More than 5 million Americans have heart failure, with approximately 5% of those affected being veterans. As the number of patients with CHF continues to rise, new treatment options are needed to improve the quality of care. Current studies show Telehealth is one treatment option. The purpose of this scholarly project was to determine if veterans diagnosed with CHF were able to maintain optimal weight and blood pressure following participation in Care Coordination Home Telehealth (CCHT) program. The CCHT program provides care to veterans, through the use of monitoring devices placed in their home. Bandura's self-efficacy theory was used as a guide to develop veterans' self-management skills. A retrospective chart review was conducted on 26 veterans with CHF enrolled in the CCHT program. Post participation weight and blood pressure were analyzed at 16 weeks to determine whether there was a difference from the pre-participation measures. There was no change in systolic blood pressure, diastolic blood pressure, or weight levels during the 16-week period. Limitations of this project were the small sample size (n = 26), attrition rate (n = 43), no data on nurse interaction, and a short follow-up period. Implications for nursing practice and enhancing the program's efficacy are recommended. This scholarly project has the potential to support social change by expanding veteran's access to care.

Heart failure is ranked as one of the leading causes of hospitalizations and mortality among adults of all racial/ethnic groups in the United States. Telemonitoring, as a homecare intervention for heart failure management, has been used across all groups although the benefit for Hispanics not established. The purpose of this retrospective, quantitative study was to determine the differences in hospital readmission between Hispanic, non-Hispanic Black, and non-Hispanic White patients with heart failure disease who either received or did not receive home telemonitoring services from a homecare agency in Connecticut. The research questions for this study examined the effect of home telemonitoring, race, age, gender, and insurance on heart failure hospitalization across the 3 groups. The chronic care model was used as the theoretical framework for this study because it offers a method for reforming healthcare to ensure optimization in chronic disease management. A purposive sample of 138 records of patients admitted between January 1, 2012 and June 30, 2017 with a diagnosis of heart failure provided the data for the study. Data were analyzed by conducting a simple and multiple logistic regression analysis. The key findings of the simple logistic analysis showed that only Hispanics who used telemonitoring were almost 4 times less likely to be readmitted to the hospital compared to Hispanics who did not use telemonitoring (p = 0.04). The multiple logistic analysis revealed race, age, gender, and insurance were not significant predictors of readmissions (p > 0.05). The findings from this study may promote positive social change by providing healthcare providers with a better understanding of the effects of home telemonitoring for treating adult Hispanic patients with heart failure disease.

<p>Technology of today makes it possible to change the way traditional healthcare is conducted. As the population grows older, and the elderly is becoming an increasing part of the whole population, the need for cost efficient and personalised care increases. By implementing home healthcare IT projects, it is possible for more patients to be treated at home with sustained quality of care.</p><p>This thesis documents the work of a master’s degree project carried out during the autumn of 2005. The project is part of a research project within the Department of Biomedical Engineering at Linköping University. The project aims at developing a data model for storing medical data. The model should be general and easy to expand. This model is intended to be used within a larger system allowing a patient to measure medical data from a remote location.</p>

Technology of today makes it possible to change the way traditional healthcare is conducted. As the population grows older, and the elderly is becoming an increasing part of the whole population, the need for cost efficient and personalised care increases. By implementing home healthcare IT projects, it is possible for more patients to be treated at home with sustained quality of care. This thesis documents the work of a master’s degree project carried out during the autumn of 2005. The project is part of a research project within the Department of Biomedical Engineering at Linköping University. The project aims at developing a data model for storing medical data. The model should be general and easy to expand. This model is intended to be used within a larger system allowing a patient to measure medical data from a remote location.

The intent of this project was to integrate an existing mobile phone-based telemonitoring system into a home care nursing environment. Analyses were conducted to examine nursing workflows and home care constraints. User-centric design, development, and testing were used to modify the current telemonitoring system for a home care pilot study with heart failure clients. Interim results show technology acceptance by home care nurses and improved self-awareness in clients; the telehomecare system offers its greatest value as an opportunity for client education following clinical alerts. The pilot study will continue with a focus on increased client recruitment and selectivity towards those most in need of chronic disease management. It is expected that the system will result in an improvement in health outcomes and more efficient delivery of home care visits. The results from this study will provide insight into the impact of a new service delivery model for home care nurses.

The intent of this project was to integrate an existing mobile phone-based telemonitoring system into a home care nursing environment. Analyses were conducted to examine nursing workflows and home care constraints. User-centric design, development, and testing were used to modify the current telemonitoring system for a home care pilot study with heart failure clients. Interim results show technology acceptance by home care nurses and improved self-awareness in clients; the telehomecare system offers its greatest value as an opportunity for client education following clinical alerts. The pilot study will continue with a focus on increased client recruitment and selectivity towards those most in need of chronic disease management. It is expected that the system will result in an improvement in health outcomes and more efficient delivery of home care visits. The results from this study will provide insight into the impact of a new service delivery model for home care nurses.

The aim of this thesis is a data transfer protocol implementation for a mobile control unit for transporting lungs. Apart from this thesis the data transfer protocol is used in AlveoPic project. The introductory part is focused on an anatomical and physiological background of a human respiratory system. Consequently it describes the i-Lung module and the mobile circulation module (MCM). It deals with the healthcare informatics interoperability standards with an emphasis to the ISO/IEEE 11073 standard. The subsequent part is represented by MCM’s simulator realization and design of a monitoring application. The final part aims at an analysis of the test cases for a monitoring application’s and a protocol framework’s control.

Hjärtsvikt är ett kliniskt syndrom som ofta innebär stor påverkan på det dagliga livet med nedsatt livskvalitet och frekventa sjukhusinläggningar. Förekomsten av hjärtsvikt ökar i världen och behovet av sjukhusvård förväntas stiga de närmaste åren. Egenvården är en viktig del av behandlingen vid hjärtsvikt. En välinformerad och motiverad patient bidrar till optimal egenvård. Telemonitorering används i allt större utsträckning för att patienter ska kunna monitorera sina symtom och vitala parametrar i hemmet. Syftet var att undersöka patientens upplevelse av att använda telemonitorering som en del av egenvården vid hjärtsvikt. Metoden var litteraturöversikt med systematiskt arbetssätt. Databassökningar gjordes i PubMed och Cinahl där 16 artiklar inkluderades. Artiklarna var publicerade 2011–2021. Artiklarna kvalitetsgranskades med modifierat bedömningsunderlag av Caldwell et al. (2011). Analysen utfördes med integrerad analys. Resultatet visade att telemonitoreringen bidrog till att patienterna upplevde en ökad trygghet, tillgänglighet och delaktighet. Patienterna uppgav att deras självförtroende ökade när det kom till att ta hand om sin hjärtsvikt. Ansvaret och motivationen för egenvården blev större hos patienterna och de fick en ökad insikt om hur egenvården är kopplat till olika symtom. Genom telemonitoreringen fick patienterna en ny rutin i sin egenvård och tekniken var ett stöd för dem i sin egenvård och hälsa. Telemonitoreringen bidrog även till att några patienter upplevde att ansvaret över egenvården inte var deras utan att det låg på vårdpersonalen. Vissa patienter upplevde att tekniken var krånglig och svår vilket skapade sämre följsamhet och ökad oro hos patienterna. Slutsatsen är att telemonitorering upplevdes som ett egenvårdsstöd hos patienter med hjärtsvikt. Genom detta stöd kunde faktorer som egenvårdsunderhåll, uppfattning av symtom och egenvårdshantering blir möjliga vilka är grunden i en god egenvård vid hjärtsvikt. / Heart failure is a clinical syndrome that often has a major impact on daily life with reduced quality of life and frequent hospitalizations. The incidence of heart failure is increasing in the world and hospital care is expected to increase in the next few years. Self-care is an important part of the treatment for heart failure. A well-informed and motivated patient contributes to optimal self-care. Telemonitoring is increasingly used to enable patients to monitor their symptoms and vital parameters at home. The aim was to investigate patient's experience of using telemonitoring as a part of self-carein heart failure. Method was a literature review with a systematic approach. Database searches were performed in PubMed and Cinahl where 16 articles were included. The articles were published between 2011–2021. The articles were quality reviewed with a modified assessment tool by Caldwell et al. (2011). The analysis was done with integrated analysis. The results showed that telemonitoring contributed to the patients experiencing increased security, accessibility and participation. The patients stated that their self-confidence increased when it came to taking care of their heart failure. Responsibility and motivation for self-care increased among the patients and they gained an increased insight into how self-care was linked to different symptoms. Through telemonitoring, patients gained a new routine in their self-care and the technology was a support for them in their self-care and health. Telemonitoring also contributed to some patients feeling that the responsibility for self-care was not theirs but that it was up to the care staff. Some patients experienced that the technology was complicated and difficult to manage, which created poorer compliance and increased anxiety in the patients. The conclusion is that telemonitoring was perceived as a self-care support in patients with heart failure. Through this support factors such as self-care maintenance, symptom perception and self-care management may be possible which are the basis of good self-care in heart failure.

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.

abstract: Semi-supervised learning (SSL) is sub-field of statistical machine learning that is useful for problems that involve having only a few labeled instances with predictor (X) and target (Y) information, and abundance of unlabeled instances that only have predictor (X) information. SSL harnesses the target information available in the limited labeled data, as well as the information in the abundant unlabeled data to build strong predictive models. However, not all the included information is useful. For example, some features may correspond to noise and including them will hurt the predictive model performance. Additionally, some instances may not be as relevant to model building and their inclusion will increase training time and potentially hurt the model performance. The objective of this research is to develop novel SSL models to balance data inclusivity and usability. My dissertation research focuses on applications of SSL in healthcare, driven by problems in brain cancer radiomics, migraine imaging, and Parkinson’s Disease telemonitoring. The first topic introduces an integration of machine learning (ML) and a mechanistic model (PI) to develop an SSL model applied to predicting cell density of glioblastoma brain cancer using multi-parametric medical images. The proposed ML-PI hybrid model integrates imaging information from unbiopsied regions of the brain as well as underlying biological knowledge from the mechanistic model to predict spatial tumor density in the brain. The second topic develops a multi-modality imaging-based diagnostic decision support system (MMI-DDS). MMI-DDS consists of modality-wise principal components analysis to incorporate imaging features at different aggregation levels (e.g., voxel-wise, connectivity-based, etc.), a constrained particle swarm optimization (cPSO) feature selection algorithm, and a clinical utility engine that utilizes inverse operators on chosen principal components for white-box classification models. The final topic develops a new SSL regression model with integrated feature and instance selection called s2SSL (with “s2” referring to selection in two different ways: feature and instance). s2SSL integrates cPSO feature selection and graph-based instance selection to simultaneously choose the optimal features and instances and build accurate models for continuous prediction. s2SSL was applied to smartphone-based telemonitoring of Parkinson’s Disease patients. / Dissertation/Thesis / Doctoral Dissertation Industrial Engineering 2019