Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 7 Articles
The aim of this study was to summarize and analyse findings fromfour prior studies on the use of the Internet as a source of health\r\ninformation in five European countries (Norway, Denmark, Germany, Greece, and Portugal). A cross-study comparison of data\r\nwas performed. All the studies included fit with a trend of a sharp and continuous growth in the use of the Internet for health\r\ninformation access in the major part of the last decade. Importantly, the Internet has become an important mass media source\r\nof health information in northern Europe. While the use of the Internet for health information is somewhat less common in the\r\nsouth European countries, its use is also clearly increasing there.We discuss the advantages of cross-study comparisons of data and\r\nmethodological challenges. As the use of the Internet for health information is likely to peak in some countries in the near future,\r\nnew population surveys on health information access should focus more on the details of information that is accessed and which\r\nsites that are most used and trusted....
Introduction. Telemedicine is promoted as a means to increase access to specialty medical care among the urban underserved, yet\r\nlittle is known about its acceptability among these populations. We used components of a diffusion of innovation conceptual\r\nframework to analyze preexperience perceptions about telemedicine to assess its appeal among urban underserved African\r\nAmericans and Latinos. Methods. Ten focus groups were conducted with African American (n = 43) and Latino participants\r\n(n = 44) in both English and Spanish and analyzed for key themes. Results. Both groups perceived increased and immediate\r\naccess to multiple medical opinions and reduced wait time as relative advantages of telemedicine. However, African Americans\r\nexpressed more concerns than Latinos about confidentiality, privacy, and the physical absence of the specialist. This difference may\r\nreflect lower levels of trust in new health care innovations among African Americans resulting from a legacy of past abuses in the US\r\nmedical system as compared to immigrant Latinos who do not have this particular historical backdrop. Conclusions. These findings\r\nhave implications for important issues such as adoption of telemedicine, patient satisfaction, doctor-patient interactions, and the\r\ndevelopment and tailoring of strategies targeted to each of these populations for the introduction, marketing, and implementation\r\nof telemedicine....
The paper addresses an ICT-based, user-driven innovation process in the health sector in rural areas in Norway. The empirical\r\nbase is the introduction of a new model for psychiatric health provision. This model is supported by a technical solution based\r\non mobile phones that is aimed to help the communication between professional health personnel and patients. This innovation\r\nwas made possible through the use of standard mobile technology rather than more sophisticated systems. The users were heavily\r\ninvolved in the development work. Our analysis shows that by thinking simple and small-scale solutions, including to take the\r\nuser�s needs and premises as a point of departure rather than focusing on advanced technology, the implementation process\r\nwas made possible. We show that by combining theory on information infrastructures, user-oriented system development, and\r\ninnovation in a three-layered analytical framework, we can explain the interrelationship between technical, organizational, and\r\nhealth professional factors that made this innovation a success....
Background: Frequent rehospitalisations and poorer survival chances in heart failure (HF) patients may partly be\r\nexplained by poor medication adherence. There are multiple medication-related reasons for suboptimal adherence,\r\nbut psychological reasons may also be important. A novel TELEmonitoring device may improve MEDication\r\nadherence in HF patients (TELEMED-HF). TELEMED-HF is a randomized, controlled clinical intervention trial designed\r\nto examine (1) the efficacy and cost-efficiency of an electronic medication adherence support system in improving\r\nand monitoring HF patients� medication adherence; (2) the effect of medication adherence on hospitalizations and\r\nhealth care consumption; as well as on (3) clinical characteristics, and Quality of Life (QoL); and (4) clinical,\r\nsociodemographic, and psychological determinants of medication adherence.\r\nMethods/Design: Consecutive patients with chronic, systolic HF presenting to the outpatient clinic of the\r\nTweeSteden Hospital, The Netherlands, will be approached for study participation and randomly assigned (1:1)\r\nfollowing blocked randomization procedures to the intervention (n = 200) or usual care arm (n = 200). Patients in\r\nthe intervention arm use the medication support device for six months in addition to usual care. Post-intervention,\r\npatients return to usual care only and all patients participate in four follow-up occasions over 12 months. Primary\r\nendpoints comprise objective and subjective medication adherence, healthcare consumption, number of\r\nhospitalizations, and cost-effectiveness. Secondary endpoints include disease severity, physical functioning, and\r\nQoL.\r\nDiscussion: The TELEMED-HF study will provide us a comprehensive understanding of medication adherence in\r\nHF patients, and will show whether telemonitoring is effective and cost-efficient in improving adherence and\r\npreventing hospitalization in HF patients.\r\nTrial registration number: NCT01347528...
Millennium Development Goals (MDGs) are unlikely to be met in most low- and middle-income countries (LMIC). Smartphones\r\nand smartphone proxy systems using simpler phones, equipped with the capabilities to identify location/time and link to the web,\r\nare increasingly available and likely to provide an excellent platform to support healthcare self-management, delivery, quality,\r\nand supervision. Smart phones allow information to be delivered by voice, texts, pictures, and videos as well as be triggered\r\nby location and date. Prompts and reminders, as well as real-time monitoring, can improve quality of health care. We propose a\r\nthree-tier model for designing platforms for both professional and paraprofessional health providers and families: (1) foundational\r\nfunctions (informing, training, monitoring, shaping, supporting, and linking to care); (2) content-specific targets (e.g., for MDG;\r\ndevelopmentally related tasks); (3) local cultural adaptations (e.g., language). We utilize the Maternal and Child Health (MCH)\r\nMDG in order to demonstrate how the existing literature can be organized and leveraged on open-source platforms and provide\r\nexamples using our own experience in Africa over the last 8 years....
Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease. However, access to these\r\nservices is limited especially in rural and remote areas. Telerehabilitation has the potential to deliver pulmonary rehabilitation\r\nprograms to these communities. The aim of this study was threefold: to establish the technical feasibility of transmitting realtime\r\npulse oximetry data, determine the validity of remote measurements compared to conventional face-to-face measures, and\r\nevaluate the participants� perception of the usability of the technology. Thirty-seven healthy individuals participated in a single\r\nremote pulmonary rehabilitation exercise session, conducted using the eHAB telerehabilitation system. Validity was assessed by\r\ncomparing the participant�s oxygen saturation and heart rate with the data set received at the therapist�s remote location. There\r\nwas an 80% exact agreement between participant and therapist data sets. The mean absolute difference and Bland and Altman�s\r\nlimits of agreement fell within the minimum clinically important difference for both oxygen saturation and heart rate values.\r\nParticipants found the system easy to use and felt confident that they would be able to use it at home. Remote measurement of\r\npulse oximetry data for a pulmonary rehabilitation exercise session was feasible and valid when compared to conventional face-toface\r\nmethods....
Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often\r\nlimited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there\r\nare few examples of successful health system implementation. Program Development. An iterative process of program design\r\nwas built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a ââ?¬Å?human faceââ?¬Â to the\r\npilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced\r\nconcerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health\r\nplan use automated text messaging to provide personalized self-management support for member patients with diabetes and\r\nfacilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a\r\nnurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the\r\nexisting health system to support a de novo care management program by leveraging mobile technology. The program supports\r\nself-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and\r\nneeds of health plan administrators....
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