Telemonitoring Healthcare System-Based Mobile Agent Technology

Author(s):  
Nardjes Bouchemal ◽  
Ramdane Maamri ◽  
Naila Bouchemal

Generally, distributed computing through a handheld/mobile device has to be considered with care because of the limited capabilities on these devices. Especially in ubiquitous telemonitoring healthcare, which refers to the disposition of any type of health services, such that medical staff members (physicians, emergency workers, other healthcare providers, etc.) through mobile computing devices can access them and expect data to be made available. In this chapter, the authors present a new system based on ubiquitous agents to assist telemonitoring employees, not only anytime and anywhere but also on any device.

2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background: In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients.Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method: We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically.Results: The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically.Conclusion: Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alan Chi-Lun-Chiao ◽  
Mohammed Chehata ◽  
Kenneth Broeker ◽  
Brendan Gates ◽  
Leila Ledbetter ◽  
...  

Abstract Objectives This overview of reviews aimed to identify (1) aspects of the patient experience when seeking care for musculoskeletal disorders from healthcare providers and the healthcare system, and (2) which mechanisms are used to measure aspects of the patient experience. Data sources Four databases were searched from inception to December 20th, 2019. Review methods Systematic or scoping reviews examining patient experience in seeking care for musculoskeletal from healthcare providers and the healthcare system were included. Independent authors screened and selected studies, extracted data, and assessed the methodological quality of the reviews. Patient experience concepts were compiled into five themes from a perspective of a) relational and b) functional aspects. A list of mechanisms used to capture the patient experience was also collected. Results Thirty reviews were included (18 systematic and 12 scoping reviews). Relational aspects were reported in 29 reviews and functional aspects in 25 reviews. For relational aspects, the most prevalent themes were “information needs” (education and explanation on diseases, symptoms, and self-management strategies) and “understanding patient expectations” (respect and empathy). For functional aspects, the most prevalent themes were patient’s “physical and environmental needs,” (cleanliness, safety, and accessibility of clinics), and “trusted expertise,” (healthcare providers’ competence and clinical skills to provide holistic care). Interviews were the most frequent mechanism identified to collect patient experience. Conclusions Measuring patient experience provides direct insights about the patient’s perspectives and may help to promote better patient-centered health services and increase the quality of care. Areas of improvement identified were interpersonal skills of healthcare providers and logistics of health delivery, which may lead to a more desirable patient-perceived experience and thus better overall healthcare outcomes. Trial registration Systematic review registration: PROSPERO (CRD42019136500).


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Kaseliene ◽  
L Blazeviciute ◽  
O Mesceriakova-Veliuliene

Abstract Background The Lithuanian National Electronic Health (e-health) System was only launched in 2015. The aim of this study is to evaluate the e-health system in the Kaunas City Outpatient Clinic using a system of balanced performance indicators. Methodology The survey was carried out from October until December, 2018, at the Kaunas City Outpatient Clinic (Lithuania). The study included 264 medical staff members and 384 patients. Results 62% of the patients and 100% medical staff of the clinic used various e-health system services. The most often used services by the patients were SMS reminder (75.5%), online registration (70.8%) and electronic prescription (59.3%). The physicians took the most advantage of assigning electronic prescriptions (88.2%), filling the sickness certificates (78.9%), booking laboratory tests and receiving their results electronically (63.9%). Majority of the medical staff and patients stated that the e-health services are of high quality (77.6 and 89.5%, respectively), reliable (86 and 90.8%) and have a wide spectrum of services (75.3 and 93.7%). The most common problems that patients faced when using the e-health system services were the malfunctions and failures of the system (68.9%) or missing health data of the patient (59.7%). According to the medical staff, e-health system technologies do not cover the needs of employees in full extent (95.1%), also, the e-health system is still not completely reliable (97.7%). Only 56.7% specialists stated, that they have enough skills to work with the e-health system, 77.7% would like to improve their professional qualifications in this field. The Clinic used the funds of the institution, municipality or EU structural funds to develop the e-health system, update the computer equipment and software, and acquire licenses. Conclusions More efficient and effective e-health services and developing the capacity of the e-health usage are required to promote high-quality health care in Lithuania. Key messages Although majority of the patients and medical staff members use various e-health system services and are satisfied with their quality, there still are problems with the operation of the system. Specialists feel the lack of skills to work with the e-health system.


2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.


2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.


2021 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen

Abstract Background: In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9% to 55% and it was the lowest of all Sub-Saharan African countries in 2016. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective: The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia.Methods: Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g poor providers’ competency), health facilities (e.g. supply constraints and unsupportive environment), adolescents (e.g perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion: As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussein Mekonnen

Abstract Background In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9 to 55% and it was the lowest of all Sub-Saharan African countries in 2016. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia. Methods Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g. poor providers’ competency), health facilities (e.g. supply constraints and unsupportive environment), adolescents (e.g. perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.


2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We used a phenomenological perspective to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. We conducted semi-structured individual interviews with 12 participants. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Relatives – a health service alliance – quality creator’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.


2019 ◽  
Vol 13 (2) ◽  
pp. 218-233
Author(s):  
Arsalan Gharaveis ◽  
Debajyoti Pati ◽  
D. Kirk Hamilton ◽  
Mardelle Shepley ◽  
Susan Rodiek ◽  
...  

Aim: This mixed-methods study delivers empirical evidence on the influence of visibility on healthcare teamwork in Emergency Departments (EDs). This study researchers hypothesized that with changes of visibility in EDs, teamwork among medical staff members will be impacted. Background: Prior research results suggest that visibility can influence health-setting efficacy. Teamwork is one of the components of each healthcare system that can be supported by environmental design. Method: Visibility in four subject sites from the same healthcare system was objectively measured by morphology plan analyses. Teamwork among medical staff members was the behavioral variable of interest and explored through field observations, interviews, and surveys. Results: The qualitative outcomes demonstrated that teamwork can be enhanced by improved visibility, while the quantitative findings supported the idea that some specific measures of visibility were correlated with teamwork. Conclusion: This study provides a model for future research on the association between healthcare staff behavior and ED plan configuration. The enhancement of ED design, considering the significance of visibility, enhances the perceptions of nurses and physicians in terms of teamwork.


1977 ◽  
Vol 16 (04) ◽  
pp. 234-240 ◽  
Author(s):  
Joann Gustafson ◽  
J. Nelson ◽  
Ann Buller

The contribution of a special library project to a computerized problem-oriented medical information system (PROMIS) is discussed. Medical information displays developed by the PROMIS medical staff are accessible to the health care provider via touch screen cathode terminals. Under PROMIS, members of the library project developed two information services, one concerned with the initial building of the medical displays and the other with the updating of this information. Information from 88 medical journals is disseminated to physicians involved in the building of the medical displays. Articles meeting predetermined selection criteria are abstracted and the abstracts are made available by direct selective dissemination or via a problem-oriented abstract file. The updating service involves comparing the information contained in the selected articles with the computerized medical displays on the given topic. Discrepancies are brought to the attention of PROMIS medical staff members who evaluate the information and make appropriate changes in the displays. Thus a feedback loop is maintained which assures the completeness, accuracy, and currency of the computerized medical information. The development of this library project and its interface with the computerized health care system thus attempts to deal with the problems in the generation, validation, dissemination, and application of medical literature.


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