ORCID Profile
0000-0003-1616-2170
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Organisational, Interpersonal and Intercultural Communication | Bioethics (human and animal) | Ethical Use of New Technology (e.g. Nanotechnology, Biotechnology) | Library and Information Studies | Sociology | Health Informatics | Clinical Nursing: Secondary (Acute Care) | Sociology and Social Studies of Science and Technology |
ANZSRC Socio-Economic Objective (SEO)
Expanding Knowledge through Studies of Human Society | Social Structure and Health | Bioethics | Communication Across Languages and Culture | Expanding Knowledge in the Medical and Health Sciences | Expanding Knowledge in Technology
Related Links
Publications
Artificial Intelligence Education for the Health Workforce: Expert Survey of Approaches and Needs (Preprint)
Publisher: JMIR Publications Inc.
Date: 25-11-2021
Abstract: he preparation of the current and future health workforce for the possibility of using artificial intelligence (AI) in health care is a growing concern as AI applications emerge in various care settings and specializations. At present, there is no obvious consensus among educators about what needs to be learned or how this learning may be supported or assessed. ur study aims to explore health care education experts’ ideas and plans for preparing the health workforce to work with AI and identify critical gaps in curriculum and educational resources across a national health care system. survey canvassed expert views on AI education for the health workforce in terms of educational strategies, subject matter priorities, meaningful learning activities, desired attitudes, and skills. A total of 39 senior people from different health workforce subgroups across Australia provided ratings and free-text responses in late 2020. he responses highlighted the importance of education on ethical implications, suitability of large data sets for use in AI clinical applications, principles of machine learning, and specific diagnosis and treatment applications of AI as well as alterations to cognitive load during clinical work and the interaction between humans and machines in clinical settings. Respondents also outlined barriers to implementation, such as lack of governance structures and processes, resource constraints, and cultural adjustment. urther work around the world of the kind reported in this survey can assist educators and education authorities who are responsible for preparing the health workforce to minimize the risks and realize the benefits of implementing AI in health care.
Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review
Publisher: JMIR Publications Inc.
Date: 04-05-2022
DOI: 10.2196/30405
Abstract: The adoption of electronic health records (EHRs) and electronic medical records (EMRs) has been slow in the mental health context, partly because of concerns regarding the collection of sensitive information, the standardization of mental health data, and the risk of negatively affecting therapeutic relationships. However, EHRs and EMRs are increasingly viewed as critical to improving information practices such as the documentation, use, and sharing of information and, more broadly, the quality of care provided. This paper aims to undertake a scoping review to explore the impact of EHRs on information practices in mental health contexts and also explore how sensitive information, data standardization, and therapeutic relationships are managed when using EHRs in mental health contexts. We considered a scoping review to be the most appropriate method for this review because of the relatively recent uptake of EHRs in mental health contexts. A comprehensive search of electronic databases was conducted with no date restrictions for articles that described the use of EHRs, EMRs, or associated systems in the mental health context. One of the authors reviewed all full texts, with 2 other authors each screening half of the full-text articles. The fourth author mediated the disagreements. Data regarding study characteristics were charted. A narrative and thematic synthesis approach was taken to analyze the included studies’ results and address the research questions. The final review included 40 articles. The included studies were highly heterogeneous with a variety of study designs, objectives, and settings. Several themes and subthemes were identified that explored the impact of EHRs on information practices in the mental health context. EHRs improved the amount of information documented compared with paper. However, mental health–related information was regularly missing from EHRs, especially sensitive information. EHRs introduced more standardized and formalized documentation practices that raised issues because of the focus on narrative information in the mental health context. EHRs were found to disrupt information workflows in the mental health context, especially when they did not include appropriate templates or care plans. Usability issues also contributed to workflow concerns. Managing the documentation of sensitive information in EHRs was problematic clinicians sometimes watered down sensitive information or chose to keep it in separate records. Concerningly, the included studies rarely involved service user perspectives. Furthermore, many studies provided limited information on the functionality or technical specifications of the EHR being used. We identified several areas in which work is needed to ensure that EHRs benefit clinicians and service users in the mental health context. As EHRs are increasingly considered critical for modern health systems, health care decision-makers should consider how EHRs can better reflect the complexity and sensitivity of information practices and workflows in the mental health context.
Patient-Reported Outcome Measures of Utilizing Person-Generated Health Data in the Case of Simulated Stroke Rehabilitation: Development Method (Preprint)
Publisher: JMIR Publications Inc.
Date: 29-10-2019
Abstract: erson-generated health data (PGHD) are health data that people generate, record, and analyze for themselves. Although the health benefits of PGHD use have been reported, there is no systematic way for patients to measure and report the health effects they experience from using their PGHD. Patient-reported outcome measures (PROMs) allow patients to systematically self-report their outcomes of a health care service. They generate first-hand evidence of the impact of health care services and are able to reflect the real-world ersity of actual patients and management approaches. Therefore, this paper argues that a PROM of utilizing PGHD, or PROM-PGHD, is necessary to help build evidence-based practice in clinical work with PGHD. his paper aims to describe a method for developing PROMs for people who are using PGHD in conjunction with their clinical care— i PROM-PGHD /i , and the method is illustrated through a case study. he five-step qualitative item review (QIR) method was augmented to guide the development of a PROM-PGHD. However, using QIR as a guide to develop a PROM-PGHD requires additional socio-technical consideration of the PGHD and the health technologies from which they are produced. Therefore, the QIR method is augmented for developing a PROM-PGHD, resulting in the PROM-PGHD development method. worked ex le was used to illustrate how the PROM-PGHD development method may be used systematically to develop PROMs applicable across a range of PGHD technology types used in relation to various health conditions. his paper describes and illustrates a method for developing a PROM-PGHD, which may be applied to many different cases of health conditions and technology categories. When applied to other cases of health conditions and technology categories, the method could have broad relevance for evidence-based practice in clinical work with PGHD.
Internet Protocol Television for Personalized Home-Based Health Information: Design-Based Research on a Diabetes Education System
Publisher: JMIR Publications Inc.
Date: 10-03-2014
DOI: 10.2196/RESPROT.3201
Person-Generated Health Data in Simulated Rehabilitation Using Kinect for Stroke: Literature Review
Publisher: JMIR Publications Inc.
Date: 08-05-2018
DOI: 10.2196/REHAB.9123
Digital Health Interventions in Physiotherapy: Development of Client and Health Care Provider Survey Instruments
Publisher: JMIR Publications Inc.
Date: 28-07-2021
DOI: 10.2196/25177
Abstract: The advancement of digital health has widened the scope of technology use across multiple frontiers of health care services, including personalized therapeutics, mobile health, eHealth record management, and telehealth consultations. The World Health Organization (WHO) responded to this in 2018 by publishing an inaugural broad classification framework of digital health interventions (DHIs) used to address contemporary health system needs. This study aims to describe the systematic development of dual survey instruments (clinician and patient) to support data collection, administered in a physiotherapy setting, about perceptions toward DHIs. This is achieved by adapting the WHO framework classification for DHIs for application in real-world research. Using a qualitative item review approach, WHO DHI descriptors were adapted and refined systematically to be used in a survey form. This approach was designed to align with the processes of delivering and receiving care in clinical practice, using musculoskeletal physiotherapy as a practical case scenario. Complementary survey instruments (for health care providers and clients) were developed by adapting descriptor items. These instruments will be used in a larger study exploring the willingness of physiotherapists and patients to use digital technologies in the management of musculoskeletal conditions. This study builds on the WHO-standardized DHI framework. We developed dual novel survey instruments by adapting and refining the functions of DHIs. These may be deployed to explore the perceived usefulness and application of DHIs for different clinical care functions. Researchers may wish to use these survey instruments to examine digital health use systematically in a variety of clinical fields or technology scenarios in a way that is standardized and generalizable.
Resolving Neuroscience Questions Using Ontologies and Templates
Publisher: Springer International Publishing
Date: 2020
Person-Generated Health Data in Simulated Rehabilitation Using Kinect for Stroke: Literature Review (Preprint)
Publisher: JMIR Publications Inc.
Date: 13-10-2017
Abstract: erson- or patient-generated health data (PGHD) are health, wellness, and clinical data that people generate, record, and analyze for themselves. There is potential for PGHD to improve the efficiency and effectiveness of simulated rehabilitation technologies for stroke. Simulated rehabilitation is a type of telerehabilitation that uses computer technologies and interfaces to allow the real-time simulation of rehabilitation activities or a rehabilitation environment. A leading technology for simulated rehabilitation is Microsoft’s Kinect, a video-based technology that uses infrared to track a user’s body movements. his review attempts to understand to what extent Kinect-based stroke rehabilitation systems (K-SRS) have used PGHD and to what benefit. he review is conducted in two parts. In part 1, aspects of relevance for PGHD were searched for in existing systematic reviews on K-SRS. The following databases were searched: IEEE Xplore, Association of Computing Machinery Digital Library, PubMed, Biomed Central, Cochrane Library, and C bell Collaboration. In part 2, original research papers that presented or used K-SRS were reviewed in terms of (1) types of PGHD, (2) patient access to PGHD, (3) PGHD use, and (4) effects of PGHD use. The search was conducted in the same databases as part 1 except Cochrane and C bell Collaboration. Reference lists on K-SRS of the reviews found in part 1 were also included in the search for part 2. There was no date restriction. The search was closed in June 2017. The quality of the papers was not assessed, as it was not deemed critical to understanding PGHD access and use in studies that used K-SRS. n part 1, 192 papers were identified, and after assessment only 3 papers were included. Part 1 showed that previous reviews focused on technical effectiveness of K-SRS with some attention on clinical effectiveness. None of those reviews reported on home-based implementation or PGHD use. In part 2, 163 papers were identified and after assessment, 41 papers were included. Part 2 showed that there is a gap in understanding how PGHD use may affect patients using K-SRS and a lack of patient participation in the design of such systems. his paper calls specifically for further studies of K-SRS—and for studies of technologies that allow patients to generate their own health data in general—to pay more attention to how patients’ own use of their data may influence their care processes and outcomes. Future studies that trial the effectiveness of K-SRS outside the clinic should also explore how patients and carers use PGHD in home rehabilitation programs.
Quality Assurance of Health Wearables Data: Participatory Workshop on Barriers, Solutions, and Expectations
Publisher: JMIR Publications Inc.
Date: 22-01-2020
DOI: 10.2196/15329
Abstract: The ubiquity of health wearables and the consequent production of patient-generated health data (PGHD) are rapidly escalating. However, the utilization of PGHD in routine clinical practices is still low because of data quality issues. There is no agreed approach to PGHD quality assurance therefore, realizing the promise of PGHD requires in-depth discussion among erse stakeholders to identify the data quality assurance challenges they face and understand their needs for PGHD quality assurance. This paper reports findings from a workshop aimed to explore stakeholders’ data quality challenges, identify their needs and expectations, and offer practical solutions. A qualitative multi-stakeholder workshop was conducted as a half-day event on the c us of an Australian University located in a major health care precinct, namely the Melbourne Parkville Precinct. The 18 participants had experience of PGHD use in clinical care, including people who identified as health care consumers, clinical care providers, wearables suppliers, and health information specialists. Data collection was done by facilitators capturing written notes of the proceedings as attendees engaged in participatory design activities in written and oral formats, using a range of whole-group and small-group interactive methods. The collected data were analyzed thematically, using deductive and inductive coding. The participants’ discussions revealed a range of technical, behavioral, operational, and organizational challenges surrounding PGHD, from the time when data are collected by patients to the time data are used by health care providers for clinical decision making. PGHD stakeholders found consensus on training and engagement needs, continuous collaboration among stakeholders, and development of technical and policy standards to assure PGHD quality. Assuring PGHD quality is a complex process that requires the contribution of all PGHD stakeholders. The variety and depth of inputs in our workshop highlighted the importance of co-designing guidance for PGHD quality guidance.
Health information work - a scoping review protocol
Publisher: PeerJ
Date: 14-02-2019
DOI: 10.7287/PEERJ.PREPRINTS.27535V1
Abstract: Background: The work of managing health data, health information or health knowledge is a vital, yet unacknowledged, function in our current health system. This protocol is for a literature review which explores the evolution and development of the concept of health information work. Methodology: A scoping review of published literature in the domains of health sciences, information technology and information sciences has been carried out. A thematic and bibliometric analysis of the resulting set of publications is currently being undertaken. Results: The review results will shed light on the responsibilities and the contribution of the health information workforce, with a synthesis of themes identified in the literature, and analysis of publication year spans, prominent authors, institutions and source journals.
Health information work - a scoping review protocol
Publisher: PeerJ
Date: 15-02-2019
DOI: 10.7287/PEERJ.PREPRINTS.27535V2
Abstract: Background: The work of managing health data, health information or health knowledge is a vital, yet unacknowledged, function in our current health system. This protocol is for a literature review which explores the evolution and development of the concept of health information work. Methodology: A scoping review of published literature in the domains of health sciences, information technology and information sciences has been carried out. A thematic and bibliometric analysis of the resulting set of publications is currently being undertaken. Results: The review results will shed light on the responsibilities and the contribution of the health information workforce, with a synthesis of themes identified in the literature, and analysis of publication year spans, prominent authors, institutions and source journals.
Hospital Bring-Your-Own-Device Security Challenges and Solutions: Systematic Review of Gray Literature (Preprint)
Publisher: JMIR Publications Inc.
Date: 09-02-2020
Abstract: s familiarity with and convenience of using personal devices in hospitals help improve the productivity, efficiency, and workflow of hospital staff, the health care bring-your-own-device (BYOD) market is growing consistently. However, security concerns owing to the lack of control over the personal mobile devices of staff, which may contain sensitive data such as personal health information of patients, make it one of the biggest health care information technology (IT) challenges for hospital administrations. iven that the hospital BYOD security has not been adequately addressed in peer-reviewed literature, the aim of this paper was to identify key security challenges associated with hospital BYOD usage as well as relevant solutions that can cater to the identified issues by reviewing gray literature. Therefore, this research will provide additional practical insights from current BYOD practices. comprehensive gray literature review was conducted, which followed the stepwise guidelines and quality assessment criteria set out by Garousi et al. The searched literature included tier 1 sources such as health care cybersecurity market reports, white papers, guidelines, policies, and frameworks as well as tier 2 sources such as credible and reputed health IT magazines, databases, and news articles. Moreover, a deductive thematic analysis was conducted to organize the findings based on Schlarman’s People Policy Technology model, promoting a holistic understanding of hospitals’ BYOD security issues and solutions. total of 51 sources were found to match the designed eligibility criteria. From these studies, several sociotechnical issues were identified. The major challenges identified were the use of devices with insufficient security controls by hospital staff, lack of control or visibility for the management to maintain security requirements, lack of awareness among hospital staff, lack of direction or guidance for BYOD usage, poor user experience, maintenance of legal requirements, shortage of cybersecurity skills, and loss of devices. Although technologies such as mobile device management, unified endpoint management, containerization, and virtual private network allow better BYOD security management in hospitals, policies and people management measures such as strong security culture and staff awareness and training improve staff commitment in protecting hospital data. he findings suggest that to optimize BYOD security management in hospitals, all 3 dimensions of the security process (people, policy, and technology) need to be given equal emphasis. As the nature of cybersecurity attacks is becoming more complex, all dimensions should work in close alignment with each other. This means that with the modernization of BYOD technology, BYOD strategy, governance, education, and relevant policies and procedures also need to adapt accordingly.
Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit
Publisher: Springer Science and Business Media LLC
Date: 28-09-2021
DOI: 10.1186/S12913-021-07033-8
Abstract: Efforts to ensure safe and optimal medication management are crucial in reducing the prevalence of medication errors. The aim of this study was to determine the associations of person-related, environment-related and communication-related factors on the severity of medication errors occurring in two health services. A retrospective clinical audit of medication errors was undertaken over an 18-month period at two Australian health services comprising 16 hospitals. Descriptive statistical analysis, and univariate and multivariable regression analysis were undertaken. There were 11,540 medication errors reported to the online facility of both health services. Medication errors caused by doctors (Odds Ratio (OR) 0.690, 95% CI 0.618–0.771), or by pharmacists (OR 0.327, 95% CI 0.267–0.401), or by patients or families (OR 0.641, 95% CI 0.472–0.870) compared to those caused by nurses or midwives were significantly associated with reduced odds of possibly or probably harmful medication errors. The presence of double-checking of medication orders compared to single-checking (OR 0.905, 95% CI 0.826–0.991) was significantly associated with reduced odds of possibly or probably harmful medication errors. The presence of electronic systems for prescribing (OR 0.580, 95% CI 0.480–0.705) and dispensing (OR 0.350, 95% CI 0.199–0.618) were significantly associated with reduced odds of possibly or probably harmful medication errors compared to the absence of these systems. Conversely, insufficient counselling of patients (OR 3.511, 95% CI 2.512–4.908), movement across transitions of care (OR 1.461, 95% CI 1.190–1.793), presence of interruptions (OR 1.432, 95% CI 1.012–2.027), presence of covering personnel (OR 1.490, 95% 1.113–1.995), misread or unread orders (OR 2.411, 95% CI 2.162–2.690), informal bedside conversations (OR 1.221, 95% CI 1.085–1.373), and problems with clinical handovers (OR 1.559, 95% CI 1.136–2.139) were associated with increased odds of medication errors causing possible or probable harm. Patients or families were involved in the detection of 1100 (9.5%) medication errors. Patients and families need to be engaged in discussions about medications, and health professionals need to provide teachable opportunities during bedside conversations, admission and discharge consultations, and medication administration activities. Patient counselling needs to be more targeted in effort to reduce medication errors associated with possible or probable harm.
Digital Health and Professional Identity in Australian Health Libraries: Evidence from the 2018 Australian Health Information Workforce Census
Publisher: University of Alberta Libraries
Date: 12-03-2020
DOI: 10.18438/EBLIP29640
Abstract: Abstract Objective – This research aimed to examine the characteristics of the current health library professional workforce in Australia. The study also sought to explore the areas of health library competency domains and job functions that may reflect progress toward a specialized digital health information capability. Methods – Health librarians’ responses to the May 2018 Australian Health Information Workforce Census were analysed and compared with results obtained in earlier census counts. The health librarian characteristics were also compared with other health information occupations included in the Census. Results – There were 238 usable health librarian responses. These indicate that the health librarian workforce continues to be a comparatively mature population, with substantial experience, increasing involvement in data- and technology-intensive functions, high levels of professional association membership, and participation in continuing education activities. Notably there are emerging role titles and job functions which point to a greater digital health focus in the changing work realm. Conclusion – The health librarian workforce has adapted its skills, in line with the increased digital emphasis in health information work. However, as with other health information occupational groups, it is possible that health system planners and funders are not aware of librarians’ current functions and skills. This mature workforce may undergo significant attrition and consequent loss of expertise in the next decade. Continued advocacy and strategic planning around these factors with workforce, healthcare quality, and educational organizations will be required.
Factors in the development of clinical informatics competence in early career health sciences professionals in Australia: a qualitative study
Publisher: Springer Science and Business Media LLC
Date: 11-06-2010
DOI: 10.1007/S10459-010-9238-3
Abstract: This paper reports on a qualitative study investigating how Australian health professionals may be developing and deploying essential clinical informatics capabilities in the first 5 years of their professional practice. It explores the experiences of four professionals in applying what they have learned formally and informally during their university education and during workplace learning and training. This study is based on a broad review of the literature on clinical informatics education and training its findings support international analyses and suggest that new strategic efforts among stakeholders in the healthcare system are required to make progress in building workforce capacity in this field, in Australia and elsewhere.
Digital Health Interventions in Physiotherapy: Development of Client and Health Care Provider Survey Instruments (Preprint)
Publisher: JMIR Publications Inc.
Date: 20-10-2020
Abstract: he advancement of digital health has widened the scope of technology use across multiple frontiers of health care services, including personalized therapeutics, mobile health, eHealth record management, and telehealth consultations. The World Health Organization (WHO) responded to this in 2018 by publishing an inaugural broad classification framework of digital health interventions (DHIs) used to address contemporary health system needs. his study aims to describe the systematic development of dual survey instruments (clinician and patient) to support data collection, administered in a physiotherapy setting, about perceptions toward DHIs. This is achieved by adapting the WHO framework classification for DHIs for application in real-world research. sing a qualitative item review approach, WHO DHI descriptors were adapted and refined systematically to be used in a survey form. This approach was designed to align with the processes of delivering and receiving care in clinical practice, using musculoskeletal physiotherapy as a practical case scenario. omplementary survey instruments (for health care providers and clients) were developed by adapting descriptor items. These instruments will be used in a larger study exploring the willingness of physiotherapists and patients to use digital technologies in the management of musculoskeletal conditions. his study builds on the WHO-standardized DHI framework. We developed dual novel survey instruments by adapting and refining the functions of DHIs. These may be deployed to explore the perceived usefulness and application of DHIs for different clinical care functions. Researchers may wish to use these survey instruments to examine digital health use systematically in a variety of clinical fields or technology scenarios in a way that is standardized and generalizable. >
Quality Assurance of Health Wearables Data: Participatory Workshop on Barriers, Solutions, and Expectations (Preprint)
Publisher: JMIR Publications Inc.
Date: 07-2019
Abstract: he ubiquity of health wearables and the consequent production of patient-generated health data (PGHD) are rapidly escalating. However, the utilization of PGHD in routine clinical practices is still low because of data quality issues. There is no agreed approach to PGHD quality assurance therefore, realizing the promise of PGHD requires in-depth discussion among erse stakeholders to identify the data quality assurance challenges they face and understand their needs for PGHD quality assurance. his paper reports findings from a workshop aimed to explore stakeholders’ data quality challenges, identify their needs and expectations, and offer practical solutions. qualitative multi-stakeholder workshop was conducted as a half-day event on the c us of an Australian University located in a major health care precinct, namely the Melbourne Parkville Precinct. The 18 participants had experience of PGHD use in clinical care, including people who identified as health care consumers, clinical care providers, wearables suppliers, and health information specialists. Data collection was done by facilitators capturing written notes of the proceedings as attendees engaged in participatory design activities in written and oral formats, using a range of whole-group and small-group interactive methods. The collected data were analyzed thematically, using deductive and inductive coding. he participants’ discussions revealed a range of technical, behavioral, operational, and organizational challenges surrounding PGHD, from the time when data are collected by patients to the time data are used by health care providers for clinical decision making. PGHD stakeholders found consensus on training and engagement needs, continuous collaboration among stakeholders, and development of technical and policy standards to assure PGHD quality. ssuring PGHD quality is a complex process that requires the contribution of all PGHD stakeholders. The variety and depth of inputs in our workshop highlighted the importance of co-designing guidance for PGHD quality guidance.
The Rapid Development of Virtual Care Tools in Response to COVID-19: Case Studies in Three Australian Health Services
Publisher: JMIR Publications Inc.
Date: 06-04-2022
DOI: 10.2196/32619
Abstract: News of the impact of COVID-19 around the world delivered a brief opportunity for Australian health services to plan new ways of delivering care to large numbers of people while maintaining staff safety through greater physical separation. The rapid pivot to telemedicine and virtual care provided immediate and longer term benefits however, such rapid-cycle development also created risks. The aim of this study was to understand the sociotechnical aspects of the rapid-cycle development of seven different COVID-19 virtual care tools, and to identify enablers, barriers, and risks at three health services in Victoria, Australia. A qualitative, embedded, multiple case study design was adopted. Researchers from three health services collaborated with university researchers who were independent from those health services to gather and analyze structured interview data from key people involved in either clinical or technical aspects of designing and deploying seven different virtual care tools. The overall objectives of each health service reflected the international requirements for managing large numbers of patients safely but remotely and for protecting staff. However, the governance, digital maturity, and specific use cases at each institution shaped the methodology and specific outcomes required. Dependence on key in iduals and their domain knowledge within an existing governance framework generally enabled rapid deployment, but sometimes posed barriers. Existing relationships with technical service developers enabled strong solutions, which in some cases were highly scalable. Conventional project methodologies such as steering committees, scope, budget control, tight functional specification, consumer engagement and codesign, universal accessibility, and postimplementation evaluation were ignored almost universally in this environment. These three health services took a variety of approaches to the rapid-cycle development of virtual care tools to meet their urgent needs for triaging and remote monitoring during the first year of the COVID-19 pandemic. Their experiences provided insights into many social and technical barriers and enablers to the development of virtual care tools. If these are addressed proactively, they will improve clinical governance and technical management of future virtual care. Some changes can be made within in idual health services, while others entail health system policy reforms. Enhancing the environment for virtual care tool design and implementation now will yield returns not only during future health emergencies but also in many more routine care settings.
Using Social Media While Waiting in Pain: A Clinical 12-Week Longitudinal Pilot Study
Publisher: JMIR Publications Inc.
Date: 07-08-2015
DOI: 10.2196/RESPROT.4621
Biomedical Informatics Methods for Personalized Medicine and Participatory Health
Publisher: Elsevier
Date: 2014
Patient-Reported Outcomes and Therapeutic Affordances of Social Media: Findings From a Global Online Survey of People With Chronic Pain
Publisher: JMIR Publications Inc.
Date: 22-01-2015
DOI: 10.2196/JMIR.3915
How Frauds in Times of Crisis Target People
Publisher: Informa UK Limited
Date: 02-03-2202
Health outcomes and related effects of using social media in chronic disease management: A literature review and analysis of affordances
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.JBI.2013.04.010
Abstract: Whilst the future for social media in chronic disease management appears to be optimistic, there is limited concrete evidence indicating whether and how social media use significantly improves patient outcomes. This review examines the health outcomes and related effects of using social media, while also exploring the unique affordances underpinning these effects. Few studies have investigated social media's potential in chronic disease, but those we found indicate impact on health status and other effects are positive, with none indicating adverse events. Benefits have been reported for psychosocial management via the ability to foster support and share information however, there is less evidence of benefits for physical condition management. We found that studies covered a very limited range of social media platforms and that there is an ongoing propensity towards reporting investigations of earlier social platforms, such as online support groups (OSG), discussion forums and message boards. Finally, it is hypothesized that for social media to form a more meaningful part of effective chronic disease management, interventions need to be tailored to the in idualized needs of sufferers. The particular affordances of social media that appear salient in this regard from analysis of the literature include: identity, flexibility, structure, narration and adaptation. This review suggests further research of high methodological quality is required to investigate the affordances of social media and how these can best serve chronic disease sufferers. Evidence-based practice (EBP) using social media may then be considered.
Telemedicine for Gestational Diabetes Mellitus (TeleGDM): A Mixed-Method Study Protocol of Effects of a Web-Based GDM Support System on Health Service Utilization, Maternal and Fetal Outcomes, Costs,
Publisher: JMIR Publications Inc.
Date: 09-08-2016
DOI: 10.2196/RESPROT.6044
Development and Validation of a Taxonomy for Characterizing Measurements in Health Self-Quantification
Publisher: JMIR Publications Inc.
Date: 03-11-2017
DOI: 10.2196/JMIR.6903
Patient-Reported Outcome Measures of Utilizing Person-Generated Health Data in the Case of Simulated Stroke Rehabilitation: Development Method
Publisher: JMIR Publications Inc.
Date: 07-05-2020
DOI: 10.2196/16827
Abstract: Person-generated health data (PGHD) are health data that people generate, record, and analyze for themselves. Although the health benefits of PGHD use have been reported, there is no systematic way for patients to measure and report the health effects they experience from using their PGHD. Patient-reported outcome measures (PROMs) allow patients to systematically self-report their outcomes of a health care service. They generate first-hand evidence of the impact of health care services and are able to reflect the real-world ersity of actual patients and management approaches. Therefore, this paper argues that a PROM of utilizing PGHD, or PROM-PGHD, is necessary to help build evidence-based practice in clinical work with PGHD. This paper aims to describe a method for developing PROMs for people who are using PGHD in conjunction with their clinical care—PROM-PGHD, and the method is illustrated through a case study. The five-step qualitative item review (QIR) method was augmented to guide the development of a PROM-PGHD. However, using QIR as a guide to develop a PROM-PGHD requires additional socio-technical consideration of the PGHD and the health technologies from which they are produced. Therefore, the QIR method is augmented for developing a PROM-PGHD, resulting in the PROM-PGHD development method. A worked ex le was used to illustrate how the PROM-PGHD development method may be used systematically to develop PROMs applicable across a range of PGHD technology types used in relation to various health conditions. This paper describes and illustrates a method for developing a PROM-PGHD, which may be applied to many different cases of health conditions and technology categories. When applied to other cases of health conditions and technology categories, the method could have broad relevance for evidence-based practice in clinical work with PGHD.
Recommendations for the Quality Management of Patient-Generated Health Data in Remote Patient Monitoring: Mixed Methods Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 23-12-2021
Abstract: atient-generated health data (PGHD) collected from innovative wearables are enabling health care to shift to outside clinical settings through remote patient monitoring (RPM) initiatives. However, PGHD are collected continuously under the patient’s responsibility in rapidly changing circumstances during the patient’s daily life. This poses risks to the quality of PGHD and, in turn, reduces their trustworthiness and fitness for use in clinical practice. sing a sociotechnical health informatics lens, we developed a data quality management (DQM) guideline for PGHD captured from wearable devices used in RPM with the objective of investigating how DQM principles can be applied to ensure that PGHD can reliably inform clinical decision-making in RPM. irst, clinicians, health information specialists, and MedTech industry representatives with experience in RPM were interviewed to identify DQM challenges. Second, these stakeholder groups were joined by patient representatives in a workshop to co-design potential solutions to meet the expectations of all the stakeholders. Third, the findings, along with the literature and policy review results, were interpreted to construct a guideline. Finally, we validated the guideline through a Delphi survey of international health informatics and health information management experts. he guideline constructed in this study comprised 19 recommendations across 7 aspects of DQM. It explicitly addressed the needs of patients and clinicians but implied that there must be collaboration among all stakeholders to meet these needs. he increasing proliferation of PGHD from wearables in RPM requires a systematic approach to DQM so that these data can be reliably used in clinical care. The developed guideline is an important next step toward safe RPM.
Designing a mobile app to assess real-world listening difficulties: a qualitative study of consumer perspectives (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-03-2023
Abstract: here is scope to improve clinical care for people with hearing loss, empowering these consumers and supporting shared decision making and problem solving with their audiologists, by enabling in iduals to collect their own hearing data in their personal real-world settings. Previous research has indicated clinician receptivity to this approach. o explore consumer perspectives regarding their listening difficulties and the potential of using a mobile app for documenting listening difficulties in real-world environments. hree focus groups involved 27 adults who self-reported hearing impairment. Most were fitted with hearing devices. A facilitator used a topic guide to generate discussion, which was video- and audio-recorded. Verbatim transcriptions were analysed using inductive content analysis. onsumers supported the concept of a mobile app which would facilitate real-time self-assessment and tracking of listening difficulties in real-world situations. Consumers provided information about early or missed indicators of listening difficulties and prompts for seeking hearing device fitting, as well as descriptions of their listening difficulties, the factors which made listening difficult, and the impacts and consequences of their difficulties. Consumers desired a flexible, visual-based app that provided options for data collection and entry and that could be tailored for use in the listening situations important to the in idual. hese findings provide design directions for prototyping and piloting a mobile app to provide data that is useful for increasing both the user’s and their clinician’s understanding of the in idual’s difficulties. /a
Recommendations for the Quality Management of Patient-Generated Health Data in Remote Patient Monitoring: Mixed Methods Study
Publisher: JMIR Publications Inc.
Date: 24-02-2023
DOI: 10.2196/35917
Abstract: Patient-generated health data (PGHD) collected from innovative wearables are enabling health care to shift to outside clinical settings through remote patient monitoring (RPM) initiatives. However, PGHD are collected continuously under the patient’s responsibility in rapidly changing circumstances during the patient’s daily life. This poses risks to the quality of PGHD and, in turn, reduces their trustworthiness and fitness for use in clinical practice. Using a sociotechnical health informatics lens, we developed a data quality management (DQM) guideline for PGHD captured from wearable devices used in RPM with the objective of investigating how DQM principles can be applied to ensure that PGHD can reliably inform clinical decision-making in RPM. First, clinicians, health information specialists, and MedTech industry representatives with experience in RPM were interviewed to identify DQM challenges. Second, these stakeholder groups were joined by patient representatives in a workshop to co-design potential solutions to meet the expectations of all the stakeholders. Third, the findings, along with the literature and policy review results, were interpreted to construct a guideline. Finally, we validated the guideline through a Delphi survey of international health informatics and health information management experts. The guideline constructed in this study comprised 19 recommendations across 7 aspects of DQM. It explicitly addressed the needs of patients and clinicians but implied that there must be collaboration among all stakeholders to meet these needs. The increasing proliferation of PGHD from wearables in RPM requires a systematic approach to DQM so that these data can be reliably used in clinical care. The developed guideline is an important next step toward safe RPM.
Participatory Methods to Engage Health Service Users in the Development of Electronic Health Resources: Systematic Review (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-07-2018
Abstract: hen health service providers (HSP) plan to develop electronic health (eHealth) resources for health service users (HSU), the latter’s involvement is essential. Typically, however, HSP, HSU, and technology developers engaged to produce the resources lack expertise in participatory design methodologies suited to the eHealth context. Furthermore, it can be difficult to identify an established method to use, or determine how to work stepwise through any particular process. e sought to summarize the evidence about participatory methods and frameworks used to engage HSU in the development of eHealth resources from the beginning of the design process. e searched for studies reporting participatory processes in initial development of eHealth resources from 2006 to 2016 in 9 bibliographic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Emcare, Cochrane Library, Web of Science, ACM Guide to Computing Literature, and IEEE Xplore. From 15,117 records initially screened on title and abstract for relevance to eHealth and early participatory design, 603 studies were assessed for eligibility on full text. The remaining 90 studies were rated by 2 reviewers using the Mixed Methods Appraisal Tool Version 2011 (Pluye et al MMAT) and analyzed with respect to health area, purpose, technology type, and country of study. The 30 studies scoring 90% or higher on MMAT were included in a detailed qualitative synthesis. f the 90 MMAT-rated studies, the highest reported (1) health areas were cancer and mental disorders, (2) eHealth technologies were websites and mobile apps, (3) targeted populations were youth and women, and (4) countries of study were the United States, the United Kingdom, and the Netherlands. Of the top 30 studies the highest reported participatory frameworks were User-Centered Design, Participatory Action Research Framework, and the Center for eHealth Research and Disease Management (CeHRes) Roadmap, and the highest reported model underpinning development and engagement was Social Cognitive Theory. Of the 30 studies, 4 reported on all the 5 stages of the CeHRes Roadmap. he top 30 studies yielded 24 participatory frameworks. Many studies referred to using participatory design methods without reference to a framework. The application of a structured framework such as the CeHRes Roadmap and a model such as Social Cognitive Theory creates a foundation for a well-designed eHealth initiative that ensures clarity and enables replication across participatory design projects. The framework and model need to be clearly articulated and address issues that include resource availability, responsiveness to change, and the criteria for good practice. This review creates an information resource for future eHealth developers, to guide the design of their eHealth resource with a framework that can support further evaluation and development. ROSPERO CRD42017053838 www.crd.york.ac.uk rospero/display_record.php?RecordID=53838
Electronic health records for integrated mental health care: protocol for a scoping review
Publisher: Informa UK Limited
Date: 25-09-2021
Enabling Better Use of Person-Generated Health Data in Stroke Rehabilitation Systems: Systematic Development of Design Heuristics
Publisher: JMIR Publications Inc.
Date: 28-07-2020
DOI: 10.2196/17132
Abstract: An established and well-known method for usability assessment of various human-computer interaction technologies is called heuristic evaluation (HE). HE has been adopted for evaluations in a wide variety of specialized contexts and with objectives that go beyond usability. A set of heuristics to evaluate how health information technologies (HITs) incorporate features that enable effective patient use of person-generated health data (PGHD) is needed in an era where there is a growing demand and variety of PGHD-enabled technologies in health care and where a number of remote patient-monitoring technologies do not yet enable patient use of PGHD. Such a set of heuristics would improve the likelihood of positive effects from patients’ use of PGHD and lower the risk of negative effects. This study aims to describe the development of a set of heuristics for the design and evaluation of how well remote patient therapeutic technologies enable patients to use PGHD (PGHD enablement). We used the case of Kinect-based stroke rehabilitation systems (K-SRS) in this study. The development of a set of heuristics to enable better use of PGHD was primarily guided by the R3C methodology. Closer inspection of the methodology reveals that neither its development nor its application to a case study were described in detail. Thus, where relevant, each step was grounded through best practice activities in the literature and by using Nielsen’s heuristics as a basis for determining the new set of heuristics. As such, this study builds on the R3C methodology, and the implementation of a mixed process is intended to result in a robust and credible set of heuristics. A total of 8 new heuristics for PGHD enablement in K-SRS were created. A systematic and detailed process was applied in each step of heuristic development, which bridged the gaps described earlier. It is hoped that this would aid future developers of specialized heuristics, who could apply the detailed process of heuristic development for other domains of technology, and additionally for the case of PGHD enablement for other health conditions. The R3C methodology was also augmented through the use of qualitative studies with target users and domain experts, and it is intended to result in a robust and credible set of heuristics, before validation and refinement. This study is the first to develop a new set of specialized heuristics to evaluate how HITs incorporate features that enable effective patient use of PGHD, with K-SRS as a key case study. In addition, it is the first to describe how the identification of initial HIT features and concepts to enable PGHD could lead to the development of a specialized set of heuristics.
Rapid Design and Delivery of an Experience-Based Co-designed Mobile App to Support the Mental Health Needs of Health Care Workers Affected by the COVID-19 Pandemic: Impact Evaluation Protocol
Publisher: JMIR Publications Inc.
Date: 09-03-2021
DOI: 10.2196/26168
Abstract: The COVID-19 pandemic has highlighted the importance of health care workers’ mental health and well-being for the successful function of the health care system. Few targeted digital tools exist to support the mental health of hospital-based health care workers, and none of them appear to have been led and co-designed by health care workers. RMHive is being led and developed by health care workers using experience-based co-design (EBCD) processes as a mobile app to support the mental health challenges posed by the COVID-19 pandemic to health care workers. We present a protocol for the impact evaluation for the rapid design and delivery of the RMHive mobile app. The impact evaluation will adopt a mixed methods design. Qualitative data from photo interviews undertaken with up to 30 health care workers and semistructured interviews conducted with up to 30 governance stakeholders will be integrated with qualitative and quantitative user analytics data and user-generated demographic and mental health data entered into the app. Analyses will address three evaluation questions related to engagement with the mobile app, implementation and integration of the app, and the impact of the app on in idual mental health outcomes. The design and development will be described using the Mobile Health Evidence Reporting and Assessment guidelines. Implementation of the app will be evaluated using normalization process theory to analyze qualitative data from interviews combined with text and video analysis from the semistructured interviews. Mental health impacts will be assessed using the total score of the 4-item Patient Health Questionnaire (PHQ4) and subscale scores for the 2-item Patient Health Questionnaire for depression and the 2-item Generalized Anxiety Scale for anxiety. The PHQ4 will be completed at baseline and at 14 and 28 days. The anticipated average use period of the app is 30 days. The rapid design will occur over four months using EBCD to collect qualitative data and develop app content. The impact evaluation will monitor outcome data for up to 12 weeks following hospital-wide release of the minimal viable product release. The study received funding and ethics approvals in June 2020. Outcome data is expected to be available in March 2021, and the impact evaluation is expected to be published mid-2021. The impact evaluation will examine the rapid design, development, and implementation of the RMHive app and its impact on mental health outcomes for health care workers. Findings from the impact evaluation will provide guidance for the integration of EBCD in rapid design and implementation processes. The evaluation will also inform future development and rollout of the app to support the mental health needs of hospital-based health care workers more widely. DERR1-10.2196/26168
Enabling Better Use of Person-Generated Health Data in Stroke Rehabilitation Systems: Systematic Development of Design Heuristics (Preprint)
Publisher: JMIR Publications Inc.
Date: 20-11-2019
Abstract: n established and well-known method for usability assessment of various human-computer interaction technologies is called heuristic evaluation (HE). HE has been adopted for evaluations in a wide variety of specialized contexts and with objectives that go beyond usability. A set of heuristics to evaluate how health information technologies (HITs) incorporate features that enable effective patient use of person-generated health data (PGHD) is needed in an era where there is a growing demand and variety of PGHD-enabled technologies in health care and where a number of remote patient-monitoring technologies do not yet enable patient use of PGHD. Such a set of heuristics would improve the likelihood of positive effects from patients’ use of PGHD and lower the risk of negative effects. his study aims to describe the development of a set of heuristics for the design and evaluation of how well remote patient therapeutic technologies enable patients to use PGHD (PGHD enablement). We used the case of Kinect-based stroke rehabilitation systems (K-SRS) in this study. he development of a set of heuristics to enable better use of PGHD was primarily guided by the R3C methodology. Closer inspection of the methodology reveals that neither its development nor its application to a case study were described in detail. Thus, where relevant, each step was grounded through best practice activities in the literature and by using Nielsen’s heuristics as a basis for determining the new set of heuristics. As such, this study builds on the R3C methodology, and the implementation of a mixed process is intended to result in a robust and credible set of heuristics. total of 8 new heuristics for PGHD enablement in K-SRS were created. A systematic and detailed process was applied in each step of heuristic development, which bridged the gaps described earlier. It is hoped that this would aid future developers of specialized heuristics, who could apply the detailed process of heuristic development for other domains of technology, and additionally for the case of PGHD enablement for other health conditions. The R3C methodology was also augmented through the use of qualitative studies with target users and domain experts, and it is intended to result in a robust and credible set of heuristics, before validation and refinement. his study is the first to develop a new set of specialized heuristics to evaluate how HITs incorporate features that enable effective patient use of PGHD, with K-SRS as a key case study. In addition, it is the first to describe how the identification of initial HIT features and concepts to enable PGHD could lead to the development of a specialized set of heuristics.
Attrition Within Digital Health Interventions for People With Multiple Sclerosis: Systematic Review and Meta-analysis (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-02-2021
Abstract: igital health interventions have revolutionized multiple sclerosis (MS) care by supporting people with MS to better self-manage their disease. It is now understood that the technological elements that comprise this category of digital health interventions can influence participant engagement in self-management programs, and people with MS can experience significant barriers, influenced by these elements, to remaining engaged during a period of learning. It is essential to explore the influence of technological elements in mitigating attrition. his study aimed to examine the study design and technological elements of documented digital health interventions targeted at people with MS—digital health interventions that were intended to support a program of engagement over a defined period—and to explore how these correlated with attrition among participants of randomized controlled trials (RCTs). e conducted a systematic review and meta-analysis of RCTs (n=32) describing digital health self-management interventions for people with MS. We analyzed attrition in included studies, using a random-effects model and meta-regression to measure the association between potential moderators. here were no measured differences in attrition between the intervention and control arms however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 14.7% and 15.6%, respectively. his paper provides insight into the technological composition of digital health interventions designed for people with MS and describes the degree of attrition in both study arms. This paper will aid in the design of future studies in this area, particularly for digital health interventions of this type.
Ethics of research into learning and teaching with Web 2.0: reflections on eight case studies
Publisher: Springer Science and Business Media LLC
Date: 22-09-2013
The Rapid Development of Virtual Care Tools in Response to COVID-19: Case Studies in Three Australian Health Services (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-08-2021
Abstract: ews of the impact of COVID-19 around the world delivered a brief opportunity for Australian health services to plan new ways of delivering care to large numbers of people while maintaining staff safety through greater physical separation. The rapid pivot to telemedicine and virtual care provided immediate and longer term benefits however, such rapid-cycle development also created risks. he aim of this study was to understand the sociotechnical aspects of the rapid-cycle development of seven different COVID-19 virtual care tools, and to identify enablers, barriers, and risks at three health services in Victoria, Australia. qualitative, embedded, multiple case study design was adopted. Researchers from three health services collaborated with university researchers who were independent from those health services to gather and analyze structured interview data from key people involved in either clinical or technical aspects of designing and deploying seven different virtual care tools. he overall objectives of each health service reflected the international requirements for managing large numbers of patients safely but remotely and for protecting staff. However, the governance, digital maturity, and specific use cases at each institution shaped the methodology and specific outcomes required. Dependence on key in iduals and their domain knowledge within an existing governance framework generally enabled rapid deployment, but sometimes posed barriers. Existing relationships with technical service developers enabled strong solutions, which in some cases were highly scalable. Conventional project methodologies such as steering committees, scope, budget control, tight functional specification, consumer engagement and codesign, universal accessibility, and postimplementation evaluation were ignored almost universally in this environment. hese three health services took a variety of approaches to the rapid-cycle development of virtual care tools to meet their urgent needs for triaging and remote monitoring during the first year of the COVID-19 pandemic. Their experiences provided insights into many social and technical barriers and enablers to the development of virtual care tools. If these are addressed proactively, they will improve clinical governance and technical management of future virtual care. Some changes can be made within in idual health services, while others entail health system policy reforms. Enhancing the environment for virtual care tool design and implementation now will yield returns not only during future health emergencies but also in many more routine care settings.
Digital divides? Student and staff perceptions of information and communication technologies
Publisher: Elsevier BV
Date: 05-2010
An Impact Evaluation protocol for the rapid design and delivery of an experience-based co-designed mobile app to support the mental health needs of healthcare workers impacted by COVID-19. (Preprint)
Publisher: JMIR Publications Inc.
Date: 02-12-2020
Abstract: he COVID-19 pandemic has highlighted the importance of health care workers’ mental health and well-being for the successful function of the health care system. Few targeted digital tools exist to support the mental health of hospital-based health care workers, and none of them appear to have been led and co-designed by health care workers. MHive is being led and developed by health care workers using experience-based co-design (EBCD) processes as a mobile app to support the mental health challenges posed by the COVID-19 pandemic to health care workers. We present a protocol for the impact evaluation for the rapid design and delivery of the RMHive mobile app. he impact evaluation will adopt a mixed methods design. Qualitative data from photo interviews undertaken with up to 30 health care workers and semistructured interviews conducted with up to 30 governance stakeholders will be integrated with qualitative and quantitative user analytics data and user-generated demographic and mental health data entered into the app. Analyses will address three evaluation questions related to engagement with the mobile app, implementation and integration of the app, and the impact of the app on in idual mental health outcomes. The design and development will be described using the Mobile Health Evidence Reporting and Assessment guidelines. Implementation of the app will be evaluated using normalization process theory to analyze qualitative data from interviews combined with text and video analysis from the semistructured interviews. Mental health impacts will be assessed using the total score of the 4-item Patient Health Questionnaire (PHQ4) and subscale scores for the 2-item Patient Health Questionnaire for depression and the 2-item Generalized Anxiety Scale for anxiety. The PHQ4 will be completed at baseline and at 14 and 28 days. he anticipated average use period of the app is 30 days. The rapid design will occur over four months using EBCD to collect qualitative data and develop app content. The impact evaluation will monitor outcome data for up to 12 weeks following hospital-wide release of the minimal viable product release. The study received funding and ethics approvals in June 2020. Outcome data is expected to be available in March 2021, and the impact evaluation is expected to be published mid-2021. he impact evaluation will examine the rapid design, development, and implementation of the RMHive app and its impact on mental health outcomes for health care workers. Findings from the impact evaluation will provide guidance for the integration of EBCD in rapid design and implementation processes. The evaluation will also inform future development and rollout of the app to support the mental health needs of hospital-based health care workers more widely. ERR1-10.2196/26168
Attrition Within Digital Health Interventions for People With Multiple Sclerosis: Systematic Review and Meta-analysis
Publisher: JMIR Publications Inc.
Date: 09-02-2022
DOI: 10.2196/27735
Abstract: Digital health interventions have revolutionized multiple sclerosis (MS) care by supporting people with MS to better self-manage their disease. It is now understood that the technological elements that comprise this category of digital health interventions can influence participant engagement in self-management programs, and people with MS can experience significant barriers, influenced by these elements, to remaining engaged during a period of learning. It is essential to explore the influence of technological elements in mitigating attrition. This study aimed to examine the study design and technological elements of documented digital health interventions targeted at people with MS—digital health interventions that were intended to support a program of engagement over a defined period—and to explore how these correlated with attrition among participants of randomized controlled trials (RCTs). We conducted a systematic review and meta-analysis of RCTs (n=32) describing digital health self-management interventions for people with MS. We analyzed attrition in included studies, using a random-effects model and meta-regression to measure the association between potential moderators. There were no measured differences in attrition between the intervention and control arms however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 14.7% and 15.6%, respectively. This paper provides insight into the technological composition of digital health interventions designed for people with MS and describes the degree of attrition in both study arms. This paper will aid in the design of future studies in this area, particularly for digital health interventions of this type.
Hospital Bring-Your-Own-Device Security Challenges and Solutions: Systematic Review of Gray Literature
Publisher: JMIR Publications Inc.
Date: 18-06-2020
DOI: 10.2196/18175
Abstract: As familiarity with and convenience of using personal devices in hospitals help improve the productivity, efficiency, and workflow of hospital staff, the health care bring-your-own-device (BYOD) market is growing consistently. However, security concerns owing to the lack of control over the personal mobile devices of staff, which may contain sensitive data such as personal health information of patients, make it one of the biggest health care information technology (IT) challenges for hospital administrations. Given that the hospital BYOD security has not been adequately addressed in peer-reviewed literature, the aim of this paper was to identify key security challenges associated with hospital BYOD usage as well as relevant solutions that can cater to the identified issues by reviewing gray literature. Therefore, this research will provide additional practical insights from current BYOD practices. A comprehensive gray literature review was conducted, which followed the stepwise guidelines and quality assessment criteria set out by Garousi et al. The searched literature included tier 1 sources such as health care cybersecurity market reports, white papers, guidelines, policies, and frameworks as well as tier 2 sources such as credible and reputed health IT magazines, databases, and news articles. Moreover, a deductive thematic analysis was conducted to organize the findings based on Schlarman’s People Policy Technology model, promoting a holistic understanding of hospitals’ BYOD security issues and solutions. A total of 51 sources were found to match the designed eligibility criteria. From these studies, several sociotechnical issues were identified. The major challenges identified were the use of devices with insufficient security controls by hospital staff, lack of control or visibility for the management to maintain security requirements, lack of awareness among hospital staff, lack of direction or guidance for BYOD usage, poor user experience, maintenance of legal requirements, shortage of cybersecurity skills, and loss of devices. Although technologies such as mobile device management, unified endpoint management, containerization, and virtual private network allow better BYOD security management in hospitals, policies and people management measures such as strong security culture and staff awareness and training improve staff commitment in protecting hospital data. The findings suggest that to optimize BYOD security management in hospitals, all 3 dimensions of the security process (people, policy, and technology) need to be given equal emphasis. As the nature of cybersecurity attacks is becoming more complex, all dimensions should work in close alignment with each other. This means that with the modernization of BYOD technology, BYOD strategy, governance, education, and relevant policies and procedures also need to adapt accordingly.
Transforming the future of digital health education: Redesign of a graduate program using competency mapping (Preprint)
Publisher: JMIR Publications Inc.
Date: 30-10-2023
“We are very individual”: Anticipated effects on stroke survivors of using their person-generated health data (Preprint)
Publisher: JMIR Publications Inc.
Date: 25-11-2019
Abstract: erson-generated health data (PGHD) are produced by people when they use health information technologies. People who use PGHD may have changes in their engagement with their own health care, their relationship with their healthcare providers, and their sense of social support and connectedness. Research into evaluating those reported effects however, has not kept up thus a method for developing patient-reported outcome measures (PROMs) of utilising PGHD, called the PROM-PGHD Development Method, was previously designed and applied to the exemplar case of Kinect-based stroke rehabilitation systems (K-SRS). A key step of the method ensures that the patient’s voice is included. Allowing stroke survivors to participate in the development and evaluation of health services and treatment can inform health care providers on decisions about stroke care, and thereby improve health outcomes. Moreover, eliciting the input of stroke survivors is important because there could be differences in their perspectives and that of their care providers, regarding treatment and management. his paper presents the perspectives of stroke survivors and clinicians on the anticipated effects of stroke survivors’ use of PGHD from a poststroke simulated rehabilitation technology. his study gathered the perspectives of six stroke survivors and five clinicians through three focus groups and three interviews, recruited for convenience. In the stroke survivors’ focus groups, participants were asked to give their perspectives on how using the PGHD from Jintronix may affect their outcomes while in the clinicians’ focus group, clinicians were asked for their perspectives on how PGHD use may affect the outcomes of stroke survivors. Participants were also asked questions intended to encourage them to comment on the initial items of the PROM-PGHD. Deductive thematic analysis was performed. urvivors and clinicians had varying perspectives in three of the six themes presented, and puts emphasis on the importance of allowing stroke survivors to participate in the evaluation of digital health services. However, the potential for tensions to occur between the needs and preferences of patients and their care providers could be reduced through a similar understanding of health treatment goals. This paper has further demonstrated that outcomes of utilising PGHD can be measured. For instance, stroke survivors described that using PGHD could result in positive, negative, and nil effects on their health behaviours. his study is the first to gather and compare the perspectives of stroke survivors and clinicians, in order to develop a PROM-PGHD for a simulated rehabilitation system. The reported PGHD utilisation outcomes would directly inform the development of a PROM-PGHD for K-SRS, of which this paper is a key step. Additionally, they could help inform health care providers on decisions about stroke care. This is particularly relevant in the area of poststroke simulated rehabilitation technologies.
Feasibility trial of a multiple sclerosis lifestyle educational online course: qualitative analysis of participants' motivations, expectations and experiences (Preprint)
Publisher: JMIR Publications Inc.
Date: 27-02-2022
Abstract: odification of lifestyle-related risk factors for multiple sclerosis (MS) has been associated with improved health outcomes when compared with standard medical management alone. Based on an existing evidence-based lifestyle education program offered as a residential workshop, the MS Online Course (MSOC) was developed to translate the face-to-face program into an online educational intervention. We performed a preliminary small randomised controlled trial (RCT), to quantitatively and qualitatively assess the feasibility of the MSOC. This paper reports qualitative aspects of participant involvement in this preliminary study. s part of an assessment of feasibility, to explore participants’ motivations, expectations, and experiences of the MSOC. SOC trial participants were recruited via online advertisements through MS society websites of Canada, New Zealand, and the United States, and an Australian MS Facebook group. Consenting participants were randomised to one of two arms: the MSOC standard care course, containing material relating to MS and lifestyle sourced from public facing MS websites or the MSOC intervention course, based on a face-to-face lifestyle modification program. Following completion of the respective courses, participants were invited to undertake semi-structured interviews. Reflexive thematic analysis of interviews was performed to identify themes related to participants’ motivations, expectations, and experiences of the MSOC. f 31 eligible participants, 17 people completed the MSOC feasibility RCT and 14 agreed to be interviewed. Four themes were identified: 1) “Wanting to help others” (helping through volunteering, contributing to knowledge base and spreading the word 2) “Obtaining knowledge to help better manage MS” (reassurance and confirmation of existing knowledge new credible knowledge and evidence) 3) “Doing whatever I can to help myself” (understanding lifestyle modification, changing my lifestyle, and remaining well and high-functioning) and 4) “Developing new attitudes” (finding positivity and feeling more confident and in control). articipants were motivated to undertake the MSOC to help others with MS through participation in research, to help themselves by improving their knowledge and to find ways in which they could manage their own MS. Expectations included the obtaining of credible, reliable information to substantiate their existing knowledge, and to further understand lifestyle modification. Participants’ experiences varied from experiencing little to no impact, to confirming existing knowledge, obtaining new knowledge, and early implementation of new or modified lifestyle behaviours. Although not identified as an expectation prior to undertaking the MSOC, some participants experienced improved positivity, confidence, and a greater sense of control. These insights surrounding participants’ motivations, expectations and experiences may assist in recruitment strategies, course redevelopment and outcome measures for future studies. Identification of participants’ changing attitudes, which they considered a high priority in their lives, suggests outcome measures should include measures of confidence and agency his study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ID: ACTRN12621000245897).
Participatory methods to engage health service users in the development of electronic health resources: Systematic review
Publisher: JMIR Publications Inc.
Date: 22-02-2019
DOI: 10.2196/11474
Use of social web technologies by international and domestic undergraduate students: Implications for internationalising learning and teaching in Australian universities
Publisher: Informa UK Limited
Date: 03-2010
Exposome informatics: considerations for the design of future biomedical research information systems
Publisher: Oxford University Press (OUP)
Date: 05-2014
Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review (Preprint)
Publisher: JMIR Publications Inc.
Date: 13-05-2021
Abstract: he adoption of electronic health records (EHRs) and electronic medical records (EMRs) has been slow in the mental health context, partly because of concerns regarding the collection of sensitive information, the standardization of mental health data, and the risk of negatively affecting therapeutic relationships. However, EHRs and EMRs are increasingly viewed as critical to improving information practices such as the documentation, use, and sharing of information and, more broadly, the quality of care provided. his paper aims to undertake a scoping review to explore the impact of EHRs on information practices in mental health contexts and also explore how sensitive information, data standardization, and therapeutic relationships are managed when using EHRs in mental health contexts. e considered a scoping review to be the most appropriate method for this review because of the relatively recent uptake of EHRs in mental health contexts. A comprehensive search of electronic databases was conducted with no date restrictions for articles that described the use of EHRs, EMRs, or associated systems in the mental health context. One of the authors reviewed all full texts, with 2 other authors each screening half of the full-text articles. The fourth author mediated the disagreements. Data regarding study characteristics were charted. A narrative and thematic synthesis approach was taken to analyze the included studies’ results and address the research questions. he final review included 40 articles. The included studies were highly heterogeneous with a variety of study designs, objectives, and settings. Several themes and subthemes were identified that explored the impact of EHRs on information practices in the mental health context. EHRs improved the amount of information documented compared with paper. However, mental health–related information was regularly missing from EHRs, especially sensitive information. EHRs introduced more standardized and formalized documentation practices that raised issues because of the focus on narrative information in the mental health context. EHRs were found to disrupt information workflows in the mental health context, especially when they did not include appropriate templates or care plans. Usability issues also contributed to workflow concerns. Managing the documentation of sensitive information in EHRs was problematic clinicians sometimes watered down sensitive information or chose to keep it in separate records. Concerningly, the included studies rarely involved service user perspectives. Furthermore, many studies provided limited information on the functionality or technical specifications of the EHR being used. e identified several areas in which work is needed to ensure that EHRs benefit clinicians and service users in the mental health context. As EHRs are increasingly considered critical for modern health systems, health care decision-makers should consider how EHRs can better reflect the complexity and sensitivity of information practices and workflows in the mental health context.
Developing a Framework to Generate Evidence of Health Outcomes From Social Media Use in Chronic Disease Management
Publisher: JMIR Publications Inc.
Date: 08-08-2013
DOI: 10.2196/MED20.2717
Artificial Intelligence Education for the Health Workforce: Expert Survey of Approaches and Needs
Publisher: JMIR Publications Inc.
Date: 04-04-2022
DOI: 10.2196/35223
Abstract: The preparation of the current and future health workforce for the possibility of using artificial intelligence (AI) in health care is a growing concern as AI applications emerge in various care settings and specializations. At present, there is no obvious consensus among educators about what needs to be learned or how this learning may be supported or assessed. Our study aims to explore health care education experts’ ideas and plans for preparing the health workforce to work with AI and identify critical gaps in curriculum and educational resources across a national health care system. A survey canvassed expert views on AI education for the health workforce in terms of educational strategies, subject matter priorities, meaningful learning activities, desired attitudes, and skills. A total of 39 senior people from different health workforce subgroups across Australia provided ratings and free-text responses in late 2020. The responses highlighted the importance of education on ethical implications, suitability of large data sets for use in AI clinical applications, principles of machine learning, and specific diagnosis and treatment applications of AI as well as alterations to cognitive load during clinical work and the interaction between humans and machines in clinical settings. Respondents also outlined barriers to implementation, such as lack of governance structures and processes, resource constraints, and cultural adjustment. Further work around the world of the kind reported in this survey can assist educators and education authorities who are responsible for preparing the health workforce to minimize the risks and realize the benefits of implementing AI in health care.
Activity Theory as a Theoretical Framework for Health Self-Quantification: A Systematic Review of Empirical Studies
Publisher: JMIR Publications Inc.
Date: 27-05-2016
DOI: 10.2196/JMIR.5000
Related Organisations
No related organisations have been discovered for Kathleen Gray.
Related Funding Activities
Discovery Projects - Grant ID: DP150100597
Start Date: 2015
End Date: 03-2018
Amount: $582,200.00
Funder: Australian Research Council
View Funded ActivityDiscovery Projects - Grant ID: DP220100884
Start Date: 10-2022
End Date: 10-2025
Amount: $435,000.00
Funder: Australian Research Council
View Funded Activity