Assignment 3: Part 1 and 2
By Lisa Christian
Part 1
MPE is a malignant pleural effusion, it is a build up of fluid in the chest walls.
There are many diseases or infections that can cause MPE. It is common with Cancer.
An MPE occurs, when cells from lung cancer or another disease transfer themselves into the pleural cavity chest area. These types of cells increase the amount of fluid produced and reduced the amount of fluid that can be absorbed.
Common cancers which develop MPEs, include lung cancers, breast cancers, lymphomas, and mesilymphomas. The cells could also spread from the stomach, colon, kidneys and ovaries.
Some people have no symptoms at all, but this can be a very bothersome and troublesome condition.
Here are some of the most common symptoms:
Shortness of breath, either at rest or when exercising.
Chest pain
Chest pressure
Coughs
Pain when breathing deep breaths
Fevers
Fatigue
MPE is determined by a gp in physical exam. The following tests can also confirm:
Chest xray
CT scan of the chest
Ultrasound of the chest
If the patient has an MPE, the gp will need to take a sample of fluid from the chest, – this is called thoracentesis and it can be done with or without a biopsy as well.
So there is pain asscoiated with this condition and a little bit of discomfort collecting the sample.
Medical cancer doctors (oncologists) may use the same procedure of thoracentesis to drain the fluid. Pleuradosis is another treatment that can be used in the hospital.
IPC is a new alternative where an indweling cathetar is placed in the chest under two small cuts, the small flexible cathetar allows patients to drain fluid out themselves from their chest, from home.
Using telehealth is a virtual method to assist this stay at home procedure.
The Technology Acceptance Model is how I would consider planning this virtual technology.
The TAM model, means that the acceptance of a technology is only as good as its user acceptance rate and user experience.
This model looks at three main considerations. These are:
Attitude
Intentions to use
Actual user experience
By looking at attitudes and the user experience you take in that the user may not be happy with the service if its presented or shown to them poorly.
If it is explained clearly with a positive approach, users may adopt to wanting to learn how to use it. So thinking of the tam model, are patients willing to use an IPC at home? Well it would bring a lot of convenience and ease symptoms but patients may be nervous of using it. Therefore the idea of paramedics helping may also encourage patients to learn how to drain the fluid themselves and look after themselves better. The technology is ready, so are the virtual telehealth services. In addition to that, new telehealth services can be created to increase awareness and to appeal to different patient ages, genders, cultures, stereotypes and languages.
Its worth noticing, that whether people receive IPC may be whether society itself accepts the technology, may be whether they talk about IPC well. It may for a long time, remain a mystery to some people and others may be reluctant, because they'd rather have assistance. But its for their benefit that patients take to it.
“To determine the perceived usefulness of a product, users are asked to rate the product on six points using a Likert scale.
1.
Using this product at work would help me complete tasks faster.
2.
Using this product would improve my job performance.
3. Using this
product would increase my productivity.
4. Using would increase my
effectiveness at work. *
5. Using this product would make it
easier to do my job.
6. I would find this product useful at
work.”(usersense.io, 2023.)
Another model that IPC could be designed in mind with UTAUT.
“UTAUT (Unified Theory of Acceptance and Use of Technology) is a model from business informatics that measures the acceptance of an innovation by users in order to gain access to individual usage behavior. This is done by evaluating four influencing factors: performance expectation, effort expectation, social influences and facilitating circumstances. From this, measures for the development and communication of the innovation can be derived.”(fh-munster, 2023)
So it has a big focus and in depth study on the social trends surround the application and its uses. However it doesn't appear to focus on as much on the telehealth program and procedure itself. So to design a useful treatment program, through telehealth for IPC, the designer really needs to consider aspects from a couple of different models. That being said, if the designer stops to listen to social trends and acceptance, they can develop the IPC telehealth program with those ideas in mind. For example, they can pick or design pictures that a patient with those attitudes can relate to, to decorate the IPC website or telehealth program. Then with the TAM model, the designer can evaluate the applications success, based on its use.
The gaps here where the designer considers too much of the one model, without stopping to evaluate using aspects of another, such as UTAUT and TAM models.
Thankyou for reading, I hope this brief essay has brought understanding in the areas of IPC, MPE, TAM and UTAUT.
Part 2
In addition to these models, as part 2 of this assignment, I consider 2 additional tools and frameworks for telehealth:
Mobile health evidence reporting and assessment (mERA) checklist
Haute Autorité de Santé (HAS) model
"The French National Authority for Health (Haute Autorité de Santé, or HAS) was established to assist France's public institutions in optimizing the basket of reimbursable goods and services and to help health care professionals continuously improve their clinical practice by defining best-care standards and identifying relevant tools and methods.”(USA.gov, 2023) The model analyses, the effects of impact of health benefits, costs to outlay and effectiveness of telehealth. This systems, helps caregivers connect to doctors for care of their family and friends. It helps them to have assistance in learning about their loved one's conditions. For specialists, it allows them to schedule more appointments with convenience so that patients actually get to see their specialists without extensive ongoing waitlists.
Logical framework approach (LFA)
The logical framework approach is a goal oriented form of management and planning for projects, like telehealth. It is useful for telehealth, because it helps stakeholders confront complex issues that may occur with telehealth. It also helps the stakeholders being able to monitor and evaluate their telehealth program.
“An LFA is a management tool for effective planning and implementation of developmental projects. It provides clear, concise and systematic information about a project through a framework. We know about various components of a project such as goal, objectives, activities, results and indicators. The LFA helps in connecting all these components in one framework, presenting the tight relationship between them, leading to the achievement of the expected outcomes.”(Funds for NGOs, 2023.)
Model for assessment of telemedicine (MAST)
The MAST is a tool for medical economic analysis of telehealth systems.
It is an evaluation tool for analysing the effectiveness of the telehealth system.
It includes assessment of the growth of the technology and of the organisation that implements and uses it.
Costs are important to consider in telehealth so that the organisation charges a feasible service fee, that covers the outlay for the organisation and the doctor's fee. Even if its covered by medicare, the fees still need to be realistic. Most likely if the costs to use telehealth are similar to that of an in person consultation, then it is likely to be a realistic, expected fee,
“The evaluation of telemedicine can be achieved using different evaluation models or theoretical frameworks. […] MAST includes pre-implementation assessment (e.g. by use of participatory design), followed by multidisciplinary assessment, including description of the patients and the application and assessment of safety, clinical effectiveness, patient perspectives, economic aspects organisational aspects and socio-cultural, legal and ethical aspects.”(Sage Publications, 2023)
Mobile health evidence reporting and assessment (mERA) checklist
“To improve the completeness of reporting of mobile health (mHealth) interventions, the WHO mHealth Technical Evidence Review Group developed the mHealth evidence reporting and assessment (mERA) checklist.”(BMJ Publishing, 2023)
“The guiding principle for the development of these criteria was to identify a minimum set of information needed to define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features), to support replication of the intervention.”(BMJ Publishing, 2023)
It is estimated, that through widespread use, the mHealth standards will help improve the general overall quality of modern day healthcare. So organisations might aspire to meet the guildelines on the checklist and that will improve the kind of health service they offer.
Thank you for reading.
References:
BMJ Publishing, 2023.
Accessed from: Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist | The BMJ on 6/6/23.
fh-munster, 2023.
Accessed from: UTAUT Model - Science-to-Business Marketing Research Centre - FH Münster (fh-muenster.de) on: 3/6/23.
Sage Publishing, 2023.
Accessed from: The Model for Assessment of Telemedicine (MAST): A scoping review of empirical studies - Kristian Kidholm, Jane Clemensen, Liam J Caffery, Anthony C Smith, 2017 (sagepub.com) on 6/6/23.
thoracic.org, 2023.
Accessed from: malignant-pleural-effusions.pdf (thoracic.org) on: 3/6/23.
usersence.io, 2023.
Accessed from: Technology Acceptance Model (TAM) (usersense.io) on 3/6/23.
nih.gov, 2023.
Accessed from: National Authority for Health: France - PubMed (nih.gov) on 6/6/23.
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