Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2007
Assessing the impact of recording quality target data on the GP consultation using multi-channel video.
In the UK routinely collected computerized clinical data is used to assess progress towards financially incentivised quality targets for chronic disease management including hypertension. ⋯ We have successfully piloted a novel technique for observing the influence of the computer on the consultation. Despite increasing computer use to record quality target data the overwhelming proportion of the consultation remains doctor patient interaction.
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Stud Health Technol Inform · Jan 2007
Obstacle crossing in a virtual environment with the rehabilitation gait robot LOKOMAT.
The rehabilitation robot LOKOMAT has been developed at the Balgrist University Hospital to automate treadmill training of spinal cord injury and stroke patients. A virtual environment setup was implemented to increase patient's motivation and provide biofeedback, consisting of visual, acoustic and haptic modalities. Based on the knee and hip angles of the orthosis, an animated figurine moves through a virtual environment. ⋯ We focused on delay times caused by the setup, stability of the haptic obstacle rendering and on the level of immersion as judged by four healthy subjects. Results show that subjects judged the system's performance well (questionnaire scores over 80%). Problems exist though for obstacle rendering (questionnaire scores of 55%).
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Stud Health Technol Inform · Jan 2007
Feasibility and usability of a home monitoring concept based on mobile phones and near field communication (NFC) technology.
Utilization of mobile information and communication technologies in home monitoring applications is becoming more and more common. The mobile phone, acting as a patient terminal for patients suffering from chronic diseases, provides an active link to the caregiver to transmit health status information and receive feedback. In such a concept the usability is still limited by the necessity of entering the values via the mobile phone's small keypad. ⋯ The focus of this paper is to describe the development of a prototype application based on this technology embedded in a home monitoring system. The feasibility and usability of this approach are evaluated and compared with concepts used in previous approaches. The high quantifier with respect to overall usability indicates that NFC may be the technology of choice for some tasks in home monitoring applications.
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Stud Health Technol Inform · Jan 2007
Whose work practice? Situating an electronic triage system within a complex system.
An electronic triaging system was introduced into a busy children's hospital emergency department. Within 18 months of its introduction, amidst complaints from staff about patient safety related to work slow downs, a decision was made to stop using the system. ⋯ We suggest that difficulties with the triage system resulted partly because data resulting from the triage encounter are used in several domains including the care domain, the access domain, the federal equity and accountability domain, the local accounting and quality domain and the research domain, each of which has different primary stakeholders, with varying needs. Greater attention to identification of data requirements for each of these domains and acknowledgement of varied stakeholder interests prior to software selection and implementation may improve future implementations.
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Stud Health Technol Inform · Jan 2007
Conceptualisation of socio-technical integrated information technology solutions to improve incident reporting through Maslow's hierarchy of needs: a qualitative study of junior doctors.
Medical errors are common, especially within the acute healthcare delivery. The identification of systemic factors associated with adverse events and the construction of models to improve the safety of the healthcare system seems straightforward, this process has been proven to be much more difficult in the realism of medical practice due to the failure of the incident reporting system to capture the essential information, especially from the perspective of junior doctors. The failure of incidence reporting system has been related to the lack of socio-technical consideration for both system designs and system implementations. ⋯ Using Maslow's hierarchy of needs as the conceptual framework, the guiding principles aim to design electronic incident reporting systems which will motivate junior doctors to participate in the process. This research paper aims to make a significant contribution to the fields of socio-technical systems and medical errors management. The design and implementation of the new incident reporting system has great potential to motivate junior doctors to change the culture of incident reporting and to work towards a safer future healthcare system.