Redesigning Work With a Lightweight Approach to Coordination Technology.

Coordination of information and resources is central to efficient ward management. Tools to aid coordination include standardized procedures and paper lists and, more recently, electronic tools such as whiteboards and mobile solutions. This study reports on the experiences and effects of designing and implementing collaboration technology, and how the use of light-weight technology has enabled redesign of traditional work processes. The process followed the principles for user-centered development and is evaluated through observations and informal interviews of users and stakeholders. In addition to the expected changes in work processes, we found that short redesign cycles with heavy user involvement afforded by this technology enabled implementation of new ways of structuring and combining information that were not foreseen. This turned the collaboration technology into a tool that also guided prioritization between tasks and contributed to the effects seen in use of resources, user satisfaction, and quality of treatment.

Wearable and Mobile Technology for Safe and Active Living.

The study explores how mobile safety alarms can be utilized for ambient assisted living (AAL), and provides elderly safety, autonomy, independence and mobility. The aim is to generate knowledge on usage, usability and technical requirements to harvest the potential benefits of using wearable and mobile technologies in care for safe and active living. The study is based on real life pilots in three Norwegian municipalities with 71 users, their caregivers and relatives. Pilot users wore the mobile safety alarm while performing their daily activities - indoor and outdoor. The study shows increased safety to users, their relatives and caregivers and increased activity and mobility indicating improved social and physical health. Further development of wearables and mobile technologies is requested to meet user needs, and the inclusion of relatives imposes new challenges in terms of privacy. Mobile safety alarms represent a huge potential for efficiency and innovation in integrated care, but new tools are required for efficient collaboration and operation for large-scale implementations.

Persons with Dementia and Their Caregivers Using GPS.

The aim of the study is to generate knowledge on the use of Global Positioning Systems (GPS) to support autonomy and independence for persons with dementia. By studying a larger cohort of persons with dementia (n=208) and their caregivers, this study provides essential knowledge for planning and implementing GPS technology as a part of public health care services. Commercially available GPS technology was provided to the cohort of 208 persons with dementia from nineteen different Norwegian municipalities. The participants used GPS when performing outdoor activities as part of their daily life during a period of time between 2012 and 2014. Their family caregivers were instructed on how to use the GPS technology for locating the participants. The study documents that using GPS for locating persons with dementia provide increased safety for the person with dementia, their family caregivers and their professional caregivers. Furthermore the results confirm that by using GPS, persons with dementia may maintain their autonomy, enjoy their freedom and continue their outdoor activities despite the progression of the disease. Preconditions for successful implementation are that health professionals are trained to assess the participant's needs, that ethical dilemmas are considered, that caregivers have adequate knowledge about using the technology and that procedures and routines for administrating the GPS and locating persons with dementia are established. Early intervention and close collaboration between persons with dementia, family caregivers and professional caregivers are important for successful implementation of GPS in public health care.

Criteria for successful uptake of AAL technologies: lessons learned from Norwegian pilot projects.

Implementation of AAL-technology as an integrated part of public health and care services requires a systematic and multidisciplinary approach. There are several challenges that need to be handled in parallel and with sustained effort over time, to tackle the multidimensional problem of building the value chain that is required for widespread uptake of AAL technology. Several pilot projects are on-going in Norway, involving municipalities, technology providers and research partners. Examples are "Home Safety" (NO: Trygghetspakken) and "Safe Tracks" (NO: Trygge spor). This paper will elaborate on our lessons learned with focus on five main points: 1) User-friendly and robust technology 2) Technology adapted organization 3) Service oriented technology providers 4) Care service organizations as demanding customer and 5) Sustainable financial model.

Towards quality assurance of AAL services.

The Ambient Assisted Living domain is a fast growing area with many new technological artefacts and services developed. Most of the systems developed address end-users' needs. Yet, they have not achieved a large market penetration. The work presented here argues that this is primarily due to not sufficiently addressing the quality requirements posed by the health care organizations. Satisfying quality requirements requires a standardized and easily accessible framework for measuring quality. We present the initial steps towards such a framework by building on relevant ISO standards.

Towards a "Sample-In, Answer-Out" Point-of-Care Platform for Nucleic Acid Extraction and Amplification: Using an HPV E6/E7 mRNA Model System.

The paper presents the development of a "proof-of-principle" hands-free and self-contained diagnostic platform for detection of human papillomavirus (HPV) E6/E7 mRNA in clinical specimens. The automated platform performs chip-based sample preconcentration, nucleic acid extraction, amplification, and real-time fluorescent detection with minimal user interfacing. It consists of two modular prototypes, one for sample preparation and one for amplification and detection; however, a common interface is available to facilitate later integration into one single module. Nucleic acid extracts (n = 28) from cervical cytology specimens extracted on the sample preparation chip were tested using the PreTect HPV-Proofer and achieved an overall detection rate for HPV across all dilutions of 50%-85.7%. A subset of 6 clinical samples extracted on the sample preparation chip module was chosen for complete validation on the NASBA chip module. For 4 of the samples, a 100% amplification for HPV 16 or 33 was obtained at the 1 : 10 dilution for microfluidic channels that filled correctly. The modules of a "sample-in, answer-out" diagnostic platform have been demonstrated from clinical sample input through sample preparation, amplification and final detection.