Developing and Utilizing Digital Technology in Healthcare for Assessment and Monitoring

ISBN-13: 9783030606961 / Angielski / Miękka / 2021 / 153 str.

Andreas Charalambous

Spis treści

See the biographies of authors who agreed on writing a chapter (see attachment tab)

1. Utilizing technology to extract PROMs – Patient-reported outcome measures (PROMs) refer to standardized instruments designed to measure particular phenomena or constructs of individuals’ health status in defined populations. Patient Reported Outcome Measures have become a routine assessment method for patients’ symptoms, quality of life, quality of provided care just to name a few.  While PROMs have long been collected in research, there are examples of successful implementation in clinical settings (e.g., oncology) as valuable information to guide patient care. Beyond clinical care, PROMs are now included in quality and outcome metrics and payer mandates as well as population health and research studies. This chapter will emphasise on the utilization of technology to optimize the collection of PROMs (i.e. primarily in the clinical context) and the best ways that these data can influence practice. 

2. Utilizing technology to manage symptoms – Cancer is a disease that is accompanied by a several symptoms whilst its treatments (i.e chemotherapy, radiotherapy, immunotherapy, targeted therapies) can also induce symptoms (its severity varies with some being severe and require dose limitation or even treatment interruption) that can have a depilating effect on the person’s quality of life. These cancer-relate or treatment-related symptoms can also have a negative impact on the patient’s adherence to treatment or even the treatment effectiveness. This chapter will deal with the ways that technology can facilitate the monitoring and management of symptoms in cancer patients across the cancer care continuum. 

3. Personalizing the technological experience (i.e. individualised experience) - The key to delivering a truly personalized experience is a deep understanding of each person that the technological intervention is aiming at. Personalization is tuning and adjusting the technology to the preferences and needs of a particular user. A personalized experience can be delivered via rules and/or algorithms. With rules, you manually define which group (or segment) of people will see a specific experience. With algorithms, you let machine learning decide which experience to show each individual person. This chapter will elaborate on how technological interventions can be personalised to patients’ needs and preferences.  

4. (The process of) Developing technological solutions for healthcare – This chapter will elaborate on the process of developing technological solutions for healthcare. 

5. The ethics of technological solutions (i.e. social robots) - A social robot is a physically embodied, autonomous agent that communicates and interacts with humans on an emotional level. Within the healthcare context, social robots have been utilised to entertain, assist, and educate patients (i.e. primarily children with cancer) who suffer from physical pain and distress caused by both the disease and its treatment process. This chapter explores the ways that Social Robots can be utilised in the cancer care context as well at the ethical dimensions that their use might trigger. Ethical reasons for and against this robot revolution in healthcare have been presented in recent years. There has been concern that robots in healthcare will displace workers and will change the moral quality and standard of care for the worse but also the issues of responsibility and privacy should be explored.  

6. Supporting decision-making through technology - Clinical decision-making is a central part of everyday practice.  It has never been an easy task.  It carries with it the burden of responsibility for a patient’s health and wellbeing. Each patient is a unique case and one that is dynamic requiring to make a lot of decisions usually within a short period of time (sometime under urgent circumstances). In order to make informed decisions issues such as clinical circumstances, experience and judgment, scientific evidence, and patient preferences need to be taken into consideration which constitute a tremendous amount of data. The universal availability of apps and smart mobile devices has generated clinical decision support tools (CDS).  A CDC is an information-based technology system. CDS tools have the potential to improve clinical diagnostic decision-making and patient safety. This chapter deals with the ways that technology can support decision making in clinical practice. Emphasis will be placed on the utilization of clinical decision support tools and their integration in clinical practice. 

7. Utilizing Augmented Reality and Virtual Reality in symptom management - Virtual reality (VR) technology provides an immersive, multisensory, and three-dimensional (3D) environment that enables users to have modified experiences of reality by creating a sense of “presence” (i.e. interactive). The sense of presence, or “being there” in VR, is facilitated through the use of technology such as head-mounted displays, gesture-sensing gloves, synthesized sounds, and vibrotactile platforms, which allow for the stimulation of multiple senses and active exploration of the virtual environment. Augmented Reality (AR) provides an enhanced version of reality where live direct or indirect views of physical real-world environments are augmented with superimposed computer-generated images over a user’s view of the real-world, thus enhancing one’s current perception of reality. To date, VR and AR have been used in numerous clinical and non-clinical settings to promote healthy lifestyles or well-being, to help treat anxiety disorders, control pain, support physical rehabilitation, and distract patients during wound care. This chapter will explore the uses of VR and AR within healthcare with an emphasis on mood disturbances and pain triggered by cancer or its related treatments. 

8. Utilising IoT (Internet of Things) in healthcare - The growth of the Internet of Things (IoT) has meant that more and more people (including patients, healthcare users and healthcare providers) are becoming hyperconnected across multiple devices that can range from desktop to laptops, mobiles and smart devices people use on a daily basis: wearables like Fitbit, the Apple Watch, car navigation and entertainment, and even home appliances. The IoT is primarily a network of physical devices that uses connectivity to enable the exchange of data. IoT in healthcare facilitates mundane albeit important tasks to improve patient outcomes, and also takes some of the burden off health practitioners. Tasks such as remote patient monitoring, treatment progress observation, and the housing of vaccines are all capabilities of medical devices with integrated IoT. 

9. The use of gaming in healthcare - Serious Games is a term used to describe the development of games specifically designed to achieve some change in the player. This could be a change in knowledge, attitude, physical ability, cognitive ability, health, or mental wellbeing. One of primary motivators in computer games is the sense of agency provided by being able to influence the course of events, the tight relationship between your actions, and the outcome of the game. The chapter will explore how and in what areas of healthcare, serious games have been implemented and what challenges their utilisation entails. 

10. mhealth interventions for the promotion of physical activity - Mobile health (mHealth) technology has rapidly gained popularity in the general population. mHealth technology includes wearable PA monitors or trackers and smartphone applications (apps) designed to help people to manage their own health and wellbeing. This chapter will elaborate on the types of mhealth interventions and the ways that these interventions can be utilised to promote physical activity. 

11. Implementation of digital interventions in practice – This chapter will focus on how various digital interventions are utilised in practice in order to optimise their acceptance, adherence to their use and effectiveness. 

12. Challenges and future directions – developing and utilising technology in the healthcare setting is not without challenges. This chapter will provide insight to these challenges that developers and users of such technologies might face and how these can be changed into opportunities. Scientists, clinicians and educators are just beginning to scratch the surface when it comes to current applications of technology in the healthcare context for the management of the disease. Historically, these technologies have been expensive, available to few and mostly sought out by researchers and specialised technicians. These technologies have been integrated into a variety of healthcare settings for routine painful medical procedures, physical therapy, pain rehabilitation, chronic pain management and to treat a variety of psychiatric conditions (i.e., anxiety, post-traumatic stress disorder), to name a few but on the horizon there are new areas and possibilities opened up for such technologies.

O autorze

Andreas Charalambous, BSc, MSc, PGCert (Research), PhD (Oncology Nursing), started his nursing career in 1995. With a clinical background in cancer care and more specifically in oncology, he has worked clinically and academically in Cyprus, U.K and Finland. He has a long and proven track in academia since 2004. He holds an Associate’s Professor’s position of Oncology and Palliative Care at the Cyprus University of Technology and an Adjunct Professor’s  position at the University of Turku (Finland). He is EONS (European Oncology Nursing Society) President (2019-2021). Presently he is involved in several National and International research programs (i.e HORIZON, COST, ERASMUS+, EEPO, ICP) in various fields of care with specific interest in cancer and palliative care, elderly care (i.e various contexts) and dementia. He has published over 100 National and International publications in esteem journals in the fields of cancer care, quality care, supportive care and Integrative Medicine (i.e interest in non-pharmacological interventions). A major area of research interest includes the application of health technologies in specific cancer and dementia (with a palliative care interest) groups of patients. These technologies include the use of Virtual Reality Environments in managing mood disturbances of patients that undergo treatment for lung cancer and dementias (i.e. Alzheimer’s), the support of the educational needs of informal caregivers through virtual coaching applications and the use of App’s as (advanced) assessing tools for specific treatment toxicities just to report a few. The bibliometrics of his work are: H-index 26 and i10-index 56 and over 2000 citations.

Blurb

This book discusses the current trends in nursing and healthcare in relation to the integration of information technological interventions across the care continuum. The use of such interventions in healthcare has increased rapidly in recent years, partly due to the rise in technological gadgets/applications used in daily routines (e.g. actigraphy bracelets, smartphones) and their unique properties that can be utilized in assessing, monitoring and managing a patient’s condition remotely. This book highlights the areas and the ways in which these interventions can facilitate patient assessment and monitoring and complement conventional treatments in the management of disease-induced or treatment-induced side effects. Furthermore, the book describes the development of such interventions and examines how they are designed to promote adherence and acceptance by the user. To this end, the book also discusses the need for personalizing the technological experience according to the user’s preferences and needs. Drawing on the latest studies in these areas, it not only provides suggestions for undertaking research in this context, but also offers insights into how these technologies impact patients’ clinical outcomes. Lastly, it addresses the challenges of utilizing such technologies and future directions.

Providing multiple perspectives on the topic, the book appeals to a wide range of readers, including nurses, clinicians, researchers, technology experts and students, making them familiar with a broad selection of technological interventions and their application in clinical practice. Moreover, it highlights the factors that need to be considered in the development (and testing) of future interventions, in particular in nursing, and provides inspiration for future studies.