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Hoerter JE, Debbaneh PM, Jiang NK. Differences in Patient Secure Message Volume Among Otolaryngologists: A Retrospective Cohort Study. Ann Otol Rhinol Laryngol 2024:34894241264114. [PMID: 39054802 DOI: 10.1177/00034894241264114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To identify differences in inbox and secure message burden among otolaryngologists based on demographics and subspecialty over 4 years. METHODS Inbox data were queried from January 2019 until December 2022. Otolaryngologists were categorized into cohorts by area of practice and gender. All inbox tasks, secure messages, and clinical encounters were collected and compared by gender, practice type, and years in practice. Means were compared using t-tests and chi-squared tests. RESULTS Of the 128 physicians, 45.7% were comprehensive otolaryngologists and 61.3% were male. The most common subspecialties were facial plastics (15.6%), oncology (8.6%), and otology (7.8%). Otolaryngologists had an average of 143.5 inbox tasks per month, with 97.2 (67.7%) of them being secure messages, resulting in an average of 1.14 inbox tasks and 0.80 secure messages per clinical encounter. The ratio of secure messages per clinical encounter was consistent across all specialties except oncology (1.10, P = .003). Otology (0.86, P = .032) and facial plastics (0.95, P = .028) had significantly lower ratios of inbox tasks to clinical encounters when compared to their colleagues, while oncology had a higher ratio (1.70, P < .001). No significant differences in inbox burden were observed between genders, years in practice, or languages spoken. Secure messages steadily increased over the study period. CONCLUSION Inbox burden for otolaryngologists primarily stems from patient secure messages and varies across subspecialties. Considerations should be made to the inbox burden of head and neck oncologists. The implementation of support systems for inbox management could improve the imbalance between clinical and non-clinical responsibilities in otolaryngology. LEVEL OF EVIDENCE Level III, Retrospective Cohort Study.
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Affiliation(s)
- Jacob E Hoerter
- Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Peter M Debbaneh
- Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Nancy K Jiang
- Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
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2
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Vessa B, Malhotra R, Chemerinski A, Howard D, Morelli S. One Result, Many Eyes: Creating a Results Safety Net in a University Hospital-Based Reproductive Endocrinology and Infertility Clinic. Am J Med Qual 2024; 39:135-136. [PMID: 38713603 DOI: 10.1097/jmq.0000000000000170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Affiliation(s)
- Blake Vessa
- PGY4 Obstetrics and Gynecology Resident, Rutgers Health/Cooperman Barnabas Medical Center, Newark and Livingston, NJ
| | - Radhika Malhotra
- PGY1 Internal Medicine Resident, New Jersey Medical School, Newark, NJ
| | - Anat Chemerinski
- PGY7 Reproductive Endocrinology and Infertility Fellow, New Jersey Medical School/University Reproductive Associates, Newark and Hasbrouk Heights, NJ
| | - David Howard
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, NJ
| | - Sara Morelli
- Reproductive Endocrinology and Infertility Fellowship New Jersey Medical School/University Reproductive Associates, Newark and Hasbrouk Heights, NJ
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3
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Berger L, Cramer E, WEIß C, Sütterlin M, Spaich S. Patient Preferences With Regard to Care Structures for Cervical or Vulvar Dysplasia in Certified Dysplasia Clinics in Germany. In Vivo 2023; 37:2244-2252. [PMID: 37652527 PMCID: PMC10500514 DOI: 10.21873/invivo.13326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/31/2023] [Accepted: 06/09/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM The aim of this study was to evaluate patient preferences regarding cervical dysplasia clinics. Specifically, preferences in terms of diagnostic and therapeutic pathways as well as logistical and structural aspects were addressed to recognize unmet needs and improve existing structures of cervical dysplasia care. PATIENTS AND METHODS This questionnaire-based study was conducted between June and December 2022 at an academic medical center in Southwestern Germany. A total of 226 patients who had an appointment at the certified dysplasia clinic were included. RESULTS The vast majority of patients (74.8%) preferred counseling at the certified dysplasia clinic in the case of an abnormal finding of the cervix or labia. A prompt appointment (within a maximum of 4 weeks), a timely notification about test results (within a maximum of 2 weeks), a travel time <60 minutes and seeing the same doctor during follow-up appointments were recognized as important aspects. While about half of the patients (53.5%) were indifferent to the sex of the gynecologist, almost all of the remaining patients stated they would prefer to be seen by a female doctor (44.3% female doctor vs. 2.2% male doctor). CONCLUSION Most women expect very timely appointments and result notifications. Moreover, they favor short travel times and continuity of care. The identified patient preferences should be considered to increase patient satisfaction and quality of care when developing and optimizing management at specialized dysplasia clinics.
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Affiliation(s)
- Laura Berger
- Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany;
| | - Elke Cramer
- Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Christel WEIß
- Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marc Sütterlin
- Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Saskia Spaich
- Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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Lynch JA, Idleburg MJ, Butsch Kovacic M, Childers-Buschle KE, Dufendach KR, Lipstein EA, McGowan ML, Myers MF, Prows CA. Developing video education materials for the return of genomic test results to parents and adolescents. PEC INNOVATION 2022; 1:100051. [PMID: 36532300 PMCID: PMC9757811 DOI: 10.1016/j.pecinn.2022.100051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To describe the development, implementation, and revision of a video to provide information about genomic testing and the return of genomic research results to adolescents and parents. METHODS Formative, community-engaged research was conducted in three stages: development, implementation, and revision. Existing research participant advisory groups were used for focus groups and convenience sampling was used for interviews. Participants included parents, young adults without children, and adolescents. Transcripts of recorded sessions were used for formative analysis. RESULTS Video was the preferred format for delivering genomic testing information to adolescents during the development stage. During implementation, adolescents identified video length as an impediment to recall. During the revision stage, participants preferred the video in separate short segments, supported plan to require only one short video and leaving other short videos optional. Participants were divided on whether the required short video provided enough information, but all participants reported that watching additional videos would not have changed their decisions about receiving test results. CONCLUSION Genomic education videos should be brief (<4 mins) to improve the odds that participants will view the entirety of any required video. INNOVATION The development of participant materials should incorporate plans for monitoring implementation and plans for revising materials.
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Affiliation(s)
- John A. Lynch
- Department of Communication, College of Arts & Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Michaela J. Idleburg
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Melinda Butsch Kovacic
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Rehabilitation, Exercise, and Nutrition Science, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
| | | | - Kevin R. Dufendach
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Ellen A. Lipstein
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Michelle L. McGowan
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Women’s, Gender & Sexuality Studies, College of Arts & Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Melanie F. Myers
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Cynthia A. Prows
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
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5
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Johnson KM, Esselmann J, Purdy AC, Jorns JM. Patient Use of Pathology Reports via Online Portals. Arch Pathol Lab Med 2022; 146:1053-1055. [PMID: 35802939 DOI: 10.5858/arpa.2021-0579-ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Kimberly M Johnson
- From the Department of Pathology, Penrose-St Francis Health Services, Colorado Springs, Colorado (Johnson)
| | - Jennifer Esselmann
- From the Department of Oncology (Esselmann), the Medical College of Wisconsin, Milwaukee
| | - Anna C Purdy
- From the Department of Surgery (Purdy), the Medical College of Wisconsin, Milwaukee
| | - Julie M Jorns
- From the Department of Pathology (Jorns), the Medical College of Wisconsin, Milwaukee
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6
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Korngiebel DM, West KM. Patient Recommendations for the Content and Design of Electronic Returns of Genetic Test Results: Interview Study Among Patients Who Accessed Their Genetic Test Results via the Internet. JMIRX MED 2022; 3:e29706. [PMID: 37725563 PMCID: PMC10414314 DOI: 10.2196/29706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/26/2021] [Accepted: 01/29/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND Genetic test results will be increasingly made available electronically as more patient-facing tools are developed; however, little research has been done that collects data on patient preferences for content and design before creating results templates. OBJECTIVE This study identifies patient preferences for the electronic return of genetic test results, including what considerations should be prioritized for content and design. METHODS Following user-centered design methods, 59 interviews were conducted by using semistructured protocols. The interviews explored the content and design issues of patient portals that facilitated the return of test results to patients. We interviewed patients who received electronic results for specific types of genetics tests (pharmacogenetic tests, hereditary blood disorder tests, and tests for the risk of heritable cancers) or electronically received any type of genetic or nongenetic test results. RESULTS In general, many of participants felt that there always needed to be some clinician involvement in electronic result returns and that electronic coversheets with simple summaries would be helpful for facilitating this. Coversheet summaries could accompany, but not replace, the more detailed report. Participants had specific suggestions for such results summaries, such as only reporting the information that was the most important for patients to understand, including next steps, and doing so by using clear language that is free of medical jargon. Electronic result returns should also include explicit encouragement for patients to contact health care providers about questions. Finally, many participants preferred to manage their care by using their smartphones, particularly in instances when they needed to access health information on the go. CONCLUSIONS Participants recommended that a patient-friendly front section should accompany the more detailed report and made suggestions for organization, content, and wording. Many used their smartphones regularly to access test results; therefore, health systems and patient portal software vendors should accommodate smartphone app design and web portal design concomitantly when developing platforms for returning results.
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7
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Thomas J, Dahm MR, Li J, Georgiou A. Can patients contribute to enhancing the safety and effectiveness of test-result follow-up? Qualitative outcomes from a health consumer workshop. Health Expect 2020; 24:222-233. [PMID: 33283413 PMCID: PMC8077113 DOI: 10.1111/hex.13150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/21/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background Missed test‐results and failure to follow‐up test‐results are major patient safety concerns. Strategies to improve test‐results management have predominantly focused on clinician‐based interventions, with patients principally involved in studies of test‐result communication preferences, the impact of patient portals or experiences with reporting processes in primary care. Objective To identify consumer perspectives and experiences of the challenges they have faced with test‐results management, through consumer participation in qualitative data analysis. Design and participants Volunteers (n = 10) were recruited to participate in a health consumer reference group workshop on test‐results management. Prior to the workshop, consumers selected topics for discussion using a preference poll. During the workshop, consumers participated in qualitative data analysis of de‐identified excerpts of previously collected interview data discussing hospital test‐results management. Researchers (n = 5) guided consumers through the analytical process and discussion of themes. Discussions were audio‐recorded and transcribed for qualitative analysis. Results Consumer‐selected topics for discussion were ‘Transitions of Care’ and ‘Access’. Consumer data analysis prompted broader discussion including lived experiences. Following the workshop, a second level of content analysis pinpointed issues with implications for patient safety highlighting that consumers were astutely aware of macrolevel ‘Systems Factors’ relating to ‘Emergency Departments’ and the health system, as well as microlevel ‘Patient Factors’ (eg patient preferences and circumstances) which impact a patient's understanding during the ‘Communication’ (clinician to patient/between clinicians) of test‐results ‘Information’ (or lack thereof). Conclusions Consumers identified the challenges patients experience with test‐results management, and our findings highlight areas for potential improvement in patient safety. Patient or public contribution Ten health consumer volunteers actively participated in the test‐results management data analysis workshop conducted in this study. Two health consumers also volunteered to read and comment on the draft manuscript.
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Affiliation(s)
- Judith Thomas
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
| | - Maria R Dahm
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.,Institute for Communication in Health Care (ICH), College of Arts and Social Sciences, Australian National University, Canberra, ACT, Australia
| | - Julie Li
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
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8
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Burman ME. How Giving and Receiving Information Has Shaped My Cancer Journey. Ann Fam Med 2020; 18:555-557. [PMID: 33168685 PMCID: PMC7708289 DOI: 10.1370/afm.2588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/17/2020] [Accepted: 04/07/2020] [Indexed: 11/09/2022] Open
Abstract
I have been a nurse for 40 years and I now have metastatic breast cancer. I have learned a lot, especially about giving bad news, disclosing the diagnosis to others, and using the hospital's patient portal. First, how bad news is given to patients is important and should provide clear next steps for follow-up and treatment. Second, telling family, friends, and colleagues about a new cancer diagnosis is more challenging than you might expect. It is emotionally draining and time consuming, and support by primary care clinicians (PCCs) could make a difference. Finally, patient portals can be very beneficial, but their use in a complex diagnostic process like metastatic cancer can be problematic. Primary care clinicians should explicitly discuss use of portals with patients so that they receive the information they need in the way they want.
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Affiliation(s)
- Mary E Burman
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, Wyoming
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Lynch JA, Sharp RR, Aufox SA, Bland ST, Blout C, Bowen DJ, Buchanan AH, Halverson C, Harr M, Hebbring SJ, Henrikson N, Hoell C, Holm IA, Jarvik G, Kullo IJ, Kochan DC, Larson EB, Lazzeri A, Leppig KA, Madden J, Marasa M, Myers MF, Peterson J, Prows CA, Kulchak Rahm A, Ralston J, Milo Rasouly H, Scrol A, Smith ME, Sturm A, Stuttgen K, Wiesner G, Williams MS, Wynn J, Williams JL. Understanding the Return of Genomic Sequencing Results Process: Content Review of Participant Summary Letters in the eMERGE Research Network. J Pers Med 2020; 10:jpm10020038. [PMID: 32413979 PMCID: PMC7354464 DOI: 10.3390/jpm10020038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 01/26/2023] Open
Abstract
A challenge in returning genomic test results to research participants is how best to communicate complex and clinically nuanced findings to participants in a manner that is scalable to the large numbers of participants enrolled. The purpose of this study was to examine the features of genetic results letters produced at each Electronic Medical Records and Genomics (eMERGE3) Network site to assess their readability and content. Letters were collected from each site, and a qualitative analysis of letter content and a quantitative analysis of readability statistics were performed. Because letters were produced independently at each eMERGE site, significant heterogeneity in readability and content was found. The content of letters varied widely from a baseline of notifying participants that results existed to more detailed information about positive or negative results, as well as materials for sharing with family members. Most letters were significantly above the Centers for Disease Control-suggested reading level for health communication. While continued effort should be applied to make letters easier to understand, the ongoing challenge of explaining complex genomic information, the implications of negative test results, and the uncertainty that comes with some types of test and result makes simplifying letter text challenging.
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Affiliation(s)
- John A. Lynch
- Department of Communication, University of Cincinnati, Cincinnati, OH 45220, USA
- Correspondence:
| | | | - Sharon A. Aufox
- Center for Genomic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (S.A.A.); (C.H.)
| | - Sarah T. Bland
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (S.T.B.); (J.P.)
| | - Carrie Blout
- Harvard Pilgrim Health Care Institute, Boston, MA 02115, USA;
| | - Deborah J. Bowen
- Department of Bioethics and Humanities, School of Medicine, University of Washington, Seattle, WA 98195, USA;
| | - Adam H. Buchanan
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Colin Halverson
- School of Medicine, Indiana University-Purdue University, Indianapolis, IN 46202, USA;
| | - Margaret Harr
- Center for Applied Genomics, Children’s Hospital of Pennsylvania, Philadelphia, PA 19104, USA;
| | | | - Nora Henrikson
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - Christin Hoell
- Center for Genomic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (S.A.A.); (C.H.)
| | - Ingrid A. Holm
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA;
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Gail Jarvik
- Departments of Medicine (Medical Genetics) and Genome Sciences, University of Washington, Seattle, WA 98195, USA;
| | - Iftikhar J. Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA; (I.J.K.); (D.C.K.); (K.S.)
| | - David C. Kochan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA; (I.J.K.); (D.C.K.); (K.S.)
| | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
- Division of General Internal Medicine, University of Washington, Seattle, WA 98195, USA
| | - Amanda Lazzeri
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Kathleen A. Leppig
- Genetic Services, Kaiser Permanente of Washington, Seattle, WA 98101, USA;
- University of Washington Biomedical and Health Informatics, Seattle, WA 98195, USA
| | - Jill Madden
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Maddalena Marasa
- Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY 10032, USA; (M.M.); (H.M.R.)
| | - Melanie F. Myers
- College of Medicine, University of Cincinnati, Cincinnati, OH 45220, USA;
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Josh Peterson
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (S.T.B.); (J.P.)
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Cynthia A. Prows
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Alanna Kulchak Rahm
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - James Ralston
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
- University of Washington Biomedical and Health Informatics, Seattle, WA 98195, USA
| | - Hila Milo Rasouly
- Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY 10032, USA; (M.M.); (H.M.R.)
| | - Aaron Scrol
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente of Washington, Seattle, WA 98101, USA; (N.H.); (E.B.L.); (J.R.); (A.S.)
| | - Maureen E. Smith
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | - Amy Sturm
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Kelsey Stuttgen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA; (I.J.K.); (D.C.K.); (K.S.)
| | - Georgia Wiesner
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
- Vanderbilt Clinical and Translational Hereditary Cancer Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Marc S. Williams
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
| | - Julia Wynn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10027, USA;
| | - Janet L. Williams
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA; (A.H.B.); (A.L.); (A.K.R.); (A.S.); (M.S.W.); (J.L.W.)
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10
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Edmonds S, Lou Y, Robinson B, Cram P, Roblin DW, Wright NC, Saag K, Wolinsky FD. Characteristics of older adults using patient web portals to view their DXA results. BMC Med Inform Decis Mak 2019; 19:187. [PMID: 31533717 PMCID: PMC6751667 DOI: 10.1186/s12911-019-0904-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 08/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background Sharing test results with patients via patient web portals is a new trend in healthcare. No research has been done examining patient web portal use with bone density test results. The objective of our study was to identify patient characteristics associated with the use of patient web portals to view their bone density test results. Methods A secondary analysis of data from a pragmatic randomized controlled trial of 7749 participants ≥50 years old that had presented for a dual energy X-ray absorptiometry (DXA) bone density test. Patients were interviewed at enrollment and 12 weeks later. Multivariable logistic regression identified patient characteristics that differentiated those who used the web portal from those who did not. Results Our sample included 4669 patients at the two (University of Iowa [UI], and Kaiser Permanente of Georgia [KPGA]) clinical sites that had patient web portals. Of these patients, 3399 (72.8%) reported knowing their test results 12 weeks post-DXA, with 649 (13.9%) reporting that they viewed their DXA results using the web portal. Web portal users were more likely to be from UI than KPGA, and were younger, more educated, had higher health literacy, had osteopenia, and had the same sex as their referring physician (all p < 0.05). Conclusion Only 19.1% of the 3399 patients who knew their DXA results used the available patient web portals to find out about them. Web portal users differed from non-users on several characteristics. This suggests that simply making patient web portals available for use may not be sufficient to appreciably enhance patient awareness of their test results. Based on these findings, a better understanding of the reasons why older, less educated, and less activated patients do not access their test results through patient web portals is needed.
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Affiliation(s)
- Stephanie Edmonds
- Carver College of Medicine, Department of Internal Medicine, University of Iowa, 200 Newton Rd. 5231 WL, Iowa City, IA, 52242, USA. .,CADRE, Iowa City VA Health System, Iowa City, IA, USA.
| | - Yiyue Lou
- College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Brandi Robinson
- Kaiser Permanente, Center for Clinical and Outcomes Research, Atlanta, GA, USA
| | - Peter Cram
- College of Medicine, Department of Internal Medicine, University of Toronto, Toronto, Canada.,University of Toronto Health Network, Toronto, Canada
| | | | - Nicole C Wright
- School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Kenneth Saag
- School of Medicine, Department of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Fredric D Wolinsky
- Carver College of Medicine, Department of Internal Medicine, University of Iowa, 200 Newton Rd. 5231 WL, Iowa City, IA, 52242, USA.,College of Public Health, Department of Health Management and Policy, University of Iowa, Iowa City, IA, USA.,College of Nursing, University of Iowa, Iowa City, IA, USA
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11
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Sieving RE, Gewirtz O'Brien JR, Saftner MA, Argo TA. Sexually Transmitted Diseases Among US Adolescents and Young Adults: Patterns, Clinical Considerations, and Prevention. Nurs Clin North Am 2019; 54:207-225. [PMID: 31027662 DOI: 10.1016/j.cnur.2019.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article describes prevalence and recent trends in the most common sexually transmitted diseases (STD) among young people in the United States. Common clinical presentations and best practices related to screening and treatment of these conditions are summarized. Clinical considerations for working with adolescents and young adults in the area of sexual and reproductive health are highlighted. Key approaches for sexually transmitted disease prevention with adolescents and young adults are presented.
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Affiliation(s)
- Renee E Sieving
- School of Nursing and Department of Pediatrics, University of Minnesota, University of MN School of Nursing, 5-140 Weaver Densford Hall, 308 Harvard Street Southeast, Minneapolis, MN 55455, USA.
| | - Janna R Gewirtz O'Brien
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware Street Southeast Suite 353, Minneapolis, MN 55414, USA
| | - Melissa A Saftner
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard Street Southeast, Minneapolis, MN 55455, USA
| | - Taylor A Argo
- Department of Pediatrics, Pediatric Education Office, University of Minnesota, Room M136, 1st Floor, East Building, 2450 Riverside Avenue, Minneapolis, MN 55454, USA
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12
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Breast Arterial Calcification in the Mammogram Report: The Patient Perspective. AJR Am J Roentgenol 2019; 212:209-214. [DOI: 10.2214/ajr.18.20171] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Schultz CL, Alderfer MA. Are on-line patient portals meeting test result preferences of caregivers of children with cancer? A qualitative exploration. Pediatr Blood Cancer 2018; 65:e27306. [PMID: 30007016 DOI: 10.1002/pbc.27306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Management of pediatric cancer entails frequent laboratory and radiology testing to monitor response to treatment, side effects, and possible relapse of disease. Little is known about how caregivers of children with cancer would like to receive results of these tests and whether on-line patient portals may meet those preferences. PROCEDURES One-on-one semistructured interviews were conducted with 19 caregivers of children with cancer purposively sampled for breadth on demographic characteristics. Inductive qualitative content coding/analysis was utilized to distill caregiver's preferred methods for test result acquisition and their views of using an on-line patient portal to do so. RESULTS The relative prioritization of speed of information and mode of communication (i.e., "in person," by phone, etc.) revealed three preference styles. Factors including type of testing, type of result, and the time course within their child's care modified these preferences, and the desire to reduce anxiety played a central role. Caregivers recognized advantages of portal use including getting results "fast," being able to visualize trends in results, "keeping a record," and not interfering with clinic flow. Perceived disadvantages included the results being "complicated" or easily misunderstood, and learning results prior to disclosure by care team. CONCLUSION This study provides insight into the importance of understanding of how caregivers want test results and how they utilize the portal. Preferences for result acquisition vary on many factors and include the desire to decrease anxiety. As portal use increases, we have a duty to integrate this technology responsibly.
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Affiliation(s)
- Corinna L Schultz
- Nemours Center for Cancer and Blood Disorders, Wilmington, Delaware.,Nemours/AI duPont Hospital for Children & Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Melissa A Alderfer
- Nemours/AI duPont Hospital for Children & Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.,Center for Healthcare Delivery Sciences, Wilmington, Delaware
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Shah SD, Liebovitz D. It Takes Two to Tango: Engaging Patients and Providers With Portals. PM R 2018; 9:S85-S97. [PMID: 28527507 DOI: 10.1016/j.pmrj.2017.02.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 11/20/2022]
Abstract
Patient portals are designed to be tools to more fully engage patients in their health care and help enable them to better manage their own health information. As the U.S. health care system rapidly adopted electronic health records (EHRs) over the past decade, many with linked patient portals, enthusiasm and expectations for this new technology as a means to engage and empower patients grew. Most patient portals have a set of core features designed to facilitate health care transactions, information tracking, and communication with care team members. The evidence supporting the anticipated benefits of patient portals on patient outcomes, however, remains mixed and incomplete. Moreover, a paradox exists in that, despite a high consumer interest in patient portals, widespread adoption remains relatively low. Potential reasons include the need for greater provider endorsement, examination and adaptation of clinical workflows, and the recognition of patient engagement as a reciprocal process.
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Affiliation(s)
- Sachin D Shah
- Departments of Medicine and Pediatrics, University of Chicago, 5841 S. Maryland Ave, MC 3051, Chicago, IL 60637(∗).
| | - David Liebovitz
- Department of Medicine, University of Chicago, Chicago, IL(†)
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Alpert JM, Morris BB, Thomson MD, Matin K, Brown RF. Implications of Patient Portal Transparency in Oncology: Qualitative Interview Study on the Experiences of Patients, Oncologists, and Medical Informaticists. JMIR Cancer 2018; 4:e5. [PMID: 29581090 PMCID: PMC5891668 DOI: 10.2196/cancer.8993] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/04/2017] [Accepted: 12/23/2017] [Indexed: 12/16/2022] Open
Abstract
Background Providing patients with unrestricted access to their electronic medical records through patient portals has impacted patient-provider communication and patients’ personal health knowledge. However, little is known about how patient portals are used in oncology. Objective The aim of this study was to understand attitudes of the portal’s adoption for oncology and to identify the advantages and disadvantages of using the portal to communicate and view medical information. Methods In-depth semistructured interviews were conducted with 60 participants: 35 patients, 13 oncologists, and 12 medical informaticists. Interviews were recorded, transcribed, and thematically analyzed to identify critical incidents and general attitudes encountered by participants. Results Two primary themes were discovered: (1) implementation practices influence attitudes, in which the decision-making and execution process of introducing portals throughout the hospital did not include the input of oncologists. Lack of oncologists’ involvement led to a lack of knowledge about portal functionality, such as not knowing the time period when test results would be disclosed to patients; (2) perceptions of portals as communication tools varies by user type, meaning that each participant group (patients, oncologists, and medical informaticists) had varied opinions about how the portal should be used to transmit and receive information. Oncologists and medical informaticists had difficulty understanding one another’s culture and communication processes in their fields, while patients had preferences for how they would like to receive communication, but it largely depended upon the type of test being disclosed. Conclusions The majority of patients (54%, 19/35) who participated in this study viewed lab results or scan reports via the portal before being contacted by a clinician. Most were relatively comfortable with this manner of disclosure but still preferred face-to-face or telephone communication. Findings from this study indicate that portal education is needed for both patients and oncologists, especially when portals are implemented across entire health systems since highly specialized areas of medicine may have unique needs and uses. Patient portals in oncology can potentially alter the way diagnoses are delivered and how patients and oncologists communicate. Therefore, communication about the portal should be established during initial consultations so patients can decide whether they want to be informed in such a manner.
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Affiliation(s)
- Jordan M Alpert
- Department of Advertising, University of Florida, Gainesville, FL, United States
| | - Bonny B Morris
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Maria D Thomson
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Khalid Matin
- Division of Hematology and Oncology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Richard F Brown
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
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Roblin DW, Cram P, Lou Y, Edmonds SW, Hall SF, Jones MP, Saag KG, Wright NC, Wolinsky FD. Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study. Arch Osteoporos 2018; 13:4. [PMID: 29307094 PMCID: PMC7409367 DOI: 10.1007/s11657-017-0402-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 11/13/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Calcium and vitamin D intake and exercise are suboptimal among older adults. Following bone densitometry, a letter communicating individualized fracture risk accompanied by an educational brochure improved participants' lifestyle-but no more than existing communication strategies-over 52 weeks. Simple communication strategies are insufficient for achieving optimal levels of bone health behaviors. PURPOSE The Patient Activation After DXA Result Notification (PAADRN) study was designed to evaluate whether a letter with individualized fracture risk and an educational brochure mailed to patients soon after their DXA might improve bone health behaviors (daily calcium intake, vitamin D supplementation, and weekly exercise sessions) compared to slower, less individualized communication characterizing usual care. METHODS Participants ≥ 50 years were recruited, at three sites, following their DXA and randomized with 1:1 allocation to intervention and control (usual care only) groups. Data were collected at enrollment interview and by phone survey at 12 and 52 weeks thereafter. Intention-to-treat analyses were conducted on 7749 of the 20,397 eligible participants who enrolled. Changes in bone health behaviors were compared within and between study groups. Average treatment effects and heterogeneity of treatment effects were estimated with multivariable linear and logistic regression models. RESULTS In unadjusted analyses, calcium intake, vitamin D supplementation, and weekly exercise sessions increased significantly over 52 weeks within both the intervention and control groups (all p < 0.001). In unadjusted analyses and multivariable models, increases in each behavior did not significantly differ between the intervention and control groups. Intervention group participants with a > 20% 10-year fracture risk at enrollment did, however, have a significantly greater increase in calcium intake compared to other study participants (p = 0.031). CONCLUSIONS Bone health behaviors improved, on average, over 52 weeks among all participants following a DXA. Receipt of the PAADRN letter and educational brochure did not directly improve bone health behaviors compared to usual care. TRIAL REGISTRATION The Patient Activation after DXA Result Notification (PAADRN) Study is registered at ClinicalTrials.Gov: NCT01507662, https://clinicaltrials.gov/ct2/show/NCT01507662.
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Affiliation(s)
- Douglas W. Roblin
- Mid-Atlantic Permanente Research Institute, 2101 East Jefferson St., 3 West, Rockville, MD 20852, USA,Center for Clinical and Outcomes Research, Kaiser Permanente, Atlanta, GA, USA
| | - Peter Cram
- Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA,Faculty of Medicine, University of Toronto, Toronto, Canada,Division of General Internal Medicine and Geriatrics, Mt. Sinai/UHN Hospitals, Toronto, Canada
| | - Yiyue Lou
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Stephanie W. Edmonds
- Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA,College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Sylvie F. Hall
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Michael P. Jones
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Kenneth G. Saag
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nicole C. Wright
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fredric D. Wolinsky
- Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA,College of Nursing, University of Iowa, Iowa City, IA, USA,Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, USA
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Rounds JA, Merianos AL, Bernard AL. Cardiometabolic risk factors and MyChart enrollment among adult patients. HEALTH POLICY AND TECHNOLOGY 2017. [DOI: 10.1016/j.hlpt.2017.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Cram P, Saag KG, Lou Y, Edmonds SW, Hall SF, Roblin DW, Wright NC, Jones MP, Wolinsky FD. Racial Differences and Disparities in Osteoporosis-related Bone Health: Results From the PAADRN Randomized Controlled Trial. Med Care 2017; 55:561-568. [PMID: 28288074 PMCID: PMC5432397 DOI: 10.1097/mlr.0000000000000718] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Determining whether observed differences in health care can be called disparities requires persistence of differences after adjustment for relevant patient, provider, and health system factors. We examined whether providing dual-energy x-ray absorptiometry (DXA) test results directly to patients might reduce or eliminate racial differences in osteoporosis-related health care. DESIGN, SUBJECTS, AND MEASURES We analyzed data from 3484 white and 1041 black women who underwent DXA testing at 2 health systems participating in the Patient Activation after DXA Result Notification (PAADRN) pragmatic clinical trial (ClinicalTrials.gov NCT-01507662) between February 2012 and August 2014. We examined 7 outcomes related to bone health at 12 weeks and 52 weeks post-DXA: (1) whether the patient correctly identified their DXA baseline results; (2) whether the patient was on guideline-concordant osteoporosis pharmacotherapy; (3) osteoporosis-related satisfaction; (4) osteoporosis knowledge; (5 and 6) osteoporosis self-efficacy for exercise and for diet; and (7) patient activation. We examined whether unadjusted differences in outcomes between whites and blacks persisted after adjusting for patient, provider, and health system factors. RESULTS Mean age was 66.5 years and 29% were black. At baseline black women had less education, poorer health status, and were less likely to report a history of osteoporosis (P<0.001 for all). In unadjusted analyses black women were less likely to correctly identify their actual DXA results, more likely to be on guideline-concordant therapy, and had similar patient activation. After adjustment for patient demographics, baseline health status and other factors, black women were still less likely to know their actual DXA result and less likely to be on guideline-concordant therapy, but black women had greater patient activation. CONCLUSIONS Adjustment for patient and provider level factors can change how racial differences are viewed, unmasking new disparities, and providing explanations for others.
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Affiliation(s)
- Peter Cram
- Department of Medicine, University of Toronto, Toronto, Canada
- Division of General Internal Medicine and Geriatrics, Mt. Sinai/UHN Hospitals, Toronto, Canada
- Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Kenneth G. Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL
| | - Yiyue Lou
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA
| | - Stephanie W. Edmonds
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA
- University of Iowa College of Nursing, Iowa City, IA
- CADRE, Iowa City VA Healthcare System, Iowa City, IA
| | - Sylvie F. Hall
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA
| | - Douglas W. Roblin
- Kaiser Permanente, Atlanta, GA
- School of Public Health, Georgia State University, Atlanta, GA
| | - Nicole C. Wright
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Michael P. Jones
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA
| | - Fredric D. Wolinsky
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA
- University of Iowa College of Nursing, Iowa City, IA
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Boggan JC, Swaminathan A, Thomas S, Simel DL, Zaas AK, Bae JG. Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module. J Grad Med Educ 2017; 9:195-200. [PMID: 28439353 PMCID: PMC5398151 DOI: 10.4300/jgme-d-16-00460.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/30/2016] [Accepted: 11/13/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. OBJECTIVE This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. METHODS We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback. Residents performed audits of ambulatory patients requiring laboratory or radiologic testing by means of a shared online interface. The intervention consisted of an educational module viewed with initial audits, development of a personalized improvement plan after Phase 1, and repeated real-time feedback of individual relative performance compared at clinic and program levels. Outcomes included results communicated within 14 days and prespecified "significant" results communicated within 72 hours. RESULTS A total of 76 of 86 eligible residents (88%) reviewed 1713 individual ambulatory patients' charts in Phase 1, and 73 residents (85%) reviewed 1509 charts in Phase 2. Follow-up rates were higher in Phase 2 than Phase 1 for communicating results within 14 days and significant results within 72 hours (85% versus 78%, P < .001; and 82% versus 70%, P = .002, respectively). Communication of "significant" results was more likely to occur via telephone, compared with communication of nonsignificant results. CONCLUSIONS Participation in a shared audit and feedback quality improvement project can improve rates of resident follow-up and communication of results, although communication gaps remained.
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Capsule Commentary on Shultz et al., Patient Preferences for Test Result Notification. J Gen Intern Med 2015; 30:1698. [PMID: 26080751 PMCID: PMC4617946 DOI: 10.1007/s11606-015-3433-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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