The effectiveness and cost effectiveness of the PAtient-Centred Team (PACT) model: study protocol of a prospective matched control before-and-after study.

Background: The present study protocol describes the evaluation of a comprehensive integrated care model implemented at two hospital sites at the University Hospital of North Norway (UNN). The PAtient Centred Team (PACT) model includes proactive, patient-centred interdisciplinary teams that aim to improve the continuum and quality of care of frail elderly patients and reduce health care costs. The main objectives of the evaluation are to analyse the effectiveness and cost effectiveness of using patient-centred teams as part of routine service provision for this patient group.

Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey.

Background: Overall, men are less likely than women to seek health care services for mental health problems, but differences between genders in higher age groups are equivocal. The aim of the current study was to investigate the association between gender and the use of psychiatric outpatient specialist services in Norway, both in a general population and in a subpopulation with self-reported anxiety and/or depression.

Methods: Using questionnaires from 12,982 participants (30-87 years) in the cross-sectional sixth Tromsø Study (2007-8) we estimated proportions reporting anxiety/depression, and proportions using psychiatric outpatient specialist services in a year.

Relationship between the Quality of Service Provided through Store-and-Forward Telemedicine Consultations and the Difficulty of the Cases - Implications for Long-Term Quality Assurance.

We examined the difficulty of telemedicine cases and the quality of the resultant consultation in a mature store-and-forward telemedicine network. A random sample of 10 telemedicine cases was selected from those occurring over a 3-month period (5% of the workload) and they were scored by three experienced observers. Inter-observer agreement on the difficulty scores was poor (Fleiss's kappa = 0.

The Role of Medical Transcriptionists in Producing High-Quality Documentation.

This study aimed to investigate the quality-assurance work conducted by medical transcriptionists in the production of medical records, and the implications of these findings when designing a structured electronic patient record (EPR) system in which physicians are supposed to write documentation themselves. Both qualitative and quantitative methods were applied. Qualitative data were collected through informal discussions and focus-group interviews.

Communication Pattern Regarding Alarms and Patient Signals Between Nurses, Other Health Care Actors, Patients and Devices.

CallMeSmart is a context aware communication system for hospitals. The system is being used by nurses and the physicians at the Oncology department, University Hospital of North Norway. CallMeSmart has been designed to increase the efficiency of communication between the nurse-physician and physician-physician.

Type 1 Diabetes in Twitter: Who All Listen To?

Knowing what the conversation on Twitter regarding type 1 diabetes (T1D) is about can help in understanding the kind of information relevant to the individuals affected by the disease. The profile of Twitter users posting on T1D was collected and classified. The number of re-tweets was also registered.

Semantic Interoperability in Clinical Decision Support Systems: A Systematic Review.

The interoperability of Clinical Decision Support (CDS) systems with other health information systems has become one of the main limitations to their broad adoption. Semantic interoperability must be granted in order to share CDS modules across different health information systems. Currently, numerous standards for different purposes are available to enable the interoperability of CDS systems.

Video Conferencing Services in Healthcare: One Communication Platform to Support All.

We present a novel approach to the design of video conferencing (VC) systems, taking advantage of recent technological achievements in web-based implementation. Delivering VC functionality as a service over the Internet opens new grounds for easier integration, support, and application in many scenarios, since hardware-agnostic ad-hoc VC connections are a feature of the proposed architecture. Validity is demonstrated through latency measures in surgical telementoring service and comparing them to reported thresholds.

Secretaries' role in EHR Documentation and the Implications of Establishing a Structured EHR System.

Secretaries play an important quality assurance role in today's medical record production. This study aimed to identify quality assurance tasks that a future system cannot easily compensate for when developing a new structured EHR in which the physicians do the writing themselves. The study identified two tasks, which we suggest should also be performed by secretaries in the future.

On the Development of a Hospital-Patient Web-Based Communication Tool: A Case Study From Norway.

Surgery cancellations are undesirable in hospital settings as they increase costs, reduce productivity and efficiency, and directly affect the patient. The problem of elective surgery cancellations in a North Norwegian University Hospital is addressed. Based on a three-step methodology conducted at the hospital, the preoperative planning process was modeled taking into consideration the narratives from different health professions.

Assessing the Potential Use of Eye-Tracking Triangulation for Evaluating the Usability of an Online Diabetes Exercise System.

The Online Diabetes Exercise System was developed to motivate people with Type 2 diabetes to do a 25 minutes low-volume high-intensity interval training program. In a previous multi-method evaluation of the system, several usability issues were identified and corrected. Despite the thorough testing, it was unclear whether all usability problems had been identified using the multi-method evaluation.

The Online Big Blue Test for Promoting Exercise: Health, Self-Efficacy, and Social Support.

Background: Recent articles have documented the influence of self-efficacy and social support on exercising. Simultaneously, insulin use is also related to the perception of self-efficacy and social support in patients with diabetes. We combine these two ideas through the Big Blue Test experience in a social networking site and propose to analyze whether a change in blood sugar levels after completion of the Big Blue Test and insulin use are related to the perception of self-efficacy and social support in patients with diabetes.

Archetype-based data warehouse environment to enable the reuse of electronic health record data.

Background: The reuse of data captured during health care delivery is essential to satisfy the demands of clinical research and clinical decision support systems. A main barrier for the reuse is the existence of legacy formats of data and the high granularity of it when stored in an electronic health record (EHR) system. Thus, we need mechanisms to standardize, aggregate, and query data concealed in the EHRs, to allow their reuse whenever they are needed.

Quantitative home-based assessment of Parkinson's symptoms: the SENSE-PARK feasibility and usability study.

Background: Currently, assessment of symptoms associated with Parkinson's disease is mainly performed in the clinic. However, these assessments have limitations because they provide only a snapshot of the condition.

Methods: The feasibility and usability of an objective, continuous and relatively unobtrusive system (SENSE-PARK System), which consists of wearable sensors (three worn during the day and one worn at night), a smartphone-based App, a balance board and computer software, was tested 24/7 over 12 weeks in a study including 22 PD patients.

What device should be used for telementoring? Randomized controlled trial.

Background And Objective: The paper analyzes behavioral patterns of mentors while using different mentoring devices to demonstrate the feasibility of multi-platform mentoring. The fundamental differences of devices supporting telementoring create threats for the perception and interpretation of the transmitted video, highlighting the necessity of exploring hardware usability aspects in a safety critical surgical mentoring scenario.

Materials And Methods: Three types of devices, based on the screen size, formed the arms for the randomized controlled trial.

Assessing the impact of telestration on surgical telementoring: A randomized controlled trial.

Introduction: Using graphical annotations in surgical telementoring promises vast improvements in both clinical and educational outcomes. However, these assumptions do not consider the potential patient safety risks resulting from this feature. Major differences in regulations regarding the implementation of telestration encourage an assessment of the utility of this feature on the outcomes of telementoring sessions.

How to organize for a large-scale openEHR-based Electronic Patient Record.

This paper reports from a large-scale openEHR-based EPR project 2012-2016 in the North Norway Regional Health Authority. To be able to support patient pathways across the health region's trusts, there is a need for standardized routines and practices. Therefore, the North Norway Regional Health Authority has since 2011 had an increased regional focus to prepare for this new system.

Privacy-preserving Statistical Query and Processing on Distributed OpenEHR Data.

Unlabelled: Reuse of data from EHRs is essential for many purposes. The objective of the study was to explore how distributed electronic health record (EHR) data can be reused for privacy-preserving statistical query and processing.

Method: We have designed and created a proof of concept prototype solution based on the OpenEHR specification to ensure interoperability and to query the EHRs.

Development and trial of ePoint.telemed - An open web-based platform for home monitoring of chronic heart failure patients.

In North Norway no routine home telemonitoring services for chronic heart failure has yet been established and hence no investigations in the field have been published, although large distances and a sparse population are causes for extra public and private expenditure on travelling for patients when they make a visit to the hospital. In this paper we describe the ePoint.telemed platform for home telemonitoring of patients with chronic heart failure (CHF).

Multidisciplinary Modelling of Symptoms and Signs with Archetypes and SNOMED-CT for Clinical Decision Support.

Clinical Decision Support Systems (CDSS) help to improve health care and reduce costs. However, the lack of knowledge management and modelling hampers their maintenance and reuse. Current EHR standards and terminologies can allow the semantic representation of the data and knowledge of CDSS systems boosting their interoperability, reuse and maintenance.

Middle Managers' Experiences and Role in Implementing an Interactive Tailored Patient Assessment eHealth Intervention in Clinical Practice.

The role of nurse and physician managers is considered crucial for implementing eHealth interventions in clinical practice, but few studies have explored this. The aim of the current study was to examine the perceptions of nurse and physician managers regarding facilitators, barriers, management role, responsibility, and action taken in the implementation of an eHealth intervention called Choice into clinical practice. Individual qualitative interviews were conducted with six nurses and three physicians in management positions at five hospital units.

Integrating visual dietary documentation in mobile-phone-based self-management application for adolescents with type 1 diabetes.

The goal of modern diabetes treatment is to a large extent focused on self-management to achieve and maintain a healthy, low HbA1c. Despite all new technical diabetes tools and support, including advanced blood glucose meters and insulin delivery systems, diabetes patients still struggle to achieve international treatment goals, that is, HbA1c < 7.5 in children and adolescents.