Telehealth

The VISYTER Telerehabilitation System

by Alan C. Lee

Designing with Care: The Future of Pervasive Healthcare

by Alan Card

Ingrid Mulder, Yvonne Schikhof, Martijn Vastenburg, Alan Card, Tory Dunn, Andreas Komninos, Marilyn McGee-Lennon, Mark Santcroos, Gabriele Tiotto, Mieke van Gils, Jan-Willem van 't Klooster, Annelies Veys, Mohammed Zarifi Eslami, "Designing with Care: The Future of Pervasive Healthcare," IEEE Pervasive Computing, vol. 8, no. 4, pp. 85-88, Oct.-Dec. 2009, doi:10.1109/MPRV.2009.71

Humane care—which is an important design paradigm relevant for pervasive healthcare—means designing systems with care,... more Humane care—which is an important design paradigm relevant for pervasive healthcare—means designing systems with care, keeping in mind both users and other stakeholders. Understanding human values is a key factor in creating any successful healthcare application and is essential to avoid dehumanizing and stigmatizing users. By considering human values, designers and developers can create pervasive healthcare applications that better fit users' needs and desires. The Designing with Care 09 workshop aimed to bring together researchers, designers, and practitioners to share their experiences with incorporating values into the design of pervasive healthcare systems and to help understand the sensitive issues involved in designing for healthcare. Based on the findings from the workshop, the present state of the art is discussed, and a research agenda is presented.

Evaluation of Web 2.0 Technologies for Developing Online Telehealth Systems

by Jaspaljeet Singh Dhillon

The Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2012), Melbourne, Australia, 12 May 2012

Co-authored with Czarina Ramos, Burkhard C. W¨unsche and Christof Lutteroth

Telehealth and telecare applications are a promising technology for improving the quality of care while using... more Telehealth and telecare applications are a promising technology for improving the quality of care while using healthcare resources more effectively. Major obstacles to a more widespread use are the high initial costs and a vendor specific design, which makes it difficult and expensive to add new functionalities. The Internet offers an opportunity to make telehealth applications more accessible, while also adding social aspects and the opportunity for third-party developers to add content. A preliminary user study confirmed that elderly are interested in such an application, and provided guidelines for the user interface design and required functionalities. In this paper, we evaluate technologies for developing online telehealth platforms, and present a first prototype which is extendable and has social networking capabilities. Our results show that a combination of open web standards such as OpenSocial and a CMS such as Drupal represents a suitable design. We illustrate the capabilities of our design and prototype by developing a memory game, which can be submitted by third party developers, similar to a Facebook application, and which utilises the social context of our telehealth application.

Support systems for Telehealth services: Critical operational and ICT complementary assets for large-scale provisioning

by Americo Cunha

CUNHA, A.B., CAPRETZ, M.A.M., RAPTOPOULOS, L.S.C. “Support Systems for Telehealth Services: Critical operational and ICT complementary assets for large-scale provisioning,” in the proceedings of the IEEE Toronto International Conference - Science and Technology for Humanity. Toronto, Canada. 2009.

This paper evaluates the current operational barriers of large-scale Telehealth services provisioning, focusing... more This paper evaluates the current operational barriers of large-scale Telehealth services provisioning, focusing specifically on the challenges of Information and Communication Technologies (ICT). The complementary assets, besides the core clinical and medical protocols, are required for performing technological innovations in large-scale service operations. The paper ends with a evaluation of two frameworks used by telecom providers during the technological convergence wave of the 1990s. An analysis comparing the Telecommunications Convergence phenomenon of those days and current Telehealth context can provide insights for developing a more consistent Telehealth operational framework.

dataNUTES: Uma Proposta de Sistema de Informações para o Gerenciamento de Serviços de Telessaúde

by Alexandre Luna

DIAS, F. C., DE O LUNA, ALEXANDRE J. H., PINTO, E. R., NOVAES, M. A., MELLO, M. R.(2008) dataNUTES: Uma Proposta de Sistema de Informações para o Gerenciamento de Serviços de Telessaúde. In: CBIS208 – XI Congresso Brasileiro de Informática em Saúde, 2008, Campos do Jordão. ANAIS do XI Congresso Brasileiro de Informática em Saúde (CBIS2008), 2008.

This article presents the strategies and methodologies adopted in the development of a web based information system... more This article presents the strategies and methodologies adopted in the development of a web based information system to manage telehealth services, called dataNUTES. The system aim to  support the deployment and maintenance of a telehealth network, the Telehealth Centers Network of Pernambuco, and is underdevelopment by the UFPE  Telehealth Centre.

Desenvolvimento Distribuído de uma Aplicação de Telessaúde com a Metodologia Ágil SCRUM.

by Alexandre Luna

DE O. LUNA, A.J.H., CLEYVERSON P. COSTA, NOVAES, M. A., MELLO, M. R., DIAS, F. C. (2008) Desenvolvimento Distribuído de uma Aplicação de Telessaúde com a Metodologia Ágil SCRUM. In: CBIS208 – XI Congresso Brasileiro de Informática em Saúde, 2008, Campos do Jordão - SP. Anais do CBIS2008 - XI Congresso Brasileiro de Informática em Saúde, 2008.
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LUNA, Alexandre J. H. DE O.; COSTA, Cleyverson P. and NOVAES, Magdala A. (2010d). Desenvolvimento Distribuído de uma Aplicação de Telessaúde com a Metodologia Ágil SCRUM. In Revista Científica Tecnologus 4, no. 1: 6. Disponível em: <http://www.unibratec.com.br/revistacientifica/n4_artigos.html&gt;. Acesso em: 17/08/2010.

This paper presents a complete study case of a Distributed Software Development, supported by the SCRUM agile... more This paper presents a complete study case of a Distributed Software Development, supported by the SCRUM agile methodology. This study case was conducted by setting up a Software Factory to develop a Multimedia Library, a system for sharing learning objects used by the telemedicine and telehealth projects of the Center of Telehealth at UFPE.

ABORDAGEM DA ENGENHARIA DE REQUISITOS EM PROJETOS DE DESENVOLVIMENTO DE SOFTWARE PARA TELESSAÚDE/TELEMEDICINA

by Alexandre Luna

Monografia apresentada ao Curso de pós-graduação em Ciência da Computação, Centro de Informática, Universidade Federal de Pernambuco, como requisito parcial para conclusão da disciplina Engenharia de Requisitos.

Professor: Prof. Ph.D Jaelson Brelaz de Castro

Because of advances in information technology and telecommunications, telemedicine and Telehealth, and other areas of... more Because of advances in information technology and telecommunications, telemedicine and Telehealth, and other areas of research and development of Medical Informatics, took a big boost. The Telemedicine can be defined as the use of information technology and communications to support medical care to patients in remote locations, relying on the exchange of information. Already the Telehealth can be defined as the use of
information technology and communication to provide health services, knowledge on information in contexts where the distance is a critical factor. The terms are confused in
some approaches, but are best described as: complementary.

The Telemedicine and Telehealth can be made with what exists in most modern and sophisticated in terms of technology, but the costs of establishing and maintaining these systems can often prevent the realization of this activity in the routine medical. For this reason, besides having an affordable, a system of telemedicine must also be carefully planned and designed.
In this context the processes of engineering requirements are extremely important to minimize the risks of the cycle of development projects of this nature.

From this perspective we are studying the state of the art of the approach of Engineering Requirements in developing software in the areas of Telehealth and telemedicine, searching work in progress in different groups of searches and presenting the
confrontation of these visions compared the experiences recently experienced by author in a case study.

Telemedicine in the Future

by Paul Heinzelmann

Virtual Telemedicine Using Natural Language Processing

by Imran Sarwar Bajwa

International Journal of Information Technology and Web Engineering 5(1) pp:43-55

Conventional telemedicine has limitations due to the existing time constraints in the response of a medical... more Conventional telemedicine has limitations due to the existing time constraints in the response of a medical specialist. One major reason is that telemedicine based medical facilities are subject to the availability of a medical expert and telecommunication facilities. On the other hand, communication using telecommunication is only possible on fixed and appointed time. Typically, the field of telemedicine exists in both medical and telecommunication areas to provide medical facilities over a long distance, especially in remote areas. In this article, the authors present a solution for ‘virtual telemedicine’ to cope with the problem of the long time constraints in conventional telemedicine. Virtual Telemedicine is the use of telemedicine with the methods of artificial intelligence.

Telehealth in practice: using Normalisation Process Theory To Bridge The Translational Gap

by Frances Mair

Co-authored with Deborah Morrison.

Clinical Decision Support System based Virtual Telemedicine

by Imran Sarwar Bajwa

IEEE 3rd International Conference on Intelligent Human-Machine Systems and Cybernetics (IHMSC 2011) pp.78-83

Telemedicine is a blessing for the people of remote areas because it provides high level medical facilities in an... more Telemedicine is a blessing for the people of remote areas because it provides high level medical facilities in an efficient way at low cost. Store-and-Forward method of telemedicine suits more to the progressive countries like Pakistan as not only because it is easy to set up but also due to its cheap operating cost. However, the high response time taken by store & forward telemedicine becomes a critical factor in emergency cases, where each minute has a price. The response time factor can be overcome by using virtual telemedicine approach. In virtual telemedicine, a Clinical Decision Support System (CDSS) is deployed at rural station. The CDSS is intelligent enough to diagnose a patient’s disease and prescribe proper medication. In a case, the CDSS can not answer a query, the CDSS immediately sends an e-mail to a medical expert (doctor) and when the response is received the CDSS knowledge-base is updated for the future queries. In this research paper, we not only report a NL-based CDSS that can answer NL queries but also present a complete architecture of a virtual telemedicine setup.

Virtual Telemedicine and Virtual Telehealth: A Natural Language Based Implementation to Address Time Constraint Problem

by Imran Sarwar Bajwa

Models for Capitalizing on Web Engineering Advancements: Trends and Discoveries, IGI Global, ISBN: 9781466600232, January, 2012

Telemedicine is modern technology that is employed to provide low cost but high standard medical facilities to the... more Telemedicine is modern technology that is employed to provide low cost but high standard medical facilities to the people of remote areas. Store-and-Forward method of telemedicine suits more to the progressive countries like Pakistan as not only because it is easy to set up but also due to its cheap operating cost. However, the high response time taken by store & forward telemedicine becomes a critical factor in emergency cases, where each minute has a price. The response time factor can be overcome by using virtual telemedicine approach. In virtual telemedicine, a Clinical Decision Support System (CDSS) is deployed at rural station. The CDSS is intelligent enough to diagnose a patient’s disease and prescribe proper medication. In a case, the CDSS can not answer a query, the CDSS immediately sends an e-mail to a medical expert (doctor) and when the response is received the CDSS knowledge-base is updated for the future queries. In this research paper, we not only report a NL-based CDSS that can answer NL queries but also present a complete architecture of a virtual telemedicine setup.

Designing a Web-based Telehealth System for Elderly People: An Interview Study in New Zealand

by Jaspaljeet Singh Dhillon

The 24th International Symposium on Computer-Based Medical Systems (CBMS 2011), University of the West of England, Bristol, 27-30 June 2011

Co-authored with Czarina Ramos, Burkhard C. W¨unsche and Christof Lutteroth

Designing healthcare systems for the elderly is a challenging endeavour. Telehealth systems are gaining popularity... more Designing healthcare systems for the elderly is a challenging endeavour. Telehealth systems are gaining popularity among elderly users, but such applications are mostly doctor-centric and are predominantly used for managing and/or treating diseases instead of preventing them. They do little to motivate patients to change their lifestyle and proactively manage their health. To address these shortcomings, we propose a web-based telehealth system, which uses Web 2.0 technologies in order to add social support and user defined content. In this study, we determine the functional and interface requirements of the system by conducting open individual semi-structured interviews with eight elderly people of age range 60 to 87. A paper prototype and three interfaces of existing Web 2.0 health applications were used to determine the optimum user interface design of the system. A qualitative content analysis was used to evaluate the responses. Overall, the respondents were positive about the idea of using the web to manage their healthcare from home and made several suggestions such as including applications to manage their diet, physiotherapy exercises to improve their health conditions and simple network games to reduce loneliness.

Towards A Ubiquitous Patient-Centric Telehealth System

by Jaspaljeet Singh Dhillon

The 9th New Zealand Computer Science Research Student Conference (NZCSRSC 2011), Massey University, Palmerston North, 18-21 April 2011

Co-authored with Burkhard C. Wünsche and Christof Lutteroth

The elderly population is growing fast in most developed countries. The aging population, high medical expenses, the... more The elderly population is growing fast in most developed countries. The aging population, high medical expenses, the shrinking number of health workers and elderly carers demand for more healthcare innovation that empower health consumers to manage their health independently from home. Telehealth is thought to be a solution for effective elderly healthcare. However, the usage of telehealth is limited by a design often centered around the requirements of the clinical user, healthcare provider, and the equipment vendor. Many existing systems suffer from high initial costs, cannot be extended by third parties, require extra costs to add new functionalities, and are designed to create a continuing revenue source for the vendor. Furthermore the systems are usually designed to manage diseases rather than prevent them, and do not address the social and psychological needs of the patient. Based on these shortcomings, we propose a novel web-based telehealth framework called Healthcare4Life, which is ubiquitous, extendable by third parties, contains social aspects, and puts the user in control. In contrast to previous work, we propose an open structure with a middlewarelike functionality. The framework emphasises the need for social
support and psychological factors influencing usage and compliance. In this paper, we describe telehealth usability requirements and analysis of existing consumer health informatics applications which leads to the design of a novel ubiquitous telehealth system.

Research Report Series: A Taxonomy of Usability Requirements for Home Telehealth Systems (TR Number: UoA-SE-2010-1)

by Jaspaljeet Singh Dhillon

Technical Report (complete version of the conference paper)
Co-authored with Christof Lutteroth, Burkhard C. W¨unsche

Over the past decade increasing healthcare and elderly care costs and demographic changes are rapidly making... more Over the past decade increasing healthcare and elderly care costs and demographic changes are rapidly making traditional healthcare concepts unaffordable for many developed countries. Telecare and telehealth applications have become increasingly popular because of their promise to reduce costs and staffing requirements while maintaining or even improving care. So far applications are mostly restricted to monitoring tasks in a home environment. Adoption and use is further constrained by the high initial costs, the lack of extendability, and a system design which is centred around the clinical users. Patient factors are considered, but usually only incorporated into the user interface design rather than the system and its application. In this paper we present a taxonomy of usability requirements and design concepts for home telehealth systems which enable a more patient centric design. We systematically explore the usability problems of past and current telehealth. Problems faced by users of home telehealth systems are identified and solutions delineated. The paper aims to build a good understanding of the technology needs of the elderly population. It represent a solid foundation for constructing novel and more general telehealth solutions in order to make the technology more effective and more widely available.

Taxonomy of usability requirements for home telehealth systems

by Jaspaljeet Singh Dhillon

The 11th Annual ACM SIGCHI NZ Conference on Computer-Human Interaction (CHINZ 2010), Massey University, Auckland, New Zealand, 8 July 2010

Co-authored with Christof Lutteroth and Burkhard C. W¨unsche

Over the past decade increasing healthcare and elderly care costs and demographic changes are rapidly making... more Over the past decade increasing healthcare and elderly care costs and demographic changes are rapidly making traditional healthcare concepts unaffordable for many developed countries. Telecare and telehealth applications have become increasingly popular because of their promise to reduce costs and staffing requirements while maintaining or even improving care. Most of the existing applications are centred around the clinical users. Patient factors are considered, but usually only incorporated into the user interface design rather than the system and its application. The patient population, and especially the large proportion of elderly patients, has unique needs, capabilities and limitations that must be considered throughout the design process of such applications. In this paper we present a taxonomy of usability requirements and design concepts for home telehealth systems which enable a more patient centric design. We systematically explore the usability problems of past and current telehealth applications. Problems faced by users of home telehealth systems are identified and solutions delineated. The paper aims to build a good understanding of the technology needs of the elderly population. It represent a solid foundation for constructing novel and more general telehealth solutions in order to make the technology more effective and more widely available.

Framework for Healthcare4Life: a ubiquitous patient-centric telehealth system

by Jaspaljeet Singh Dhillon

The 11th Annual ACM SIGCHI NZ Conference on Computer-Human Interaction (CHINZ 2010), Massey University, Auckland, New Zealand, 8 July 2010

Co-authored with Burkhard C. Wünsche and Christof Lutteroth

Health care systems in many developed countries are rapidly approaching a crisis point. The reasons are an aging... more Health care systems in many developed countries are rapidly approaching a crisis point. The reasons are an aging population, a shrinking number of workers, health care costs increasing faster than the economy, expensive new treatment options, poor public finances, and the reducing pool of health care professionals. The problem is compounded by the fact that elderly are more often affected by chronic diseases which require ongoing, often expensive, treatment. Telehealth and telecare applications are rapidly gaining in popularity because of their promise to use existing health care resources more effectively and hence to lower costs. However, usage is limited by a design often centered around the requirements of the clinical user, healthcare provider, and the equipment vendor. Many existing systems suffer from high initial costs, cannot be extended by third parties, require extra costs to add new functionalities, and are designed to create a continuing revenue source for the vendor. Furthermore the systems are usually designed to manage diseases rather than prevent them, and do not address the social and psychological needs of the patient. In this paper we critically analyse existing consumer health informatics systems and propose a framework for overcoming the identified shortcomings. The proposed system is ubiquitous, extendable by third parties, contains social aspects, and puts the user in control. Evidence from related research suggests that the design will increase motivation and participation, encourage family and social support, and improve the recording of health parameters by reducing user resistance.

Designing a Web-based Telehealth System for Elderly People: An Interview Study in New Zealand

by Jaspaljeet Singh Dhillon

The 24th International Symposium on Computer-Based Medical Systems (CBMS 2011), University of the West of England, Bristol, 27-30 June 2011

Co-authored with Czarina Ramos, Burkhard C. W¨unsche and Christof Lutteroth

Designing healthcare systems for the elderly is a challenging endeavour. Telehealth systems are gaining popularity... more Designing healthcare systems for the elderly is a challenging endeavour. Telehealth systems are gaining popularity among elderly users, but such applications are mostly doctor-centric and are predominantly used for managing and/or treating diseases instead of preventing them. They do little to motivate patients to change their lifestyle and proactively manage their health. To address these shortcomings, we propose a web-based telehealth system, which uses Web 2.0 technologies in order to add social support and user defined content. In this study, we determine the functional and interface requirements of the system by conducting open individual semi-structured interviews with eight elderly people of age range 60 to 87. A paper prototype and three interfaces of existing Web 2.0 health applications were used to determine the optimum user interface design of the system. A qualitative content analysis was used to evaluate the responses. Overall, the respondents were positive about the idea of using the web to manage their healthcare from home and made several suggestions such as including applications to manage their diet, physiotherapy exercises to improve their health conditions and simple network games to reduce loneliness.

Towards A Ubiquitous Patient-Centric Telehealth System

by Jaspaljeet Singh Dhillon

The 9th New Zealand Computer Science Research Student Conference (NZCSRSC 2011), Massey University, Palmerston North, 18-21 April 2011

Co-authored with Burkhard C. Wünsche and Christof Lutteroth

The elderly population is growing fast in most developed countries. The aging population, high medical expenses, the... more The elderly population is growing fast in most developed countries. The aging population, high medical expenses, the shrinking number of health workers and elderly carers demand for more healthcare innovation that empower health consumers to manage their health independently from home. Telehealth is thought to be a solution for effective elderly healthcare. However, the usage of telehealth is limited by a design often centered around the requirements of the clinical user, healthcare provider, and the equipment vendor. Many existing systems suffer from high initial costs, cannot be extended by third parties, require extra costs to add new functionalities, and are designed to create a continuing revenue source for the vendor. Furthermore the systems are usually designed to manage diseases rather than prevent them, and do not address the social and psychological needs of the patient. Based on these shortcomings, we propose a novel web-based telehealth framework called Healthcare4Life, which is ubiquitous, extendable by third parties, contains social aspects, and puts the user in control. In contrast to previous work, we propose an open structure with a middlewarelike functionality. The framework emphasises the need for social
support and psychological factors influencing usage and compliance. In this paper, we describe telehealth usability requirements and analysis of existing consumer health informatics applications which leads to the design of a novel ubiquitous telehealth system.

A Virtual Telehealth Framework: Applications and Technical Considerations

by Imran Sarwar Bajwa

IEEE 7th International Conference on Emerging Technologies 2011 (ICET 2011)

Since last two decades, telehealth has been emerged into an expansion of telemedicine. A telehealth system provides... more Since last two decades, telehealth has been emerged into an expansion of telemedicine. A telehealth system provides the curative care and preventive care. In telehealth, patient’s data is sent by email to a physician or a medical expert for diagnosis and medical prescription. Telehealth system can be used as real time method or store forward method. However, in perspective of developing countries like Pakistan, real-time telehealth is not feasible due to its high cost. Whereas, the store and forward method based telehealth can be a cost-effect solution. It has been identified that a major problem with store-and-forward method is long time-factor that can be longer to 48 hours in certain cases. The situation may become more verse if patient is in serious condition and requires immediate medication. To address this issue a concept of virtual telehealth is proposed in this paper. We have incorporated a clinical decision support system to reply the patients’ query locally. The presented solution can make telehealth more financially feasible, technically implemental in developing countries like Pakistan.