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Dang TH, Wickramasinghe N, Forkan ARM, Jayaraman PP, Burbury K, O'Callaghan C, Whitechurch A, Schofield P. Co-Design, Development, and Evaluation of a Mobile Solution to Improve Medication Adherence in Cancer: Design Science Research Approach. JMIR Cancer 2024; 10:e46979. [PMID: 38569178 PMCID: PMC11024750 DOI: 10.2196/46979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 01/27/2024] [Accepted: 02/14/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Medication nonadherence negatively impacts the health outcomes of people with cancer as well as health care costs. Digital technologies present opportunities to address this health issue. However, there is limited evidence on how to develop digital interventions that meet the needs of people with cancer, are perceived as useful, and are potentially effective in improving medication adherence. OBJECTIVE The objective of this study was to co-design, develop, and preliminarily evaluate an innovative mobile health solution called Safety and Adherence to Medication and Self-Care Advice in Oncology (SAMSON) to improve medication adherence among people with cancer. METHODS Using the 4 cycles and 6 processes of design science research methodology, we co-designed and developed a medication adherence solution for people with cancer. First, we conducted a literature review on medication adherence in cancer and a systematic review of current interventions to address this issue. Behavioral science research was used to conceptualize the design features of SAMSON. Second, we conducted 2 design phases: prototype design and final feature design. Last, we conducted a mixed methods study on patients with hematological cancer over 6 weeks to evaluate the mobile solution. RESULTS The developed mobile solution, consisting of a mobile app, a web portal, and a cloud-based database, includes 5 modules: medication reminder and acknowledgment, symptom assessment and management, reinforcement, patient profile, and reporting. The quantitative study (n=30) showed that SAMSON was easy to use (21/27, 78%). The app was engaging (18/27, 67%), informative, increased user interactions, and well organized (19/27, 70%). Most of the participants (21/27, 78%) commented that SAMSON's activities could help to improve their adherence to cancer treatments, and more than half of them (17/27, 63%) would recommend the app to their peers. The qualitative study (n=25) revealed that SAMSON was perceived as helpful in terms of reminding, supporting, and informing patients. Possible barriers to using SAMSON include the app glitches and users' technical inexperience. Further needs to refine the solution were also identified. Technical improvements and design enhancements will be incorporated into the subsequent iteration. CONCLUSIONS This study demonstrates the successful application of behavioral science research and design science research methodology to design and develop a mobile solution for patients with cancer to be more adherent. The study also highlights the importance of applying rigorous methodologies in developing effective and patient-centered digital intervention solutions.
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Affiliation(s)
- Thu Ha Dang
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
- Digital Cancer Care Innovation, Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Digital Health Cooperative Research Centre, Sydney, Australia
| | - Nilmini Wickramasinghe
- Department of Health and Bio Statistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
- Epworth Healthcare, Melbourne, Australia
- Optus Chair Digital Health, La Trobe University, Melbourne, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Abdur Rahim Mohammad Forkan
- Digital Innovation Lab, Department of Computer Science and Software Engineering, School Software and Electrical Engineering, Swinburne University of Technology, Hawthorn, Australia
| | - Prem Prakash Jayaraman
- Factory of the Future and Digital Innovation Lab, School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Kate Burbury
- Digital and Healthcare Innovation, Peter McCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Clare O'Callaghan
- Caritas Christi and Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, Australia
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Ashley Whitechurch
- Department of Clinical Haematology, Peter MacCallum Cancer Centre & Royal Melbourne Hospital, Melbourne, Australia
| | - Penelope Schofield
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
- Digital Cancer Care Innovation, Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
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Giunti G, Doherty CP. Cocreating an Automated mHealth Apps Systematic Review Process With Generative AI: Design Science Research Approach. JMIR Med Educ 2024; 10:e48949. [PMID: 38345839 PMCID: PMC10897815 DOI: 10.2196/48949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/28/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The use of mobile devices for delivering health-related services (mobile health [mHealth]) has rapidly increased, leading to a demand for summarizing the state of the art and practice through systematic reviews. However, the systematic review process is a resource-intensive and time-consuming process. Generative artificial intelligence (AI) has emerged as a potential solution to automate tedious tasks. OBJECTIVE This study aimed to explore the feasibility of using generative AI tools to automate time-consuming and resource-intensive tasks in a systematic review process and assess the scope and limitations of using such tools. METHODS We used the design science research methodology. The solution proposed is to use cocreation with a generative AI, such as ChatGPT, to produce software code that automates the process of conducting systematic reviews. RESULTS A triggering prompt was generated, and assistance from the generative AI was used to guide the steps toward developing, executing, and debugging a Python script. Errors in code were solved through conversational exchange with ChatGPT, and a tentative script was created. The code pulled the mHealth solutions from the Google Play Store and searched their descriptions for keywords that hinted toward evidence base. The results were exported to a CSV file, which was compared to the initial outputs of other similar systematic review processes. CONCLUSIONS This study demonstrates the potential of using generative AI to automate the time-consuming process of conducting systematic reviews of mHealth apps. This approach could be particularly useful for researchers with limited coding skills. However, the study has limitations related to the design science research methodology, subjectivity bias, and the quality of the search results used to train the language model.
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Affiliation(s)
- Guido Giunti
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Colin P Doherty
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, St James Hospital, Dublin, Ireland
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Kylén E, Stenholm J, Johansson M, Aggestam L, Svensson A. The Development and Evaluation of an Animated Video for Pre- and Postoperative Instructions for Patients with Osteoarthritis-A Design Science Research Approach. Geriatrics (Basel) 2024; 9:19. [PMID: 38392106 PMCID: PMC10887600 DOI: 10.3390/geriatrics9010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Osteoarthritis (OA) is a condition in the hip or knee joints that develops during a long period of time and sometimes needs hip or knee joint replacement surgery when pain gets too intense for the patient. This paper describes how an animated video for pre- and postoperative instructions for patients with osteoarthritis was designed. The design science research (DSR) approach was followed by creating a web-based animated video. The web-based animated video is used to support surgical departments with education for patients suffering from OA. In the web-based animated video, information about OA surgical treatment and its pre- and post-arrangements was included. The relevance, the rigor, and the design cycles were focused on, with some iterations of and improvements in the animations. Even after implementation, there was a feedback-loop with comments from the surgeons and their patients. Moreover, as more departments will use the web-based animated video, they want to make their special mark on it, so that further changes will be made. This paper presents the design and successful implementation of an animated video for pre- and postoperative instructions for patients with osteoarthritis, tightly linked to the patient journey and the workflow of healthcare professionals. The animated video serves not only as a tool to improve care but also as a basis for further scientific research studies.
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Affiliation(s)
- Erik Kylén
- MedFilm AB, Staveredsgatan 20, 461 31 Trollghättan, Sweden
| | - Joel Stenholm
- MedFilm AB, Staveredsgatan 20, 461 31 Trollghättan, Sweden
| | - Madeleine Johansson
- Department of Adult Psychiatry, NU-Care Hospital, Lärketorpsvägen, 461 73 Trollhättan, Sweden
| | - Lena Aggestam
- Department of Engineering Science, University West, Gustava Melins Gata 2, 461 32 Trollhättan, Sweden
| | - Ann Svensson
- School of Business Economics and IT, University West, Gustava Melins Gata 2, 461 32 Trollhättan, Sweden
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Wichmann J, Paetow T, Leyer M, Aweno B, Sandkuhl K. Determining design criteria for indoor positioning system projects in hospitals: A design science approach. Digit Health 2024; 10:20552076241229148. [PMID: 38362236 PMCID: PMC10868474 DOI: 10.1177/20552076241229148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 01/10/2024] [Indexed: 02/17/2024] Open
Abstract
Objectives Indoor navigation systems (indoor positioning systems) can improve orientation for patients in hospitals and help employees to track assets. Many hospitals would like to implement indoor positioning systems but do not know how. To support them in doing this, and to gain knowledge about the requirements for indoor positioning system implementation, our research identifies the design criteria relevant to indoor positioning system implementation projects. Methods A design science research process is built to design and evaluate an artifact. For this, five indoor positioning system developers and five hospital IT management representatives from various hospitals and companies in Germany are interviewed. Further, controlled experiments are conducted in Germany, using an ultrasound-based indoor positioning system. Results We determined and tested indoor positioning system functions, evaluated indoor positioning system performance criteria, and identified the operating conditions in hospitals. Our results show that indoor positioning system functions should provide a benefit to a hospital's daily operations, that some performance criteria are more important than others, and that operating conditions are important, e.g., radiation. Conclusion As a theoretical contribution, we show how design science research can be applied to the context of indoor positioning systems in hospitals. In addition, we make a practical contribution in that our propositions can be used for future indoor positioning system developments.
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Affiliation(s)
| | - Thomas Paetow
- Wismar University of Applied Sciences, Wismar, Germany
| | - Michael Leyer
- Philipps-University of Marburg, Marburg, Germany
- Queensland University of Technology, Brisbane, QLD, Australia
| | - Bisrat Aweno
- DEJ Technology GmbH, Rostock, Elmenhorst/Lichtenhagen, Germany
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Guan V, Zhou C, Wan H, Zhou R, Zhang D, Zhang S, Yang W, Voutharoja BP, Wang L, Win KT, Wang P. A Novel Mobile App for Personalized Dietary Advice Leveraging Persuasive Technology, Computer Vision, and Cloud Computing: Development and Usability Study. JMIR Form Res 2023; 7:e46839. [PMID: 37549000 PMCID: PMC10442736 DOI: 10.2196/46839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/23/2023] [Accepted: 05/10/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The Australian Dietary Guidelines (ADG) translate the best available evidence in nutrition into food choice recommendations. However, adherence to the ADG is poor in Australia. Given that following a healthy diet can be a potentially cost-effective strategy for lowering the risk of chronic diseases, there is an urgent need to develop novel technologies for individuals to improve their adherence to the ADG. OBJECTIVE This study describes the development process and design of a prototype mobile app for personalized dietary advice based on the ADG for adults in Australia, with the aim of exploring the usability of the prototype. The goal of the prototype was to provide personalized, evidence-based support for self-managing food choices in real time. METHODS The guidelines of the design science paradigm were applied to guide the design, development, and evaluation of a progressive web app using Amazon Web Services Elastic Compute Cloud services via iterations. The food layer of the Nutrition Care Process, the strategies of cognitive behavioral theory, and the ADG were translated into prototype features guided by the Persuasive Systems Design model. A gain-framed approach was adopted to promote positive behavior changes. A cross-modal image-to-recipe retrieval model under an Apache 2.0 license was deployed for dietary assessment. A survey using the Mobile Application Rating Scale and semistructured in-depth interviews were conducted to explore the usability of the prototype through convenience sampling (N=15). RESULTS The prominent features of the prototype included the use of image-based dietary assessment, food choice tracking with immediate feedback leveraging gamification principles, personal goal setting for food choices, and the provision of recipe ideas and information on the ADG. The overall prototype quality score was "acceptable," with a median of 3.46 (IQR 2.78-3.81) out of 5 points. The median score of the perceived impact of the prototype on healthy eating based on the ADG was 3.83 (IQR 2.75-4.08) out of 5 points. In-depth interviews identified the use of gamification for tracking food choices and innovation in the image-based dietary assessment as the main drivers of the positive user experience of using the prototype. CONCLUSIONS A novel evidence-based prototype mobile app was successfully developed by leveraging a cross-disciplinary collaboration. A detailed description of the development process and design of the prototype enhances its transparency and provides detailed insights into its creation. This study provides a valuable example of the development of a novel, evidence-based app for personalized dietary advice on food choices using recent advancements in computer vision. A revised version of this prototype is currently under development.
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Affiliation(s)
- Vivienne Guan
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Chenghuai Zhou
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Hengyi Wan
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rengui Zhou
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Dongfa Zhang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sihan Zhang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Wangli Yang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bhanu Prakash Voutharoja
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lei Wang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Khin Than Win
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Peng Wang
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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Shania M, Handayani PW, Asih S. Designing High-Fidelity Mobile Health for Depression in Indonesian Adolescents Using Design Science Research: Mixed Method Approaches. JMIR Form Res 2023; 7:e48913. [PMID: 37399059 PMCID: PMC10365601 DOI: 10.2196/48913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND COVID-19 mitigation protocols, enacted to control the pandemic, have also been shown to have a negative impact on mental health, including the mental health of adolescents. The threat of being infected by SARS-CoV-2 and substantial changes in lifestyle, including limited social interaction due to stay-at-home orders, led to loneliness as well as depressive symptoms. However, offline psychological assistance is restricted, as psychologists are bounded by mitigation protocols. Further, not all adolescents' guardians are open to their children attending or have the means to pay for psychological service; thus, adolescents remain untreated. Having a mobile health (mHealth) app for mental health that uses monitoring, provides social networks, and delivers psychoeducation may provide a solution, especially in countries that have limited health facilities and mental health workers. OBJECTIVE This study aimed to design an mHealth app to help prevent and monitor depression in adolescents. The design of this mHealth app was carried out as a high-fidelity prototype. METHODS We used a design science research (DSR) methodology with 3 iterations and 8 golden rule guidelines. The first iteration used interviews, and the second and third iterations used mixed method approaches. The DSR stages include the following: (1) identify the problem; (2) define the solution; (3) define the solution objective; (4) develop, demonstrate, and evaluate the solution; and (5) communicate the solution. This study involved students and medical experts. RESULTS The first iteration resulted in a wireframe and prototype for the next iteration. The second iteration resulted in a System Usability Scale score of 67.27, indicating a good fit. In the third iteration, the system usefulness, information quality, interface quality, and overall values were 2.416, 2.341, 2.597, and 2.261, respectively, indicating a good design. Key features of this mHealth app include a mood tracker, community, activity target, and meditation, and supporting features that complement the design include education articles and early detection features. CONCLUSIONS Our findings provide guidance for health facilities and to design and implement future mHealth apps to help treat adolescent depression.
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Affiliation(s)
- Mila Shania
- Faculty of Psychology, University of Indonesia, Depok, Indonesia
| | | | - Sali Asih
- Faculty of Psychology, University of Indonesia, Depok, Indonesia
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Casal-Guisande M, Ceide-Sandoval L, Mosteiro-Añón M, Torres-Durán M, Cerqueiro-Pequeño J, Bouza-Rodríguez JB, Fernández-Villar A, Comesaña-Campos A. Design of an Intelligent Decision Support System Applied to the Diagnosis of Obstructive Sleep Apnea. Diagnostics (Basel) 2023; 13:diagnostics13111854. [PMID: 37296707 DOI: 10.3390/diagnostics13111854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/07/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Obstructive sleep apnea (OSA), characterized by recurrent episodes of partial or total obstruction of the upper airway during sleep, is currently one of the respiratory pathologies with the highest incidence worldwide. This situation has led to an increase in the demand for medical appointments and specific diagnostic studies, resulting in long waiting lists, with all the health consequences that this entails for the affected patients. In this context, this paper proposes the design and development of a novel intelligent decision support system applied to the diagnosis of OSA, aiming to identify patients suspected of suffering from the pathology. For this purpose, two sets of heterogeneous information are considered. The first one includes objective data related to the patient's health profile, with information usually available in electronic health records (anthropometric information, habits, diagnosed conditions and prescribed treatments). The second type includes subjective data related to the specific OSA symptomatology reported by the patient in a specific interview. For the processing of this information, a machine-learning classification algorithm and a set of fuzzy expert systems arranged in cascade are used, obtaining, as a result, two indicators related to the risk of suffering from the disease. Subsequently, by interpreting both risk indicators, it will be possible to determine the severity of the patients' condition and to generate alerts. For the initial tests, a software artifact was built using a dataset with 4400 patients from the Álvaro Cunqueiro Hospital (Vigo, Galicia, Spain). The preliminary results obtained are promising and demonstrate the potential usefulness of this type of tool in the diagnosis of OSA.
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Affiliation(s)
- Manuel Casal-Guisande
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Spain
- Design, Expert Systems and Artificial Intelligent Solutions Group (DESAINS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - Laura Ceide-Sandoval
- Design, Expert Systems and Artificial Intelligent Solutions Group (DESAINS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - Mar Mosteiro-Añón
- Pulmonary Department, Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - María Torres-Durán
- Pulmonary Department, Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - Jorge Cerqueiro-Pequeño
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Spain
- Design, Expert Systems and Artificial Intelligent Solutions Group (DESAINS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - José-Benito Bouza-Rodríguez
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Spain
- Design, Expert Systems and Artificial Intelligent Solutions Group (DESAINS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - Alberto Fernández-Villar
- Pulmonary Department, Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
| | - Alberto Comesaña-Campos
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Spain
- Design, Expert Systems and Artificial Intelligent Solutions Group (DESAINS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
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Mavragani A. Design, Development, and Evaluation of an Automated Solution for Electronic Information Exchange Between Acute and Long-term Postacute Care Facilities: Design Science Research. JMIR Form Res 2023; 7:e43758. [PMID: 36800213 PMCID: PMC9985001 DOI: 10.2196/43758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Information exchange is essential for transitioning high-quality care between care settings. Inadequate or delayed information exchange can result in medication errors, missed test results, considerable delays in care, and even readmissions. Unfortunately, long-term and postacute care facilities often lag behind other health care facilities in adopting health information technologies, increasing difficulty in facilitating care transitions through electronic information exchange. The research gap is most evident when considering the implications of the inability to electronically transfer patients' health records between these facilities. OBJECTIVE This study aimed to design and evaluate an open standards-based interoperability solution that facilitates seamless bidirectional information exchange between acute care and long-term and postacute care facilities using 2 vendor electronic health record (EHR) systems. METHODS Using the design science research methodology, we designed an interoperability solution that improves the bidirectional information exchange between acute care and long-term care (LTC) facilities using different EHR systems. Different approaches were applied in the study with a focus on the relevance cycle, including eliciting detailed requirements from stakeholders in the health system who understand the complex data formats, constraints, and workflows associated with transferring patient records between 2 different EHR systems. We performed literature reviews and sought experts in the health care industry from different organizations with a focus on the rigor cycle to identify the components relevant to the interoperability solution. The design cycle focused on iterating between the core activities of implementing and evaluating the proposed artifact. The artifact was evaluated at a health care organization with a combined footprint of acute and postacute care operations using 2 different EHR systems. RESULTS The resulting interoperability solution offered integrations with source systems and was proven to facilitate bidirectional information exchange for patients transferring between an acute care facility using an Epic EHR system and an LTC facility using a PointClickCare EHR system. This solution serves as a proof of concept for bidirectional data exchange between Epic and PointClickCare for medications, yet the solution is designed to expand to additional data elements such as allergies, problem lists, and diagnoses. CONCLUSIONS Historically, the interoperability topic has centered on hospital-to-hospital data exchange, making it more challenging to evaluate the efficacy of data exchange between other care settings. In acute and LTC settings, there are differences in patients' needs and delivery of care workflows that are distinctly unique. In addition, the health care system's components that offer long-term and acute care in the United States have evolved independently and separately. This study demonstrates that the interoperability solution improves the information exchange between acute and LTC facilities by simplifying data transfer, eliminating manual processes, and reducing data discrepancies using a design science research methodology.
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Affiliation(s)
- Amaryllis Mavragani
- College of Business & Information SystemsDakota State UniversityMadison, SDUnited States
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Kerstiens S, Bender EM, Rizzo MG, Landi A, Gleason LJ, Huisingh-Scheetz M, Rubin D, Ferguson M, Madariaga MLL. Technology-assisted behavioral intervention to encourage prehabilitation in frail older adults undergoing surgery: Development and design of the BeFitMe™ Apple Watch app. Digit Health 2023; 9:20552076231203957. [PMID: 37766907 PMCID: PMC10521300 DOI: 10.1177/20552076231203957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Objective Increasing the physical activity of frail, older patients before surgery through prehabilitation (prehab) can hasten return to autonomy and reduce complications postoperatively. However, prehab participation is low in the clinical setting. In this study, we re-design an existing prehab smartphone application (BeFitMe™) using a novel standalone Apple Watch platform to increase accessibility and usability for vulnerable patients. Methods Design Science Research Methodology was used to (1) develop an approach to clinical research using standalone Apple Watches, (2) re-design BeFitMe™ for the Apple Watch platform, and (3) incorporate user feedback into app design. In phase 3, beta and user testers gave feedback via a follow-up phone call. Exercise data was extracted from the watch after testing. Descriptive statistics were used to summarize accessibility and usability. Results BeFitMe™ was redesigned for the Apple Watch with full functionality without requiring patients to have an iPhone or internet connectivity and the ability to passively collect exercise data without patient interaction. Three study staff participated in beta testing over 3 weeks. Six randomly chosen thoracic surgery patients participated in user testing over 12 weeks. Feedback from beta and user testers was addressed with updated software (versions 1.0-1.10), improved interface and notification schemes, and the development of educational materials used during enrollment. The majority of users (5/6, 83%) participated by responding to at least one notification and data was able to be collected for 54/82 (68%) of the days users had the watches. The amount of data collected in BeFitMe™ Watch app increased from 2/11 (16%) days with the first patient tester to 13/13 (100%) days with the final patient tester. Conclusions The BeFitMe™ Watch app is accessible and usable. The BeFitMe™ Watch app may help older patients, particularly those from vulnerable backgrounds with fewer resources, participate in prehab prior to surgery.
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Affiliation(s)
- Savanna Kerstiens
- Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Edward M. Bender
- Department of Cardiothoracic Surgery, Stanford University Medicine, Stanford, CA, USA
| | - Michael G. Rizzo
- Department of Orthopedic Surgery, University of Miami, Coral Gables, FL, USA
| | - Andrea Landi
- Department of Medicine, Section of Geriatric & Palliative Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Lauren J. Gleason
- Department of Medicine, Section of Geriatric & Palliative Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatric & Palliative Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Daniel Rubin
- Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, IL, USA
| | - Mark Ferguson
- Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
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Alotaibi FM, Al-Dhaqm A, Al-Otaibi YD, Alsewari AA. A Comprehensive Collection and Analysis Model for the Drone Forensics Field. Sensors (Basel) 2022; 22:6486. [PMID: 36080945 PMCID: PMC9460793 DOI: 10.3390/s22176486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Unmanned aerial vehicles (UAVs) are adaptable and rapid mobile boards that can be applied to several purposes, especially in smart cities. These involve traffic observation, environmental monitoring, and public safety. The need to realize effective drone forensic processes has mainly been reinforced by drone-based evidence. Drone-based evidence collection and preservation entails accumulating and collecting digital evidence from the drone of the victim for subsequent analysis and presentation. Digital evidence must, however, be collected and analyzed in a forensically sound manner using the appropriate collection and analysis methodologies and tools to preserve the integrity of the evidence. For this purpose, various collection and analysis models have been proposed for drone forensics based on the existing literature; several models are inclined towards specific scenarios and drone systems. As a result, the literature lacks a suitable and standardized drone-based collection and analysis model devoid of commonalities, which can solve future problems that may arise in the drone forensics field. Therefore, this paper has three contributions: (a) studies the machine learning existing in the literature in the context of handling drone data to discover criminal actions, (b) highlights the existing forensic models proposed for drone forensics, and (c) proposes a novel comprehensive collection and analysis forensic model (CCAFM) applicable to the drone forensics field using the design science research approach. The proposed CCAFM consists of three main processes: (1) acquisition and preservation, (2) reconstruction and analysis, and (3) post-investigation process. CCAFM contextually leverages the initially proposed models herein incorporated in this study. CCAFM allows digital forensic investigators to collect, protect, rebuild, and examine volatile and nonvolatile items from the suspected drone based on scientific forensic techniques. Therefore, it enables sharing of knowledge on drone forensic investigation among practitioners working in the forensics domain.
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Affiliation(s)
- Fahad Mazaed Alotaibi
- Faculty of Computing and Information Technology (FCIT), King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | - Arafat Al-Dhaqm
- Faculty of Engineering, School of Computing, Universiti Teknologi Malaysia, Skudai 81310, Malaysia
| | - Yasser D. Al-Otaibi
- Department of Information Systems, Faculty of Computing and Information Technology in Rabigh, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Abdulrahman A. Alsewari
- School of Computing and Digital Technology, Faculty of Computing, Engineering and the Built Environment, Birmingham City University, Birmingham B4 7XG, UK
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11
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Ahlin K, Wästlund E, Ahmad A, Nöjd S, Mozelius P, Sodhro AH. IoT in Elementary School for Everyone - A Research Plan. Stud Health Technol Inform 2022; 294:955-956. [PMID: 35612256 DOI: 10.3233/shti220638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We propose a tentative research plan to increase students' mental health in elementary schools by implementing Internet of Things (IoT) technology. The research plan should answer how to support students' mental health using IoT solutions and the critical factors influencing testbeds for IoT solutions with the previously mentioned purpose. Our intended research method is Design Science, which we plan to use stepwise.
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Affiliation(s)
- Karin Ahlin
- Service Centre Research, Karlstad University, Sweden
| | - Erik Wästlund
- Service Centre Research, Karlstad University, Sweden
| | | | - Sture Nöjd
- Service Centre Research, Karlstad University, Sweden
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12
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Lapão LV, Peyroteo M, Maia M, Seixas J, Gregório J, Mira da Silva M, Heleno B, Correia JC. Implementation of Digital Monitoring Services During the COVID-19 Pandemic for Patients With Chronic Diseases: Design Science Approach. J Med Internet Res 2021; 23:e24181. [PMID: 34313591 PMCID: PMC8396539 DOI: 10.2196/24181] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/14/2021] [Accepted: 07/02/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is straining health systems and disrupting the delivery of health care services, in particular, for older adults and people with chronic conditions, who are particularly vulnerable to COVID-19 infection. OBJECTIVE The aim of this project was to support primary health care provision with a digital health platform that will allow primary care physicians and nurses to remotely manage the care of patients with chronic diseases or COVID-19 infections. METHODS For the rapid design and implementation of a digital platform to support primary health care services, we followed the Design Science implementation framework: (1) problem identification and motivation, (2) definition of the objectives aligned with goal-oriented care, (3) artefact design and development based on Scrum, (4) solution demonstration, (5) evaluation, and (6) communication. RESULTS The digital platform was developed for the specific objectives of the project and successfully piloted in 3 primary health care centers in the Lisbon Health Region. Health professionals (n=53) were able to remotely manage their first patients safely and thoroughly, with high degrees of satisfaction. CONCLUSIONS Although still in the first steps of implementation, its positive uptake, by both health care providers and patients, is a promising result. There were several limitations including the low number of participating health care units. Further research is planned to deploy the platform to many more primary health care centers and evaluate the impact on patient's health related outcomes.
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Affiliation(s)
- Luís Velez Lapão
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Research and Development Unit in Mechanical and Industrial Engineering (UNIDEMI), NOVA School of Science and Technology, Universidade Nova de Lisboa, Caparica, Portugal
| | - Mariana Peyroteo
- Comprehensive Health Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- NOVA School of Science and Technology, Universidade Nova de Lisboa, Caparica, Portugal
| | - Melanie Maia
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
- NOVA School of Social Sciences and Humanities, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Jorge Seixas
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - João Gregório
- Research Center for Biosciences and Health Technologies, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | | | - Bruno Heleno
- Comprehensive Health Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Jorge César Correia
- Unit of Patient Education, Division of Endocrinology, Diabetology, Nutrition and Patient Education, Department of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Mulgund P, Sharman R, Rifkin D, Marrazzo S. Design, Development, and Evaluation of a Telemedicine Platform for Patients With Sleep Apnea (Ognomy): Design Science Research Approach. JMIR Form Res 2021; 5:e26059. [PMID: 34279237 PMCID: PMC8329758 DOI: 10.2196/26059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/30/2021] [Accepted: 06/11/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND With an aging population and the escalating cost of care, telemedicine has become a societal imperative. Telemedicine alternatives are especially relevant to patients seeking care for sleep apnea, with its prevalence approaching one billion cases worldwide. Increasing awareness has led to a surge in demand for sleep apnea care; however, there is a shortage of the resources and expertise necessary to cater to the rising demand. OBJECTIVE The aim of this study is to design, develop, and evaluate a telemedicine platform, called Ognomy, for the consultation, diagnosis, and treatment of patients with sleep apnea. METHODS Using the design science research methodology, we developed a telemedicine platform for patients with sleep apnea. To explore the problem, in the analysis phase, we conducted two brainstorming workshops and structured interviews with 6 subject matter experts to gather requirements. Following that, we conducted three design and architectural review sessions to define and evaluate the system architecture. Subsequently, we conducted 14 formative usability assessments to improve the user interface of the system. In addition, 3 trained test engineers performed end-to-end system testing to comprehensively evaluate the platform. RESULTS Patient registration and data collection, physician appointments, video consultation, and patient progress tracking have emerged as critical functional requirements. A telemedicine platform comprising four artifacts-a mobile app for patients, a web app for providers, a dashboard for reporting, and an artificial intelligence-based chatbot for customer onboarding and support-was developed to meet these requirements. Design reviews emphasized the need for a highly cohesive but loosely coupled interaction among the platform's components, which was achieved through a layered modular architecture using third-party application programming interfaces. In contrast, critical findings from formative usability assessments focused on the need for a more straightforward onboarding process for patients, better status indicators during patient registration, and reorganization of the appointment calendar. Feedback from the design reviews and usability assessments was translated into technical improvements and design enhancements that were implemented in subsequent iterations. CONCLUSIONS Sleep apnea is an underdiagnosed and undertreated condition. However, with increasing awareness, the demand for quality sleep apnea care is likely to surge, and creative alternatives are needed. The results of this study demonstrate the successful application of a framework using a design science research paradigm to design, develop, and evaluate a telemedicine platform for patients with sleep apnea and their providers.
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Affiliation(s)
| | - Raj Sharman
- State University of New York at Buffalo, Buffalo, NY, United States
| | - Daniel Rifkin
- Sleep Centers of Western New York, Buffalo, NY, United States
| | - Sam Marrazzo
- Buffalo Niagara Medical Campus, Inc, Buffalo, NY, United States
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14
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Kowatsch T, Lohse KM, Erb V, Schittenhelm L, Galliker H, Lehner R, Huang EM. Hybrid Ubiquitous Coaching With a Novel Combination of Mobile and Holographic Conversational Agents Targeting Adherence to Home Exercises: Four Design and Evaluation Studies. J Med Internet Res 2021; 23:e23612. [PMID: 33461957 PMCID: PMC7939948 DOI: 10.2196/23612] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/28/2020] [Accepted: 01/18/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Effective treatments for various conditions such as obesity, cardiac heart diseases, or low back pain require not only personal on-site coaching sessions by health care experts but also a significant amount of home exercises. However, nonadherence to home exercises is still a serious problem as it leads to increased costs due to prolonged treatments. OBJECTIVE To improve adherence to home exercises, we propose, implement, and assess the novel coaching concept of hybrid ubiquitous coaching (HUC). In HUC, health care experts are complemented by a conversational agent (CA) that delivers psychoeducation and personalized motivational messages via a smartphone, as well as real-time exercise support, monitoring, and feedback in a hands-free augmented reality environment. METHODS We applied HUC to the field of physiotherapy and conducted 4 design-and-evaluate loops with an interdisciplinary team to assess how HUC is perceived by patients and physiotherapists and whether HUC leads to treatment adherence. A first version of HUC was evaluated by 35 physiotherapy patients in a lab setting to identify patients' perceptions of HUC. In addition, 11 physiotherapists were interviewed about HUC and assessed whether the CA could help them build up a working alliance with their patients. A second version was then tested by 15 patients in a within-subject experiment to identify the ability of HUC to address adherence and to build a working alliance between the patient and the CA. Finally, a 4-week n-of-1 trial was conducted with 1 patient to show one experience with HUC in depth and thereby potentially reveal real-world benefits and challenges. RESULTS Patients perceived HUC to be useful, easy to use, and enjoyable, preferred it to state-of-the-art approaches, and expressed their intentions to use it. Moreover, patients built a working alliance with the CA. Physiotherapists saw a relative advantage of HUC compared to current approaches but initially did not see the potential in terms of a working alliance, which changed after seeing the results of HUC in the field. Qualitative feedback from patients indicated that they enjoyed doing the exercise with an augmented reality-based CA and understood better how to do the exercise correctly with HUC. Moreover, physiotherapists highlighted that HUC would be helpful to use in the therapy process. The longitudinal field study resulted in an adherence rate of 92% (11/12 sessions; 330/360 repetitions; 33/36 sets) and a substantial increase in exercise accuracy during the 4 weeks. CONCLUSIONS The overall positive assessments from both patients and health care experts suggest that HUC is a promising tool to be applied in various disorders with a relevant set of home exercises. Future research, however, must implement a variety of exercises and test HUC with patients suffering from different disorders.
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Affiliation(s)
- Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St Gallen, St Gallen, Switzerland.,Future Health Technologies Programme, Campus for Research Excellence and Technological Enterprise, Singapore-ETH Centre, Singapore, Singapore
| | - Kim-Morgaine Lohse
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Valérie Erb
- Graduate School of Culture Technology, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.,People and Computing Lab, Department of Informatics, University of Zurich, Zurich, Switzerland
| | - Leo Schittenhelm
- Centre for Digital Health Interventions, Institute of Technology Management, University of St Gallen, St Gallen, Switzerland
| | - Helen Galliker
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Rea Lehner
- Future Health Technologies Programme, Campus for Research Excellence and Technological Enterprise, Singapore-ETH Centre, Singapore, Singapore
| | - Elaine M Huang
- People and Computing Lab, Department of Informatics, University of Zurich, Zurich, Switzerland
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15
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Cerqueiro-Pequeño J, Comesaña-Campos A, Casal-Guisande M, Bouza-Rodríguez JB. Design and Development of a New Methodology Based on Expert Systems Applied to the Prevention of Indoor Radon Gas Exposition Risks. Int J Environ Res Public Health 2020; 18:E269. [PMID: 33396542 PMCID: PMC7795946 DOI: 10.3390/ijerph18010269] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 11/16/2022]
Abstract
Exposure to high concentration levels of radon gas constitutes a major health hazard, being nowadays the second-leading cause of lung cancer after smoking. Facing this situation, the last years have seen a clear trend towards the search for methodologies that allow an efficient prevention of the potential risks derived from the presence of harmful radon gas concentration levels in buildings. With that, it is intended to establish preventive and corrective actions that might help to reduce the impact of radon exposure on people, especially in places where workers and external users must stay for long periods of time, as it may be the case of healthcare buildings. In this paper, a new methodology is developed and applied to the prevention of the risks derived from the exposure to radon gas in indoor spaces. Such methodology is grounded in the concurrent use of expert systems and regression trees that allows producing a diagram with recommendations associated to the exposure risk. The presented methodology has been implemented by means of a software application that supports the definition of the expert systems and the regression algorithm. Finally, after proving its applicability with a case study and discussing its contributions, it may be claimed that the benefits of the new methodology might lead on to an innovation in this field of study.
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Affiliation(s)
| | - Alberto Comesaña-Campos
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Spain; (J.C.-P.); (J.-B.B.-R.)
| | - Manuel Casal-Guisande
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Spain; (J.C.-P.); (J.-B.B.-R.)
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16
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Comesaña-Campos A, Casal-Guisande M, Cerqueiro-Pequeño J, Bouza-Rodríguez JB. A Methodology Based on Expert Systems for the Early Detection and Prevention of Hypoxemic Clinical Cases. Int J Environ Res Public Health 2020; 17:E8644. [PMID: 33233826 PMCID: PMC7699904 DOI: 10.3390/ijerph17228644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 12/20/2022]
Abstract
Respiratory diseases are currently considered to be amongst the most frequent causes of death and disability worldwide, and even more so during the year 2020 because of the COVID-19 global pandemic. Aiming to reduce the impact of these diseases, in this work a methodology is developed that allows the early detection and prevention of potential hypoxemic clinical cases in patients vulnerable to respiratory diseases. Starting from the methodology proposed by the authors in a previous work and grounded in the definition of a set of expert systems, the methodology can generate alerts about the patient's hypoxemic status by means of the interpretation and combination of data coming both from physical measurements and from the considerations of health professionals. A concurrent set of Mamdani-type fuzzy-logic inference systems allows the collecting and processing of information, thus determining a final alert associated with the measurement of the global hypoxemic risk. This new methodology has been tested experimentally, producing positive results so far from the viewpoint of time reduction in the detection of a blood oxygen saturation deficit condition, thus implicitly improving the consequent treatment options and reducing the potential adverse effects on the patient's health.
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Affiliation(s)
- Alberto Comesaña-Campos
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Galicia, Spain; (J.C.-P.); (J.-B.B.-R.)
| | - Manuel Casal-Guisande
- Department of Design in Engineering, University of Vigo, 36208 Vigo, Galicia, Spain; (J.C.-P.); (J.-B.B.-R.)
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17
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Müller-Polyzou R, Reuter-Oppermann M, Engbert A, Schmidt R. Identifying user assistance systems for radiotherapy to increase efficiency and help saving lives. Health Syst (Basingstoke) 2020; 10:318-336. [PMID: 34745592 DOI: 10.1080/20476965.2020.1803148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Increasing efficiency and reducing risk in radiotherapy cancer treatment is of high importance. User assistance systems within a digitally connected radiotherapy environment can support all involved professionals to perform their individual tasks faster and better. This paper presents a qualitative analysis of radiotherapy workflows and a corresponding process modelling in order to identify hypothetical user assistance systems for specific process activities. In addition, the results of an empirical study on the identified systems are presented together with derived requirements and design principles for these systems. A structured online survey with 50 medical physicists in Germany has been conducted. Among others the acceptance, the increase of perceived efficiency and the risk reduction while using the assistance systems are analysed and discussed. The results support the creation of value adding user assistance systems for radiotherapy that improve efficiency, reduce treatment risks and reach high user acceptance levels.
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Affiliation(s)
- Ralf Müller-Polyzou
- Institute for Product and Process Innovation , Leuphana University Lueneburg, Lueneburg, Germany
| | | | - Anke Engbert
- Product Management, LAP GmbH Laser Applikationen, Lueneburg, Germany
| | - Raphael Schmidt
- Product Management, LAP GmbH Laser Applikationen, Lueneburg, Germany
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18
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Casal-Guisande M, Comesaña-Campos A, Cerqueiro-Pequeño J, Bouza-Rodríguez JB. Design and Development of a Methodology Based on Expert Systems, Applied to the Treatment of Pressure Ulcers. Diagnostics (Basel) 2020; 10:diagnostics10090614. [PMID: 32825387 PMCID: PMC7555597 DOI: 10.3390/diagnostics10090614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 11/16/2022] Open
Abstract
The medical treatment of chronic wounds, pressure ulcers in particular, burdens healthcare systems nowadays with high expenses that result mainly from their monitoring and assessment stages. Decision support systems applied within the ‘remote medicine’ framework may be of help, not only to the process of monitoring the evolution of chronic wounds under treatment, but also to facilitate the prevention and early detection of potential risk conditions in the affected patients. In this paper, the design and definition of a new decision-support methodology to be applied to the monitoring and assessment stages of the medical treatment process for pressure ulcers is proposed. Built upon the use and development of expert systems, the methodology makes it possible to generate alerts derived from the evolution of a patient’s chronic wound, by means of the interpretation and combination of data coming from both an image of the wound, and the considerations of a healthcare professional with expertise in the subject matter. Some positive results are already shown regarding the determination of the ulcer’s status in the tests that have been carried out so far. Therefore, it is considered that the proposed methodology might lead to substantial improvements regarding both the treatment’s efficiency and cost savings.
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Miranda A, Miah SJ. Design and Evaluation of a Contextual Model for Information Retrieval From Web-Scale Discovery Services to Improve Evidence-Based Practice by Health Care Practitioners: Mixed Methods Study. J Med Internet Res 2019; 21:e12621. [PMID: 31436167 PMCID: PMC6724502 DOI: 10.2196/12621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 03/05/2019] [Accepted: 07/09/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Practicing evidence-based health care is challenging because of overwhelming results presented to practitioners by Google-like Web-scale discovery (WSD) services that index millions of resources while retrieving information based on relevancy algorithms with limited consideration for user information need. OBJECTIVE On the basis of the user-oriented theory of information need and following design science principles, this study aimed to develop and evaluate an innovative contextual model for information retrieval from WSD services to improve evidence-based practice (EBP) by health care practitioners. METHODS We identified problems from literature to support real-world requirements for this study. We used design science research methodology to guide artefact design. We iteratively improved prototype of the context model using artificial formative evaluation. We performed naturalistic summative evaluation using convergent interviewing of health care practitioners and content analysis from a confirmatory focus group consisting of health researchers to evaluate the model's validity and utility. RESULTS The study iteratively designed and applied the context model to a WSD service to meet 5 identified requirements. All 5 health care practitioners interviewed found the artefact satisfied the 5 requirements to successfully evaluate the model as having validity and utility. Content analysis results from the confirmatory focus group mapped top 5 descriptors per requirement to support a true hypothesis that there is significant discussion among participants to justify concluding that the artefact had validity and utility. CONCLUSIONS The context model for WSD satisfied all requirements and was evaluated successfully for information retrieval to improve EBP. Outcomes from this study justify further research into the model.
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Affiliation(s)
- Alvet Miranda
- Victoria University Business School, Victoria University, Footscray Park Campus, Footscray, Australia
| | - Shah Jahan Miah
- Victoria University Business School, Victoria University, Footscray Park Campus, Footscray, Australia
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20
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Alharbey R, Chatterjee S. An mHealth Assistive System "MyLung" to Empower Patients with Chronic Obstructive Pulmonary Disease: Design Science Research. JMIR Form Res 2019; 3:e12489. [PMID: 30888329 PMCID: PMC6444216 DOI: 10.2196/12489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/12/2019] [Accepted: 03/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) comprises a group of progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. Breathlessness has negative implications on patients' lives, which leads to physical and psychological limitations. Moreover, the lack of relevant and updated information about the causes and consequences of the disease can exacerbate the problems of health literacy, information accessibility, and medical adherence. OBJECTIVE The objective of this study is to design an innovative mobile health (mHealth) app system called "MyLung" that provides complete solutions in order to increase self-awareness and promote better self-care management. This system, an information technology artifact, includes three novel integrative modules: education, risk reduction, and monitoring. METHODS The utility and effectiveness of the assistive mobile-based technology were evaluated using a mixed-methods approach. The study combined quantitative and qualitative research methods to thoroughly understand how the assistive mobile-based technology can influence patients' behavioral intention to change their lifestyle. Thirty patients were categorized into two groups (intervention group and control group). RESULTS The results from the quantitative analysis led to four follow-up interviews in the qualitative study. The results of the quantitative study provided significant evidence to show that the design of MyLung leads to a change in the awareness level, self-efficacy, and behavioral intention for patients with COPD. The t tests revealed a significant difference before and after using the mobile-based app with regard to the awareness level (mean 3.28 vs 4.56; t10=6.062; P<.001), self-efficacy (mean 3.11 vs 5.56; t10=2.96; P=.01), and behavioral intention (mean 2.91 vs 4.55; t10=3.212; P=.009). Independent sample t tests revealed significant differences between the intervention group and the control group in terms of the awareness level (mean 4.56 vs 3.31; t19=4.80; P<.001) and self-efficacy (mean 5.56 vs 3.66; t19=2.8; P<.01). Integration of findings from quantitative and qualitative studies reveled the impact of the design in a comprehensive manner. These inferences are referred to as "meta-inferences" in this study. CONCLUSIONS We designed an innovative assistive mobile-based technology to empower patients with COPD, which helped increase awareness and engage patients in self-care management activities. The assistive technology aims to inform patients about the risk factors of COPD and to improve access to relevant information. Meta-inferences that emerge from the research outputs contribute to research into chronic management information systems by helping us gain a more complete understanding of the potential impacts of this proposed mobile-based design on patients with chronic disease.
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Affiliation(s)
- Riad Alharbey
- Information Systems and Technology, College of Computer Science and Engineering, University of Jeddah, Jeddah, Saudi Arabia
| | - Samir Chatterjee
- Center for Information Systems & Technology, Claremont Graduate University, Claremont, CA, United States
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21
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Mendes LHDS, Mendes LCS, Dos Santos LL, Senff CO, Veiga CPD, Duclós LC. An Artifact for Evaluating the Quality of Health Service Providers: Evidence From Brazil. Inquiry 2018; 55:46958018790168. [PMID: 30156927 PMCID: PMC6116070 DOI: 10.1177/0046958018790168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this article is to present an artifact for evaluating the quality and
performance of service providers in the field of health care: the UNIPLUS
Program. To verify the scientific nature of the artifact and ensure that it
meets the criteria set by the community and the environment, the premises of
Design Science Research (DSR) were used. As this research field lacks empirical
evidence, the artifact was tested from 2013 to 2015 with 25 health care service
providers from different categories, with an emphasis on hospitals and clinics
located in 7 cities in the south of Brazil. This article makes 3 main
contributions to the field: (1) the artifact can be applied to any health
insurance operator in Brazil and other countries, as it meets the legal norms
and requirements established by current legislation; (2) it helps health service
providers by generating information that identifies shortfalls and possibilities
for improvement for every aspect analyzed in the evaluation process; and (3) it
uses the DSR methodology in an evaluation artifact that evaluates the quality
and performance of services in the field of health care. The artifact proved to
be adequate for the purpose in question, helping to improve the quality of care
and institutional performance.
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Walters LEM, Scott RE, Mars M. A Teledermatology Scale-Up Framework and Roadmap for Sustainable Scaling: Evidence-Based Development. J Med Internet Res 2018; 20:e224. [PMID: 29925492 PMCID: PMC6031901 DOI: 10.2196/jmir.9940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/12/2018] [Accepted: 04/17/2018] [Indexed: 11/13/2022] Open
Abstract
Background The objectives of South Africa’s electronic health (eHealth) strategy recognize the value proposition that telemedicine practices hold for rural and urban referrals, but a lack of accepted and formalized scale-up has impeded realization of benefits. While both synchronous and asynchronous teledermatology exist, these remain localized and not scaled-up. Skin pathology is often the first sign of an HIV/AIDS infection, which remains a major cause of morbidity and mortality in South Africa. It is essential to replace the current inefficient dermatology referral process with a swift, organized, and efficacious one. Objective The objective of this study is to present an evidenced-based teledermatology scale-up framework (TDSF) and implementation roadmap (TDSF-IR). Methods A qualitative method with a design science research process model was used which consisted of 5 phases: (1) Awareness, which confirmed the need for an evidence-based TDSF and supporting TDSF-IR; (2) Suggestion, where a proposal was delivered on how to develop a TDSF and TDSF-IR; (3) Development, where we identified recommended design requirements and used these to identify and critique existing teledermatology or related scale-up frameworks; (4) Evaluation and validation, where we assessed outputs of the development phase against the design requirements and validated by confirming the veracity of the TDSF and TDSF-IR (validation involved 4 key senior teledermatology stakeholders using a questionnaire with a 5-point Likert scale); and (5) Conclusion, where validation results were used to finalize and communicate the TDSF and TDSF-IR to users. Results The study identified 5 TDSF components: eHealth building blocks, eHealth strategic objectives and budget, scale-up continuum periods, scale-up drivers, and scale-up phases. In addition, 36 subcomponents were identified. Each was further characterized and described to enable design of the final evidence-based TDSF. An implementation roadmap (TDSF-IR) was also prepared as a guide for an implementer with step-by-step instructions for application of the TDSF. For the validation study of the TDSF and supporting TDSF-IR, 4 purposively selected key senior teledermatology management stakeholders were asked if they found it useful as a guide to assist the South African public health system with teledermatology scale-up. The mean (SD) of Likert-scale rating was 4.0 (0.53) where 4=Agree and 33 of 36 responses were either agree or strongly agree. Conclusions This study developed a TDSF and supporting roadmap (TDSF-IR) that are evidence-based. The proposed approach and described tools could be adapted to assist with ensuring scale-up and sustainability for other eHealth practices in other locations.
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Affiliation(s)
- Laticha Elizabeth Marolana Walters
- Department of TeleHealth, University of KwaZulu-Natal, Durban, South Africa.,Meraka Institute, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Richard Ernest Scott
- Department of TeleHealth, University of KwaZulu-Natal, Durban, South Africa.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,NT Consulting - Global e-Health Inc, Calgary, AB, Canada
| | - Maurice Mars
- Department of TeleHealth, University of KwaZulu-Natal, Durban, South Africa
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Nhavoto JA, Grönlund Å, Chaquilla WP. SMSaúde: Design, Development, and Implementation of a Remote/Mobile Patient Management System to Improve Retention in Care for HIV/AIDS and Tuberculosis Patients. JMIR Mhealth Uhealth 2015; 3:e26. [PMID: 25757551 PMCID: PMC4376127 DOI: 10.2196/mhealth.3854] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 11/13/2022] Open
Abstract
Background The widespread and low cost of mobile phones and the convenience of short message service (SMS) text messaging suggest potential suitability for use with alternative strategies for supporting retention in care and adherence to the treatment of various chronic diseases, such as HIV and tuberculosis (TB). Despite the growing body of literature reporting positive outcomes of SMS text message-based communication with patients, there is yet very little research about the integration of communication technologies and electronic medical records or electronic patient tracking systems. Objective To design, develop, and implement an integrated mobile phone text messaging system used to follow up with patients with HIV and TB in treatment in Mozambique. Methods Following the design science research methodology, we developed a Web-based system that provides support to patients. A case study involving three health care sites in Mozambique was a basis for discussing design issues for this kind of system. We used brainstorming techniques to solicit usability requirements, focus group meetings to discuss and define system architecture, and prototyping to test in real environments and to improve the system. Results We found six sets of system requirements that need to be addressed for success: data collection, telecommunication costs, privacy and data security, text message content, connectivity, and system scalability. A text messaging system was designed and implemented in three health facilities. These sites feed data into a central data repository, which can be used for analysis of operations and decision support. Based on the treatment schedule, the system automatically sent SMS text message appointment reminders, medication reminders, as well as motivational and educational messages to patients enrolled in antiretroviral therapy and TB treatment programs. Conclusions We successfully defined the requirements for, designed, and implemented a mobile phone text messaging system to support HIV and TB treatments. Implementation of this system could improve patients’ self-management skills and strengthen communication between patients and health care providers.
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