Objective:Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery.Materials and Methods:The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework.Results:The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive.Conclusions:The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances.
As technology scales down to nanometer dimensions, static power consumption has become more and more important. We propose a low power method to manage power consumption; it considers dual supply voltage (V/sub dd/) and dual threshold voltage (V/sub th/) at the same time to deal with the scheduling problem in the behavioral synthesis stage. A flexible design space of power, and a better performance can be achieved when we use the proposed method. An algorithm combining GA (genetic algorithm) and SA (simulated annealing) is used to solve the scheduling problem. Experimental results illustrate 41.6% power reduction on average.
With the popularity of group-oriented applications, secure and efficient communication among all group members has become a major issue. We propose a distributed key management protocol for group members to share a secret group key, which can be used to protect shared information. The protocol manages the group key of a dynamic group, where members can freely join or leave, and each time the key is updated using two broadcast messages. The protocol algorithms provide group key secrecy, forward group key secrecy, and backward group key secrecy. The complexities of the group key computation time, the storage space for every member, and the total communication bandwidth to update the group key are approximately of logarithmic order of the group size, which make the protocol attractive for environments with less computation power and smaller storage.
Nurse rostering is a critical issue in hospitals around the world. With multiple constraints that must be considered to ensure job satisfaction, nurse scheduling usually poses a heavy financial burden on human resources with limited available staff resources. Managers also need to reproduce the roster of duties for the nursing staff. In addition, the staff allocation should be based on the visit number of patients. Hence, to address this issue, we implemented an automatic mechanism of nurse scheduling based on integer linear programing, along with multiple criteria constraints, which are suitable for real-world practice, and users can configure conditions for tasks and nurses as constraints in the integer linear programing. Finally, the platform could assign 36 staff members to 23 stations based on the proposed dynamic optimal algorithm following 20 stringent constraints in 0.5 second. Moreover, the specific manipulation shifts of scheduling on the platform is easy and can be automatically computed in minimum time. Compared with the manual scheduling, the proposed automatic mechanism could perform the scheduling task quickly and fairly. Most importantly, the platform is adequately reliable to decrease the burden for scheduling.
National Taiwan University Hospital (NTUH) is an academic hospital having over hundred years' history and large scale. There are existing problems in the NTUH portal site. It contains multi-system entrances and display, maintenance of numerous function linkages. In here, we design a new portal site to solve these problems. The single sign on service (SSOS) solves the multi-system entrance problem. For the function linkage problem, we design dynamic, hierarchical drop-down navigation menus to enlarge the browsing capacity for covering over 250 function links and two bulletins in one page. The XML formatted configuration files are designed to dynamically establish function linkages. The approach makes the linkage management easier. Moreover, we maintain configuration parameters, i.e., access control capabilities, linkage modes and multi-server redirections, as well as target control, in configuration files. All these features enhance NTUH portal site administration flexible and usage intuitive. In addition, the future works have been addressed clearly.
Background: Surgical cancer patients often have deteriorated physical activity (PA), which in turn, contributes to poor outcomes and early recurrence of cancer. Mobile health (mHealth) platforms are progressively used for monitoring clinical conditions in medical subjects. Despite prevalent enthusiasm for the use of mHealth, limited studies have applied these platforms to surgical patients who are in much need of care because of acutely significant loss of physical function during the postoperative period. Objective: The aim of our study was to determine the feasibility and clinical value of using 1 wearable device connected with the mHealth platform to record PA among patients with gastric cancer (GC) who had undergone gastrectomy. Methods: We enrolled surgical GC patients during their inpatient stay and trained them to use the app and wearable device, enabling them to automatically monitor their walking steps. The patients continued to transmit data until postoperative day 28. The primary aim of this study was to validate the feasibility of this system, which was defined as the proportion of participants using each element of the system (wearing the device and uploading step counts) for at least 70% of the 28-day study. "Definitely feasible," "possibly feasible," and "not feasible" were defined as ≥70%, 50%-69%, and 90%). Furthermore, we used a multivariable-adjusted model to predict early discharge, which demonstrated that every 1000-step increment of walking on postoperative day 5 was associated with early discharge (odds ratio 2.72, 95% CI 1.17-6.32; P=.02). Conclusions: Incorporating the use of mobile phone apps with wearable devices to record PA in patients of postoperative GC was feasible in patients undergoing gastrectomy in this study. With the support of the mHealth platform, this app offers seamless tracing of patients' recovery with a little extra burden and turns subjective PA into an objective, measurable parameter.
The importance of effective surgical wound care cannot never be underestimated. Poorly managing surgical wounds may cause many serious complications. Thus, it raises the necessity to develop a patient-friendly self-care system which can help both patients and medical professionals to ensure the state of the surgical wounds without any special medical equipment. In this paper, a surgical wound assessment system for self-care is proposed. The proposed system is designed to enable patients capture surgical wound images of themselves by using a mobile device and upload these images for analysis. Combining image-processing and machine-learning techniques, the proposed method is composed of four phases. First, images are segmented into superpixels where each superpixel contains the pixels in the similar color distribution. Second, these superpixels corresponding to the skin are identified and the area of connected skin superpixels is derived. Third, surgical wounds will be extracted from this area based on the observation of the texture difference between skin and wounds. Lastly, state and symptoms of surgical wound will be assessed. Extensive experimental results are conducted. With the proposed method, more than 90% state assessment results are correct and more than 91% symptom assessment results consistent with the actual diagnosis. Moreover, case studies are provided to show the advantage and limitation of this system. These results show that this system could perform well in the practical self-care scenario.
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