healthcare technology

医疗保健技术
  • 文章类型: Journal Article
    雾计算是一个分散的计算基础设施,处理数据或接近其来源,减少延迟和带宽使用。该技术因其在关键医疗场景中增强实时数据处理和决策能力的潜力而在医疗保健领域获得关注。对医疗保健中雾计算的现有文献进行了系统综述。审查包括在PubMed等主要数据库中的搜索,IEEEXplore,Scopus,谷歌学者。使用的搜索词是“医疗保健中的雾计算,“\”实时诊断和雾计算,\"\"连续病人监护雾计算,预测分析雾计算,雾计算医疗保健中的“\”互操作性,“\”可扩展性问题雾计算医疗保健,“和”安全挑战雾计算医疗保健。“考虑了2010年至2023年之间发表的文章。纳入标准包括同行评审的文章,会议文件,并回顾有关雾计算在医疗保健中的应用的文章。排除标准是没有英文文章,那些与医疗保健应用无关的,以及那些缺乏经验数据的人。数据提取的重点是雾计算在实时诊断中的应用,连续监测,预测分析,以及已确定的互操作性挑战,可扩展性,和安全。雾计算通过促进实时数据分析,显著增强了诊断能力,对于中风检测等紧急诊断至关重要,通过处理更接近其来源的数据。它还可以通过实时处理生命体征和生理参数来改善手术期间的监测,从而提高患者的安全性。在慢性病管理中,通过可穿戴设备进行持续的数据收集和分析,可以实现主动的疾病管理和及时调整治疗计划。此外,雾计算通过实现远程专家和患者之间的实时通信来支持远程医疗,从而改善服务不足地区获得专科护理的机会。雾计算在医疗保健领域提供了变革性的潜力,提高诊断精度,病人监护,个性化治疗。应对互操作性的挑战,可扩展性,安全性对于充分实现雾计算在医疗保健中的好处至关重要,带来更加互联和高效的医疗环境。
    Fog computing is a decentralized computing infrastructure that processes data at or near its source, reducing latency and bandwidth usage. This technology is gaining traction in healthcare due to its potential to enhance real-time data processing and decision-making capabilities in critical medical scenarios. A systematic review of existing literature on fog computing in healthcare was conducted. The review included searches in major databases such as PubMed, IEEE Xplore, Scopus, and Google Scholar. The search terms used were \"fog computing in healthcare,\" \"real-time diagnostics and fog computing,\" \"continuous patient monitoring fog computing,\" \"predictive analytics fog computing,\" \"interoperability in fog computing healthcare,\" \"scalability issues fog computing healthcare,\" and \"security challenges fog computing healthcare.\" Articles published between 2010 and 2023 were considered. Inclusion criteria encompassed peer-reviewed articles, conference papers, and review articles focusing on the applications of fog computing in healthcare. Exclusion criteria were articles not available in English, those not related to healthcare applications, and those lacking empirical data. Data extraction focused on the applications of fog computing in real-time diagnostics, continuous monitoring, predictive analytics, and the identified challenges of interoperability, scalability, and security. Fog computing significantly enhances diagnostic capabilities by facilitating real-time data analysis, crucial for urgent diagnostics such as stroke detection, by processing data closer to its source. It also improves monitoring during surgeries by enabling real-time processing of vital signs and physiological parameters, thereby enhancing patient safety. In chronic disease management, continuous data collection and analysis through wearable devices allow for proactive disease management and timely adjustments to treatment plans. Additionally, fog computing supports telemedicine by enabling real-time communication between remote specialists and patients, thereby improving access to specialist care in underserved regions. Fog computing offers transformative potential in healthcare, improving diagnostic precision, patient monitoring, and personalized treatment. Addressing the challenges of interoperability, scalability, and security will be crucial for fully realizing the benefits of fog computing in healthcare, leading to a more connected and efficient healthcare environment.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:跨语言评估基于人工智能(AI)的模型对于确保多语言环境中信息的公平访问和准确性至关重要。这项研究旨在比较英语和阿拉伯语中用于传染病查询的AI模型效率。
    方法:该研究采用了METRICS清单来设计和报告基于AI的医疗保健研究。测试的AI模型包括ChatGPT-3.5,ChatGPT-4,Bing,还有Bard.询问包括15个关于艾滋病毒/艾滋病的问题,结核病,疟疾,COVID-19和流感。人工智能生成的内容由两名双语专家使用经过验证的CLEAR工具进行评估。
    结果:在比较AI模型在传染病查询中的英语和阿拉伯语性能时,注意到变异性。英语查询显示出一贯优异的性能,在巴德的带领下,其次是Bing,ChatGPT-4和ChatGPT-3.5(P=0.012)。在阿拉伯语中也观察到了同样的趋势,尽管没有统计学意义(P=.082)。分层分析显示,在大多数清晰的组成部分中,英语的分数更高,特别是在完整性方面,准确度,适当性,和相关性,尤其是ChatGPT-3.5和Bard.在五个传染病主题中,英语胜过阿拉伯语,除了Bing和Bard的流感查询。四个人工智能模型的英语表现被评为“优秀”,显著优于“高于平均水平”的阿拉伯同行(P=0.002)。
    结论:在应对传染病查询时,英语和阿拉伯语在AI模型性能方面存在差异。这种语言差异可能会对以阿拉伯语为母语的AI模型提供的健康内容的质量产生负面影响。建议AI开发人员解决此问题,以增强健康结果为最终目标。
    BACKGROUND: Assessment of artificial intelligence (AI)-based models across languages is crucial to ensure equitable access and accuracy of information in multilingual contexts. This study aimed to compare AI model efficiency in English and Arabic for infectious disease queries.
    METHODS: The study employed the METRICS checklist for the design and reporting of AI-based studies in healthcare. The AI models tested included ChatGPT-3.5, ChatGPT-4, Bing, and Bard. The queries comprised 15 questions on HIV/AIDS, tuberculosis, malaria, COVID-19, and influenza. The AI-generated content was assessed by two bilingual experts using the validated CLEAR tool.
    RESULTS: In comparing AI models\' performance in English and Arabic for infectious disease queries, variability was noted. English queries showed consistently superior performance, with Bard leading, followed by Bing, ChatGPT-4, and ChatGPT-3.5 (P = .012). The same trend was observed in Arabic, albeit without statistical significance (P = .082). Stratified analysis revealed higher scores for English in most CLEAR components, notably in completeness, accuracy, appropriateness, and relevance, especially with ChatGPT-3.5 and Bard. Across the five infectious disease topics, English outperformed Arabic, except for flu queries in Bing and Bard. The four AI models\' performance in English was rated as \"excellent\", significantly outperforming their \"above-average\" Arabic counterparts (P = .002).
    CONCLUSIONS: Disparity in AI model performance was noticed between English and Arabic in response to infectious disease queries. This language variation can negatively impact the quality of health content delivered by AI models among native speakers of Arabic. This issue is recommended to be addressed by AI developers, with the ultimate goal of enhancing health outcomes.
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  • 文章类型: Journal Article
    在过去的二十年里,人们对医疗保健技术的采用越来越感兴趣。尽管许多研究已经深入研究了特定技术对不同组织单位和医学专业绩效的影响,调查结果往往存在分歧。与既定的文学不同,我们的方法侧重于组织的角度来分析技术如何影响医院环境中的流程绩效。更确切地说,我们编制了来自意大利56家医疗机构的定制数据集,并利用普通最小二乘(OLS)回归作为主要分析工具,对2016年至2019年的面板数据进行了全面分析.数据显示了一个组织对医疗设备的使用与其整体过程性能之间的明确关系。我们的研究强调了通过战略性地集成新技术和设备来实现工艺性能大幅改善的重要性。鼓励政策制定者考虑引入激励措施,以推动医院投资于创新技术。此外,监测新设备的支出可以作为评估临床实践中技术采用程度的有价值的指标。
    Over the past two decades, there has been a growing scholarly interest in the adoption of technology in healthcare. While numerous studies have delved into the effects of specific technologies on the performance of different organizational units and medical specialties, the findings have often been divergent. Unlike the established literature, our approach focuses on the organization\'s perspective to analyze how technology impacts process performance in hospital settings. More precisely, we compiled a tailored dataset from 56 healthcare organizations in Italy and conducted a comprehensive analysis of panel data from 2016 to 2019, utilizing Ordinary Least Squares (OLS) regression as our main analytical tool. The data shows a clear relationship between an organization\'s use of medical devices and its overall process performance. Our research highlights the importance of achieving substantial improvements in process performance by strategically integrating new technologies and devices. Policymakers are encouraged to consider introducing incentives to drive hospitals to invest in innovative technologies. Furthermore, monitoring expenditures on new devices could serve as a valuable metric for assessing the extent of technology adoption within clinical practices.
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  • 文章类型: Journal Article
    自20世纪50年代所谓的“数字革命”开始以来,技术工具已经被开发出来,以简化和优化传统技术,耗时,和许多医生费力的收藏。近年来,已经开发了越来越复杂的“自动收集”系统,他们实际上可以进入日常临床实践。本文不仅提供了此类工具演变的历史概述,而且还探讨了从传统到数字回忆的过渡的道德和医学法律影响,包括保护数据机密性,在数字和健康素养较差的患者中,保持医患对话的沟通有效性和护理安全性。
    It is since the beginning of the so-called \'digital revolution\' in the 1950s that technological tools have been developed to simplify and optimise traditional, time-consuming, and laborious anamnestic collection for many physicians. In recent years, more and more sophisticated \'automated\' anamnestic collection systems have been developed, to the extent that they can actually enter daily clinical practice. This article not only provides a historical overview of the evolution of such tools, but also explores the ethical and medico-legal implications of the transition from traditional to digital anamnesis, including the protection of data confidentiality, the preservation of the communicative effectiveness of the doctor-patient dialogue and the safety of care in patients with poor digital and health literacy.
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  • 文章类型: Journal Article
    病人-护士口头沟通的复杂性为护理研究提供了宝贵的见解,但是传统的文档方法经常错过这些关键的细节。本研究探讨了语音处理技术在护理研究中的新兴作用,强调病人与护士的口头交流。我们在各种医疗机构进行了案例研究,揭示了电子健康记录在捕捉重要的病人-护士遭遇方面的巨大差距。我们的研究表明,语音处理技术可以有效地弥合这一差距,提高文档准确性,丰富质量护理评估和风险预测数据。该技术在家庭医疗保健中的应用,门诊设置,像痴呆症护理这样的专业领域说明了它的多功能性。它提供了实时决策支持的潜力,改善沟通培训,和加强远程医疗实践。本文提供了将语音处理整合到护理实践中的承诺和挑战的见解,为未来患者护理和医疗保健数据管理的进步铺平了道路。
    The complex nature of verbal patient-nurse communication holds valuable insights for nursing research, but traditional documentation methods often miss these crucial details. This study explores the emerging role of speech processing technology in nursing research, emphasizing patient-nurse verbal communication. We conducted case studies across various healthcare settings, revealing a substantial gap in electronic health records for capturing vital patient-nurse encounters. Our research demonstrates that speech processing technology can effectively bridge this gap, enhancing documentation accuracy and enriching data for quality care assessment and risk prediction. The technology\'s application in home healthcare, outpatient settings, and specialized areas like dementia care illustrates its versatility. It offers the potential for real-time decision support, improved communication training, and enhanced telehealth practices. This paper provides insights into the promises and challenges of integrating speech processing into nursing practice, paving the way for future patient care and healthcare data management advancements.
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  • 文章类型: Journal Article
    为了应对与NHS内部广泛的文档实践相关的挑战,本文介绍了结构化头脑风暴会议的结果,这是首席护士研究员项目的一部分,题为“医疗保健中的数字文档:赋予护士和患者以最佳护理的能力”。“扎根于罗扎诺·洛辛博士的“护理技术能力”理论,该项目利用维恩图框架将数字成熟度评估(DMA)结果与“看起来怎么样”(WGLL)框架集成,ANCC卓越之路,和莱斯特NHS信托大学医院的eHospitalEPR计划愿景。参与者,包括临床信息技术促进者和护理领导者,参与确定数字能力之间的协同作用和差距,卓越的护理,和以病人为中心的护理,为优化的数字患者护理模型提供可操作的见解。调查结果强调需要整体数字解决方案,以提高文档效率,支持卓越的员工,改善患者预后。
    In response to challenges associated with extensive documentation practices within the NHS, this paper presents the outcomes of a structured brainstorming session as part of the Chief Nurse Fellows project titled \'Digital Documentation in Healthcare: Empowering Nurses and Patients for Optimal Care.\" Grounded in Dr. Rozzano Locsin\'s theory of \"Technological Competency as Caring in Nursing,\" this project leverages a Venn diagram framework to integrate Digital Maturity Assessment (DMA) results with the \"What Good Looks Like\" (WGLL) Framework, the ANCC Pathway to Excellence, and the eHospital EPR program vision of University Hospitals of Leicester NHS Trust. Participants, including Clinical IT facilitators and nursing leaders, engaged in identifying synergies and gaps across digital proficiency, nursing excellence, and patient-centric care, contributing actionable insights towards an optimized digital patient care model. The findings emphasize the need for holistic digital solutions that enhance documentation efficiency, support staff excellence, and improve patient outcomes.
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  • 文章类型: Journal Article
    低收入和中等收入国家对老龄化人口的全球估计正在逐步增加,这伴随着与在这些可怕人口中公平和有效的医疗保健服务需求相关的限制。不幸的是,尽管人数越来越多,在不同的人群中,手机的使用并不平衡,研究表明年轻人的收养率高于老年人。
    本研究的目的是确定老年人对使用手机来支持Kiruddu国家转诊医院长期疾病自我管理的看法。
    这项描述性横断面设计研究是对基鲁都国家转诊医院门诊部收治的30名60岁以上老年人的样本人群进行的,坎帕拉,乌干达。我们在采访指南和一个焦点小组讨论之后进行了面对面的采访。我们后来使用了功能手机和平板电脑手机来评估每个设备的个人易用性。对录音进行专业转录,并将转录本编码到NVIVO版本12分析软件中进行主题分析。
    几乎所有访问该设施的受访者都患有一种疾病,这阻碍了他们充分利用手机来支持他们的自我保健。再加上其他因素,如财政紧张,卫生工作者在如何使用手机支持健康方面缺乏支持,设施的支持不足,以及移动数据的成本等。
    这项研究提供了经验证据,表明几乎没有已知的手机采用模型可以使政策制定者,系统开发人员,和卫生工作者促进乌干达老年人口使用手机来管理他们的长期疾病。
    UNASSIGNED: The global estimate of the aging population is progressively increasing in low and middle-income countries and this is accompanied by the limitations associated with the need for equitable and efficient healthcare delivery among this dire population. Unfortunately, despite the increasing numbers, the adoption of mobile phones is not balanced in the different populations with research showing young persons\' adoption rate is higher than that of elderly persons.
    UNASSIGNED: This current study was conducted to identify elderly people\'s perceptions of the use of mobile phones to support the self-management of long-term illnesses at Kiruddu National Referral Hospital.
    UNASSIGNED: This descriptive-cross-sectional design study was conducted on a sample population of 30 elderly individuals older than 60 years admitted at the outpatient department of Kiruddu National Referral Hospital, Kampala, Uganda. We conducted face-to-face interviews following an interview guide and one focus group discussion. We later used a feature mobile phone and a tablet mobile phone to assess the individual ease of use of each device. The audio recordings were professionally transcribed and transcripts were coded into NVIVO version 12 analysis software for thematic analysis.
    UNASSIGNED: Almost all of the respondents who visited the facility had an ailment that hindered their full utilization of the mobile phone to support their self-care. This together with other factors like financial constraints, lack of support from the health workers on how to use mobile phones to support health, inadequate support from the facility, and cost of mobile data among others.
    UNASSIGNED: This study provides empirical evidence that there is hardly a known mobile phone adoption model to enable policymakers, systems developers, and health workers to promote the elderly population\'s use of mobile phones to manage their long-term illnesses in Uganda.
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  • 文章类型: Journal Article
    在《医疗保健科学》上发表的先前实践和政策文章中,我们引入了人工智能(AI)模型的部署应用,以预测长期住院患者再入院情况,从而在新加坡自2017年开始实施的医院到家(H2H)计划的背景下,为患有复杂疾病的患者提供社区护理干预.在这篇关于实践和政策的文章中,我们进一步阐述了新加坡的H2H计划和护理模式,及其用于多次再入院预测的支持AI模型,通过以下方式:(1)通过提供人工智能和支持信息系统的更新,(2)通过报告客户参与和相关服务交付结果,包括与员工相关的时间节省和患者在节省的床位方面的福利,(3)通过分享有关(i)由于与计划参与者人群相关的数据集的高度异质性和由此产生的可变性而遇到的分析挑战的经验教训,(ii)平衡对更简单和稳定的预测模型的竞争需求与继续进一步增强模型并添加更多预测变量,以及(iii)当系统的AI部分与支持的临床信息系统高度关联时,继续进行模型更改的复杂性,(4)通过强调H2H的努力如何支持新加坡公共医疗系统更广泛的Covid-19应对努力,最后(5)通过评论从运行此H2H计划和相关社区护理模型以及支持AI预测模型获得的经验和相关能力,预计将为2023年起的下一波新加坡公共医疗保健工作做出贡献。为了读者的方便,在本文开头重复了一些介绍H2H计划和先前在先前的HealthcareScience出版物中出现的多次再入院AI预测模型的内容。
    In a prior practice and policy article published in Healthcare Science, we introduced the deployed application of an artificial intelligence (AI) model to predict longer-term inpatient readmissions to guide community care interventions for patients with complex conditions in the context of Singapore\'s Hospital to Home (H2H) program that has been operating since 2017. In this follow on practice and policy article, we further elaborate on Singapore\'s H2H program and care model, and its supporting AI model for multiple readmission prediction, in the following ways: (1) by providing updates on the AI and supporting information systems, (2) by reporting on customer engagement and related service delivery outcomes including staff-related time savings and patient benefits in terms of bed days saved, (3) by sharing lessons learned with respect to (i) analytics challenges encountered due to the high degree of heterogeneity and resulting variability of the data set associated with the population of program participants, (ii) balancing competing needs for simpler and stable predictive models versus continuing to further enhance models and add yet more predictive variables, and (iii) the complications of continuing to make model changes when the AI part of the system is highly interlinked with supporting clinical information systems, (4) by highlighting how this H2H effort supported broader Covid-19 response efforts across Singapore\'s public healthcare system, and finally (5) by commenting on how the experiences and related capabilities acquired from running this H2H program and related community care model and supporting AI prediction model are expected to contribute to the next wave of Singapore\'s public healthcare efforts from 2023 onwards. For the convenience of the reader, some content that introduces the H2H program and the multiple readmissions AI prediction model that previously appeared in the prior Healthcare Science publication is repeated at the beginning of this article.
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  • 文章类型: Journal Article
    医院的病人运输效率低下往往会导致延误,过度劳累的员工,和次优的资源利用率,最终影响患者护理。现有的调度管理算法通常在仿真环境中进行评估,引起人们对它们在现实世界中的适用性的担忧。这项研究提出了一个现实世界的实验,弥合了理论调度算法和现实世界实现之间的差距。它在台中的台中退伍军人总医院应用过程能力分析,台湾,并利用物联网对员工和医疗设备进行实时跟踪,以应对与手动调度流程相关的挑战。从医院收集的实验数据在2021年1月至2021年12月之间进行了统计评估。我们的实验结果,比较了传统调度方法与信标调度方法的使用,发现传统调度的加班延迟为41.0%;相比之下,信标调度方法的加班延迟为26.5%。这些发现证明了该解决方案的变革潜力,不仅可以用于医院运营,还可以在智能医院的背景下提高整个医疗保健行业的服务质量。
    Inefficient patient transport in hospitals often leads to delays, overworked staff, and suboptimal resource utilization, ultimately impacting patient care. Existing dispatch management algorithms are often evaluated in simulation environments, raising concerns about their real-world applicability. This study presents a real-world experiment that bridges the gap between theoretical dispatch algorithms and real-world implementation. It applies process capability analysis at Taichung Veterans General Hospital in Taichung, Taiwan, and utilizes IoT for real-time tracking of staff and medical devices to address challenges associated with manual dispatch processes. Experimental data collected from the hospital underwent statistical evaluation between January 2021 and December 2021. The results of our experiment, which compared the use of traditional dispatch methods with the Beacon dispatch method, found that traditional dispatch had an overtime delay of 41.0%; in comparison, the Beacon dispatch method had an overtime delay of 26.5%. These findings demonstrate the transformative potential of this solution for not only hospital operations but also for improving service quality across the healthcare industry in the context of smart hospitals.
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