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Development of a Multi-Agent m-Health Application Based on Various Protocols for Chronic Disease Self-Management

  • Mobile Systems
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Abstract

The purpose of this study was to develop and evaluate a mobile health application (Self-Management mobile Personal Health Record: “SmPHR”) to ensure the interoperability of various personal health devices (PHDs) and electronic medical record systems (EMRs) for continuous self-management of chronic disease patients. The SmPHR was developed for Android 4.0.3, and implemented according to the optimized standard protocol for each interface of healthcare services adopted by the Continua Health Alliance (CHA). That is, the Personal Area Network (PAN) interface between the application and PHD implements ISO/IEEE 11073-20,601, 10,404, 10,407, 10,415, 10,417, and Bluetooth Health Device Profile (HDP), and EMRs with a wide area network (WAN) interface implement HL7 V2.6; the Health Record Network (HRN) interface implements Continuity of Care Document (CCD) and Continuity of Care Record (CCR). Also, for SmPHR, we evaluated the transmission error rate between the interface using four PHDs and personal health record systems (PHRs) from previous research, with 611 users and elderly people after receiving institutional review board (IRB) approval. In the evaluation, the PAN interface showed 15 (2.4 %) errors, and the WAN and HRN interface showed 13 (2.1 %) errors in a total of 611 transmission attempts. Also, we received opinions regarding SmPHR from 15 healthcare professionals who took part in the clinical trial. Thus, SmPHR can be provided as an interconnected PHR mobile health service to patients, allowing ‘plug and play’ of PHDs and EMRs through various standard protocols.

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References

  1. World Health Organization. Noncommunicable Disease Country Profiles. Available from: http://apps.who.int/iris/bitstream/10665/128038/1/9789241507509_eng.pdf

  2. Organization for Economic Cooperation and Development. Health Care Quality Review: Korea Assessment and Recommendations. Available: http://www.oecd.org/korea/49818570.pdf

  3. Ministry of Health and Welfare. Korea National Health and Nutrition Examination Survey (KNHANES V-3). Available from: https://knhanes.cdc.go.kr/knhanes/index.do

  4. Health Insurance Review & Assessment Service, National Health Insurance Service. 2011 National Health Insurance Statistical Yearbook. Available from: http://www.hira.or.kr/cms/open/04/02/03/01/__icsFiles/afieldfile/2012/12/10/2011.pdf

  5. Trust for America’s Health. Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings. Available from: http://healthyamericans.org/reports/prevention08/Prevention08.pdf

  6. Trigo, J.D., Chiarugi, F., Alesanco, A., Martinez-Espronceda, M., Serrano, L., Chronaki, C.E., Escayola, J., Martinez, I., and Garcia, J., Interoperability in digital electrocardiography: Harmonization of ISO/IEEE ×73-PHD and SCP-ECG. IEEE Transactions on Information Technology in Biomedicine (TITB). 14(6):1303–1317, 2010.

    Article  Google Scholar 

  7. Bert, F., Giacometti, M., Gualano, M.R., and Siliquini, R., Smartphones and health promotion: a review of the evidence. Journal of Medical Systems. 38(1):1–11, 2014.

    Article  Google Scholar 

  8. Hu, N.Z., Lee, C.Y., Hou, M.C., and Chen, Y.L., A cloud system for mobile medical services of traditional Chinese medicine. Journal of Medical Systems. 37(6):1–13, 2013.

    Article  Google Scholar 

  9. Chiarini, G., Ray, P., Akter, S., Masella, C., and Ganz, A., MHealth technologies for chronic disease and elders: a systematics review. IEEE Journal on Selected Areas in Communications/Supplement. 31(9):6–18, 2013.

    Article  Google Scholar 

  10. Tang, P.C., Ash, J.S., Bates, D.W., Overhage, J.M., and Sands, D.Z., Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. Journal of the American Medical Informatics Association. 13(2):121–126, 2006.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Riegel, B., Moser, D.K., Anker, S.D., Appel, L.J., Dunbar, S.B., Grady, K.L., Gurvitz, M.Z., Havranek, E.P., Lee, C.S., Lindenfeld, J., Peterson, P.N., Pressler, S.J., Schocken, D.D., and Whellan, D.J., State of the science: promoting self-care in persons with heart failure: a scientific statement from the American heart association. Circulation. 120:1141–1163, 2009.

    Article  PubMed  Google Scholar 

  12. National Heart Foundation. Living well with chronic heart failure. Available from: http://www.heartfoundation.org.au/SiteCollectionDocuments/Living-well-with-chronic-heart-failure.pdf

  13. Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J.J., Ponikowski, P., Poole-Wilson, P.A., Stromberg, A., van Veldhuisen, D.J., Atar, D., Hoes, A.W., Keren, A., Mebazaa, A., Nieminen, M., Priori, S.G., and Swedberg, K., ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). European Journal of Heart Failure. 10(10):939–989, 2008.

    Article  Google Scholar 

  14. Yasnoff, W.A., Humphreys, B.L., Overhage, J.M., Detmer, D.E., Brennan, P.F., Morris, R.W., Middleton, B., Bates, D.W., and Fanning, J.P., A consensus action agenda for achieving the national health information infrastructure. Journal of the American Medical Informatics Association. 11(4):332–338, 2004.

    Article  PubMed  PubMed Central  Google Scholar 

  15. McDonald, C.J., The barriers to electronic medical record systems and how to overcome them. Journal of the American Medical Informatics Association. 4:213–221, 1997.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  16. Chen, H.M., and Liou, Y.Z., Performance evaluation of continuity of care records (CCRs): parsing models in a mobile health management system. Journal of Medical Systems. 38(10):1–19, 2014.

    Article  CAS  Google Scholar 

  17. Groupe Speciale Mobile Association. Touching lives through mobile health - Assessment of the global market opportunity. Available from: https://www.pwc.in/en_IN/in/assets/pdfs/publications-2012/touching-lives-through-mobile-health-february-2012.pdf

  18. Sha, K., Zhan, G., Shi, W., Lumley, M., Wiholm, C., and Arnetz, B., SPA: Smart Phone Assisted Chronic Illness Self-Management with Participatory Sensing. In Proceedings of the 2nd International Workshop on Systems and Networking Support for Health Care and Assisted Living Environments. 5(3):1–5, 2008.

    Article  Google Scholar 

  19. ISO/IEEE 11073-20601. Institute of Electrical and Electronics Engineers. New York, NY: IEEE; 2010. “Health informatics – personal health device communication – part 20601: application profile – optimized exchange protocol” (online access http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue _detail.htm?csnumber = 54331)

  20. ASTM Standard E2369 - 05e1. ASTM International. West Conshohocken, PA: ASTM; 2005. “Standard Specification for Continuity of Care Record (CCR)” (online access http://www.astm.org/Standards/E2369.html)

  21. CDA implementation of ASTM E2369 – 05e1. Health Level Seven International. Ann Arbor, MI: HL7; 2007. “HL7 implementation guide: CDA release 2 – continuity of care document (CCD)” (online access http://www.hl7.org/implement/standards/product_brief.cfm?product_id=6)

  22. Lingxia, L., Chen, M., Rodrigues, J.J., Lai, X., and Vuong, S., A novel web-enabled healthcare solution on healthvault system. Journal of Medical Systems. 36(3):1095–1105, 2012.

    Article  Google Scholar 

  23. Schnall, R., Cimino, J.J., and Bakken, S., Development of a prototype continuity of care record with context-specific links to meet the information needs of case managers for persons living with HIV. International Journal of Medical Informatics. 81(8):549–555, 2012.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Alsafadi, Y., Sheng, O.R.L., and Nartinez, R., Comparison of Communication Protocols in Medical Information Exchange Standards. Computer-Based Medical Systems 1994, Proceedings of the 7th IEEE Symposium:258–263, 1994.

  25. Kim, H.S., Cho, H., and Lee, I.K., Development of an electronic claim system based on an integrated electronic health record platform to guarantee interoperability. Healthcare Informatics Research. 17(2):101–110, 2011.

    Article  PubMed  PubMed Central  Google Scholar 

  26. ISO/IEEE 11073-10404. Institute of Electrical and Electronics Engineers. New York, NY: IEEE; 2010. “Health informatics – personal health device communication – part 10404: device specialization – pulse oximeter” (online access http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?Csnumber =54572)

  27. ISO/IEEE 11073-10407. Institute of Electrical and Electronics Engineers. New York, NY: IEEE; 2010. “Health informatics – personal health device communication – part 10407: device specialization – blood pressure monitor” (online access http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=54572)

  28. ISO/IEEE 11073-10415. Institute of Electrical and Electronics Engineers. New York, NY: IEEE; 2010. “Health informatics – personal health device communication – part 10415: device specialization – weighing scale” (online access http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=54310)

  29. ISO/IEEE 11073-10417. Institute of Electrical and Electronics Engineers. New York, NY: IEEE; 2010. “Health informatics – personal health device communication – part 10417: device specialization – glucose meter” (online access http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=61896)

  30. Health Device Profile. Bluetooth Special Interest Group. Kirkland, WA: Bluetooth SIG; 2012. “Health device profile (HDP) data exchange specifications” (online access https://www.bluetooth.org/en-us/specification/assigned-numbers/health-device-profile)

  31. ScalableLayout. Available from: https://github.com/ssomai/ScalableLayout

  32. Kim, H.S., Cho, H., and Lee, I.K., The Development of a Graphical User Interface Engine for the Convenient Use of the HL7 Version 2.x Interface Engine. Healthcare Informatics Research. 17(4):214–223, 2011.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lee, I.K., Cho, H., and Kim, H.S., Development of a Management Tool of CCD/CCR-centric Standard Clinical Document. Journal of Korean Institute of Intelligent Systems. 22(4):507–514, 2012.

    Article  Google Scholar 

  34. A&D Medical. A&D UA-767 PBT-C. Available from: http://www.telemedicine.jp/product_ua767pbt-c.html

  35. A&D Medical. A&D UC-321 PBT-C. Available from: http://www.telemedicine.jp/product_uc321pbt-c.html

  36. Foracare. Fora D40d. Available from: http://www.foracare.com/Blood-Pressure-D40.html

  37. Nonin. Nonin Oynx 2 9560. Available from: http://www.nonin.com/Onyx9560

  38. Kyungpook university hospital. Public health medical service. Available from: http://public.knuh.kr/

  39. International Data Corporation. Smartphone OS Market Share. Available from: http://www.idc.com/prodserv/smartphone-os-market-share.jsp

  40. Mathur, A., Kvedar, J.C., and Watson, A.J., Connected health: a new framework for evaluation of communication technology use in care improvement strategies for type 2 diabetes. Current Diabetes Reviews. 3(4):229–234, 2007.

    Article  PubMed  Google Scholar 

  41. Jaana, M., and Pare, G., Home telemonitoring of patients with diabetes: a systematic assessment of observed effects. Journal of Evaluation in Clinical Practice. 13:242–253, 2007.

    Article  PubMed  Google Scholar 

  42. Livingston G., Parker K., and Fox S., Latinos Online, 2006–2009: Narrowing the Gap. Available from: http://pewhispanic.org/files/reports/119.pdf

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Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2012R1A1A2004829).

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Authors and Affiliations

  1. Department of Medical Informatics, Kyungpook National University, 680, Gukchaebosang-ro, Jung-gu, Daegu, Korea

    Hyun Sang Park & Hune Cho

  2. Faculty of Medical Industry Convergence, Daegu Haany University, 1, Hanuidae-ro, Gyeongsan-si, Gyeongsangbuk-do, Korea

    Hwa Sun Kim

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Correspondence to Hwa Sun Kim.

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This article is part of the Topical Collection on Mobile Systems

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Park, H.S., Cho, H. & Kim, H.S. Development of a Multi-Agent m-Health Application Based on Various Protocols for Chronic Disease Self-Management. J Med Syst 40, 36 (2016). https://doi.org/10.1007/s10916-015-0401-5

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