frederic ehrler | Université de Genève (original) (raw)

Papers by frederic ehrler

Studies in health technology and informatics, May 18, 2023

Alerting systems have a strong potential to improve quality of care in hospital by ensuring that ... more Alerting systems have a strong potential to improve quality of care in hospital by ensuring that clinicians provide more effective and timely care to their patients. Many systems have been implemented but often fail to unleash their full potential due to the problem of alert fatigue. As an attempt to reduce this fatigue we have developed a targeted alerting system ensuring only the concerned clinicians receives the alerts. The conception of the system went through several steps going from the identification of the requirement, the prototyping and implementation into several systems. The results present the different parameters taken into consideration and developed frontends. We finally discuss the important considerations of alerting system, such as the necessity of a governance. The system still needs a formal evaluation to validate that it responds to its promises before being deployed more largely.

Swiss medical informatics, Aug 17, 2011

The rise of cheaper and more powerful mobile devices make them a new and attractive platform for ... more The rise of cheaper and more powerful mobile devices make them a new and attractive platform for clinical applications. The interaction paradigm and portability of the device facilitates bedside human-machine interactions. The better accessibility to information and decision-support anywhere in the hospital improves the efficiency and the safety of care processes. In this study, we attempt to find out what are the most appropriate Operating System (OS) and Software Development Kit (SDK) to support the development of clinical applications on mobile devices. The Android platform is a Linux-based, open source platform that has many advantages. Two main SDKs are available on this platform: the native Android and the Adobe Flex SDK. Both of them have interesting features, but the latter has been preferred due its portability at comparable performance and ease of development.

PubMed, 2015

The administration of intravenous drugs is a significant source of medical errors. Protocol based... more The administration of intravenous drugs is a significant source of medical errors. Protocol based care are have been demonstrated to be an efficient way to favor best practices and to avoid simple errors such as those related to expiration date, hygiene regulation among other. The recent availability of the Google Glass, a hands free wearable device offers new opportunities to access care protocols at patients' bedside. In this article, we present a prototype application for displaying care protocols developed through a user centered design. The software enables the navigation through the different steps of care protocols and their validation using barcodes. Three interactions paradigms, tactile, vocal and by eye blink are proposed in order to provide hands free manipulation when necessary. The realization of a concrete project revealed some limitations that should be taken in account in order to ensure the proper behavior of the tool. If no formal evaluation has been performed, the first feedbacks are very positive and encourage us to go forward and test the tool in real care situations.

PubMed, 2007

Patient records contain most crucial documents for managing the treatments and healthcare of pati... more Patient records contain most crucial documents for managing the treatments and healthcare of patients in the hospital. Retrieving information from these records in an easy, quick and safe way helps care providers to save time and find important facts about their patient's health. This paper presents the scalability issues induced by the indexing and the retrieval of the information contained in the patient records. For this study, EasyIR, an information retrieval tool performing full text queries and retrieving the related documents has been used. An evaluation of the performance reveals that the indexing process suffers from overhead consequence of the particular structure of the patient records. Most IR tools are designed to manage very large numbers of documents in a single index whereas in our hypothesis, one index per record, which usually implies few documents, has been imposed. As the number of modifications and creations of patient records are significant in a day, using a specialized and efficient indexation tool is required.

PubMed, 2016

Early recognition and management of patients at risk and more aggressive implementation of eviden... more Early recognition and management of patients at risk and more aggressive implementation of evidence-based resuscitation guidelines play a role to the reduction of patients' mortality. If, in paediatric emergency department, the proper adherence to the paediatric cardiac arrest guidelines is critical to increase the chance of survival, this adherence is unfortunately often suboptimal. Connected glasses, such as the Google Glass, offer an interesting support to provide guidelines at the point of care. However, existing guidelines format is not adapted to be used directly on the small screen of connected glasses. Their transformation to be displayed on the Google Glass is not a simple task. Problems such as the navigation and the formalization of the guidelines must be solved. In this article, we present the transformation process of the paediatric cardiac arrest algorithm from its paper version to its implementation on the Google Glass.

Lecture Notes in Computer Science, Aug 29, 2007

As the number of published documents increase quickly, there is a crucial need for fast and sensi... more As the number of published documents increase quickly, there is a crucial need for fast and sensitive categorization methods to manage the produced information. In this paper, we focused on the categorization of biomedical documents with concepts of the Gene Ontology, an ontology dedicated to gene description. Our approach discovers associations between the predefined concepts and the documents using string

PubMed, Jun 16, 2020

Collecting accurate food consumption data is challenging for nutrition practitioners. Mobile devi... more Collecting accurate food consumption data is challenging for nutrition practitioners. Mobile devices are interesting alternatives to traditional ways of collecting assessments by reducing burden of use. Our objective was to develop and evaluate a mobile application for food intake documentation, targeting particularly the parents of pediatric patients. NutriKids is an application designed to guide users step by step in their assessment by asking relevant questions and taking advantage of the camera function. The quality of nutritional assessment using NutriKids was evaluated through the analysis of food diaries completed during two days under real-life conditions (home use). NutriKids demonstrated to provide satisfying degree of quality in 84% of the reported items. A detailed analysis of quality components highlighted that NutriKids interface could be improved for quantitative estimation and for specific information on added fat or sugar. Besides, a feedback survey highlighted the high acceptability of the application by the participants. These findings demonstrate the potential of this guided approach application. With further development of NutriKids and controlled based assessment with larger populations, we hypothesize that our results would reach statistical significance in all aspects of nutritional assessment quality.

Studies in health technology and informatics, Nov 23, 2020

Due to the large number of smartphone users, mHealth has become a popular support to foster users... more Due to the large number of smartphone users, mHealth has become a popular support to foster users' health behavior change Personalization is an important factor to increase the effectiveness of mHealth interventions. Based on a literature review, we have listed and categorized personalization concepts associated with behavior change in mHealth into 4 dimensions, users, system functionalities, information, and app properties. The users dimension refers to user-related characteristics such as personality, player profile, need for cognition and perception of social norms. The system functionalities contain the functionalities that can be found in applications such as reminders as well as gamification functionalities such as collectibles. The information dimension concerns the way information is transmitted, such as the source of the message must be expert or the type of feedback to be provided. Finally, there are app properties such as the aesthetics of the application. For the next part, it would be interesting to discover the links we can make between the dimensions.

BACKGROUND Although mobile health apps (mHealth) has the potential to motivate people to adopt he... more BACKGROUND Although mobile health apps (mHealth) has the potential to motivate people to adopt healthier behaviors, many of them fail to maintain these behavior over time. This long-term adherence can be improved by personalizing the proposed interventions. Based on the literature, we have created a conceptual framework guiding the selection of appropriate functionalities according to the user's profile. OBJECTIVE This cross-sectional study aims to check if the relationships linking functionalities and profiles proposed in our conceptual framework are confirmed by the preferences of users collected through questionnaires. METHODS An online questionnaire lead participants to discover several functionalities of a mobile app aiming to foster healthier behavior. The participants must select the 5 functionalities they consider as the most relevant to motivate a healthier behavior and evaluate them on a score ranging from 0 to 100. RESULTS Data collection was conducted between July 2021 and December 2021. CONCLUSIONS This protocol will allow us to define the functionalities that are preferred by users according to their profile according to our conceptual framework.

BACKGROUND Medication non-adherence remains a significant challenge in the management of chronic ... more BACKGROUND Medication non-adherence remains a significant challenge in the management of chronic conditions, often leading to suboptimal treatment outcomes and increased healthcare costs. Innovative interventions that address the underlying factors contributing to non-adherence are needed. Gamified mobile applications have shown promise in promoting behavior change and engagement OBJECTIVE This pilot study aimed to evaluate the efficacy and usability of a gamified mobile application that employed a narrative storytelling approach to enhance medication adherence among patients following Acute Coronary Syndrome (ACS). The study aimed to assess changes in participants' beliefs about medication and self-reported adherence before and after the intervention. Additionally, user feedback regarding the narrative component of the app was gathered. METHODS Eighteen patients who recently experienced ACS were recruited for a one-month intervention using the gamified app. Participants' be...

Computers in health care, 2023

Studies in health technology and informatics, May 25, 2022

Studies in Health Technology and Informatics, 2020

SMART-MEDS is a gamification-based mobile application to improve medication adherence. In its fir... more SMART-MEDS is a gamification-based mobile application to improve medication adherence. In its first version, it relied on storytelling to bolster user engagement. The feedback collected from users after one month testing revealed that although they appreciated the proposed story, they did not find it compelling enough. On the positive side they really appreciated to learn about their medications and disease through a dedicated quiz. In this paper, we present a new version of the app redesigned based on the collected feedback. We have based ourselves on the theories of gamification and self-efficiency to propose new mechanics such as mini-games, and interactive dialogues with a chatbot. Everything is wrapped up inside a new story that takes us on a journey through Switzerland. We also tried to reinforce the app educational aspects by integrating documentation directly inside the new mechanics. This new app seems to address all the issues raised during the first user tests, and will b...

La maladie d’Alzheimer est une maladie neurodégénérative et extrêmement invalidante en fin de vie... more La maladie d’Alzheimer est une maladie neurodégénérative et extrêmement invalidante en fin de vie. La plupart des malades sont pris en charge par leurs familles, à domicile. Celles-ci sont souvent peu préparées et manquent d’information sur l’évolution de la maladie. En conséquence, ces proches ont des difficultés lors de la gestion des activités de la vie quotidienne avec le malade et développent souvent un état de stress important, qui nuit autant à la relation avec le soigné qu’à leur propre santé. Le projet Carezheimer a pour objectif de créer un serious game personnalisé visant à apprendre aux proches-aidants comment mieux s’adapter aux situations problèmatiques de la vie quotidienne. Nous nous intéressons plus particulièrement à mesurer l’impact de la personnalisation. Une revue de littérature identifie les principales difficultés rencontrées par les proches-aidants et permet d’extraire les principales variables impactant la relation entre le malade et le proche-aidant. Ensuite, une simulation 3D sera développée dans laquelle l’utilisateur pourra rejouer des scènes de la vie quotidienne en testant différentes stratégies de soin. Les facteurs de personnalisation, identifiés grâce à un questionnaire en pré-jeux, influenceront les actions pendant le jeu, qui adaptera les situations en accord avec l’évolution de la maladie. Un entretien semi-directif portant sur les différents facteurs contributifs du niveau de stress des proches aidants permettra une mesure qualitative du stress avant et après l’intervention du serious game. Une étude complémentaire validera la diminution du fardeau du proche-aidant par des tests cliniques, voire par la réalisation de tests effectués à domicile avec un suivi à long terme

JMIR Pediatrics and Parenting, 2022

Background Patient experience in emergency departments (EDs) remains often suboptimal and can be ... more Background Patient experience in emergency departments (EDs) remains often suboptimal and can be a source of stress, particularly in pediatric settings. In an attempt to support patients and their families before, during, and after their visit to a pediatric ED, a mobile health (mHealth) app was developed by a multidisciplinary team based on patient-centered care principles. Objective This study aims to evaluate the usability (effectiveness, efficiency, and satisfaction) of a new mHealth app, InfoKids, by potential end users through usability testing. Methods The app was assessed through an in-laboratory, video-recorded evaluation in which participants had to execute 9 goal-oriented tasks, ranging from account creation to the reception of a diagnostic sheet at the end of the emergency care episode. Effectiveness was measured based on the task completion rate, efficiency on time on task, and user satisfaction according to answers to the System Usability Scale questionnaire. Think-alo...

BACKGROUND Mobile apps are increasingly being used in various domains of medicine. Few are eviden... more BACKGROUND Mobile apps are increasingly being used in various domains of medicine. Few are evidence-based, and their benefits can only be achieved if end users intend to adopt and use them. To date, only a small fraction of mobile apps have published data on their field usability and end user acceptance results, especially in emergency medicine. OBJECTIVE This study aims to determine the usability and acceptance of an evidence-based mobile app while safely preparing emergency drugs at the point of care during pediatric in- and out-of-hospital cardiopulmonary resuscitations by frontline caregivers. METHODS In 2 multicenter randomized controlled parent trials conducted at 6 pediatric emergency departments from March 1 to December 31, 2017, and 14 emergency medical services from September 3, 2019, to January 21, 2020, the usability and technology acceptance of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app were evaluated among skilled pediatric emergency nurs...

Trials, 2021

BackgroundEffective team communication, coordination, and situational awareness (SA) by team memb... more BackgroundEffective team communication, coordination, and situational awareness (SA) by team members are critical components to deliver optimal cardiopulmonary resuscitation (CPR). Complexity of care during CPR, involvement of numerous providers, miscommunication, and other exogenous factors can all contribute to negatively influencing patient care, thus jeopardizing survival. We aim to investigate whether an mHealth supportive tool (the Interconnected and Focused Mobile Apps on patient Care Environment [InterFACE]) developed as a collaborative platform to support CPR providers in real-time and share patient-centered information would increase SA during pediatric CPR.MethodsWe will conduct a prospective, cluster randomized controlled trial by groups of 6 participants in a tertiary pediatric emergency department (33,000 consultations/year) with pediatric physicians and nurses. We will compare the impact of the InterFACE tool with conventional communication methods on SA and effective...

AMIA ... Annual Symposium proceedings. AMIA Symposium, 2018

Patient adherence to medications is crucial for reducing cardiovascular risk after an acute coron... more Patient adherence to medications is crucial for reducing cardiovascular risk after an acute coronary syndrome (ACS). Although causes for low adherence are diverse, forgetfulness and lack of awareness about treatment importance are accountable for many cases. As a result, medication reminder apps have attempted to tackle this problem. In our work, we present the development of an app with gamification mechanisms to foster adherence and to support the behavior change processes of the Health Access Process Approach (HAPA) theoretical framework. To design our intervention, we relied on a user-centric approach. We listed the main factors related to high and low adherence from the Medication Adherence Reasons Scale (MAR-Scale) and identified functionalities that could address it. We focused in particular on forgetfulness, knowledge and beliefs about medication as the main barriers for adherence. We implemented a quiz and storytelling as gamification strategies to help motivate patients co...

Studies in health technology and informatics, 2018

Supporting caregivers' workflow with mobile applications (apps) is a growing trend. At the be... more Supporting caregivers' workflow with mobile applications (apps) is a growing trend. At the bedside, apps can provide new ways to support the documentation process rather than using a desktop computer in a nursing office. Although these applications show potential, few existing reports have studied the real impact of such solutions. At the University Hospitals of Geneva, we developed BEDside Mobility, a mobile application supporting nurses' daily workflow. In a pilot study, the app was trialed in two wards for a period of one month. We collected data of the actual usage of the app and asked the users to complete a tailored technology acceptance model questionnaire at the end of the study period. Results show that participation remain stable with time with participants using in average the tool for almost 29 minutes per day. The technology acceptance questionnaires revealed a high usability of the app and good promotion from the institution although users did not perceive any ...