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- Borycki, Elizabeth M., et al.
(författare)
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Enhancing Safety During a Pandemic Using Virtual Care Remote Monitoring Technologies and UML Modeling
- 2021
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Ingår i: IMIA Yearbook of Medical Informatics. - : Thieme. - 0943-4747 .- 2364-0502. ; 30:1, s. 264-271
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This paper describes a methodology for gathering requirements and early design of remote monitoring technology (RMT) for enhancing patient safety during pandemics using virtual care technologies. As pandemics such as COrona VIrus Disease (COVID-19) progress there is an increasing need for effective virtual care and RMT to support patient care while they are at home. METHODS: The authors describe their work in conducting literature reviews by searching PubMed.gov and the grey literature for articles, and government websites with guidelines describing the signs and symptoms of COVID-19, as well as the progression of the disease. The reviews focused on identifying gaps where RMT could be applied in novel ways and formed the basis for the subsequent modelling of use cases for applying RMT described in this paper. RESULTS: The work was conducted in the context of a new Home of the Future laboratory which has been set up at the University of Victoria. The literature review led to the development of a number of object-oriented models for deploying RMT. This modeling is being used for a number of purposes, including for education of students in health infomatics as well as testing of new use cases for RMT with industrial collaborators and projects within the smart home of the future laboratory. CONCLUSIONS: Object-oriented modeling, based on analysis of gaps in the literature, was found to be a useful approach for describing, communicating and teaching about potential new uses of RMT. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit.
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| 2. |
- Fernandez-Luque, Luis, et al.
(författare)
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Evidence-Based Health Informatics as the Foundation for the COVID-19 Response : A Joint Call for Action
- 2022
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Ingår i: Methods of Information in Medicine. - : Thieme Verlag. - 0026-1270 .- 2511-705X. ; 59:6, s. 183-192
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Tidskriftsartikel (refereegranskat)abstract
- Background As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis. Aim In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis. Methods Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript. Results Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19. Discussion Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.
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| 3. |
- Georgsson, Mattias, 1969-, et al.
(författare)
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Employing a user-centered cognitive walkthrough to evaluate a mHealth diabetes self-management application : A case study and beginning method validation
- 2019
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Ingår i: Journal of Biomedical Informatics. - : Elsevier. - 1532-0464 .- 1532-0480. ; 91
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Self-management of chronic diseases using mobile health (mHealth) systems and applications is becoming common. Current evaluation methods such as formal usability testing can be very costly and time-consuming; others may be more efficient but lack a user focus. We propose an enhanced cognitive walkthrough (CW) method, the user-centered CW (UC-CW), to address identified deficiencies in the original technique and perform a beginning validation with think aloud protocol (TA) to assess its effectiveness, efficiency and user acceptance in a case study with diabetes patient users on a mHealth self-management application. Materials and methods: A total of 12 diabetes patients at University of Utah Health, USA, were divided into UC-CW and think aloud (TA) groups. The UC-CW method included: making the user the main evaluator for detecting usability problems, having a dual domain facilitator, and using three other improved processes: validated task development, higher level tasks and a streamlined evaluation process. Users interacted with the same mHealth application for both methods. Post-evaluation assessments included the NASA RTLX instrument and a set of brief interview questions. Results: Participants had similar demographic characteristics. A total of 26 usability problems were identified with the UC-CW and 20 with TA. Both methods produced similar ratings: severity across all views (UC-CW = 2.7 and TA = 2.6), numbers of problems in the same views (Main View [UC-CW = 11, TA = 10], Carbohydrate Entry View [UC-CW = 4, TA = 3] and List View [UC-CW = 3, TA = 3]) with similar heuristic violations (Match Between the System and Real World [UC-CW = 19, TA = 16], Consistency and Standards [UC-CW = 17, TA = 15], and Recognition Rather than Recall [UC-CW = 13, TA = 10]). Both methods converged on eight usability problems, but the UC-CW group detected five critical issues while the TA group identified two. The UC-CW group identified needed personalized features for patients’ disease needs not identified with TA. UC-CW was more efficient on average time per identified usability problem and on the total evaluation process with patients. NASA RTLX scores indicated that participants experienced the UC-CW half as cognitively demanding. Common themes from interviews indicated the UC-CW as enjoyable and easy to perform while TA was considered somewhat awkward and more cognitively challenging. Conclusions: UC-CW was effective for finding severe, recurring usability problems and it highlighted the need for personalized user features. The method was also efficient and had high user acceptance. These results indicate UC-CW's utility and user acceptance in evaluating a mHealth self-management application. It provides an additional usability evaluation technique for researchers. © 2019
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| 4. |
- Rahimi, Bahlol, 1975-
(författare)
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Supporting Collaborative Work through ICT : How End-users Think of and Adopt Integrated HealthInformation Systems
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Health Information Systems (HISs) are implemented to support individuals,organizations, and society, making work processes integrated andcontributing to increase service quality and patient safety. However, theoutcomes of many HIS implementations in both primary care and hospitalsettings have either not met yet all the expectations decision-makersidentified or have failed in their implementation. There is, therefore, agrowing interest in increasing knowledge about prerequisites to be fulfilledin order to make the implementation and adoption of HIS more effective andto improve collaboration between healthcare providers.The general purpose of the work presented in this thesis is to explore issuesrelated to the implementation, use, and adoption of HISs and its contributionfor improving inter- and intra-organizational collaboration in a healthcarecontext. The studies included have, however, different research objectivesand consequently used different research methods such as case study,literature review, meta-analysis, and surveys. The selection of the researchmethodology has thus depended on the aim of the studies and their expectedresults.In the first study performed we showed that there is no standard frameworkto evaluate effects and outputs of implementation and use of ICT-basedapplications in the healthcare setting, which makes the comparison ofinternational results not possible yet.Critical issues, such as techniques employed to teach the staff when usingintegrated system, involvement of the users in the implementation process,and the efficiency of the human computer interface were particularlyreported in the second study included in this thesis. The results of this studyalso indicated that the development of evidence-based implementation processes should be considered in order to diminish unexpected outputs thataffect users, patients and stakeholders.We learned in the third study, that merely implementing of a HIS will notautomatically increase organizational efficiency. Strategic, tactical, andoperational actions have to be taken into consideration, includingmanagement involvement, integration in healthcare workflow, establishingcompatibility between software and hardware, user involvement, andeducation and training.When using an Integrated Electronic Prescribing System (IEPS), pharmaciesstaff declared expedited the processing of prescriptions, increased patientsafety, and reduced the risk for prescription errors, as well as the handingover of erroneous medications to patients. However, they stated also that thesystem does not avoid all mistakes or errors and medication errors stilloccur. We documented, however, in general, positive opinions about theIEPS system in the fifth article. The results in this article indicated thatsafety of the system compared to a paper-based one has increased. Theresults showed also an impact on customer relations with the pharmacy; andprevention of errors. However, besides finding an adoption of the IEPS, weidentified a series of undesired and non planned outputs that affect theefficiency and efficacy of use of the system.Finally, we captured in the sixth study indications for non-optimality in thecomputer provider entry system. This is because; the system was not adaptedto the three-quarters of physicians and one-half of nurses’ specificprofessional practice. Respondents pointed out also human-computerinteraction constrains when using the system. They indicated also the factthat the system could lead to adverse drug events in some circumstances.The work presented in this thesis contributes to increase knowledge in thearea of health informatics on how ICT supports inter- and intraorganizationalcollaborative work in a healthcare context and to identifyfactors and prerequisites needed to be taken into consideration whenimplementing new generations of HIS.
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| 5. |
- Vimarlund, Vivian, 1951-, et al.
(författare)
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Ambient Assisted Living : Identifying New Challenges and Needs for Digital Technologies and Service Innovation
- 2021
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Ingår i: IMIA Yearbook of Medical Informatics. - : Thieme. - 0943-4747 .- 2364-0502. ; 30:1, s. 141-149
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ambient assisted living (AAL) market is rapidly becoming fundamental to the delivery of health and social care services for the elderly. Worldwide many different steps have been taken to increase the engagement of older adults with these technologies. Much of this work has focused on the development of novel digital services that increase wellbeing or tackle social challenges. AIM: The aim of the study was to identify and describe the demands for AAL-services from the perspective of older adults. We also examine the challenges and needs of the ambient assisted living market using a needs based approach. METHOD: An exploratory case study was conducted with an aim to capture information about older adults' demands for AAL services. A survey was used to collect the data. The survey study respondents validated the results. RESULTS: The results of the study indicate that the area of AAL needs be studied from a multiple-sided market perspective. Our research suggests there is a need to describe and understand the factors that facilitate or constrain the implementation of services with focus on health and social care. There is also a need to describe and analyze the relationship between policy and practice and its effects on the AAL market. It is necessary to capture expressed demand, to identify market challenges at the macro level and to be able to understand how services should operate and serve older adults in practice. Such research is critical to the development of guidance for policy makers, suppliers and service providers. DISCUSSION: Older adults are asking for intelligent, assistive living solutions that help them to continue to live independent lives and remain socially included in their networks, associations, and communities. The elderly need services that stimulate and maintain their physical and intellectual capital. The development of innovative AAL environments is, however, a complex social process that involves the use and delivery of innovative ICT-based services. The implementation and use of AAL to support older adults involve service providers and elderly consumers. CONCLUSIONS: The results of the study may be of interest to policy makers, entrepreneurs, technology suppliers, service providers and health and social care organizations, who are willing to innovate and influence the development of the AAL market through their choices and decisions. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit.
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