The experience of using home automation by individuals with disability.

Purpose: People with disability often require long-term support within the home. Advances in technology have made home automation more readily available to support people living with disability. However, few studies describe the perspectives of people using home automation. The aim of this study was to explore the experience of individuals living with long term serious disability using home automation.Materials and methods: A phenomenological approach was adopted. In-depth, semi-structured interviews were conducted. Data were analysed using an inductive approach to identify themes.Results: Two overarching categories of themes were identified: 'benefits' and 'challenges'. Benefits captured the outcomes experienced by people living with disability using home automation and the impact upon their lives. Participants described several challenges with using home automation such as self-advocating to receive home automation, long waiting periods in the assessment and installation process, frustrations when home automation did not work, and the challenges experienced from being without home automation.Conclusion: This research identified the benefits and challenges of home automation experienced by people with long term serious disability. The findings can be used to understand the importance of home automation and the impact it has upon the lives of people living with disability.

It is recognised that home automation can have a positive impact upon the lives of people living with disability.Funding for home automation is a complicated process with long waiting times. This process needs to be readdressed in order for people to receive home automation in a timely manner to prevent negative experiences.Home automation within the community could support people living with disability to access the community more.It is important to develop facilities and communities that are accessible and inclusive for people with disabilities.

A scoping review to explore the health, social and economic outcomes of home automation for people with disability.

PURPOSE: People with disability often require long-term care. Long-term care is changing with the availability and advances in cost and function of technologies, such as home automation. Home automation has the potential to reduce paid carer hours and can potentially offer many benefits to people with a disability. The aim of this scoping review is to identify the health, social and economic outcomes experienced by people living with a disability who use home automation. MATERIALS AND METHODS: Two electronic databases were searched by title and abstract to identify international literature that describes home automation experiences from the perspectives of people with disability. A thematic approach was taken to synthesise the data to identify the key outcomes from home automation. RESULTS: The review identified 11 studies reporting home automation outcomes for people living with a disability. Seven outcomes were associated with home automation: independence, autonomy, participation in daily activities, social and community connectedness, safety, mental health, and paid care and informal care. CONCLUSION: Advances in technology and changes in funding to support people living with a disability have made access to home automation more readily available. Overall, the study findings showed that there is a range of potential benefits of home automation experienced by individuals living with a disability.Implications for RehabilitationA wide range of outcomes have been evaluated following the installation of home automation systems for people with disability.Key outcomes evaluated to date include independence, autonomy, participation, safety, mental health, and reduced need for paid carers.Outcomes of home automation appear to be connected; for example, improved participation may lead to improved mental health.

Home Automation for Adults With Disability Following an Injury: Protocol for a Social Return on Investment Study.

BACKGROUND: People with disability following a serious injury require long-term care. The most common injuries resulting in long-term disability are spinal cord and acquired brain injuries. While the long-term effects are difficult to predict and will vary between individuals, the costs of care and recovery span well beyond the initial treatment phase and include long-term care. Long-term care is changing with the availability and advances in cost and function of technologies, such as home automation. "Home automation" refers to technology that automates or remotely controls household functions. Home automation costs vastly differ, but home automation has the potential to positively impact the lives of people with disabilities. However, there is a dearth of evidence relating to the impact of home automation for people with a disability and few rigorous evaluations about the costs and return on investment. OBJECTIVE: The purpose of this study is to describe the impact of home automation for people with long-term disability following a serious injury (such as a motor vehicle accident) using case studies, and by conducting an evaluation of the costs and outcomes for individuals, families, and the wider community using a Social Return on Investment (SROI) approach. METHODS: SROI is a form of economic evaluation that develops a theory of change to examine the relationship among inputs, outputs, and outcomes and, in recent years, has gained popularity internationally, including in Australia. SROI has six phases: (1) identify scope and stakeholders, (2) map outcomes, (3) evidence outcomes and give them value, (4) establish impact, (5) calculate the SROI, and (6) report findings. Individuals with a disability who use home automation and key stakeholders will be interviewed. Stakeholders will be individuals involved in home automation for people with disabilities, such as allied health professionals, medical practitioners, equipment suppliers, engineers, and maintenance professionals. Users of home automation will be people who have a disability following a serious injury, have the capacity to provide consent, and have 1 or more elements of home automation. The impact of home automation will be established with financial proxies and appropriate discounts applied to avoid overestimating the social return. The SROI ratio will be calculated, and findings will be reported. RESULTS: The project was funded in November 2021 by the Lifetime Support Authority. Recruitment is underway, and data collection is expected to be completed by October 2022. The final results of the study will be published in March 2023. CONCLUSIONS: To our knowledge, this study represents the first study in Australia and internationally to employ SROI to estimate the social, personal, and community outcomes of home automation for people with a disability following a serious injury. This research will provide valuable information for funders, consumers, researchers, and the public to guide and inform future decision-making. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42493.

Managing electromyogram contamination in scalp recordings: An approach identifying reliable beta and gamma EEG features of psychoses or other disorders.

OBJECTIVE: In publications on the electroencephalographic (EEG) features of psychoses and other disorders, various methods are utilized to diminish electromyogram (EMG) contamination. The extent of residual EMG contamination using these methods has not been recognized. Here, we seek to emphasize the extent of residual EMG contamination of EEG. METHODS: We compared scalp electrical recordings after applying different EMG-pruning methods with recordings of EMG-free data from 6 fully paralyzed healthy subjects. We calculated the ratio of the power of pruned, normal scalp electrical recordings in the six subjects, to the power of unpruned recordings in the same subjects when paralyzed. We produced "contamination graphs" for different pruning methods. RESULTS: EMG contamination exceeds EEG signals progressively more as frequencies exceed 25 Hz and with distance from the vertex. In contrast, Laplacian signals are spared in central scalp areas, even to 100 Hz. CONCLUSION: Given probable EMG contamination of EEG in psychiatric and other studies, few findings on beta- or gamma-frequency power can be relied upon. Based on the effectiveness of current methods of EEG de-contamination, investigators should be able to reanalyze recorded data, reevaluate conclusions from high-frequency EEG data, and be aware of limitations of the methods.

A Novel Privacy Preservation and Quantification Methodology for Implementing Home-Care-Oriented Movement Analysis Systems.

Human movement is generally evaluated through both observations and clinical assessment scales to identify the state and deterioration of a patient's motor control. Lately, technological systems for human motion analysis have been used in clinics to identify abnormal movement states, while they generally suffer from privacy challenges and concerns especially at home or in remote places. This paper presents a novel privacy preservation and quantification methodology that imitates the forgetting process of human memory to protect privacy in patient-centric healthcare. The privacy preservation principle of this methodology is to change the traditional data analytic routines into a distributed and disposable form (i.e., DnD) so as to naturally minimise the disclosure of patients' health data. To help judge the efficacy of DnD-based privacy preservation, the researchers further developed a risk-driven privacy quantification framework to supplement the existing privacy quantification techniques. To facilitate validating the methodology, this research also involves a home-care-oriented movement analysis system that comprises a single inertial measurement sensor and a mobile application. The system can acquire personal information, raw data of movements and indexes to evaluate the risk of falls and gait at homes. Moreover, the researchers conducted a technological appreciation survey of 16 health professionals to help understand the perception of this research. The survey obtains positive feedback regarding the movement analysis system and the proposed methodology as suitable for home-care scenarios.

Student Experience and Its Relationship with Campus Mental Well-Being.

This research offers a generalizable Campus Mental Well-being Sense of Coherence Framework for improving student experience by classifying SES variables according to Antonovsky's salutogenic health logic (GRRs and SRRs) and by mapping these variables to the Information Infrastructure to Experience Framework (IEF).

How Is Quality of mHealth Interventions for Cancer Survivors Defined and Described? An Umbrella Review.

PURPOSE: Although there are commonly accepted criteria of what defines quality of health care including cancer care, less is known about what defines quality of mHealth interventions in health care. The aim of this review was to identify how quality of mHealth interventions for cancer survivors is described and measured. METHODS: CINAHL, EmCare, JBI, Medline, SCOPUS, and ProQuest databases from January 2008 to January 2020 were searched. Review papers with search terms related to mobile devices, quality, and cancer relevant to adults with cancer were included. Interventions needed to consist of mHealth technologies, such as mobile applications or short message service, or wearable devices. Title and abstract screening, full-text screening, and data extraction were performed independently by two reviewers. Conflicts were resolved by a third reviewer. Reviews were evaluated for coverage of quality according to six metrics defined by the Institute of Medicine: patient-centeredness, equitability, safety, effectiveness, timeliness, and efficiency. Any additional quality items were recorded. A Measurement Tool to Assess systematic Reviews (AMSTAR) was used to rate the quality of the reviews included. RESULTS: The initial search yielded 766 papers with seven systematic reviews meeting the eligibility criteria. Four papers were of AMSTAR moderate quality, with three of low quality. The median number of quality metrics reported in a review was two (the range was 1-4). Efficacy and safety and timeliness and efficiency were most reported (n = 4), followed by usability (n = 3), equitability and access (n = 2), privacy and security (n = 2), and patient-centeredness (n = 2). CONCLUSION: There is great variability in how quality of mHealth interventions is defined with no reviews addressing all quality metrics. A comprehensive approach to measure quality of mHealth interventions is needed.

A Sense of Coherence Approach to Improving Patient Experience Using Information Infrastructure Modeling: Design Science Research.

BACKGROUND: Health care provider organizations are complex and dynamic environments. Consequently, how the physical and social environment of such organizations interact with an individual is a primary driver of an individual's experience. Increasingly, the capabilities required for them to successfully interact with those within their care are critically dependent on the information infrastructure they have in place, which enables people, both patients and staff, to work optimally together to deliver their clinical and operational objectives. OBJECTIVE: This study aims to design a framework to address the challenge of how to assemble information systems in health care to support an improved sense of coherence for patients, as well as potentially innovate patients' experiences, by connecting and orchestrating the synergy among people, processes, and systems. METHODS: It is necessary to understand the needs of health care providers and patients to address this challenge at a level relevant to information process design and technology development. This paper describes the design science research method used to combine the sense of coherence, which is a core concept within the Antonosky salutogenic approach to health and well-being, with an established information infrastructure maturity framework, demonstrating the coalescence of 2 distinct conceptual perspectives on care delivery. This paper provides an approach to defining a positive and supportive health care experience and linking this to the capabilities of an information- and technology-enabled environment. RESULTS: This research delivers a methodology for describing the patient experience in a form relevant to information infrastructure design, articulating a pathway from information infrastructure to patient experience. It proposes that patient experience can be viewed pragmatically in terms of the established sense of coherence concept, with its ability to identify and guide resources to modulate a patient's environmental stressors. This research establishes a framework for determining and optimizing the capability of a facility's information infrastructure to support the sense of coherence defined by the experiences of its patients. CONCLUSIONS: This groundbreaking research provides a framework for health care provider organizations to understand and assess the ability of their information infrastructure to support and improve the patient experience. The tool assists providers in defining their technology-dependent operational goals around patient experience and, consequently, in identifying the information capabilities needed to support these goals. The results demonstrate how a fundamental shift in thinking about the use of information infrastructure can transform the patient experience. This study details an approach to describing information infrastructure within an experience-oriented framework that enables the impact of technology on experience to be designed explicitly. The contribution to knowledge is a new perspective on modeling how information infrastructure can contribute to supportive health-promoting environments. Furthermore, it may significantly affect the design and deployment of future digital infrastructures in health care.

Health literacy, digital health literacy and the implementation of digital health technologies in cancer care: the need for a strategic approach.

ISSUE ADDRESSED: Digital health technologies can potentially reduce health disparities in cancer care. However, the benefits of digital health technology depend partly on users' digital health literacy, that is, "capabilities and resources required for individuals to use and benefit from digital health resources," which combines health and digital literacy. We examined issues for digital health technology implementation in cancer care regarding digital health literacy, via stakeholder consultation. METHODS: Consumers, health care professionals, researchers, developers, nongovernment and government/policy stakeholders (N = 51) participated in focus groups/interviews discussing barriers, enablers, needs and opportunities for digital health implementation in cancer care. Researchers applied framework analysis to identify themes of digital health literacy in the context of disparity and inclusion. RESULTS: Limited digital and traditional health literacy were identified as barriers to digital technology engagement, with a range of difficulties identified for older, younger and socio-economically or geographically disadvantaged groups. Digital health technology was a potential enabler of health care access and literacy, affording opportunities to increase reach and engagement. Education combined with targeted design and implementation were identified means of addressing health and digital literacy to effectively implement digital health in cancer care. CONCLUSIONS: Implementing digital health in cancer care must address the variability of digital health literacy in recipients, including groups living with disadvantage and older and younger people, in order to be effective. SO WHAT?: If cancer outcome disparity is to be reduced via digital health technologies, they must be implemented strategically to address digital health literacy needs. Health policy should reflect this approach.

Health Smart Homes: User Perspectives.

Health Smart Homes aim to assist the health and well-being of elderly people through digital technologies, by helping them to continue their daily living activities with safety and independence. This paper presents a landscape review to evaluate the effectiveness and feasibility of Health Smart Home technologies for advancing autonomy and quality of life from the perspectives of elderly users. The review was derived from an initial search of peer reviewed journals from three different data sources: PubMed (3808 papers), Google Scholar (7987 papers), and Scopus (595 papers). Of these, fourteen articles eventually met the inclusion criteria for the review and were subjected to further data extraction and quality assessment. The aim of this paper is to identify the perceptions of users by reviewing Health Smart Homes functions, services, benefits and implementation. Health Smart Homes could provide more opportunities to deliver IT-based health services by proactively monitoring and customizing the user environment, to the userâAZs needs and preferences.

Identifying Emerging Trends in Medical Informatics: A Synthesis Approach.

Medical informatics is a young and rapidly evolving field, influenced by and impacting on many different knowledge domains. Recent contributions on scoping the associated body of knowledge are confounded both by variations in popular use of terminology for established areas, and by the advent of new areas without yet established terminology. Determining the scope of a topic through online bibliographic search filters is a well-established approach in scientific research and has been developed as a human-directed task. Establishing the best approach and automating the process has proved a difficult problem. This paper explores the use of text analysis of bibliographic information using available search engines and NVIVO text analysis tools to test the potential for dynamic word based filters based on data mining. Results show that word searches of abstracts are more effective than topic searches for identifying health informatics papers, however more work is required to refine search terms to improve generalisability. Using data mining to track changes in word use in medical informatics journals, may make it possible to establish a more dynamic search filter to match the evolving nature of the field of health informatics.

Health Smart Homes: New Challenges.

Health Smart Homes provide various forms of assisted living support, by monitoring the activities and health status of their occupants to generate flows of information and sometimes interventions involving the occupants and their careers. Technologies of varying complexity must be combined to produce the underlying Health Smart Home system, and processing of the resulting data may require methods of varying sophistication. These aspects have been well studied, but no widely-adopted approaches for practical implementation of systems or systematic processing of data have been developed. Also, the integration of Health Smart Home services with the overall health care system has not been regularized. This paper identifies and categorizes the emerging high-level challenges beyond those in the basic technical and algorithmic spaces. These challenges will influence future directions for Health Smart Homes and their wider adoption and integration with health systems.

The Hare and the Hortoise: The Potential Versus the Reality of eTP Implementation.

In a health system increasingly driven by cost constraints, there is a focus on improved electronic transfer of information to support healthcare delivery. One area of healthcare that has moved more quickly than others to achieve this is prescribing in the primary care environment. Whilst the move to electronic transfer of prescriptions has reduced transcription errors, the regulatory environment persists with handwritten signatures. This constraint, whilst addressed slowly with technology solutions, needs support from legislative change. The ultimate step is to have a secure mobile model, which would support the move to a fully-electronic, paperless transaction model.

Interpreting international governance standards for health IT use within general medical practice.

General practices in Australia recognise the importance of comprehensive protective security measures. Some elements of information security governance are incorporated into recommended standards, however the governance component of information security is still insufficiently addressed in practice. The International Organistion for Standardisation (ISO) released a new global standard in May 2013 entitled, ISO/IEC 27014:2013 Information technology - Security techniques - Governance of information security. This standard, applicable to organisations of all sizes, offers a framework against which to assess and implement the governance components of information security. The standard demonstrates the relationship between governance and the management of information security, provides strategic principles and processes, and forms the basis for establishing a positive information security culture. An analysis interpretation of this standard for use in Australian general practice was performed. This work is unique as such interpretation for the Australian healthcare environment has not been undertaken before. It demonstrates an application of the standard at a strategic level to inform existing development of an information security governance framework.

Information security governance: a risk assessment approach to health information systems protection.

It is no small task to manage the protection of healthcare data and healthcare information systems. In an environment that is demanding adaptation to change for all information collection, storage and retrieval systems, including those for of e-health and information systems, it is imperative that good information security governance is in place. This includes understanding and meeting legislative and regulatory requirements. This chapter provides three models to educate and guide organisations in this complex area, and to simplify the process of information security governance and ensure appropriate and effective measures are put in place. The approach is risk based, adapted and contextualized for healthcare. In addition, specific considerations of the impact of cloud services, secondary use of data, big data and mobile health are discussed.

Creating context: making sense of geo-location and social media data for health.

Information that is persistently collected, unrelated to direct clinical care may be a Pandora's Box for health improvement and monitoring. The use and linkage of disparate data sources, particularly those relating to geo-location and social media present enormous opportunities and challenges for healthcare. To date these sources have been difficult to harness and make sense of, yet they are now beginning to be exploited. It is the innovation in analytic methodology that may hold the key if the issues that may confound the results can be addressed. These issues are encompassed in privacy, and with the scientific quality and completeness of the data. The future for alternative application of geo-location and social media data is here and now, and if they can be harnessed carefully, healthcare may be the biggest beneficiary.

It will never happen to us: the likelihood and impact of privacy breaches on health data in Australia.

With the recent introduction of the Australian e-health system, health reforms and legislation were passed. Whilst the aim of these health reforms was reasonable and sensible, the implementation was rushed and less than perfect. The Deloitte e-health Strategy [1] which was endorsed by the National Health and Hospital Reform Commission (NHHRC) recommended that based on international experience implementation of shared electronic health records nationally was a ten year journey. In Australia this was condensed into two years. The resultant effect has been that privacy, which is essential for the uptake of technologies to share data in a compliant manner, may be compromised. People trust transparent systems. Where there is a breach in privacy people deserve the respect and right to know about it so that they can mitigate damages and with full disclosure, retain their trust in the system. If this is not evident, the public will refuse to share their information. Hence, whilst the technologies may work, their use may be limited. The consequence of this in Australia would be the continuance of dangerous and inefficient silos of health data.

Does the PCEHR mean a new paradigm for information security? Implications for health information management.

Australia is stepping up to the new e-health environment. With this comes new legislation and new demands on information security. The expanded functionality of e-health and the increased legislative requirements, coupled with new uses of technology, means that enhancement of existing security practice will be necessary. This paperanalyses the new operating environment for Australian healthcare and the legislation governing it, and highlights the changes that are required to meet this new context. Individuals are now more responsible for security and organisations should be prompted to review their security measures in light of the new demands of legislative compliance.

Viability of healthcare service delivery alternatives for the Australian mining sector.

The changing and demanding nature of the mining workforce in rural and remote Australia brings unique challenges to the delivery of healthcare services. In an attempt to control costs whilst delivering cost effective and quality healthcare, new models of delivery must be considered. For a workforce that is fly-in/fly-out, the provision of healthcare is problematic given the lack of consistency in location. A cost-benefit framework is analysed comparing three models of service provision using travel to a major location, locum services and remote health monitoring. Ultimately, new models of care must be considered to address the issues of increasing workforce turnover, to cater for rising healthcare costs, and to improve the health of such communities.