Value of a multidisciplinary geriatric oncology committee on patient care in a community-based, academic cancer center.

Introduction: The heterogeneity in health and functional ability among older patients makes the management of cancer a unique challenge. The Geriatric Oncology Program at the University of Maryland Baltimore Washington Medical Center (BWMC) was created to optimize cancer management for older patients. This study aimed to assess the benefits of the implementation of such a program at a community-based academic cancer center.

Analysis of 10 years of open, laparoscopic, and robotic rectal surgeries in the community setting.

Background: Colorectal cancer is the fourth most common cancer in the US. Many of these patients will require operations. Although there is significant data in the literature that supports minimally invasive colorectal operations in the academic setting, few studies have examined their performance in community hospitals.

Synergetic role of integrating the departments of cancer registry and clinical research at an academic comprehensive cancer center.

Integration of the cancer registry and clinical research departments can have a significant impact on the accreditation process of a Commission on Cancer (CoC) Program. Here in we demonstrate that the integration of both departments will benefit as there is increased knowledge, manpower and crossover in job responsibilities in our CoC-accredited Academic Comprehensive Cancer Center. In our model this integration has led to a more successful cooperative interaction among departments, which has in turn created an enhanced combined effect on overall output and productivity.

Introducing Home Blood Pressure Telemonitoring for Children with Hypertension.

The goal of this study was to introduce home blood pressure (BP) telemonitoring in children with hypertension and to assess the feasibility of this approach. Acceptance of the system was assessed by attitudinal survey and semi-structured qualitative interview. Qualitative interview results showed consistently positive comments for content, interface and process components.

Mobile App to Reduce Inactivity in Sedentary Overweight Women.

Recent studies demonstrated that the duration of inactivity (sedentary state) is independently associated with increased risk of cardiovascular disease. Our goal was to develop the technology that can measure the amount of inactivity in real time, remind a person that a preprogrammed period of inactivity has occurred and encourage a period of activity, and provide web-based feedback with tailored information to the participant and investigators. Once it was developed, we carried out a pilot study in a group of sedentary overweight women.

Monitoring medication adherence in multiple sclerosis using a novel web-based tool: A pilot study.

Monitoring medication adherence in multiple sclerosis (MS) can be time consuming and expensive; however, non-adherence is common and is very costly in terms of lost therapeutic benefit and unused medications. To address this problem, we employed a web-based system to monitor and potentially modify medication adherence. Participants (n = 30) were randomized either to routine care or to the MS Home Automated Telehealth (MS HAT) system.

Computerized Insulin Order Sets Can Lead to Unanticipated Consequences.

Computerized order sets for medication management were recently shown to be associated with increased patient safety risks in primary care setting. This study was aimed at demonstrating similar phenomenon in a hospital setting. After introduction of computerized order set targeting hypoglycemia, the frequency of hypoglycemia significantly decreased from 1/1/07 to 12/31/08.

Feasibility of post-acute hip fracture telerehabilitation in older adults.

Recent studies demonstrated potential of home-based telerehabilitation in older adults and individuals with mobility impairment. However limited evidence exists on feasibility of home-based telerehabilitation in older adults after hip fracture. The aims of this study were: (1) to assess impact of home-based telerehabilitation of community dwelling older adults in post-acute phase of recovery after hip fracture on mobility, psycho-behavioral factors, quality of life, and satisfaction with care; (2) to estimate acceptance of the telerehabilitation system and adherence to the exercise program.

A critical review of consumer health devices for stress self-management.

A number of consumer health devices have been advertised as effective means to manage individual stress. However, objective evidence of their efficacy is not readily available. We present a critical analysis of evidence related to efficacy of stress management devices based on comprehensive literature review and information provided by the vendors.

Exploring three perspectives on feasibility of a patient portal for older adults.

Introduction: It is not clear whether older adults with chronic disease and their caregivers are likely to use patient portals.

Methods: Older adults with a diagnosis of chronic obstructive pulmonary disease or congestive heart failure were evaluated as well as their caregivers. We explored whether these patients and/or their caregivers were able to use common portal elements.

Avatar-based interactive ileostomy education in hospitalized patients.

Computer-assisted education can be an effective means for patient engagement and empowerment however the feasibility of postoperative computer-assisted ileostomy education has not been studied systematically. The purpose of this study was to assess feasibility and patient acceptance of tablet-based interactive ileostomy education in patients with new stomas, and to evaluate the impact of this education modality on knowledge and self-efficacy. An interactive multimedia education for ileostomy management guided by adult learning theories was tested in 15 hospitalized patients with new ileostomies.

Is Internet search better than structured instruction for web-based health education?

Internet provides access to vast amounts of comprehensive information regarding any health-related subject. Patients increasingly use this information for health education using a search engine to identify education materials. An alternative approach of health education via Internet is based on utilizing a verified web site which provides structured interactive education guided by adult learning theories.

Defining patient-centered characteristics of a telerehabilitation system for patients with COPD.

Studies have shown that pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) can help to restore or enhance residual functional capacity and improve quality of life. Home-based telemedicine systems can promote comprehensive pulmonary rehabilitation in COPD patients. Successful acceptance of such systems depends on how well they reflect needs, values and preferences of older adults with COPD.