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Consensus based framework for digital mobility monitoring.

ABSTRACT: Digital mobility assessment using wearable sensor systems has the potential to capture walking performance in a patient's natural environment. It enables monitoring of health status and disease progression and evaluation of interventions in real-world situations. In contrast to laboratory settings, real-world walking occurs in non-conventional environments and under unconstrained and uncontrolled conditions. Despite the general understanding, there is a lack of agreed definitions about what constitutes real-world walking, impeding the comparison and interpretation of the acquired data across systems and studies. The goal of this study was to obtain expert-based consensus on specific aspects of real-world walking and to provide respective definitions in a common terminological framework. An adapted Delphi method was used to obtain agreed definitions related to real-world walking. In an online survey, 162 participants from a panel of academic, clinical and industrial experts with experience in the field of gait analysis were asked for agreement on previously specified definitions. Descriptive statistics was used to evaluate whether consent (> 75% agreement as defined a priori) was reached. Of 162 experts invited to participate, 51 completed all rounds (31.5% response rate). We obtained consensus on all definitions ("Walking" > 90%, "Purposeful" > 75%, "Real-world" > 90%, "Walking bout" > 80%, "Walking speed" > 75%, "Turning" > 90% agreement) after two rounds. The identification of a consented set of real-world walking definitions has important implications for the development of assessment and analysis protocols, as well as for the reporting and comparison of digital mobility outcomes across studies and systems. The definitions will serve as a common framework for implementing digital and mobile technologies for gait assessment and are an important link for the transition from supervised to unsupervised gait assessment.

SUBMITTER: Kluge F

PROVIDER: S-EPMC8378707 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Mobility restrictions have been identified as key non-pharmaceutical interventions to limit the spread of the SARS-COV-2 epidemics. However, these interventions present significant drawbacks to the social fabric and negative outcomes for the real economy. In this paper we propose a real-time monitoring framework for tracking the economic consequences of various forms of mobility reductions involving European countries. We adopt a granular representation of mobility patterns during both the first and second waves of SARS-COV-2 in Italy, Germany, France and Spain to provide an analytical characterization of the rate of losses of industrial production by means of a nowcasting methodology. Our approach exploits the information encoded in massive datasets of human mobility provided by Facebook and Google, which are published at higher frequencies than the target economic variables, in order to obtain an early estimate before the official data becomes available. Our results show, in first place, the ability of mobility-related policies to induce a contraction of mobility patterns across jurisdictions. Besides this contraction, we observe a substitution effect which increases mobility within jurisdictions. Secondly, we show how industrial production strictly follows the dynamics of population commuting patterns and of human mobility trends, which thus provide information on the day-by-day variations in countries' economic activities. Our work, besides shedding light on how policy interventions targeted to induce a mobility contraction impact the real economy, constitutes a practical toolbox for helping governments to design appropriate and balanced policy actions aimed at containing the SARS-COV-2 spread, while mitigating the detrimental effect on the economy. Our study reveals how complex mobility patterns can have unequal consequences to economic losses across countries and call for a more tailored implementation of restrictions to balance the containment of contagion with the need to sustain economic activities.

Project description:BACKGROUND:Digital transformation in health care is being driven by the need to improve quality, reduce costs, and enhance the patient experience of health care delivery. It does this through both the direct intervention of technology to create new diagnostic and treatment opportunities and also through the improved use of information to create more engaging and efficient care processes. OBJECTIVE:In a modern digital hospital, improved clinical and business processes are often driven through enhancing the information flows that support them. To understand an organization's ability to transform their information flows requires a clear understanding of the capabilities of an organization's information technology infrastructure. To date, hospital facilities have been challenged by the absence of uniform ways of describing this infrastructure that would enable them to benchmark where they are and create a vision of where they would like to be. While there is an industry assessment measure for electronic medical record (EMR) adoption using the Healthcare Information and Management Systems Society Analytics EMR Adoption Model, there is no equivalent for assessing the infrastructure and associated technology capabilities for digital hospitals. Our aim is to fill this gap, as hospital administrators and clinicians need to know how and why to invest in information infrastructure to support health information technology that benefits patient safety and care. METHODS:Based on an operational framework for the Capability Maturity Model, devised specifically for health care, we applied information use characteristics to define eight information systems maturity levels and associated technology infrastructure capabilities. These levels are mapped to user experiences to create a linkage between technology infrastructure and experience outcomes. Subsequently, specific technology capabilities are deconstructed to identify the technology features required to meet each maturity level. RESULTS:The resulting assessment framework clearly defines 164 individual capabilities across the five technology domains and eight maturity levels for hospital infrastructure. These level-dependent capabilities characterize the ability of the hospital's information infrastructure to support the business of digital hospitals including clinical and administrative requirements. Further, it allows the addition of a scoring calculation for each capability, domain, and the overall infrastructure, and it identifies critical requirements to meet each of the maturity levels. CONCLUSIONS:This new Infrastructure Maturity Assessment framework will allow digital hospitals to assess the maturity of their infrastructure in terms of their digital transformation aligning to business outcomes and supporting the desired level of clinical and operational competency. It provides the ability to establish an international benchmark of hospital infrastructure performance, while identifying weaknesses in current infrastructure capability. Further, it provides a business case justification through increased functionality and a roadmap for subsequent digital transformation while moving from one maturity level to the next. As such, this framework will encourage and guide information-driven, digital transformation in health care.

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Consensus based framework for digital mobility monitoring.

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