Cross Sectional E-Health Evaluation Study for Telemedicine and M-Health Approaches in Monitoring COVID-19 Patients with Chronic Obstructive Pulmonary Disease (COPD)

Mobile App for Patients With Chronic Obstructive Pulmonary Diseases During Home-Based Exercise Care: Usability Study

BACKGROUND

Digital health tools have demonstrated promise in the treatment and self-management of chronic diseases while also serving as an important means for reducing the workload of health care professionals (HCPs) and enhancing the quality of care. However, these tools often merely undergo large-scale testing or enter the market without undergoing rigorous user experience analysis in the early stages of their development, leading to frequent instances of low use or failure.

OBJECTIVE

This study aims to assess the usability of and satisfaction with a mobile app designed for the clinical monitoring of patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation at home.

METHODS

This study used a mixed methods approach involving two key stakeholders-patients with chronic obstructive pulmonary disease and HCPs-across three phases: (1) mobile app mock-up design, (2) usability testing, and (3) satisfaction evaluation. Using convenience sampling, participants were grouped as HCPs (n=12) and patients (n=18). Each received a tablet with mock-ups for usability testing through interviews, with audio recordings transcribed and analyzed anonymously in NVivo12.0, focusing on mock-up features and usability insights. Task difficulty was rated from 1 (very easy) to 5 (very difficult), with noncompletion deemed a critical error. Usability satisfaction was measured on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree).

RESULTS

The research indicated a notable difference in app usability perceptions: 66% (8/12) of HCPs found tasks "very easy," compared to only 22% (4/18) of patients. Despite this, no participant made critical errors or withdrew, and satisfaction was high. HCPs completed tasks in about 20 minutes, while patients took 30. Older adults faced challenges with touch screens and scroll menus, suggesting the need for intuitive design aids like auditory support and visual health progress indicators, such as graphs. HCPs noted potential data delays affecting service, while non-native-speaking caregivers faced interpretation challenges. A secure pairing system for privacy in teleconsultations proved difficult for older users; a simpler icon-based system is recommended. This study highlights the need to consider stakeholder abilities in medical app design to enhance function implementation.

CONCLUSIONS

Most HCPs (11/12, 91%) found the app intuitive, though they recommended adding icons to show patient progress to support clinical decisions. In contrast, 62% (11/18) of patients struggled with tablet navigation, especially with connectivity features. To ensure equitable access, the design should accommodate older users with diverse abilities. Despite challenges, both groups reported high satisfaction, with patients expressing a willingness to learn and recommending the app. These positive usability evaluations suggest that, with design improvements, such apps could see increased use in home-based care.

Evaluating an Advanced Practice Provider-Managed Coronavirus Disease 2019 Deterioration Program

Background

COVID-19 changed how healthcare systems could provide quality healthcare to patients, safely. An urban healthcare system created an advanced practice provider (APP)-managed continuous remote patient monitoring (cRPM) program.

Methods

A mixed-method study design focusing on the usable and feasible nature of the cRPM program. Both APP-guided interviews and online questionnaires were analyzed.

Results

There was overwhelmingly positive APP feedback utilizing the remote monitoring solution including providing quality healthcare, detecting early clinical deterioration, and desiring to adapt the solution to other acute or chronic diseases.

Implications

Understanding the clinical users' feedback on usability and feasibility of cRPM highlights the significance of rapid clinical assessment, urgent care escalation and provider accessibility.

Usability of telehealth among healthcare providers during COVID-19 pandemic in Nineveh Governorate, Iraq

Objectives

To identify the usability of telehealth services and barriers during the coronavirus disease (COVID-19) pandemic among healthcare providers in Nineveh Governorate-Iraq.

Study design

This was a multicenter cross-sectional survey.

Methods

We collected the required data from April to July 2022 using self-administered open-ended questionnaires. The healthcare providers were physicians, pharmacists, and nurses with at least six months of services at hospitals. A modified form of the Telehealth Usability Questionnaire (TUQ) was used to assess the usability of telehealth services.

Results

There were 460 healthcare providers, of which 269/460 (58.5%) were users of telehealth services. These were mostly physicians (n = 167/269, 62.1%), nurses (52/269, 19.3%), and pharmacists (n = 50/269, 18.6%), with a p-value of 0.001. During the COVID-19 pandemic, physicians (n = 100/167, 60.0%) and pharmacists (n = 28/50, 56.0%) increased their provision of telehealth services. Approximately 60% of physicians and nurses preferred to provide telehealth services in a synchronized manner. The participants mostly used smartphones to provide telehealth services through Messenger/Facebook and WhatsApp applications, specifically utilizing voice and/or video messages. There was some agreement among the participants (n = 269) regarding the usability of telehealth services. The overall mean score (±SD) was 4.8 (±0.88). The most reported barriers to telehealth services were poor Internet services, the presence of specific diseases, lack of technical comprehension, and insufficient time allocated to the service.

Conclusion

Healthcare providers demonstrated a tendency towards the usability of telehealth services. Despite the available barriers, triage collaborations among patients, healthcare providers, and healthcare institutions are needed to achieve more successful adoption of these services.

mHealth and eHealth Applications for a Medicalized Quarantine Hotel during the COVID-19 Pandemic

BACKGROUND

In Taiwan, the number of confirmed cases of coronavirus disease 2019 (COVID-19) has risen significantly in May 2021. The second wave of the epidemic occurred in May 2022. mHealth (mobile health, social media communities) and eHealth (electronic health, Hospital Information System) can play an important role in this pandemic by minimizing the spread of the virus, leveraging health care providers' time, and alleviating the challenges of medical education.

OBJECTIVES

This study aimed to describe the process of using mHealth and eHealth to build a medicalized quarantine hotel (MQH) and understand the physical and mental impact of COVID-19 on patients admitted to the MQH.

METHODS

In this retrospective observational study, data from 357 patients who stayed at the MQH were collected and their psychological symptoms were assessed using an online Brief Symptom Rating Scale (BSRS). Descriptive statistics, independent sample t-test, univariate analysis of variance, and multiple linear regression analysis were performed.

RESULTS

The patients' mean age was 35.5  ±   17.6 years, and 52.1% (n  =  186) of them were males. Altogether, 25.2% (n  =  90) of the patients had virtual visits. The average duration of the hotel stay was 6.8  ±   1.4 days, and five patients (0.01%) were transferred to the hospital. The three most common symptoms reported were cough (39%), followed by the sore throat (22.8%), and stuffy/runny nose (18.9%). Most patients achieved a total BSRS score of 0 to 5 points (3,569/91.0%), with trouble falling asleep (0.65  ±   0.65), feeling tense or high-strung (0.31  ±   0.66), and feeling down or depressed (0.27  ±   0.62) scoring highest. The BSRS score was the highest on the first day. The sex of the patients was significantly related to the BSRS score (p  <  0.001).

CONCLUSION

mHealth and eHealth can be used to further monitor an individual's physiological and psychological states. Early intervention measures are needed to improve health care quality.

Empowering Self-Efficacy by Using Patient Empowerment among Chronic Obstructive Pulmonary Disease: Pre-Post-Test Study

Patient empowerment is increasingly acknowledged as a milestone of high-quality patient-centered care. This study was conducted using COPD Self-Efficacy Scale to determine the effectiveness of the patient empowerment intervention program among chronic obstructive pulmonary disease patients on self-efficacy. We employed an interventional design with a pre-test and post-test. Sixty COPD patients comprised the final sample of the study. The current study revealed significant improvement in overall self-efficacy factors among most participants. Statistically significant positive correlations were found between the total self-efficacy post-empower intervention model scores concerning age, sex, work, educational level, and marital status. The study's findings revealed that the patient empowerment intervention program positively affected COPD patients' self-efficacy.

Telemedicine to Expand Access to Critical Care Around the World

This multiauthored communication gives a state-of-the-art global perspective on the increasing adoption of tele-critical care. Exponentially increasing sophistication in the deployment of Computers, Information, and Communication Technology has ensured extending the reach of limited intensivists virtually and reaching the unreached. Natural disasters, COVID-19 pandemic, and wars have made tele-intensive care a reality. Concerns and regulatory issues are being sorted out, cross-border cost-effective tele-critical care is steadily increasing Components to set up a tele-intensive care unit, and overcoming barriers is discussed. Importance of developing best practice guidelines and retraining is emphasized.