This is Yuri Quintana's presentation from November 11th's Health Innovators event "Leveraging Innovation to Improve Medication Adherence".
Please see more information about Health Innovators at http://www.healthinno.org.
Please visit http://www.bidmc.org/ to see more information about BIDMC
MEDICATION REMINDER AND HEALTHCARE – AN ANDROID APPLICATIONijmpict
This is an Android-based application in which an automatic alarm ringing system is implemented. It
focuses on doctor and patient interaction. Patients need not remember their medicine dosage timings as
they can set an alarm on their dosage timings. The alarm can be set for multiple medicines and timings
including date, time and medicine description. A notification will be sent to them through email or message
inside the system preferably chosen by the patients. They can search doctor disease wise. The patients will
get the contact details of doctors as per their availability. Also the users can see different articles related to
medical fields and health care tips. The system focuses on easy navigation and good user interface. Many
such Medical Reminder Systems have been developed where a new hardware is required but in our work
we have made an attempt to develop a system which is economical, time-saving and supports medication
adherence.
MEDICATION REMINDER AND HEALTHCARE – AN ANDROID APPLICATIONijmpict
This is an Android-based application in which an automatic alarm ringing system is implemented. It
focuses on doctor and patient interaction. Patients need not remember their medicine dosage timings as
they can set an alarm on their dosage timings. The alarm can be set for multiple medicines and timings
including date, time and medicine description. A notification will be sent to them through email or message
inside the system preferably chosen by the patients. They can search doctor disease wise. The patients will
get the contact details of doctors as per their availability. Also the users can see different articles related to
medical fields and health care tips. The system focuses on easy navigation and good user interface. Many
such Medical Reminder Systems have been developed where a new hardware is required but in our work
we have made an attempt to develop a system which is economical, time-saving and supports medication
adherence.
The use of mobile applications, through smart phones, smartphones, has been considered by many to be the technological revolution of greatest repercussion in recent times. Compared to a handheld computer and with access to millions of applications, its main feature is unlimited mobility, accompanying its user at all times and in any place. In health, it is known that professionals are constantly moving outside of the institutions in which they work, so mobility is fundamental, which contributes to the interoperability of mobile technologies. This study aims to identify the research involving mobile technology applied to the vaccination being used. The methodology used is of the type integrative review of the literature. The final sample had 14 papers.
Meyer staying connected when is mobile technology harmful to patients fina...Conrad Meyer JD MHA FACHE
Staying connected when is mobile technology harmful to patients: Physicians and nurses are constantly interrupted and distracted during delivery of healthcare to patients. Since healthcare is data driven, Physicians and nurses are using smartphones, tablets, iPhones, iPads and other devices to constantly stay connected to the latest data. In addition, studies show that society as a whole, including Physicians and nurses, feel a constant desire to "stay connected" to the internet and social media. So when does all of this connectivity harm patients? When Physicians and nurses are distracted and lose focus from tending to their patients, bad things can happen - missteps, missed medications, over medications, wrong side surgeries, etc. just to name a few. When patients are paying for a Physician's or a nurse's focus - patients should expect to receive it. The challenge for Hospitals, Physicians and nurses in this age of "staying connected" is how to manage all of the distractions, whether or not causes by smartphones or tablets, and to provide the focus of their attention on those who not only paid for it, but expect it to make sure they receive the healthcare they need: the patients. This presentation provides some insights on what other studies have found and some suggestions on what policies might help in managing the distractions/interruptions healthcare providers face in the ever growing digital age!
emPATH is an open sourced mobile framework from UCSF. The framework is used to execute medical protocols on mobile devices. It originated from work done by Larry Suarez in the area of the autonomous management of distributed artifacts.
Presented at the 8th Healthcare CIO Certificate Program, Ramathibodi Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University on March 12, 2018
12 Gifts of Digital Health: How Futuristic Technologies Changed Healthcare an...Enspektos, LLC
When people talk about how digital technologies will influence health, many assume changes will happen years or decades into the future. Yet, in 2014 a range of digital tech, from Big Data to genomics, gave people the gift of life, knowledge and more. Look back at the year that was in digital health and understand that he future is now.
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on October 12, 2020
Introduction to Health Informatics and Health IT in Clinical Settings (Part 2...Nawanan Theera-Ampornpunt
Presented at the 10th Healthcare CIO Certificate Program, Ramathibodi School of Hospital Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on February 17, 2020
Information Technology Management in Healthcare Organizations: Part 2 (Octobe...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on October 20, 2021
Introduction to Health Informatics and Health IT (Part 1) (February 10, 2021)Nawanan Theera-Ampornpunt
Presented at the 11th Healthcare CIO Certificate Program, School of Hospital Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on February 10, 2021
Karen Day, University of Auckland
Koray Atalag, University of Auckland
Denise Irvine, e3health
Bryan Houliston, Auckland University of Technology
(4/11/10, Illott, 1.45)
Invited presentation at Presenting Data: How to Convey Information Most Effectively Seminar, Centre of Research Excellence in Patient Safety, School of Public Health and Preventive Medicine, Monash University, February 2015.
The use of mobile applications, through smart phones, smartphones, has been considered by many to be the technological revolution of greatest repercussion in recent times. Compared to a handheld computer and with access to millions of applications, its main feature is unlimited mobility, accompanying its user at all times and in any place. In health, it is known that professionals are constantly moving outside of the institutions in which they work, so mobility is fundamental, which contributes to the interoperability of mobile technologies. This study aims to identify the research involving mobile technology applied to the vaccination being used. The methodology used is of the type integrative review of the literature. The final sample had 14 papers.
Meyer staying connected when is mobile technology harmful to patients fina...Conrad Meyer JD MHA FACHE
Staying connected when is mobile technology harmful to patients: Physicians and nurses are constantly interrupted and distracted during delivery of healthcare to patients. Since healthcare is data driven, Physicians and nurses are using smartphones, tablets, iPhones, iPads and other devices to constantly stay connected to the latest data. In addition, studies show that society as a whole, including Physicians and nurses, feel a constant desire to "stay connected" to the internet and social media. So when does all of this connectivity harm patients? When Physicians and nurses are distracted and lose focus from tending to their patients, bad things can happen - missteps, missed medications, over medications, wrong side surgeries, etc. just to name a few. When patients are paying for a Physician's or a nurse's focus - patients should expect to receive it. The challenge for Hospitals, Physicians and nurses in this age of "staying connected" is how to manage all of the distractions, whether or not causes by smartphones or tablets, and to provide the focus of their attention on those who not only paid for it, but expect it to make sure they receive the healthcare they need: the patients. This presentation provides some insights on what other studies have found and some suggestions on what policies might help in managing the distractions/interruptions healthcare providers face in the ever growing digital age!
emPATH is an open sourced mobile framework from UCSF. The framework is used to execute medical protocols on mobile devices. It originated from work done by Larry Suarez in the area of the autonomous management of distributed artifacts.
Presented at the 8th Healthcare CIO Certificate Program, Ramathibodi Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University on March 12, 2018
12 Gifts of Digital Health: How Futuristic Technologies Changed Healthcare an...Enspektos, LLC
When people talk about how digital technologies will influence health, many assume changes will happen years or decades into the future. Yet, in 2014 a range of digital tech, from Big Data to genomics, gave people the gift of life, knowledge and more. Look back at the year that was in digital health and understand that he future is now.
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on October 12, 2020
Introduction to Health Informatics and Health IT in Clinical Settings (Part 2...Nawanan Theera-Ampornpunt
Presented at the 10th Healthcare CIO Certificate Program, Ramathibodi School of Hospital Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on February 17, 2020
Information Technology Management in Healthcare Organizations: Part 2 (Octobe...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on October 20, 2021
Introduction to Health Informatics and Health IT (Part 1) (February 10, 2021)Nawanan Theera-Ampornpunt
Presented at the 11th Healthcare CIO Certificate Program, School of Hospital Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on February 10, 2021
Karen Day, University of Auckland
Koray Atalag, University of Auckland
Denise Irvine, e3health
Bryan Houliston, Auckland University of Technology
(4/11/10, Illott, 1.45)
Invited presentation at Presenting Data: How to Convey Information Most Effectively Seminar, Centre of Research Excellence in Patient Safety, School of Public Health and Preventive Medicine, Monash University, February 2015.
Final presentation of theoretical Alzheimer's medication adherence system, designed at Tufts University by Conor Ward, Emily Eickhoff, Alex Pugnali, Chris Shultz, and Rachel Terveer.
Healthcare Report: Robots, Tablets & Social MediaIDG Connect
IDG Connect has released a new report on how consumer devices are dramatically changing healthcare. It examines the numerous benefits it offers, such as the integration of iPads into practicing medicine, and the use of apps that can track patient health. It also questions the impact of these devices on the patient-doctor relationship. Are these devices actually improving patient care – or are they contributing to destroying the heart of healthcare – the traditional patient-doctor relationship?
Data Visuallization for Decision Making - Intel White PaperNicholas Tenhue
Visualization tools could help healthcare providers make sense of large volumes of complex health data and improve the speed and accuracy of decisions. This Intel White Paper is based on Nicholas Tenhue's MSc ICT Innovation thesis work.
Nicholas can be reached at http://www.nicholastenhue.com
E health in Nigeria Current Realities and Future Perspectives. A User Centric...Ibukun Fowe
In this era of the digital revolution, innovative computer software programs and Information and communications technologies (ICTs) are disrupting different industries of most economies and the healthcare sector is one of the nascent and emerging opportunities for technology disruption and innovation. This is an “inevitable” welcome development as Global health innovation is at the forefront of embracing the use of technology solutions in various parts of the world to improve access to health services and medicines, and Nigeria is not to be an exception. This symposium is focused on asking the fundamental questions; how much impact are e-health applications making in the Nigerian health sector and how do we improve the level of impact and
effectiveness of these applications via a user-centric approach?
Taking these proactive steps serve to ensure that we focus on the real needs of the Nigerian people and put in place quality and safety measures that will give users the confidence needed to use e-health applications and solutions adequately and appropriately. This symposium invites key-stakeholders in the e-health
ecosystem to share their views on the pains and gains of e-health as of today and how to shape the future of e-health in Nigeria (and similar countries). Some of the presentations and panelist sessions will include real field experience and user-centered qualitative research that will elicit the current level of impact and the real needs of e-health users in the southwest region of Nigeria.
Yogendra Jain of RX Advance - November 11th Health Innovators Presentationmlkrgr
This is Yogendra Jain's presentation from November 11th's Health Innovators event "Leveraging Innovation to Improve Medication Adherence".
Please see more information about Health Innovators at http://www.healthinno.org.
Please visit http://www.rxadvance.com/ to see more information about RX Advance.
Kevin Ban of Dovetail Health - November 11th Health Innovators Presentationmlkrgr
This is Carol McCall's presentation from Health Innovators November 11th event "Leveraging Innovation to Improve Medication Adherence".
Learn more about Health Innovators at http://www.healthinno.org
Learn more about Dovetail Health at http://www.dovetailhealth.com/.
This is Dr. Peter Madras' presentation that was given at the Health Innovators meeting on July 21st.
For more information on Health Innovators, please visit us at http://www.healthinno.org
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Yuri Quintana of BIDMC - November 11th Health Innovators Presentation
1. Global Trends in e-Health and
Medication Adherence
Yuri
Quintana,
Ph.D.
Division
of
Clinical
Informa8cs
BIDMC
and
Harvard
Medical
School
An Academic Division of the Dept of Medicine
at Harvard Medical Faculty Physicians at BIDMC, Inc.
TM
11/11/14
2. AGENDA
o Global health trends
o Global m-health trends
o Evaluation of medication adherence systems
o Design and evaluation considerations
o Road ahead
Global E-Health and Medication Adherence
11/11/14 2
3. Global Health Trend 1 – Aging Population
• The
global
popula8on
age
60
or
above
is
expected
to
more
than
triple
by
2050
Source: Deloitte 2014 Global health care outlook
https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/dttl-lshc-2014-global-health-care-sector-report.pdf
11/11/14 Global E-Health and Medication Adherence 3
4. Global Health Trend 2 – Cost and Quality
• 5.3%
annual
spending
increase
in
health
costs
expected
globally
over
next
five
years
Sector: Deloitte 2014 Global health care sector outlook
www.deloitte.com/2014healthcareoutlook
11/11/14 Global E-Health and Medication Adherence 4
5. Global Health Trend 3 – Access to Care
• There
will
be
a
shortage
of
230,000
physicians
across
Europe
in
the
near
future.
• The
number
of
caregivers
in
36
countries
in
Africa
is
inadequate
to
deliver
even
the
most
basic
immuniza8on
and
maternal
health
services.
Source: Deloitte 2014 Global health care outlook
https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/dttl-lshc-2014-global-health-care-sector-report.pdf
11/11/14 Global E-Health and Medication Adherence 5
6. Global Health Trend 4 – Technology
• New
technologies
(m-‐health,
cloud,
wearable)
are
driving
change
in
the
way
physicians,
payers,
pa8ents
and
stakeholders
interact
Source: mHealth in an mWorld - Delloitte Center for Health Solutions
http://www.deloitte.com/view/en_US/us/Industries/life-sciences/2545b66b8dc4b310VgnVCM2000003356f70aRCRD.htm
11/11/14 Global E-Health and Medication Adherence 6
7. Global Medication Adherence Trends
Source: Economic aspect of medication adherence using mobile medication reminder in French Health System
http://www.medetel.lu/download/2014/parallel_sessions/presentation/day2/Economic_aspect_of_medication.pdf
11/11/14 7
8. Global m-Health Trends
• 247
million
Americans
have
downloaded
a
health
app
• In
2013,
95
million
Americans
are
using
mobile
phones
as
health
tools
• 77%
of
U.S.
seniors
own
a
cell
phone
and
their
smartphone
ownership
has
increased
55%
in
the
past
year
• 42%
of
U.S.
hospitals
are
using
digital
health
technology
to
treat
pa8ents
• Mobile
remote
pa8ent
monitoring
expected
to
save
the
U.S.
$36
billion
in
health
care
costs
by
2018
• Wireless
pill
bo^les
helped
increase
medica8on
compliance
• Mobile
health
is
a
$1.3
billion
industry
and
by
2018
is
expected
to
reach
$20
billion
Source: Mobile Health Tools Make Big Impact by Jonathan Spalter
http://mobilefuture.org/mobile-health-tools-make-big-impact/
11/11/14 Global E-Health and Medication Adherence 8
9. Drug information ✓ ✓
Drug interactions ✓
Multiple user profiles ✓ ✓ ✓ ✓
Profile sharing via ✓ ✓ ✓ ✓ ✓
email
Sharing across multiple ✓
devices
Evaluation of Mobile Medication Systems
Figure 1. Screenshots of the mobile medication management applications included in the assessment.
Source:
Phansalkar
S,
Zachariah
M,
Seidling
HM,
Mendes
C,
Volk
L,
Bates
DW.
Evalua8on
of
medica8on
alerts
in
electronic
health
records
for
compliance
with
human
factors
http://principles.
mhealth.jmir.J
Am
org/2014/Med
1/e11/ Inform
Assoc.
2014
Oct;21(e2):e332-‐40.
doi:
10.1136/amiajnl-‐2013-‐JMIR 002279.
Mhealth Epub
Uhealth 2014
2014 | Apr
vol. 2 29.
| iss. 1 | e11 | p.3
PubMed
PMID:
24780721;
PubMed
Central
PMCID:
PMC4173170.
http://www.ncbi.nlm.nih.gov/pubmed/?term=(page number 24780721
not for citation purposes)
XSL•FO
RenderX
11/11/14 Global E-Health and Medication Adherence 9
10. wheelchair and okay, she wasn’t computer literate.
But had she been, you know, if she’d had it with her,
in her chair, she could’ve looked at it and said ‘yeah
hey I need to take this pill’ or there’s a reminder, or
‘no I can’t’, somebody’s making lunch for her, ‘no I
can’t have grapefruit because I’ve taken Lipitor’ or
something like that. I’m sure that kind of information
more useful, if you’re concerned, if you’re lot of medications. Because I know some people are taking seven or eight a day. [Female, Most also felt it was only appropriate for professionals to recommend an mHealth application used it themselves and if the patient was willing, was technologically literate.
User Perceptions of Mobile Medication Systems
Table 5. Participants summarize the experience of trying mobile medication management applications in one word.
Negative Words (Count) Neutral Words (Count) Positive Words (Count)
Frustrating (5) Different (1) Fascinating (2)
Challenging (3) Perplexing (1) Fun (2)
Overwhelming (2) Enlightening (1)
Stressful/nerve-wracking (2) Doable (1)
Confusing (1) Interesting (1)
Exhausting (1) Useful (1)
Complicated (1) Informative (1)
Functionality
Mobile medication management applications can be
conceptually separated into two categories: adherence
(MyMedRec, Pillboxie) and information (DrugHub,
PocketPharmacist). An “ideal" application was described as
including both features:
Source:
Phansalkar
S,
Zachariah
M,
Seidling
HM,
Mendes
C,
Volk
L,
Bates
DW.
Evalua8on
of
medica8on
alerts
in
electronic
health
records
for
compliance
with
human
factors
principles.
J
Am
Med
Inform
Assoc.
2014
Oct;21(e2):e332-‐40.
doi:
10.1136/amiajnl-‐2013-‐002279.
Epub
2014
Apr
29.
PubMed
PMID:
24780721;
PubMed
Central
PMCID:
PMC4173170.
http://www.ncbi.nlm.nih.gov/pubmed/?term=24780721
When asked to estimate the cost of applications, participants valued drug information applications I found MyMedRec covers everything, it’s ordered
properly. But it did miss the other little features, the
Something like drug interactions? I don’t bothered by anything like that. I mean I know but I want my pharmacist to say to me when don’t take this or do take that. You know what I didn’t go to school, I don’t want to responsibility of worrying about that... Group 1]
11/11/14 Global E-Health and Medication Adherence 10
11. of a task in Pillboxie, users had to tap outside the task window.
felt this should be standardized,
So ultimately, you’d want a universal language, and
a universal kind of, you know, this is where the back
button is, this is where the forward button is. But if
that doesn’t happen, then every app has its own
unique way. [Female, Group 2]
Evaluation of Mobile Medication Systems
I’m impatient as hell. So when it comes to an app, it’s
got to be simple. See…it wasn’t easy for me to find
the prompts, you know, partly from [my] glasses, but
also I’m impatient and I quit looking. And I said ‘Oh
I’ve spent all this time entering the stuff but if I put
Table 6. Application actions and features identified by participants as being nonintuitive or difficult to interpret.
Action/feature Description of challenge
Though typically used to add a new item, the symbol had little meaning for first time users. Also, because it is often found
in the top corners it is easily missed.
A “+” to add a new item
The back arrow is used to return the user to the previous screen but instead of testing the button, the research team was
often asked, “How do I go back without losing my information?”
Go back
The word “cancel” typically means “undo” but many participants felt it implied finality and described how they “cancel”
social or service contracts such as memberships, subscriptions, and appointments.
Cancel
Scrolling Without a scrollbar, participants rarely looked for additional information.
Audio reminders The audio alarms were inaudible to many participants, especially males.
When typing, many participants focused on the keyboard and missed the autocorrect feature that would change drug names
or dosage units (eg, “mcg” to “mg”).
Autocorrect
Inconsistent terminology led participants miss features. For example, reminder features were called “schedule,” “dose re-minder,”
or “first dose” in each application.
Inconsistent terminology
Greyed text was used to provide examples of data that could be entered into a field, but participants typically misinterpreted
the grey text to be the information of another user.
Sample text
Participants associated a black frame as being outside of the application and noninteractive, thus overlooking peripheral
buttons completely.
Peripheral buttons
Accessibility
One of the challenges faced by participants was that the
adherence features we examined (dose reminders, refill
reminders) made assumptions about the end user. For example,
the reminder strategies (alarms, notification boxes) assumed
users were “attached” to mobile devices. Participants said, for
This is an important distinction because though the tablets are
less portable, they are more accessible to individuals with
age-related vision loss. In one case, a participant with severe
low vision noted that touchscreen devices were surprisingly
accessible,
Source:
Phansalkar
S,
Zachariah
M,
Seidling
HM,
Mendes
C,
Volk
L,
Bates
DW.
Evalua8on
of
medica8on
alerts
in
electronic
health
records
for
compliance
with
human
factors
principles.
J
Am
Med
Inform
Assoc.
2014
Oct;21(e2):e332-‐40.
doi:
10.1136/amiajnl-‐2013-‐002279.
Epub
2014
Apr
29.
PubMed
PMID:
24780721;
PubMed
Central
PMCID:
PMC4173170.
http://www.ncbi.nlm.nih.gov/pubmed/?term=24780721
11/11/14 Global E-Health and Medication Adherence 11
I was always afraid to even look at them or try them,
12. User Interface Design Problems
• Simple
Screen
Design
-‐
Linear
Naviga8on
• Most
used
features
must
be
simple
to
use
• Avoiding
feature
creep
and
clu^ered
design
• Design
for
Seniors
–
font
size,
color,
naviga8on
• Need
to
follow
User
Center
Design
Process
• Need
more
coordina8on
and
itera8on
between
user
requirements,
wire
framing
and
usability
tes8ng
11/11/14 Global E-Health and Medication Adherence 12
13. m-health Evaluations
• Global
case
studies
demonstrate
that
mHealth
solu8ons
for
NCD
management
are
feasible
..but..
there
is
li^le
evidence
about
the
costs
and
savings
of
these
technologies
Source:
dx.doi.org/10.1145/2093698.2093868
• A
review
found
18
of
29
mobile
systems
using
text
messaging
improved
medica8on
adherence.
Nega8ve
studies
tended
to
have
more
basic
and
repe88ous
content
with
a
simple
medica8on
reminder,
while
posi8ve
studies
delivered
a
variety
of
educa8onal
and
mo8va8onal
content
with
‘tailored’
or
‘personalized’
SMS
Source:
dx.doi.org/10.1111/jan.12400
• Diversity
and
mul8modal
reminder
methods
should
be
considered
to
increase
usability
for
seniors
Source:
www.ncbi.nlm.nih.gov/pubmed/?term=25099993
11/11/14 Global E-Health Conference 13
14. Global Design Considerations
• Care
coordina8on
needs
to
be
considered
in
design
of
systems
–
engagement
with
family
and
care
providers
• Cultural
and
language
customiza8ons
needed
• Health
literacy
needs
to
be
considered
in
each
popula8on
• Deep
integra8on
with
local
healthcare
IT
systems
is
key
• Training
of
staff
and
pa8ents
needs
to
be
planned
• Evalua8on
and
ROI
needs
to
define
the
metrics
for
adherence,
u8liza8on,
and
costs
that
relate
to
local
business
models
11/11/14 Global E-Health and Medication Adherence 14
15. Road Ahead
• Need
to
define
evalua8on
metrics
and
ROI
models
for
compara8ve
analysis
• Need
to
have
more
outcome
evalua8ons
of
implemented
systems
• Need
to
understand
the
modifica8ons
need
to
adapt
systems
to
other
healthcare
networks
and
countries
for
global
deployments
• Need
to
have
best
prac8ces
on
design
for
user
interfaces,
implementa8on,
cultural
and
language
localiza8ons
11/11/14 Global E-Health and Medication Adherence 15
16. References
Health literacy
http://www.nlm.nih.gov/medlineplus/healthliteracy.html
mHealth in an mWorld - Delloitte Center for Health Solutions
http://www.deloitte.com/view/en_US/us/Industries/life-sciences/2545b66b8dc4b310VgnVCM2000003356f70aRCRD.htm
mhealth Competence Center - Barcelona
http://www.mobilehealthglobal.com/catalogue/
Mobile Health Tools Make Big Impact by Jonathan Spalter
http://mobilefuture.org/mobile-health-tools-make-big-impact/
Deloitte 2014 Global health care outlook
https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/dttl-lshc-2014-global-health-care-sector-report.pdf
Emerging mHealth: Paths for growth
http://www.pwc.co.nz/healthcare-industry-sector/publications/emerging-mhealth-mobile-health-from-patients-payers-and-providers/
The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature
http://www.ncbi.nlm.nih.gov/pubmed/22534082
Economic aspect of medication adherence using mobile medication reminder in French Health System
http://www.medetel.lu/download/2014/parallel_sessions/presentation/day2/Economic_aspect_of_medication.pdf
Adherence to medication among chronic patients in Middle Eastern countries: review of studies
http://apps.who.int/iris/bitstream/10665/118131/1/17_4_2011_0356_0363.pdf?ua=1
Experiences in mHealth for Chronic Disease Management in 4 Countries
http://www.ghdonline.org/uploads/Piette2011-ExperienceMHealth4Countries_1.pdf
A quantitative systematic review of the efficacy of mobile phone interventions to improve medication adherence.
http://www.ncbi.nlm.nih.gov/pubmed/24689978
Evaluating User Perceptions of Mobile Medication Management Applications With Older Adults: A Usability Study
http://mhealth.jmir.org/article/viewFile/mhealth_v2i1e11/2
17. Thank you!
Yuri
Quintana,
Ph.D.
Director,
Global
Health
Informa8cs
Division
of
Clinical
Informa8cs
BIDMC
and
Harvard
Medical
School
yquintan@bidmc.harvard.edu
An Academic Division of the Dept of Medicine
at Harvard Medical Faculty Physicians at BIDMC, Inc.
TM
http://www.hmfpinformatics.org
Global E-Health and Medication Adherence
11/11/14 17