scholarly journals Enabling Better Use of Person-Generated Health Data in Stroke Rehabilitation Systems: Systematic Development of Design Heuristics

10.2196/17132 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17132
Author(s):  
Gerardo Luis Dimaguila ◽  
Kathleen Gray ◽  
Mark Merolli
Keyword(s):  
Stroke Rehabilitation ◽  
Information Technologies ◽  
Best Practice ◽  
Health Data ◽  
Health Information Technologies ◽  
Positive Effects ◽  
Credible Set ◽  
Remote Patient ◽  
Patient Use

Background An established and well-known method for usability assessment of various human-computer interaction technologies is called heuristic evaluation (HE). HE has been adopted for evaluations in a wide variety of specialized contexts and with objectives that go beyond usability. A set of heuristics to evaluate how health information technologies (HITs) incorporate features that enable effective patient use of person-generated health data (PGHD) is needed in an era where there is a growing demand and variety of PGHD-enabled technologies in health care and where a number of remote patient-monitoring technologies do not yet enable patient use of PGHD. Such a set of heuristics would improve the likelihood of positive effects from patients’ use of PGHD and lower the risk of negative effects. Objective This study aims to describe the development of a set of heuristics for the design and evaluation of how well remote patient therapeutic technologies enable patients to use PGHD (PGHD enablement). We used the case of Kinect-based stroke rehabilitation systems (K-SRS) in this study. Methods The development of a set of heuristics to enable better use of PGHD was primarily guided by the R3C methodology. Closer inspection of the methodology reveals that neither its development nor its application to a case study were described in detail. Thus, where relevant, each step was grounded through best practice activities in the literature and by using Nielsen’s heuristics as a basis for determining the new set of heuristics. As such, this study builds on the R3C methodology, and the implementation of a mixed process is intended to result in a robust and credible set of heuristics. Results A total of 8 new heuristics for PGHD enablement in K-SRS were created. A systematic and detailed process was applied in each step of heuristic development, which bridged the gaps described earlier. It is hoped that this would aid future developers of specialized heuristics, who could apply the detailed process of heuristic development for other domains of technology, and additionally for the case of PGHD enablement for other health conditions. The R3C methodology was also augmented through the use of qualitative studies with target users and domain experts, and it is intended to result in a robust and credible set of heuristics, before validation and refinement. Conclusions This study is the first to develop a new set of specialized heuristics to evaluate how HITs incorporate features that enable effective patient use of PGHD, with K-SRS as a key case study. In addition, it is the first to describe how the identification of initial HIT features and concepts to enable PGHD could lead to the development of a specialized set of heuristics.

scholarly journals Enabling Better Use of Person-Generated Health Data in Stroke Rehabilitation Systems: Systematic Development of Design Heuristics (Preprint)

2019 ◽  
Author(s):  
Gerardo Luis Dimaguila ◽  
Kathleen Gray ◽  
Mark Merolli
Keyword(s):  
Stroke Rehabilitation ◽  
Information Technologies ◽  
Best Practice ◽  
Health Data ◽  
Health Information Technologies ◽  
Positive Effects ◽  
Credible Set ◽  
Remote Patient ◽  
Patient Use

BACKGROUND An established and well-known method for usability assessment of various human-computer interaction technologies is called heuristic evaluation (HE). HE has been adopted for evaluations in a wide variety of specialized contexts and with objectives that go beyond usability. A set of heuristics to evaluate how health information technologies (HITs) incorporate features that enable effective patient use of person-generated health data (PGHD) is needed in an era where there is a growing demand and variety of PGHD-enabled technologies in health care and where a number of remote patient-monitoring technologies do not yet enable patient use of PGHD. Such a set of heuristics would improve the likelihood of positive effects from patients’ use of PGHD and lower the risk of negative effects. OBJECTIVE This study aims to describe the development of a set of heuristics for the design and evaluation of how well remote patient therapeutic technologies enable patients to use PGHD (PGHD enablement). We used the case of Kinect-based stroke rehabilitation systems (K-SRS) in this study. METHODS The development of a set of heuristics to enable better use of PGHD was primarily guided by the R3C methodology. Closer inspection of the methodology reveals that neither its development nor its application to a case study were described in detail. Thus, where relevant, each step was grounded through best practice activities in the literature and by using Nielsen’s heuristics as a basis for determining the new set of heuristics. As such, this study builds on the R3C methodology, and the implementation of a mixed process is intended to result in a robust and credible set of heuristics. RESULTS A total of 8 new heuristics for PGHD enablement in K-SRS were created. A systematic and detailed process was applied in each step of heuristic development, which bridged the gaps described earlier. It is hoped that this would aid future developers of specialized heuristics, who could apply the detailed process of heuristic development for other domains of technology, and additionally for the case of PGHD enablement for other health conditions. The R3C methodology was also augmented through the use of qualitative studies with target users and domain experts, and it is intended to result in a robust and credible set of heuristics, before validation and refinement. CONCLUSIONS This study is the first to develop a new set of specialized heuristics to evaluate how HITs incorporate features that enable effective patient use of PGHD, with K-SRS as a key case study. In addition, it is the first to describe how the identification of initial HIT features and concepts to enable PGHD could lead to the development of a specialized set of heuristics.

scholarly journals Measuring the outcomes of using person-generated health data: a case study of developing a PROM item bank

2019 ◽  
Vol 26 (1) ◽  
pp. e100070 ◽  
Author(s):  
Gerardo Luis Dimaguila ◽  
Kathleen Gray ◽  
Mark Merolli
Keyword(s):  
Stroke Rehabilitation ◽  
Best Practice ◽  
Patient Reported Outcome Measures ◽  
Health Condition ◽  
Health Data ◽  
Item Bank ◽  
Self Report ◽  
Development Method ◽  
Patient Reported

IntroductionPatient-reported outcome measures (PROMs) allow patients to self-report the status of their health condition or experience independently. A key area for PROMs to contribute in building the evidence base is in understanding the effects of using person-generated health data (PGHD), and using PROMs to measure outcomes of using PGHD has been suggested in the literature. Key considerations inherent in the stroke rehabilitation context makes the measurement of PGHD outcomes in home-based poststroke rehabilitation, which uses body-tracking technologies, an important use case.ObjectiveThis paper describes the development of a preliminary item bank of a PROM-PGHD for Kinect-based stroke rehabilitation systems (K-SRS), or PROM-PGHD for K-SRS.MethodsThe authors designed a method to develop PROMs of using PGHD, or PROM-PGHD. The PROM-PGHD Development Method was designed by augmenting a key PROM development process, the Qualitative Item Review, and follows PROM development best practice. It has five steps, namely, literature review; binning and winnowing; initial item revision; eliciting patient input and final item Revision.ResultsA preliminary item bank of the PROM-PGHD for K-SRS is presented. This is the result of implementing the first three steps of the PROM-PGHD Development Method within the domains of interest, that is, stroke and Kinect-based simulated rehabilitation.ConclusionsThis paper has set out a case study of our method, showing what needs to be done to ensure that the PROM-PGHD items are suited to the health condition and technology category. We described it as a case study because we argue that it is possible for the PROM-PGHD method to be used by others to measure effects of PGHD utilisation in other cases of health conditions and technology categories. Hence, it offers generalisability and has broader clinical relevance for evidence-based practice with PGHD. This paper is the first to offer a case study of developing a PROM-PGHD.

scholarly journals A Contemporary Case Study Illustrating the Integration of Health Information Technologies into the Organisation and Clinical Practice of Radiation Oncology

2005 ◽  
Vol 34 (4) ◽  
pp. 136-145 ◽  
Author(s):  
Andrew A Miller ◽  
Aaron K Phillips
Keyword(s):  
Information System ◽  
Quality Assurance ◽  
Radiation Oncology ◽  
Information Technologies ◽  
Data Use ◽  
Design Management ◽  
Implementation Cost ◽  
Health Information Technologies ◽  
Local Solutions

The development of software in radiation oncology departments has seen the increase in capability from the Record and Verify software focused on patient safety to a fully-fledged Oncology Information System (OIS). This paper reports on the medical aspects of the implementation of a modern Oncology Information System (IMPAC MultiAccess®, also known as the Siemens LANTIS®) in a New Zealand hospital oncology department. The department was successful in translating paper procedures into electronic procedures, and the report focuses on the changes in approach to organisation and data use that occurred. The difficulties that were faced, which included procedural re-design, management of change, removal of paper, implementation cost, integration with the HIS, quality assurance and datasets, are highlighted along with the local solutions developed to overcome these problems.

scholarly journals Virtual health care for community management of patients with COVID-19.

2020 ◽  
Author(s):  
Owen Hutchings ◽  
Cassandra Dearing ◽  
Dianna Jagers ◽  
Miranda Shaw ◽  
Freya Raffan ◽  
...  
Keyword(s):  
Health Care ◽  
Health Service ◽  
Hospital Admission ◽  
Information Technologies ◽  
Care Program ◽  
Community Management ◽  
Inpatient Setting ◽  
Health Information Technologies ◽  
Health Care Program ◽  
Remote Patient

Objectives: To describe the implementation and early experience of virtual health care for community management of patients with COVID-19. Design: observational cohort study. Setting: large Australian metropolitan health service with established virtual health care program and remote patient monitoring capability. Participants: patients with COVID-19 living within the health service who can self-isolate safely, do not require immediate admission to an inpatient setting, have no major active comorbid illness and can be managed at home or other suitable accommodation. Main outcome measures: care escalation rates, including hospital admission. Results: between 11-29 March 2020, 162/173 (93.6%) locally diagnosed patients with COVID-19 were accepted to the virtual health care program, median age 38y (range 11-79). For the 62 patients discharged during this period the median length of stay was 8 days (range 1-17). The peak of 100 prevalent patients equated to approximately 25 patients per Registered Nurse per shift. Patients were contacted a median of 16 times (range 1-30) during this period, with video consultations used 66.3% of the time; 132/162 (81.5%) patients were monitored remotely. Care escalation rates were low: ambulance attendance, 5 (3%); ED attendance, 4 (2.5%); hospital admission, 3 (1.9%). There were no deaths. Conclusions: community-based virtual health care is feasible for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian context for pandemic management. Health services implementing virtual health care should anticipate challenges with rapid technology deployments and provide adequate support to resolve them including strategies supporting consumer use of health information technologies.

scholarly journals Investigating the possibilities of using patient-generated health data in emergency care: an explorative study

2021 ◽  
Vol 4 (1) ◽  
pp. 10-16
Author(s):  
Fie Brosbøl Kobberup ◽  
Brit-Silje Sode ◽  
Gitte Boier Tygesen ◽  
Malik Kalmriz
Keyword(s):  
Emergency Care ◽  
Information Technologies ◽  
Participant Observation ◽  
Patient Flow ◽  
Health Data ◽  
Urgent Care ◽  
Patient Questionnaire ◽  
Health Information Technologies ◽  
Large Patient ◽  
Patient Pathways

AbstractIt is well known that emergency departments (EDs) are exposed to human errors and unintended events due to large patient flow, high work pressure and overload of information. Strategies for providing efficient and effective health care are therefore imperative, and health information technologies are suggested to be one of the solutions. This study sought to investigate if the use of patient-generated health data gathered through a digital patient questionnaire and visualised as a patient-generated journal (PGJ v.1.0) has the potential to improve the care delivered in EDs.MethodsUsing a mixed-method approach, the PGJ (v.1.0) was investigatedfrom key stakeholders’ perspectives. First, we examined the PGJ from a patient perspective via participant observation (n = 18) and interviews (n = 18), supported by statistical data from the PGJ (n = 56). Second, we used questionnaires to explore the physicians’ perspectives (n = 9). Lastly, two interviews were conducted with healthcare leaders from the ED. The data were compared and analysed using descriptive statistics and hermeneutic analysis.Results From the findings, it appears that patients in need of urgent care accept the use of patient-generated data, and patients highly favoured being active in their patient pathway. However, the system needed some adjustments to fit the patients’abilities in urgent situations.The physicians expressed mixed attitudes towards the PGJ: the majority agreed that the system needed some adjustments in order for the full benefits to be gained, but thought that it had potential to improve their work processes when fully developed.Conclusions This study concludes that the use of patient-generated data is well accepted by patients in an urgent setting, and that the PGJ has the potential to improve quality of care in patient pathways by adding value to patient flows as well as clinical workflows. The concept of utilising patient-generated health data in emergency care should therefore be further developed and investigated.

Health Information Technology Collaboration in Community Health Centers

2013 ◽  
pp. 171-196
Author(s):  
Elizabeth J. Forrestal ◽  
Leigh W. Cellucci ◽  
Xiaoming Zeng ◽  
Michael H. Kennedy ◽  
Doug Smith
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Information ◽  
Information Technologies ◽  
Community Health Centers ◽  
Health Centers ◽  
Non Profit ◽  
Health Information Technologies ◽  
Collaborative Ventures

Health-Center-Controlled Networks (HCCNs) are collaborative ventures that provide health information technologies to Community Health Centers (CHCs). Community Partners HealthNet (CPH), Inc. is a HCCN. CPH’s member organizations are non-profit health care organizations that provide primary health care to individuals in medically underserved areas. As non-profits, they must regularly seek grant funding from foundations and state and federal agencies to provide quality, accessible health care. Consequently, initiatives to adopt and implement Health Information Technologies (HIT) require individual CHCs to carefully consider how best to incorporate HIT for improved patient care. This case study describes CPH, discusses the collaboration of six individual CHCs to create CPH, and then explains CPH’s on-going operations.

scholarly journals Development of priorities for a Canadian strategy to advance activity-based therapies after spinal cord injury

Spinal Cord ◽  
2021 ◽  
Author(s):  
Kristin E. Musselman ◽  
Kristen Walden ◽  
Vanessa K. Noonan ◽  
Hope Jervis-Rademeyer ◽  
Nancy Thorogood ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Stroke Rehabilitation ◽  
Participatory Design ◽  
Best Practice ◽  
Optimal Timing ◽  
Activity Levels ◽  
Cord Injury ◽  
Healthcare Administrators ◽  
Psychosocial Benefits

Abstract Study Design Participatory design. Objectives Activity-based therapies (ABT) have physical and psychosocial benefits for individuals with spinal cord injury (SCI). A Canadian ABT summit was held to: (1) identify methods used in stroke rehabilitation that may be appropriate for SCI; (2) understand the current state of ABT activities in Canada; and (3) identify priorities for ABT research and care for the next five years. Setting Stakeholder-engaged meeting at a tertiary rehabilitation hospital. Methods Thirty-nine stakeholders, including individuals with SCI, frontline clinicians, healthcare administrators, researchers, funders and health policy experts, attended. Two participants were note-takers. Priority identification occurred through input from stakeholder groups, followed by individual voting. Conventional content analysis was used to synthesize the information in the meeting notes. Results The strengths of ABT in stroke rehabilitation included clear and clinically feasible definitions, measurements and interventions, and recognized requirements for implementation (e.g. behavior change, partnerships). Knowledge gaps concerning ABT activities in Canada were identified for acute and community settings, non-traumatic populations, and the interventions, equipment and standardized measures (i.e. upper limb, activity levels) used. Five priorities for ABT across the continuum of care were identified: (1) Identify current ABT activities; (2) Create a network to facilitate dialog; (3) Track engagement in ABT activities; (4) Develop and implement best practice recommendations; and (5) Study optimal timing, methods, and dose of ABT. Working groups were formed to address priorities 1–3. Conclusions The priorities will guide SCI research and care activities in Canada over the next five years. Sponsorship Praxis Spinal Cord Institute.

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