Dissertations / Theses on the topic 'Patient health interface'

Les services de santé à distance, dans un cadre médical ou de bien-être, sont actuellement en pleine croissance, soulevant de nouveaux challenges. De par l’utilisation d’inter-faces numériques de santé (applications, objets connectés ou sites Internet), ces services s’intègrent de plus en plus dans la vie quoti-dienne des patients, à domicile et sans soutien médical, faisant évoluer l’exercice de consul-tation de leurs données de santé. Ce travail de recherche étudie l’impact émo-tionnel de la consultation de données person-nelles sensibles et vise à améliorer l’expérience-patient dans l’utilisation des interfaces de santé. Une première expérimentation a permis d’éva-luer les réponses émotionnelles à la consultation des données de santé. Les résultats soulèvent des impacts sur le stress perçu, la durée de la consultation et l’activité cardiaque des participants, montrant la nécessité de consi-dérer les émotions dans la conception des outils de santé à distance. Une méthode de conception centrée-patient d’une interface de santé est ensuite proposée. Elle comprend : une comparaison culturelle des outils existants, une enquête sur les expérien-ces et préférences des patients, et une expé-rimentation basée sur un algorithme génétique interactif visant à optimiser le design de l’inter-face pour améliorer la satisfaction-patient. La représentation des données de glycémie sur une application de diabète est utilisée comme un cas d’application. Les résultats soulèvent l’intérêt de l’optimisation des interfaces de santé pour améliorer l’expérience-patient et en-courager des comportements sains. La person-nalisation de ces interfaces pour répondre aux besoins de chacun est aussi suggérée
Remote health services, in a medical or well-being context, are currently growing rapidly, raising new challenges. Through the use of digital health interfaces (apps, connected devices or websites), these services are increa-singly integrated into the daily lives of patients, at home and without medical support, changing the way they consult their health data. This research work investigates the emotional impact of the consultation of sensitive personal data and aims at improving the patient expe-rience in the use of health interfaces. A first experiment assessed emotional res-ponses to the consultation of health data. The results showed the impacts on the perceived stress, the duration of the data consultation and the cardiac activity of the participants, sug-gesting the need to consider emotions in the design of remote health tools. A patient-centered design method of a health interface is then proposed. It includes: a cul-tural comparison of existing tools, a survey on patients' expériences and preferences, and an experiment based on an Interactive Genetic Algorithm optimizing the interface design to im-prove patient satisfaction. The representation of blood sugar data on a diabetes app is used as an application case. The results show the interest of optimizing health interface to im-prove patient experience and encourage heal-thy behaviors. Customization of these interfa-ces to meet individual needs is also suggested

One thousand four hundred and twenty two patients in an Acute General Hospital in Mansfield were studied over a one year period, 1989-90, in order to determine their needs for formal and informal care on discharge. The research method included a screening project for 189 patients on admission, an analysis of 1064 referrals to the Hospital Social Workers, and 169 referrals to the Hospital Discharge Scheme for Volunteer support. Patient/client needs for formal and informal care were found, and unmet needs after Hospital discharge were identified. Problems relating to formal care systems and shortage of Public Sector resources were found to cause serious difficulties for patients and Carers. The availability of Carers and lack of family members in informal care structures was a key issue. The work showed how Volunteers from the Discharge Scheme were able to contribute to the work of formal and informal Carers and ensure that safe Hospital Discharges occurred for very vulnerable people.

In exploring the use of emotional labour among nurses within the nurse/patient relationship, this study employed the conceptual framework of ‘emotional labour’ associated with Arlie Hochschild-as a means of examining the “nature” of the nurse patient interface, including the dynamics, challenges and intricacies that shape this relationship of care. The portrayal of emotional care offered to patients dealing with suffering and illness by nurses as an entirely natural activity for women is related to the devaluation of emotional labour. The focus of this study is how nurses manage their emotional involvement with patients to provide quality services. The study was conducted in Mthatha in the former Transkei in the Eastern Cape Province with nurses who worked St Mary’s Life Group and the Nelson Mandela Academic Hospital. A qualitative research design and qualitative ethnographic research methodology was chosen as suitable for answering the research question. Data was collected using semi-structured interviews and a focus group, and transcribed verbatim. Data analysis included identifying consistent emotional labour themes in the responses. The study’s main findings revealed that emotional labour strategies of surface acting and deep acting were utilised as a means of meeting organisational rules established by management of the two health care institutions that were investigated. Nurses understood that only desirable traits like include friendliness, smiling and proving a calming environment for patients should be exhibited. It was revealed that nurses often used sentimental work and emotion work in performing their tasks as this made their work easier. Lastly, the research revealed that external factors like overcrowding and shortages in personnel, accompanied by the emotional demands on nurses’ work has adverse effect on nurses work environment. The dissertation has contributed to the limited body of knowledge about emotional labour in the South African context and the lived experiences of nurses deploying their labour to patients.

Indiana University-Purdue University Indianapolis (IUPUI)
With the continuous growth of health information on the Internet, providing user-orientated health service online has become a great challenge to health providers. Understanding the information needs of the users is the first step to providing tailored health service. The purpose of this study is to examine the navigation behavior of different user groups by extracting their search terms and to make some suggestions to reconstruct a website for more customized Web service. This study analyzed five months’ of daily access weblog files from one local health provider’s website, discovered the most popular general topics and health related topics, and compared the information search strategies for both patient/consumer and doctor groups. Our findings show that users are not searching health information as much as was thought. The top two health topics which patients are concerned about are children’s health and occupational health. Another topic that both user groups are interested in is medical records. Also, patients and doctors have different search strategies when looking for information on this website. Patients get back to the previous page more often, while doctors usually go to the final page directly and then leave the page without coming back. As a result, some suggestions to redesign and improve the website are discussed; a more intuitive portal and more customized links for both user groups are suggested.

A segurança do paciente e a qualidade da assistência à saúde, no uso de medicamentos, têm sido foco de preocupação e estudos em nível mundial. Os pacientes podem estar especialmente vulneráveis a danos imediatamente após alta hospitalar, e a ocorrência de eventos adversos relacionados a medicamentos pode resultar em atendimento em serviços de urgência ou em readmissão hospitalar. Este estudo teve como objetivo compreender a dinâmica e os desafios do cuidado fornecido ao paciente, pela equipe de saúde do hospital, visando à segurança no processo de uso de medicamentos após alta hospitalar. Foi realizada pesquisa exploratória por meio de entrevistas junto a médicos, enfermeiros, farmacêuticos e assistentes sociais do Hospital Universitário da Universidade de São Paulo. Atualmente, a principal estratégia adotada pelo hospital visando à segurança do paciente, com foco no processo de uso de medicamentos após alta hospitalar, é a orientação de alta ao paciente e/ou cuidador, realizada de forma estruturada, em casos selecionados, principalmente envolvendo pacientes pediátricos. A reconciliação medicamentosa está em fase de implantação na instituição e, em situações específicas, ocorre mobilização da equipe multidisciplinar para viabilização do acesso a medicamentos prescritos na alta hospitalar. Visita domiciliar é desenvolvida junto a pacientes críticos com problemas de locomoção, e não conta com a participação de farmacêuticos. As principais barreiras para implantação, desenvolvimento e ampliação dessas atividades são a falta de recursos humanos e de tecnologias da informação e a necessidade de alterações no procedimento de alta. Entre os fatores facilitadores estão características da equipe, como iniciativa, comprometimento, responsabilidade por resultados e qualificação, além do apoio da alta administração. O desenvolvimento de atividades acadêmicas junto à atenção básica facilita o estabelecimento de pontes entre o hospital e demais serviços de saúde, contribuindo para a transposição da barreira da falta de contato entre as equipes. No entanto, as limitações das atividades desenvolvidas e a falta de articulação adequada para a continuidade do cuidado, com foco no processo de uso de medicamentos, podem comprometer a segurança do paciente na interface entre hospital, atenção básica e domicílio.
Patient safety and quality of health care on medication use have been a central topic of discussion and focused in studies worldwide. Patients can be particularly vulnerable in the period immediately following their discharge from hospital and the occurrence of adverse drug events may require emergency care and hospital readmission. The present study aimed to understand the dynamics and challenges of care provided to patients by hospital providers focusing on safe use of medications after discharge. An exploratory study was conducted. Data was collected through interviews with physicians, nurses, pharmacists and social workers at the Hospital Universitário da Universidade de São Paulo, Brazil. The hospitals current main strategy for safe use of medications after hospital discharge is to provide structured counseling to selected patients and/or their caregivers especially pediatric patients. Medication reconciliation is being implemented and a multidisciplinary team can help ensure access to prescription drugs at discharge in some cases. Home visits are paid to patients with severe conditions and mobility problems but pharmacists are not involved. The main barriers to implementation, development, and expansion of these activities include limited human and information technology resources and changes required to patient discharge procedures. The main facilitators are a skilled team of care providers, committed to improving care and accountable for results and support from senior management. Care provided by students and residents at a primary care setting helps create bridges to integrate hospital care and other care services and overcome the interaction barrier between care teams. However, limited actions and inadequate coordination of follow- up care focused on medication use may compromise patient safety at the interface of hospital, primary care and the home setting.

Introdução: A utilização das ferramentas e instrumentos da informática no processo do atendimento de pacientes auxilia os profissionais da saúde, pois facilita a coleta e armazenamento das informações, proporcionando qualidade no atendimento e criando condições de enfrentamento dos desafios do mundo globalizado. Nesse contexto, a utilização de dados de prontuário eletrônico de pacientes vinculados à pesquisa clínica em um hospital universitário público pode auxiliar no aprimoramento da assistência à saúde, assim como subsidia dados de pesquisas no âmbito da saúde. Objetivos: Identificar e avaliar os registros provenientes de pesquisas clínicas postos nos sistemas coorporativos do Hospital de Clínicas de Porto Alegre (HCPA), no período de 2014 a 2016. Método: A pesquisa utilizou abordagem quantitativa e qualitativa, de análise de conteúdo de referências e de dados provenientes da rede de informação clínica e assistencial através do cruzamento de informações do sistema integrado Aplicativo para Gestão de Hospitais Universitários (AGHU) e pelo Grupo de Pesquisa e Pós-Graduação (GPPG) do Hospital de Clínicas de Porto Alegre, no período entre janeiro de 2014 e dezembro de 2016. Resultados: Entre os projetos, 58,6% encaminharam relatórios de pesquisa, sendo que somente 23,8% possuem registro de participantes de pesquisa. No entanto, apenas 10,3% dentre todos os estudos que indicaram utilizar pacientes no seu protocolo de pesquisa tem concordância de registro entre o GPPG8 e o AGHU. Cerca de 25,6% do total de relatórios de pesquisa encaminhados apresentam informações quanto aos seus produtos de pesquisa. As pesquisas com patrocínio privado demonstraram encaminhar mais relatórios de atualização dos projetos, porém com menor índice na apresentação dos produtos científicos (1,4%). Considerações finais: Potenciais limitações no uso dos registros existentes no AGHU foram identificadas para decisões terapêuticas pela equipe assistencial de maneira geral, tendo em vista a aparente subnotificação de informações relativas ao andamento e desfecho dos estudos desenvolvidos. Entretanto, não foi possível analisar as causas dos registros possivelmente inadequados ou incompletos, sugerindo-se pesquisas específicas com a incorporação de questionários ou entrevistas individuais para permitir maior aprofundamento na temática. Produtos: A pesquisa identificou a necessidade de três produtos derivados do estudo: (1) material explicativo para os pesquisadores informando a necessidade do registro apropriado dos participantes no sistema coorporativo; (2) modelo de relatório de pesquisa para encerramento de projeto, disponibilizado pelo GPPG, em formato online para pesquisadores responsáveis pelo projeto de pesquisa; e (3) sugestão de melhoria das informações disponibilizadas pela aba “Projetos de Pesquisa” no prontuário online dos pacientes que estão vinculados a projetos de pesquisa, informando os potenciais resultados de pesquisas envolvidas com estes à área assistencial.
Introduction: Using informatics tools on the medical care process for patients helps health professionals, makes easier to collect and to storage information, as well as exchange this information among professionals and institutions, offering quality of care and creating conditions to face challenges in a globalized world. In this context, using electronic medical records data of patients enrolled on clinical trials in a public hospital may help improving health care, as well as provide research health data. Objectives: To identify and evaluate records from clinical trials registered on corporative systems from Hospital de Clinicas de Porto Alegre (HCPA), from 2014 to 2016. Method: The research used quantitative and qualitative approach, analyzing references content and data from the network for clinical data, crossing information from Aplicativo para Gestão de Hospitais Universitários (AGHU) and Grupo de Pesquisa e Pós-Graduação (GPPG) of HCPA, from 2014 and 2016. Results: Among the projects 58,6% forwarded research reports, but just 23,8% with record of research participants. However, only 10,3% of studies that report participants enrolled in study protocol matched records in GPPG8 and AGHU. About 25,6% of total research reports informed research products. Researches with private sponsor showed more update reports, but with lower presentations of scientific products (1,4%). Final considerations: Potential limitations on using existent records on AGHU were identified for therapeutic decisions by clinical team in general, with apparent underreporting of information relate to development and closure for studies developed. However was not possible to analyze causes for possibly inaccurate or incomplete records, suggesting specific research with individual questionnaires or interviews in order to allow deepening the understanding on the theme. Products: The research identify the need for three product from the study: (1) a explicative material to researchers, informing an appropriate participant’s registration on the corporative system; (2) a model of research report for project termination, available on GPPG, online, to lead researchers in research projects; and (3) improvement suggestion on information available by “research projects” tab on the online medical records for patients enroll in research projects, informing potential results associated to medical care area.

The Emergency department at Södersjukhuset currently suffers from very long waiting times. This is partly due to problems within visualisation and mapping of patient data and other information that is fundamental in the handling of patients at the Emergency department. This led to a need in the creation of improvement suggestions to the visualisation of the patient flow between the Emergency department and the Gastroenterology department at Södersjukhuset. During the project, a simulated graphical user interface was created with the purpose of mimicking Södersjukhusets current patient flow. This simulated user interface would visualise the patient flow between the Emergency department and the Gastroenterology department. Additionally, a patient symptoms estimation algorithm was implemented to guess the likelihood of a patient being admitted to a department. The result shows that there are many possible improvements to Södersjukhusets current hospital information system, TakeCare, that would facilitate the care coordinators work and in turn lower the waiting times at the Emergency department.
Akutmottagningen på Södersjukhuset har i dagsläget väldigt långa väntetider. Detta beror till viss del utav problem inom visualiseringen och kartläggning av patient data och annan fundamental information för att hantera patienter på akutmottagningen. Detta ledde till att det finns ett behov att skapa förbättringsförslag på visualiseringen av patientflödet mellan akutmottagningen och gastroenterologiavdelningen på Södersjukhuset. Under projektets gång skapades ett simulerat användargränssnitt med syfte att efterlikna Södersjukhusets nuvarande patientflöde. Denna lösning visualiserar patientflödet mellan akutmottagningen och gastroenterologiavdelningen. Dessutom implementerades en enkel sorteringsalgoritm som kan bedöma sannolikheten om en patient skall bli inlagd på en avdelning. Resultatet visar att det finns flera möjliga förbättringar i Södersjukhusets nuvarande elektroniska journalsystemet, TakeCare, som skulle underlätta vårdkoordinatorernas arbete och därmed sänka väntetiderna på akutmottagningen.

As the bulk of medical health records shift from paper-based file systems to electronic formats, the promise of the transformation process called healthcare reform included adding efficiencies to medical practice workflows, lower costs, improved quality of care and most important, and the freeing of patient information from traditional propriety silos. With this incoming largess of protected health information data now viewable through online patient portals, patients can be empowered to become educated and active in their own health care decisions, but only if they have admission to their information. A digital divide currently exists in many medical practices where only a very few patients have access to their personal health information. The primary goal was to facilitate organizational change needed for physician-managed practices to increase patient adoption and meaningful use of patient portals for secure communication, wellness education, review of labs and other tests, and receipt of clinical summaries. The methodology utilized the appreciative inquiry 4-D model as the underlying basis of three phases: Phase 1-fundamental study, Phase 2-strategic action plan, and Phase 3 supporting organizational change. The physicians or providers in independent medical practices are the key determinate of the organizational workflows. The results have added significantly to the understanding of organizational change as related to patient engagement and the adoption and meaningful use of patient portals in independent physician-managed clinics. As medical practices and their physician leaders raise patient portal workflow processes to a higher level of importance, it is expected that patients will begin to adopt these procedures as their preferred methods and bring about a change in the patient-provider relationship.

The process of patient care relies on clinical data spread across specialized hospital departments. Powerful software is being designed to assimilate this disconnected patient data before treatment can be decided. However, these data are often presented to clinicians on interfaces that do not fit clinical workflows, leading to poor operational efficiency and increased patient safety risks. This project relies on ethnographic design methods to create evidence of clinician preferences pertaining to the presentation and collection of information on user interfaces in patient rooms. Using data gathered in clinical observation, a prototype interface was designed to enable doctors to conduct clinical tasks through a usable patient room interface. The prototype evaluation with doctors identified clinical tasks that are relevant in the patient room and provided insight into the perceived usability of such an interface. The evaluation sessions also elucidated on issues of patient-centeredness in technology design, effortless authentication and interface customizability.

>Magister Scientiae - MSc
The purpose of this thesis is to discuss the development of a web application from scratch. It serves to build a health management information system from basic principles and covers all the software engineering activities starting from the gathering of requirements, evaluating these and eventually implementing a health management information system by applying several iterations of the Agile-extreme-programming-software-engineering approach to develop a Health Management System for the Kabul University Poly-clinic located at Kabul University campus in order to computerize clerical activities at the hospital. Questionnaires were used to uncover the clerical problems experienced by the hospital sta . Attempts to address these problems by designing and im- plementing software and re ne the software after some iterations of feedback- redesign-and-implementation following the guidelines of Agile extreme pro- gramming. The previous Health management systems at the hospital were paper based. The new computerized system has eased the burdens of tracking the les of patients at the hospital, leading to easier and more e cient access to information by the health-care professionals at the hospital. An assessment of the impact this has had on the medical and clerical sta and the smoother administration of the hospital by repeated user acceptance testing by means of questionnaires con rms the success of the project.

The recent trend toward patients participating in their own healthcare has opened up numerous opportunities for computing research. This dissertation focuses on how technology can foster this participation, through user interfaces to effectively communicate personal health status and care progress to hospital patients. I first characterize the design space for electronic information communication to patients through field studies conducted in multiple hospital settings. These studies utilize a combination of survey instruments, and low- and high-fidelity prototypes, including a document-editing prototype through which users can view and manage clinical data to automatically associate it with progress notes. The prototype, activeNotes, includes the first known techniques supporting clinical information requests directly within a document editor. A usage study with ICU physicians at New York-Presbyterian Hospital (NYP) substantiated our design and revealed how electronic information related to patient status and care progress is derived from a typical Electronic Health Record system. Insights gained from this study informed following studies to understand how to design abstracted, plain-language views suitable for patients. We gauged both patient and physician responses to information display prototypes deployed in patient rooms for a formative study exploring their design. Following my reports on this study, I discuss the design, development and pilot evaluations of a prototype Personal Health Record application providing live, abstracted clinical information for patients at NYP. The portal, evaluated by cardiothoracic surgery patients, is the first of its kind to allow patients to capture and monitor live data related to their care. Patient use of the portal influenced the subsequent design of tools to support users in making sense of online medication information. These tools, designed with nurses and pharmacists and evaluated by cardiothoracic surgery patients at NYP, were developed using topic modeling approaches and text analysis techniques. Embodied in a prototype called Remedy, they enable rapid filtering and comparison of medication-related search results, based on a number of website features and content topics. I conclude by discussing how findings from this series of studies can help shape the ongoing design and development of patient-centered technology.

South Africa is home to a wide range of cross border migrants and the provision of healthcare to this segment of the South African population has been a topical issue in different forums. There are reports that some cross border migrants are denied access to healthcare despite the existence of legislation that allows them certain rights to public healthcare in South Africa and it is against this backdrop that this research is premised. The research focused on understanding the dynamics of the interaction between frontline healthcare personnel and migrant patients at an inner city public health facility in Johannesburg and used the concepts of street level bureaucracy, access to healthcare and interface analysis in guiding the research and conceptualising the data. Participant and non participant observation, interviews, focus group discussions and conversations were employed to gain insight into the nature of interaction between frontline staff and cross border migrants. The findings suggest that documents are not a requisite for cross border migrants to access healthcare and the decisions made by frontline healthcare personnel are influenced by working conditions, frustrations, attitudes of staff and language and cultural differences between the frontline staff and cross border migrants. The study concluded that while the different behaviour patterns of the frontline staff impact on the degree of fit between cross border migrants and the public health system outright denial of access to healthcare for cross border migrants by frontline staff is not common.

碩士
國立雲林科技大學
視覺傳達設計系
105
Taiwan is a high-prevalence area of Hepatitis B infection,the prevalence rate of chronic hepatitis B virus in adults is 15% to 20%. In recent years, for the innovation of mobile application, medical system has converted from “eHealth”, which operated by Management Information System, into “mHealth” with more in-depth self-management and customization. Moreover, there is a growing number of people start using health management APP for self-monitoring their health in order to improve qualities in health and lifestyle. This study focused on patients with Hepatits B as main research objects to assist researcher for the process of interface design of self-management aiding APP by using User Experience Innovation Design (UXID). In addition, this study contained three stages: (1) The first phase analyzed the demands of users by using semi-structured interview,open-ended questionnaire and persona. (2)In the second phase, the focus group method is used to design concept and APP interface sketch, and the interface sketch is plotted on the computer as the initial interface prototype, and heuristic evaluation is carried out with the expert. (3) In the third phase, the results of the heuristic evaluation were modified and the usability of the APP interface was tested with six hepatitis B patients. The consequence of study included: This study selected mobile users aged between 21 to 49 as main user group for user analysis. Also, features including medicines management, virus recording, reminder of outpatient clinic revisit and knowledge center about Hepatits B had been proposed by focused group method. Lastly, the APP structure and Graphical User Interface were consequently completed. The consequence of study included: (1) Through the first phase of the user needs survey, the study developed three user roles, the main groups of the user is for men aged 40 to 49,the minor groups of the user is for 30 to 39-year-old female and 50 to 59-year-old male minor groups. The needs of the user are divided into disease needs, medication needs and living needs. (2) Through the development of focus groups and the heuristic assessment of experts, The APP of this study is named the B liver saver. The main functions are three parts, Respectively, B liver calendar, B liver management and liver new knowledge. (3) After the usability test, most users believe that the function of the APP can help them to self-health management. And for the interface usability, users felt this APP is easy to use and learn

Indiana University-Purdue University Indianapolis (IUPUI)
Identifying spatial and temporal patterns of disease occurrence by mapping the residential locations of affected people can provide information that informs response by public health practitioners and improves understanding in epidemiological research. A common method of locating patients at the individual level is geocoding residential addresses stored in electronic medical records (EMRs) using address matching procedures in a geographic information system (GIS). While the process of geocoding is becoming more common in public health studies, few researchers take the time to examine the effects of using different address databases on match rate and positional accuracy of the geocoded results. This research examined and compared accuracy and match rate resulting from four commonly-used geocoding databases applied to sample of 59,341 subjects residing in and around Marion County/ Indianapolis, IN. The results are intended to inform researchers on the benefits and downsides to their selection of a database to geocode patient addresses in EMRs.