Design of Psychological Consultation System Based on Weighted Fuzzy Hybrid Algorithm

In order to overcome the problems of low security and high message delay in traditional counseling systems, this article designs and proposes a new counseling system based on the weighted hybrid algorithm. According to the principle of system design, the system architecture diagram and system role are designed. In the hardware part of the system, the user management module, online consultation module, and knowledge base module are designed to realize the psychological consultation function of the system. In the software part, the weighted hybrid algorithm is used to divide the psychological information state of the consultants effectively. Combined with the hardware and software of the system, the overall design of the system is completed. The experimental results show that, compared with the traditional consulting system, the designed system can effectively ensure the information security of consultants and reduce the message delay of the system, which has higher practical application value.

Development of an Android-Based Application for Family Planning Education and Consultation (SIDUTA KB)

In suppressing the rate of population growth, the government seeks to optimize the Family Planning (KB) program. Miroto Public Health Center is a health center in the Central Semarang District which experienced a decrease of 13.4% of new family planning memberships. The decline was caused by the increase in the number of births, the delay in contraceptive services and the soaring unmet need during the pandemic. To support the role of cadres in providing socialization easily without having to meet during this pandemic, a Family Planning Education and Consultation System (SIDUTA KB) was created. Methods: This study uses Research and Development (RnD) which refers to the Sugiyono model with limited trials. The research data analysis technique is descriptive analysis and the data collected consists of qualitative and quantitative. Results: In this study, design validation was carried out through media expert tests with a percentage score of 83.55% (5 experts), material experts at 81.11% (3 experts), and users by 86.72% (73 users). Conclusion: SIDUTA KB makes it easy for users to find educational content about family planning programs, conduct consultations, and choose Miroto Health Center facilities or services related to the family planning program.

Pre-Consultation System Based on the Artificial Intelligence Has a Better Diagnostic Performance Than the Physicians in the Outpatient Department of Pediatrics

Artificial intelligence (AI) has been deeply applied in the medical field and has shown broad application prospects. Pre-consultation system is an important supplement to the traditional face-to-face consultation. The combination of the AI and the pre-consultation system can help to raise the efficiency of the clinical work. However, it is still challenging for the AI to analyze and process the complicated electronic health record (EHR) data. Our pre-consultation system uses an automated natural language processing (NLP) system to communicate with the patients through the mobile terminals, applying the deep learning (DL) techniques to extract the symptomatic information, and finally outputs the structured electronic medical records. From November 2019 to May 2020, a total of 2,648 pediatric patients used our model to provide their medical history and get the primary diagnosis before visiting the physicians in the outpatient department of the Shanghai Children's Medical Center. Our task is to evaluate the ability of the AI and doctors to obtain the primary diagnosis and to analyze the effect of the consistency between the medical history described by our model and the physicians on the diagnostic performance. The results showed that if we do not consider whether the medical history recorded by the AI and doctors was consistent or not, our model performed worse compared to the physicians and had a lower average F1 score (0.825 vs. 0.912). However, when the chief complaint or the history of present illness described by the AI and doctors was consistent, our model had a higher average F1 score and was closer to the doctors. Finally, when the AI had the same diagnostic conditions with doctors, our model achieved a higher average F1 score (0.931) compared to the physicians (0.92). This study demonstrated that our model could obtain a more structured medical history and had a good diagnostic logic, which would help to improve the diagnostic accuracy of the outpatient doctors and reduce the misdiagnosis and missed diagnosis. But, our model still needs a good deal of training to obtain more accurate symptomatic information.

Treating rare tumors with the assistance of the expert virtual consultation system: two cases of juvenile granulosa cell tumors

Background: The lack of internationally recognized guidelines for very rare tumors, such as juvenile granulosa cell tumors (JGCTs), which are nonepithelial, unusual ovarian tumors, is a challenge for pediatric oncologists, especially in developing countries with limited resources and experience in treating rare tumors. Methods: We report clinical data of 2 girls with JGCTs treated at the Pediatric Cancer and Blood Disorders Center of Armenia with the assistance of the EXPeRT (European Cooperative Study Group for Pediatric Rare Tumors) international cooperation panel. Case presentation: Two girls (16 and 15 years old) with JGCTs of the ovaries, stage Ic, underwent surgery and, with consultation through an online advisory board ( http://vrt.cineca.it/ ), received 4 cycles of chemotherapy according to the PEI regimen (cisplatin, etoposide, ifosfamide). Conclusion: Very rare tumors, especially in advanced stages, have limited data and a low survival rate. International collaboration with the EXPeRT group is beneficial for physicians with limited experience and facilitates research in pediatric oncology.

Examining GP online consultation in a primary care setting in east midlands, UK

Background Increasing pressure threatens to overwhelm primary care services, affecting the quality of care and their role as gatekeepers to specialised care services. This study investigated healthcare users’ acceptability of – and the effectiveness of – an e-consultation system in primary care services. Methods Seven GP practices in East-Midlands, all of whom use online consultation system participated in the study, with a retrospective review being undertaken of 189 electronic patients’ records (age range of 18–76 years) over 5 months. The focus was on the electronic records of patients who accessed the service for five different conditions identified as presenting common conditions seen by the GPs practices. Statistical analysis was done using SPSS to perform an exploratory data analysis and descriptive statistics. Results The results showed a positive reception of the online consultation platform, with an average satisfaction score of 4.15 (most likely to recommend score = 5). Given the nature of the conditions, 47.6% of patients had experienced a previous episode of the health condition they were seeking consultation for, and a total of 72% had existing comorbidities. Follow-up activity occurred for 87.3% of patients, 66.1% of which included at least one follow-up visit for the same condition as the initial online consultation. Conclusion The results suggest that online consultation is convenient for patients, and it also has the potential to relieve pressure placed on primary care services. Although a number of challenges were identified, such as patient verification, this study gives insight into – and enhances our understanding of – the use of online GP consultations.

The Impact of Integrating the Palliative Prognostic Index into Palliative Consultation on Patients with Haematologic Malignancies: A Case control study

Background The study aims to investigate the influence of integrating the Palliative Prognostic Index (PPI) into the consultation system for patients with haematologic malignancies. Methods We retrospectively enrolled 53 patients with haematologic malignancies. The PPI was evaluated at the first palliative consultation. Patients were divided into two groups: before the use of the PPI (23 patients) and after the use of the PPI (30 patients). Results We first confirmed that the life expectancy for patients with haematologic malignancies was correlated with the PPI score ranking (p < 0.01). For patients with a PPI score > 6, agreement to attend hospice care was significantly higher (p = 0.01). After the use of the PPI, the mean survival time from the first consultation to death was 131.4 ± 55.9 days, which was significantly longer than before the use of the PPI (p < 0.01). Meanwhile, more leukaemia patients received palliative consultation and fewer antibiotics in their end of life care. Although there was no difference in agreement for hospice care after the first consultation, we believed that the concept of palliative care had been delivered to patients and their families. Conclusions The PPI score is a good prognostic index for patients with haematologic malignancies. The use of the PPI score in the first consultation enables patients, families and haematologists to become aware of the necessity of palliative care.

Optimizing e-Consultations to Adolescent Medicine Specialists: Qualitative Synthesis of Feedback From User-Centered Design

Background e-Consultations between primary care physicians and specialists are a valuable means of improving access to specialty care. Adolescents and young adults (AYAs) face unique challenges in accessing limited adolescent medicine specialty care resources, which contributes to delayed or forgone care. e-Consultations between general pediatricians and adolescent medicine specialists may alleviate these barriers to care. However, the optimal application of this model in adolescent medicine requires careful attention to the nuances of AYA care. Objective This study aims to qualitatively analyze feedback obtained during the iterative development of an e-consultation system for communication between general pediatricians and adolescent medicine specialists tailored to the specific health care needs of AYAs. Methods We conducted an iterative user-centered design and evaluation process in two phases. In the first phase, we created a static e-consultation prototype and storyboards and evaluated them with target users (general pediatricians and adolescent medicine specialists). In the second phase, we incorporated feedback to develop a functional prototype within the electronic health record and again evaluated this with general pediatricians and adolescent medicine specialists. In each phase, general pediatricians and adolescent medicine specialists provided think-aloud feedback during the use of the prototypes and semistructured exit interviews, which was qualitatively analyzed to identify perspectives related to the usefulness and usability of the e-consultation system. Results Both general pediatricians (n=12) and adolescent medicine specialists (n=12) perceived the usefulness of e-consultations for AYA patients, with more varied perceptions of potential usefulness for generalist and adolescent medicine clinicians. General pediatricians and adolescent medicine specialists discussed ways to maximize the usability of e-consultations for AYAs, primarily by improving efficiency (eg, reducing documentation, emphasizing critical information, using autopopulated data fields, and balancing specificity and efficiency through text prompts) and reducing the potential for errors (eg, prompting a review of autopopulated data fields, requiring physician contact information, and prompting explicit discussion of patient communication and confidentiality expectations). Through iterative design, patient history documentation was streamlined, whereas documentation of communication and confidentiality expectations were enhanced. Conclusions Through an iterative user-centered design process, we identified user perspectives to guide the refinement of an e-consultation system based on general pediatrician and adolescent medicine specialist feedback on usefulness and usability related to the care of AYAs. Qualitative analysis of this feedback revealed both opportunities and risks related to confidentiality, communication, and the use of tailored documentation prompts that should be considered in the development and use of e-consultations with AYAs.

Effect of Information Platform-Based Consultation on Improving Patient Experience

Purpose: An information platform consultation system was constructed to evaluate the effectiveness of the system on the patient experience. Methods: Based on the daily consultation process, the information platform-based consultation system was developed with three entrances: browser, app, and WeChat Official Account. It integrates two ports for medical and nursing staff and patients and function modules including pre-appointment, outpatient payment, consultation file, hospitalization file, daily expenditures. Online hospital, and hotspot push. We compared the rate of non-attendance and patient satisfaction rate before and after the application of the information platform-based consultation system. Results: The patient’s missed appointment rate was significantly lowered (P<0.05), waiting time for consultation was significantly shorter (P<0.05), and the patient satisfaction was significantly higher than those before the implement of the information platform consultation system (P<0.05). Conclusion: Information platform consultation system can simplify the patient consultation process, promote the sharing and mutual recognition of medical information resources, reduce operating costs, increase patient satisfaction, and improve patient experience, and the platform can be widely promoted as an alternative for hospital management.