International Journal Of Telemedicine And Applications[JOURNAL]
Sun
200 papers
Managing Emergencies in Rural North Queensland: The Feasibility of Teletraining.
Pandit T, Ray RA, Sabesan S
Int J Telemed Appl · 2018 · PMID 29849606 · Full text
INTRODUCTION: Historically, the use of videoconference technologies in emergency medicine training has been limited. Whilst there are anecdotal reports of the use of teletraining for emergency medicine by rural doctors i...
INTRODUCTION: Historically, the use of videoconference technologies in emergency medicine training has been limited. Whilst there are anecdotal reports of the use of teletraining for emergency medicine by rural doctors in Australia, minimal evidence exists in the literature. This paper aimed to explore the use of teletraining in the context of managing emergency presentations in rural hospitals. METHODS: Using a qualitative approach, a mixture of junior and senior doctors were invited to participate in semistructured interviews. Data were transcribed and analysed line by line. Applying the grounded theory principles of open and axial coding, themes and subthemes were generated. RESULTS: A total of 20 interviews were conducted with rural doctors, rural doctors who are medical educators, and emergency medicine specialists. Two major themes-(1) teletraining as education and (2) personal considerations-and ten subthemes were evident from the data. Most participants had some previous experience with teletraining. Access to peer teaching over videoconference was requested by rural generalist registrars. There was a preference for interactive training sessions, over didactic lectures with little mention of technical barriers to engagement. The ability of teletraining to reduce professional isolation was a major benefit for doctors practicing in remote locations. DISCUSSION: For these rural doctors, teletraining is a feasible method of education delivery. Wider application of teletraining such as its use in peer teaching needs to be explored. The benefits of teletraining suggest that teletraining models need to be core business for health services and training providers, including specialist colleges.
On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia.
Sáenz JP, Novoa MP, Correal D … +1 more , Eapen BR
Int J Telemed Appl · 2018 · PMID 29785181 · Full text
BACKGROUND: The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no sp...
BACKGROUND: The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies-sets of concepts that represent knowledge in a given domain-are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. OBJECTIVE: Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. METHODS: A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. RESULTS: The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. CONCLUSIONS: This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.
Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics.
Molfenter T, Brown R, O'Neill A … +2 more , Kopetsky E, Toy A
Int J Telemed Appl · 2018 · PMID 29713341 · Full text
Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of...
Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations in the United States of America. Fifty percent of the organizations expressed high rates of interest in seven of the telemedicine applications, demonstrating the appeal of telemedicine within this field. The top three self-reported telemedicine applications being used were (1) computerized screening/assessments (44.6%), (2) telephone-based recovery supports (29.5%), and (3) telephone-based therapy (28.37%). The greatest gaps between interest and use were for (1) texting appointment reminders (55.2% differential), (2) mobile apps for posttreatment recovery (46.6% differential), and (3) recovery support chats (46.6% differential). A Latent Class Analysis (LCA) of the organizations' telemedicine use behavior identified three groupings: "Innovators" that were using a range of technologies ( = 27, 7.4%); "Technology Traditionalists" that limited their use to telephone, video, and web portal technologies ( = 101, 27.8%); and "Low Tech" that had low overall technology use ( = 235, 64.7%). Future studies should build on how telemedicine could be applied in SUD settings, organizational behaviors towards its adoption, and telemedicine's effect on treatment adherence and clinical outcomes.
What Kind of Information and Communication Technologies Do Patients with Type 2 Diabetes Mellitus Prefer? An Ecuadorian Cross-Sectional Study.
Chérrez-Ojeda I, Vanegas E, Calero E … +6 more , Plaza K, Cano JA, Calderon JC, Valdano J, Gutierrez JO, Guevara J
Int J Telemed Appl · 2018 · PMID 29666639 · Full text
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 cr...
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.
Characterizing the Use of Telepsychiatry for Patients with Opioid Use Disorder and Cooccurring Mental Health Disorders in Ontario, Canada.
LaBelle B, Franklyn AM, Pkh Nguyen V … +3 more , Anderson KE, Eibl JK, Marsh DC
Int J Telemed Appl · 2018 · PMID 29610570 · Full text
Rural patients with opioid use disorder (OUD) face a variety of barriers when accessing opioid agonist therapy (OAT) and psychiatric services, due to the limited supply of physicians and the vast geographic area. The tel...
Rural patients with opioid use disorder (OUD) face a variety of barriers when accessing opioid agonist therapy (OAT) and psychiatric services, due to the limited supply of physicians and the vast geographic area. The telemedicine allows for contact between patients and their physician-regardless of physical distance. . We characterize the usage of telemedicine to deliver psychiatric services to patients with OUD in Ontario, as well as traits of treatment-seeking patients with opioid dependence and concurrent psychiatric disorders. . A retrospective cohort study was conducted using an administrative database for patients who received psychiatric services via telemedicine between 2008 and 2014 and who also had OUD. We identified 9,077 patients with concurrent opioid use and other mental health disorders who had received psychiatric services via telemedicine from 2008 to 2014; 7,109 (78.3%) patients lived in Southern Ontario and 1,968 (21.7%) in Northern Ontario. Telemedicine was used more frequently to provide mental health services to patients residing in Northern Ontario than Southern Ontario. . Telemedicine is increasingly being utilized throughout Ontario for delivering mental health treatment. There is an opportunity to increase access to psychiatric services for patients with opioid dependence and concurrent psychiatric disorders through the use of the telemedicine.
Patients' and Healthcare Personnel's Experiences of Health Coaching with Online Self-Management in the Renewing Health Project.
Lindberg I, Lindberg B, Söderberg S
Int J Telemed Appl · 2017 · PMID 29463979 · Full text
BACKGROUND: Telehealth applications have shown positive effects for people with chronic conditions and their awareness of health. OBJECTIVE: To describe patients' and healthcare personnel's experiences of using health co...
BACKGROUND: Telehealth applications have shown positive effects for people with chronic conditions and their awareness of health. OBJECTIVE: To describe patients' and healthcare personnel's experiences of using health coaching with online self-management in primary health care. METHOD: A pragmatic randomised controlled trial was conducted. Patients in the intervention group measured and reported medical parameters such as blood pressure, blood glucose, prothrombin complex (PK) values, and 2-channel ECG. Data were collected through a questionnaire, individual interviews with patients, and focus group discussions with healthcare personnel. The questionnaire was analysed using statistics; texts from interviews and focus groups were analysed using content analysis. FINDINGS: Patients were satisfied and believed that the intervention had enhanced their care and increased accessibility without causing concerns about privacy. Although being positive, patients commented the lack of support and feedback from healthcare personnel. Healthcare personnel regarded the intervention valuable for the patients' abilities to perform self-management healthcare tasks but preferred that patients did so without them supporting the patients. CONCLUSION: Patients expressed satisfaction and acceptance regarding the use of the application. It seems that healthcare personnel are convinced about the benefits for patients and the potential for the intervention but are not convinced about its benefits for healthcare organisations.
Ruling Out Brain CT Contraindications prior to Intravenous Thrombolysis: Diagnostic Equivalence between a Primary Interpretation Workstation and a Mobile Tablet Computer.
Salazar AJ, Useche N, Granja M … +2 more , Morillo AJ, Bermúdez S
Int J Telemed Appl · 2017 · PMID 29250111 · Full text
OBJECTIVE: The aim of this study was to evaluate the equivalence of brain CT interpretations performed using a diagnostic workstation and a mobile tablet computer, in a telestroke service. MATERIALS AND METHODS: The ethi...
OBJECTIVE: The aim of this study was to evaluate the equivalence of brain CT interpretations performed using a diagnostic workstation and a mobile tablet computer, in a telestroke service. MATERIALS AND METHODS: The ethics committee of our institution approved this retrospective study. A factorial design with 1452 interpretations was used. The assessed variables were the type of stroke classification, the presence of contraindications to the tPA administration, the presence of a hyperdense intracranial artery sign (HMCA), and the Alberta Stroke Program Early CT Score (ASPECTS) score. These variables were evaluated to determine the effect that the reading system had on their magnitudes. RESULTS: The achieved distribution of observed lesions using both the reading systems was not statistically different. The differences between the two reading systems to claim equivalence were 1.6% for hemorrhagic lesions, 4.5% for cases without lesion, and 5.2 for overall ischemic lesion. Equivalence was achieved at 2.1% for ASPECTS ≤ 6, 6.5% for the presence of imaging contraindication to the tPA administration, and 7.2% for the presence of HMCA. CONCLUSION: The diagnostic performance for detecting acute stroke is likely equivalent whether a tablet computer or a diagnostic workstation is used or not.
The Internet Use for Health Information Seeking among Ghanaian University Students: A Cross-Sectional Study.
Osei Asibey B, Agyemang S, Boakye Dankwah A
Int J Telemed Appl · 2017 · PMID 29225620 · Full text
The aim of the study was to investigate university students' use of the Internet for health purpose in the Ghanaian context. The study employed a quantitative cross-sectional design. A total of 650 out of 740 students se...
The aim of the study was to investigate university students' use of the Internet for health purpose in the Ghanaian context. The study employed a quantitative cross-sectional design. A total of 650 out of 740 students selected from 3 different universities participated, giving a response rate of 87.7% (650/740). Data were obtained using questionnaires and frequency and percentages were used to analyze data. The results show that university students are active users of the Internet as 78.3% (509/650) used Internet daily and 67.7% (440/650) use Internet for health purposes, for reasons including availability and ease of accessing information, privacy, confidentiality, and affordability. Use of Internet was constrained by unreliable and slow connection, high cost of Internet, and unreliable power supply. Also, 72.4% (315/435) used the online health information obtained as a basis for lifestyle change and only 39.5% (170/430) consulted health professionals after obtaining online information. The study concludes that students use Internet to seek online health support. The use of Internet to communicate with young people in relation to their health must therefore be explored. There is the need to be aware of online safety issues for young adults, including the need to provide information on privacy options.
The "e-Generation": The Technological Usage and Experiences of Medical Students from a Developing Country.
Galappatthy P, Wathurapatha WS, Ranasinghe P … +3 more , Wijayabandara MDMS, Warapitiya DS, Weerasuriya K
Int J Telemed Appl · 2017 · PMID 29138632 · Full text
BACKGROUND: The medical community is increasingly using Portable Electronic Devices (PEDs). We evaluated usage of PEDs and medical apps among medical students from Sri Lanka. METHODS: This descriptive cross-sectional stu...
BACKGROUND: The medical community is increasingly using Portable Electronic Devices (PEDs). We evaluated usage of PEDs and medical apps among medical students from Sri Lanka. METHODS: This descriptive cross-sectional study was conducted at Faculty of Medicine, University of Colombo. Medical students from 2nd to 5th year were invited for the study. A self-administered questionnaire was used to collect details of PEDs availability, accessibility, and usage, perceived advantages/barriers of PEDs, and availability, accessibility, and usage of medical apps. RESULTS: Sample size was 505 (response rate, 61.8%). Mean age was 23.2 ± 1.3 years and majority were females (60.4%, = 305). Majority (87.5%, = 442) of students owned a PED. Nonaffordability was the most common reason for having not owning a PED (46%). Nonaffordability and lack of knowledge were key determinants of the usage of PEDs and medical "apps." Doubts about reliability and lack of knowledge regarding reliable electronic sources of information were other significant barriers. CONCLUSIONS: Our results show that a significant majority of students owned a PED, a higher percentage than what is reported elsewhere. Considering barriers identified, it is important for institutions to promote usage of PEDs and medical apps by providing financial support, training, and knowledge to build confidence in technology.
Videoconferencing for Health Care Provision for Older Adults in Care Homes: A Review of the Research Evidence.
Newbould L, Mountain G, Hawley MS … +1 more , Ariss S
Int J Telemed Appl · 2017 · PMID 29081795 · Full text
A scoping review was conducted to map the research evidence on the use of videoconferencing for remote health care provision for older adults in care homes. The review aimed to identify the nature and extent of the exist...
A scoping review was conducted to map the research evidence on the use of videoconferencing for remote health care provision for older adults in care homes. The review aimed to identify the nature and extent of the existing evidence base. Databases used were Embase, Medline, Web of Science, and Cochrane Library Reviews. The review identified 26 articles for inclusion, of which 14 were case studies, making the most used study design. Papers described videoconferencing as being used for assessment, management of health care, clinical support, and diagnosis, with eight of the papers reporting the use of videoconferencing for more than one clinical purpose. A further eight papers reported the use of videoconferencing for assessment alone. The literature reported the collection of various types of data, with 12 papers describing the use of both qualitative and quantitative data. The outcomes mainly addressed staff satisfaction ( = 9) and resident satisfaction ( = 8). Current evidence supports the feasibility of videoconferencing in care homes. However, research needs to be undertaken to establish the contexts and mechanisms that underpin the successful implementation of videoconferencing in care homes and to define useful measures for success.
An HTML5-Based Pure Website Solution for Rapidly Viewing and Processing Large-Scale 3D Medical Volume Reconstruction on Mobile Internet.
Qiao L, Chen X, Zhang Y … +7 more , Zhang J, Wu Y, Li Y, Mo X, Chen W, Xie B, Qiu M
Int J Telemed Appl · 2017 · PMID 28638406 · Full text
This study aimed to propose a pure web-based solution to serve users to access large-scale 3D medical volume anywhere with good user experience and complete details. A novel solution of the interaction mode was proposed...
This study aimed to propose a pure web-based solution to serve users to access large-scale 3D medical volume anywhere with good user experience and complete details. A novel solution of the interaction mode was proposed, which absorbed advantages of remote volume rendering and surface rendering. On server side, we designed a message-responding mechanism to listen to interactive requests from clients ( model) and to guide volume rendering. On client side, we used HTML5 to normalize user-interactive behaviors on model and enhance the accuracy of behavior request and user-friendly experience. The results showed that more than four independent tasks (each with a data size of 249.4 MB) could be simultaneously carried out with a 100-KBps client bandwidth (extreme test); the first loading time was <12 s, and the response time of each behavior request for final high quality image remained at approximately 1 s, while the peak value of bandwidth was <50-KBps. Meanwhile, the FPS value for each client was ≥40. This solution could serve the users by rapidly accessing the application via one URL hyperlink without special software and hardware requirement in a diversified network environment and could be easily integrated into other telemedical systems seamlessly.
Do Face-to-Face Training and Telephonic Reminder Improve Dry Powder Inhaler Technique in Patients with COPD?
Poudel RS, Shrestha S, Bhatta P … +1 more , Piryani RM
Int J Telemed Appl · 2017 · PMID 28386274 · Full text
. Current modes of instruction on inhaler technique are inadequate. We aimed to evaluate the value of face-to-face training and telephonic reminder (FFTTR) for improving Rotahaler technique in experienced patients with C...
. Current modes of instruction on inhaler technique are inadequate. We aimed to evaluate the value of face-to-face training and telephonic reminder (FFTTR) for improving Rotahaler technique in experienced patients with COPD. . A single group pre-/postinterventional study was conducted at Chitwan Medical College Teaching Hospital, Nepal. We assessed the Rotahaler technique of thirty consecutive patients using Rotahaler device for more than one year. Patients with incorrect technique ( = 20) were instructed and trained by a pharmacist. Telephonic reminder was used to reinstruct patients on the correct technique on weekly basis for two weeks and technique was reassessed after 4 weeks of their first training. Descriptive statistics including Wilcoxon Signed Rank test were applied. . The mean age was 66.06 ± 10.6. Of 30 patients, 10 (33.3%) performed Rotahaler technique correctly at baseline and were excluded from FFTTR intervention. FFTTR corrected the technique in 18 (90%) patients and the median (IQR) score increased from 6 (5-6) to 8 (8-8) ( < 0.001). The most incorrect steps were "breathe out gently but not towards the inhaler mouthpiece" (16, 80%) and "hold breath for about 10 seconds" (18, 90%) at baseline which improved after intervention. . FFTTR approach markedly improved Rotahaler technique in patients with COPD.
Clinical Decision Support Systems for Comorbidity: Architecture, Algorithms, and Applications.
Fan A, Lin D, Tang Y
Int J Telemed Appl · 2017 · PMID 28373881 · Full text
In this paper, we present the design of a clinical decision support system (CDSS) for monitoring comorbid conditions. Specifically, we address the architecture of a CDSS by characterizing it from three layers and discuss...
In this paper, we present the design of a clinical decision support system (CDSS) for monitoring comorbid conditions. Specifically, we address the architecture of a CDSS by characterizing it from three layers and discuss the algorithms in each layer. Also we address the applications of CDSSs in a few real scenarios and analyze the accuracy of a CDSS in consideration of the potential conflicts when using multiple clinical practice guidelines concurrently. Finally, we compare the system performance in our design with that in the other design schemes. Our study shows that our proposed design can achieve a clinical decision in a shorter time than the other designs, while ensuring a high level of system accuracy.
Research on Optimization of Pooling System and Its Application in Drug Supply Chain Based on Big Data Analysis.
Wu D, Mao H
Int J Telemed Appl · 2017 · PMID 28293258 · Full text
Reform of drug procurement is being extensively implemented and expanded in China, especially in today's big data environment. However, the pattern of supply mode innovation lags behind procurement improvement. Problems...
Reform of drug procurement is being extensively implemented and expanded in China, especially in today's big data environment. However, the pattern of supply mode innovation lags behind procurement improvement. Problems in financial strain and supply break frequently occur, which affect the stability of drug supply. Drug Pooling System is proposed and applied in a few pilot cities to resolve these problems. From the perspective of supply chain, this study analyzes the process of setting important parameters and sets out the tasks of involved parties in a pooling system according to the issues identified in the pilot run. The approach is based on big data analysis and simulation using system dynamic theory and modeling of Vensim software to optimize system performance. This study proposes a theoretical framework to resolve problems and attempts to provide a valuable reference for future application of pooling systems.
A Way to Understand Inpatients Based on the Electronic Medical Records in the Big Data Environment.
Mao H, Sun Y
Int J Telemed Appl · 2017 · PMID 28280506 · Full text
In recent decades, information technology in healthcare, such as Electronic Medical Record (EMR) system, is potential to improve service quality and cost efficiency of the hospital. The continuous use of EMR systems has...
In recent decades, information technology in healthcare, such as Electronic Medical Record (EMR) system, is potential to improve service quality and cost efficiency of the hospital. The continuous use of EMR systems has generated a great amount of data. However, hospitals tend to use these data to report their operational efficiency rather than to understand their patients. Base on a dataset of inpatients' medical records from a Chinese general public hospital, this study applies a configuration analysis from a managerial perspective and explains inpatients management in a different way. Four inpatient configurations (valued patients, managed patients, normal patients, and potential patients) are identified by the measure of the length of stay and the total hospital cost. The implications of the finding are discussed.
Real-Time Fall Risk Assessment Using Functional Reach Test.
Williams B, Allen B, Hu Z … +5 more , True H, Cho J, Harris A, Fell N, Sartipi M
Int J Telemed Appl · 2017 · PMID 28167961 · Full text
Falls are common and dangerous for survivors of stroke at all stages of recovery. The widespread need to assess fall risk in real time for individuals after stroke has generated emerging requests for a reliable, inexpens...
Falls are common and dangerous for survivors of stroke at all stages of recovery. The widespread need to assess fall risk in real time for individuals after stroke has generated emerging requests for a reliable, inexpensive, quantifiable, and remote clinical measure/tool. In order to meet these requests, we explore the Functional Reach Test (FRT) for real-time fall risk assessment and implement the FRT function in , a real-time and automatic mobile health system for poststroke recovery and rehabilitation. is designed, developed, and delivered as an Application (App) running on a hardware platform consisting of an iPad and one or two wireless body motion sensors based on different mobile health functions. The FRT function in is extensively tested on healthy human subjects to verify its concept and feasibility. Preliminary performance will be presented to justify the further exploration of the FRT function in through clinical trials on individuals after stroke, which may guide its ubiquitous exploitation in the near future.
How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era.
Chen X, Zhang X
Int J Telemed Appl · 2016 · PMID 28115932 · Full text
Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how rela...
Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.
Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana.
Rothstein JD, Jennings L, Moorthy A … +6 more , Yang F, Gee L, Romano K, Hutchful D, Labrique AB, LeFevre AE
Int J Telemed Appl · 2016 · PMID 28070186 · Full text
Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant...
Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs) in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources.
An Iterative, Mixed Usability Approach Applied to the Telekit System from the Danish TeleCare North Trial.
Lilholt PH, Schaarup C, Hejlesen OK
Int J Telemed Appl · 2016 · PMID 27974888 · Full text
. The aim of the present study is to evaluate the usability of the telehealth system, coined Telekit, by using an iterative, mixed usability approach. . Ten double experts participated in two heuristic evaluations (HE1,...
. The aim of the present study is to evaluate the usability of the telehealth system, coined Telekit, by using an iterative, mixed usability approach. . Ten double experts participated in two heuristic evaluations (HE1, HE2), and 11 COPD patients attended two think-aloud tests. The double experts identified usability violations and classified them into Jakob Nielsen's heuristics. These violations were then translated into measurable values on a scale of 0 to 4 indicating degree of severity. In the think-aloud tests, COPD participants were invited to verbalise their thoughts. . The double experts identified 86 usability violations in HE1 and 101 usability violations in HE2. The majority of the violations were rated in the 0-2 range. The findings from the think-aloud tests resulted in 12 themes and associated examples regarding the usability of the Telekit system. The use of the iterative, mixed usability approach produced both quantitative and qualitative results. . The iterative, mixed usability approach yields a strong result owing to the high number of problems identified in the tests because the double experts and the COPD participants focus on different aspects of Telekit's usability. This trial is registered with Clinicaltrials.gov, NCT01984840, November 14, 2013.
Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services.
Salazar AJ, Romero JA, Bernal OA … +3 more , Moreno AP, Velasco SC, Díaz XA
Int J Telemed Appl · 2016 · PMID 27777584 · Full text
The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized f...
The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations. The variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curves (AUC). . The mean values for the observed variables were as follows: accuracy ranged from 0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC ranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Our findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using a film digitizer or a digital camera.
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