Background: Health information systems are important for health planning and monitoring of progress. Still, data from health facilities are often of limited quality in Low-and-Middle-Income Countries. Quality deficits are partially rooted in the fact that paper-based documentation is still the norm at facility level, leading to mistakes in summarizing and manual copying. Digitalization of data at facility level would allow automatization of these procedural steps. Here we aimed to evaluate the feasibility, usability and acceptability of a scanning innovation called Smart Paper Technology for digital data processing. Methods: We used a mixed-methods design to understand users' engagement with Smart Paper Technology and to identify potential positive and negative effects of this innovation in three health facilities in Southern Tanzania. Eight focus group discussions and 11 in-depth interviews with users were conducted. We quantified time used by health care providers for documentation and patient care using time-motion methods. Thematic analysis was used to analyze qualitative data. Descriptive statistics and multivariable linear models were generated to compare the difference before and after introduction and adjust for confounders. Results: Health care providers and health care managers appreciated the forms' simple design features and perceived Smart Paper Technology as time-saving and easy to use. The time-motion study with 273.3 and 224.0 hours of observations before and after introduction of Smart Paper Technology, respectively, confirmed that working time spent on documentation did not increase (27.0% at baseline and 26.4% post-introduction; adjusted p=0.763). Time spent on patient care was not negatively impacted (26.9% at baseline and 37.1% at post-intervention; adjusted p=0.001). Health care providers described positive effects on their accountability for data and service provision relating to the fact that individually signed forms were filled. Discussion: Health care providers perceived Smart Paper Technology as feasible, easy to integrate and acceptable in their setting, particularly as it did not add time to documentation.

Health information systems are important for health planning and progress monitoring. Still, data from health facilities are often of limited quality in Low-and-Middle-Income Countries. Quality deficits are partially rooted in the fact that paper-based documentation is still the norm at facility level, leading to mistakes in summarizing and manual copying. Digitization of data at facility level would allow automatization of these procedural steps. Here we aimed to evaluate the feasibility, usability and acceptability of a scanning innovation called Smart Paper Technology for digital data processing. We used a mixed-methods design to understand users’ engagement with Smart Paper Technology and identify potential positive and negative effects of this innovation in three health facilities in Southern Tanzania. Eight focus group discussions and 11 in-depth interviews with users were conducted. We quantified time used by health care providers for documentation and patient care using time-motion methods. Thematic analysis was used to analyze qualitative data. Descriptive statistics and multivariable linear models were generated to compare the difference before and after introduction and adjust for confounders. Health care providers and health care managers appreciated the forms’ simple design features and perceived Smart Paper Technology as time-saving and easy to use. The time-motion study with 273.3 and 224.0 hours of observations before and after introduction of Smart Paper Technology, respectively, confirmed that working time spent on documentation did not increase (27.0% at baseline and 26.4% post-introduction; adjusted p = 0.763). Time spent on patient care was not negatively impacted (26.9% at baseline and 37.1% at post-intervention; adjusted p = 0.001). Health care providers described positive effects on their accountability for data and service provision relating to the fact that individually signed forms were filled. Health care providers perceived Smart Paper Technology as feasible, easy to integrate and acceptable in their setting, particularly as it did not add time to documentation.

The interest in high performance chip architectures for biomedical applications is gaining a lot of research and market interest. Heart diseases remain by far the main cause of death and a challenging problem for biomedical engineers to monitor and analyze. Electrocardiography (ECG) is an essential practice in heart medicine. However, ECG analysis still faces computational challenges, especially when 12 lead signals are to be analyzed in parallel, in real time, and under increasing sampling frequencies. Another challenge is the analysis of huge amounts of data that may grow to days of recordings. Nowadays, doctors use eyeball monitoring of the 12-lead ECG paper readout, which may seriously impair analysis accuracy. Our solution leverages the advance in multi-processor system-on-chip architectures, and it is centered on the parallelization of the ECG computation kernel. Our Hardware-Software (HW/SW) Multi-Processor System-on-Chip (MPSoC) design improves upon state-of-the-art mostly for its capability to perform real-time analysis of input data, leveraging the computation horsepower provided by many concurrent DSPs, more accurate diagnosis of cardiac diseases, and prompter reaction to abnormal heart alterations. The design methodology to go from the 12-lead ECG application specification to the final HW/SW architecture is the focus of this paper. We explore the design space by considering a number of hardware and software architectural variants, and deploy industrial components to build up the system

In this article we focus on multiprocessor system-on-chip (MPSoC) architectures for human heart electrocardiogram (ECG) real time analysis as a hardware/software (HW/SW) platform offering an advance relative to state-of-the-art solutions. This is a relevant biomedical application with good potential market, since heart diseases are responsible for the largest number of yearly deaths. Hence, it is a good target for an application-specific system-on-chip (SoC) and HW/SW codesign.We investigate a symmetric multiprocessor architecture based on STMicroelectronics VLIW DSPs that process in real time 12-lead ECG signals. This architecture improves upon state-of-the-art SoC designs for ECG analysis in its ability to analyze the full 12 leads in real time, even with high sampling frequencies, and its ability to detect heart malfunction for the whole ECG signal interval. We explore the design space by considering a number of hardware and software architectural options. Comparing our design with present-day solutions from an SoC and application point-ofview shows that our platform can be used in real time and without failures. Nabiev, R. 2008. A multiprocessor system-on-chip for real-time biomedical monitoring and analysis: ECG prototype architectural design space exploration.

The World Health Organization in WHAS8.28 e Health Resolution has called upon the use of low-cost information and communication technology (ICT) to improve the quality of service delivery in low and middle income countries and to build up health worker's capacity especially at the primary health care (PHC) level. Thanks to market demands and technological progress, the cost for computer hardware is decreasing. Due to this progress, project such as ICT4MPOWER can provide low cost ICT infrastructure to hospitals and rural clinics in Uganda for better health outcomes of the rural population. However, as number of low-cost computers increase, the more maintenance will be needed. Establishing local technical support team to maintain computer infrastructure in rural clinics of developing countries is a big challenge, since rural clinics lack funds to recruit and sustain local technical support team. Sustaining technical support team locally and providing maintenance for implemented ICT infrastructure is one of the reasons why e health projects are hard to sustain in rural areas of developing countries. Authors present a framework for simple, practical and low-cost maintenance of computer infrastructure applicable in healthcare organizations of low and middle income countries. It includes innovative use of already existing technology (External Hard Drive) and Centralized Technical Support Team (CTST).