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The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
The Guideview mHealth System
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The Guideview mHealth System

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  • The Research design will follow a randomized crossover with two groups of individuals, two treatments or interventions over two periods of time.This design allows to make every subject its own control and balance for learning after tasks. There are methods to identify the effect of the ordering. Differences among groups are the order that they receive the treatments, or in this particular case the order in which the use the different type of job aid.
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    • 1. M. Sriram Iyengar, PhD Assistant Professor, School of Health Information Sciences University of Texas Health Science Center at Houston This entire presentation is Copyright © 2009 -2010, M Sriram Iyengar. Please do not distribute any part, or the whole, without permission. Contact m.sriram.iyengar@uth.tmc.edu
    • 2.  GuideView is a technology for creating and delivering healthcare advice on multiple platforms especially mobile devices such as PDAs and cell phones (Windows mobile and iPhones. Others nearing completion)  It delivers clinical guidelines in an interactive, step-by-step format that includes rich media: text, voice/audio, images and video. This reduces cognitive load.  This content (called a guideview) is stored in the cell phone – can operate in resource-poor environments where cellular network or internet does not exist.  It is communications-enabled: can automatically make phone calls (or send emails) to pre-stored phone numbers (or e-mail addresses) stored in the underlying guideview.  Two main user components: GuideView Author and GuideView Player(s).
    • 3. Can easily create the guideline flow as interconnected steps, and embed text, voice (any language), images/video in each step. Phone Numbers and email addresses can also be included.
    • 4. Displays the guidelines step by step. Does not need access to cell network or internet. Information provided with text, audio (voice) images and video: can be used even when patients have low literacy Records execution of each step along with time stamp in a history log. Also includes GPS location of patient encounter Can automatically make phone calls or send emails. SMS messaging being developed. Picture shows Spanish language AIEPI pediatric protocol executing on Windows Mobile cell phone
    • 5.  Low availability of physicians and trained nurses is endemic in many contexts ◦ Developing countries ◦ Rural areas of developed countries  Community Health Workers, barefoot Doctors, promotores de salud and similar non-physician care providers are often the primary (and only) providers of healthcare to hundreds of millions.  These CHWs are mobile professionals However, studies have shown that Community Health Workers (CHWs) performance is less than optimal even with support of paper-based job-aids
    • 6.  Subjects: 50 community health workers in Medellin, Colombia  Randomized two-groups two-treatment two-period crossover – each subject is own control Period 1 Period 2 Group A Used GuideView on cell phone Used Traditional methods (paper-based guidelines) Group B Used Traditional methods Used GuideView on cell phone (paper-based guidelines) Time
    • 7.  Simulated cases •Pediatrics 10 AIEPI – Spanish IMCI (Integral Management of Childhood Illnesses) •Pneumonia •Diarrhea •Malaria •Teething Other Standardized protocols: •Adult Trauma 10 •Car crash •Bomb attack/Landmines •Minor accidents •Adult Medical Cases 10 •Stroke •Heart arrest •Airway obstruction •Food poisoning
    • 8.  Use of Cell phone GuideView reduces Error rate by 35.15% (p=0.001) as compared to paper materials  GuideView increases protocol adherence by 35%  Decreases mental workload  Decreases frustration  Decreases overall workload  Acceptability and intention to use > 90%
    • 9.  Providing interactive, structured rich media clinical guidelines on cell phones can reduce errors  Performance of Community health Workers can be enhanced  Very high levels of intention to use and usability indicate that CHWs will find the technology greatly acceptable
    • 10.  Microsoft Research: Global competition, Cellphone as platform for Healthcare  US Army Telemedicine Advanced Technology research center  NASA Johnson Space Center (GuideView originally developed here to assist astronauts provide medical care to each other on long duration space missions) Contact: Sriram Iyengar, m.sriram.iyengar@uth.tmc.edu Mobile: 281 793 4733

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