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Cabrita M.R.,New University of Lisbon | Cabrita A.M.,Telemedicine Group | Cabrita A.M.,University of Twente | Cruz-Machado V.A.,New University of Lisbon
Advances in Intelligent Systems and Computing | Year: 2014

Healthcare is experiencing a significant growth in the scientific understanding and practical approach of diseases, care pathways, treatments and clinical decisions. However, the literature reveals that this exponential growth of knowledge is not consistent with the users’ ability to effectively disseminate, transfer and apply healthcare knowledge in clinical practice. Healthcare is intensive in knowledge and its efficient use can profoundly impact the quality of patient care decisions and health outcomes.Over the past decade Knowledge Management (KM), as a concept and a set of practices, has penetrated increasingly into the fabric of managerial processes in organizations all over theworld.KMrefers to strategies and processes for identifying, capturing, structuring, sharing, storing and applying an organization’s knowledge to extract sustainable competitive advantages. KM in healthcare may be seen as a set of methodologies and techniques to facilitate the creation, acquisition, development, dissemination and utilization of healthcare knowledge assets. The goal of Healthcare Knowledge Management (HKM) is to structure, provide and promote timely and effectively healthcare knowledge to healthcare professionals, patients, individuals and policy makers when and where they need it in order to help them to take high quality, and cost-effective care decisions. The Evidence-Based Practice (EBP) approach focuses on the need for clinicians to keep up to date and improve not only their own skills in seeking the evidence, but also to build on their own knowledge base of what effective practice is. KM can only improve healthcare when knowledge has been successfully integrated with EBP. KM in the context of evidence-based healthcare creates a learning environment and ensures that best practice is captured and disseminated. This work aims to explore how KM practices can leverage different types of healthcare knowledge in the context of EBP. This research is theoretical in nature and seeks to contribute to understand the numerous challenges that exist to fully realize the HKM portfolio, namely knowledge processes that can improve the quality of patient care. © Springer-Verlag Berlin Heidelberg 2014. Source


op den Akker H.,Telemedicine Group | Jones V.M.,University of Twente | Hermens H.J.,Telemedicine Group
User Modeling and User-Adapted Interaction | Year: 2014

Technology mediated healthcare services designed to stimulate patients’ self-efficacy are widely regarded as a promising paradigm to reduce the burden on the healthcare system. The promotion of healthy, active living is a topic of growing interest in research and business. Recent advances in wireless sensor technology and the widespread availability of smartphones have made it possible to monitor and coach users continuously during daily life activities. Physical activity monitoring systems are frequently designed for use over long periods of time placing usability, acceptance and effectiveness in terms of compliance high on the list of design priorities to achieve sustainable behavioral change. Tailoring, or the process of adjusting the system’s behavior to individuals in a specific context, is an emerging topic of interest within the field. In this article we report a survey of tailoring techniques currently employed in state of the art real time physical activity coaching systems. We present a survey of state of the art activity coaching systems as well as a conceptual framework which identifies seven important tailoring concepts that are currently in use and how they relate to each other. A detailed analysis of current use of tailoring techniques in real time physical activity coaching applications is presented. According to the literature, tailoring is currently used only sparsely in this field. We underline the need to increase adoption of tailoring methods that are based on available theories, and call for innovative evaluation methods to demonstrate the effectiveness of individual tailoring approaches. © 2014, Springer Science+Business Media Dordrecht. Source


Nassabi M.H.,University of Twente | Den Akker H.O.,University of Twente | Den Akker H.O.,Telemedicine Group | Vollenbroek M.,University of Twente | Vollenbroek M.,Telemedicine Group
Proceedings ABIS 2014 - 20th International Workshop on Adaptivity and User Modeling | Year: 2014

The increasing ageing population and the prevalence of chronic diseases have introduced new challenges to healthcare systems motivating researchers to use telemonitoring solutions for providing care. In some solutions, a special focus has been given to promoting physical activity as it can decrease the risk of becoming frail and prevents further health complications. The focus of this research is to keep seniors physically active by designing and developing an intelligent system that recommends exercises tailored to an individual's health status, goals and preferences hence aiming for an adaptive personalized solution. Source


Jansen-Kosterink S.,Telemedicine Group | Veld R.H.,Telemedicine Group | Hermens H.,Telemedicine Group | Hermens H.,University of Twente | And 2 more authors.
Health and Technology | Year: 2015

This study involved an evaluation of a telemedicine service implemented as a partial replacement of a physical outpatient rehabilitation program. The telemedicine service was an exercise-based tele-rehabilitation service facilitating remote physical rehabilitation for patients suffering from chronic lower back pain or pulmonary disease. Effectiveness was evaluated with multiple outcomes on quality (complaints, disability and physical condition) and access (usability, satisfaction and motivational character of the service). Patients referred by their rehabilitation physician to a physical outpatient rehabilitation program between October 2009 and May 2010 were asked to participate in the control group. Patients referred to the program between June 2010 and December 2011 were asked to participate in the intervention group. The control group received the conventional rehabilitation program. The intervention group received the rehabilitation program in which telemedicine was used as partial replacement of face to face care. Instead of 3 visits per week to the clinic as was being carried out in conventional care, patients visited the outpatient rehabilitation clinic for 2 days and they were instructed to exercise at least 1 day in their own environment using the exercise-based tele-rehabilitation service. One hundred and eighteen patients were included in this study: 38 patients in the control group and 80 patients in the intervention group. Both groups equally benefit from the outpatient rehabilitation program. There were no significant differences between the groups. The usability (system usability scale sore of 71.2 (SD 15.0; n=47), satisfaction (average rate 6.0 (SD 2.0; n=55), and level of motivation of the exercisebased tele-rehabilitation service were sufficient, but slightly disappointing. The telemedicine supported the outpatient rehabilitation program as partial replacement of face to face care was as effective as the conventional outpatient rehabilitation program. © IUPESM and Springer-Verlag Berlin Heidelberg 2015. Source


Jansen-Kosterink S.,Telemedicine Group | In 'T Veld R.H.,Telemedicine Group | Hermens H.,Telemedicine Group | Hermens H.,University of Twente | And 2 more authors.
Telemedicine and e-Health | Year: 2015

Background: Different kinds of telemedicine services have made their entry into healthcare. In this article we focus on a telerehabilitation service for physical exercise, designed and implemented as partial replacement of a 3-day outpatient rehabilitation program for chronic disease patients. The aim of this article is to examine the use pattern of this telerehabilitation service by chronic disease patients and to examine the association between actual use and clinical benefit experienced by these patients. Materials and Methods: Chronic lower back pain (CLBP) patients and pulmonary disease (PD) patients referred to the physical outpatient rehabilitation programs were asked to participate in and to use the telerehabilitation service. The actual use was expressed as frequency and duration of use, and the measurement of clinical benefit focused on complaints and physical functioning. Results: Sixty-two patients finished the outpatient rehabilitation using the telerehabilitation service. During the weeks of home rehabilitation the majority of the patients used the service. On average the service was used one or two times a week for a total of 35-38 min for both pathologies, with this value being lower than the time that was replaced. Frequency of use was significantly associated with the change in physical functioning outcome for both pathologies (CLBP, r=0.41, p=0.02; PD, r=0.55, p=0.003). Conclusions: Chronic disease patients used a telerehabilitation service as partial replacement of their face-to-face rehabilitation program, and more frequent use was positively related to higher clinical benefit. © Copyright 2015, Mary Ann Liebert, Inc. 2015. Source

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