Successes and Failures in Telehealth 2017

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1 LOGO Mobile health (m-health) for chronic management: a review of the literature By: Sharareh R. Niakan Kalhori October 31, 2017 List of Content: Aim of Study Material and Methods Conclusion Authors 1 What is Chronic Wound? Chronic is defined as a break in the skin of long duration (6 weeks) or frequent recurrence. Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity. In today s society, chronic s represent a major healthcare burden. Approximately 1% to 2% of individuals will be affected by leg ulceration during their lifetime, and this figure will likely increase as the population ages. Global care expenditures amount to $13 to $15 billion annually. Chronic Wound Types Venous Stasis Ulcers Arterial Ulcers Diabetic Ulcers Pressure Ulcers (Bedsores) Traumatic Ulcers Post-Surgical Wounds Chronic Care Management: Management is on aesthetics, comfort, prevention of bleeding and dealing with malodour (usually caused by infection) (SESLD and ISLHD Wound Care Committee, April 2014). 1

2 Chronic Wound Mnagement includes 5 majors steps: Prevention Early Detection and correct Diagnosis Assessment and Treatment Durable Monitoring, Control and Follow-up Patients Support for Self-care and Selfmanagement m-health Definition The defined m-health or mobile health as medical and public health practice supported by mobile device, such as mobile phones, patient monitoring devices, personal digital assistant(pdas), and other wireless devices (definition by Global Observatory for e-health(goe)). Aims of Study General aim: to reveal the role of m-health technology in the management of chronic s through previously defined steps enhancement. Material &Methods Data bases We searched four database for studies reporting use of mobile devices to manage chronic. We then checked the reference list of retrieved review papers and hand searched the Journal of Medical Internet Research identifing seven more papers. Search criteria The mobile devices should be used in one of the stage of chronic management. Number of reviewers Two of the researchers reviewed the articles. The PRISMA of searched sources Record identified through searching Emabase, PubMEd, ISI, Scopus N=656 Study screen eligibility N=507 Article assessed after tittles and abstracts screening N=141 Study included in review N=76 Record after duplicate removed N=507 Additional records identified through other source (manual) N=8 Complementary research: N=6 References: N=2 Study excluded based on title and abstract N=366 Article excluded N=65 Material &Methods Inclusion Criteria English Papers Reporting the usage of mobile devices for identify, manage, control, improve, heal or enhance self-care and selfmanagement of chronic for patients and providers Exclusion Criteria Records including Technical reports, commentaries, opinions, letters, debates and review article Also any study not using mobile devices was deleted. 2

3 THE FREQUENCY OF TARGET GROUPS WHO USED MOBILE DEVICES FOR CHRONIC CARE MANAGEMENT THE FREQUENCY OF PLATFORM OF MOBILE DEVICES USED FOR CHRONIC WOUND MANAGEMENT 8% 2 Health care professionals and workers Patients Both group 42% 6% 37% IOS Android Both Platform None Unspecified Unespecified 8% 7% THE FREQUENCY OF WOUND TYPE WHICH HAVE BEEN MANAGED BY MOBILE DEVICES THE FREQUENCY OF STEPS THAT MOBILE DEVICES USED FOR CHRONIC WOUND MANAGEMENT 5% 5% 6% 13% 29% Diabetic foot ulcer Bed sore, Pressure ulcer, Decubitus ulcer Wound after surgery Skin ulcer leg and extremity More than 2 type ulcer other Unspecified 16% 13% 33% 20% 10% prevention detection and diagnosis assessment and monitoring,contol and follow-up self-management and selfcare unespesified more than two stage Type of chronic Diabetic foot ulcer Pressure Ulcer, Bedsore & Decubitus Ulcer What have been done for each type of Chronic Wound by Mobile Devices Health Stages sorted in order of frequency prevention diagnosis monitoring &control follow up assessment & Prevention monitor control and follow up Assessment and self-management and self-care Technology of Mobile Devices mobile phone to capture image To capture and analyze the images of electronic smart devices and sensor for data collecting. sensor and mobile phone to capture image and analyzing the images of. Features in Mobile apps alerting, tracking reminding Education messaging Alerting Reminding tracking messaging Type of chronic Skin Ulcer After surgery Extremity Continue Health stages sorted in order of frequency assessment and monitor, control and follow- up monitor, control and follow-up phase Assessment & monitor, control and follow- up Technology of Mobile Devices mobile app mobile phone to capture image and analyze the images of. Features in Mobile apps tracking tracking communication 3

4 in prevention step: Mainly two type of including diabetic foot ulcer and pressure ulcer (bed sore, decubitus ulcer) Applied Technologies: - mobile Apps, sensor and electronic and smart devices; mobile Apps either were developed solely or to improve their performance were integrated with sensors in a system. In Detection &Diagnosis step: Wound Type: only on diabetic foot ulcers. Main Technologies: mobile application and taking images of by mobile. Feature: The most common feature used in this section was tracking. Feature in prevention step: Tracking, Alerting, Reminding and Messaging. In Treatment & Assessment step: The variety of s studied in this section was more than the previous two sections and diabetic foot ulcer and pressure ulcer were more common than others. Technology: In this section, as in previous sections develop and use of mobile application was more commonplace than others, then use of mobile devices for image capturing was common. Also mobile devices were used to analyze images. Features Messaging was the most common features. In Self-management & Self-care step: : In this section, three types of include pressure ulcer, Skin ulcer and Spinabifida were studied. Technology: The only technology used in this section was mobile application. Features: Reminding, Tracking and Education were the features used in this section. In Monitor, Control & Follow-up step: All of the chronic s were reported in reviewed studies. Technology: Mobile devices used for capturing and analyzing the images of, but in some cases only mobile Apps were also used. The use of the sensor was also reported. Features: The features that used in this section was Alerting, Tracking and Communication. Conclusion The most commonly use of mobile devices in the chronic management is develop and use mobile application that can used alone or in conjunction with a sensor and in second grade is using the mobile device for image capturing and image analyzing. Common features that used in chronic management development were alerting, tracking, reminding, messaging, data collecting, education and communication. 4

5 Conclusion The use of mobile phone for chronic management may lead in: providing higher quality care increasing the knowledge of care providers, patients and their relatives facilitating tele- care reducing the cost of patient care and patient transportation decreasing the rate of infection, amputation and death. Authors : Dr. Reza Safdari, Professor of Health Information Management at Tums, Tehran, Iran Dr. Farhad Fatehi, Postdoctoral Research Fellow at the UQ Centre for Online Health, Queensland, Brisbane, Australia Mahsa Mosadeghi-Nik, MSc student of Medical Informatics at Tums, Iran Dr. Sharareh R. Niakan Kalhori, Assistant Professor at TUMS, Tehran, Iran LOGO 27 5