Design and implementation of a patient navigation system in rural Nepal: Improving patient experience in resource-constrained settings

Healthcare ◽  
2015 ◽  
Vol 3 (4) ◽  
pp. 251-257 ◽  
Author(s):  
Anant Raut ◽  
Poshan Thapa ◽  
David Citrin ◽  
Ryan Schwarz ◽  
Bikash Gauchan ◽  
...  
Author(s):  
Teemu Laukkarinen ◽  
Lasse Määttä ◽  
Jukka Suhonen ◽  
Timo D. Hämäläinen ◽  
Marko Hännikäinen

Resource constrained Wireless Sensor Networks (WSNs) require an automated firmware updating protocol for adding new features or error fixes. Reprogramming nodes manually is often impractical or even impossible. Current update protocols require a large external memory or external WSN transport protocol. This paper presents the design, implementation, and experiments of a Program Image Dissemination Protocol (PIDP) for autonomous WSNs. It is reliable, lightweight and it supports multi-hopping. PIDP does not require external memory, is independent of the WSN implementation, transfers firmware, and reprograms the whole program image. It was implemented on a node platform with an 8-bit microcontroller and a 2.4 GHz radio. Implementation requires 22 bytes of data memory and less than 7 kilobytes of program memory. PIDP updates 178 nodes within 5 hours. One update consumes under 1‰ of the energy of two AA batteries.


2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 6s-6s ◽  
Author(s):  
Maheswari Jaganathan ◽  
Dhiauddin Hai ◽  
Nur Hidayati Zainal ◽  
Nadia Rajaram ◽  
Mohamed Yusof ◽  
...  

Abstract 23 Background: Breast cancer incidence is rapidly increasing in Asia as a result of changes in life expectancy and lifestyle factors. In Malaysia, incidence is expected to double in the next decade and survival is poor (50% to 75%) because of late presentation and poor adherence to treatment. This burden is greater for women in underserved communities, but few studies have examined systematic approaches to reduce late presentation and poor treatment adherence. We sought to determine whether a patient navigation program (PNP) could be a community-based solution to improve outcomes of patients with breast cancer, particularly in a resource-constrained setting. Methods: PNP was implemented in a secondary hospital that serves a suburban area near Kuala Lumpur. A decision aid, which incorporated local key messages, was developed. Nurses and community workers in the program received skills training in navigation, communications, patient management, and resource identification and utilization. Data were retrieved from baseline questionnaires and a patient tracking system and was analyzed by using descriptive statistics. Results: In the first year of the program, 225 women were served, of whom 137 were patients with breast cancer. Compared with the prior year, more patients in the PNP received diagnoses within 14 days of their first visit (67.7% v 62.4%; P = .516) and had surgery within 28 days from diagnosis (68.4% v 61.3%; P = .487). There were also fewer reported patients who experienced default in the PNP (4.4% v 6.6%; P = .797). Conclusion: This 1-year evaluation showed that patient navigation is feasible in a resource-constrained setting, but longer follow-up is required to determine the impact on outcomes. Moving forward, we seek to increase the efficiency of patient navigation by increasing access to palliative care and improving interdepartment coordination and patient tracking systems. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Maheswari Jaganathan No relationship to disclose Dhiauddin Hai No relationship to disclose Nur Hidayati Zainal No relationship to disclose Nadia Rajaram No relationship to disclose Mohamed Yusof No relationship to disclose Soo-Hwang Teo Honoraria: AstraZeneca Consulting or Advisory Role: AstraZeneca Speakers' Bureau: AstraZeneca Research Funding: AstraZeneca Travel, Accommodations, Expenses: AstraZeneca


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