MO1053: Development of Home Dialysis Patient Support System Using Cloud System I––System Development and Evaluation
Authors: Umeda Tokuo , Okawa Akiko , Kobayashi Natsumi , Sekine Yuki 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Due to COVID-19 and the aging of the Japanese population, it is becoming increasingly difficult for patients to travel to medical facilities. Although the utilization rate of communication networks and devices for the elderly is low, many people of all ages are now using the Internet. However, in Japan, there are no computer systems that directly connect medical institutions and people’s homes because of the restricted connection of medical institutions to the Internet. Therefore, the utilization rate of the medical support system for home-based patients using the Internet is not high.
We have been developing a remote medical support system for home-based patients that is both safe and secure. Here, we focused on exercise support for dialysis patients at home, and developed and evaluated a dialysis patient exercise support system that can efficiently share information between patients and medical facilities regardless of where and when dialysis or exercise is performed.

METHOD
A system for sharing medical information was developed in the PHP programming language to use the Microsoft Azure cloud service. Figure 1 shows a schematic diagram of the developed system. All patient record data can be entered via drop-down menus. In addition, drainage packs and meal menus can be registered as images of up to 3 MB in size in the developed system. Pedaling exercise was added to this system. Patients used an ergometer to perform pedaling exercises, which allowed the amount of pedaling to be automatically entered into the system. A dynamo was connected to the ergometer to store electricity, which could be used to charge mobile devices and promote continuous exercise.
The developed system was evaluated by volunteers, consisting of 12 females and 4 males in their 20s, 2 males in their 30s, 1 female and 1 male in their 40s and 1 female and 2 males in their 50s. Web usability was assessed by task execution rate and the website usability scale (WUS).
Data were captured directly from the ergometer into records of the patient's exercises.

RESULTS
The developed system allows medical professionals to view patient biometric data. The patients exercised with an ergometer, and the exercise data were automatically imported from the ergometer directly into the developed system in CSV format via e-mail. The amount of exercise could also be entered manually using the drop-down menus. These numerical data could also be displayed as a graph, thus making it possible to visually capture changes over time. In addition, as the amount of electricity obtained from exercise can be stored, it can be used to charge mobile devices.
There was no erroneous input because there was no keyboard input for data entry, and the subjects’ task completion rate was 100%. The system developed in this study can also be used by patients who are unfamiliar with personal computers. The second use of the developed system was easier than the first, and the evaluation of the patients was high. According to the WUS evaluation results in Figure 2f, the item with the greatest difference according to age group was ‘display’. The highest rated item was ‘response’. The average total evaluation for all age groups was ∼3.5, so further improvements are required for the display in the developed system.

CONCLUSION
We have added a function to encourage continuous exercise using an ergometer to our support system for home dialysis patients. The developed system not only allows home-based patient dialysis information to be input, output and displayed without errors, but also allows healthcare professionals to remotely check the data using graphs and photographs. In addition, it was possible to convert the exercise performed by the patient into electrical power that could be used to charge mobile devices, thus supporting the continuation of exercise for dialysis patients.
This research was supported in part by Gakushin Kaken (JP18K19710, JP20H03982).