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Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana 加纳农村社区孕产妇、新生儿和儿童护理的移动客户端数据应用程序的可行性、可用性和可接受性的定性评估
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-12-01 DOI: 10.1155/2016/2515420
Jessica D Rothstein, L. Jennings, Anitha Moorthy, Fan Yang, Lisa Gee, K. Romano, David Hutchful, A. Labrique, A. Lefevre
Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs) in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources.
移动电话应用程序可以加强关键卫生服务的提供和卫生服务数据的准确性。然而,一线卫生工作者关于使用移动应用程序跟踪孕妇和刚分娩妇女的意见和经验被低估了。本评估定性地评估了加纳农村社区卫生护士(CHNs)用于孕产妇、新生儿和儿童客户数据管理的移动客户数据应用程序的可行性、可用性和可接受性。移动应用程序使chn能够输入、汇总和查询客户端数据。它还向客户发送访问提醒,并提供向地区官员报告护理水平的机制。对CHNs、助产士和地区卫生官员进行了14次访谈和2个焦点小组,进行了编码和主题分析。结果表明,该应用程序很容易集成到护理中,提高了CHN的工作效率,并且由于其促进客户随访,数据报告和决策的能力而被接受。然而,这款应用的可行性和可用性受到了大量客户、员工短缺以及软件和设备挑战的阻碍。为农村和资源贫乏地区的一线卫生工作者成功整合移动客户端数据应用程序,需要实时监测、项目投资和有针对性的人力资源改革。
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引用次数: 62
How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era 环境不确定性如何调节相对优势和感知可信度对大数据时代中国机构采用移动医疗服务的影响
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-12-01 DOI: 10.1155/2016/3618402
Xing Chen, Xing Zhang
Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.
尽管一个组织采用移动医疗服务对大数据时代移动技术的传播具有重要意义,但在文献中却很少得到关注。本研究探讨了相对优势和感知可信度如何影响组织对移动医疗服务的采用,以及环境不确定性如何改变相对优势和感知可信度与采用的关系。开发了一个整合相对优势、感知可信度、环境不确定性和组织使用移动医疗服务意愿的研究模型。定量数据收集自320家中国医疗机构的高级管理人员和信息系统管理人员。实证结果表明,虽然相对优势和感知信誉都对组织使用移动医疗服务的意愿有积极影响,但相对优势的作用比感知信誉更重要。此外,环境不确定性正向调节相对优势对组织采用移动医疗服务的影响。因此,在具有高度不确定性特征的环境中,由于相对优势,移动保健服务比在低不确定性环境中更有可能被采用。
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引用次数: 16
An Iterative, Mixed Usability Approach Applied to the Telekit System from the Danish TeleCare North Trial 一种迭代、混合可用性方法应用于Telekit系统,来自丹麦telemare North试验
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-11-01 DOI: 10.1155/2016/6351734
P. H. Lilholt, Clara Schaarup, O. Hejlesen
Objective. The aim of the present study is to evaluate the usability of the telehealth system, coined Telekit, by using an iterative, mixed usability approach. Materials and Methods. Ten double experts participated in two heuristic evaluations (HE1, HE2), and 11 COPD patients attended two think-aloud tests. The double experts identified usability violations and classified them into Jakob Nielsen's heuristics. These violations were then translated into measurable values on a scale of 0 to 4 indicating degree of severity. In the think-aloud tests, COPD participants were invited to verbalise their thoughts. Results. The double experts identified 86 usability violations in HE1 and 101 usability violations in HE2. The majority of the violations were rated in the 0–2 range. The findings from the think-aloud tests resulted in 12 themes and associated examples regarding the usability of the Telekit system. The use of the iterative, mixed usability approach produced both quantitative and qualitative results. Conclusion. The iterative, mixed usability approach yields a strong result owing to the high number of problems identified in the tests because the double experts and the COPD participants focus on different aspects of Telekit's usability. This trial is registered with Clinicaltrials.gov, NCT01984840, November 14, 2013.
目标。本研究的目的是评估远程医疗系统的可用性,创造Telekit,通过使用迭代,混合可用性方法。材料与方法。10名双专家参与了2项启发式评估(HE1、HE2), 11名COPD患者参加了2项有声思维测试。双重专家确定了可用性违规,并将其分类为Jakob Nielsen的启发式。然后将这些违规行为转换为可测量的值,其范围为0到4,表示严重程度。在大声思考测试中,COPD参与者被邀请用语言表达他们的想法。结果。双重专家在HE1中确定了86个可用性违规,在HE2中确定了101个可用性违规。大多数违规行为的评分在0-2之间。有声思维测试的结果产生了关于Telekit系统可用性的12个主题和相关示例。迭代、混合可用性方法的使用产生了定量和定性的结果。结论。由于双重专家和COPD参与者关注Telekit可用性的不同方面,因此在测试中发现了大量问题,因此迭代的混合可用性方法产生了强有力的结果。该试验已在Clinicaltrials.gov注册,编号NCT01984840, 2013年11月14日。
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引用次数: 1
Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services 计算机x线摄影、胶片和数字化胶片在远程摄影服务中的临床表现的非劣效性和等效性评价
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-09-01 DOI: 10.1155/2016/3642960
A. Salazar, Javier Romero, Oscar Bernal, Angela Moreno, Sofía Velasco, Xavier A. Díaz
Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations. The variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curves (AUC). Result. The mean values for the observed variables were as follows: accuracy ranged from 0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC ranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Conclusion. Our findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using a film digitizer or a digital camera.
目标。本研究的目的是评估和比较实施低成本筛查的不同选择的临床表现。我们比较了计算机x线摄影、胶片印刷图像和用专门的胶片数字化仪和数码相机制作的数字化胶片。材料和方法。我们机构的伦理委员会批准了这项研究。我们评估了观察人员在癌症检测方面的临床表现的等效性。析因设计包括70名筛查患者,4种技术替代方案,以及由7名放射科医生解释的病例,共1960次观察。评估的变量包括阳性预测值(PPV)、准确性、敏感性、特异性和受试者工作特征曲线下面积(AUC)。结果。观察变量的平均值为:准确度为0.77 ~ 0.82,PPV为0.67 ~ 0.68,灵敏度为0.64 ~ 0.74,特异度为0.87 ~ 0.90,AUC为0.87 ~ 0.90。当差异为0.1时,表示等价,所有替代方案对所有变量都是等价的。结论。我们的研究结果表明,使用胶片数字化仪或数码相机,远程摄影筛查项目可以以低成本提供给服务不足的人群。
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引用次数: 6
The Self-Perception and Usage of Medical Apps amongst Medical Students in the United States: A Cross-Sectional Survey 美国医学生对医疗应用程序的自我认知和使用:一项横断面调查
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-09-01 DOI: 10.1155/2016/3929741
Cara Quant, L. Altieri, J. Torres, N. Craft
Background. Mobile medical software applications (apps) are used for clinical decision-making at the point of care. Objectives. To determine (1) the usage, reliability, and popularity of mobile medical apps and (2) medical students' perceptions of app usage effect on the quality of patient-provider interaction in healthcare settings. Methods. An anonymous web-based survey was distributed to medical students. Frequency of use, type of app used, and perceptions of reliability were assessed via univariate analysis. Results. Seven hundred thirty-one medical students responded, equating to a response rate of 29%. The majority (90%) of participants thought that medical apps enhance clinical knowledge, and 61% said that medical apps are as reliable as textbooks. While students thought that medical apps save time, improve the care of their patients, and improve diagnostic accuracy, 53% of participants believed that mobile device use in front of colleagues and patients makes one appear less competent. Conclusion. While medical students believe in the utility and reliability of medical apps, they were hesitant to use them out of fear of appearing less engaged. Higher levels of training correlated with a greater degree of comfort when using medical apps in front of patients.
背景。移动医疗软件应用程序(app)用于在护理点进行临床决策。目标。确定(1)移动医疗应用程序的使用、可靠性和普及程度;(2)医学生对应用程序使用对医疗保健环境中医患互动质量的影响的看法。方法。一份匿名网络调查被分发给医学生。通过单变量分析评估使用频率、应用程序类型和对可靠性的感知。结果。731名医学生参与了调查,回复率为29%。大多数(90%)的参与者认为医疗app增强了临床知识,61%的人认为医疗app和教科书一样可靠。虽然学生们认为医疗应用程序节省了时间,改善了对病人的护理,提高了诊断的准确性,但53%的参与者认为,在同事和病人面前使用移动设备会让人显得不那么称职。结论。虽然医科学生相信医疗应用程序的实用性和可靠性,但由于担心显得不那么投入,他们对使用这些应用程序犹豫不决。在病人面前使用医疗应用程序时,训练水平越高,舒适度越高。
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引用次数: 29
Continuing Medical Education via Telemedicine and Sustainable Improvements to Health 通过远程医疗和健康的可持续改善继续医学教育
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-08-01 DOI: 10.1155/2016/2424709
Fuhmei Wang
Background. This research aims to investigate the quantitative relationship between telemedicine and online continuing medical education (CME) and to find the optimal CME lectures to be delivered via telemedicine to improve the population's health status. Objective. This study examines the following: (1) What factors foster learning processes in CME via telemedicine? (2) What is the possible role of online CME in health improvement? And (3) How optimal learning processes can be integrated with various health services? Methods. By applying telemedicine experiences in Taiwan over the period 1995–2004, this study uses panel data and the method of ordinary least squares to embed an adequate set of phenomena affecting the provision of online CME lectures versus health status. Results. Analytical results find that a nonlinear online CME-health nexus exists. Increases in the provision of online CME lectures are associated with health improvements. However, after the optimum has been reached, greater provision of online CME lectures may be associated with decreasing population health. Conclusion. Health attainment could be partially viewed as being determined by the achievement of the appropriately providing online CME lectures. This study has evaluated the population's health outcomes and responded to the currently inadequate provision of online CME lectures via telemedicine.
背景。本研究旨在探讨远程医疗与在线继续医学教育(CME)之间的定量关系,并寻找最佳的远程医疗持续医学教育讲座,以改善人群的健康状况。目标。本研究探讨了以下问题:(1)哪些因素促进了远程医疗继续医学教育的学习过程?(2)在线继续教育在改善健康方面可能发挥的作用是什么?(3)如何将最佳学习过程与各种卫生服务相结合?方法。本研究以1995-2004年台湾地区的远程医疗经验为基础,采用面板数据和普通最小二乘方法,拟合影响持续进修课程提供与健康状况的现象。结果。分析结果表明,存在一种非线性的在线cme -健康关系。在线继续教育课程的增加与健康状况的改善有关。然而,在达到最佳水平后,提供更多的在线继续教育讲座可能与人口健康下降有关。结论。健康成就可以部分地被视为是由适当提供在线继续教育课程的成就所决定的。本研究评估了人群的健康结果,并对目前通过远程医疗提供的在线CME讲座的不足作出了回应。
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引用次数: 3
Towards mHealth Systems for Support of Psychotherapeutic Practice: A Qualitative Study of Researcher-Clinician Collaboration in System Design and Evaluation 迈向支持心理治疗实践的移动医疗系统:研究人员-临床医生在系统设计和评估中的合作的定性研究
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-03-01 DOI: 10.1155/2016/5151793
Karin Halje, T. Timpka, J. Ekberg, Magnus Bång, A. Fröberg, H. Eriksson
We examined clinicians' and researchers' experiences from participation in collaborative research on the introduction of Internet and mobile information systems (mHealth systems) in psychotherapeutic routines. The study used grounded theory methodology and was set in a collaboration that aimed to develop and evaluate mHealth support of psychotherapy provided to young people. Soundness of the central objects developed in the design phase (the collaboration contract, the trial protocol, and the system technology) was a necessary foundation for successful collaborative mHealth research; neglect of unanticipated organizational influences during the trial phase was a factor in collaboration failure. The experiences gained in this study can be used in settings where collaborative research on mHealth systems in mental health is planned.
我们检查了临床医生和研究人员参与在心理治疗常规中引入互联网和移动信息系统(移动健康系统)的合作研究的经验。该研究采用了扎根理论的方法,旨在开发和评估向年轻人提供的心理治疗的移动健康支持。在设计阶段开发的中心对象(协作合同、试验协议和系统技术)的可靠性是成功的协作移动健康研究的必要基础;在试验阶段忽视意料之外的组织影响是协作失败的一个因素。本研究中获得的经验可用于计划在心理健康方面开展移动医疗系统合作研究的环境中。
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引用次数: 6
Effect of Reinforcement of Oral Health Education Message through Short Messaging Service in Mobile Phones: A Quasi-Experimental Trial 通过手机短信服务加强口腔健康教育信息的效果:一项准实验试验
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-01-31 DOI: 10.1155/2016/7293516
H. Jadhav, A. Dodamani, G. Karibasappa, R. Naik, M. Khairnar, M. Deshmukh, Prashanth Vishwakarma
Objective. This paper aims to assess the effectiveness of reinforcement of oral health education message through short messaging service (SMS) in mobile phones. Material and Methods. 400 subjects from two colleges (200 from each college) belonging to 18–20 years age group possessing mobile phones were randomly selected and baseline examination of oral hygiene and gingival status was carried out using Oral Hygiene Index (OHI) and Gingival Index (GI). Oral health education was provided to all the subjects. Oral health education message was reinforced through short messaging service (SMS) in mobile phones for the subjects belonging to the intervention group. There was no such reinforcement for the control group. Follow-up examinations were done at the end of 1st, 2nd, 3rd, and 6th month. After the 3rd month, subjects of the intervention group did not receive oral health education message through short messaging service (SMS) and were followed up after next three months. Compiled data was analyzed using SPSS version 16 statistical software. Result. Mean OHI and GI scores in intervention group were significantly (p < 0.01) less than those of control group after the 2nd, 3rd, and 6th month. Conclusion. Reinforcement of oral health education message through short messaging service (SMS) is effective media to improve oral health.
目标。本文旨在评估通过手机短信服务加强口腔健康教育信息的有效性。材料与方法:随机抽取两所高校18-20岁有手机人群400名(每所200名),采用口腔卫生指数(OHI)和牙龈指数(GI)对口腔卫生和牙龈状况进行基线检查。对所有受试者进行口腔健康教育。干预组通过手机短信服务加强口腔健康教育。而对照组则没有这种强化。随访检查分别于第1、2、3、6个月末进行。干预组3个月后不接受口腔健康短信教育,随访3个月。整理后的数据采用SPSS 16版统计软件进行分析。结果。干预组患者术后第2、3、6个月的平均OHI、GI评分均显著低于对照组(p < 0.01)。结论。通过短信服务加强口腔健康教育是改善口腔健康的有效媒介。
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引用次数: 23
Tablet PC Enabled Body Sensor System for Rural Telehealth Applications 基于平板电脑的农村远程医疗身体传感器系统
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-01-18 DOI: 10.1155/2016/5747961
N. V. Panicker, A. S. Kumar
Telehealth systems benefit from the rapid growth of mobile communication technology for measuring physiological signals. Development and validation of a tablet PC enabled noninvasive body sensor system for rural telehealth application are discussed in this paper. This system includes real time continuous collection of physiological parameters (blood pressure, pulse rate, and temperature) and fall detection of a patient with the help of a body sensor unit and wireless transmission of the acquired information to a tablet PC handled by the medical staff in a Primary Health Center (PHC). Abnormal conditions are automatically identified and alert messages are given to the medical officer in real time. Clinical validation is performed in a real environment and found to be successful. Bland-Altman analysis is carried out to validate the wrist blood pressure sensor used. The system works well for all measurements.
远程医疗系统得益于测量生理信号的移动通信技术的快速发展。本文讨论了一种用于农村远程医疗的平板电脑无创身体传感器系统的开发和验证。该系统包括实时连续收集生理参数(血压、脉搏率和体温),并借助身体传感器单元对患者进行跌倒检测,并将采集到的信息无线传输到初级卫生中心(PHC)医务人员处理的平板电脑上。系统会自动识别异常情况,并实时向医务人员发送警报信息。在真实环境中进行临床验证,发现是成功的。进行Bland-Altman分析以验证所使用的手腕血压传感器。该系统适用于所有测量。
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引用次数: 21
A Multiple-Classifier Framework for Parkinson's Disease Detection Based on Various Vocal Tests. 基于各种发声测试的帕金森病检测多分类器框架
IF 4.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2016-01-01 Epub Date: 2016-04-12 DOI: 10.1155/2016/6837498
Mahnaz Behroozi, Ashkan Sami

Recently, speech pattern analysis applications in building predictive telediagnosis and telemonitoring models for diagnosing Parkinson's disease (PD) have attracted many researchers. For this purpose, several datasets of voice samples exist; the UCI dataset named "Parkinson Speech Dataset with Multiple Types of Sound Recordings" has a variety of vocal tests, which include sustained vowels, words, numbers, and short sentences compiled from a set of speaking exercises for healthy and people with Parkinson's disease (PWP). Some researchers claim that summarizing the multiple recordings of each subject with the central tendency and dispersion metrics is an efficient strategy in building a predictive model for PD. However, they have overlooked the point that a PD patient may show more difficulty in pronouncing certain terms than the other terms. Thus, summarizing the vocal tests may lead into loss of valuable information. In order to address this issue, the classification setting must take what has been said into account. As a solution, we introduced a new framework that applies an independent classifier for each vocal test. The final classification result would be a majority vote from all of the classifiers. When our methodology comes with filter-based feature selection, it enhances classification accuracy up to 15%.

最近,语音模式分析在建立预测性远程诊断和远程监控模型以诊断帕金森病(PD)方面的应用吸引了许多研究人员。为此,已有多个语音样本数据集;UCI 数据集名为 "帕金森语音数据集(含多种类型的声音记录)",其中包含各种发声测试,包括持续元音、单词、数字和短句,这些数据是从健康人和帕金森病患者(PWP)的一套口语练习中整理出来的。一些研究人员声称,用中心倾向和离散度量来总结每个受试者的多个录音是建立帕金森病预测模型的有效策略。然而,他们忽略了一点,即帕金森病患者在发音某些词语时可能会比发音其他词语时更加困难。因此,总结发声测试可能会导致有价值的信息丢失。为了解决这个问题,分类设置必须将所说内容考虑在内。作为解决方案,我们引入了一个新的框架,为每个发声测试应用一个独立的分类器。最终的分类结果将是所有分类器的多数票。当我们的方法与基于过滤器的特征选择相结合时,分类准确率可提高 15%。
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引用次数: 0
期刊
International Journal of Telemedicine and Applications
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