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Posted on Jul 28, 2016 in Original Article | 0 comments

An integrated mHealth model for type 2 diabetes patients using mobile tablet devices

Sora Park, PhD1, Sally Burford, PhD1, Leif Hanlen, PhD2, Paresh Dawda, MBBS/DRCOG3, Paul Dugdale, PhD/FAFPHM4, Christopher Nolan, MBBS/PhD5, John Burns, Adjunct Professor6

1News & Media Research Centre, University of Canberra, ACT, Australia; 2Data61, University of Canberra, Australian National University, ACT, Australia; 3Ochre Health Medical Centre, ACT, Australia; 4College of Medicine, Biology & Environment, Australian National University, ACT, Australia; 5College of Medicine, Biology & Environment, Australian National University, Canberra Hospital, ACT, Australia; 6University of Canberra, ACT, Australia

Corresponding Author: sora.park@canberra.edu.au

Journal MTM 5:2:24–32, 2016

doi: 10.7309/jmtm.5.2.4


Background: Ease of use, proximity to the user and various health maintenance applications enable mobile tablet devices to improve patient self-management. With mobile phones becoming prevalent, various mobile health (mHealth) programs have been devised, to improve patient care and strengthen healthcare systems.

Aims: This study explored how mHealth programs can be developed for type 2 diabetes patients through a co-design participatory workshop between practitioners and researchers. The aim was to design a mHealth pilot program from the input.

Methods: A co-design workshop was conducted with 15 participants, including general practitioners, specialists, nurses and a multidisciplinary research team. Participants generated 31 statements in response to a trigger question and engaged in a structured discussion. Thematic cluster analysis was conducted on the statements and discussions.

Results: Through the analysis, patients’ self-management and health system integration emerged as the main topics. Further analysis revealed that there were two distinct areas of patient self-management; ‘compelled’ and ‘empowered’.

Conclusion: With the results, a loose-knit mHealth pilot program was developed wherein patients with various levels of conditions and digital skills could be incorporated. In order to encourage sustainable changes, practitioners proposed that mobile devices must be situated in the patients’ everyday settings and that digital training should be provided.


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Posted on Jul 28, 2016 in Original Article | 0 comments

Scope of Mobile Phones in Mental Health Care in Low Resource Settings

M Sood, Additional Prof.1, RK Chadda, Prof.1, K Sinha Deb, Assistant Prof.1, R Bhad, Senior Resident1, A Mahapatra, Senior Resident1, R Verma, Assistant Prof.1, AK Mishra, Assistant Prof.1

1Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India

Corresponding Author: soodmamta@gmail.com

Journal MTM 5:2:33–37, 2016

doi: 10.7309/jmtm.5.2.5


Introduction: Mobile apps are used as an aid in the mental health services in many high income countries. The present study was conducted to assess frequency of mobile phone use amongst patients with mental illness.

Methods: Patients attending psychiatric outpatient department of a public funded tertiary care hospital in India were assessed for use of mobile phone and its possible utility in mental health service delivery using a semi structured questionnaire.

Results: The study had 350 subjects, out of whom 307 (87.7%) reported using mobile phone on a regular basis. Mobile phone was used for phone calls, sending and receiving short text messages (SMS) recreation, and accessing social networking sites. Most of the users agreed that the mobile phone could be used as an aid in mental health service delivery, and expressed willingness to receive educational messages.

Conclusion: Patients with mental illness attending psychiatric outpatient services in India use mobile phones and are willing to use as a treatment aid.


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Posted on Mar 28, 2016 in Original Article | 0 comments

Smartphone use in Paediatric Practice: a national survey

Adamos Hadjipanayis, Prof.1, Alexios Klonis, Dr2, Omar Assem Abdel-Mannan, Dr3, Alastair G Sutcliffe, Dr4

1Assistant Professor of Paediatrics, Faculty of Medicine, European University Cyprus, Cyprus; 2School of Clinical Medicine, University of Cambridge, United Kingdom; 3Academic Clinical Fellow, General and Adolescent Paediatric Unit, Institute of Child Health, United Kingdom; 4Professor of General Paediatrics, Institute of Child Health, UCL, United Kingdom

Corresponding Author: Adamos@paidiatros.com

Journal MTM 5:1:3–8, 2016

doi:10.7309/jmtm.5.1.2


Introduction: Smartphones have become universal among the general public since their launch in 2007. Alongside this, the use of smartphones and mobile medical applications (apps) by clinicians has risen exponentially.

Objectives: The aim of this study is to present the current prevalence of smartphone ownership among Cypriot paediatricians and the patterns of their use in everyday clinical practice.

Study design: A standardized telephone survey was conducted by trained interviewers on a random sample of all 225 currently registered and active paediatricians across all districts of Cyprus.

Results: From a total of 78 randomly selected eligible participants, 75 (96%) paediatricians agreed to participate in the study. The majority of physicians reported that they owned a smartphone (n =53, 71%) and the rest (n=22, 29%) used a Symbian phone as their primary device. Of those who owned a smartphone, 40% (n=21) reported using at least one app related to their clinical work. The mean number of applications used by these users was 3.5. The majority (44/53, 83%) responded that they did not use their smartphone as a tool for managing patient appointments, while 9 out of the 53 (17%) responded positively. Over 80% of participants used their smartphone to take or receive a picture or a video from their patients for professional purposes.

Conclusion: This study found a high level of smartphone ownership and usage among medical Cypriot paediatricians, corroborating with previous literature for other specialties in other countries. Despite the benefits they offer, more rigorous validation practices regarding mobile medical apps need to be established to ensure they are used safely and appropriately.


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Posted on Mar 27, 2016 in Original Article | 0 comments

Smartphone Use and Perceptions among Medical Students and Practicing Physicians

Andrew Buchholz, DO MPH, LT, MC, USN1, Brittany Perry, DO2, Lucia Beck Weiss, MS3, Danielle Cooley, DO3

1Naval Medical Center Portsmouth, Directorate for Mental Health, Portsmouth, VA, USA; 2Alfred I. DuPont Hospital for Children, Wilmington, DE, USA; 3Rowan University School of Osteopathic Medicine, Department of Family Medicine, Stratford, NJ, USA

Corresponding Author: andrew.c.buchholz.mil@mail.mil

Journal MTM 5:1:27–32, 2016

doi:10.7309/jmtm.5.1.5


Background: Smartphones have become mainstream, including in the healthcare setting. However, little formal research has been performed to examine mobile medical technology.

Aims: To examine smartphone use and perceptions among medical students and physicians in a statewide medical university.

Methodology: An IRB approved 23-item survey eliciting smartphone use and perceptions was developed by the research team and an e-mail invitation for participation was sent to all medical students, resident and attending physicians in three medical schools.

Results: A total of 544 surveys were submitted; 347 were completed and analyzed. 93.9% of respondents had smartphones, with no significant difference between students and physicians. Of those with the technology, 82.9% stated they have used it at least once in a clinical setting. Respondents perceived fast access to information to be the greatest benefit to mobile medical technology (96.6%), as well as simplified access (75.5%). Greatest perceived barriers to using this technology were uncertainty about available applications (39.4%) and inexperience (23.4%). There was no significant difference between students and physicians with regard to either category. Concerning patient-centered applications, assistance with lifestyle modification (78.8%) and increased adherence to treatment plans (73.8%) were agreed upon as potential benefits. Greatest perceived barriers to recommending this technology were added cost to the patient (52.6%) and concerns about patient self-diagnosis (47.7%), with no significant difference found between students and physicians.

Conclusion: These data demonstrate smartphone usage is prominent in the healthcare setting and indicates strong agreement regarding its benefits and barriers. Implementing smartphone education into medical curricula may be beneficial to healthcare providers.


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Posted on Mar 27, 2016 in Original Article | 0 comments

Ipad Usage and Impact on Pediatric Medical Students’ Learning and Patient Care

Robert Riss, MD1, Angellar Manguvo, PhD2, Jennifer Quaintance, PhD3, Mohamed Radhi, MD4, Maria Dycoco, MD5

1Children’s Mercy Hospital, Associate Director of Medical Student Education, Department of Pediatrics, University of Missouri at Kansas City, USA; 2Instructional Design Specialist & Assistant Professor, University of Missouri at Kansas City, Department of Medical Education, USA; 3Director of Medical Education Support Services, University of Missouri at Kansas City, Department of Medical Education, USA; 4Associate Professor, Children’s Mercy Hospital, Department of Pediatrics, University of Missouri at Kansas City, USA; 5Director of Medical Student Education, Children’s Mercy Hospital, Department of Pediatrics, University of Missouri at Kansas City, USA

Corresponding Author: rriss@cmh.edu

Journal MTM 5:1:19–26, 2016

doi:10.7309/jmtm.5.1.4


Background and Aims: The advent of mobile technologies has stimulated an academic shift in medical education from traditional methods to mobile teaching and learning. This study investigated medical students’ current and anticipated iPad usage as well as perceived impact of iPads on their learning and patient care. The ultimate purpose of the inquiry was to improve future implementation processes.

Methods: Twenty-three iPads were loaded with applications including Cerner Citrix Receiver, question banks, review texts, DynaMed, and the iTunes U application that contained clerkship curriculum. Fifty-eight students used the iPads during a Pediatrics rotation and filled out a survey upon completion. Descriptive statistics were generated from quantitative responses while thematic analysis was used to summarize ideas from qualitative responses. An exploratory mixed methods approach was used to integrate qualitative and quantitative findings. T-tests were used to determine differential usage as a function of prior iPad ownership and experience.

Results and Conclusions: Students variably used iPads to access question banks, didactics and review texts, conduct internet searches, and monitor patient information. IPads were most used compared to other electronic and print sources with cited advantages of portability, convenience, instant accessibility, enhancement of professional conduct, and time management. Respondents proposed other areas in which iPads could be used in the rotation. This highlighted the need to expand our iPad initiative to cover other aspects of learning. Given that prior iPad ownership and experience did not determine differences in usage, the observed variability in iPad usage suggests mere diversity of baseline needs.


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Posted on Mar 26, 2016 in Original Article | 0 comments

Clinical performance of the HeartBuds, an electronic smartphone listening device, compared to FDA approved Class I and Class II stethoscopes

Ritesh S. Patel1, Julio Schwarz, MD1, Valerie Danesh, RN2, Arnold Einhorn, MD3, David Bello, MD1,3

1University of Florida College of Medicine, USA; 2Orlando Health Corporate Office of Research Operations, Clinical Research Coordinator in Critical Care, USA; 3Orlando Health Heart Institute, USA

Corresponding Author: rspatel1@ufl.edu

Journal MTM 5:1:45–51, 2016

doi:10.7309/jmtm.5.1.7


Background: Auscultation with stethoscopes is essential to the physical exam. However, the stethoscope has not appreciably changed since Leared and Cammann developed the first binaural stethoscopes in the mid 1800s. Technological advances make it possible to use smartphone technology to auscultate patients. The HeartBuds, a listening device that integrates with an iPhone app, achieves this purpose.

The purpose of this study was to compare HeartBuds’ acoustic superiority over the FDA approved class I blue disposable stethoscopes, which are commonly used in practice to reduce hospital infection rates, and demonstrate equivalence to the gold standard FDA class I analog stethoscope, the Littmann Cardiology III, and the FDA class II digital stethoscope, the Littmann Electronic 3200.

Methods: 50 adult patients were auscultated with each of the above-mentioned stethoscopes by two independent examiners. They rated their acoustic quality and completed surveys documenting body sounds heard.

Results: The disposable stethoscope was significantly worse at identifying cardiac murmurs (p < 0.002), and performed poorly when auscultating for carotid bruits (p < 0.058). The HeartBuds stethoscope was equivalent to its more commonly used counterparts, the Littmann Cardiology III and the Littmann Electronic 3200. Examiners also found it to be of comparable acoustic quality to these models.

Conclusion: HeartBuds is a smartphone compatible listening device that was superior in examining cardiovascular sounds to approved FDA Class I disposable stethoscopes, and equivalent to FDA approved class I and class II Littmann stethoscopes. Considering HeartBuds equivalence to more expensive stethoscopes while costing much less, the HeartBuds can potentially reduce infection rates without sacrificing quality.


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