The purpose of this dissertation is to explore the contemporary area of information technologies employed in health care (eHealth). Focusing on the systems already employed in the Czech Republic, it aims to analyse them, to quantify expenditures of their introduction and maximum benefits derived from these, as well as to evaluate their real current profit. Out of the three existing national systems, this dissertation concentrates on the two only (eRecept, ePACS), as it became impossible to evaluate the third -- IZIP system due to scarcity of the relevant information available. In the field of expenditures not only generally published numbers are taken into consideration, but this dissertation also evaluates the expenditures of other subjects involved (IT systems producers, health care providers, etc.). As the first dissertation in the Czech Republic it quantifies benefits derived from the existing eHealth systems and unlike foreign theses it greatly emphasizes just the expenditures of other subjects involved. Included in this dissertation is also the evaluation of achievements of the eHealth systems in the Czech Republic complete with supposed grounds for this situation. This dissertation also recommends courses of action for contractors of these systems to ensure future basis for more economical and successful eHealth systems. These recommendations are mainly based on analysis of development of the existing national eHealth systems. For the complex evaluation of the costs, maximum of possible and real benefit of the individual eHealth systems the research approach adopted in this dissertation includes descriptive method and SWOT analysis, extrapolation and abstraction, comparative and factor analysis.

Autism Spectrum Disorder (ASD) is a developmental disorder characterized primarily by social skills deficits that can impair the individual’s ability to develop and maintain meaningful relationships. Research has shown that social skills training provides lasting improvement in social interactions. However, many factors can hinder the availability of intervention groups outside of major metropolitan areas. Individual online social skills interventions have been shown to translate to increases in everyday social skills, and while further investigation is required, current literature suggests that there is great potential for live, interactive online social skills groups to provide similar benefits to in-person intervention groups. Thus, online groups may be one solution to the barriers to accessing available resources. This study sought to explore the feasibility of conducting a live, interactive online social skills group by comparing two groups using the same curriculum; one in-person group that met in a lab on a local college campus, and one piloted online group that met through Zoom, a video conference platform, each for 14 weeks. Each group also participated in person in social activities on campus to gather preliminary generalization data. The online intervention was acceptable to therapists and participants, and a group of therapists who implemented both delivery models reported some advantages and disadvantages of an online format for social skills, expressing a preference for in-person delivery model when possible, but acceptability of online delivery where in-person groups are not available. The online model showed somewhat lower levels of participation, but slightly higher attendance rates than the in-person model. Understanding both the advantages and disadvantages to online social skills, clinicians can utilize the method the best fits their needs.

The purpose of this study was to gain a deeper understanding of the patient’s perspective regarding social interactions in video healthcare meetings. Social presence theory was used in the context of how video calls can result in vital aspects of social interactions disappearing and how that can affect the outcome of a doctor consultation in contrast to physical meetings. A qualitative method with semi-structured interviews was applied to this study. This study included 7 participants with similar age range from 26-36 years old including both genders. This study resulted in many different views and perspectives whereas some participants found it harder to communicate virtually whereas others did not think that social interactions was not even an important factor. The conclusion that could be made from this study is that virtual healthcare meetings are good depending on which context they are used for. Furthermore, the doctor cannot always get the full picture because the camera creates a psychological distance which makes it harder for the doctor to observe as much as he/she can in a physical setting which can lead to many signals and cues missing out.

Background: Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. Aims: This dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. Methods: A parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completer's only analysis were undertaken. Results: Engagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. Conclusion: Due to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The intervention's effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced the most substantial changes on the outcome measures. This may suggest tailoring of interventions according to tinnitus severity. Larger samples are needed to confirm this.

No description available.

This work develops a simple and low-cost microphone-based spirometer with a scalable infrastructure that can be used to monitor COPD and Asthma symptoms. The data acquired from the system is archived in the cloud for further procuring and reporting. To develop this system, we utilize an off-the-shelf ESP32 development board, MEMS microphone, oxygen mask, and 3D printable mounting tube to keep the costs low. The system utilizes the MEMS microphone to measure the audio signal of a user's exhalation, calculates diagnostic estimations and uploads the estimations to the cloud to be remotely monitored. Our results show a practical system that can identify COPD and Asthma symptoms and report the data to both the patient and the physician. The system developed can provide a means of gathering respiratory data to better assist doctors and assess patients to provide remote care.

No description available.

Digital tools are being implemented in every area of society. Digital healthcare, or E-health, is an area that is increasing in popularity with various mobile applications and online services available. Entergate, a company based in Halmstad, has developed a service called EnterMedic. It is a cloud service that collects data from patients through online questionnaires. Once submitted, the service can directly forward data from these questionnaires to patient journals. EnterMedic also helps researchers with data to develop effective work methods in healthcare. The service was however limited to the web. This thesis consists of developing a mobile version of the service as it is more convenient to use compared to a web-based one and research contributing to what E-health applications can be used for. Interactivity is a desired feature for applications. EnterMedic will provide the users with feedback after questionnaire submissions, to help them track their state of health. / Digitala verktyg blir implementerade i alla områden av samhället. Digital hälsovård, eller E-hälsa, är ett område som ökar i populäritet med olika mobiltelefon applikationer och on-line tjänster tillgängliga. Entergate, ett företag baserat i Halmstad, har utvecklat en tjänst som heter EnterMedic. Det ar en moln-tjänst som samlar data från patienter genom online formulär. När dessa skickas in kan tjänsten direkt vidarebefodra datan från formulären till patient journaler. EnterMedic hjälper även forskare med data för att utveckla mer effektiva arbetsmetoder inom hälsovården. Tjänsten är dock begränsad till webben. Det här examensarbetet består av att utveckla en mobil version av tjänsten då det är mer bekvämt att använda jämfört med en webb-baserad tjänst och forskning som bidrar till vad E-hälsa applikationer kan användas för. Interaktivitet är en önskad funktion för applikationer. EnterMedic kommer förse användare med återkoppling efter att ett formulär har skickats in, som i sin tur hjälper dem följa sitt hälsotillstånd.

Telehealth initiated a transformation in the realm of innovative strategies to meet the demands of an ever-changing health care system. Adapting provisions to new delivery care models such as telehealth is one way to improve access to care. The purpose of this project was to explore evidence of best practices in telehealth through an extensive, systematic literature review. The practice-focused question focused on identifying advantages of and barriers to the use of telehealth for improving patient satisfaction and quality of care. The plan-do-study-act cycle served as a model for accelerating quality improvement through improved systems of practice, and the Critical Appraisal Skills Program tool was used to identify factors in the literature that indicated the clinical effectiveness of telehealth and the contributions of information technology to patient outcomes throughout the care continuum. Applying Melnyk and Fineout-Overholt's model, which consists of 7 levels for grading evidence, 11 articles were identified as meeting the inclusion criteria. With respect to comparing telehealth services, this review identified areas for future research, including how telehealth can be used to bridge the gap between hospital and home with the integration of telehealth being integrated into routine care as a means to deliver medical, health, and educational services that contribute to improving patient outcomes. The implications of this project related to social change include supporting evidence that positive change is possible when modalities of health care delivery include the patient as part of care, benefiting both patient and provider.

The Red Cross traditional method of Disaster Health System (DHS) response is ' boots on the ground.' Texas, the 2nd largest state by population and land mass, has only 15 DHS volunteer nurses who were not able to meet the needs of disaster victims in Texas with the traditional response method. The Texas Red Cross DHS volunteer nurses began piloting a virtual DHS model in 2014. The research question was how Texas Red Cross nurses designed, developed, implemented, and evaluated the Texas Red Cross virtual DHS Model. The purpose of this case study was to provide this information in a case study. The research approach followed a single investigator case study design that utilized Roger's diffusion of innovations theory and Lewin's change theory to identify how this virtual pilot was created and implemented in Texas. The processes developed and utilized are provided in detail in this case study. Data maintained by the Texas DHS team from March, 2016 to March, 2017 provided evidence that all 1,724 cases assigned to the DHS team were worked and closed by a Texas DHS volunteer. A qualitative summary of nurses' satisfaction with this model was uniformly positive. This provided support for the use of the virtual model for communication to meet the disaster-related health needs of disaster victims in Texas. The use of a virtual model for disaster management supports positive social change in addressing the disaster-related health needs of disaster victims in Texas and for possible use by other Red Cross DHS stakeholders.