Electronic physiologic and subjective data acquisition in home-dwelling heart failure patients: An assessment of patient use and perception of usability

Gardner, Cubby L.; Flanagan, M. Casey; Franklin, Cathy; John-Swayers, Cherly; Walsh-Pouch, Stacy; Bryant, F. Joyce; Romano, Carol A.; Gibbons, Susanne W.; Jong, Marla De; Hoang, Albert; Becher, Dorothy; Burke, Harry B.

doi:10.1016/j.ijmedinf.2016.06.001

Cited by 7 publications

(9 citation statements)

References 24 publications

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“…To best achieve this goal in cancer patients receiving often complex and toxic multidrug chemotherapy, it is important that the care model integrates the need for adequate safety [4,9,10]. Thus, an oftentimes complex compendium of procedures given to home-dwelling patients might be required [11]. Consequently, current practice usually involves chemotherapy administration at least partly within the hospital setting either as inpatient or outpatient, which can affect patient’s quality of life and increase the financial burden on patients and national health systems [5,9].…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of the First Domomedicine Platform Securing Multidrug Chronotherapy Delivery in Metastatic Cancer Patients at Home: The inCASA European Project

Innominato¹,

Komarzynski²,

Mohammad-Djafari³

et al. 2016

J Med Internet Res

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BackgroundTelehealth solutions can improve the safety of ambulatory chemotherapy, contributing to the maintenance of patients at their home, hence improving their well-being, all the while reducing health care costs. There is, however, need for a practicable multilevel monitoring solution, encompassing relevant outputs involved in the pathophysiology of chemotherapy-induced toxicity. Domomedicine embraces the delivery of complex care and medical procedures at the patient’s home based on modern technologies, and thus it offers an integrated approach for increasing the safety of cancer patients on chemotherapy.ObjectiveThe objective was to evaluate patient compliance and clinical relevance of a novel integrated multiparametric telemonitoring domomedicine platform in cancer patients receiving multidrug chemotherapy at home.MethodsSelf-measured body weight, self-rated symptoms using the 19-item MD Anderson Symptom Inventory (MDASI), and circadian rest-activity rhythm recording with a wrist accelerometer (actigraph) were transmitted daily by patients to a server via the Internet, using a dedicated platform installed at home. Daily body weight changes, individual MDASI scores, and relative percentage of activity in-bed versus out-of-bed (I

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Section: Introductionmentioning

confidence: 99%

Clinical Relevance of the First Domomedicine Platform Securing Multidrug Chronotherapy Delivery in Metastatic Cancer Patients at Home: The inCASA European Project

Innominato¹,

Komarzynski²,

Mohammad-Djafari³

et al. 2016

J Med Internet Res

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“…The descriptive statistics will be summarized on patients’ background and experience. The significance of overall System Usability Scale [26] will be assessed by using the Student t test [37,38]. The User Engagement Scale [36] and Networked Minds survey [32] will be used for analysis.…”

Section: Methodsmentioning

confidence: 99%

“…The User Engagement Scale [36] and Networked Minds survey [32] will be used for analysis. The significance of iHeartU use will also be assessed by comparing the ratio of observed use to expected use to the hypothetical mean of 1.0 by using the Student t test [38]. The interrater agreement of raw system usability scores will be assessed by the intraclass correlation coefficient with 95% CIs [39].…”

Section: Methodsmentioning

confidence: 99%

A Patient-Centered Mobile Phone App (iHeartU) With a Virtual Human Assistant for Self-Management of Heart Failure: Protocol for a Usability Assessment Study

Zhang¹,

Babu²,

Jindal³

et al. 2019

JMIR Res Protoc

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Background Heart failure (HF) causes significant economic and humanistic burden for patients and their families, especially those with a low income, partly due to high hospital readmission rates. Optimal self-care is considered an important nonpharmacological aspect of HF management that can improve health outcomes. Emerging evidence suggests that self-management assisted by smartphone apps may reduce rehospitalization rates and improve the quality of life of patients. We developed a virtual human–assisted, patient-centered mobile health app (iHeartU) for patients with HF to enhance their engagement in self-management and improve their communication with health care providers and family caregivers. iHeartU may help patients with HF in self-management to reduce the technical knowledge and usability barrier while maintaining a low cost and natural, effective social interaction with the user. Objective With a standardized systematic usability assessment, this study had two objectives: (1) to determine the obstacles to effective and efficient use of iHeartU in patients with HF and (2) to evaluate of HF patients’ adoption, satisfaction, and engagement with regard to the of iHeartU app. Methods The basic methodology to develop iHeartU systems consists of a user-centric design, development, and mixed methods formative evaluation. The iterative design and evaluation are based on the guidelines of the American College of Cardiology Foundation and American Heart Association for the management of heart failure and the validated “Information, Motivation, and Behavioral skills” behavior change model. Our hypothesis is that this method of a user-centric design will generate a more usable, useful, and easy-to-use mobile health system for patients, caregivers, and practitioners. Results The prototype of iHeartU has been developed. It is currently undergoing usability testing. As of September 2018, the first round of usability testing data have been collected. The final data collection and analysis are expected to be completed by the end of 2019. Conclusions The main contribution of this project is the development of a patient-centered self-management system, which may support HF patients’ self-care at home and aid in the communication between patients and their health care providers in a more effective and efficient way. Widely available mobile phones serve as care coordination and “no-cost” continuum of care. For low-income patients with HF, a mobile self-management tool will expand their accessibility to care and reduce the cost incurred due to emergency visits or readmissions. The user-centered design will improve the level of engagement of patients and ultimately lead to better health outcomes. Developing and testing a novel mobile system for patients with HF that incorporates chronic disease management is critical for advancing research and clinical practice of care for them. This research fil...

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“…We previously conducted a 39 heart failure patient study to assess patients’ ability to use mobile devices at home [22]. Experienced heart failure clinicians selected five clinical variables for their diagnostic and prognostic value in heart failure.…”

Section: Methodsmentioning

confidence: 99%

Assessing the usability by clinicians of VISION: A hierarchical display of patient-collected physiological information to clinicians

Gardner

Liu

Fontelo

et al. 2017

BMC Med Inform Decis Mak

Self Cite

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BackgroundThe inability of patients to accurately and completely recount their clinical status between clinic visits reduces the clinician’s ability to properly manage their patients. One way to improve this situation is to collect objective patient information while the patients are at home and display the collected multi-day clinical information in parallel on a single screen, highlighting threshold violations for each channel, and allowing the viewer to drill down to any analog signal on the same screen, while maintaining the overall physiological context of the patient. All this would be accomplished in a way that was easy for the clinician to view and use.MethodsPatients used five mobile devices to collect six heart failure-related clinical variables: body weight, systolic and diastolic blood pressure, pulse rate, blood oxygen saturation, physical activity, and subjective input. Fourteen clinicians practicing in a heart failure clinic rated the display using the System Usability Scale that, for acceptability, had an expected mean of 68 (SD, 12.5). In addition, we calculated the Intraclass Correlation Coefficient of the clinician responses using a two-way, mixed effects model, ICC (3,1).ResultsWe developed a single-screen temporal hierarchical display (VISION) that summarizes the patient’s home monitoring activities between clinic visits. The overall System Usability Scale score was 92 (95% CI, 87-97), p < 0.0001; the ICC was 0.89 (CI, 0.79-0.97), p < 0.0001.ConclusionClinicians consistently found VISION to be highly usable. To our knowledge, this is the first single-screen, parallel variable, temporal hierarchical display of both continuous and discrete information acquired by patients at home between clinic visits that presents clinically significant information at the point of care in a manner that is usable by clinicians.

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Electronic physiologic and subjective data acquisition in home-dwelling heart failure patients: An assessment of patient use and perception of usability

Cited by 7 publications

References 24 publications

Clinical Relevance of the First Domomedicine Platform Securing Multidrug Chronotherapy Delivery in Metastatic Cancer Patients at Home: The inCASA European Project

Clinical Relevance of the First Domomedicine Platform Securing Multidrug Chronotherapy Delivery in Metastatic Cancer Patients at Home: The inCASA European Project

A Patient-Centered Mobile Phone App (iHeartU) With a Virtual Human Assistant for Self-Management of Heart Failure: Protocol for a Usability Assessment Study

Assessing the usability by clinicians of VISION: A hierarchical display of patient-collected physiological information to clinicians

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