ABSTRACT
Background: Both COVID-19 and the measures taken to control the pandemic may significantly affect cardiovascular health. The effects of a lockdown on physical activity and its potential consequences for arrhythmia burden remain largely unknown. Purpose(s): In this study, we investigated the effect of the lockdown during the first COVID-19 wave on patients' physical activity and arrhythmia burden. Method(s): All patients with an ICD connected to a Carelink homemonitoring system from two Dutch hospitals were included. Anonymized data on physical activity, heart rate, and occurrence of ventricular tachycardia/ fibrillation (VT/VF), and atrial fibrillation/tachycardia (AF/AT) were obtained and were compared between March-April 2020 (lockdown) and March-April 2019 (reference) within each patient. The study was approved by the local ethics committee. Result(s): The ICDs of 531 patients registered significantly less activity during de lockdown period compared to the reference period (210+/-104 min vs 182+/-103 min, p<0.0001, Figure 1, panels A and B), while weather conditions improved (1A). Daytime and nighttime heart rates were significantly lower during lockdown compared to the reference period (71.3+/-9 bpm vs 72.6+/-9 bpm, p<0.0001 and 63.4+/-9 vs 63.8+/-9, p=0.02, respectively). AF/AT burden increased (Figure 2A) while number of VT/VF episodes decreased (2B). There was no significant difference in number of NSVT episodes. Conclusion(s): During the lockdown in the first COVID-19 wave, the Carelink system revealed significantly less activity, increase in AF/AT burden and decrease in VT/VF episodes. Further investigation is needed to understand the relationship between physical activity and the occurrence of arrhythmias in ICD patients. (Figure Presented).
ABSTRACT
Cloud computing is an evolving technology to maintain the database of any system. Data collected from any part of the system will be transferred to the cloud, and it will be retrieved at any point in time. It plays a vital role in biomedical applications, where a huge number of patient records are needed to be maintained. In recent years, we faced an unexpected pandemic condition due to COVID-19 diseases. Routine human life has turned upside down due to it. This disease affects various age groups of people, and the number of patients affected is also growing exponentially, day after day, across the globe. The treatment for this critical illness is not the same for patients of different age levels. Aged people may be already affected by various diseases, whereas middle-aged and children may not be. COVID-19 is getting more vulnerable, and the death rate is increasing. Diagnosing this disease is a tedious task for doctors. Symptoms collected from patients of various ages and the treatment methods offered to them should be appropriately maintained. This may ease out ways to cure the upcoming affected patients. In this paper, we present an overall review of various cloud-based electronic health care recording methods that are currently available. Personal health records (PHRs) are stored on a remote cloud server using these approaches. The selective information will be shared when needed by a physician for diagnosis and treatment. Many new cloud-based systems are developed, which have more secure and safe data transfer compared to the conventional client–server model. Security is the most concerned parameter for the emerging cloud technologies as PHRs are to be maintained confidentially. The various existing cloud-based models are reviewed in the aforementioned aspect. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Telemedicine is the delivery of health care from a distance. It also includes research and evaluation of such services using health data which are stored in "Electronic Health Record" (EHR) platforms. EHR has proved to be useful in monitoring health care delivery but setting up of such platforms is tedious and resource-consuming in developing countries. With the recent surge of telemedicine utility during the COVID-19 pandemic, telemedicine has emerged to be pivotal in reaching stranded patients needing care without EHR-based practice. The practice of patient health record (PHR)-based teleconsultations in India has demonstrated how a conventional "paper and pen" method can be combined to popularise telemedicine utility. Thus, use of PHR-based system to maintain health records would prove to be a pragmatic solution for physicians in low-resource settings to improve their reach to a larger population in need for the future.
Subject(s)
COVID-19 , Telemedicine , Humans , Pandemics , Developing Countries , India , Telemedicine/methodsABSTRACT
With the prevailing COVID-19 pandemic, the lack of digitally-recorded and connected health data poses a challenge for analysing the situation. Virus outbreaks, such as the current pandemic, allow for the optimisation and reuse of data, which can be beneficial in managing future outbreaks. However, there is a general lack of knowledge about the actual flow of information in health facilities, which is also the case in Uganda. In Uganda, where this case study was conducted, there is no comprehensive knowledge about what type of data is collected or how it is collected along the journey of a patient through a health facility. This study investigates information flows of clinical patient data in health facilities in Uganda. The study found that almost all health facilities in Uganda store patient information in paper files on shelves. Hospitals in Uganda are provided with paper tools, such as reporting forms, registers and manuals, in which district data is collected as aggregate data and submitted in the form of digital reports to the Ministry of Health Resource Center. These reporting forms are not digitised and, thus, not machine-actionable. Hence, it is not easy for health facilities, researchers, and others to find and access patient and research data. It is also not easy to reuse and connect this data with other digital health data worldwide, leading to the incorrect conclusion that there is less health data in Uganda. The a FAIR architecture has the potential to solve such problems and facilitate the transition from paper to digital records in the Uganda health system. © 2022 Chinese Academy of Sciences. Published under a Creative Commons Attribution 4.0 International (CC BY 4.0) license.
ABSTRACT
Background: Both COVID-19 and the measures taken to control the pandemic may significantly affect cardiovascular health. The effects of a lockdown on physical activity and its potential consequences for arrhythmia burden remain largely unknown. Purpose: In this study, we investigated the effect of the lockdown during the first COVID-19 wave on patients' physical activity and arrhythmia burden. Methods: All patients with an ICD connected to a Carelink home-monitoring system from two Dutch hospitals were included. Anonymized data on physical activity, heart rate, and occurrence of ventricular tachycardia/fibrillation (VT/VF), and atrial fibrillation/tachycardia (AF/AT) were obtained and were compared between March-April 2020 (lockdown) and March-April 2019 (reference) within each patient. The study was approved by the local ethics committee. Results: The ICDs of 531 patients registered significantly less activity during de lockdown period compared to the reference period (21,895 ±12,394min vs 25,173±12,532min, p<0.0001, panel a). Daytime and nighttime heart rates were significantly lower during lockdown compared to the reference period (71.3±9bpm vs 72.6±9bpm, p<0.0001 and 63.4±9 vs 63.8±9, p=0.02, respectively). 94 patients with VT/VF during the reference period did not show any VT/VF during lockdown, while only 4 patients without VT/VF during the reference period showed VT/VF during lockdown (p<0.0001, panel B). There was no significant difference in the occurrence of NSVT or AF/AT. Conclusion: During the lockdown in the first COVID-19 wave, the Carelink system revealed significantly less activity and lower heart rates. Moreover, there was a significant reduction in the occurrence of VT/VF. (Figure Presented).
ABSTRACT
Medical professionals need new technologies like the Internet of Things (IoT) and Artificial Intelligence (AI) to combat COVID-19. A major aspect of this study is to examine how IoT-based remote monitoring technology can be used to record the medical history of patients, trace, monitor, analyze, and prevent COVID-19 and other health outbreaks. We have designed an IoT based patient's health record (PHR) that includes actual and prospective information about the patient, including their contacts with healthcare providers, medications, and a history of operations and hospitalizations. By making medical records available to patients, they can become more involved in their own health care, and this will help reduce direct contact with health care providers. The risk of a virus or infection spreading among medical health care providers and patients can be minimized through reduced contact. The system stores patient's personal information and medical records. Information regarding the next appointment, medicine intake, and prescriptions is sent to the patients on their email address. Additionally, we have built an Ambulance Kit using Arduino Nano, which is intended for use during medical emergencies.
ABSTRACT
BACKGROUND: Comprehensive multi-institutional patient portals that provide patients with web-based access to their data from across the health system have been shown to improve the provision of patient-centered and integrated care. However, several factors hinder the implementation of these portals. Although barriers and facilitators to patient portal adoption are well documented, there is a dearth of evidence examining how to effectively implement multi-institutional patient portals that transcend traditional boundaries and disparate systems. OBJECTIVE: This study aims to explore how the implementation approach of a multi-institutional patient portal impacted the adoption and use of the technology and to identify the lessons learned to guide the implementation of similar patient portal models. METHODS: This multimethod study included an analysis of quantitative and qualitative data collected during an evaluation of the multi-institutional MyChart patient portal that was deployed in Southwestern Ontario, Canada. Descriptive statistics were performed to understand the use patterns during the first 15 months of implementation (between August 2018 and October 2019). In addition, 42 qualitative semistructured interviews were conducted with 18 administrative stakeholders, 16 patients, 7 health care providers, and 1 informal caregiver to understand how the implementation approach influenced user experiences and to identify strategies for improvement. Qualitative data were analyzed using an inductive thematic analysis approach. RESULTS: Between August 2018 and October 2019, 15,271 registration emails were sent, with 67.01% (10,233/15,271) registered for an account across 38 health care sites. The median number of patients registered per site was 19, with considerable variation (range 1-2114). Of the total number of sites, 55% (21/38) had ≤30 registered patients, whereas only 2 sites had over 1000 registered patients. Interview participants perceived that the patient experience of the portal would have been improved by enhancing the data comprehensiveness of the technology. They also attributed the lack of enrollment to the absence of a broad rollout and marketing strategy across sites. Participants emphasized that provider engagement, change management support, and senior leadership endorsement were central to fostering uptake. Finally, many stated that regional alignment and policy support should have been sought to streamline implementation efforts across participating sites. CONCLUSIONS: Without proper management and planning, multi-institutional portals can suffer from minimal adoption. Data comprehensiveness is the foundational component of these portals and requires aligned policies and a key base of technology infrastructure across all participating sites. It is important to look beyond the category of the technology (ie, patient portal) and consider its functionality (eg, data aggregation, appointment scheduling, messaging) to ensure that it aligns with the underlying strategic priorities of the deployment. It is also critical to establish a clear vision and ensure buy-ins from organizational leadership and health care providers to support a cultural shift that will enable a meaningful and widespread engagement.