Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 5 Articles
Background: Patients and citizens need access to their health information to get a retrospective as well as a\nprospective view on their care and rehabilitation processes. However, patientsâ?? health information is stored in\nseveral health information systems and interoperability problems often hamper accessibility. In Sweden a national\nhealth information exchange (HIE) platform has been developed that enables information exchange between\ndifferent health information systems. The aim of this study is to explore the opportunities and limitations of\naccessing and interacting with important health information through the Swedish national HIE platform.\nMethods: A single case study approach was used for this study as an in-depth understanding of the subject was\nneeded. A fictive patient case with a pseudo-name was created based on an interview with a stroke coordinator in\nStockholm County. Information access through the national health information exchange platform and available\nservice contracts and application programming interfaces were studied using different scenarios.\nResults: Based on the scenarios created in this study, patients would be able to access some health related\ninformation from their electronic health records using the national health information exchange platform. However,\nthere is necessary information which is not retrievable as it is either stored in electronic health records and eHealth\nservices which are not connected to the national health information exchange platform or there is no service\ncontract developed for these types of information. In addition, patients are not able to share information with\nhealthcare professionals.\nConclusion: The national Swedish HIE platform provides the building blocks needed to allow patients online\naccess to their health information in a fragmented and distributed health system. However, more complex\ninteraction scenarios allowing patients to communicate with their health care providers or to update their health\nrelated information are not yet supported. Therefore it is of great importance to involve patients throughout the\ndesign and evaluation of eHealth services on both national and local levels to ensure that their needs for\ninteroperability and information exchange are met....
With the increase in global life expectancy and the advance of technology, the creation of\nage-friendly environments is a priority in the design of new products for elderly people healthcare.\nThis paper presents a proposal for a real-time health monitoring system of older adults living in\ngeriatric residences. This system was developed to help caregivers to have a better control in\nmonitoring the health of their patients and have closer communication with their patientsâ?? family\nmembers. To validate the feasibility and effectiveness of this proposal, a prototype was built, using\na biometric bracelet connected to a mobile application, which allows real-time visualization of all\nthe information generated by the sensors (heart rate, body temperature, and blood oxygenation) in\nthe bracelet. Using these data, caregivers can make decisions about the health status of their patients.\nThe evaluation found that the users perceived the system to be easy to learn and use, providing\ninitial evidence that our proposal could improve the quality of the adultâ??s healthcare....
In Spain, the average waiting time for a specialist consultation is 58 days. A determinant\nfactor that contributes to this situation is the poor communication between primary care and specialised\ncare, which is mainly due to the waiting days for a consultation, number of avoided/avoidable\nface-to-face referrals, and waiting days for the resolution of the process. DETELPROG is a referral\nsystem in which the family physician requests a scheduled outpatient internal medicine consultation,\nintegrated into the usual consultations agenda of both physicians, the family, and the outpatient clinic\nphysician, in order to have a telephone consultation. A randomized controlled clinical trial has been\ncarried out to assess the effectiveness of DELTELPROG. In a sample of 255 patients, the experimental\ngroup was referred via a scheduled telephone call, and those in the control group, by face-to-face\nhospital consultation area. The results showed statistically significant differences between both\ngroups of 27 days (95% confidence interval (CI): 20-33) regarding specialised consultation, 47 days\n(95% CI: 17-74) as for the resolution of the process, and 91.7% for avoided face-to-face consultations.\nThe DETELPROG resulted as a low coverage system (53%), which makes it a complementary referral\nmodel. It is necessary to make an in-depth analysis of the causes that have led to this technologically\nlow coverage....
Background: Patients undergoing major cancer surgery frequently require post-acute care for complications and\nadverse effects. Enhanced recovery after surgery programmes mean that patients are increasingly discharged home\nearlier. Symptom/complication detection post-discharge is sub-optimal. Systematic patient monitoring post-discharge\nfollowing surgery may be optimally achieved through routine electronic patient-reported outcome (ePRO) data\ncapture. ePRO systems that employ clinical algorithms to guide management of patients and automatically alert\nclinicians of clinically-concerning symptoms can improve patient outcomes and decrease hospital admissions. ePRO\nsystems that provide individually-tailored self-management advice and integrate live ePRO data into electronic health\nrecords (EHR) may also advance personalised health and patient-centred care. This study aims to develop a hospital\nEHR-integrated ePRO system to improve detection and management of complications post-discharge following\ncancer-related surgery.\nMethods: The ePRO system was developed in two phases: (1) Development of a web-based ePRO symptom-report\nfrom validated European Organisation for Research and Treatment of Cancer (EORTC) questionnaires, clinical opinion\nand patient interviews, followed by hospital EHR integration; (2) Development of clinical algorithms triggering\nsymptom severity-dependent patient advice and clinician alerts from: (i) prospectively-collected patientcompleted\nePRO symptom-report data; (ii) stakeholder meetings; (iii) patient interviews. Patient advice was\ndeveloped from: (i) clinician-patient telephone consultations and patient interviews; (ii) review of hospital\npatient information leaflets (PIL) and patient support websites.\nResults: Phase 1, including interviews with 18 patients, identified 35 symptom-report items. In phase 2, 130/300\n(43%) screened patients were eligible. 61 (47%) consented to participate and 59 (97%) provided 444 complete selfreports.\nStakeholder meetings (9 clinicians, 1 patient/public representative) and patient interviews (n = 66) refined\nadvice/alert accuracy. 15 telephone consultations, 7 patient interviews and review of 28 PILs and 3 patient support\nwebsites identified 4 themes to inform self-management advice. Comparisons between ePRO symptom-report data,\ntelephone consultations and clinical events/outcomes (n = 27 patients) further refined clinical algorithms....
Background. Maternal health is an important part of basic public health services in Chinaâ??s medical reform. Effective management\nis an important guarantee of maternal health. Telemedicine has been widely used in maternal health management. Objective. This\nstudy explores the role of usual healthcare combined with telemedicine in the management of high-risk pregnancy. Methods. The\nstudy was a retrospective. Data were obtained from Hangzhou Maternity Hospital between October 2012 and September 2016,\nincluding 93465 pregnant women who were in usual high-risk pregnancy management (usual group) and 134884 pregnant\nwomen who were in telemedicine combined with usual high-risk pregnancy management (telemedicine group). The differences in\nhigh-risk scores and pregnancy outcomes between the usual and the telemedicine groups were compared. Results. The high-risk\nfactors were analyzed, and the results showed that the first fixed high-risk factor was scar uterus and the first dynamic high-risk\nfactor was hepatitis B. Comparing the data of two groups, the number of prenatal visits increased significantly in the telemedicine\ngroup (p value <0.05). Although the critical proportion of high-risk women was 2.13% in the usual group and 5.88% in the\ntelemedicine group, respectively (p value <0.01), maternal mortality decreased in the telemedicine group (p value <0.05).\nConclusion. The combination of telemedicine and usual healthcare can urge the pregnant women to carry out antenatal visits on\ntime, which is one of the important factors to improve the outcome of high-risk pregnancy....
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