Abstract
While several studies have shown how telemedicine and, in particular, home telemonitoring programs lead to an improvement in the patient’s quality of life, a reduction in hospitalizations, and lower healthcare costs, different variables may affect telemonitoring effectiveness and purposes. In the present paper, an integrated software system, based on Sentiment Analysis and Text Mining, to deliver, collect, and analyze questionnaire responses in telemonitoring programs is presented. The system was designed to be a complement to home telemonitoring programs with the objective of investigating the paired relationship between opinions and the adherence scores of patients and their changes through time. The novel contributions of the system are: (i) the design and software prototype for the management of online questionnaires over time; and (ii) an analysis pipeline that leverages a sentiment polarity score by using it as a numerical feature for the integration and the evaluation of open-ended questions in clinical questionnaires. The software pipeline was initially validated with a case-study application to discuss the plausibility of the existence of a directed relationship between a score representing the opinion polarity of patients about telemedicine, and their adherence score, which measures how well patients follow the telehomecare program. In this case-study, 169 online surveys sent by 38 patients enrolled in a home telemonitoring program provided by the Cystic Fibrosis Unit at the “Bambino Gesù” Children’s Hospital in Rome, Italy, were collected and analyzed. The experimental results show that, under a Granger-causality perspective, a predictive relationship may exist between the considered variables. If supported, these preliminary results may have many possible implications of practical relevance, for instance the early detection of poor adherence in patients to enable the application of personalized and targeted actions.
Highlights
The survey instrument and the analysis pipeline were applied to a real case study related to the remote follow-up of patients with cystic fibrosis, held in collaboration with the Cystic Fibrosis Unit, at Children’s Hospital “Bambino Gesù”, Rome, Italy
The main goal of the proposed system is to present a methodology to capture the underlying opinions that chronic patients have about the program they are enrolled in and to investigate whether these features may help in the early prediction of patient drop-out from the telemedicine program
The design of a self-hosted web-based survey instrument built on top of LimeSurvey for the management of online inquiries over time; an analysis pipeline that exploits sentiment analysis techniques to infer a sentiment polarity score for each open-ended answer and uses it as a numerical feature; and the validation of both the survey instrument and the analysis pipeline, which were applied to collect and analyze 169 Telemedicine Drop-Out (TDO) survey responses sent by 38 patients enrolled in a home telemonitoring program provided by the Cystic Fibrosis Unit at the “Bambino Gesu” Children
Summary
Telemedicine can be defined as the set of health services providing medical care in patients’ daily living environment, which is possible thanks to the support of information and telecommunication technologies [1].Common goals of telemedicine programs are substantially threefold [2,3,4]: Information 2020, 11, 550; doi:10.3390/info11120550 www.mdpi.com/journal/information to increase self-management skills for patients whether they have a chronic condition or, for instance, during recovery or a rehabilitation phase after surgery or in the follow-up after a long time hospitalization and during the treatment for depression and other mental health conditions; to improve patient surveillance and medication adherence by remote monitoring of their health status; and to reduce healthcare costs by optimizing the doctor’s work by reducing the number of accesses to the emergency room and reducing the average of hospital admissions per patient.A subfield of telemedicine is telehomecare, or home telemonitoring, which enables the rapid exchange of information between health systems and patients. Telemedicine can be defined as the set of health services providing medical care in patients’ daily living environment, which is possible thanks to the support of information and telecommunication technologies [1]. Patients enrolled in a telehomecare program are provided with bio-monitoring devices and Internet reporting systems installed in their daily living environment. The devices can be used to autonomously measure vital signals, related to the specific condition of the patient. These measurements are transmitted and evaluated by health professionals (physicians and nurses) who will subsequently re-contact patients via phone call or message to check their symptoms and, eventually, provide an early medical response
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