EQUITY AND INCLUSION IN HEALTHCARE CONFERENCE

Previously Published Papers on "Equity and Inclusion in Healthcare Conference"

• Patient Perspectives on Telehealth during the Pandemic in the United States

  Authors: Manal Sultan Alhussein, Xiang Michelle Liu, Keywords: Telehealth, patient satisfaction, pandemic, healthcare, remote patient monitor. DOI:10.5281/zenodo. Abstract: Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.

• Robotic Assistance in Nursing Care: Survey on Challenges and Scenarios

  Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein, Keywords: Robotics and automation, engineering management, engineering in medicine and biology, medical services, public healthcare. DOI:10.5281/zenodo. Abstract: Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

• Vision-Based Daily Routine Recognition for Healthcare with Transfer Learning

  Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan, Keywords: Daily activity recognition, healthcare, IoT sensors, transfer learning. DOI:10.5281/zenodo. Abstract: We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

• Sustainability of Healthcare Insurance in India: A Review of Health Insurance Scheme Launched by States in India

  Authors: Mohd Zuhair, Ram Babu Roy, Keywords: Health insurance, out of pocket expenditure, universal healthcare, sustainability. DOI:10.5281/zenodo. Abstract: This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

• The Effect on the Smoking and Health Behavior of Wellness of Students Who Are Learned in the University of Health Sciences

  Authors: Serife Zehra Altunkurek, Kezban Kaya, Keywords: Healthcare students, lifestyle-related behavior, wellness, smoking DOI:10.5281/zenodo.2706638 Abstract: Objective: To evaluate healthcare students’ wellness and to determine the relationship between wellness and other lifestyle-related behaviors including diet, exercise, sleep, stress, and tobacco and alcohol consumption. Material and Method: This descriptive cross-sectional study surveyed 984 students at the University of Health Sciences in Ankara, Turkey. Data were collected using a questionnaire that included questions on sociodemographic characteristics and a Turkish version of an established health and wellness measure. Results: The data revealed that 17.8% of the students smoke. There was no statistically significant difference between the participants' wellness scores and their smoking status. However, the student’s wellness was significantly associated with physical activity (p < 0.001), which, overall, was deemed as insufficient in this population. Statistically significant associations were also identified between participants’ wellness and their ability to cope with stress and regular sleep (p < 0.001). Conclusion: Healthcare students do not engage in sufficient physical activity and that this affects their overall wellness. Therefore, academic institutions should provide more opportunities for students to exert themselves physically through a diversity of inclusive activities. Such efforts, in addition to promoting healthy sleep and stress-coping practices, will greatly benefit students’ short- and long-term health and wellness.

• Collaboration in Palliative Care Networks in Urban and Rural Regions of Switzerland

  Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig, Keywords: Collaboration, healthcare networks, palliative care, Switzerland. DOI:10.5281/zenodo.2580922 Abstract: Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

• Development of Affordable and Reliable Diagnostic Tools to Record Vital Parameters for Improving Health Care in Low Resources Settings

  Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria, Keywords: Healthcare for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device. DOI:10.5281/zenodo.2021677 Abstract: In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

• A Pre-Assessment Questionnaire to Identify Healthcare Professionals’ Perception on Information Technology Implementation

  Authors: Y. Atilgan Şengül, Keywords: Healthcare, health informatics, medical record system, questionnaire. DOI:10.5281/zenodo.1316466 Abstract: Health information technologies promise higher quality, safer care and much more for both patients and professionals. Despite their promise, they are costly to develop and difficult to implement. On the other hand, user acceptance and usage determine the success of implemented information technology in healthcare. This study provides a model to understand health professionals’ perception and expectation of health information technology. Extensive literature review has been conducted to determine the main factors to be measured. A questionnaire has been designed as a measurement model and submitted to the personnel of an in vitro fertilization clinic. The respondents’ degree of agreement according to five-point Likert scale was 72% for convenient access to data and 69.4% for the importance of data security. There was a significant difference in acceptance of electronic data storage for female respondents. Also, other significant differences between professions were obtained.

• Co-payment Strategies for Chronic Medications: A Qualitative and Comparative Analysis at European Level

  Authors: Pedro M. Abreu, Bruno R. Mendes, Keywords: Clinical pharmacy, co-payments, healthcare, medicines. DOI:10.5281/zenodo.1128069 Abstract: The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

• An Inclusion Project for Deaf Children into a Northern Italy Contest

  Authors: G. Tamanza, A. Bossoni, Keywords: Autonomy, inclusion, skills, well-being. DOI:10.5281/zenodo.1125371 Abstract: 84 deaf students (from primary school to college) and their families participated in this inclusion project in cooperation with numerous institutions in northern Italy (Brescia-Lombardy). Participants were either congenitally deaf or their deafness was related to other pathologies. This research promoted the integration of deaf students as they pass from primary school to high school to college. Learning methods and processes were studied that focused on encour­aging individual autonomy and socialization. The research team and its collaborators included school teachers, speech ther­apists, psychologists and home tutors, as well as teaching assistants, child neuropsychiatrists and other external authorities involved with deaf persons social inclusion programs. Deaf children and their families were supported, in terms of inclusion, and were made aware of the research team that focused on the Bisogni Educativi Speciali (BES or Special Educational Needs) (L.170/2010 - DM 5669/2011). This project included a diagnostic and evaluative phase as well as an operational one. Results demonstrated that deaf children were highly satisfied and confident; academic performance improved and collaboration in school increased. Deaf children felt that they had access to high school and college. Empowerment for the families of deaf children in terms of networking among local services that deal with the deaf also improved while family satisfaction also improved. We found that teachers and those who gave support to deaf children increased their professional skills. Achieving autonomy, instrumental, communicative and relational abilities were also found to be crucial. Project success was determined by temporal continuity, clear theoretical methodology, strong alliance for the project direction and a resilient team response.