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Access and Preferences for Mobile Technology among Diverse Hepatitis C Patients: Implications for Expanding Treatment Care

Posted on Jul 16, 2019 in Original Article | 0 comments

Julie Beaulac1,2, Louise Balfour1,2, Kim Corace2, Mark Kaluzienski3, Curtis Cooper2,3,4

1Department of Psychology, The Ottawa Hospital, Ottawa, Canada;

2Ottawa Hospital Research Institute, Ottawa, ON;

3Faculty of Medicine, University of Ottawa;

4The Division of Infectious Diseases, Department of Medicine, University of Ottawa

Corresponding Author:

Journal MTM 8:1:11–19, 2019


Background: Mobile technology interventions present opportunities for enhanced patient engagement and outcomes.

Aims: To assess the feasibility and patient attitudes toward using mobile technology in HCV care.

Methods: Cross-sectional survey data were collected from HCV patients (N=115) at two sites, an academic hospital-based outpatient viral HCV program (n= 92) and a mostly low SES community-based site (n = 23). Measures included demographics, HCV disease status and risk factors, and mobile technology access and preferences. Differences in mobile technology access, use, and preferences by treatment site, treatment experience, ethnicity, gender, education level, and income level were assessed by Mann-Whitney and chi-square tests.

Results: 78% owned a mobile device. Of these, 69% reported having Internet access and 72% unlimited text plans. 66% reported comfort in texting. Half liked the idea of using a cell phone for HCV clinical care; others expressed dislike/uncertainty. Poorer access to mobile technology was reported by treatment naïve, community site, and non-White participants (p values ranging from 0.02 to 0.01). Respondents from the community rated lower comfort in texting (p = 0.01). A similar trend was noted for respondents with incomes below $30,000 as compared to higher income (p = 0.09). Yet, groups similarly liked the idea of using mobile technology in HCV care.

Conclusion: Mobile technology is an alternative model to augment existing HCV care. Variability in acceptability and accessibility of this approach was highlighted. Tailoring care delivery to individual patients with a particular focus on patients being served in community-based programs with low SES will be critical.

Keywords: Hepatitis C, Patient Engagement, Patient Attitudes, Cell Phones, Cross-Sectional Survey

Evaluating Artificial Intelligence and Telemedicine-based Care Models in Dermatology

Posted on Jul 16, 2019 in Perspective Pieces | 0 comments


Rose Liu1

1School of Medicine, Nursing and Health Sciences, Monash University, Clayton VIC, Australia

Corresponding Author:

Abstract: Access to dermatology services in rural and remote Australia is challenged by geographical isolation, expense and long waiting periods for specialist consultations. This is particularly concerning as Australia is a country with one of the highest rates of melanoma and melanoma mortality in the world. Advances in Artificial Intelligence and telemedicine can increase access to dermatological care disease.

This perspective piece evaluates these technologies and the issues faced during previous implementation attempts in Australia.

Journal MTM 8:1:50–52, 2019


Key words: “Teledermatology” “Telemedicine” “Mobile Health” “Dermatology” “Artificial Intelligence” “Public Health”

An Affordable Smart Phone Communication System from Highway to Helipad: A Case Series

Posted on Jul 16, 2019 in Perspective Pieces | 1 comment


Jordan Koll1, Douglas Martin MD FRCP(C)2,3, Gregory Hansen MD FRCP(C) MPH MSc4

1Public Health Agency of Canada, Winnipeg, Manitoba, Canada; 2Department of Emergency Medicine, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada; 3Shock Trauma Air Rescue Society (STARS), Winnipeg, Manitoba, Canada; 4Divison of Pediatric Critical Care, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada.

Corresponding Author:

Journal MTM 8:1:53–60, 2019


Introduction: Improving communication between all providers involved with rural trauma and urgent care patients may be beneficial. In our proof of concept study, we examine the potential of an open architecture and flexible smart phone system, utilizing an affordable, off-the-shelf and secure application called Wickr.

Methods: Two patient scenarios were constructed to test the capabilities of the Wickr application for data transfer. Roles were distributed between three players: one represented the transport medical doctor, another played the air medical crew, and the final assumed all the other roles. As the two scenarios unfolded simultaneously, phone conversations, text messages, pictures, and imaging files were conducted between the players by smart phones via downloaded Wickr applications. Upon completion, players answered nine questions on a 5-point Likert scale that focused on the quality of the videos, texts and pictures shared, as well as indicators that we deemed essential to transport communication systems from our experience.

Results: Scores on video, picture and sound quality ranged from good to excellent. Scores on user friendliness, task suitability, speed, information discretion and customizable data retention ranges from somewhat agree to agree.

Conclusion: Wickr was quick, user friendly, and well suited for the clinical communication during simultaneous patient scenarios. Whether it is a capable system for a busy helicopter emergency medical service has not been evaluated.

Key Words: emergency medical services, mhealth, rural health, telemedicine, emergency care, Prehospital

A mobile electronic record for lifestyle coaches in gestational diabetes prevention

Posted on Jul 16, 2019 in Original Article | 0 comments


David Simmons FRACP MD1, Tosin Daniels BSc (Hons)2, Daniel J Simmons BEng3, Mireille NM van Poppel4, Jürgen Harreiter MD5

1Western Sydney University, NSW, Australia and Cambridge University Hospitals, Cambridge, England

2Cambridge University Hospitals, Cambridge, England

3Techtonic Software, Norfolk, England

4Department of Public and Occupational Health, EMGO+-Institute for Health and Care Research, VU University Medical Centre, 1081 BT Amsterdam, the Netherlands and Institute of Sport Science, University of Graz, 8010 Graz, Austria

5Department of Medicine III, Division of Endocrinology, Gender Medicine Unit Medical University of Vienna

On behalf of the DALI core investigators group (see Appendix)

Corresponding author:

Journal MTM 8:1:37–49, 2019


Background: Lifestyle programmes require a structured approach to be effective. Maintaining fidelity of coach-based interventions is challenging. Mobile devices may assist by supporting the use of an algorithm based approach.

Aims: To describe the development and challenges associated with a mobile technology approach to supporting a coach-based lifestyle programme for the prevention of gestational diabetes mellitus (GDM) in pregnancy.

Methods: Narrative approach to system design, with a survey of 12 lifestyle coaches involved in the pan-European multicentre DALI (Randomised controlled trial for the prevention of gestational diabetes mellitus (GDM) with vitamin D And Lifestyle Intervention) study.

Results: A mobile device based programme was associated with more technical issues than a web-based approach, particularly in relation to upgrades to improve usability and utility. Even after multiple upgrades, a paper approach was preferred by some coaches, and by most for aspects of the intervention that required greater coach-participant interaction (eg goal setting). Coaches generally preferred the mobile device approach for obtaining pre-existing data, structured data entry and for intervention prompts.

Conclusion: Mobile technology can facilitate coach-delivered lifestyle interventions. However, more work is required to minimise intrusion into the behavioural intervention.

Myanmar is ready to engage mHealth applications for improved postoperative care

Posted on Jul 16, 2019 in Original Article | 0 comments


Sariah Khormaee MD PhD1, Athena Nguyen2, Esther Bartlett3, Michael Lwin4, Peter Chang MD5, Misja Ilcisin6

1Hospital for Special Surgery, Orthopedic Surgery

2Santa Clara University College of Arts and Sciences

3Santa Clara University College of Arts and Sciences

4KoeKoe Tech Co., Ltd

5Washington University, Orthopaedic Surgery

6KoeKoe Tech Co., Ltd

Corresponding author:

Journal MTM 8:1:29–36, 2019


Background: There is incredible potential for telemedicine to advance postoperative care. Work in high-income nations shows the potential to use mobile phones to monitor postoperative recovery progress. However, there is little information about the attitudes of people in low resource countries, like Myanmar, toward the adoption of mHealth in postoperative care.

Aims: This study presents survey results collected in Myanmar to better understand cultural attitudes of this population towards adopting mHealth technologies to improve postoperative patient care.

Methods: A thirteen-question survey was developed, focused on demographic questions and attitudes towards physicians, the internet, and willingness to perform tasks on their mobile phones. Respondents were selected in a sample of convenience in urban and rural public spaces.

Results: Of the 125 people approached, 112 agreed to participate in the survey. A wide range of ages (18-78), genders (55.4% female), locations (22.3% rural, 77.7% urban) and ethnicities (67% Burmese) were represented. 85.7% were willing to make contact with a surgeon in a hypothetical postoperative setting via mobile phone. 83.0% were willing to fill out a survey about their postoperative state and 69.6% were willing to send a picture of their wound with their surgeon via mobile phone. A majority of respondents had a very high level of trust in physicians in general, most already owned a mobile phone with access to the internet and used it to look up health information.

Conclusion: Our results indicate that Myanmar could provide a promising location for the implementation of mHealth technologies to improve post-operative care.

Keywords: mobile health, telecare, health information on the Web, ehealth, assistive technologies