[Dolodoc: a virtual pain management coach]. / Dolodoc : un coach virtuel pour mieux gérer la douleur chronique.

Dolodoc is a mobile application aimed at improving autonomy and quality of life for individuals living with chronic pain. Designed as a virtual coach, it offers counseling according to 7 important dimensions of quality of life. Activities, pain and fulfillment of the 7 dimensions of quality of life can be recorded in the application. Moreover, a report can be exported to enhance patient monitoring during clinical interactions. Dolodoc was developed with a user-centered approach and is based on scientific evidence related to the self-management of chronic pain. Indeed, counseling by the coach is based on a multimodal strategy, incorporating elements of physical activity, pacing, positive psychology, and relaxation, among others. Overall, Dolodoc is an innovation that can be used in various clinical settings with an individualized approach.

Dolodoc est une application ayant pour but d'améliorer l'autonomie et la qualité de vie des personnes vivant avec la douleur chronique. Conçue comme un coach virtuel, elle propose des conseils ainsi qu'un suivi d'activités se référant à 7 dimensions importantes pour la qualité de vie. Ces éléments sont consignables dans l'application et un rapport peut être exporté pour agrémenter le suivi du patient. Dolodoc a été développé selon une approche centrée sur l'utilisateur et se base sur des preuves scientifiques en lien avec l'autogestion des douleurs chroniques. En effet, les conseils sont multimodaux et intègrent, entre autres, l'activité physique, le pacing, la psychologie positive et la relaxation. Disponible gratuitement, Dolodoc est une innovation dont l'utilisation individualisée peut s'adapter à différents contextes cliniques.

The Impact of a Tablet App on Adherence to American Heart Association Guidelines During Simulated Pediatric Cardiopulmonary Resuscitation: Randomized Controlled Trial.

BACKGROUND: Evidence-based best practices are the cornerstone to guide optimal cardiopulmonary arrest resuscitation care. Adherence to the American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite advances in resuscitation science and survival improvement over the last decades, only approximately 38% of children survive to hospital discharge after in-hospital cardiac arrest and only 6%-20% after out-of-hospital cardiac arrest. OBJECTIVE: We investigated whether a mobile app developed as a guide to support and drive CPR providers in real time through interactive pediatric advanced life support (PALS) algorithms would increase adherence to AHA guidelines and reduce the time to initiation of critical life-saving maneuvers compared to the use of PALS pocket reference cards. METHODS: This study was a randomized controlled trial conducted during a simulation-based pediatric cardiac arrest scenario caused by pulseless ventricular tachycardia (pVT). A total of 26 pediatric residents were randomized into two groups. The primary outcome was the elapsed time in seconds in each allocation group from the onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, including the time intervals between defibrillation attempts and drug doses, shock doses, and the number of shocks. All outcomes were assessed for deviation from AHA guidelines. RESULTS: Mean time to the first defibrillation attempt (121.4 sec, 95% CI 105.3-137.5) was significantly reduced among residents using the app compared to those using PALS pocket cards (211.5 sec, 95% CI 162.5-260.6, P<.001). With the app, 11 out of 13 (85%) residents initiated chest compressions within 60 seconds from the onset of pVT and 12 out of 13 (92%) successfully defibrillated within 180 seconds. Time to all other defibrillation attempts was reduced with the app. Adherence to the 2018 AHA pVT algorithm improved by approximately 70% (P=.001) when using the app following all CPR sequences of action in a stepwise fashion until return of spontaneous circulation. The pVT rhythm was recognized correctly in 51 out of 52 (98%) opportunities among residents using the app compared to only 19 out of 52 (37%) among those using PALS cards (P<.001). Time to epinephrine injection was similar. Among a total of 78 opportunities, incorrect shock or drug doses occurred in 14% (11/78) of cases among those using the cards. These errors were reduced to 1% (1/78, P=.005) when using the app. CONCLUSIONS: Use of the mobile app was associated with a shorter time to first and subsequent defibrillation attempts, fewer medication and defibrillation dose errors, and improved adherence to AHA recommendations compared with the use of PALS pocket cards.

[Mobile applications and self-management of chronic pain]. / Applications mobiles et autogestion des douleurs chroniques.

Self-management of chronic pain should enable patients to regain an acceptable quality of life, autonomy, and reduce the number of consultations. These strategies are increasingly available on mobile applications, which have been evaluated for their content and effectiveness in several reviews. The vast majority of applications offer only one self-management strategy, few opportunities for interactions, and have not involved patients and healthcare professionals in their development. It is therefore still difficult to determine their effectiveness in the self-management of chronic pain. However, mobile applications should not be neglected. On the contrary, it is necessary to develop validated applications in French considering the five criteria classically recommended for self-management. Then such applications can be prescribed by health professionals as part of the multimodal management of chronic pain.

L'autogestion des douleurs chroniques doit permettre aux patients de retrouver une qualité de vie acceptable, une autonomie, et de diminuer les consultations. Ces stratégies sont de plus en plus disponibles sur des applications mobiles dont plusieurs revues ont évalué le contenu et l'efficacité. Il en ressort que la grande majorité des applications ne proposent qu'une seule stratégie d'autogestion, offrent peu de possibilités d'interactions, et n'ont pas impliqué dans leur développement patients ou professionnels de la santé. Il est ainsi encore difficile de déterminer leur efficacité dans l'autogestion des douleurs chroniques. Cependant, les applications mobiles ne sont pas un moyen à négliger, il faut au contraire développer des applications validées en français tenant compte des cinq critères classiquement recommandés pour l'autogestion. Alors de telles applications pourront être prescrites par les professionnels de la santé dans le cadre de la prise en charge multimodale des douleurs chroniques.

Electronic Patient-Generated Health Data to Facilitate Disease Prevention and Health Promotion: Scoping Review.

BACKGROUND: Digital innovations continue to shape health and health care. As technology socially integrates into daily living, the lives of health care consumers are transformed into a key source of health information, commonly referred to as patient-generated health data (PGHD). With chronic disease prevalence signaling the need for a refocus on primary prevention, electronic PGHD might be essential in strengthening proactive and person-centered health care. OBJECTIVE: This study aimed to review and synthesize the existing literature on the utilization and implications of electronic PGHD for primary disease prevention and health promotion purposes. METHODS: Guided by a well-accepted methodological framework for scoping studies, we screened MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, EMBASE, and IEEE Digital Library. We hand-searched 5 electronic journals and 4 gray literature sources, additionally conducted Web searches, reviewed relevant Web pages, manually screened reference lists, and consulted authors. Screening was based on predefined eligibility criteria. Data extraction and synthesis were guided by an adapted PGHD-flow framework. Beyond initial quantitative synthesis, we reported narratively, following an iterative thematic approach. Raw data were coded, thematically clustered, and mapped, allowing for the identification of patterns. RESULTS: Of 183 eligible studies, targeting knowledge and self-awareness, behavior change, healthy environments, and remote monitoring, most literature (125/183, 68.3%) addressed weight reduction, either through physical activity or nutrition, applying a range of electronic tools from socially integrated to full medical devices. Participants generated their data actively (100/183, 54.6%), in combination with passive sensor-based trackers (63/183, 34.4%) or entirely passively (20/183, 10.9%). The proportions of active and passive data generation varied strongly across prevention areas. Most studies (172/183, 93.9%) combined electronic PGHD with reflective, process guiding, motivational and educational elements, highlighting the role of PGHD in multicomponent digital prevention approaches. Most of these interventions (110/183, 60.1%) were fully automatized, underlining broader trends toward low-resource and efficiency-driven care. Only a fraction (47/183, 25.6%) of studies provided indications on the impact of PGHD on prevention-relevant outcomes, suggesting overall positive trends, especially on vitals (eg, blood pressure) and body composition measures (eg, body mass index). In contrast, the impact of PGHD on health equity remained largely unexplored. Finally, our analysis identified a list of barriers and facilitators clustered around data collection and use, technical and design considerations, ethics, user characteristics, and intervention context and content, aiming to guide future PGHD research. CONCLUSIONS: The large, heterogeneous volume of the PGHD literature underlines the topic's emerging nature. Utilizing electronic PGHD to prevent diseases and promote health is a complex matter owing to mostly being integrated within automatized and multicomponent interventions. This underlines trends toward stronger digitalization and weaker provider involvement. A PGHD use that is sensitive to identified barriers, facilitators, consumer roles, and equity considerations is needed to ensure effectiveness.

Patients' time perception in the waiting room of an ambulatory emergency unit: a cross-sectional study.

BACKGROUND: Patient satisfaction has become an increasingly important element in a service-oriented healthcare market. Although satisfaction is influenced by many factors, the waiting time to be seen by medical staff has been shown to be one of the key criteria. However, waiting is not an objective experience and several factors can influence its perception. METHODS: We conducted a questionnaire-based, cross-sectional study among patients attending the emergency unit of a Swiss university hospital in order to explore the key factors influencing wait perception. RESULTS: A total of 509 patients participated in the study. Appropriate assessment of emergency level by caregivers, the feeling of being forgotten, respect of privacy, and lack of information on the exact waiting time were identified as significant variables for wait perception. CONCLUSIONS: Our study confirmed the existence of a 'golden hour' when the patient is willing to wait until the medical encounter. In case the wait cannot be limited, an appropriate assessment of the emergency level by caregivers and avoiding the patients of feeling being forgotten are very important factors to avoid a negative perception of the waiting time before seeing a doctor. TRIAL REGISTRATION: (ID REQ-2016-00555).

[InfoKids: changing the patients' journey paradigm in an Emergency Department]. / InfoKids : changement de paradigme du parcours patients dans un service d'urgences.

Nowadays, citizens are little supported to decide whether they should consult the Emergency Departments (ED) in case of illness or trauma. Moreover, once in the ED, they often must deal with overcrowding, long waiting times, the acute nature of the visits, administrative data management, and a lack of follow-up after the visit. To improve this situation, we have developed an e-health solution delivering a more patient-centered experience by connecting patients, caregivers, and administrative clerks through a web and mobile applications. This innovative system is intended to improve the entire emergency care process, facilitating the caregiver and administrative work and supporting patients before, during, and after their ED consultation.

De nos jours, les citoyens sont peu soutenus en cas de maladie ou de traumatisme pour décider si leur état de santé justifie une consultation aux urgences. Arrivés aux urgences, les patients doivent faire face à des délais d'attente, au stress engendré par une urgence médicale et au manque d'information concernant le suivi à domicile. Afin d'améliorer cette situation, nous avons développé une solution d'e-santé, composée d'applications web et mobiles, guidant le patient de manière personnalisée tout au long de son parcours et connectant patients, soignants et employés administratifs. Ce système novateur améliore l'ensemble du processus de soins d'urgence en facilitant le travail des soignants, des administratifs et en soutenant les patients avant, pendant et après leurs consultations aux urgences.

Adherence to AHA Guidelines When Adapted for Augmented Reality Glasses for Assisted Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial.

BACKGROUND: The American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) are nowadays recognized as the world's most authoritative resuscitation guidelines. Adherence to these guidelines optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite their availability, suboptimal quality of CPR is still common. Currently, the median hospital survival rate after pediatric in-hospital cardiac arrest is 36%, whereas it falls below 10% for out-of-hospital cardiac arrest. Among emerging information technologies and devices able to support caregivers during resuscitation and increase adherence to AHA guidelines, augmented reality (AR) glasses have not yet been assessed. In order to assess their potential, we adapted AHA Pediatric Advanced Life Support (PALS) guidelines for AR glasses. OBJECTIVE: The study aimed to determine whether adapting AHA guidelines for AR glasses increased adherence by reducing deviation and time to initiation of critical life-saving maneuvers during pediatric CPR when compared with the use of PALS pocket reference cards. METHODS: We conducted a randomized controlled trial with two parallel groups of voluntary pediatric residents, comparing AR glasses to PALS pocket reference cards during a simulation-based pediatric cardiac arrest scenario-pulseless ventricular tachycardia (pVT). The primary outcome was the elapsed time in seconds in each allocation group, from onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, as well as the time intervals between defibrillation attempts and drug doses, shock doses, and number of shocks. All these outcomes were assessed for deviation from AHA guidelines. RESULTS: Twenty residents were randomized into 2 groups. Time to first defibrillation attempt (mean: 146 s) and adherence to AHA guidelines in terms of time to other critical resuscitation endpoints and drug dose delivery were not improved using AR glasses. However, errors and deviations were significantly reduced in terms of defibrillation doses when compared with the use of the PALS pocket reference cards. In a total of 40 defibrillation attempts, residents not wearing AR glasses used wrong doses in 65% (26/40) of cases, including 21 shock overdoses >100 J, for a cumulative defibrillation dose of 18.7 Joules per kg. These errors were reduced by 53% (21/40, P<.001) and cumulative defibrillation dose by 37% (5.14/14, P=.001) with AR glasses. CONCLUSIONS: AR glasses did not decrease time to first defibrillation attempt and other critical resuscitation endpoints when compared with PALS pocket cards. However, they improved adherence and performance among residents in terms of administering the defibrillation doses set by AHA.

A Mobile Device App to Reduce Time to Drug Delivery and Medication Errors During Simulated Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial.

BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusion is both complex and time-consuming, placing children at higher risk than adults for medication errors. Following an evidence-based ergonomic-driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion. OBJECTIVE: The aim of our study was to determine whether the use of PedAMINES reduces drug preparation time (TDP) and time to delivery (TDD; primary outcome), as well as medication errors (secondary outcomes) when compared with conventional preparation methods. METHODS: The study was a randomized controlled crossover trial with 2 parallel groups comparing PedAMINES with a conventional and internationally used drugs infusion rate table in the preparation of continuous drug infusion. We used a simulation-based pediatric CPR cardiac arrest scenario with a high-fidelity manikin in the shock room of a tertiary care pediatric emergency department. After epinephrine-induced return of spontaneous circulation, pediatric emergency nurses were first asked to prepare a continuous infusion of dopamine, using either PedAMINES (intervention group) or the infusion table (control group), and second, a continuous infusion of norepinephrine by crossing the procedure. The primary outcome was the elapsed time in seconds, in each allocation group, from the oral prescription by the physician to TDD by the nurse. TDD included TDP. The secondary outcome was the medication dosage error rate during the sequence from drug preparation to drug injection. RESULTS: A total of 20 nurses were randomized into 2 groups. During the first study period, mean TDP while using PedAMINES and conventional preparation methods was 128.1 s (95% CI 102-154) and 308.1 s (95% CI 216-400), respectively (180 s reduction, P=.002). Mean TDD was 214 s (95% CI 171-256) and 391 s (95% CI 298-483), respectively (177.3 s reduction, P=.002). Medication errors were reduced from 70% to 0% (P<.001) by using PedAMINES when compared with conventional methods. CONCLUSIONS: In this simulation-based study, PedAMINES dramatically reduced TDP, to delivery and the rate of medication errors.

Influence of Pedometer Position on Pedometer Accuracy at Various Walking Speeds: A Comparative Study.

BACKGROUND: Demographic growth in conjunction with the rise of chronic diseases is increasing the pressure on health care systems in most OECD countries. Physical activity is known to be an essential factor in improving or maintaining good health. Walking is especially recommended, as it is an activity that can easily be performed by most people without constraints. Pedometers have been extensively used as an incentive to motivate people to become more active. However, a recognized problem with these devices is their diminishing accuracy associated with decreased walking speed. The arrival on the consumer market of new devices, worn indifferently either at the waist, wrist, or as a necklace, gives rise to new questions regarding their accuracy at these different positions. OBJECTIVE: Our objective was to assess the performance of 4 pedometers (iHealth activity monitor, Withings Pulse O2, Misfit Shine, and Garmin vívofit) and compare their accuracy according to their position worn, and at various walking speeds. METHODS: We conducted this study in a controlled environment with 21 healthy adults required to walk 100 m at 3 different paces (0.4 m/s, 0.6 m/s, and 0.8 m/s) regulated by means of a string attached between their legs at the level of their ankles and a metronome ticking the cadence. To obtain baseline values, we asked the participants to walk 200 m at their own pace. RESULTS: A decrease of accuracy was positively correlated with reduced speed for all pedometers (12% mean error at self-selected pace, 27% mean error at 0.8 m/s, 52% mean error at 0.6 m/s, and 76% mean error at 0.4 m/s). Although the position of the pedometer on the person did not significantly influence its accuracy, some interesting tendencies can be highlighted in 2 settings: (1) positioning the pedometer at the waist at a speed greater than 0.8 m/s or as a necklace at preferred speed tended to produce lower mean errors than at the wrist position; and (2) at a slow speed (0.4 m/s), pedometers worn at the wrist tended to produce a lower mean error than in the other positions. CONCLUSIONS: At all positions, all tested pedometers generated significant errors at slow speeds and therefore cannot be used reliably to evaluate the amount of physical activity for people walking slower than 0.6 m/s (2.16 km/h, or 1.24 mph). At slow speeds, the better accuracy observed with pedometers worn at the wrist could constitute a valuable line of inquiry for the future development of devices adapted to elderly people.

Adapting Gamification Strategies According to Targeted Health Behavior Change: Findings from a Focus Group.

In healthcare, improving lifestyle behaviors like medication adherence remains challenging, with an impact on treatment success and patient outcomes. Mobile health (mHealth) applications offer promising solutions by leveraging smartphone ubiquity and digital accessibility. However, sustaining user engagement and behavior change presents obstacles. This study explores the specificities of gamification-integrating game-like elements into non-game contexts-to improve mHealth applications for 3 health behaviors. During a focus group, 15 participants discussed the potential of 17 gamification strategies to improve medication adherence, physical activity, and diet within mHealth applications. Individual choices varied widely, with preferences influenced by targeted behaviors. Physical activity focused on self-monitoring and challenges, while dieting emphasized cooperation. Simulation models were particularly intriguing, projecting long-term benefits of behavior changes. Future research should explore personalized design options and consider individual characteristics. Iterative design cycles with end-users are crucial for refining concepts and sustaining user engagement. Overall, gamification presents an innovative avenue for empowering patients and transforming healthcare delivery.

Toward Laboratory Notification in Pediatric Emergency Departments.

This study explores how patient's laboratory result are accessed in pediatric emergency departments. The rapid turnaround of laboratory results and their timely access by the medical team are crucial for effective patient management and care decision-making. This study revealed a systematic access prioritization to the Electronic Health Record, led by physicians, followed by nurses, and then other healthcare staff Despite efforts to streamline access through computerized laboratory results, optimized laboratory turnaround time and integration of final results into the electronic health record remain key challenges. Delays in accessing analysis results issued by the central hospital laboratory are consistently experienced across various laboratory types, indicating broader systemic workflow issues rather than inefficiencies specific to individual laboratories.

Supporting drug prescription through autocompletion.

Computerized prescription is a central component in modern clinical information systems. It allows scheduling drugs delivery, exams and other types of care. It is thought to be a useful tool for the reduction of medication errors and for the improvement of medication logistics. Whereas the success of the computerized prescription depends on the unambiguous selection of the manipulated concepts, there is a strong variability between the preferred terms of clinicians of different backgrounds. Moreover, users sometimes want to use synonyms or don't know the exact spelling of the term. This makes the search for desired procedure name through large size vocabularies time-consuming for users. In order to facilitate the prescriptions process, we have built a tool that proposes the most likely terms based on the first letters inputted by the user. The tool helps selecting the most appropriate term by ranking the possible results in a clever manner. Experimental evaluation shows promising results and indicates the tool ease the terminology manipulations.

Informing Family About Patient Trajectory During Surgery: Design and Preliminary Evaluation.

The patient empowerment movement has highlighted the importance of providing information to the patients to improve care outcome. However, relatives of patients are not yet taken into consideration. This is especially problematic during surgeries since families are often left without real-time information about the trajectory of the patient, inducing worries. Based on this observation we have developed the SMS-Chir solution that connects our surgery service management system with the automatic sending of SMS at key moments in order to inform families about the progression of the surgery. The system has been conceived thanks to the results of a focus group involving four experts. The evaluation was done by monitoring the use of the system over time and by sending questionnaires after intervention. Results analysis shows a limited use of the system but a high satisfaction of the beneficiaries. This study highlights the importance of managerial factors (resistance to change) in order to onboard the necessary stakeholders in the process.

Conception and Development of a Targeted Alert System: Multisystem Considerations.

Alerting systems have a strong potential to improve quality of care in hospital by ensuring that clinicians provide more effective and timely care to their patients. Many systems have been implemented but often fail to unleash their full potential due to the problem of alert fatigue. As an attempt to reduce this fatigue we have developed a targeted alerting system ensuring only the concerned clinicians receives the alerts. The conception of the system went through several steps going from the identification of the requirement, the prototyping and implementation into several systems. The results present the different parameters taken into consideration and developed frontends. We finally discuss the important considerations of alerting system, such as the necessity of a governance. The system still needs a formal evaluation to validate that it responds to its promises before being deployed more largely.

Personalization of Mobile Apps for Health Behavior Change: Protocol for a Cross-sectional Study.

BACKGROUND: Mobile health apps have the potential to motivate people to adopt healthier behavior, but many fail to maintain this behavior over time. However, it has been suggested that long-term adherence can be improved by personalizing the proposed interventions. Based on the literature, we created a conceptual framework for selecting appropriate functionalities according to the user's profile. OBJECTIVE: This cross-sectional study aims to investigate if the relationships linking functionalities and profiles proposed in our conceptual framework are confirmed by user preferences. METHODS: A web-based questionnaire comprising several sections was developed to determine the mobile app functionalities most likely to promote healthier behavior. First, participants completed questionnaires to define the user profile (Big Five Inventory-10, Hexad Scale, and perception of the social norm using dimensions of the Theory of Planned Behavior). Second, participants were asked to select the 5 functionalities they considered to be the most relevant to motivate healthier behavior and to evaluate them on a score ranging from 0 to 100. We will perform logistic regressions with the selected functionalities as dependent variables and with the 3 profile scales as predictors to allow us to understand the effect of the participants' scores on each of the 3 profile scales on the 5 selected functionalities. In addition, we will perform logistic ordinal regressions with the motivation score of the functionalities chosen as dependent variables and with scores of the 3 profile scales as predictors to determine whether the scores on the different profile scales predict the functionality score. RESULTS: Data collection was conducted between July and December 2021. Analysis of responses began in January 2022, with the publication of results expected by the end of 2022. CONCLUSIONS: This study will allow us to validate our conceptual model by defining the preferred functionalities according to user profiles. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/38603.

Effectiveness of a Mobile App (PIMPmyHospital) in Reducing Therapeutic Turnaround Times in an Emergency Department: Protocol for a Pre- and Posttest Study.

BACKGROUND: Delays in reviewing issued laboratory results in emergency departments (EDs) can adversely affect efficiency and quality of care. One opportunity to improve therapeutic turnaround time could be to provide real-time access to laboratory results on mobile devices available to every caregiver. We developed a mobile app named "Patients In My Pocket in my Hospital" (PIMPmyHospital) to help ED caregivers automatically obtain and share relevant information about the patients they care for including laboratory results. OBJECTIVE: This pre- and posttest study aims to explore whether the implementation of the PIMPmyHospital app impacts the timeliness with which ED physicians and nurses remotely access laboratory results while actively working in their real-world environment, including ED length of stay, technology acceptance and usability among users, and how specific in-app alerts impact on its effectiveness. METHODS: This single-center study of nonequivalent pre- and posttest comparison group design will be conducted before and after the implementation of the app in a tertiary pediatric ED in Switzerland. The retrospective period will cover the previous 12 months, and the prospective period will cover the following 6 months. Participants will be postgraduate residents pursuing a ≤6-year residency in pediatrics, pediatric emergency medicine fellows, and registered nurses from the pediatric ED. The primary outcome will be the mean elapsed time in minutes from delivery of laboratory results to caregivers' consideration by accessing them either through the hospital's electronic medical records or through the app before and after the implementation of the app, respectively. As secondary outcomes, participants will be queried about the acceptance and usability of the app using the Unified Theory of Acceptance and Use of Technology model and the System Usability Scale. ED length of stay will be compared before and after the implementation of the app for patients with laboratory results. The impact of specific alerts on the app, such as a flashing icon or sound for reported pathological values, will be reported. RESULTS: Retrospective data collection gathered from the institutional data set will span a 12-month period from October 2021 to October 2022, while the 6-month prospective collection will begin with the implementation of the app in November 2022 and is expected to cease at the end of April 2023. We expect the results of the study to be published in a peer-reviewed journal in late 2023. CONCLUSIONS: This study will show the potential reach, effectiveness, acceptance, and use of the PIMPmyHospital app among ED caregivers. The findings of this study will serve as the basis for future research on the app and any further development to improve its effectiveness. Trial Registration: ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331. TRIAL REGISTRATION: ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43695.

INCA - Individual Nomad Clinical Assistant - supporting nurses with mobile devices.

INTRODUCTION: A completely structured nursing record has been deployed in the 8 hospitals of the University hospitals of Geneva. Even with laptops, the access to the records restrains nurses' mobility during their bedside work. It has lead to a strong demand for mobile devices. PROBLEM: There are several papers showing that mobile computers can lead to increase time for data acquisition, increased errors and omissions. Thus, there are important challenges at developing these tools, while respecting the mobile paradigm and the needs for qualitative and efficient acquisition. A simple translation of user interfaces from usual computers is not recommended. RESULTS: After evaluating various user interfaces with users in real conditions, we propose a solution that eases the selection of patients, the navigation into the various screens, and provides a very clear list of tasks to achieve for nurses. CONCLUSION: The article exposes the difficulties to adapt an existing tool on mobile devices. Despite these difficulties, by organizing smartly the displayed information, we produced a tool with similar functionalities but better adapted to the user.

Challenges and issues of geolocation in clinical environment.

Reaching a good indoor geolocation without deploying extensive and expensive infrastructure is a challenge, because satellite positioning system is not available indoors. Geolocation could be of major use in healthcare facilities; to help care providers, visitors and patients to navigate, to improve movements and flows efficiency or to implement location-awareness systems. A system able to provide the location of a person in a hospital requires precision, multi-floors and obstacles management and should also perform in basements and outdoors. Such system needs also to be insensitive to environmental variations occurring in a hospital. These changes may be various kinds of obstacles. These can be the displacement of metallic objects, metallic machines, strong magnetic fields or simply human displacement. A system conforming to the above requirements can also answer various security questions, operational workflow management but also assist movement of people.

Design Considerations for the Use of Patient-Generated Health Data in the Electronic Medical Records.

Patient-generated health data (PGHD) is of growing interest to physicians, particularly if they are integrated in the electronic medical record (EMR). Concerns about how to manage vast amounts of PGHD and potential liability issues have limited their use. Based on interviews with specialists, we present types of PGHD, workflow processes and needs. We then discuss consideration for how to manage PGHD with approaches for analyses to detect abnormal results, and present implications for alert systems and visualization requirements in multi-patient views.

Perception of the Communication Campaign for @choum a Symptom Reporting App: Insights from Semi Structured Interviews.

As an attempt to identify cluster of spread of COVID, we have developed the @choum functionality enabling individuals to signal when they perceived COVID-19 symptoms. The associated communication campaign did not encounter the expected success and only a limited amount of person did download the app. As an attempt to understand the barriers of use we have recruited a sample of general population to perform semi structured interview. Interview transcripts were analyzed using thematic analysis. Results highlight 3 profiles, engaged, critics and disengaged. We observe that these 3 profiles have different perception of the communication campaign, engaged participants being much more convinced by its message whereas disengaged people lack strongly of trust. This study helped us to identify what messages must be emphasized in order to attract critic people that may be convinced to use the tool.