Browsing by Author "Hamill, Melinda"
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- ItemDemonstrating the BlackBerry as a clinical communication tool: a pilot study conducted through the Centre for Innovation in Complex Care.(2008-12-11) Quan, Sherman; Wu, Robert; Morra, Dante; Wong, Brian M; Mraz, Richard; Hamill, Melinda; Abrams, Howard; Rossos, Peter GCanadians are living longer with chronic medical conditions which have led to an increasing complexity and volume of care for hospitalized patients Effective in patient care depends on the effective coordination of care through rapid and efficient communication between various care providers A delay in coordinating this care has downstream effects on other parts of the system ultimately contributing to increased emergency department wait times To address this system wide issue the Centre for Innovation in Complex Care at the University Health Network collaborated with Sunnybrook Health Sciences Centre to pilot the use of BlackBerry devices on the general internal medicine wards to improve clinical communication We describe the implementation process impact on clinical care and lessons learned from this experience We observed that residents quickly adopted this new technology and felt that it improved their workflow efficiency and productivity
- ItemA mobile phone based remote patient monitoring system for chronic disease management.(2007-10-03) Trudel, Mathieu; Cafazzo, Joseph A; Hamill, Melinda; Igharas, Walter; Tallevi, Kevin; Picton, Peter; Lam, Jack; Rossos, Peter G; Easty, Anthony C; Logan, AlexanderRising concern over the poor state of chronic disease management led to the user informed design and development of a home tele monitoring system Focus groups with patients and primary care providers guided the research team towards a design that would accommodate the workflow and concerns of the healthcare providers and the low use and comfort with technology found among the patient population The system was trialed in a before and after pilot study of 34 patients with diabetes and hypertension Findings demonstrate a significant improvement in systolic and diastolic blood pressure An RCT beginning in 2007 is being conducted to confirm these findings It is hypothesized that this user centred approach utilizing focus groups iterative design and human factors methods of evaluation will lead to the next generation of home tele monitoring applications that are more intuitive less cumbersome and ultimately bring about greater patient compliance and better physician management
- ItemMobile phone-based remote patient monitoring system for management of hypertension in diabetic patients.(2007-09-03) Logan, Alexander G; McIsaac, Warren J; Tisler, Andras; Irvine, M Jane; Saunders, Allison; Dunai, Andrea; Rizo, Carlos A; Feig, Denice S; Hamill, Melinda; Trudel, Mathieu; Cafazzo, Joseph ABACKGROUND Rising concern over the poor level of blood pressure BP control among hypertensive patients has prompted searches for novel ways of managing hypertension The objectives of this study were to develop and pilot test a home BP tele management system that actively engages patients in the process of care METHODS Phase 1 involved a series of focus group meetings with patients and primary care providers to guide the system s development In Phase 2 33 diabetic patients with uncontrolled ambulatory hypertension were enrolled in a 4 month pilot study using a before and after design to assess its effectiveness in lowering BP its acceptability to users and the reliability of home BP measurements RESULTS The system developed using commodity hardware comprised a Bluetooth enabled home BP monitor a mobile phone to receive and transmit data a central server for data processing a fax back system to send physicians reports and a BP alerting system In the pilot study 24 h ambulatory BP fell by 11 5 13 7 SD mm Hg both P Under 001 and BP control improved significantly Substantially more home readings were received by the server than expected based on the preset monitoring schedule Of 42 BP alerts sent to patients almost half n 20 were due to low BP Physicians received no critical BP alerts Patients perceived the system as acceptable and effective CONCLUSIONS The encouraging results of this study provide a strong rationale for a long term randomized clinical trial to determine whether this home BP tele management system improves BP control in the community among patients with uncontrolled hypertension
- ItemTelemanagement of hypertension: a qualitative assessment of patient and physician preferences.(2007-05-30) Halifax, Nancy V D; Cafazzo, Joseph A; Irvine, M Jane; Hamill, Melinda; Rizo, Carlos A; McIssac, Warren J; Rossos, Peter G; Logan, Alexander GBACKGROUND Prevalence surveys have consistently found that the blood pressure control rate among people with hypertension is less than 25 Studies of telemedicine as a means of providing care to hypertensive patients have shown that this approach is effective in lowering blood pressure Major design flaws and high operating costs however have hindered its adoption by physicians and patients OBJECTIVES In the present commentary the field of telemedicine as it pertains to hypertension management is reviewed and the investigators experiences in developing a new telemedicine system are outlined METHODS An applied qualitative case study approach was used to determine the information needs for the design of a telemedicine system Opinions were elicited separately from type 2 diabetic patients with hypertension n 24 and family practitioners in active clinical practice n 18 RESULTS Physician and patient focus group meetings provided key information that led to changes in the prototype system The low level of computer and Internet use by patients in everyday life and by physicians in practice related activities precluded their inclusion in the design of the system for information retrieval and receiving clinical alerts For patients the mobile phone appeared to be an acceptable alternative The only practical automated means to disseminate reports and alerts to physicians was by fax which was the most universally available device in a doctor s office CONCLUSION This tightly focused qualitative study led to the development of design principles for a prototype system increasing the likelihood of user acceptance and improving its effectiveness