Kamel Boulos MN. Telehealthcare for older people: barriers to large-scale roll-outs (Round table: Use of technologies to promote healthy aging and improve disability). In: Proceedings of the 1st Barcelona Conference on Healthy Aging (University of Barcelona), Barcelona, Spain, 14-15 November 2013 (invited presentation). URL: http://www.healthyageingbarcelona.com/speakers8.html
Livewell Project @ Health Informatics Scotland 2014, Glasgow, 2 Sep 2014Maged N. Kamel Boulos
Please cite as:
Kamel Boulos MN, Livewell Project Consortium. Livewell Project (project overview and early user feedback and impressions from the Summer 2014 pilot testing phase). In: Online Proceedings of Health Informatics Scotland 2014 Conference, Glasgow, Scotland, 2 September 2014. URLs: http://www.webcitation.org/6SIO8Vo19 and http://www.knowledge.scot.nhs.uk/his/events/health-informatics-scotland-conference-2014/presentations-and-audio.aspx
http://www.slideshare.net/sl.medic/livewellhis-glasgow2-sep2014
Environmental eHealth : A critical compenent of eHealth readiness assessment by Richard Scott, CEO & Principal
Consultant for NT Consulting, Editor - Journal ISfTeH, Canada
Digital Contact Tracing Tools for COVID-19 : Digital contact tracing tools vary in purpose, features, and complexity, but they can add value to traditional contact tracing efforts by:
eHealth Summit: "ICT Use in Irish General Practices: An Intra-Practice Adopti...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Jane Bourke, Lecturer in Economics, University College Cork.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
Livewell Project @ Health Informatics Scotland 2014, Glasgow, 2 Sep 2014Maged N. Kamel Boulos
Please cite as:
Kamel Boulos MN, Livewell Project Consortium. Livewell Project (project overview and early user feedback and impressions from the Summer 2014 pilot testing phase). In: Online Proceedings of Health Informatics Scotland 2014 Conference, Glasgow, Scotland, 2 September 2014. URLs: http://www.webcitation.org/6SIO8Vo19 and http://www.knowledge.scot.nhs.uk/his/events/health-informatics-scotland-conference-2014/presentations-and-audio.aspx
http://www.slideshare.net/sl.medic/livewellhis-glasgow2-sep2014
Environmental eHealth : A critical compenent of eHealth readiness assessment by Richard Scott, CEO & Principal
Consultant for NT Consulting, Editor - Journal ISfTeH, Canada
Digital Contact Tracing Tools for COVID-19 : Digital contact tracing tools vary in purpose, features, and complexity, but they can add value to traditional contact tracing efforts by:
eHealth Summit: "ICT Use in Irish General Practices: An Intra-Practice Adopti...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Jane Bourke, Lecturer in Economics, University College Cork.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
eHealth Summit: "Case Study: How Finland became a leader in eHealth adoption"...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Maritta Korhonen, head of development, Ministry of Social Affairs and Health, Finland.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
Teledentistry platforms connect dentists to each other and to patients for real-time consultations, via live stream or video conferencing. These opportunities for collaboration lead to faster treatment plans and more efficient care delivery.
eHealth Summit: "Case Study: The applied research for connected health (ARCH)...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Maria Quinlan, Research Lead Change Work-Package, ARCH.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
TeleDent is the all in one teledentistry solution that allows not only dentists, but any nursing home, clinic, FQHC or health care setting to link patients with oral health care consultations - via asynchronous or real-time video.
Ross McKenna
Portfolio Manager, Health System Infrastructure
Information Strategy and Architecture
National Health Board Business Unit
Ministry of Health
Telehealth and telemedicine have been widely used to deliver healthcare services like patient/clinician contact, disease prevention and curative care, advice, reminders, education, monitoring, and remote admissions. This presentation covers
- What is Telehealth
- Difference between Telehealth and Telemedicine
- The market of Telehealth
- The problem/need gap it solves
- The attitude of clinicians and patients towards Telehealth
- Telehealth benefits and limitations
- Telehealth services/modalities
- Adoption stages
- Telehealth Case study
The National Health IT Board Perspective: Transformational healthcare, professionalism and sustainability. Presented by Graeme Osborne, Director, National Health IT Board; Dr Andrew Miller, General Practitioner and e-ambassador; Carolyn Gullery, General Manager Planning, Funding & Decision Support, Canterbury & West Coast District Health Boards at HINZ 2014, 11 November 2014, 8.30am, Plenary Room
eHealth Summit: "Case Study: How Finland became a leader in eHealth adoption"...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Maritta Korhonen, head of development, Ministry of Social Affairs and Health, Finland.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
Teledentistry platforms connect dentists to each other and to patients for real-time consultations, via live stream or video conferencing. These opportunities for collaboration lead to faster treatment plans and more efficient care delivery.
eHealth Summit: "Case Study: The applied research for connected health (ARCH)...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Maria Quinlan, Research Lead Change Work-Package, ARCH.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
TeleDent is the all in one teledentistry solution that allows not only dentists, but any nursing home, clinic, FQHC or health care setting to link patients with oral health care consultations - via asynchronous or real-time video.
Ross McKenna
Portfolio Manager, Health System Infrastructure
Information Strategy and Architecture
National Health Board Business Unit
Ministry of Health
Telehealth and telemedicine have been widely used to deliver healthcare services like patient/clinician contact, disease prevention and curative care, advice, reminders, education, monitoring, and remote admissions. This presentation covers
- What is Telehealth
- Difference between Telehealth and Telemedicine
- The market of Telehealth
- The problem/need gap it solves
- The attitude of clinicians and patients towards Telehealth
- Telehealth benefits and limitations
- Telehealth services/modalities
- Adoption stages
- Telehealth Case study
The National Health IT Board Perspective: Transformational healthcare, professionalism and sustainability. Presented by Graeme Osborne, Director, National Health IT Board; Dr Andrew Miller, General Practitioner and e-ambassador; Carolyn Gullery, General Manager Planning, Funding & Decision Support, Canterbury & West Coast District Health Boards at HINZ 2014, 11 November 2014, 8.30am, Plenary Room
Integrating UX into Voice of the Customer ProgramsKathi Kaiser
Centralis' Kathi Kaiser outlines the organizational challenges that limit the participation of user experience professionals in corporate "Voice of the Customer" initiatives.
Kaiser proposes a cross-functional model for UX, analogous to quality departments in hospitals or safety functions in manufacturing. An interdisciplinary UX Council integrates each department's unique perspective on customer needs, supported by a UX Strategy function to execute the priorities of the Council.
Kaiser urges UX professionals to adopt a cooperative, service-focused mentality when working with other departments to reduce in-fighting and focus organizational energy on the pursuit of success through meeting & exceeding customer needs.
Presented at the User Experience Professionals' Association annual conference, June, 2012.
It is important to get practical insights into the problems faced by community dwelling elderly in rural and urban India.
Information collected can act as a guideline for taking necessary steps to reform awareness and attitude of assistive technology amongst professional care providers of the elderly and the elderly in India.This keynote presentation was done at Akita,Japan ,in October 2009.
Evaluar la experiencia del usuario (UX) en contexto de múltiples interfacesCarmen Gerea
Con el aumento exponencial del uso del smartphone ha generado un cambio de paradigma: los usuarios han pasado de la interacción con una sola interfaz a interactuar con varias interfaces (varios dispositivos) para cumplir un objetivo. Tanto para la academia como para los profesionales, la interacción con varios dispositivos es uno de los principales desafíos en el estudio de la experiencia del usuario. Los métodos, herramientas y métricas que miden actualmente la usabilidad y la experiencia del usuario (UX) - como la tasa de completitud de la tarea, el tiempo de ejecución de la tarea o la satisfacción - requieren ser replanteadas en este nuevo contexto de uso. El presente trabajo en curso tiene como propósito caracterizar estas interfaces múltiples para el uso personal y profesional, como primera etapa de la propuesta de un modelo de evaluación de la UX orientada a informar procesos de diseño. Para mapear las prácticas actuales, la investigación inicia con una revisión sistemática de métodos, herramientas y métricas de evaluación de la UX contexto de múltiples interfaces. A continuación, los hallazgos de estudios específicos en wearable - mobile, mobile - desktop y mobile - mobile, serán usados para identificar requerimientos de diseño para servicios digitales en contextos de múltiples interfaces, y un modelo de evaluación será propuesto. Finalmente, realizaremos la validación empírica del modelo y propondremos instrumentos de evaluación.
Presenter: Student
Institution: Grantham University
Date: July 2, 2020
ADOPTING TECHNOLOGY IN HEALTHCARE MANAGEMENT AND THE EFFECTS ON PATIENT OUTCOME
In this presentation you will be exposed to the following:
Problem statement and its current scope
Literature review
Strategic plan, who will benefit and what will the healthcare environment looks like once resolved
Recommendations/ limitations
References
CONTENTS OF THIS PRESENTATION
TABLE OF CONTENTS
PROBLEM STATEMENT
Current scope
LITERATURE REVIEW
Theoretical framework in which the problem exists
01
03
02
04
05
STRATEGIC PLAN
Implementation and benefits
RECOMMENDATION FOR FUTURE STUDY/LIMITATIONS
Social and political barriers to implementation
REFERENCES
Over 20 references with vast majority within five years.
COMMENTS
PROBLEM STATEMENT
01
Current Scope
Problem statement
Many healthcare professionals are less adoptive to technology advances, they are not up to date with new medical discoveries, performance measurements and decrease coordination with each other (Seblega 2010). These deficiencies resulted in the analysis of challenges that exists with technology adoption to include, costs, interoperability, outdated technology, difficulty in use of technology and complicated asset tracking and implementation.
Who are affected?
Practicioners, managers, employees, investors, patients and the economy on a whole
Demographics
Analysis done on the two selected countries of Nigeria and the United States both concluded that technology adoption in healthcare is linked to usefulness and ease of use of technology.
01 CONTINUES
History of problem
Discussion about the use of computers began in 1960s.
The possibility of electronic health records (EHR), were examined in 1991.
When did the problem appeared?
Since the discussion to use technology to enhance medical care
01 CONTINUES
CURRENT SCOPE
The challenges in health technology adoption is significant because despite the evolution of the society, the importance of these tools for modern technology to improve quality care outcomes and other elaborate benefits that are associated with it is limited (underutilized or low) because of factors to include financial concerns, poor infrastructure, low technical expertise and resistance from healthcare professionals (Zayyad 2018).
01 CONTINUES
What is currently being done?
The resistance experienced by both health professionals and patients soon decrease even because of the Coronavirus pandemic. This pandemic is a push factor towards medical technology adoption. Wicklund (2020), explained that the future of healthcare is now reshaped. The increase in the use of telemedicine is seen across the world as it helps in deciding which patients are to be seen in the hospital or elsewhere. This is believed that in order to prevent the spread of the virus patients must be isolated. In addition, there are technologies used to deal with Coronavirus namely symptom trackers, Chat.
hsns09:The Scottish telecare development programme:the evaluation - Sophie BealeIriss
Sophie Beale,York Health Economics Consortium,University of York.
http://php.york.ac.uk/inst/yhec/?q=contact/keycontacts
Connected Practice Symposium,Human Services in the Network Society,Changes, Challenges & Opportunities. The Institute for Advanced Studies, Glasgow 14-15 September 2009.
http://connectedpractice.iriss.org.uk/
How data science can be used to break down the interoperability problem GlobalTechCouncil
Have you ever experienced any of the following scenarios?
• The alarm of the infusion-pump keeps beeping, but the nurse station can’t recognize it. When you finally call the nurse, she says that there is an issue.
• The oximeter alarm goes off, and the nurse comes just to say that you don’t have to worry because this happens a lot.
this happens a lot.
HIM 500 Final Project Guidelines and Rubric Overview .docxpooleavelina
HIM 500 Final Project Guidelines and Rubric
Overview
Practitioners in health information management and healthcare informatics are expected to be keenly aware of new and upcoming technologies that might
benefit their organization. This becomes more complex as these individuals must also consider the impact that those technologies might have on the practice of
medicine at their institution. When faced with new technologies, leaders in health information management must evaluate the state of the organization and
make an informed decision that will affect the organization as a whole. This means addressing not just the needs of the health information management team,
but the needs of all roles within the institution, while also addressing any issues of compliance the organization might be facing.
For your final project in this course, you will imagine you have been hired as a contractor for a small medical facility to consult on the selection of a new
technology. Their organization has been struggling, so you must first speak to the state of the organization and then offer an informed recommendation as to
which of the technologies would suit the organization best. The project is divided into three milestones, which will be submitted at various points throughout
the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules Three, Five and Seven. The final product will
be submitted in Module Nine.
In this assignment, you will demonstrate your mastery of the following course outcomes:
Determine standard technology systems and their uses in modern healthcare institutions through analysis of current and historical technology use in
health information management and healthcare informatics
Analyze the interrelationship between various professional roles within healthcare institutions and their use of technology systems for informing
recommendations regarding health information technology systems
Determine the potential impact of violating health regulations and laws regarding health information technology systems on healthcare organizations
Develop health information technology recommendations for healthcare institutions that are compliant with health regulations and laws and ensure
ethical management of health information
Determine effective investment of resources in health information technology for healthcare institutions based on the needs of the healthcare
institution
Prompt
Imagine you have been contracted to consult on the recent developments at the Featherfall Medical Center. Featherfall has been struggling of late; it has had a
series of problems that have prompted your hiring. It has faced the following issues:
1. Featherfall has recently violated several government regulations regarding the current state of its technology and how it is being used. The technology
system is vastly out of date, and staff are not always using the tech ...
Challenges of a telemedicine pilot - Carolina Escobar, MD, VIMA - TFSSVSee
A frank look at the specific challenges and successes of deploying telemedicine for oncology consults - from the Telehealth Failures & Secrets To Success Conference:
vsee.com/telehealth-failures-conference
A Mobile Health Application for Healthy Living: HWOW (Healthier Work for Offi...Dr. Mustafa Değerli
Değerli, M. (2020). A Mobile Health Application for Healthy Living: HWOW (Healthier Work for Office Workers). 14th Turkish National Software Engineering Symposium. (UYMS 2020). 10.1109/UYMS50627.2020.9247024 - https://ieeexplore.ieee.org/xpl/conhome/9247008/proceeding
Make sure it is in APA 7 format and at least 3-4 paragraphs and refe.docxendawalling
Make sure it is in APA 7 format and at least 3-4 paragraphs and references.
Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.
In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.
To Prepare:
Reflect on the Resources related to digital information tools and technologies.
Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.
By Day 3 of Week 6
Post
a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.
By Day 6 of Week 6
Respond
to at least
two
of your colleagues
* on two different days
, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.
Click on the
Reply
button below to reveal the textbox for entering your message. Then click on the
Submit
button to post your message.
*Note:
Throughout this program, your fellow students are referred to as colleagues.
Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next .
As leaders we understand that our job is to possibly idolize and c.docxfestockton
As leaders we understand that our job is to possibly idolize and carry out the impossible. Healthcare managers primary role is to manage and maintain stabilization. One of the main issues that effects healthcare is intelligence taking over an organization in a setting where elderly people can barely function coherently alone. Quest Diagnostics has switched over to electronically checking in on a kiosk system. MyQuest benefits a patient to receive their results on a portal, without going through the hassle of contacting your doctor or avoiding anxiety throughout the wait for a call back. Is this change saving a hassle or enhancing complications and trouble in an organization?
Change can be hard for some and easy for others. To the healthcare professional manager a change in a structured system may benefit the pace and results of outcomes at this organization. To the patient it may be an additional loop hole in the obstacle course they are not in favor of. The problem initiates when there’s order put in place to carry out new solutions effectively and there’s a complaint and the manager has to see how to satisfy this one customer out of a million because this too can be the rise or fall of an appointment. Managers should stand on what they believe is a better system that works for the majority and not bend it for any reason. Once there’s a tweak in the system it opens up a hole for everyone to think rules will be bent if there’s a complaint. We should question our thinking and communicate effectively with all other leadership to create the most effective system to please as much of the patients as possible. We can not please every human and doing cover ups or quick fixes creates a catastrophe.
Most doctors that have been practicing for years are used to coding manually and paper charts. Recently in the past two years all healthcare settings are forced to switch to icd coding, a new set of codes that are put in place to take the old ones that had been used for years out. This helps the specifications of the patient condition to easily communicate with the patients insurance and lessens the use of multiple codes. This also alters the doctors practice when they are still using paper orders and charts and haven’t learned the codes correctly so are causing patients to be billed by insurance.
When critically analyzing the solution to this problem we should use the problem-solving skills of asking the 5 whys. In a fast past setting we usually like to immediately fix the problem in the area or satisfy the majority. This can result to quick fixes which is like only placing a band aid over a bullet wound. Longterm this result can be detrimental to the organization. Quick fixes should be avoided as much as possible by healthcare management or anyone in leadership.
· Stephens, J. H., & Ledlow, G. R. (2010). Real healthcare reform: Focus on primary care access. Hospital Topics, 88(4), 98–106.
· Cliff, B. (2012). Excellence in patient satis ...
IEEE DEST 2013 tGov paper eHealth - The Future Service Model for Home & Co...Hans A. Kielland Aanesen
Abstract — This document describes how future home and community health care services can be delivered using a range of new technologies and using standards developed by the EPR-forum and OASIS, and provides an overview of current efforts to build a new demonstrator showing how these services can be provided by the interoperability of the various edevices and systems.
Monitoring and evaluation toolkit - Conférence de la 2e édition du Cours international « Atelier Paludisme » - TUSEO Luciano - World Health Organization / Roll Back Malaria - maloms@iris.mg
Similar to Telehealthcare for older people: barriers to large-scale roll-outs (20)
Towards precision and accuracy digital public health: informed decision-makin...Maged N. Kamel Boulos
Cite as: Kamel Boulos MN. Towards precision and accuracy digital public health: informed decision-making using novel community-level physical activity indicators from app data aggregates of user populations. Invited talk at the 2019 International Geoinformatics Week - Annual meeting of Geoinformatics in Sustainable Ecosystem and Society (GSES), Zhujiang Hotel, Guangzhou, China, 22-25 November 2019 URLs: http://gig.geoweek2019.org/ and http://gig.geoweek2019.org/main/news/8.html
Abstract: Big data aggregates from popular mobile physical activity (PA) tracking gadgets and the apps/platforms they are paired to can provide unique population insights that could help public health authorities devise superior PA promotion interventions, better target them, and dynamically monitor their effect over time, making adjustments to the interventions as necessary.
How is AI actually empowering clinicians, augmenting telehealth, and transfor...Maged N. Kamel Boulos
An UPDATED version of this presentation is available at http://healthcybermap.org/KamelBoulos-CN-AI-Apr19.pdf
How is AI actually empowering clinicians, augmenting telehealth, and transforming the world’s largest healthcare system (serving 1.4 billion people in China)?
智能医学
Cite as: Kamel Boulos MN. VRGIS and big data for smarter, healthier cities (within the Invited Session on 'Digital technologies and the impact in biometry', Chair: R Assunção, Discussant: A Charpentie, Presenters: MN Kamel Boulos, J Mills Flemming, G Câmara). XXIXth International Biometric Conference, Barcelona International Convention Centre, Barcelona, Spain, 10 July 2018.
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Abstract:
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The latest generation of virtual and mixed reality hardware has rekindled interest in VRGIS (Virtual Reality GIS) and ARGIS (Augmented Reality GIS) applications in health, and opened up new and exciting opportunities and possibilities for using these technologies in the personal and public health arenas (Kamel Boulos et al., 2017). This presentation will offer a snapshot of some of the most remarkable VRGIS and ARGIS solutions that rely on big data, including real-time data, to deliver the vision of smart healthy cities (Kamel Boulos et al., 2015).
1. Kamel Boulos et al. From urban planning and emergency training to Pokémon Go: applications of virtual reality GIS (VRGIS) and augmented reality GIS (ARGIS) in personal, public and environmental health. Int J Health Geogr. 2017, 16:7. DOI: 10.1186/s12942-017-0081-0
2. Kamel Boulos et al. 'Social, innovative and smart cities are happy and resilient': insights from the WHO EURO 2014 International Healthy Cities Conference. Int J Health Geogr. 2015, 14:3. DOI: 10.1186/1476-072X-14-3
On the promises, challenges and risks of Pokémon Go and similar geosocial (lo...Maged N. Kamel Boulos
Cite as: Kamel Boulos MN. On the promises, challenges and risks of Pokémon Go and similar geosocial (location-based) exergames (invited contribution). In: Proceedings of GEOMED 2017: International Conference on Spatial Statistics, Spatial Epidemiology & Spatial Aspects of Public Health, Porto, Portugal, 08 September 2017. Conference URLs: http://www.i3s.up.pt/geomed2017/speakers.html and http://www.i3s.up.pt/geomed2017/scientific_programme.html
Games, Geosocial Apps, Social Media Ads and Dashboards for Sexual Health Prom...Maged N. Kamel Boulos
Kamel Boulos MN. Games, Geosocial Apps, Social Media Ads and Dashboards for Sexual Health Promotion. Invited presentation at the eHealth week - Track 3 panel debate for 12 May 2017 (09:30-10:30): '#SocialMediaInHealthcare: Y it matters 4U!', Conference Room: Cettina de Cesare 3, Intercontinental Hotel, St Julian's, Malta. In: Proceedings of eHealth Week 2017 (HIMSS Europe), Intercontinental Hotel, St Julian's, Malta, 10-12 May 2017. <urls: />
IBM Watson Health: How cognitive technologies have begun transforming clinica...Maged N. Kamel Boulos
Cite as: Kamel Boulos MN. IBM Watson Health: how cognitive technologies have begun transforming clinical medicine and healthcare (Oral session IV – Patient safety tools, Thursday 19 May 2016, 15:45-16:45, Hotel Puijonsarvi, Kuopio). In: Proceedings of the 4th Nordic Conference on Research in Patient Safety and Quality in Healthcare (NSQH2016), Kuopio, Finland, 18-20 May 2016 (organised by University of Eastern Finland), p.29. URL: http://www.uef.fi/NSQH2016 (In: Nykanen I (ed.). The 4th Nordic Conference on Research in Patient Safety and Quality in Healthcare. Kuopio, Finland, May 18-20, 2016. Program and Abstracts. Publications of the University of Eastern Finland. Report and Studies in Health Sciences 21. 2016, p.29 (of 119 p.). ISBN: 978-952-61-2130-7 (nid.), ISSNL: 1798-5722, ISSN: 1798-5730.)
IBM Watson health: how cognitive technologies have begun transforming clinical medicine and healthcare
Maged N Kamel Boulos
ABSTRACT
Background: IBM Watson Health (http://www.ibm.com/smarterplanet/us/en/ibmwatson/health/) belongs to a new generation of smart cognitive computing technologies (a type of artificial intelligence) that are poised to transform the way healthcare is delivered, and to vastly improve clinical outcomes, quality of care and patient safety.
Objectives: Our goal was to collect and document the huge potential of a range of emerging and exemplary uses of IBM Watson in healthcare in both developed and developing country settings.
Methods: A survey of current peer reviewed and grey literature has been conducted, looking for reports and case studies involving the use of IBM Watson in different health and healthcare applications.
Results, conclusions and clinical implications: With its ability to make sense of unstructured medical information by analysing the meaning and context of natural language, and uncovering important knowledge buried within large volumes of data and information, including medical images, IBM Watson is exceptionally well suited for clinical and healthcare decision support, where there are often elements of ambiguity and uncertainty. It has been (or is currently being) successfully deployed in many developed countries in the West, as well as in developing countries, such as India and South Africa. IBM Watson unlocks a complex case by acquiring information from multiple sources, e.g., accessing the electronic patient record, then parsing all related medical evidence at up to 60 million pages per second. After processing all of this information, Watson offers relevant and prioritised suggestions to the decision-maker, e.g., helping clinicians identify the best diagnosis and treatment options in complex oncology cases, and providing hospital managers with new operational insights. The ultimate goals are to reduce cost, medical errors, mortality rates, and help improve patients' quality of life.
Towards a successful implementation of game mechanics (gamification) in e-hea...Maged N. Kamel Boulos
Cite as: Kamel Boulos MN. Towards a successful implementation of game mechanics (gamification) in e-health interventions (updated: 09//2015). In: Baptista TM, Kamel Boulos MN, Rodrigues FM, Rocha A. E-Health, psychology and medicine: the future of a close cooperation (invited symposium). In: Proceedings of the 14th European Congress of Psychology, Milan, Italy, 7-10 July 2015. URL: http://www.ecp2015.it/scientific-program/invited-symposia/ - WebCite cache: http://www.webcitation.org/6YIHINbi0
Please cite as: Kamel Boulos MN. Creating self-aware and smart healthy cities. Invited plenary keynote address followed by sub-plenary round table at WHO 2014 International Healthy Cities Conference, Athens, Greece, 25 October 2014. http://www.healthycities2014.org/ehome/89657/192014/?&
PPT updated in May 2015.
Oct 2017: See also https://www.slideshare.net/sl.medic/how-the-internet-of-things-and-people-can-help-improve-our-health-wellbeing-and-quality-of-life
Public engagement and participation in health geography: crowdmaps (crowdsour...Maged N. Kamel Boulos
Cite as: Kamel Boulos MN. Public engagement and participation in health geography: crowdmaps (crowdsourced maps) by citizens, for citizens. In: Proceedings of GEOMED 2013, the 8th international interdisciplinary conference on spatial epidemiology, spatial statistics and geomedical systems, The Edge—University of Sheffield conference venue, Sheffield, UK, 16-18 September 2013 - http://www.shef.ac.uk/scharr/sections/ph/conferences/geomed2013/programmeandspeakers
Telehealthcare for older people with comorbidity: lessons from eCAALYXand pr...Maged N. Kamel Boulos
Invited presentation by MN Kamel Boulos at http://www.aal-europe.eu/innovate-uk/ (12 March 2013) - (C) The eCAALYX Project Consortium - http://ecaalyx.org/
Author: Prof. Maged N. Kamel Boulos, MBBCh, MSc (Derm), MSc (Med Informatics), PhD, FHEA, SMIEEE
Associate Professor in Health Informatics
University of Plymouth, UK
---
Themes covered:
Networked Social Media in Learning and Teaching (contexts: higher education; medicine and healthcare, including patient education and clinicians’ collaboration and CPD—Continuing Professional Development).
Networked Social Media in Research (both as a primary focus for research and as tools/enablers in research).
The above two themes are interrelated and frequently overlap in research-led higher education institutions (research-informed teaching and practice).
e-Health and the Social Web ("Web 2.0")/the 3-D Web: Looking to the future wi...Maged N. Kamel Boulos
The Social Web and the 3-D Web/virtual worlds and globes in Medicine and Health
e-Health and the Social Web/the 3-D Web: Looking to the future with sociable technologies and social software
Covers 3-D social networks and virtual worlds/the 3-D Web (including Second Life) and how they relate to Web 2.0 (M.N.K. Boulos - April 2007 - 32 slides)
Find out more at http://healthcybermap.org/sl.htm
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Telehealthcare for older people: barriers to large-scale roll-outs
1. 15 November 2013, Barcelona, Spain
Telehealthcare for older people:
barriers to large-scale roll-outs
Maged N. Kamel Boulos, MBBCh, PhD, SMIEEE
United Kingdom
mnkboulos@ieee.org
2. Quick agenda
• The first half of this presentation will cover the
rationale behind telehealthcare, as well as its
potential and current applications (mainly in the
case of older people), before moving on in the
second half of the presentation to the barriers to
its wide adoption and what needs to be done.
15 November 2013, Barcelona, Spain
3. Tele = at a distance / monitoring and intervening from a remote location
5. Video compilation: AAL (Ambient
Assisted Living) / telehealthcare
• http://youtu.be/Ewoa3vVUa5o
• Length: 7:33
Mr Peter Saraga CBE
6. Key findings from the Whole System
Demonstrator programme (England)
http://www.bmj.com/content/344/bmj.e3874
21 June 2012
The WSD programme was launched in May 2008. It is the largest randomised control trial of
telehealth and telecare in the world, involving 6191 patients* and 238 GP practices across three sites
in England (Newham, Kent and Cornwall). *Conditions covered: heart failure, chronic obstructive pulmonary disease, diabetes
See more at: http://3millionlives.co.uk/about-telehealth-and-telecare#nhs_innovations_expo
7.
8. But WSD results also showed…
• “Second generation, home based telehealth as
implemented in the Whole Systems
Demonstrator Evaluation was not effective or
efficacious compared with usual care only.
Telehealth did not improve quality of life or
psychological outcomes for patients with
chronic obstructive pulmonary disease,
diabetes, or heart failure over 12 months.”
http://www.bmj.com/content/346/bmj.f653
26 February 2013
9. • “The QALY (quality adjusted life year) gain by
patients using telehealth in addition to usual
care was similar to that by patients receiving
usual care only, and total costs associated with
the telehealth intervention were higher.
Telehealth does not seem to be a cost
effective addition to standard support and
treatment.”
http://www.bmj.com/content/346/bmj.f1035
22 March 2013
10. The limitations and pitfalls of generalisation
• Some questions to ask/discuss: would it be correct to generalise from one study,
however large it might be (even a big RCT such as the WSD), which at the end
only evaluated one specific instance of the technology (an American system in
the case of WSD) under specific settings, and to blindly apply the results to the
whole class to which that technology belongs (AAL/telehealthcare in general)
and to all possible settings?
• Not all telehealthcare solutions are the same; there are things they share in
common, but also very unique specifications and successive versions/iterations
for different solutions (technology develops and changes fast), which might
greatly affect the results of any evaluation/user acceptance study.
• By the time you get some evaluation results published, a new, supposedly better
technology/version might have already replaced the evaluated solution on the
market.
• Implementation environment, settings and user profiles can also (greatly) affect
results. For example, in the WSD, they chose sites where there was already a
good deal of healthcare and social care integration, but this is not always the
case everywhere else.
• Should we evaluate telehealthcare interventions in the same ways we evaluate
new drugs (standard RCTs/clinical trials)? (paper for reflection)
11. How do we cure ‘pilotitis’?
http://skollworldforum.org/debate/how-do-we-cure-mhealth-pilotitis-critical-lessons-in-reaching-scale/
12. • Questions asked and addressed at a recent Partners Connected Health
Symposium in Boston (Oct 2013) - quotes (lightly paraphrased) from event news
report at http://mobihealthnews.com/26699/whats-stopping-mobile-healthinterventions-from-scaling/:
– When is it time to stop running pilots and go to scale?
– What challenges does that process offer? Does every provider organisation
have to reinvent the wheel, or can they learn from each others’ pilots?
– For one organisation/site to learn from the other (transferable experiences),
we need to have a very detailed analysis of the work, time, resources and
conditions/settings that go into, and what exactly comes out, of a given
telehealthcare solution implementation, so that others can fully benefit from
what we have done.
– Pilots in clinical settings often fail to track return on investment (ROI).
13. – The problem with using ROI to evaluate pilots is that many of the newest
endeavours in medicine are preventative and/or have expensive startup costs.
So short term ROI can look deceptively bad. An example was offered of a
calculator that is used to evaluate longer-term ROI: http://www.telemedroi.com/#home
– The ‘Big Brother’ problem and what to (best) do with the ‘Big Data’ that is
continuously generated by telehealthcare sensors (need to be sensitive to
individuals’ privacy).
– The need to specifically consider the specific population an intervention is
targeting. Is the user interface one older people will be able to use? Is it available
in the right languages (also think users’ general and health literacy levels here, plus any
special usability/accessibility/other requirements they might have)? That sort of
population targeting can affect the success of an intervention, but it also makes
it harder to use the same strategies at different sites without doing somewhat
repetitive efficacy studies.
– Pilots can build an ‘ecosystem’/accumulate evidence that in the long-term will
help us with better results and better quality care. Do the learning and have a
plan to scale from it. Always start small where you think is the actual need, and
once the adoption results and outcomes are measured, you can scale it into
Quotes (lightly paraphrased) from http://mobihealthnews.com/26699/whatsdifferent markets/sites.
stopping-mobile-health-interventions-from-scaling/
14. Transferable experiences
• The NHS in England is learning
from the US Veterans Health
Administration, home of the
largest implementation of
telehealth anywhere in the
world.
• A report is now available
describing lessons learned from
both sides of the Atlantic and
recommendations for both
organisations:
http://www.2020health.org/dms/2
020health/downloads/reports/202
0vhanhsONLINE_8-3-13FINAL.pdf
Published in March 2013
15. Barriers, challenges and desiderata
Report by the Digital Policy Alliance:
http://dpalliance.org.uk/wpcontent/uploads/2013/01/1301_Telecare-andTelehealth-Briefing.pdf
Published in January 2013
16. Government (UK) warned over
rapid telehealth rollout risks
News headlines from Q1 2013 (UK)
18. Barriers, challenges and desiderata
• Despite its great potential and promises, telehealthcare is facing serious
barriers and challenges in the UK. (Similar issues can be found in other parts of
Europe.)
• The aforementioned Jan 2013 report by the Digital Policy Alliance warned of the
risks of the UK Government’s accelerated telehealth roll-out, and made a series
of recommendations to ensure the roll-out of telehealth & telecare meets the
Government’s objectives of 3 million users and £1.2bn saving over 5 years.
• The report highlighted the following main barriers:
– Skills shortage and lack of sufficient knowledge among stakeholders* of the
capabilities and uses of telehealth & telecare and of the associated professional
standards required to ensure high quality coordinated care;
(* Lack of sufficient knowledge may lead to resistance to change / fear of the new)
– Difficulty of demonstrating that the organisation bearing the cost is also
receiving the benefit (ROI): telehealth & telecare benefit patients by enabling
them to remain at home, live independently for longer and avoid hospital
admissions, but GP practices/NHS commissioners and social service departments
do not always see any (direct/immediate or short-term) financial benefits from
these outcomes; and
– Lack of appropriate multiagency coordination.
19. What needs to be considered and done /
desiderata for success
• There is an urgent need to educate and raise the awareness
of healthcare professionals and other relevant stakeholders
about the benefits and best uses of the different AAL /
telehealthcare technologies on offer.
• Capacity building and training / addressing the ‘skills gap’ /
adopting appropriate instruments for accreditation and
certification of competency of involved staff.
• Quality benchmarking, accreditation and certification should
also be extended to systems (hardware and software),
processes and services, in addition to staff, e.g., following the
models of TeleSCoPE (EU code of practice) and Happtique (US
mobile app certification).
In addition to / beyond:
etc.
20. TeleSCoPE - Telehealth Services Code of Practice
for Europe
http://www.telehealthcode.eu/images/stories/telehea/pdf/TELESCOPE_2014_CODE_FINAL_PDF__RELEASE_29_OCT_2013.pdf
21. Currently US only
http://www.happtique.com/docs/HACP_Certification_Standards.pdf
See: Kamel Boulos MN, Brewer AC, Karimkhani C, Buller DB, Dellavalle RP. Mobile medical and health
apps: state of the art, concerns, regulatory control and certification. 2013; Submitted Jul ’13 (under peer
review). Link to published paper will be posted in due course on my social media channels (see last slide).
22. What needs to be considered and done /
desiderata for success
Multiagency coordination / healthcare and social care integration
• The integration of health/care and social care has long been identified as
one of the main deficiencies in some existing AAL / telehealthcare
provisions and one of the reasons for their lacklustre results in some
scenarios (See: CommonWell (a project co-funded by the European
Commission, 2008-2012). Beyond Silos – On the way towards integrated
eCare. http://commonwell.eu/beyond-silos-integrated-ecare/).
• After all, AAL is about enabling and supporting the ‘independent living of
older people’, and using a BAN (Body Area Network) for monitoring (and
acting on) vital and other clinical signs and symptoms, although
extremely useful and important, is just one component of any
comprehensive care solution, and not the full solution.
• Robots (not all of them!) bring in the opportunity of addressing the key
issue of ‘integrating health/care and social care’ in comprehensive
solutions that involve both robotics and conventional telehealthcare
technologies.
23. Robotics
• Robotics can potentially provide AAL with the (often missing) ‘social care
component’:
– by assisting older people, including those with different types of disabilities,
in various activities of daily living and domestic chores, and
– by offering them coaching/motivation, companionship/home visits and
other much needed services.
For a detailed discussion of the topic, including the limitations and potential problems associated
with the use of robots for the care of older people and ways of mitigating them, please consult:
Dahl TS, Kamel Boulos MN. Robots in health and social care: a complementary technology to
home care and telehealthcare? 2013; Submitted Oct ’13 (under peer review). Link to published paper
will be posted on my robotics online “scrapbook of links” at: http://tinyurl.com/mnkb-robots
24. Video games and exergames
• Video games and exergames (e.g., Kinect and GPS), particularly
those with a social component (game community / multiplayer),
can also help in many ways.
The Exergamers Wellness Club uses Kinect for Xbox 360
(dancing titles) to help seniors at the St. Barnabas Senior
Centre in Los Angeles stay fit and have fun.
Kinect game revolutionising rehab for stroke
survivors.
25. What needs to be considered and done /
desiderata for success
•
•
•
•
•
Implementing appropriate technical and interoperability standards,* regulation and
increased bandwidth (infrastructure upgrade). (*Standards ensure joined-up health/care
and social care services, as well as future proof telehealthcare services that
are easily expandable and not dependent on a specific manufacturer.)
Sometimes a simpler solution / basic technology is all what is really needed and will
perform better. Introducing the latest, most sophisticated technology should never be the
goal as such (unless really justified / needed to improve an existing situation that cannot
be dealt with satisfactorily with the existing technology), as it might bring in more trouble
than (any needed) benefit, due to increased complexity and costs.
Consider all the “hidden” costs: staff (training, etc.), technical, infrastructure and site
(implementation environment) modification costs. Running, maintenance and upgrade
costs can all be very high, and should be carefully analysed and considered ahead of any
implementation to ensure long-term sustainable success.
Have ‘Plan B’/some ‘system redundancy’ to ensure reliability and robustness, e.g., the
availability and automatic triggering of proper contingency plans and mechanisms for
services that are remotely operated over the Internet to continue functioning safely when
their main Internet connection with patients is broken for whatever reason.
Transform patients’ data into clinically sound decisions and actions by using ‘intelligent’,
evidence-based software that goes beyond threshold-based, single-parameter triggers and alarms.
26. • Today, one can easily buy very many wireless sensors on the market with their essential
software drivers (for connectivity and data collection from the sensor), and then connect
them to a local hub and remote server, but that (alone) won’t make for a useful
AAL/telehealthcare solution or solve anything serious clinically speaking.
We should be well past this stage in the second decade of the 21st century.
27. ‘Intelligent’, evidence-based software beyond
threshold-based, single-parameter triggers and alarms
• Clinically safe, reliable and ‘intelligent’ (evidence-based) software remains
necessary to reason with the ‘big data’ that are continuously generated: in realworld scenarios we are speaking about 100s (or 1000s) of older people being
monitored by the same service at the same time, so it is indeed big data/
‘infoglut’, and there are also serious issues of liability here, since we are dealing
with human lives, as well as issues of service scalability and sustainability.
• The software has to make those data instantly useful and actable upon for
clinicians (and patients), and has do so in a timely manner, often in real- or nearreal-time, with minimal false positives and false negatives. It also needs to
highlight as early as possible any unfolding clinical events, subtle deterioration or
other relevant developing trends in patient’s condition.
• This ‘intelligent’ software (not to be confused with the essential drivers and basic
sensor connectivity/networking or ‘plumbing’ software) can make a real
difference, but is not as easy to acquire (as the sensors and their basic software)
from the general market or to develop and tune in-house.
• Anyone with the right skills can do system procurement and plumbing, but not
everyone can deliver a useful, safe, reliable, scalable and sustainable service
(note the difference between ‘system’ and ‘service’).
28. “There isn’t too much information, but it is a challenge to
turn that information into understanding” —Larry Smarr
Without the appropriate ‘intelligent’, evidence- and
knowledge-based software to reason with those
data, we risk giving a false (dangerous) reassurance
that everything is being monitored and under
control, while in reality this is not the case!
29. Selected resources
•
•
•
•
David Lindeman: Interview: lessons from a leader in
telehealth diffusion: a conversation with Adam
Darkins of the Veterans Health Administration. Ageing
Int 2011; 36(1): 146-154 –
http://dx.doi.org/10.1007/s12126-010-9079-7 (alt)
Katharina Spitalewsky et al: Potential and
requirements of IT for Ambient Assisted Living
technologies: results of a Delphi study. Methods Inf
Med 2013; 52: 231–238 –
http://dx.doi.org/10.3414/ME12-01-0021
Maged N. Kamel Boulos: Telehealthcare for older
people with comorbidity: lessons from eCAALYX and
project walk-through (2013) http://www.slideshare.net/sl.medic/mnkb-12mar2013aalinnovateuk
Maged N. Kamel Boulos: Telehealthcare promises and
challenges (2009) http://www.slideshare.net/sl.medic/telehealthcarepromises-and-challenges (see also:
http://ecaalyx.org/healthcybermap.org/publications/BoulosInterop3rdME-HIConfBeirutLeb31Mar10.zip)
31. Appendix: Additional notes on cost effectiveness
Cost effectiveness is not always a tiebreaker as such, especially when the
other (more cost effective) options on the table are not viable or
sustainable in the long run (e.g., due to specialised workforce
shortages/increasing demands by consumers).
In some cases, cost effectiveness/ROI might not be immediate or available
in the short term, but might still happen in the long term. Also, sometimes
the less cost-effective option carries with it some unique and compelling
advantages that are not found in other conventional solutions, e.g.,
benefits related to clinical safety and reliability/outcomes or quality of
care, etc., as seen, for example, in telerobotic surgery (da Vinci).
Telehealthcare solutions might be replacing one workforce skills shortage
(healthcare professionals) with another (but perhaps the latter
telehealthcare skills shortages can be more easily addressed).
Telehealthcare solutions might not improve quality of life over/above
other existing options (as reported in a study by Newman et al, 2013 in
BMJ2013;346 doi: http://dx.doi.org/10.1136/bmj.f653), but there might
still be a strong case for their adoption when other factors are considered.