Free, publicly-accessible full text available December 27, 2024
Note: When clicking on a Digital Object Identifier (DOI) number, you will be taken to an external site maintained by the publisher.
Some full text articles may not yet be available without a charge during the embargo (administrative interval).
What is a DOI Number?
Some links on this page may take you to non-federal websites. Their policies may differ from this site.
-
-
more » « less
Abstract Objective Combined with mobile monitoring devices, telehealth generates overwhelming data, which could cause clinician burnout and overlooking critical patient status. Developing novel and efficient ways to correctly triage such data will be critical to a successful telehealth adoption. We aim to develop an automated classification framework of existing nurses’ notes for each alert that will serve as a training dataset for a future alert triage system for telehealth programs.
Materials and Methods We analyzed and developed a coding framework and a regular expression-based keyword match approach based on the information of 24 931 alert notes from a community-based telehealth program. We evaluated our automated alert triaging model for its scalability on a stratified sampling of 800 alert notes for precision and recall analysis.
Results We found 22 717 out of 24 579 alert notes (92%) belonging to at least one of the 17 codes. The evaluation of the automated alert note analysis using the regular expression-based information extraction approach resulted in an average precision of 0.86 (SD = 0.13) and recall 0.90 (SD = 0.13).
Discussion The high-performance results show the feasibility and the scalability potential of this approach in community-based, low-income older adult telehealth settings. The resulting coded alert notes can be combined with participants’ health monitoring results to generate predictive models and to triage false alerts. The findings build steps toward developing an automated alert triaging model to improve the identification of alert types in remote health monitoring and telehealth systems.
-
Background Over the past 2 decades, various desktop and mobile telemedicine systems have been developed to support communication and care coordination among distributed medical teams. However, in the hands-busy care environment, such technologies could become cumbersome because they require medical professionals to manually operate them. Smart glasses have been gaining momentum because of their advantages in enabling hands-free operation and see-what-I-see video-based consultation. Previous research has tested this novel technology in different health care settings. Objective The aim of this study was to review how smart glasses were designed, used, and evaluated as a telemedicine tool to support distributed care coordination and communication, as well as highlight the potential benefits and limitations regarding medical professionals’ use of smart glasses in practice. Methods We conducted a literature search in 6 databases that cover research within both health care and computer science domains. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology to review articles. A total of 5865 articles were retrieved and screened by 3 researchers, with 21 (0.36%) articles included for in-depth analysis. Results All of the reviewed articles (21/21, 100%) used off-the-shelf smart glass device and videoconferencing software, which had a high level of technology readiness for real-world use and deployment in care settings. The common system features used and evaluated in these studies included video and audio streaming, annotation, augmented reality, and hands-free interactions. These studies focused on evaluating the technical feasibility, effectiveness, and user experience of smart glasses. Although the smart glass technology has demonstrated numerous benefits and high levels of user acceptance, the reviewed studies noted a variety of barriers to successful adoption of this novel technology in actual care settings, including technical limitations, human factors and ergonomics, privacy and security issues, and organizational challenges. Conclusions User-centered system design, improved hardware performance, and software reliability are needed to realize the potential of smart glasses. More research is needed to examine and evaluate medical professionals’ needs, preferences, and perceptions, as well as elucidate how smart glasses affect the clinical workflow in complex care environments. Our findings inform the design, implementation, and evaluation of smart glasses that will improve organizational and patient outcomes.more » « less
-
more » « less
Abstract Objective This study aims to investigate key considerations and critical factors that influence the implementation and adoption of smart glasses in fast-paced medical settings such as emergency medical services (EMS).
Materials and Methods We employed a sociotechnical theoretical framework and conducted a set of participatory design workshops with 15 EMS providers to elicit their opinions and concerns about using smart glasses in real practice.
Results Smart glasses were recognized as a useful tool to improve EMS workflow given their hands-free nature and capability of processing and capturing various patient data. Out of the 8 dimensions of the sociotechnical model, we found that hardware and software, human-computer interface, workflow, and external rules and regulations were cited as the major factors that could influence the adoption of this novel technology. EMS participants highlighted several key requirements for the successful implementation of smart glasses in the EMS context, such as durable devices, easy-to-use and minimal interface design, seamless integration with existing systems and workflow, and secure data management.
Discussion Applications of the sociotechnical model allowed us to identify a range of factors, including not only technical aspects, but also social, organizational, and human factors, that impact the implementation and uptake of smart glasses in EMS. Our work informs design implications for smart glass applications to fulfill EMS providers’ needs.
Conclusion The successful implementation of smart glasses in EMS and other dynamic healthcare settings needs careful consideration of sociotechnical issues and close collaboration between different stakeholders.
-
Clinical documentation is a time-consuming and challenging task, especially in time-critical medical settings. Even with a dedicated scribe person, timely and accurate documentation under time constraints is never easy. In this work, we present a unique type of fast-paced medical team--emergency medical services (EMS)--which has no designated role for documentation while constantly working outside in the field to provide urgent patient care. Through interviews with 13 EMS practitioners, we reveal several interesting and prominent characteristics of EMS documentation practice as well as their associated challenges: EMS practitioners self-organize and collaborate on documentation while in the meantime being both physically and cognitively preoccupied with high-acuity patients, having limited capability to use handheld documentation systems in real-time, and being overwhelmed by strict documentation requirements and regulations. Lastly, we use our findings to discuss both technical and non-technical implications to support timely and collaborative documentation in dynamic medical contexts while accounting for care providers' physical and cognitive constraints in using computing devices.more » « less
-
more » « less
Abstract Topological surface-states can acquire an energy gap when time-reversal symmetry is broken by interfacing with a magnetic insulator. This gap has yet to be measured. Such topological-magnetic insulator heterostructures can host a quantized anomalous Hall effect and can allow the control of the magnetic state of the insulator in a spintronic device. In this work, we observe the energy gap of topological surface-states in proximity to a magnetic insulator using magnetooptical Landau level spectroscopy. We measure Pb1-xSnxSe–EuSe heterostructures grown by molecular beam epitaxy exhibiting a record mobility and low Fermi energy. Through temperature dependent measurements and theoretical calculations, we show this gap is likely due to quantum confinement and conclude that the magnetic proximity effect is weak in this system. This weakness is disadvantageous for the realization of the quantum anomalous Hall effect, but favorable for spintronic devices which require the preservation of spin-momentum locking at the Fermi level.
-
Background Smart glasses have been gaining momentum as a novel technology because of their advantages in enabling hands-free operation and see-what-I-see remote consultation. Researchers have primarily evaluated this technology in hospital settings; however, limited research has investigated its application in prehospital operations. Objective The aim of this study is to understand the potential of smart glasses to support the work practices of prehospital providers, such as emergency medical services (EMS) personnel. Methods We conducted semistructured interviews with 13 EMS providers recruited from 4 hospital-based EMS agencies in an urban area in the east coast region of the United States. The interview questions covered EMS workflow, challenges encountered, technology needs, and users’ perceptions of smart glasses in supporting daily EMS work. During the interviews, we demonstrated a system prototype to elicit more accurate and comprehensive insights regarding smart glasses. Interviews were transcribed verbatim and analyzed using the open coding technique. Results We identified four potential application areas for smart glasses in EMS: enhancing teleconsultation between distributed prehospital and hospital providers, semiautomating patient data collection and documentation in real time, supporting decision-making and situation awareness, and augmenting quality assurance and training. Compared with the built-in touch pad, voice commands and hand gestures were indicated as the most preferred and suitable interaction mechanisms. EMS providers expressed positive attitudes toward using smart glasses during prehospital encounters. However, several potential barriers and user concerns need to be considered and addressed before implementing and deploying smart glasses in EMS practice. They are related to hardware limitations, human factors, reliability, workflow, interoperability, and privacy. Conclusions Smart glasses can be a suitable technological means for supporting EMS work. We conclude this paper by discussing several design considerations for realizing the full potential of this hands-free technology.more » « less
-
The temperature-dependent layer-resolved structure of 3 to 44 unit cell thick SrRuO 3 (SRO) films grown on Nb-doped SrTiO 3 substrates is investigated using a combination of high-resolution synchrotron x-ray diffraction and high-resolution electron microscopy to understand the role that structural distortions play in suppressing ferromagnetism in ultra-thin SRO films. The oxygen octahedral tilts and rotations and Sr displacements characteristic of the bulk orthorhombic phase are found to be strongly dependent on temperature, the film thickness, and the distance away from the film–substrate interface. For thicknesses, t, above the critical thickness for ferromagnetism ( t > 3 uc), the orthorhombic distortions decrease with increasing temperature above T C . Below T C , the structure of the films remains constant due to the magneto-structural coupling observed in bulk SRO. The orthorhombic distortions are found to be suppressed in the 2–3 interfacial layers due to structural coupling with the SrTiO 3 substrate and correlate with the critical thickness for ferromagnetism in uncapped SRO films.more » « less
