Digital Healthcare Department, BIT Computer Co. Ltd., Seoul, Republic of Korea; Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea.
Department of Medical Informatics, Kyungpook National University, Daegu, Republic of Korea.
Int J Med Inform. 2022 Oct;166:104844. doi: 10.1016/j.ijmedinf.2022.104844. Epub 2022 Aug 17.
The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare.
This study aimed to investigate the effects of video-based telehealth services using a mobile personal health record (PHR) app for vulnerable workers with metabolic risk factors.
A prospective observational study was conducted with 117 participants and 27 healthcare professionals for 16 weeks. Participants visited the research institution three times (at weeks 1, 8, and 16) and underwent health check-ups and used various features of the mobile PHR app. Healthcare professionals observed the participants's data using the monitoring system and performed appropriate interventions. The primary outcome measures were to evaluate the effects of services on changes in the participants' metabolic risk factors, and secondary outcome measures were to analyze changes in the participants' lifestyle and service satisfaction, and to observe service use through usage logs. One-way repeated measures ANOVA and Scheffé's test were performed to observe changes in participants' health status and lifestyle, and a paired t-test was performed to analyze changes in service satisfaction. Finally, in-depth interviews with healthcare professionals were performed using semi-structured questionnaires to understand service providers' perspectives after the end of the study.
Systolic blood pressure (F = 7.32, P <.001), diastolic blood pressure (F = 11.30, P <.001), body weight (F = 29.53, P <.001), BMI (F = 17.31, P <.001), waist circumference (F = 17.33, P <.001), fasting blood glucose (F = 5.11, P =.007), and triglycerides (F = 4.66, P =.01) showed significant improvements with time points, whereas high-density lipoprotein cholesterol (F = 3.35, P =.067) did not. The dietary score (F = 3.26, P =.04) showed a significant improvement with time points, whereas physical activity (F = 1.06, P =.34) did not. In terms of service satisfaction, only lifestyle improvement (P <.001) showed a significant difference. COVID-19 has affected the performance of healthcare professionals, thereby changing the perspectives toward healthcare technology services.
We evaluated the effectiveness of video-based telehealth services supporting workers' health status and lifestyle interventions using healthcare technologies such as the mobile PHR app, tele-monitoring, and video teleconsultation. Our results indicate that as a complementary means, its utility can be expanded in the field of occupational safety and health to overcome the limitations of face-to-face treatment due to COVID-19 in the future.
COVID-19 大流行限制了面对面的治疗，引发了现有医疗服务结构的变化。与其他群体不同，服务不足地区的工人获得医疗保健的机会相对较少。
本研究旨在调查使用移动个人健康记录（PHR）应用程序为代谢风险因素的弱势工人提供基于视频的远程医疗服务的效果。
对 117 名参与者和 27 名医疗保健专业人员进行了前瞻性观察研究，为期 16 周。参与者在第 1、8 和 16 周三次访问研究机构，并进行健康检查和使用移动 PHR 应用程序的各种功能。医疗保健专业人员使用监测系统观察参与者的数据并进行适当的干预。主要结局指标是评估服务对参与者代谢风险因素变化的影响，次要结局指标是分析参与者生活方式和服务满意度的变化，并通过使用情况日志观察服务使用情况。使用单向重复测量方差分析和 Scheffé 检验观察参与者健康状况和生活方式的变化，使用配对 t 检验分析服务满意度的变化。最后，对医疗保健专业人员进行深入访谈，使用半结构化问卷了解研究结束后服务提供者的观点。
收缩压（F=7.32，P<.001）、舒张压（F=11.30，P<.001）、体重（F=29.53，P<.001）、BMI（F=17.31，P<.001）、腰围（F=17.33，P<.001）、空腹血糖（F=5.11，P=.007）和甘油三酯（F=4.66，P=.01）随时间点显著改善，而高密度脂蛋白胆固醇（F=3.35，P=.067）则没有。饮食评分（F=3.26，P=.04）随时间点显著改善，而体力活动（F=1.06，P=.34）则没有。就服务满意度而言，只有生活方式改善（P<.001）差异显著。COVID-19 影响了医疗保健专业人员的表现，从而改变了他们对医疗技术服务的看法。
我们使用移动 PHR 应用程序、远程监测和视频远程咨询等医疗技术评估了基于视频的远程医疗服务对工人健康状况和生活方式干预的有效性。我们的结果表明，作为一种补充手段，其效用可以在职业安全与健康领域扩展，以克服未来因 COVID-19 导致的面对面治疗的局限性。
