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Toward Improved Treatment and Empowerment of Individuals With Parkinson Disease: Design and Evaluation of an Internet of Things System
Örebro University, Örebro University School of Business. (Centre for Empirical Research on Information Systems)
Department of Computer Science and Media Technology, Linnaeus University, Växjö, Sweden.
Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden.
Örebro University, Örebro University School of Business. (Centre for Empirical Research on Information Systems)ORCID iD: 0000-0002-1337-2394
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2022 (English)In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 6, no 6, article id e31485Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Parkinson disease (PD) is a chronic degenerative disorder that causes progressive neurological deterioration with profound effects on the affected individual's quality of life. Therefore, there is an urgent need to improve patient empowerment and clinical decision support in PD care. Home-based disease monitoring is an emerging information technology with the potential to transform the care of patients with chronic illnesses. Its acceptance and role in PD care need to be elucidated both among patients and caregivers.

OBJECTIVE: Our main objective was to develop a novel home-based monitoring system (named EMPARK) with patient and clinician interface to improve patient empowerment and clinical care in PD.

METHODS: We used elements of design science research and user-centered design for requirement elicitation and subsequent information and communications technology (ICT) development. Functionalities of the interfaces were the subject of user-centric multistep evaluation complemented by semantic analysis of the recorded end-user reactions. The ICT structure of EMPARK was evaluated using the ICT for patient empowerment model.

RESULTS: Software and hardware system architecture for the collection and calculation of relevant parameters of disease management via home monitoring were established. Here, we describe the patient interface and the functional characteristics and evaluation of a novel clinician interface. In accordance with our previous findings with regard to the patient interface, our current results indicate an overall high utility and user acceptance of the clinician interface. Special characteristics of EMPARK in key areas of interest emerged from end-user evaluations, with clear potential for future system development and deployment in daily clinical practice. Evaluation through the principles of ICT for patient empowerment model, along with prior findings from patient interface evaluation, suggests that EMPARK has the potential to empower patients with PD.

CONCLUSIONS: The EMPARK system is a novel home monitoring system for providing patients with PD and the care team with feedback on longitudinal disease activities. User-centric development and evaluation of the system indicated high user acceptance and usability. The EMPARK infrastructure would empower patients and could be used for future applications in daily care and research.

Place, publisher, year, edition, pages
JMIR Publications Inc. , 2022. Vol. 6, no 6, article id e31485
Keywords [en]
Internet of Things, Parkinson disease, objective measures, patient empowerment, self-assessment, self-management, wearable technology, web interface
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:oru:diva-99507DOI: 10.2196/31485ISI: 000854080300009PubMedID: 35679097Scopus ID: 2-s2.0-85132037074OAI: oai:DiVA.org:oru-99507DiVA, id: diva2:1669473
Note

Funding agencies:

General Electric 20160176  

Höganäs AB Statisticon AB

Nethouse Sverige AB

Newbreed EU Cofund doctoral program within the focus area of Successful Ageing at Örebro University

 

Available from: 2022-06-14 Created: 2022-06-14 Last updated: 2022-10-17Bibliographically approved
In thesis
1. Health Information Technology for Empowering Elderly Patients with Chronic Diseases
Open this publication in new window or tab >>Health Information Technology for Empowering Elderly Patients with Chronic Diseases
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Patient empowerment (PE) is at the centre of the ongoing paradigm shift toward patient-centred healthcare. Novel health information technology (HIT) interventions frequently aim to improve PE and trigger changes in the healthcare. However, little is known about the actual efficacy of HIT to induce PE. The objective of this thesis is to study how HIT can improve PE. The thesis describes empirical research in C3-Cloud, an EU project developing broad HIT-based solutions for PE in multi-morbidity care; and in EMPARK, a homebased HIT monitoring system for PE in Parkinson disease. Theoretical research covers the systematic evaluation of shortcomings hindering HITs to induce PE, and the development of ICT4PEM, a framework for HIT development targeting PE. Empirical research was based on user-centric design for ICT artefact development and evaluation. Design science research was guiding the ICT4PEM development, including utility demonstration by applying it for the project-wide evaluation of the C3-Cloud and EMPARK regarding their design, interventions, evaluation and expected effects on PE. The thesis demonstrates empirical examples on how HIT contributes to PE by enabling multidisciplinary, patient-centric individual care plan elaboration, patient monitoring, patient-targeted and clinician feedback, and clinical decision support (CDS), including a clinical guideline based intelligent CDS for multi-morbidity. ICT4PEM is the first framework, which provides a patient-centric, HIT-friendly conceptual foundation for PE, and assists HIT development on targeting PE. The ICT4PEM-based evaluation revealed strength and weaknesses of C3-Cloud and EMPARK related to their design, interventions, evaluation and expected long-term effects. It also demonstrated a utility of ICT4PEM for retrospective HIT project evaluation. In summary, the thesis provides strong evidence and reveals shortcomings about HIT efficacy to promote PE. The novel ICT4PEM framework address and resolve these shortcomings with the capacity to guide future HIT developments which aim to empower patients.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2022. p. 162
Series
Örebro Studies in Informatics ; 20
Keywords
health information technology, patient empowerment, patient-centric care, multi-morbidity, Parkinson disease, home monitoring, intelligent decisions support
National Category
Information Systems, Social aspects
Identifiers
urn:nbn:se:oru:diva-99556 (URN)9789175294605 (ISBN)
Public defence
2022-09-09, Örebro universitet, Forumhuset, Hörsal F, Fakultetsgatan 1, Örebro, 09:15 (English)
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Available from: 2022-06-13 Created: 2022-06-13 Last updated: 2022-09-09Bibliographically approved

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Karni, LiranKlein, Gunnar OskarMemedi, Mevludin

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