusion criteria: (1) studies carried out between the years of 2005 and 2015, (2) studies were published in English or Spanish, (3) studies with titles containing the keywords, (4) studies with abstracts containing information on ICT applications and AD, and (5) studies published in indexed journals, proceedings, and book chapters. Results A total of 26 studies satisfied the inclusion criteria for the current review. Among them, 16 were aimed at the patient with AD and 10 at the primary caregivers and/or family members. The studies targeted applications that included assistive technology (44%, 7/16), telecare (37%, 6/16), and telemedicine (31%, 5/16). The information systems (56%, 9/16) and Internet (44%, 7/16) were the most commonly used enabling technologies for the studies. Finally, areas of attention more covered by the studies were care (56%, 9/16), treatment (56%, 9/16), and management (50%, 8/16). Furthermore, it was found that 20

  13. Optimizing the technological and informational relationship of the health care process and of the communication between physician and patient--factors that have an impact on the process of diagnosis from the physician's and the patient's perspectives.

    Science.gov (United States)

    Purcarea, V L; Petrescu, D G; Gheorghe, I R; Petrescu, C M

    2011-05-15

    The optimization of a diagnosis process and fluency in the Health Care sector in Romania. A key to discover this complex process was to determine a correlation between the physicians and the use of information technology, on one side and the patients' perspective on the other. Integrating information technology in a physician's activity will lead to lower costs and less time spent while diagnosing patients. Using the electronic medical records and introducing a unified database with the patients' medical histories will make the process of diagnosis easier. We studied the diagnosis from the point of view of 304 patients in a public hospital and 320 physicians working there. We believed that time and accessibility to different physicians makes the diagnosis process a burden for a patient and implicitly lead to dissatisfaction with health care services. We supposed that the burden of diagnosis for physicians comes from the lack of Internet connection and computer usage knowledge. We have found out that most physicians know how to use the computer at an intermediate level and have access to Internet, online journals and databases and do not use emails to a higher extent to communicate to other specialists, but do not rely entirely on the electronic medical records. Most physicians think that it is not technology, which stands in the way of proper and fast diagnosis but the financing and the paper work from the Romanian health system. Solutions that might be taken into account to entirely motivate physicians to use electronic medical records are: 1. Adjustments can be made to the computer software interface in order to make the design more consistent (to eliminate the paper forms) and user friendly. 2. Physicians can be provided with more training and knowledge. After some statistical tests have been applied to find a correlation between the chosen variables, we have reached the conclusion that the results are encouraging and there is no correlation between the degree

  14. New concept using Passive Infrared (PIR) technology for a contactless detection of breathing movement: a pilot study involving a cohort of 169 adult patients.

    Science.gov (United States)

    Hers, V; Corbugy, D; Joslet, I; Hermant, P; Demarteau, J; Delhougne, B; Vandermoten, G; Hermanne, J P

    2013-10-01

    A pilot study has been conducted to validate the Breath Motion Detecting System (BMDS), a new concept using Passive Infrared (PIR) technology for a contactless detection of respiratory movements. The primary objective of the study was to show if movements detected during sleep by the BMDS were indeed related to breathing. This medical device is not intended to measure the respiratory rate, but in a second step, it will be able to detect pathological central apnea in adults. One hundred and sixty-nine adult patients underwent a full polysomnography in which each respiratory movement was recorded concomitantly through the BMDS. Curves obtained by the BMDS were compared to those of thoracic movements recorded by classical piezoelectric belts and of pressure obtained with nasal cannula. The correlations between the PIR sensors were highly indicative of respiratory movement detection. Since PIR sensors are sensitive only to the exemplification of the rib cage, they did not detect obstructive apnea. Unfortunately, only a few patients in the studied population had a central apnea. Moreover as our sleep laboratory was equipped only with piezoelectric bands, the central apnea respiratory effort data are not a validated signal to be used during sleep recordings. The data recorded by the BMDS demonstrate the ability of the PIR technology to detect respiratory movements in adults. The concept is practical, inexpensive and safe for the patient. Further studies with respiratory inductive plethysmography are needed to investigate the potential of BMDS to detect central apneas.

  15. The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication

    Directory of Open Access Journals (Sweden)

    Wenhao Zheng

    2018-01-01

    Full Text Available Purpose. The aim of this study was to assess the feasibility and effectiveness of the three-dimensional (3D printing technology in the treatment of Pilon fractures. Methods. 100 patients with Pilon fractures from March 2013 to December 2016 were enrolled in our study. They were divided randomly into 3D printing group (n=50 and conventional group (n=50. The 3D models were used to simulate the surgery and carry out the surgery according to plan in 3D printing group. Operation time, blood loss, fluoroscopy times, fracture union time, and fracture reduction as well as functional outcomes including VAS and AOFAS score and complications were recorded. To examine the feasibility of this approach, we invited surgeons and patients to complete questionnaires. Results. 3D printing group showed significantly shorter operation time, less blood loss volume and fluoroscopy times, higher rate of anatomic reduction and rate of excellent and good outcome than conventional group (P<0.001, P<0.001, P<0.001, P=0.040, and P=0.029, resp.. However, no significant difference was observed in complications between the two groups (P=0.510. Furthermore, the questionnaire suggested that both surgeons and patients got high scores of overall satisfaction with the use of 3D printing models. Conclusion. Our study indicated that the use of 3D printing technology to treat Pilon fractures in clinical practice is feasible.

  16. Dental care of patients after surgical therapy of inborn oro-facial clefts 3D technologies in diagnostics and therapy of cleft patients

    OpenAIRE

    Kašparová, Magdaléna

    2015-01-01

    Patients with orofacial defects, inborn or acquired, isolated or in combination with other handicaps in syndroms, suffer from various problems including psychological problems. Morphological changes within these handicaps burden not only the patients themselves, but also their families. Among the main problems are difficulties with feeding, speech or breathing. Anomalies in number or position of deciduous and permanent teeth, development of jaws and dental arches are often present. Multidisci...

  17. Information Technology in Critical Care: Review of Monitoring and Data Acquisition Systems for Patient Care and Research

    OpenAIRE

    De Georgia, Michael A.; Kaffashi, Farhad; Jacono, Frank J.; Loparo, Kenneth A.

    2015-01-01

    There is a broad consensus that 21st century health care will require intensive use of information technology to acquire and analyze data and then manage and disseminate information extracted from the data. No area is more data intensive than the intensive care unit. While there have been major improvements in intensive care monitoring, the medical industry, for the most part, has not incorporated many of the advances in computer science, biomedical engineering, signal processing, and mathema...

  18. The Application of Wearable Technology in Surgery: Ensuring the Positive Impact of the Wearable Revolution on Surgical Patients

    OpenAIRE

    Jesse Alan Slade Shantz; Jesse Alan Slade Shantz; Christian Henri Veillette

    2014-01-01

    Wearable technology has become an important trend in consumer electronics in the past year. The miniaturization and mass production of myriad sensors has made possible the integration of sensors and output devices in wearable platforms. Despite the consumer focus of the wearable revolution some surgical applications are being developed. These fall into augmentative, assistive and assessment functions and primarily layer onto current surgical workflows. Some challenges to the adoption of w...

  19. Technology-aided programs for post-coma patients emerged from or in a minimally conscious state

    Directory of Open Access Journals (Sweden)

    Giulio E. Lancioni

    2014-12-01

    Full Text Available Post-coma persons in a minimally conscious state (MCS or emerged/emerging from such state (E-MCS, who are affected by extensive motor impairment and lack of speech, may develop an active role and interact with their environment with the help of technology-aided intervention programs. Although a number of studies have been conducted in this area during the last few years, new evidence about the efficacy of those programs is warranted. These three studies were an effort in that direction. Study I assessed a technology-aided program to enable six MCS participants to access preferred environmental stimulation independently. Studies II and III assessed technology-aided programs to enable six E-MCS participants to make choices. In Study II, three of those participants were led to choose among leisure and social stimuli, and caregiver interventions automatically presented to them. In Study III, the remaining three participants were led to choose (a among general stimulus/intervention options (e.g., songs, video-recordings of family members, and caregiver interventions and then (b among variants of those options. The results of all three studies were largely positive with substantial increases of independent stimulation access for the participants of Study I and independent choice behavior for the participants of Studies II and III. The results were analyzed in relation to previous data and in terms of their implications for daily contexts working with MCS and E-MCS persons affected by multiple disabilities.

  20. The understanding and interpretation of innovative technology-enabled multidimensional physical activity feedback in patients at risk of future chronic disease.

    Directory of Open Access Journals (Sweden)

    Max J Western

    Full Text Available Innovative physical activity monitoring technology can be used to depict rich visual feedback that encompasses the various aspects of physical activity known to be important for health. However, it is unknown whether patients who are at risk of chronic disease would understand such sophisticated personalised feedback or whether they would find it useful and motivating. The purpose of the present study was to determine whether technology-enabled multidimensional physical activity graphics and visualisations are comprehensible and usable for patients at risk of chronic disease.We developed several iterations of graphics depicting minute-by-minute activity patterns and integrated physical activity health targets. Subsequently, patients at moderate/high risk of chronic disease (n=29 and healthcare practitioners (n=15 from South West England underwent full 7-days activity monitoring followed by individual semi-structured interviews in which they were asked to comment on their own personalised visual feedback Framework analysis was used to gauge their interpretation and of personalised feedback, graphics and visualisations.We identified two main components focussing on (a the interpretation of feedback designs and data and (b the impact of personalised visual physical activity feedback on facilitation of health behaviour change. Participants demonstrated a clear ability to understand the sophisticated personal information plus an enhanced physical activity knowledge. They reported that receiving multidimensional feedback was motivating and could be usefully applied to facilitate their efforts in becoming more physically active.Multidimensional physical activity feedback can be made comprehensible, informative and motivational by using appropriate graphics and visualisations. There is an opportunity to exploit the full potential created by technological innovation and provide sophisticated personalised physical activity feedback as an adjunct to

  1. The understanding and interpretation of innovative technology-enabled multidimensional physical activity feedback in patients at risk of future chronic disease.

    Science.gov (United States)

    Western, Max J; Peacock, Oliver J; Stathi, Afroditi; Thompson, Dylan

    2015-01-01

    Innovative physical activity monitoring technology can be used to depict rich visual feedback that encompasses the various aspects of physical activity known to be important for health. However, it is unknown whether patients who are at risk of chronic disease would understand such sophisticated personalised feedback or whether they would find it useful and motivating. The purpose of the present study was to determine whether technology-enabled multidimensional physical activity graphics and visualisations are comprehensible and usable for patients at risk of chronic disease. We developed several iterations of graphics depicting minute-by-minute activity patterns and integrated physical activity health targets. Subsequently, patients at moderate/high risk of chronic disease (n=29) and healthcare practitioners (n=15) from South West England underwent full 7-days activity monitoring followed by individual semi-structured interviews in which they were asked to comment on their own personalised visual feedback Framework analysis was used to gauge their interpretation and of personalised feedback, graphics and visualisations. We identified two main components focussing on (a) the interpretation of feedback designs and data and (b) the impact of personalised visual physical activity feedback on facilitation of health behaviour change. Participants demonstrated a clear ability to understand the sophisticated personal information plus an enhanced physical activity knowledge. They reported that receiving multidimensional feedback was motivating and could be usefully applied to facilitate their efforts in becoming more physically active. Multidimensional physical activity feedback can be made comprehensible, informative and motivational by using appropriate graphics and visualisations. There is an opportunity to exploit the full potential created by technological innovation and provide sophisticated personalised physical activity feedback as an adjunct to support behaviour

  2. Raman spectroscopy technology to monitor the carotenoids in skin of thalassemia patients: a novel non-invasive tool relating oxidative stress with iron burden

    Directory of Open Access Journals (Sweden)

    Anna Perrone

    2014-09-01

    Full Text Available In this work we approach the relationship between redox state and iron overload by noninvasive instrumental techniques. Intracardiac, liver iron and liver fibrosis have been monitored in transfusion-dependent thalassemia patients by magnetic resonance imaging and hepatic transient elastography examinations. These measurements have been matched with a non-invasive, and yet unexplored in clinical practice, evaluation of body’s oxidative stress through measurement of antioxidant carotenoids in skin, by a spectroscopic method based on Raman technology (RRS. The global body’s antioxidant status results from a balance between the level of antioxidants in cells and body fluids, including blood, and pro-oxidant species endogenously produced or coming from external sources. On this basis, the level of skin carotenoids can be considered a biomarker of the entire antioxidant status. In our work the use of RRS method provided information on the redox state of thalassemia patients, which was correlated with the iron status of the patients. Due to the highly adverse effects of accumulated iron, the novel, simple, non-invasive RRS to monitor dermal carotenoids with high compliance of the patients may be a useful tool for the management of thalassemia patients.

  3. BMT Roadmap: A User-Centered Design Health Information Technology Tool to Promote Patient-Centered Care in Pediatric Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Runaas, Lyndsey; Hanauer, David; Maher, Molly; Bischoff, Evan; Fauer, Alex; Hoang, Tiffany; Munaco, Anna; Sankaran, Roshun; Gupta, Rahael; Seyedsalehi, Sajjad; Cohn, Amy; An, Larry; Tewari, Muneesh; Choi, Sung Won

    2017-05-01

    Health information technology (HIT) has great potential for increasing patient engagement. Pediatric hematopoietic cell transplantation (HCT) is a setting ripe for using HIT but in which little research exists. "BMT Roadmap" is a web-based application that integrates patient-specific information and includes several domains: laboratory results, medications, clinical trial details, photos of the healthcare team, trajectory of transplant process, and discharge checklist. BMT Roadmap was provided to 10 caregivers of patients undergoing first-time HCT. Research assistants performed weekly qualitative interviews throughout the patient's hospitalization and at discharge and day 100 to assess the impact of BMT Roadmap. Rigorous thematic analysis revealed 5 recurrent themes: emotional impact of the HCT process itself; critical importance of communication among patients, caregivers, and healthcare providers; ways in which BMT Roadmap was helpful during inpatient setting; suggestions for improving BMT Roadmap; and other strategies for organization and management of complex healthcare needs that could be incorporated into BMT Roadmap. Caregivers found the tool useful and easy to use, leading them to want even greater access to information. BMT Roadmap was feasible, with no disruption to inpatient care. Although this initial study is limited by the small sample size and single-institution experience, these initial findings are encouraging and support further investigation. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  4. Evaluation the effectiveness of remote blood pressure monitoring technology in patients with hypertension on the basis of clinical recommendations performance measures

    Directory of Open Access Journals (Sweden)

    Posnenkova O.M.

    2015-06-01

    Material and Methods ― Remote BP monitoring was organized on the basis of computer system which automatically in text messages send requests about BP level to Htn patients. Obtained BP results were stored in the system and automatically worked. A doctor corrected a patient’s therapy if necessary based on this information. To evaluate the effectiveness of a new technology one year observation of 97 Htn patients was organized (54.6% – male aged 49±11 years. Patients regularly responded to automated SMS requests the computer system about the level of blood pressure. The effectiveness was evaluated with the help of the following hypertension guidelines performance measures: 1 a part of patients with four or more BP results during the previous 12 months; 2 a part of patients with BP above the goal level who prescribed two or more antihypertensive drugs on the last visit during the previous 12 months; 3 a part of patients with BP above the goal level 140/90 mm Hg who prescribed two or more antihypertensive drugs on the last visit during the previous 12 months; 4 a part of patients with goal blood pressure (less than 140/90 mmHg on the last visit during the previous 12 months. To evaluate a performance of these measures before BP monitoring the data extracted from patients’ ambulatory cards were used. Results ― 62 patients completed one-year BP monitoring A part of patients with four or more BP results during the previous 12 months increased from 21% to 100% (p<0.001. From 70% to 82% increased the part of patients who were prescribed two or more antihypertensive drugs (p=0.091. From 31% to 15% reduced the part of hypertensives with uncontrolled BP who were prescribed less than two antihypertensive drugs on the last visit (p=0.044. After one-year monitoring a goal BP was registered in 77% of Htn patients versus 13% at the start of the observation (p<0.001. Conclusion ― Htn guidelines performance measures allowed evaluate quantitatively the positive influence

  5. Building partnerships: a pilot study of stakeholders' attitudes on technology disruption in behavioral health delivery and research.

    Science.gov (United States)

    Sucala, Madalina; Nilsen, Wendy; Muench, Frederick

    2017-12-01

    Collaborations between scientists, care providers, and technology industry professionals are becoming more relevant for developing, testing, and implementing behavioral health technologies. As the need for such partnerships increases, it is important to understand stakeholders' attitudes about their role in partnering for developing such technologies and how much do they expect technology to impact behavioral research and care. The aim of this study was to investigate how much technology disruption do stakeholders expect in healthcare, as well as their perceived contribution in partnering for developing behavioral health technologies. Stakeholders (N = 74) responded to an online convenience sampling survey. Over 89% of participants reported expecting that technology will bring at least a moderate amount of disruption in the current models of behavioral healthcare, with respondents with the most experience in digital health expecting the most disruption. As for their perception of each other's role in partnering for developing behavioral health technologies, one group's weakness was considered to be complemented by another group's strength. Academics were perceived as having more theoretical and research expertise but being less technology-savvy, while industry professionals were considered to excel at technological and marketing activities. Providers were considered to have the most clinical and real-world healthcare industry expertise. Our results indicate that technology is expected to disrupt current healthcare models, while also highlighting the need for collaboration, as no single group was considered to have sufficient expertise and resources to develop successful, effective behavioral health technologies on its own. These results may contribute to a better understanding of how technology disruption is affecting behavioral healthcare from the standpoint of its key players, which may lead to better collaborative models of research and care delivery.

  6. Evolving with modern technology: Impact of incorporating audiovisual aids in preanesthetic checkup clinics on patient education and anxiety.

    Science.gov (United States)

    Kaur, Haramritpal; Singh, Gurpreet; Singh, Amandeep; Sharda, Gagandeep; Aggarwal, Shobha

    2016-01-01

    Perioperative stress is an often ignored commonly occurring phenomenon. Little or no prior knowledge of anesthesia techniques can increase this significantly. Patients awaiting surgery may experience high level of anxiety. Preoperative visit is an ideal time to educate patients about anesthesia and address these fears. The present study evaluates two different approaches, i.e., standard interview versus informative audiovisual presentation with standard interview on information gain (IG) and its impact on patient anxiety during preoperative visit. This prospective, double-blind, randomized study was conducted in a Tertiary Care Teaching Hospital in rural India over 2 months. This prospective, double-blind, randomized study was carried out among 200 American Society of Anesthesiologist Grade I and II patients in the age group 18-65 years scheduled to undergo elective surgery under general anesthesia. Patients were allocated to either one of the two equal-sized groups, Group A and Group B. Baseline anxiety and information desire component was assessed using Amsterdam Preoperative Anxiety and Information Scale for both the groups. Group A patients received preanesthetic interview with the anesthesiologist and were reassessed. Group B patients were shown a short audiovisual presentation about operation theater and anesthesia procedure followed by preanesthetic interview and were also reassessed. In addition, patient satisfaction score (PSS) and IG was assessed at the end of preanesthetic visit using standard questionnaire. Data were expressed as mean and standard deviation. Nonparametric tests such as Kruskal-Wallis, Mann-Whitney, and Wilcoxon signed rank tests, and Student's t -test and Chi-square test were used for statistical analysis. Patient's IG was significantly more in Group B (5.43 ± 0.55) as compared to Group A (4.41 ± 0.922) ( P < 0.001). There was significant reduction in total anxiety from the baseline values in both the groups. This reduction was

  7. Can technology change the work of nurses? Evaluation of a drug monitoring system for ambulatory chronic disease patients.

    Science.gov (United States)

    Callen, Joanne; Hordern, Antonia; Gibson, Kathryn; Li, Ling; Hains, Isla M; Westbrook, Johanna I

    2013-03-01

    To evaluate the impact of an electronic drug monitoring system (eDMS) for ambulatory rheumatology patients on time nurses spent on, and the process of, drug monitoring. The study was conducted in the Rheumatology Department of a large metropolitan hospital. The eDMS, a module of the Hospital Clinical Information System (HCIS), was designed to allow electronic ordering and subsequent monitoring of ambulatory patients on long-term, immunosuppressive rheumatology medications. Quantitative measures collected before and after the intervention were: time spent on specific nursing activities; who nurses spent time with; format and location of documentation monitoring; and patient throughput. Qualitative data from interviews and observations were collected to ascertain the impact of the eDMS on nurses' monitoring activities. Nurses spent significantly less time on medication monitoring tasks (33.1% versus 26.4%, P=0.003) and significantly more time on patient care (6.5-18.1%, Pspent significantly more time with patients (7.7-19.8%, Ptime saved on monitoring allowed the number of nurse directed clinics and patient throughput to increase following eDMS implementation. Qualitative data supported results from the timing study with nurses reporting that the monitoring process was more standardised, safer, took less time and simplified documentation. The eDMS was associated with a reduction in time spent on the complex task of medication monitoring allowing nurses to spend a greater proportion of their time on other patient care activities. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  8. [Use and perceptions of information and communication technologies in patients with hypertension, dyslipidemia or diabetes in a national hospital in Lima, Peru].

    Science.gov (United States)

    Rivas-Nieto, Andrea C; Málaga, Germán; Ruiz-Grosso, Paulo; Huayanay-Espinoza, Carlos A; Curioso, Walter H

    2015-01-01

    This study aimed to determine the use and perceptions towards information and communication technologies (ICT) in 206 patients with arterial hypertension, dyslipidemia and diabetes, recruited from the outpatient clinic in a national hospital in Lima, Peru. 54.4% were older adults and 70.4% were women. The use of daily phone calls was 44.7%. Most had never used a computer (78.2%), email (84%) or the Internet (84%). Many have never sent (80.6%) or received (69.9%) a text message. 70% had at some time forgotten to take their medicine. 72.8% would like to be reminded to take their medication and 67.9% had a family member who could help them with access to ICT. Despite the low use of ICT in this population, there is willingness and expectation from the patients to participate in programs that implement them.

  9. Based on Real Time Remote Health Monitoring Systems: A New Approach for Prioritization "Large Scales Data" Patients with Chronic Heart Diseases Using Body Sensors and Communication Technology.

    Science.gov (United States)

    Kalid, Naser; Zaidan, A A; Zaidan, B B; Salman, Omar H; Hashim, M; Albahri, O S; Albahri, A S

    2018-03-02

    This paper presents a new approach to prioritize "Large-scale Data" of patients with chronic heart diseases by using body sensors and communication technology during disasters and peak seasons. An evaluation matrix is used for emergency evaluation and large-scale data scoring of patients with chronic heart diseases in telemedicine environment. However, one major problem in the emergency evaluation of these patients is establishing a reasonable threshold for patients with the most and least critical conditions. This threshold can be used to detect the highest and lowest priority levels when all the scores of patients are identical during disasters and peak seasons. A practical study was performed on 500 patients with chronic heart diseases and different symptoms, and their emergency levels were evaluated based on four main measurements: electrocardiogram, oxygen saturation sensor, blood pressure monitoring, and non-sensory measurement tool, namely, text frame. Data alignment was conducted for the raw data and decision-making matrix by converting each extracted feature into an integer. This integer represents their state in the triage level based on medical guidelines to determine the features from different sources in a platform. The patients were then scored based on a decision matrix by using multi-criteria decision-making techniques, namely, integrated multi-layer for analytic hierarchy process (MLAHP) and technique for order performance by similarity to ideal solution (TOPSIS). For subjective validation, cardiologists were consulted to confirm the ranking results. For objective validation, mean ± standard deviation was computed to check the accuracy of the systematic ranking. This study provides scenarios and checklist benchmarking to evaluate the proposed and existing prioritization methods. Experimental results revealed the following. (1) The integration of TOPSIS and MLAHP effectively and systematically solved the patient settings on triage and

  10. [The application of the modern high-energy laser technologies for the surgical treatment of the patients presenting with otosclerosis].

    Science.gov (United States)

    Vishnyakov, V V; Svistushkin, V M; Sin'kov, E V

    The objective of the present study was to determine the optimal parameters of radiation of the CO2 laser during the surgical intervention for the treatment of the patients presenting with otosclerosis. The experimental part of the study was carried out with the use of the isolated temporal bones. Under the clinical conditions, the patients with the tympanic and mixed forms of otosclerosis underwent stapedoplasty with the use of the CO2 laser. It was shown that the use of the CO2 laser at different stages of stapedoplasty considerably reduces the risk of development of the post-operative complications. It is concluded that the proposed stapedoplastic technique makes it possible to decrease the duration of post-surgical rehabilitation of the patients suffering from otosclerosis.

  11. Provider-based research networks and diffusion of surgical technologies among patients with early-stage kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Meyer, Anne-Marie; Kuo, Tzy-Mey; Smith, Angela B; Wheeler, Stephanie B; Carpenter, William R; Nielsen, Matthew E

    2015-03-15

    Provider-based research networks such as the National Cancer Institute's Community Clinical Oncology Program (CCOP) have been shown to facilitate the translation of evidence-based cancer care into clinical practice. This study compared the utilization of laparoscopy and partial nephrectomy among patients with early-stage kidney cancer according to their exposure to CCOP-affiliated providers. With linked Surveillance, Epidemiology, and End Results-Medicare data, patients with T1aN0M0 kidney cancer who had been treated with nephrectomy from 2000 to 2007 were identified. For each patient, the receipt of care from a CCOP physician or hospital and treatment with laparoscopy or partial nephrectomy were determined. Adjusted for patient characteristics (eg, age, sex, and marital status) and other organizational features (eg, community hospital and National Cancer Institute-designated cancer center), multivariate logistic regression was used to estimate the association between each surgical innovation and CCOP affiliation. During the study interval, 1578 patients (26.8%) were treated by a provider with a CCOP affiliation. Trends in the utilization of laparoscopy and partial nephrectomy remained similar between affiliated and nonaffiliated providers (P ≥ .05). With adjustments for patient characteristics, organizational features, and clustering, no association was noted between CCOP affiliation and the use of laparoscopy (odds ratio [OR], 1.11; 95% confidence interval [CI], 0.81-1.53) or partial nephrectomy (OR, 1.04; 95% CI, 0.82-1.32) despite the more frequent receipt of these treatments in academic settings (P kidney cancer, indicating perhaps a more limited scope to provider-based research networks as they pertain to translational efforts in cancer care. © 2014 American Cancer Society.

  12. Clinical Evaluation of a Novel Technology for Oral Patient-Controlled Analgesia, the PCoA® Acute Device, for Hospitalized Patients with Postoperative Pain, in Pilot Feasibility Study

    Directory of Open Access Journals (Sweden)

    Stefan Wirz

    2017-01-01

    Full Text Available Background. Acute postoperative pain delays recovery and increases morbidity and mortality. Traditional administration of postoperative analgesics by nurses is often inefficient. The present study evaluated the safety, efficacy, and usability of a novel, patient-controlled analgesic dispenser, the PCoA Acute. Methods. A controlled pilot study was conducted at three medical centers. Patients scheduled for elective surgery were enrolled into two groups, both taking oral analgesics: a control group (n=43, opioids dispensed by nurses, and a test group (n=27, opioids dispensed via the PCoA Acute. Pill intake data were recorded. Pain ratings at rest and during movement were surveyed. Results. No severe adverse events were recorded. Average pill intake time was reduced from 8 : 58 minutes in the control group to 1 : 17 minutes in the test group (P value < 0.05. The test group took 67% more pills than the control group, indicating enhanced compliance. Pain scores were significantly lower for patients in the test group (P value < 0.05. Over 90% of PCoA Acute users were satisfied with its use. Conclusions. The study confirmed that PCoA Acute is safe and effective. It is well accepted by patients and medical staff. Its use can optimize pain medication administration.

  13. Laser Technology.

    Science.gov (United States)

    Gauger, Robert

    1993-01-01

    Describes lasers and indicates that learning about laser technology and creating laser technology activities are among the teacher enhancement processes needed to strengthen technology education. (JOW)

  14. Designing and evaluating an electronic patient falls reporting system: perspectives for the implementation of health information technology in long-term residential care facilities.

    Science.gov (United States)

    Mei, Yi You; Marquard, Jenna; Jacelon, Cynthia; DeFeo, Audrey L

    2013-11-01

    Patient falls are the leading cause of unintentional injury and death among older adults. In 2000, falls resulted in over 10,300 elderly deaths, costing the United States approximately $179 million in incidence and medical costs. Furthermore, non-fatal injuries caused by falls cost the United States $19 billion annually. Health information technology (IT) applications, specifically electronic falls reporting systems, can aid quality improvement efforts to prevent patient falls. Yet, long-term residential care facilities (LTRCFs) often do not have the financial resources to implement health IT, and workers in these settings are often not ready to adopt such systems. Additionally, most health IT evaluations are conducted in large acute-care settings, so LTRCF administrators currently lack evidence to support the value of health IT. In this paper, we detail the development of a novel, easy-to-use system to facilitate electronic patient falls reporting within a LTRCF using off-the-shelf technology that can be inexpensively implemented in a wide variety of settings. We report the results of four complimentary system evaluation measures that take into consideration varied organizational stakeholders' perspectives: (1) System-level benefits and costs, (2) system usability, via scenario-based use cases, (3) a holistic assessment of users' physical, cognitive, and marcoergonomic (work system) challenges in using the system, and (4) user technology acceptance. We report the viability of collecting and analyzing data specific to each evaluation measure and detail the relative merits of each measure in judging whether the system is acceptable to each stakeholder. The electronic falls reporting system was successfully implemented, with 100% reporting at 3-months post-implementation. The system-level benefits and costs approach showed that the electronic system required no initial investment costs aside from personnel costs and significant benefits accrued from user time savings

  15. Patient and cycle characteristics predicting high pregnancy rates with single-embryo transfer: an analysis of the Society for Assisted Reproductive Technology outcomes between 2004 and 2013.

    Science.gov (United States)

    Mersereau, Jennifer; Stanhiser, Jamie; Coddington, Charles; Jones, Tiffany; Luke, Barbara; Brown, Morton B

    2017-11-01

    To analyze factors associated with high live birth rate and low multiple birth rate in fresh and frozen-thawed assisted reproductive technology (ART) cycles. Retrospective cohort analysis. Not applicable. The study population included 181,523 women undergoing in vitro fertilization with autologous fresh first cycles, 27,033 with fresh first oocyte donor cycles, 37,658 with fresh second cycles, and 35,446 with frozen-thawed second cycles. None. Live birth rate and multiple birth rate after single-embryo transfer (SET) and double embryo transfer (DET) were measured, in addition to cycle characteristics. In patients with favorable prognostic factors, including younger maternal age, transfer of a blastocyst, and additional embryos cryopreserved, the gain in the live birth rate from SET to DET was approximately 10%-15%; however, the multiple birth rate increased from approximately 2% to greater than 49% in both autologous and donor fresh and frozen-thawed transfer cycles. This study reports a 10%-15% reduction in live birth rate and a 47% decrement in multiple birth rate with SET compared with DET in the setting of favorable patient prognostic factors. Our findings present an opportunity to increase the rate of SET across the United States and thereby reduce the multiple birth rate and its associated poor perinatal outcomes with assisted reproductive technology pregnancies. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  16. The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication.

    Science.gov (United States)

    Zheng, Wenhao; Chen, Chunhui; Zhang, Chuanxu; Tao, Zhenyu; Cai, Leyi

    2018-01-01

    The aim of this study was to assess the feasibility and effectiveness of the three-dimensional (3D) printing technology in the treatment of Pilon fractures. 100 patients with Pilon fractures from March 2013 to December 2016 were enrolled in our study. They were divided randomly into 3D printing group ( n = 50) and conventional group ( n = 50). The 3D models were used to simulate the surgery and carry out the surgery according to plan in 3D printing group. Operation time, blood loss, fluoroscopy times, fracture union time, and fracture reduction as well as functional outcomes including VAS and AOFAS score and complications were recorded. To examine the feasibility of this approach, we invited surgeons and patients to complete questionnaires. 3D printing group showed significantly shorter operation time, less blood loss volume and fluoroscopy times, higher rate of anatomic reduction and rate of excellent and good outcome than conventional group ( P 3D printing models. Our study indicated that the use of 3D printing technology to treat Pilon fractures in clinical practice is feasible.

  17. Use of a novel technology for presenting screening measures to detect mild cognitive impairment in elderly patients.

    Science.gov (United States)

    Wright, D W; Goldstein, F C; Kilgo, P; Brumfield, J R; Ravichandran, T; Danielson, M L; Laplaca, M

    2010-08-01

    Available screening tools for mild cognitive impairment (MCI), often a precursor to Alzheimer's disease, are insensitive or not feasible for administration in a busy primary care setting. Display Enhanced TEsting for Cognitive impairment and Traumatic brain injury (DETECT) addresses these issues by creating an immersive environment for the brief administration of neuropsychological (NP) measures. The aim of this study was to determine if the DETECT cognitive subtests can identify MCI patients as accurately as standard pen and paper NP tests. Twenty patients with MCI recruited from a memory disorders clinic and 20 age-matched controls were given both a full battery of NP tests (standard NP) and the DETECT screen. Logistic regression models were used to determine whether individual tests were predictive of group membership (MCI or control). Demographic variables including age, race, education and gender were adjusted as covariates. Selection methods were used to identify subset models that exhibited maximum discrimination between MCI patients and controls for both testing methods. Both the standard NP model (C-index = 0.836) and the DETECT model (C-index = 0.865) showed very good discrimination and were not significantly different (p = 0.7323). The DETECT system shows good agreement with standard NP tests and is capable of identifying elderly patients with cognitive impairment.

  18. A Technological Review of the Instrumented Footwear for Rehabilitation with a Focus on Parkinson’s Disease Patients

    DEFF Research Database (Denmark)

    Maculewicz, Justyna; Kofoed, Lise; Serafin, Stefania

    2016-01-01

    In this review article, we summarize systems for gait rehabilitation based on instrumented footwear and present a context of their usage in Parkinson’s disease (PD) patients’ auditory and haptic rehabilitation. We focus on the needs of PD patients, but since only a few systems were made with this...

  19. Evaluation of the Effects of Radio-Frequency Identification Technology on Patient Tracking in Hospitals: A Systematic Review.

    Science.gov (United States)

    Ebrahimzadeh, Fahimeh; Nabovati, Ehsan; Hasibian, Mohammad Reza; Eslami, Saeid

    2017-12-15

    The aim of this study was to systematically review all studies that evaluated the effects of using radio-frequency identification (RFID) for tracking patients in hospitals. The PubMed and Embase databases were searched (to August 2015) for relevant English language studies, and those that evaluated the effects of a real-time locating systems with RFID for patient tracking in hospitals were identified and extracted. Of the 652 studies found, the 17 relevant studies were extracted for inclusion. Five of the extracted studies used RFID systems in operating theaters, two in emergency departments, one in a magnetic resonance imaging department, one in a radiology room, and the remaining eight studies were in other wards. In these studies, features such as the feasibility, accuracy, precision, reliability, security, level of satisfaction, cost of care, and time efficiency of the RFID systems were reported. Of all the extracted studies, seven evaluated the accuracy of the systems in crowded and unattended areas, and five of these were satisfied with their accuracy. Six evaluated the reliability of the systems, and all of these found the systems to be reliable. Six evaluated time-savings, and all of them reported the systems to be time effective. Two focused on the cost of care, and both of these reported the systems to be cost effective. Although most studies reported a positive impact on the accuracy and precision of patient identification, there is insufficient good evidence to show that RFID systems can accurately localize patients in crowded settings.

  20. FACTORS INFLUENCING ADHERENCE TO ARVS AMONG PATIENTS ATTENDING COMPREHENSIVE CARE CLINIC WITHIN JOMO KENYATTA UNIVERSITY OF AGRICULTURE AND TECHNOLOGY, KIAMBU COUNTY, KENYA.

    Science.gov (United States)

    Mwangi, A N; Ng'ang'a, Z; Wanzala, P; Karanja, S M

    2014-04-01

    The efficacy of anti-retroviral Therapy (ART) depends on adherence to the prescribed regimen. However, lack of adherence leads to treatment failure and drug resistance among other negative outcomes. To determine factors influencing adherence to ARVS among patients attending the Comprehensive Care Clinic (CCC) within Jomo Kenyatta University of Agriculture and Technology (JKUAT). A descriptive cross sectional study. Comprehensive Care Clinic within JKUAT. Three hundred HIV positive patients, undergoing ART treatment and follow up at the JKUAT clinic for a minimum duration of one month before the study, were recruited. Of the 300 patients enrolled for the study (70% females and 30% males), 81% were adhering to ARV treatment. The factors that were significantly associated with adherence included; Support (encouragement and reminder to take drugs) (P = 0.025); the number of meals respondents took in a day (P = 0.001); pill burden (P = 0.002) and forgetfulness (P = 0.001). However, there was no significant relationship between adherence and age, marital status, education, employment status or time taken to travel to the clinic. This study concluded that, the observed level of sub-optimal adherence to ART (19%) is of public health concern. These patients are vulnerable to treatment failure and development of resistant viral strains. Consequently the modifiable factors (Support, Number of meals taken, pill burden, and forgetfulness, should be addressed to change the current tread.

  1. Technology Corner: Visualising Forensic Data: Evidence Guidelines (Part 2

    Directory of Open Access Journals (Sweden)

    Damian Schofield

    2013-06-01

    Full Text Available Visualisation is becoming increasingly important for understanding information, such as investigative data (for example: computing, medical and crime scene evidence and analysis (for example, network capability assessment, data file reconstruction and planning scenarios. Investigative data visualisation is used to reconstruct a scene or item and is used to assist the viewer (who may well be a member of the general public with little or no understanding of the subject matter to understand what is being presented. Analysis visualisations, on the other hand, are usually developed to review data, information and assess competing scenario hypotheses for those who usually have an understanding of the subject matter.Courtroom environments are morphing into cinematic display environments, the media consumed by an audience who are increasingly visually literate and media savvy (Heintz, 2002. There are a number of fundamental implications inherent in the shift from oral to visual mediation and a number of facets of this modern evidence presentation technology needs to be investigated and analysed. One of the primary issues of visualisation is that no matter how coherent the data, there will always be conjecture and debate as to how the information is/has-been visualised and, is it presented in an acceptable and meaningful way.This paper presents a range of examples of where forensic data has been visualised using various techniques and technology, the paper then examines aspects of the visual courtroom evidence presented and discusses some of the benefits and potential problems of implementing this technology. This paper is part two of a two-part series that aims to describe the use of, and provide guidelines for, the use of graphical displays in courtrooms.

  2. Information and Communication Technologies in the Care of the Elderly: Systematic Review of Applications Aimed at Patients With Dementia and Caregivers.

    Science.gov (United States)

    Martínez-Alcalá, Claudia I; Pliego-Pastrana, Patricia; Rosales-Lagarde, Alejandra; Lopez-Noguerola, J S; Molina-Trinidad, Eva M

    2016-05-02

    The interest in applying information and communications technology (ICT) in older adult health care is frequently promoted by the increasing and unsustainable costs of health care services. In turn, the unprecedented growth of the elderly population around the globe has urged institutions, companies, industries, and governments to respond to older adults' medical needs. The aim of this review is to systematically identify the opportunities that ICT offers to health services, specifically for patients with dementia and their families. A systematic review of the literature about ICT applications that have been developed to assist patients with Alzheimer's disease (AD) and their primary caregivers was conducted. The bibliographic search included works published between January 2005 and July 2015 in the databases Springer Link, Scopus, and Google Scholar. Of the published papers, 902 were obtained in the initial search, of which 214 were potentially relevant. Included studies fulfilled the following inclusion criteria: (1) studies carried out between the years of 2005 and 2015, (2) studies were published in English or Spanish, (3) studies with titles containing the keywords, (4) studies with abstracts containing information on ICT applications and AD, and (5) studies published in indexed journals, proceedings, and book chapters. A total of 26 studies satisfied the inclusion criteria for the current review. Among them, 16 were aimed at the patient with AD and 10 at the primary caregivers and/or family members. The studies targeted applications that included assistive technology (44%, 7/16), telecare (37%, 6/16), and telemedicine (31%, 5/16). The information systems (56%, 9/16) and Internet (44%, 7/16) were the most commonly used enabling technologies for the studies. Finally, areas of attention more covered by the studies were care (56%, 9/16), treatment (56%, 9/16), and management (50%, 8/16). Furthermore, it was found that 20 studies (77%, 8/26) evaluated their ICT

  3. Two-year intraocular delivery of ciliary neurotrophic factor by encapsulated cell technology implants in patients with chronic retinal degenerative diseases.

    Science.gov (United States)

    Kauper, Konrad; McGovern, Cahil; Sherman, Sandy; Heatherton, Pam; Rapoza, Rob; Stabila, Paul; Dean, Brenda; Lee, Alice; Borges, Suzanna; Bouchard, Bruce; Tao, Weng

    2012-11-01

    To evaluate the pharmacokinetics of ciliary neurotrophic factor (CNTF) delivered over a period of up to 2 years by an intraocular encapsulated cell technology (ECT) implant in patients with retinitis pigmentosa (RP) and geographic atrophy (GA). Patients from phase 1 RP (CNTF1); phase 2 GA (CNTF2); and phase 2 late and early stage RP (CNTF3, and CNTF4) studies received an ECT-CNTF implant, designated as "NT-501," in one eye. Per protocol, all implants (n = 10) were removed at 6 months from the CNTF1 study patients. Explant for the phase 2 studies was optional, but several patients were explanted at 12, 18, and 24 months post implant. A small amount of vitreous sample was collected at the time of explant. The rate of CNTF secretion from the explants and the corresponding vitreous CNTF levels were evaluated for each time point. Serum samples from these patients were evaluated for CNTF, anti-CNTF antibodies, and antibodies to the encapsulated cells. NT-501 implants produced CNTF consistently over a 2-year period. The calculated half-life of CNTF in the vitreous continuously delivered by ECT implants was 51 months, with CNTF levels statistically equivalent between the 6- and 24-month implant period. CNTF, anti-CNTF antibodies, and antibodies to the encapsulated cells were not detected in the serum of patients. This retrospective study demonstrated that the intraocular ECT implant has a favorable pharmacokinetic profile for the treatment of chronic retinal degenerative diseases without systemic exposure. (ClinicalTrials.gov numbers, NCT00063765, NCT00447954, NCT00447980, NCT00447993.).

  4. Beyond Volume: Hospital-Based Healthcare Technology for Better Outcomes in Cerebrovascular Surgical Patients Diagnosed With Ischemic Stroke: A Population-Based Nationwide Cohort Study From 2002 to 2013.

    Science.gov (United States)

    Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Lee, Tae-Hyun; Jang, Sung-In

    2016-03-01

    We examined whether the level of hospital-based healthcare technology was related to the 30-day postoperative mortality rates, after adjusting for hospital volume, of ischemic stroke patients who underwent a cerebrovascular surgical procedure. Using the National Health Insurance Service-Cohort Sample Database, we reviewed records from 2002 to 2013 for data on patients with ischemic stroke who underwent cerebrovascular surgical procedures. Statistical analysis was performed using Cox proportional hazard models to test our hypothesis. A total of 798 subjects were included in our study. After adjusting for hospital volume of cerebrovascular surgical procedures as well as all for other potential confounders, the hazard ratio (HR) of 30-day mortality in low healthcare technology hospitals as compared to high healthcare technology hospitals was 2.583 (P technology hospitals with high volume as compared to high healthcare technology hospitals with high volume was the highest (10.014, P technology hospitals had the highest 30-day mortality rate, irrespective of hospital volume. Although results of our study provide scientific evidence for a hospital volume/30-day mortality rate relationship in ischemic stroke patients who underwent cerebrovascular surgical procedures, our results also suggest that the level of hospital-based healthcare technology is associated with mortality rates independent of hospital volume. Given these results, further research into what components of hospital-based healthcare technology significantly impact mortality is warranted.

  5. Effectiveness of psycho-educational interventions with telecommunication technologies on emotional distress and quality of life of adult cancer patients: a systematic review.

    Science.gov (United States)

    Bártolo, Ana; Pacheco, Emelda; Rodrigues, Fabiana; Pereira, Anabela; Monteiro, Sara; Santos, Isabel M

    2017-12-07

    To provide a comprehensive review of psycho-educational interventions using telecommunication technologies developed for adult cancer patients, assessing their effectiveness in reducing emotional distress and improving quality of life (QoL). A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified through the electronic databases PubMed, Scopus, Web of Science, ProQuest, Psychology & Behavioral Sciences Collection (through EBSCOhost), and CENTRAL. Eight studies involving 1016 participants met inclusion criteria. The majority of the studies included (n = 6) used a randomized design and were published between 2007 and 2016. Interventions used a variety of delivery resources, such as telephone, e-mail and websites, but all were aiming to respond to information needs and develop stress control skills. A trend toward reducing distress and improving QoL was found, but estimated effect sizes were typically small (d < 0.5). Telephonically delivered psycho-educational interventions presented the highest between-group effects on these outcomes during survival, but were limited by sample size. The efficacy of interventions using distance approaches in the cancer setting is still not well-established. Further research should be conducted through well-designed studies with more interactive features that minimize the lack of face-to-face interaction. Implications for rehabilitation Rehabilitation professionals working in the field of oncology should invest in the development of psycho-educational interventions responding the patients' educational needs and promoting their stress control skills. Programs using telecommunications technologies may reduce disparities in service delivery within this setting, minimizing geographic and socio-economic barriers to engagement in the interventions. With the current technological development, it is possible to perform more interactive interventions that stimulate therapist-patient

  6. Insulin pen needles: effects of extra-thin wall needle technology on preference, confidence, and other patient ratings.

    Science.gov (United States)

    Aronson, Ronnie; Gibney, Michael A; Oza, Kunjal; Bérubé, Julie; Kassler-Taub, Kenneth; Hirsch, Laurence

    2013-07-01

    Pen needles (PNs) are essential for insulin injections using pen devices. PN characteristics affect patients' injection experience. The goal of this study was to evaluate the impact of a new extra-thin wall (XTW) PN versus usual PNs on overall patient preference, ease of injection, perceived time to complete the full dose, thumb button force to deliver the injection, and dose delivery confidence in individuals with diabetes mellitus (DM). Subjects injected insulin with the KwikPen(TM) (Eli Lilly and Company, Indianapolis, Indiana), SoloSTAR(®) (sanofi-aventis U.S. LLC, Bridgewater, New Jersey), and FlexPen(®) (Novo Nordisk A/S, Bagsvaerd, Denmark) insulin pens, and included some with impaired hand dexterity. We first performed quantitative testing of XTW and comparable PNs with the 3 insulin pens for thumb force, flow rate, and time to deliver medication. A prospective, randomized, 2-period, open-label, crossover trial was then conducted in patients aged 35 to 80 years with type 1 or type 2 DM who injected insulin by pen for ≥2 months, with at least 1 daily dose ≥10 U. Patients who used 4- to 8-mm length PNs with 31- to 32-G diameter were randomly assigned to use their current PN or the same/similar size XTW PN at home for ~1 week and the other PN the second week. They completed several comparative 150-mm visual analog scales and direct questions at the end of period 2. XTW PNs had statistically significant better performance for each studied PN characteristic (thumb force, flow, and time to deliver medication) for all pens combined and each individual pen brand (all, P ≤ 0.05). Of 216 patients randomized to study groups (80, SoloSTAR; 77, FlexPen; 59, KwikPen), 209 completed both periods; 198 were evaluable. Baseline characteristics revealed a mean (SD) age of 60.8 (9.3) years, insulin pen use duration of 4.3 (4.1) years, and mean total daily dose of 75.1 (52.3) U (range, 10-420 U). Approximately 50% of patients were female; 81.5% were white and 14.8% were

  7. Art meets science – empowering stroke patients to regain muscular control through creative graphics technology, psycho-physiology and neuroplasticity.

    OpenAIRE

    Thompson, Simon

    2012-01-01

    Treating patients with a cerebrovascular accident or stroke is complicated by severity and site of brain lesion. Muscular control is lost when neural pathways are interrupted or damaged due to embolus, thrombosis or ruptured aneurysm. Return of movement is further hindered by sustained spasticity of muscle groups or inflammation or severance to functionally important neural pathways. Neuro-feedback mechanisms have been explored in the past with some success. A new, improved and innovative met...

  8. A novel 1050nm handheld OCT imaging system for pediatric retinoblastoma patients: technology development and clinical study (Conference Presentation)

    Science.gov (United States)

    Nadiarnykh, Oleg; Moll, Annette C.; de Boer, Johannes F.

    2016-03-01

    We demonstrate a novel optical coherence tomography system specifically developed and validated for clinical imaging of retinoblastoma tumors in pediatric patients. The existing treatment options for this malignant tumor of the retina aim at reduction of tumor (re)growth risks, and vision preservation. The choice of optimal treatment strongly depends on skilled and detailed clinical assessment. Due to the limitations of the existing real-time diagnostic tools the patients at risk are periodically monitored with retinal imaging to confirm the absence of new tumor seedings. Three-dimensional visualization of tissue layer and microvasculature at improved axial and lateral resolution of interference-based OCT imaging provides sensitivity for detection of vital tumor tissue concurrent with local treatment. Our METC-approved system accommodates for the range of optical parameters of infants' eyes, and uses the 1050nm wavelength to access the deeper choroid layers of retina. The prototype is designed for patients in supine position under general anesthesia, where ergonomic handheld module is connected to fiber-based optical setup via umbilical cord. The system conforms to clinical safety requirements, including fully isolated low-voltage electric circuit. Focusing is performed with a mechanically tunable lens, where resolution is 6 µm axially, and varies with focusing at 10-18µm laterally. We will present optical design, performance limitations, and results of the ongoing clinical study, including the increased OCT diagnostic sensitivity in three dimensions in comparison with the established clinical imaging modalities. We will discuss images of early, active, and treated tumors, as well as follow-up on patients after local and systemic treatments.

  9. Biomedical Technologies in the Treatment of Skin and Soft Tissue Defects in Patients with Diabetic Foot Syndrome

    Directory of Open Access Journals (Sweden)

    Magomed D Dibirov

    2016-03-01

    Full Text Available The aim of our study was to investigate the effectiveness of collagen implants in the closure of tissue defects. We offer a method that enables us to avoid the drawbacks of autodermoplasty based on the free split-thickness skin graft. Materials and Methods: This paper describes all steps of treatment of skin and soft tissue defects in patients with diabetic foot syndrome (DFS, including ultrasonic cavitation (UC with hydrosurgical debridement (HD to remove necrotic debris, purulent pellicle and bacterial biofilm, and an alternative technique for wound defect closure using high-tech biomaterials based on type I collagen (“Collost”, “Salvecoll”. Results: Use of type I collagen (“Collost”, “Salvecoll” as a component of combination treatment of tissue defects in DFS allowed us to increase the relative rate of wound healing, reduce the incidence of high-level amputations, and significantly reduce inpatient surgical coverage around the clock and speed up a patient's transfer to outpatient care. Conclusion: Ultrasonic cavitation with hydrosurgical debridement is the most effective procedure for wound preparation for closure. The use of bioplastic collagen materials in patients with DFS is the most effective solution in the management of wound defects.

  10. Radiation therapy technology innovations applied to the treatment of head and neck patients: - Clinical results of Intensity Modulated Radiotherapy (IMRT), - Contribution of Image Guided Radiotherapy (IGRT) in the management of head and neck patients treated with IMRT

    International Nuclear Information System (INIS)

    Graff-Cailleaud, Pierre

    2011-01-01

    Numerous and exciting technological innovations were recently developed in radiotherapy. We aimed to assess benefits in two specific fields. 1) Clinical results of Intensity Modulated Radiotherapy (IMRT) applied to the treatment of Head and Neck (H and N) patients. The first study was a long-term mono-centric prospective registration of all H and N patients treated with IMRT in our institution. Locoregional control was excellent and toxicities limited. Recurrences were in-field. Dosimetric recommendations (parotids mean dose) were established. The second study assessed the impact of IMRT on health-related quality of life for H and N patients through a multicentric matched-pair comparison with conventional radiotherapy. Outstanding benefits were observed particularly in the fields of salivary dysfunction and oral discomfort. 2) Contribution of Image Guided Radiotherapy (IGRT) in the management of H and N patients treated with IMRT. The first study was a monitoring of delivered dose, using 3D dose recalculation from Megavoltage Cone-Beam CT (CBCT), as a quality assurance measure of a panel of H and N IMRT patients aligned with IGRT. Dosimetric consequences of anatomical changes were assessed. Contribution of color-coded MVCBCT dose-difference maps was studied. The aim of the second study was to quantify the inherent relative mobility between anatomic regions of the H and N area and to assess the dosimetric impact of several different matching procedures. Recommendations for the use of CBCT images in a daily practice were established. (author) [fr

  11. A patient as a self-manager of their personal data on health and disease with new technology--challenges for nursing education.

    Science.gov (United States)

    Hopia, Hanna; Punna, Mari; Laitinen, Teemu; Latvala, Eila

    2015-12-01

    Background: Digital technologies have transformed nearly every aspect of our lives. However, for many of us, they have not yet improved the way we receive or participate in our health services and disease care. Hostetter et al. (2014) explore in a new multimedia essay the changes occurring with the arrival of new digital tools, from mobile apps and data-driven software solutions to wearable sensors that transmit information to a patient's team of health care providers. Digitisation will revolutionise health technology to a new extent, as the self-measurement, cloud services, teleconsultation and robotics technologies are being used to get health expenditure under control. In the future, robots will dispense drugs, and treatment routines will utilise cloud services (Biesdorf and Niedermann, 2014; Grain and Sharper, 2013). According to the rationale of the Horizon 2020 (European Commission, 2013b) work programme, personalising health and care has been stated to empower citizens and patients to manage their own health and disease, which can result in more cost-effective healthcare systems by enabling the management of chronic diseases outside institutions, improving health outcomes, and by encouraging healthy citizens to remain so. Solutions should be developed and tested with the use of open innovation platforms, such as large-scale demonstrators for health and service innovation. It is a fact that ICT/new health technology and personal health applications are transforming patients' self-management in many ways. A huge amount of personal health application solutions are being offered in the marketplace, which engage in activities that promote health, monitoring the symptoms and signs of illness, and managing the impact of illness (European Commission eHealth Action Plan 2012-2020, 2012). The WHO (2011) has conducted a comprehensive study and published a report on Member States' use of mHealth (mobile Health) as well as the readiness and barriers to its use. The

  12. Features and Effects of Information Technology-Based Interventions to Improve Self-Management in Chronic Kidney Disease Patients: a Systematic Review of the Literature.

    Science.gov (United States)

    Jeddi, Fateme Rangraz; Nabovati, Ehsan; Amirazodi, Shahrzad

    2017-09-18

    Slowing down the progression of chronic kidney disease (CKD) and its adverse health outcomes requires the patient's self-management and attention to treatment recommendations. Information technology (IT)-based interventions are increasingly being used to support self-management in patients with chronic diseases such as CKD. We conducted a systematic review of randomized controlled trials (RCTs) to assess the features and effects of IT-based interventions on self-management outcomes of CKD patients. A comprehensive search was conducted in Medline, Scopus, and the Cochrane Library to identify relevant papers that were published until May 2016. RCT Studies that assessed at least one automated IT tool in patients with CKD stages 1 to 5, and reported at least one self-management outcome were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment tool. Out of 12,215 papers retrieved, eight study met the inclusion criteria. Interventions were delivered via smartphones/personal digital assistants (PDAs) (three studies), wearable devices (three studies), computerized systems (one study), and multiple component (one study). The studies assessed 15 outcomes, including eight clinical outcomes and seven process of care outcomes. In 12 (80%) of the 15 outcomes, the studies had revealed the effects of the interventions as statistically significant positive. These positive effects were observed in 75% of the clinical outcomes and 86% of the process of care outcomes. The evidence indicates the potential of IT-based interventions (i.e. smartphones/PDAs, wearable devices, and computerized systems) in self-management outcomes (clinical and process of care outcomes) of CKD patients.

  13. Will Medical Technology Deskill Doctors?

    Science.gov (United States)

    Lu, Jingyan

    2016-01-01

    This paper discusses the impact of medical technology on health care in light of the fact that doctors are becoming more reliant on technology for obtaining patient information, making diagnoses and in carrying out treatments. Evidence has shown that technology can negatively affect doctor-patient communications, physical examination skills, and…

  14. Biometric Digital Health Technology for Measuring Motor Function in Parkinson's Disease: Results from a Feasibility and Patient Satisfaction Study.

    Science.gov (United States)

    Mitsi, Georgia; Mendoza, Enrique Urrea; Wissel, Benjamin D; Barbopoulou, Elena; Dwivedi, Alok K; Tsoulos, Ioannis; Stavrakoudis, Athanassios; Espay, Alberto J; Papapetropoulos, Spyros

    2017-01-01

    To assess the feasibility, predictive value, and user satisfaction of objectively quantifying motor function in Parkinson's disease (PD) through a tablet-based application (iMotor) using self-administered tests. PD and healthy controls (HCs) performed finger tapping, hand pronation-supination and reaction time tasks using the iMotor application. Thirty-eight participants (19 with PD and 17 HCs) were recruited in the study. PD subjects were 53% male, with a mean age of 67.8 years (±8.8), mean disease duration of 6.5 years (±4.6), Movement Disorders Society version of the Unified Parkinson Disease Rating Scale III score 26.3 (±6.7), and Hoehn & Yahr stage 2. In the univariate analysis, most tapping variables were significantly different in PD compared to HC. Tap interval provided the highest predictive ability (90%). In the multivariable logistic regression model reaction time (reaction time test) ( p  = 0.021) and total taps (two-target test) ( p  = 0.026) were associated with PD. A combined model with two-target (total taps and accuracy) and reaction time produced maximum discriminatory performance between HC and PD. The overall accuracy of the combined model was 0.98 (95% confidence interval: 0.93-1). iMotor use achieved high rates of patients' satisfaction as evaluated by a patient satisfaction survey. iMotor differentiated PD subjects from HCs using simple alternating tasks of motor function. Results of this feasibility study should be replicated in larger, longitudinal, appropriately designed, controlled studies. The impact on patient care of at-home iMotor-assisted remote monitoring also deserves further evaluation.

  15. Modernidad, positivismo y tecnología: Influencia en la enfermería y en pacientes que necesitan equipamiento tecnológico Modernity, positivism and technology: The influence of nursing in patients who need technology equipment

    Directory of Open Access Journals (Sweden)

    Domingo Palacios-Ceña

    2008-09-01

    Full Text Available La modernidad ha sido una etapa histórica que junto al positivismo ha establecido una visión del mundo caracterizada por un papel protagonista de la razón a todos los niveles de la persona, la ciencia como fuente de respuestas a todas las preguntas del ser humano y la presencia de la técnica y de la tecnología como herramienta de ayuda destinada a mejorar las condiciones de las personas. Esta visión sigue influyendo en múltiples aspectos de la asistencia y del cuidado. Con este trabajo se pretende describir la modernidad, la corriente positivista, su influencia en la ciencia y en la investigación, como afecta la aplicación de su principal herramienta, la técnica y la tecnología, en la enfermería y en las personas enfermas que precisan de equipamiento tecnológico complejo para su proceso de enfermedad.Modernity was a historic stage which, together with the positivism, established a world vision characterized by a protagonist role of the reasoning at all human levels, the science as source of questions related to the human person and the presence of the technique and technology as helping tools aimed to increasing the health quality of the humans. This vision still is influencing in several aspects of the assistance and care. In the present manuscript our aim was to describe the modernity, the positivism tendency, their influence on science and research, and how they affect on the application of their principal tool, the technique and technology, in nurse and in those patients who need of these complex equipments during their illness.

  16. Diabetic footwear: is it an assistive technology capable of reducing peak plantar pressures in elderly patients with neuropathy?

    Directory of Open Access Journals (Sweden)

    Alexandre Faraco de Oliveira

    Full Text Available Abstract Introduction: Diabetes Mellitus is a chronic disease with high prevalence in the population in particular among the elderly. The longer time of diabetes, increased the chances of developing complications such as peripheral neuropathy, which is an important factor in the genesis of plantar lesions by changing the distribution and formation of plantar pressure peaks. Objective: Evaluate the influence of an Assistive Technology, therapeutic footwear for diabetics, in the peaks of plantar pressure of elderly. Methods: This was an experimental study of transversal type, composed by 10 elderly, diabetic, with peripheral neuropathy, using as an instrument to measure a baropodometry platform. Were measured peaks of plantar pressure, static and dynamic in three situations: barefoot, the participants' own standard footwear and with therapeutic footwear for diabetics. Data analysis by normal distribution as a single paired sample, applying the ANOVA test. Results: The use of therapeutic footwear for diabetics promoted a reduction in media of peak plantar pressure in the order of 22% in static analysis, and 31% in dynamic analysis. Conclusion: The therapeutic footwear for diabetics was able to produce significant reductions in peak plantar pressure, being more efficient than a common footwear. This effect may contribute to the prevention of injuries associated with the diabetic foot.

  17. Standard drug concentrations and smart-pump technology reduce continuous-medication-infusion errors in pediatric patients.

    Science.gov (United States)

    Larsen, Gitte Y; Parker, Howard B; Cash, Jared; O'Connell, Mary; Grant, MaryJo C

    2005-07-01

    To determine if combining standard drug concentrations with "smart-pump" technology reduces reported medication-infusion errors. Preintervention and postintervention comparison of reported medication errors related to infusion therapies during the calendar years 2002 and 2003. A 242-bed university-affiliated tertiary pediatric hospital. Change in continuous-medication-infusion process, comprising the adoption of (1) standard drug concentrations, (2) "smart" syringe pumps, and (3) human-engineered medication labels. Comparison of reported continuous-medication-infusion errors before and after the intervention. The number of reported errors dropped by 73% for an absolute risk reduction of 3.1 to 0.8 per 1000 doses. Preparation errors that occurred in the pharmacy decreased from 0.66 to 0.16 per 1000 doses; the number of 10-fold errors in dosage decreased from 0.41 to 0.08 per 1000 doses. The use of standard drug concentrations, smart syringe pumps, and user-friendly labels reduces reported errors associated with continuous medication infusions. Standard drug concentrations can be chosen to allow most neonates to receive needed medications without concerns related to excess fluid administration.

  18. Efficacy and safety of a hydrocodone extended-release tablet formulated with abuse-deterrence technology in patients with moderate-to-severe chronic low back pain.

    Science.gov (United States)

    Hale, Martin E; Zimmerman, Thomas R; Eyal, Eli; Malamut, Richard

    2015-01-01

    To evaluate efficacy and safety of hydrocodone bitartrate extended release (ER) tablets developed with CIMA(®) Abuse-Deterrence Technology (ADT) versus placebo in alleviating moderate-to-severe pain in patients with chronic low back pain. Phase 3, randomized, double-blind study consisting of a screening period (7-14 days), open-label titration period (≤ 6 weeks), and double-blind treatment period (≤ 12 weeks). Seventy-eight US centers. Changes from baseline at week 12 in weekly average of daily worst pain intensity (WPI; primary efficacy measure), weekly average pain intensity (API; secondary efficacy measure), adverse events (AEs), and study drug loss and diversion. Patients (N = 625) who entered open-label dose titration and identified the analgesic hydrocodone ER dose (30-90 mg every 12 h) providing optimal pain relief with minimal AEs were randomized to hydrocodone ER (n = 191) or placebo (n = 180) for double-blind treatment at the identified dose; 297 patients completed the study. Least squares means [SE] changes from baseline were significantly greater (worsening pain; 11-point scale) with placebo than hydrocodone ER in weekly average of daily WPI (0.74 [0.15] vs 0.11 [0.14]; p opioids, with a low occurrence of study drug loss and diversion.

  19. Applying ethical and legal principles to new technology: the University of Auckland Faculty of Medical and Health Sciences' policy 'Taking and Sharing Images of Patients.'

    Science.gov (United States)

    Jonas, Monique; Malpas, Phillipa; Kersey, Kate; Merry, Alan; Bagg, Warwick

    2017-01-27

    To develop a policy governing the taking and sharing of photographic and radiological images by medical students. The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated. The policy 'Taking and Sharing Images of Patients' sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland. Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.

  20. Use of Information and Communication Technologies in Clinical Practice Related to the Treatment of Pain. Influence on the Professional Activity and the Doctor-Patient Relationship.

    Science.gov (United States)

    Fernandez, Jorge Muriel; Cenador, Maria Begoña García; Manuel López Millan, J; Méndez, Juan Antonio Juanes; Ledesma, María José Sánchez

    2017-05-01

    The increasing relevance of Information and Communication Technologies (ICTs) in medical care is indisputable. This evidence makes it necessary to start studies that analyse the scope these new forms of access to information and understanding of medicine have on the professional activity of the physician, on the attitude and on the knowledge of patients or, on the doctor-patient relationship. The purpose of this study is to explore some of these aspects in a group of physicians whose clinical activity is related to one of the greatest social impact health problems which is the treatment of chronic pain. Starting with the completion of a questionnaire, in the study group it is observed that the interaction between social structure, increase of information flows and ICTs generate transformations in social practices and behaviour of the actors of the health system. Internet is confirmed as an information space on the subject, but is shown as an underutilized space of interaction between the doctor and his patient.

  1. La chirurgie réfractive de la cataracte: des technologies novatrices élargissent les choix des patients canadiens.

    Science.gov (United States)

    Potvin, Richard

    2016-11-01

    La chirurgie de la cataracte a toujours consisté à extraire le cristallin opacifié de l'œil pour le remplacer par une lentille artificielle. Cette intervention rend la vision du patient plus nette, sans pour autant corriger l'erreur de réfraction, c'est-à-dire la nécessité de porter des lunettes ou des lentilles cornéennes après l'opération. Les instruments diagnostiques et chirurgicaux modernes permettent désormais de corriger ces erreurs de réfraction au moment de l'opération, ce qui a fait émerger une nouvelle notion, celle de la chirurgie réfractive de la cataracte. Même si cette correction n'est pas nécessaire sur le plan médical, de nombreux patients se réjouissent de la possibilité de ne plus porter de lunettes ou d'en porter moins après l'opération, même s'ils doivent engager des frais. © 2016 The Canadian College of Health Leaders.

  2. Comparison of Postoperative Respiratory Monitoring by Acoustic and Transthoracic Impedance Technologies in Pediatric Patients at Risk of Respiratory Depression.

    Science.gov (United States)

    Patino, Mario; Kalin, Megan; Griffin, Allison; Minhajuddin, Abu; Ding, Lili; Williams, Timothy; Ishman, Stacey; Mahmoud, Mohamed; Kurth, C Dean; Szmuk, Peter

    2017-06-01

    In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia. RR was measured at regular intervals by RAM, TI, and manual count. Each TI or RAM alarm resulted in a clinical evaluation to categorize as a true or false alarm. To assess accuracy and degree of agreement of RR measured by RAM or TI compared with manual counting, a Bland-Altman analysis was utilized showing the average difference and the limits of agreement. Sensitivity and specificity of RR alarms by TI and RAM are presented. Fifty-eight posttonsillectomy children and 4 patient/parental-controlled analgesia users aged 6.5 ± 3.4 years and weighting 35.3 ± 22.7 kg (body mass index percentile 76.6 ± 30.8) were included. The average monitoring time per patient was 15.9 ± 4.8 hours. RAM was tolerated 87% of the total monitoring time. The manual RR count was significantly different from TI (P = .007) with an average difference ± SD of 1.39 ± 10.6 but were not significantly different from RAM (P = .81) with an average difference ± SD of 0.17 ± 6.8. The proportion of time when RR measurements differed by ≥4 breaths was 22% by TI and was 11% by RAM. Overall, 276 alarms were detected (mean alarms/patient = 4.5). The mean number of alarms per patient were 1.58 ± 2.49 and 2.87 ± 4.32 for RAM and TI, respectively. The mean number of false alarms was 0.18 ± 0.71 for RAM and 1.00 ± 2.78 for TI. The RAM was found to have 46.6% sensitivity (95% confidence interval [CI], 0.29-0.64), 95

  3. Cereal-Based Gluten-Free Food: How to Reconcile Nutritional and Technological Properties of Wheat Proteins with Safety for Celiac Disease Patients

    Directory of Open Access Journals (Sweden)

    Carmela Lamacchia

    2014-01-01

    Full Text Available The gluten-free diet is, to date, the only efficacious treatment for patients with Celiac Disease. In recent years, the impressive rise of Celiac Disease incidence, dramatically prompted changes in the dietary habit of an increasingly large population, with a rise in demand of gluten-free products. The formulation of gluten-free bakery products presents a formidable challenge to cereal technologists. As wheat gluten contributes to the formation of a strong protein network, that confers visco-elasticity to the dough and allows the wheat flour to be processed into a wide range of products, the preparation of cereal-based gluten-free products is a process somehow difficult process. This review focuses on nutritional and technological quality of products made with gluten-free cereals available on the market. The possibility of using flour from naturally low toxic ancient wheat species or detoxified wheat for the diet of celiacs is also discussed.

  4. Cereal-based gluten-free food: how to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients.

    Science.gov (United States)

    Lamacchia, Carmela; Camarca, Alessandra; Picascia, Stefania; Di Luccia, Aldo; Gianfrani, Carmen

    2014-01-29

    The gluten-free diet is, to date, the only efficacious treatment for patients with Celiac Disease. In recent years, the impressive rise of Celiac Disease incidence, dramatically prompted changes in the dietary habit of an increasingly large population, with a rise in demand of gluten-free products. The formulation of gluten-free bakery products presents a formidable challenge to cereal technologists. As wheat gluten contributes to the formation of a strong protein network, that confers visco-elasticity to the dough and allows the wheat flour to be processed into a wide range of products, the preparation of cereal-based gluten-free products is a somehow difficult process. This review focuses on nutritional and technological quality of products made with gluten-free cereals available on the market. The possibility of using flour from naturally low toxic ancient wheat species or detoxified wheat for the diet of celiacs is also discussed.

  5. Savvy Sellers: Dealing Drugs, Doing Gender, and Doing Difference

    Science.gov (United States)

    Ludwick, Micheline D.; Murphy, Sheigla; Sales, Paloma

    2016-01-01

    We present findings from two exploratory studies of San Francisco Bay Area women involved in illicit drug sales who saw both advantages and disadvantages to being women in traditionally male-dominated drug economies. We interviewed 160 sellers of street drugs and 50 sellers of prescription drugs during 2006-2009. Women perceived gender as a cover and managed their vulnerabilities by performing gendered actions and at times going against traditional gender expectations to protect themselves in harsh drug markets. The intersecting factors of race and type of drug sold played a crucial role, revealing the complex nature of women's social location in their drug-selling worlds. Study limitations are noted. PMID:26086305

  6. Educating the Next Generation of Energy-Savvy Workforce

    Science.gov (United States)

    Wu, Bin; Abad, Jorge

    2014-01-01

    This paper reports a problem-based learning model for the training of university students in the area of industrial energy efficiency, and discusses its context, contents, and the results from its implementation. The impact has been significant, with hundreds of university graduates trained and many of them now working in industry, leading their…