MO1047DEVELOPMENT OF A HOME CARE SUPPORT SYSTEM FOR PERITONEAL DIALYSIS PATIENTS II - MEDICAL INFORMATION SHARING CLOUD SYSTEM AND ITS EVALUATION
Authors: Okawa Akiko , Umeda Tokuo , Kobayashi Natsumi 
Published: May 2021

Abstract

Background and Aims
COVID-19 and the aging of the Japanese population are increasing the number of people requiring peritoneal dialysis at home. However, the rate of computer system utilization among the elderly is low in Japan, and the Ministry of Health, Labour and Welfare (MHLW) of Japan is currently considering permission for telemedicine. Therefore, home care support systems for home peritoneal dialysis patients are not sufficient, and even if a patient desires home medical care it may not be possible.
The MHLW emphasized the need for home care patients to share information with medical institutions and improve quality of life (QOL), including COVID-19 measures. Therefore, we have built a system that allows home-based peritoneal dialysis patients and medical institutions to share medical information and provide home-based care with peace of mind. Here, we also discuss evaluation of the developed system.

Method
A system for sharing medical information was developed in the PHP programming language on a personal computer system using Microsoft Azure cloud services, including databases and a social networking service (SNS). In the developed system, medical information, affected area, and photographs of meal contents for each patient can be uploaded and visually confirmed. The patient’s vital records can also be visually confirmed on a graph. In addition, it is possible for patients to share opinions and treatment schedules with the medical staff of medical institutions.
The developed system was evaluated by 12 simulated patients consisting of one woman and four men in their 20s, two men in their 30s, one woman and one man in their 40s, and one woman and two men in their 50s. The evaluation items were task achievement and Web usability evaluation scale (WUS). The characteristics of each age group were analyzed according to the WUS. The medical information in this system was shared using SNS, which could only be accessed by invitation.

Results
The information exchange system allowed the medical staff at the institute to receive and respond to the opinions of patients. In addition, medical staff were able to share important patient data. Figure 1 shows an example of the developed system displayed on the patient side (a) and on the medical staff side (b) at the institute. The patient filled in each item and uploaded photographs if necessary. The medical staff at the institute were able to view the medical information and uploaded photographs of each patient.
One subject required a manual to operate the system, but the task completion rate was 100%. The system developed in this study could also be used by patients in age groups unfamiliar with personal computers. With the continued adoption of Internet access, the developed system built using a web application framework has been well received by patients.
The WUS evaluation results are shown in Fig. 2. Subjects in their 20s showed the greatest increase in overall judgment of 4.0 in the 5-point WUS. The item showing differences between age groups was “display.” The standard deviation of “useful” was small, about 3.5 for all age groups. Using the system a second time was easier for the users than the first time. In addition, clinical evaluations showed that use of this system allowed home-based patients to be treated in the same way as those in hospital.

Conclusion
When using the system developed in this study, there was no relationship between age group and task achievement. The overall result of the 5-point WUS was very high (4.0). The system developed here can be recommended for use by home patients. The patient was able to receive almost the same treatment as in the hospital while at home. As a result, the system developed here can be used for treatment of peritoneal dialysis patients at home.