Development Of Healthcare Technology Research Articles

The Application of Digital Media Industry to W. Scotland, N. Ireland, & the Irish Border Health Service Regions

Digital healthcare, that is the application of digital media communication technologies to health issues, for example, in the use of smart devices to tell patients when to take medication, or to relay medical information about concurrent health measures to centralised monitoring systems, presents digital media and health industries with unique interdisciplinary possibilities to research and promote healthy lifestyles while managing illness and health risk. Moreover, digital healthcare technology development for eHealth systems enables regional and national healthcare investment to respond to emerging health and ageing population trends highlighted in the EU task force report ‘Redesigning health in Europe for 2020’ ensuring that all EU citizens have consistent access to a high level of healthcare across the EU, and at a reasonable cost to national healthcare systems. Emerging technology enabled solutions to economies, digital healthcare, or eHealth, has the potential to bring together medical and healthcare professionals, social scientists and public health policy advocates, computational and computer scientists, and digital media platform experts to invest in helping patients and clinicians optimise health management in new resource, cost-efficient, and patient independent-living ways.This short summary will outline and detail sources relevant to the digital healthcare typologies and emerging eHealth development potential in three main EU peripheral regions: Western Scotland, N. Ireland (but not Belfast), and the Republic of Ireland Border (or North East) region. First, current regional specific digital health or eHealth projects and relevant government policy per region will be summarised. Second, health research institute capacity and emerging digital hub companies will be regionally discussed. Third, broadband and telecommunications infrastructure development, and labour market intelligence will be outlined. Fourth, specific media articles, policy documents, web organizational and relevant project addresses, and funding sources per region will be listed. Finally, some conclusions are drawn in light of the regional information sources collated in this report.

Implementation of Extended Kalman Filter for Real-Time Noncontact ECG Signal Acquisition in Android-Based Mobile Monitoring System

Noncontact electrocardiogram (ECG) measurement using capacitive-coupled technique is a very reliable long-term noninvasive health-care remote monitoring system. It can be used continuously without interrupting the daily activities of the user and is one of the most promising developments in health-care technology. However, ECG signal is a very small electric signal. A robust system is needed to separate the clean ECG signal from noise in the measurement environment. Noise may come from many sources around the system, for example, bad contact between the sensor and body, common-mode electrical noise, movement artifacts, and triboelectric effect. Thus, in this paper, the extended Kalman filter (EKF) is applied to denoise a real-time ECG signal in capacitive-coupled sensors. The ECG signal becomes highly stable and noise-free by combining the common analog signal processing and the digital EKF in the processing step. Furthermore, to achieve ubiquitous monitoring, android-based application is developed to process the heart rate in a realtime ECG measurement.

Evaluating methods for engaging children in healthcare technology design

Examples of user involvement can be found throughout healthcare literature. This extends to the design and development of healthcare technology where the involvement of users has been found to positively impact the quality and safety of products. However, there is currently little known about which methods are the most appropriate for involving children in technology development. The research applied and developed a framework to guide the use of methods in the design and development of healthcare technology for upper limb rehabilitation in children with cerebral palsy. Utilising an assessment framework to explore the suitability of four interview methods for involving children in the design and development of healthcare technology, research was carried out in primary schools in the United Kingdom. The research team i) used the assessment framework to guide the collection of information for comparing methods for involving children; ii) considered additional criteria for inclusion in the framework; and iii) gathered observations and data to comment on the criteria in relation to the four interview methods. Children were able to participate in all four interview methods, although further consideration is needed to identify how children with disabilities can be involved in design activities forming part of interview methods. Differences were found between the methods relating to their robustness, reliability, validity, efficiency, enjoyment and cost. The involvement of participants with a disability highlighted the need to develop new methods that support their inclusion in healthcare technology design work. The assessment framework applied in this research was useful to inform the comparison of methods and represents a step towards a more unified approach to understanding how best to capture the perspectives of children to develop technology that meets their needs.

A China-specified Multi-level Technical Infrastructure for Diabetes

This study uses the World Health Organization Innovative Care for Chronic Conditions (ICCC) framework to specify current diabetes prevention and management challenges in China as a basis for design of a technical architectural infrastructure to address gaps and leverage strengths using smart phone technologies as a core element. We acknowledge past theoretically grounded chronic care models as well as systematic literature review of the status of diabetes care in China. We expand the boundaries of pre-existing human and organizational capabilities in the area of diabetes management by creating new and innovative artifacts intended to: (1) help policy makers and technologists understand and contribute to a comprehensive infrastructure to address management of chronic conditions in China and (2) serve as an example of ICCC specification applied to a particular context to facilitate contextual understanding and innovation for healthcare technology development.

National questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability

Objective In the health informatics field, usability studies typically focus on evaluating a single information system and involve a rather small group of end-users. However, little is known about the usability of clinical information and communication technology (ICT) environment in which healthcare professionals work daily. This paper aims at contributing to usability research and user-oriented development of healthcare technologies with three objectives: inform researchers and practitioners about the current state of usability of clinical ICT systems, increase the understanding of usability aspects specific for clinical context, and encourage a more holistic approach on studying usability issues in health informatics field. Methods A national web questionnaire study was conducted in Finland in spring 2010 with 3929 physicians actively working in patient care. For the purposes of the study, we described three dimensions of clinical ICT system usability that reflect the physicians’ viewpoint on system usage: (1) compatibility between clinical ICT systems and physicians’ tasks, (2) ICT support for information exchange, communication and collaboration in clinical work, and (3) interoperability and reliability. The dimensions derive from the definitions of usability and clinical context of use analysis, and reflect the ability of ICT systems to have a positive impact on patient care by supporting physicians in achieving their goals with a pleasant user experience. The research data incorporated 32 statements with a five-point Likert-scale on physicians’ experiences on usability of their currently used ICT systems and a summative question about school grade given to electronic health record (EHR) systems. Results Physicians’ estimates of their EHR systems were very critical. With the rating scale from 4 or fail to 10 or excellent, the average of the grades varied from 6.1 to 8.4 dependent on the kind of facility the physician is working. Questionnaire results indicated several usability problems and deficiencies which considerably hindered the efficiency of clinical ICT use and physician's routine work. Systems lacked the appropriate features to support typical clinical tasks, such as decision making, prevention of medical errors, and review of a patient's treatment chart. The systems also required physicians to perform fixed sequences of steps and tasks, and poorly supported the documentation and retrieval of patient data. The findings on ICT support for collaboration showed mainly negative results, aside from collaboration between co-located physicians. In addition, the study results pointed out physicians suffering from system failures and a lack of integration between the systems. Conclusions The described study and related results are unique in several ways. A national usability study with nearly 4000 respondents had not been conducted in other countries in which healthcare technologies are widely adopted. The questionnaire study provided a generalized picture about the usability problems, however, it should be noted that there were significant differences between legacy systems in use. Previously, researchers had not approached contextual aspects of usability the context of clinical work, where numerous systems are in use. The described usability dimensions and the presented study results can be considered as the first step towards conceptualizing ICT usability in the unique setting of clinical work.

Economic Evaluation With Clinical Trials in Neonatology

With the current economic climate, the budget crisis within the health-care system, and the rapid development of health-care technologies in the field of neonatology, it is essential for decision makers at every level to understand how to interpret published economic evaluations to help guide both practice and budget decisions. The objective of this article is to provide a stepwise approach to interpreting economic evaluations conducted alongside randomized, controlled trials (RCTs). The emphasis in assessing the validity of such an analysis is to ensure that the authors are transparent in their approach with respect to factors such as the intervention and comparator, time horizon, study perspective, sources for costs and effects, appropriate combining of costs and effects into a single metric, and assessment of uncertainty and time preference.

Priority setting for technology adoption at a hospital level: Relevant issues from the literature

The increasing pace of development of healthcare technologies obliges hospitals to increase both the rationality and the accountability of priority setting for technology adoption. This paper aims at identifying which are the relevant issues for technology assessment and selection at a hospital level and at grouping them in a reference framework. An electronic search from January 1990 onwards, covering PubMed, Medline and CILEA, has been carried out in order to collect the relevant contributions. A total of 20 studies were selected from the fields of health policy, management of technology and biomedical engineering. Two main assessment perspectives have been identified and detailed: value generation at a hospital level and level of sustainability in the implementation stage. Four types of investment in technology at a hospital level have been identified combining the perspectives. Moreover, the two perspectives have been deployed in a list of 19 relevant issues that should be reviewed during the budget process. The proposed framework can aid priority setting for technology adoption at a hospital level and contribute to increase both the rationality and the accountability of technology assessment and selection in the budget process.

국내산 나무딸기류 과일의 화학적 특성

본 연구에서는 국내에서 재배되거나 야생의 나무딸기류 20 종류를 수집하여 무게, 수분함량, 과즙의 당도, pH, 산도, pH를 측정하고, 과즙의 당 조성 및 유기산 조성 분석하여 각각의 특성을 검토하였다. 실험에 사용한 나무딸기류 과일의 무게는 0.9～7.8 g이었고, 과일의 수분함량은 82.0～90.3%였다. 나무딸기류 과즙의 당도는 6.9～16.9%(Brix)로 다양하였다. HPLC로 분석한 나무딸기류 과즙의 당은 glucose(총당 함량의 40.7～84.0%(w/w))와 fructose(6.5～57.5%)가 주를 이루고 있었고, 일부 과일에는 sucrose와 xylose도 미량 존재하였다. 과즙의 pH는 2.8～3.9였고, 적정 산도는 0.6～2.9%(w/v, citric acid)였다. 나무딸기류 과즙의 유기산을 HPLC로 분석한 결과, citric acid(총산 함량의 14.6～87.5%(w/w))와 malic acid (9.6～87.1%)가 주를 이루고 있었고, 일부 과일에는 tartaric acid, succinic acid, oxalic acid 등이 함유되어 있었다.

Ethics and Sexual Medicine practice

Ethics is a term used to describe the ways in which we understand the moral life. Morality comprises the norms for human conduct, what is right and what is wrong. As well as standards of conduct, it includes obligations, recommendations, rights and virtues. Some are widely held throughout humanity, such as prohibitions against killing, causing harm to others, stealing and falsehood. Others are specific to the community to which we belong and may not only differ between communities, but what is permitted or even virtuous in one may be forbidden or sinful in another. Many of the moral and ethical concepts surrounding life, death, organ donation, abortion and many other issues have been widely debated. Sexuality and sexual behaviour have been less well-explored, particularly in a wider public arena, because of their particular sensitivity, and their connection to a range of widely-differing socio-cultural and religious mores. In an increasingly complex world, developments in healthcare technology and international communications compel us look very carefully at our assumptions as to what is ethical thought and action, the essence of “doing right” and “not doing wrong”. It is all too easy to for us to universalise our own worldview and to make moral and ethical judgements about the beliefs and actions of others with a differing moral and ethical system, even though their system is just as firmly based in their different worldview. Although the world's major religious and socio-cultural traditions have far more in common than they have to divide them, there is no “universal” system of morality and ethics. Health professionals, as citizens of the world, must reflect on that fact and respect (even if they must disagree) with the sincerely-held views of others; this has implications for their practice, particularly within a multicultural society. The presenter does not attempt to present a “universal” framework of ethics for sexual medicine. Indeed, this is probably an impossible task. However, the presenter will try and identify areas where those from different traditions can agree and increase our understanding of why, in other areas, we cannot agree, and suggest a model that can be used to analyse and document ethical dilemmas in a useful and practical way.

Mapping the integration of social and ethical issues in health technology assessment

Since its inception, the field of health technology assessment (HTA) has stressed the need for consideration of ethical and social issues. However, few concepts or analytic tools have been developed, and because of the complexity of the endeavor and a lack of integration of work already produced, such concepts remain difficult to apply in HTA. Through a descriptive "map" of concepts, tools, and processes, we summarize the most tangible efforts on the part of HTA producers to address social and ethical issues. A literature review and content analysis of HTA reports in the Centre for Reviews and Dissemination database enables a synthesis of the reflections on, initiatives around, and gaps in knowledge related to the integration of social and ethical issues in HTA. We examine: (i) the aim of integrating ethical and social issues in HTA, (ii) the theoretical approaches used, (iii) the methods and processes applied, and (iv) the implications for HTA producers. We highlight two levels at which social and ethical issues can be considered: throughout the production process of HTA reports and as part of the organizational structure of HTA agencies. Given the profound societal changes that occur in relation to healthcare technology development, HTA producers have a responsibility to inform and enlighten technology-related public and policy debates. Fulfilling this role, though, requires that socioethical dimensions of technology and HTA are made explicit.

User involvement in healthcare technology development and assessment

Medical device users are one of the principal medical device technology stakeholders. The involvement of users in medical device technology development and assessment is central to meet their needs. This study aims to examine this issue. A structured review of the literature published from 1980 to 2005 in peer-reviewed journals was carried out from a social science perspective to investigate user involvement practice in the development and assessment of medical device technologies. This was followed by a qualitative thematic analysis. Medical device users include clinicians, patients, carers and others. Different kinds of medical devices are developed and assessed by user involvement. The user involvement occurs at different stages of the medical device technology lifecycle and the degree of user involvement is in the order of: design > testing and trials > deployment > concept stages. The methods most commonly used for capturing users' perspectives are usability tests, interviews and questionnaire surveys. The relevant engineering, medical and nursing literature, which might have been useful, was not reviewed. However, useful findings emerge that apply to health care generally. This study shows that medical device users are not homogeneous but heterogeneous in several aspects, such as needs, skills and working environments. This is an important consideration for incorporating users' perspectives in medical device technologies.

Evaluation of Complementary and Alternative Medicine for Treating Patients with Erectile Dysfunction

From the Department of Urology, Chonbuk National University Medical School, and The Institute for Medical Sciences, and The Research Institute of Clinical Medicine of Chonbuk National University Hospital, The Regional Research Centers Program of the Korean Ministry of Education & Human Resources Development through the Center for Healthcare Technology Development, Jeonju, Seoul National University, The Catholic University of Korea, Korea University, Seoul, Chungnam National University, Daejeon, Inje University, Busan, Chonnam National University Medical School, Gwangju, Pusan National University, Busan, Sungkyunkwan University, Ewha Womens University, Seoul, Ulsan University, Seoul, Korea

The healthcare technologies management program

Developing an engineer's awareness of factors that affect the cost of healthcare technology is discussed. It is concluded that the Healthcare Technologies Management Program offered by Marquette University and the Medical College of Wisconsin is a unique program that meets the unique needs of engineers and their employers. The program prepares new graduate engineers to work in hospitals, medical device companies, and consulting firms, and it provides experienced engineers with the training needed for career advancement. It provides several advantages over graduate business and technical degrees and many benefits to students and their employers. The emphasis of the program can play a role in the reduction of the costs associated with the development of healthcare technology.

Home enteral feeding: II. A health service perspective

Developments in health care technology and rising patient expectations coupled with significant organizationalchanges have led to a dramatic increase in home enteral tube feeding. There are a variety of ways in which such a service can be provided within the existing national funding framework. However, it is not always possible to realize this potential at local level. This paper describes current funding arrangements and some of the constraints thereby generated in service delivery. The drivers for change are identified together with criteria for a patient-focused home enteral tube feeding service. An innovative approach to these challenges has been adopted by one health authority in response to patient needs, staff concerns and clinical governance requirements. The ‘Avon Scheme’ is the result of viring funding from primary to secondary care and concurrently, abandoning the National Health Service prescription route. This has led to economies generated by larger scale purchasing. The savings thus realized have been reinvested in a comprehensive scheme resulting in an equitable approach to service provision, improved patient satisfaction and enhanced clinical care.

Nothing is as constant as change

Considerable change has occurred over the past three decades in the structure of health and social care management. Changes in the pattern of care delivery, training and education of nurses and other professional carers, the introduction of NVQs for health and social care, developments in health-care technology, and changing expectations of society have all played a major role.

The development of health care technology through design and emergence

The mere mention of technology in health care, perhaps more notably than in any other field, evokes extreme reactions. This probably happens because health is such an important, subjective and sensitive issue for everyone. The role of technology is to improve the way we do things. When we set out to develop a certain technology, we ask the right questions and perform the right actions, and consequently we can arrive at a well-defined and reliable technology that has been designed according to our intentions. However, technology is not always created this way. Often, and in health care especially, it emerges through serendipity, maybe from an idea we have about performing a certain action or from realizing that some action or device we are using in a completely different activity might be useful in a new context. On their own both these approaches are suboptimal. The former hardly ever comes up with genuinely creative solutions as it is done in a too rigidly predetermined way. Although the latter might come up with some exciting ideas, if not followed up properly they will never be fully exploited, or if they are they might cause innumerable problems. The ideal way for development is to regard design and emergence not as opposites, but as synergistic complements, which are both essential for development. Emergence must be incorporated into development with formal design procedures at each of its stages, whereas design steps must be applied to all emergent ideas. This latter procedure is of essential importance for the development of health care. However, it is important to be aware of some of the dangers one can experience with this procedure. New processes can be too closely associated with existing processes and open the way for the unwanted transfer of uncertainty between them. This could make the new technologies less than optimal. However, with special care these problems can be eliminated. © 1998 John Wiley & Sons, Ltd.

An inquiry concerning future health care technology: Methods and general results

New and future health care technology has important implications for the delivery and organization of health care. Furthermore, advances in health care technology are increasingly associated with social, ethical, and economic issues. Effective health planning needs to anticipate future health care technology and take into account such implications. This paper concerns an analysis of future health care technology undertaken in the Netherlands. The study involved: (a) the early identification of future developments in health care technology; and (b) prospective assessments of a number of high-priority technologies. The paper concludes that technology forecasting in health care should become an integral part of overall technology assessment activities in industrialized countries.