SARS-CoV-2 Omicron led to the most serious outbreak of COVID-19 in Hong Kong in 2022. Under the pressure of a high volume of patients and limited medical resources, Chinese herbal medicine (CHM) has been extensively used. This is a case-control study of the infected patients that aims to evaluate the effectiveness of CHM using data extracted from the Hong Kong Baptist University Telemedicine Chinese Medicine Centre database. Patients with COVID-19 confirmed by either a rapid antigen test or a polymerase chain reaction who had completed two consultations and taken CHM within 10 days of the first positive test were included in the study (CHM group, n=311). The matched control cases were those who did not take CHM within 10 days of the first positive test and were based on age (± 3 years), vaccine doses (< 3 doses, or 3 doses), and gender (no-CHM group, n=311). The outcomes included the negative conversion time (NCT, primary outcome), total score of individual symptoms, number of the reported symptoms, and individual symptom disappearance rates. The NCT of the CHM group (median days: 7.0, interquartile range: 6.0–8.0) was significantly shorter than that of the no-CHM group (8.0, 7.0–10.5; P=0.016). CHM treatment significantly reduced the total score of individual symptoms (P<0.001) and the number of the reported symptoms (P<0.001) as compared with that of the no-CHM group. Additionally, the symptom disappearance rates of symptoms such as chills, cough, sputum, dry throat, itching throat, headache, chest tightness, abdominal pain, diarrhea, and fatigue were significantly higher in the CHM group than in the no-CHM group. In conclusion, CHM intervention can significantly reduce NCT and COVID-19 symptoms. Chinese medicine can be accurately prescribed based on a telemedical consultation.
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For the month of December 2020, APBN features article contribution from variety of writers. In the Features we take a dive into how COVID-19 vaccines could be shipped worldwide in an article by Kawal Preet, President of Asia Pacific, Middle East and Africa (AMEA) region for FedEx. For the Columns section, explore the transformations in telehealth and telemedicine in the Asia Pacific region. Also, writers from ACT Genomics discuss how liquid biopsy could provide potential in replacing tissue biopsy in genomic alteration profiling. For this month in the Spotlights, are highlights from the recent APACMed Virtual Forum 2020 on how technology is changing the landscape of healthcare. Finally, Professor Nadey Hakim, a general surgeon and currently the vice president of the Royal Society of Medicine weighs in on the recent release of data on the study for Sputnik V vaccine against COVID-19.
For the month of April 2021, APBN explores the contributions of Sony in the evolution of medicine in our Features section. The article contribution by Leonard Yap, Head of Medical Imaging Solutions, Professional Solutions Company (PSAP) at Sony Electronics Asia Pacific looks at how Sony's technological contributions are revolutionizing the future of medicine. In the Columns section, we discuss the boon and bane of digital technology in healthcare and safety concerns of its use. In the Spotlights, we share about a research done by SingHealth and NUS Yong Loo Lin School of Medicine to determine the receptiveness towards tele-monitoring for the management of chronic health conditions.
Telemedicine is an emerging industry with the potential to revolutionize the delivery of healthcare for the benefit of consumers, providers and payors. In general, telemedicine refers to the use of information and telecommunication technologies to distribute both information and expertise necessary for healthcare service provision, collaboration or delivery among geographically separated participants — physicians and patients. In short, it is a generic term which is used to define various aspects of healthcare at a distance. Telemedicine has been heralded as one of several possible solutions to some of the medical dilemmas that are faced by many developing countries. In this paper, we will discuss the current state of telemedicine in developing countries in South-East Asia (SEA) in general, with Malaysia and Indonesia in particular.
Problem Statement: Improper triage and prioritization of big-data patients may result in erroneous strategic decisions. An example of such wrong decision making includes the triage of patients with chronic heart disease to low-priority groups. Incorrect decisions may jeopardize the patients’ health.
Objective: This study aims to evaluate and score the big data of patients with chronic heart disease and of those who require urgent attention. The assessment is based on multicriteria decision making in a telemedical environment to improve the triage and prioritization processes.
Methods: A hands-on study was performed. A total of 500 patients with chronic heart disease manifested in different symptoms and under various emergency levels were evaluated on the basis of the following four main measures. An electrocardiogram sensor was used to measure the electrical signals of the contractile activity of the heart over time. A SpO2 sensor was employed to determine the blood oxygen saturation levels of the patients. A blood pressure sensor was used to obtain the physiological data of the systolic and diastolic blood pressures of the patients. Finally, a non-sensory measurement (text frame) was conducted to assess chest pain and breathing. The patients were prioritized on the basis of a set of measurements by utilizing integrated back-forward adjustment for weight computation and technique for order performance by similarity to ideal solution.
Discussion Results: Patients with the most urgent cases were given the highest priority level, whereas those with the least urgent cases were assigned with the lowest priority level among all patients’ scores. The first three patients assigned to the medical committee of doctors were proven to be the most critical emergency cases with the highest priority level on the basis of their clinical symptoms. By contrast, the last three patients were proven to be the least critical emergency cases and given the lowest priority levels relative to other patients. The throughput measurement in terms of scalability based on our proposed algorithm was more efficient than that of the benchmark algorithm. Finally, the new method for determining the “big data” patients characteristics based on “4Vs” was suggested.
This study aims to adapt the Expectation Disconfirmation Theory and Technology Adoption Model to unveil provocative roles in patients’ satisfaction cognitions and subsequent continuity behaviors pertaining to telemedicine services in rural Bangladesh. A quantitative research model is developed and validated using a two-staged deep neural network and partial least squares structural equation modeling approach. The findings of this study provide evidence that five salient determinants; expectations, disconfirmation, performance, usefulness, and ease of use dominantly contribute to predicting patients’ satisfaction concerning continuity with telemedicine. This contributes to health informatics and behavioral literature by clarifying the complex interplay between patients’ satisfaction and determinants of continuity behavior in telemedicine’s domain. The findings provide novel insights into predictions of complex patients’ attitudes toward telemedicine continuity, and dynamic changes in adoption trends thereby assisting health professionals, global health experts, policymakers, and IS community in making higher quality informed decisions for people-centered future models of care.
Past decades’ rapid development of technological innovations can ease individual’s everyday lives, but they can also convey a sense of frustration. The aim of the present study was to investigate attitudes toward technologies that are expected to become widespread in the near future. The Technology Readiness Index was administered to a sample of Hungarian respondents to measure the capacity to adopt technologies. The results add significant novelties about the specific patterns related to perceptions of considerably different future technologies, emphasizing the unique role of optimism. Derivations are further specified by demographic characteristics, future directions and practical implications are also discussed.
A telemedicine system will provide sustainable, comprehensive, low-cost, fast, private, and convenient access to medical consultation and diagnosis for patients from remote locations. The telemedicine system addressed in this paper consists of a sensor jacket, which is worn by the patient for medical monitoring. The signals sensed through the jacket are processed and transmitted through a public telecommunication link, to a medical professional in a hospital at distance. The medical professional interacts with the patient through audio and video links, and simultaneously examines the data transmitted by the monitoring system. Medical assessment, diagnosis, and prescription are carried out on this basis. Sensing and signal processing are paramount to providing the patient data to the medical professional in an accurate and effective manner. This paper presents some relevant issues and techniques. Specific examples of electrocardiograms and respiratory signals are provided to illustrate the applicable signal conditioning approaches. Results are presented to demonstrate the feasibility and the effectiveness of these methods.
For some time now, successive generations of more sophisticated information and communication technologies (ICTs) have been adopted by organisations to enhance or replace more traditional methods of accessing, recording and communicating information used in problem-solving activities. Professionals in most industries have had some experience of the impact of ICT innovation and might be expected to resist innovations which they perceive to have the potential to disrupt crucial processes. This appears particularly likely to occur where there is a substantial tacit knowledge component. In this paper, we report the perceptions of key groups of healthcare professionals of the barriers to adoption of videoconferencing into knowledge-intensive processes mediating high-level problem-solving. While there was some shared perception of the critical problems, the interpretations of the underlying issues differed. The findings give some insight into the conceptualisation issues surrounding innovation management within complex systems which are emerging in the adoption of ICTs. The nature of their impact on pre-existing core communication routines involving high level expertise and tacit knowledge is considered.
Incumbents’ inertia in the face of disruptive innovations has been emphasised in prior literature. The relevance of inertia is particularly topical in the context of digital transformation. However, incumbents may be able to invest in disruptive digital innovations appropriately if they possess the motivation and ability to do so. In this paper, I use three streams of research in order to investigate contextual, organisational, and individual antecedents of incumbents’ motivation and ability to adopt and use potentially disruptive digital innovations in health care: institutional theory, the resource-based view, and technology acceptance literature. I employ factor analyses and logistic regressions to test the impact on the adoption and usage of telemedicine applications using a dataset of 9,196 European general practitioners. I examine B2B as well as B2C applications in order to determine the effect of the antecedents on different business models. My findings suggest that only isomorphic pressure, complementary assets, and perceived output quality significantly influence both adoption and usage as well as B2B and B2C business models in the same way. Formal institutions and individual factors yield ambiguous results. These findings provide important implications for the understanding of incumbents’ response to potentially disruptive digital innovations in regulated contexts.
Gait recognition has been of great importance for disease diagnosis, rehabilitation assessment, as well as personal identification. Conventional gait analysis generally has to rely heavily on complex, expensive data acquisition and computing apparatus. To significantly simplify the evaluation process the mobile phone, which is one of the most indispensable electronic media in human daily life, was adopted as a pervasive tool for gait study, by using its digital imaging recording and analysis function. The basic procedure to record and quantify the video of human gait was illustrated and demonstrated through conceptual experiments. Potential applications were discussed. Some fundamental and practical issues raised in such flexible technology were pointed out. This method is expected to be widely used in future human analysis.
Background: With the emergence of the COVID-19 pandemic, most health-care personnel and resources are redirected to prioritize care for seriously-ill COVID patients. This situation may poorly impact our capacity to care for critically injured patients. We need to devise a strategy to provide rational and essential care to hand trauma victims whilst the access to theatres and anaesthetic support is limited. Our center is a level 1 trauma center, where the pandemic preparedness required reorganization of the trauma services. We aim to summarise the clinical profile and management of these patients and highlight, how we modified our practice to optimize their care.
Methods: This is a single-centre retrospective observational study of all patients with hand injuries visiting the Department of Plastic Surgery from 22nd March to 31st May 2020. Patient characteristics, management details, and outcomes were analysed.
Results: A total of 102 hand injuries were encountered. Five patients were COVID-19 positive. The mean age was 28.9 ± 14.8 years and eighty-two (80.4%) were males. Thirty-one injuries involved fractures/dislocations, of which 23 (74.2%) were managed non-operatively. Seventy-five (73.5%) patients underwent wound wash or procedure under local anaesthetic and were discharged as soon as they were comfortable. Seventeen cases performed under brachial-plexus block, were discharged within 24 hours except four cases of finger replantation/ revascularisation and one flap cover which were discharged after monitoring for four days. At mean follow-up of 54.4 ± 21.8 days, the rates of early complication and loss to follow-up were 6.9% and 12.7% respectively.
Conclusions: Essential trauma care needs to continue keeping in mind, rational use of resources while ensuring safety of the patients and health-care professionals. We need to be flexible and dynamic in our approach, by utilising teleconsultation, non-operative management, and regional anaesthesia wherever feasible.
Background: A major consequence of the COVID-19 pandemic on the U.S. healthcare system has been the rapid transition away from in-person healthcare visits to telehealth. This study analyzed patient and surgeon satisfaction in the utilization of telehealth within the hand surgery division during the COVID-19 pandemic.
Methods: All hand surgery patients who completed a telemedicine visit from March 30th, 2020 through April 30th, 2020 completed a 14-question survey via e-mail. Hand surgeons who participated in telemedicine completed a separate 14-question survey. Survey results were presented descriptively (mean ± standard deviation) and patient factors influencing satisfaction were determined using univariate and multivariate proportional modeling.
Results: 89 patients and five surgeons completed the surveys. Patients were very satisfied with their telemedicine visits (4.21/5.00 ± 0.89). Multivariate proportional modeling determined patients who found it “very easy” (5/5) to arrange telemedicine visits had greater satisfaction (OR = 4.928; 95% CI = 0.94 to 25.84) compared to those who found it “difficult” (2/5) (p = 0.059). Patients who believed they could ask/relay questions/concerns “extremely effectively” (5/5) had greater satisfaction (OR = 55.236; CI = 11.39 to 267.80) compared to those who asked/relayed questions only “slightly effective” to “moderately effectively” (p < 0.001). Surgeons were similarly satisfied with their telemedicine experience (4.00/5.00 ± 0.89) and were confident in their diagnoses (4.20/5.00 ± 0.84). All surgeons responded they will continue using telemedicine. 30.7% of patients would choose telemedicine over an inperson visit.
Conclusions: Telemedicine provides a viable platform for healthcare delivery with high patient and surgeon satisfaction. Most patients still prefer in-person visits for the post-pandemic future.
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