Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2018
Does Point-of-Care Testing Impact Length of Stay in Emergency Departments (EDs)?: A Before and After Study of 26 Rural and Remote EDs.
The implementation of Point-of-Care Testing (PoCT) services across rural and remote emergency departments (EDs) by NSW Health Pathology has the potential to significantly improve timely access to results for certain types of pathology laboratory tests and help to deliver timely patient care. The aim of this study was to examine the impact of the implementation of PoCT on the length of stay (LOS) of patients in rural and remote EDs. A total of 3808 patients with a circulatory system illness were treated and discharged at any one of 22 rural and remote EDs during the study period. ⋯ Although average ED LOS was 11 minutes shorter in the post-PoCT period, the impact of PoCT on ED LOS was not conclusive after considering other important clinical factors (p=0.07). This study is the one of the few to examine changes in LOS following the introduction of PoCT in EDs in Australia. The study also identified areas where more robust methods could be applied in the future as the quality of PoCT data improves to further assess the potential effects of this technology on practice and outcomes.
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Stud Health Technol Inform · Jan 2018
Recommendations for Enhancing the Implementation and Utility of Shared Digital Health Records in Rural Australian Communities.
Internationally, shared digital health records are becoming an important addition to improving contemporary healthcare provision. In 2012, Australia launched its version of a shared digital health record, My Health Record, but enrolment is slow and there remain challenges in its practical implementation. ⋯ Based on the key research findings, recommendations are presented for improving national roll out of My Health Record. The findings highlight, to understand and engage vulnerable communities and support their adoption and use of shared digital health records, there is a need to move away from traditional models of healthcare delivery toward person-centred care delivered from a digital complex adaptive systems perspective.
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Stud Health Technol Inform · Jan 2018
ReviewReflection on Mobile Applications for Blood Pressure Management: A Systematic Review on Potential Effects and Initiatives.
Ischemic heart disease and stroke have been considered as the first global leading cause of death in last decades [1]. Blood pressure (BP) management is one of the easiest ways suggested for preventing and controlling cardiovascular diseases before the patient develops complications and death-following outcomes. Appearance of technology advancements in the health system has motivated researchers and health providers to study its different aspects and applications in order to improve disease prevention and management. Following these efforts, mobile health (mHealth) technologies were presented to provide people with fast and easier-to-use services. Although there are some unsolved challenges, these technologies have become popular among many people. As an important part of mHealth, mobile applications (apps) have been the focused subject of many studies in the last decade. The objective of this systematic review is to assess the potential effects of mobile apps designed for BP management by scrutinizing the related studies. ⋯ Most of the studies had emphasized positive effects of mobile apps in BP management. However, there is a necessity for performing further investigations due to the identified issues in this study such as low number of participants and limited intervention period in randomized controlled trials, and interventions limited to only hypertensive or high-risked individual.
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Stud Health Technol Inform · Jan 2018
Quro: Facilitating User Symptom Check Using a Personalised Chatbot-Oriented Dialogue System.
Automated conversational agents built with medical applications in mind, have the potential to reduce healthcare readmissions and improve accessibility to medical knowledge. In this work, we demonstrate the development and evaluation of an automated chatbot for triage and conditions assessment, based on user inputs in natural language. ⋯ Our chatbot system was able to predict user conditions correctly based on two sets of patient test cases with an average precision of 0.82. Our implementation demonstrates that a medical chatbot can help with automatic triage and pre-assessment of patients with simple symptom analysis and a conversational approach without the use of cumbersome form-based data entry.
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While it is widely accepted that whole of hospital solutions are necessary to reduce the ever-increasing burden on the public health system, little research has focussed on understanding the relationship between ambulance arrival related flow metrics and emergency department (ED) crowding. Queensland Ambulance Service (QAS) shares patient load across multiple hospitals, and receiving facilities strive to meet a Patient Off Stretcher Time (POST) target of 30 minutes. ⋯ No relationship between POST and ED length of stay was found, perhaps due to competing ED National Emergency Access Targets (NEAT). Further modelling is recommended to formally test these observations.