Inter-organisatoriske problemstillinger knyttet til etablering og drift av velferdsteknologi, telemedisin og responssenter tjenester. Prosjekt: Modell for Alarmmottak, M4ALMO Delrapport 3 – 2017

Denne rapporten er en sluttrapport fra FoU-prosjektet M4ALMO og gir en oppsummering av erfa-ringsinnhenting gjennom en serie workshops som er avholdt med representanter for brukere og tjenestene i de 10 kommunene som har deltatt in prosjektet. Det belyses viktige deler av prosedy-rer og samarbeid mellom de kommunale pleie- og omsorgstjenester og responssenter tjenester som organiseres på interkommunal basis. Det er viktig med strukturert informasjonsflyt og god sammenheng i tjenestetilbudet. Rutiner for kvalitetssikring av tjenestene må innarbeides. Det er utarbeidet forslag til prosedyrer for behovskartlegging og vedtak om teknologiske tiltak, der også involvering av pårørende og frivillig…

A Case Study of the Technology Use and Information Flow at a Hospital-driven Telemedicine Service

Health care services face the challenge of providing individualised treatment to a growing ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study health care services that are run with a patient-centred teamwork approach. In this context, a case study was made of a hospital-driven telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge, with a focus on information flow and technology use. The methods used were observation and interviews with key informants. The results showed that the technology was perceived as well-functioning for telemedicine support, b…

Infrastructure and Procedure for Simulation of Cardiac Remote Monitoring: Experiences from the Telemedicine Agder Project

Telemedicine are remote electronic clinical consultations using technology for delivery of health care services. Telemedicine can be offered as a service to citizens living at home with an aim of reducing the number of hospital visits or visits to the General Practitioner and improving longterm cost-effectiveness. In Norway, a recent health reform has caused municipalities to re-organize their design of health services, with an increased use of telemedicine. In this context, the “Telemedicine Agder” project focuses on the organization, implementation and operation of large scale telemedicine services. In the project, a simulation of a telemedicine service for monitoring of heart failure was…

Usability Evaluation of a COPD Remote Monitoring Application

- Telemedicine applications have the potential to enhance patient’s safety at home by remote monitoring of chronic diseases. Telemedicine involves the interaction between multiple user groups through a system, making the usability aspect of such system crucial for the continuous, efficient and satisfactory use of the application. The main objective of this study was to carry out a usability evaluation in the field of a telemedicine application for remote monitoring of chronic obstructive pulmonary disease (COPD) patients to improve the application’s user interface before system deployment. A field trial was performed with six COPD patients at their homes, continuously using the system’s app…

User Evaluation of a Smartphone Application for Anticoagulation Therapy

Anticoagulation therapy with Warfarin is used for specific cardiovascular diseases to control the ability of blood clotting. Traditional ways of selfmanagement therapy are based on paper forms and procedures. This paper presents an evaluation of the smartphone application Warfarin Guide, a computer-assisted decision-support system used to help patients in their management of anticoagulation therapy related to International Normalized Ratio (INR) values. The evaluation consisted of a usability test with 4 participants and a field test with 14 participants who used the application at home during four months. A mixed methods research approach included quantitative and qualitative analysis of t…

Telemedicine follow up of Chronic Obstructive Pulmonary Disease Integrated into a Patient-centered Health Care Team Setting- Impacts on Patient Empowerment and Safety

Nivå1

An Evaluation of Telemedicine Systems in Patient-centred Care Teams

Patient Experiences and Digital Involvement in Patient-centred Care Models

The provision of individualised treatment and care from health care services to patients with chronic conditions and multi-morbidities is under pressure because of an increasing elderly population. There is a need for services that are: 1) person-centred, 2) integrated and 3) proactive, and supported by digital technology. The research project 3P- Patients and Professionals in Productive Teams aims to study different patient-centred teamwork models in Norway and Denmark. This paper presents a study on patients’ experiences and digital involvement in patient-centred care teams. Qualitative research methods were applied with interviews and demonstrations of technology use made at patient’s ho…

Innovative Simulation of Health Care Services in the Usability Laboratory: Experiences from the Model for Telecare Alarm Services-project

In Norway, a recent health reform urged municipalities to prepare for telecare alarm services to handle alarms associated to welfare technology and telecare technology in citizens’ homes. That requires a re-organisation of health and social services in many municipalities and several are preparing to establish new telecare alarm services operated in inter-municipal response centres. In this context, the research project “Model for Telecare Alarm Services” aims to study how existing telecare alarm services in Norwegian municipalities are organised and operated, and identify critical factors when designing new models for future services. This paper presents how an innovative simulation of hea…

The Technology Use and Information Flow at a Municipal Telemedicine Service

Health care services face challenges with providing individualised treatment to an ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study patient-centred teamwork service models. This paper presents an evaluation of a telemedicine service for chronic obstructive pulmonary disease patients integrated with municipal health care services. Qualitative methods were used to study the technology use and information flow. The results showed that the telemedicine technology was a standalone system, not integrated with the electronic health record of the municipality. A benefit of the system was a function…

Evaluation of a Telemedicine Service Run with a Patient-centred Care Model

The number of patients with chronic conditions and multi-morbidities is increasing, addressing a need for patient-centred care. The research project Patients and Professionals in Productive Teams aims to study patient-centred teamwork for this patient group. This paper presents an evaluation of a telemedicine service for chronic obstructive pulmonary disease patients run with a patient-centred care model. Observations and interviews were made to study the technology use and information flow. The results showed that the technology worked well in a patient-centred care perspective, even though the system was a standalone system for telemedicine services. The information in the system was only…

User-Centered Design of a COPD Remote Monitoring Application Experiences from the EU-project United4Health

- Recent health reforms in Norway have produced changes at all levels of the health sector, bringing to light a need for technology solutions explicitly designed for enhancing end-user collaboration. Telemedicine technology can support in this context new services that enable communication across local borders, optimizing resources and increasing cost effectiveness. This study focuses on the user-centered design, iterative development and evaluation of the user interface of a mobile application for a new telemedicine service for remote monitoring of chronic obstructive pulmonary disease patients. The tablet device application was developed based on information gathered in a workshop and gro…

Responssentertjenester i helse og omsorgstjenesten: behov og fremtidsbilder. Delrapport 1- 2016 fra prosjektet M4ALMO

- Rapporten er en delleveranse fra RFF-prosjektet "M4ALMO - Modeller for alarmmottak". Rapporten sammenfatter funn og dokumentere kunnskap som er utviklet gjennom en serie workshops i prosjektet avholdt høsten 2015 og våren 2016. Målet har vært å kartlegge dagens utfordringer, fange ulike synspunkter og identifisere målbilder for fremtidens alarmmottak og organisering, samt diskutere nye mulige løsninger for organisering av responssentertjenester. Bidragsytere har vært representanter fra prosjektets kommunepartnere Skien, Larvik, Drammen, Oslo, Grimstad, Kristiansand, Risør og Kvinesdal på vegne av Lister-kommunene; leverandører av responssentertjenester SOS International og Telenor Object/…

User-Centered Design of a National Medical Registry for Tick-Borne Diseases

Tick-borne diseases are increasing in a global perspective, with Lyme disease and tick-borne encephalitis as the most frequent. The Norwegian National Ad-visory Unit on Tick-borne Diseases is preparing the development of a national medical registry for clinical follow-up of patients with tick-borne diseases based on the best practice guidelines and for research purposes. This paper presents the methodological approach of a user-centered design process applied in the in-itial phase of the registry development. A user workshop identified user needs, requirements and proposed a service workflow for the registry operation. As the next step, a simulation of the proposed service workflow was perf…

Integrating Telemedicine Solutions with Electronic Health Records; Evaluation of Alternatives based on the Proposed Reference Architecture for Norway

This report studies the way forward for how a telemedicine solution can be integrated for exchange of data with an existing Electronic Health Record (EHR) system. The solution used an example for this report is based on a telemedicine solution for COPD patients (Chronic Obstructive Pulmonary Disease) developed in the project “Collaborative Point-of-Care Services Agder: Follow-up of COPD patients as part of the United4Health EU Project», with financial support from the Research Council of Norway. In addition, the EHR solution from DIPS ASA is used as an example of an existing system for integration. Important parameters for choosing way forward on how to are: • urgency with regards to timeli…

Infrastructure for Health Care Simulation: Recommendations from the Model for Telecare Alarm Services Project

Nivå1

Point of Care Solutions: Implementation of Sustainable Service Models

Nivå1 Nivå1

Recommendations on a Test Infrastructure for Evaluation of Touchscreen Assistive Technology for Visually Impaired Users

Published version of a paper from the 13th Scandinavian Conference on Health Informatics, Tromsø Mobile technologies’ touchscreen allows the use of choreography of gestures to interact with the user interface. Relevant aspects in mobile technology design become crucial when targeting users with disabilities. For instance, when assistive technology is designed to support speech interaction between visually impaired users and a system, accessibility and ease-of-use of such technology should be included in the usability and technical evaluation of their effectiveness. This paper presents the analysis of the technical and physical infrastructure of a controlled laboratory environment for user e…

Warfarin Guide: Co-design of a Mobile Computer-Assisted Anticoagulant Therapy

Patients with some types of cardiovascular disease are prescribed anticoagulation therapy with Warfarin in order to control the ability of blood clotting. This work presents a co-designed mobile application, called Warfarin Guide, for a computer-assisted anticoagulant therapy. The application addresses the challenges that unexperienced patients may find when having to remember to regularly check their INR values and make temporary adjustments for INR value fluctuations that are not easy to interpret without direct medical advice. nivå1

Evaluation of the Technology Use in an Inter-disciplinary Patient-centered Health Care Team

Decentralizing the Holter service through improved primary-secondary care collaboration