1
|
van Kessel R, Ranganathan S, Anderson M, McMillan B, Mossialos E. Exploring potential drivers of patient engagement with their health data through digital platforms: A scoping review. Int J Med Inform 2024; 189:105513. [PMID: 38851132 DOI: 10.1016/j.ijmedinf.2024.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/11/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Patient engagement when providing patient access to health data results from an interaction between the available tools and individual capabilities. The recent digital advancements of the healthcare field have altered the manifestation and importance of patient engagement. However, a comprehensive assessment of what factors contribute to patient engagement remain absent. In this review article, we synthesised the most frequently discussed factors that can foster patient engagement with their health data. METHODS A scoping review was conducted in MEDLINE, Embase, and Google Scholar. Relevant data were synthesized within 7 layers using a thematic analysis: (1) social and demographic factors, (2) patient ability factors, (3) patient motivation factors, (4) factors related to healthcare professionals' attitudes and skills, (5) health system factors, (6) technological factors, and (7) policy factors. RESULTS We identified 5801 academic and 200 Gy literature records, and included 292 (4.83%) in this review. Overall, 44 factors that can affect patient engagement with their health data were extracted. We extracted 6 social and demographic factors, 6 patient ability factors, 12 patient motivation factors, 7 factors related to healthcare professionals' attitudes and skills, 4 health system factors, 6 technological factors, and 3 policy factors. CONCLUSIONS Improving patient engagement with their health data enables the development of patient-centered healthcare, though it can also exacerbate existing inequities. While expanding patient access to health data is an important step towards fostering shared decision-making in healthcare and subsequently empowering patients, it is important to ensure that these developments reach all sectors of the community.
Collapse
Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands; Digital Public Health Task Force, Association of School of Public Health in the European Region (ASPHER), Brussels, Belgium.
| | | | - Michael Anderson
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
| |
Collapse
|
2
|
Jan C, He M, Vingrys A, Zhu Z, Stafford RS. Diagnosing glaucoma in primary eye care and the role of Artificial Intelligence applications for reducing the prevalence of undetected glaucoma in Australia. Eye (Lond) 2024:10.1038/s41433-024-03026-z. [PMID: 38514852 DOI: 10.1038/s41433-024-03026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/05/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
Glaucoma is the commonest cause of irreversible blindness worldwide, with over 70% of people affected remaining undiagnosed. Early detection is crucial for halting progressive visual impairment in glaucoma patients, as there is no cure available. This narrative review aims to: identify reasons for the significant under-diagnosis of glaucoma globally, particularly in Australia, elucidate the role of primary healthcare in glaucoma diagnosis using Australian healthcare as an example, and discuss how recent advances in artificial intelligence (AI) can be implemented to improve diagnostic outcomes. Glaucoma is a prevalent disease in ageing populations and can have improved visual outcomes through appropriate treatment, making it essential for general medical practice. In countries such as Australia, New Zealand, Canada, USA, and the UK, optometrists serve as the gatekeepers for primary eye care, and glaucoma detection often falls on their shoulders. However, there is significant variation in the capacity for glaucoma diagnosis among eye professionals. Automation with Artificial Intelligence (AI) analysis of optic nerve photos can help optometrists identify high-risk changes and mitigate the challenges of image interpretation rapidly and consistently. Despite its potential, there are significant barriers and challenges to address before AI can be deployed in primary healthcare settings, including external validation, high quality real-world implementation, protection of privacy and cybersecurity, and medico-legal implications. Overall, the incorporation of AI technology in primary healthcare has the potential to reduce the global prevalence of undiagnosed glaucoma cases by improving diagnostic accuracy and efficiency.
Collapse
Affiliation(s)
- Catherine Jan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.
- Ophthalmology, Department of Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
- Lost Child's Vision Project, Sydney, NSW, Australia.
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
- Ophthalmology, Department of Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye and Vision Research, The Hong Kong Polytechnic University, Kowloon, TU428, Hong Kong SAR
| | - Algis Vingrys
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
- Ophthalmology, Department of Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, VIC, Australia
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
- Ophthalmology, Department of Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Randall S Stafford
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
3
|
Baines R, Stevens S, Austin D, Anil K, Bradwell H, Cooper L, Maramba ID, Chatterjee A, Leigh S. Patient and Public Willingness to Share Personal Health Data for Third-Party or Secondary Uses: Systematic Review. J Med Internet Res 2024; 26:e50421. [PMID: 38441944 PMCID: PMC10951832 DOI: 10.2196/50421] [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: 06/30/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND International advances in information communication, eHealth, and other digital health technologies have led to significant expansions in the collection and analysis of personal health data. However, following a series of high-profile data sharing scandals and the emergence of COVID-19, critical exploration of public willingness to share personal health data remains limited, particularly for third-party or secondary uses. OBJECTIVE This systematic review aims to explore factors that affect public willingness to share personal health data for third-party or secondary uses. METHODS A systematic search of 6 databases (MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and SocINDEX) was conducted with review findings analyzed using inductive-thematic analysis and synthesized using a narrative approach. RESULTS Of the 13,949 papers identified, 135 were included. Factors most commonly identified as a barrier to data sharing from a public perspective included data privacy, security, and management concerns. Other factors found to influence willingness to share personal health data included the type of data being collected (ie, perceived sensitivity); the type of user requesting their data to be shared, including their perceived motivation, profit prioritization, and ability to directly impact patient care; trust in the data user, as well as in associated processes, often established through individual choice and control over what data are shared with whom, when, and for how long, supported by appropriate models of dynamic consent; the presence of a feedback loop; and clearly articulated benefits or issue relevance including valued incentivization and compensation at both an individual and collective or societal level. CONCLUSIONS There is general, yet conditional public support for sharing personal health data for third-party or secondary use. Clarity, transparency, and individual control over who has access to what data, when, and for how long are widely regarded as essential prerequisites for public data sharing support. Individual levels of control and choice need to operate within the auspices of assured data privacy and security processes, underpinned by dynamic and responsive models of consent that prioritize individual or collective benefits over and above commercial gain. Failure to understand, design, and refine data sharing approaches in response to changeable patient preferences will only jeopardize the tangible benefits of data sharing practices being fully realized.
Collapse
Affiliation(s)
- Rebecca Baines
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Sebastian Stevens
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Prometheus Health Technologies Ltd, Newquay, United Kingdom
| | - Daniela Austin
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | | | - Hannah Bradwell
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Leonie Cooper
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | | | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Simon Leigh
- Prometheus Health Technologies Ltd, Newquay, United Kingdom
- Warwick Medical School, University of Warwick, Conventry, United Kingdom
| |
Collapse
|
4
|
Gregory EF, Beidas RS, Fiks AG, Lorch SA, Levine LD, Rubin DM, Maddox AI, O'Sullivan AL, Wu KK, Cronholm PF. Acceptability of Dyad Care Management After Preterm Birth: A Qualitative Study. Matern Child Health J 2024; 28:351-361. [PMID: 37980700 DOI: 10.1007/s10995-023-03848-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES Care management programs for medically complex infants interact with parents after complicated pregnancies, when gaps in maternal health care are well documented. These care managers may have the relationships and skills to promote postpartum and interconception health and health care access. It is unknown whether expanding these care management models to address maternal needs would be acceptable. METHODS We conducted qualitative interviews with women with a history of preterm birth and clinicians. For women with a history of preterm birth, additional inclusion criteria were Medicaid-insured infant in one health system and English proficiency. We purposively oversampled women whose infants received care management. Clinicians worked in two geographically adjacent health systems. Interviews explored priorities after preterm birth and perceived acceptability of mother-infant dyad care management. Interviews were audio recorded, transcribed, and coded following an integrated approach in which we applied a priori codes and captured emergent themes. RESULTS We interviewed 33 women (10/2018-7/2021) and 24 clinicians (3/2021-8/2021). Women were predominantly non-Hispanic Black, and 15 had infants receiving care management. Clinicians included physicians, nurses, and social workers from Pediatrics, Obstetrics, and Family Medicine. Subgroups converged thematically, finding care management acceptable. Tailoring programs to address stress and sleep, emphasizing care managers with strong interpersonal skills and shared experiences with care management users, and program flexibility would contribute to acceptability. CONCLUSIONS FOR PRACTICE Dyad care management after preterm birth is acceptable to potential program end-users and clinicians. Dyad health promotion may contribute to improved birth outcomes, infant, and parent health.
Collapse
Affiliation(s)
- Emily F Gregory
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
| | - Rinad S Beidas
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Alexander G Fiks
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Scott A Lorch
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Lisa D Levine
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Research Program, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - David M Rubin
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Adya I Maddox
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Ann L O'Sullivan
- University of Pennsylvania School of Nursing, Philadelphia, PA, 19104, USA
| | - Katherine K Wu
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Peter F Cronholm
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
| |
Collapse
|
5
|
Sheng X, Martirosyan Y, Hossain KS, Felix R, Singh A. Unpacking the influencing factors of telehealth usage among older consumers. Health Mark Q 2024; 41:95-111. [PMID: 38032235 DOI: 10.1080/07359683.2023.2287927] [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] [Indexed: 12/01/2023]
Abstract
This research unpacks the challenges and motivations of telehealth usage among older consumers-an understudied population in the extant telehealth literature. Through surveying a sample of older consumers who regularly migrate to winter in the southern areas of the United States, our qualitative analysis uncovers motivations (i.e., convenience, ease of use, efficiency, and a forced option) and challenges (i.e., telehealth limitations, privacy concerns, and lack of trust, access, and skills) of older consumers' telehealth usage. Furthermore, logistic regression identifies attitude toward telehealth, gender, and health status as significant predictors of telehealth usage behavior. Contributions to theory and practice are also discussed.
Collapse
Affiliation(s)
- Xiaojing Sheng
- The University of Texas Rio Grande Valley - Edinburg Campus, Edinburg, Texas, USA
| | - Yuri Martirosyan
- The University of Texas Rio Grande Valley - Edinburg Campus, Edinburg, Texas, USA
| | | | - Reto Felix
- The University of Texas Rio Grande Valley - Edinburg Campus, Edinburg, Texas, USA
| | - Arjun Singh
- The University of Texas Rio Grande Valley - Edinburg Campus, Edinburg, Texas, USA
| |
Collapse
|
6
|
Madanian S, Nakarada-Kordic I, Reay S, Chetty T. Patients' perspectives on digital health tools. PEC INNOVATION 2023; 2:100171. [PMID: 37384154 PMCID: PMC10294099 DOI: 10.1016/j.pecinn.2023.100171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023]
Abstract
Objective Digital technology has changed the way healthcare is delivered and accessed. However, the focus is mostly on technology and clinical aspects. This review aimed to integrate and critically analyse the available knowledge regarding patients' perspectives on digital health tools and identify facilitators and barriers to their uptake. Methods A narrative review was conducted using the Scopus and Google Scholar databases. Information related to facilitators and barriers to uptake was synthesised and interpreted using thematic and content analyses, respectively. Results Seventy-one out of 1722 articles identified were eligible for inclusion. Patient empowerment, self-management, and personalisation were identified as the main factors that contributed to patient uptake in using digital health tools. Digital literacy, health literacy, and privacy concerns were identified as barriers to the uptake of digital health technology. Conclusion Digital health technologies have changed the way healthcare is experienced by patients. Research highlights the disconnect between the development and implementation of digital health tools and the patients they are created for. This review may serve as the foundation for future research incorporating patients' perspectives to help increase patients' engagement with emerging technologies. Innovation Participatory design approaches have the potential to support the creation of patient-centred digital health tools.
Collapse
Affiliation(s)
- Samaneh Madanian
- Department of Computer Science and Software Engineering, School of Engineering, Computer and Mathematical Science, Auckland University of Technology (AUT), 6 St. Paul Street, AUT WZ Building, Auckland 1010, New Zealand
| | - Ivana Nakarada-Kordic
- Good Health Design, School of Art and Design, Auckland University of Technology (AUT), 27 St. Paul Street, AUT WE Building, Auckland 1010, New Zealand
| | - Stephen Reay
- Good Health Design, School of Art and Design, Auckland University of Technology (AUT), 27 St. Paul Street, AUT WE Building, Auckland 1010, New Zealand
| | - T'heniel Chetty
- Good Health Design, School of Art and Design, Auckland University of Technology (AUT), 27 St. Paul Street, AUT WE Building, Auckland 1010, New Zealand
| |
Collapse
|
7
|
Tully LM, Nye KE, Ereshefsky S, Tryon VL, Hakusui CK, Savill M, Niendam TA. Incorporating Community Partner Perspectives on eHealth Technology Data Sharing Practices for the California Early Psychosis Intervention Network: Qualitative Focus Group Study With a User-Centered Design Approach. JMIR Hum Factors 2023; 10:e44194. [PMID: 37962921 PMCID: PMC10685281 DOI: 10.2196/44194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 07/26/2023] [Accepted: 09/23/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Increased use of eHealth technology and user data to drive early identification and intervention algorithms in early psychosis (EP) necessitates the implementation of ethical data use practices to increase user acceptability and trust. OBJECTIVE First, the study explored EP community partner perspectives on data sharing best practices, including beliefs, attitudes, and preferences for ethical data sharing and how best to present end-user license agreements (EULAs). Second, we present a test case of adopting a user-centered design approach to develop a EULA protocol consistent with community partner perspectives and priorities. METHODS We conducted an exploratory, qualitative, and focus group-based study exploring mental health data sharing and privacy preferences among individuals involved in delivering or receiving EP care within the California Early Psychosis Intervention Network. Key themes were identified through a content analysis of focus group transcripts. Additionally, we conducted workshops using a user-centered design approach to develop a EULA that addresses participant priorities. RESULTS In total, 24 participants took part in the study (14 EP providers, 6 clients, and 4 family members). Participants reported being receptive to data sharing despite being acutely aware of widespread third-party sharing across digital domains, the risk of breaches, and motives hidden in the legal language of EULAs. Consequently, they reported feeling a loss of control and a lack of protection over their data. Participants indicated these concerns could be mitigated through user-level control for data sharing with third parties and an understandable, transparent EULA, including multiple presentation modalities, text at no more than an eighth-grade reading level, and a clear definition of key terms. These findings were successfully integrated into the development of a EULA and data opt-in process that resulted in 88.1% (421/478) of clients who reviewed the video agreeing to share data. CONCLUSIONS Many of the factors considered pertinent to informing data sharing practices in a mental health setting are consistent among clients, family members, and providers delivering or receiving EP care. These community partners' priorities can be successfully incorporated into developing EULA practices that can lead to high voluntary data sharing rates.
Collapse
Affiliation(s)
- Laura M Tully
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Kathleen E Nye
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Sabrina Ereshefsky
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Valerie L Tryon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Christopher Komei Hakusui
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Mark Savill
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| |
Collapse
|
8
|
Watson E, Fletcher-Watson S, Kirkham EJ. Views on sharing mental health data for research purposes: qualitative analysis of interviews with people with mental illness. BMC Med Ethics 2023; 24:99. [PMID: 37964278 PMCID: PMC10648337 DOI: 10.1186/s12910-023-00961-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/24/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Improving the ways in which routinely-collected mental health data are shared could facilitate substantial advances in research and treatment. However, this process should only be undertaken in partnership with those who provide such data. Despite relatively widespread investigation of public perspectives on health data sharing more generally, there is a lack of research on the views of people with mental illness. METHODS Twelve people with lived experience of mental illness took part in semi-structured interviews via online video software. Participants had experience of a broad range of mental health conditions including anxiety, depression, schizophrenia, eating disorders and addiction. Interview questions sought to establish how participants felt about the use of routinely-collected health data for research purposes, covering different types of health data, what health data should be used for, and any concerns around its use. RESULTS Thematic analysis identified four overarching themes: benefits of sharing mental health data, concerns about sharing mental health data, safeguards, and data types. Participants were clear that health data sharing should facilitate improved scientific knowledge and better treatments for mental illness. There were concerns that data misuse could become another way in which individuals and society discriminate against people with mental illness, for example through insurance premiums or employment decisions. Despite this there was a generally positive attitude to sharing mental health data as long as appropriate safeguards were in place. CONCLUSIONS There was notable strength of feeling across participants that more should be done to reduce the suffering caused by mental illness, and that this could be partly facilitated by well-managed sharing of health data. The mental health research community could build on this generally positive attitude to mental health data sharing by following rigorous best practice tailored to the specific concerns of people with mental illness.
Collapse
Affiliation(s)
- Emily Watson
- University of Edinburgh Medical School, Edinburgh, UK
| | | | - Elizabeth Joy Kirkham
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
- Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
| |
Collapse
|
9
|
Ajayi KV, Olowolaju S, Bolarinwa OA, Onyeka H. Association between patient-provider communication and withholding information due to privacy concerns among women in the United States: an analysis of the 2011 to 2018 Health Information National Trends Survey. BMC Health Serv Res 2023; 23:1155. [PMID: 37880666 PMCID: PMC10601290 DOI: 10.1186/s12913-023-10112-7] [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: 04/22/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Electronic medical record software is common in healthcare settings. However, data privacy and security challenges persist and may impede patients' willingness to disclose health information to their clinicians. Positive patient-provider communication may foster patient trust and subsequently reduce information nondisclosure. This study sought to characterize information-withholding behaviors among women and evaluate the association between positive patient-provider communication and women's health information-withholding behavior in the United States. METHODS Data were pooled from the 2011 to 2018 Health Information National Trends Survey. We used descriptive statistics, bivariate, and logistic regression analyses to investigate whether positive patient-provider communication significantly impacted health information-withholding behaviors. Data from 7,738 women were analyzed. RESULTS About 10.8% or 1 in 10 women endorsed withholding health information from their providers because of privacy or security concerns about their medical records. After adjusting for the covariates, higher positive patient-provider communication scores were associated with lower odds of withholding information from the provider because of privacy and security concerns (aOR 0.93; 95% CI = 0.90-0.95). Additionally, we found that age, race/ethnicity, educational status, psychological distress, and smoking status significantly predicted women's willingness to disclose health information. CONCLUSIONS Findings suggest that improving positive patient-provider communication quality may reduce women's privacy and security concerns and encourage them to disclose sensitive medical information.
Collapse
Affiliation(s)
- Kobi V Ajayi
- Department of Health Behavior, School of Public Health, Texas A&M University College Station, College Station, TX, USA
| | - Samson Olowolaju
- Department of Demography, College for Health, Community and Policy, University of Texas, San Antonio, TX, USA
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St. John University, London, UK.
- Department of Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa.
| | - Henry Onyeka
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General/Mclean Hospital, Boston, MA, USA
| |
Collapse
|
10
|
Wagner AL, Zhang F, Ryan KA, Xing E, Nong P, Kardia SLR, Platt J. US Residents' Preferences for Sharing of Electronic Health Record and Genetic Information: A Discrete Choice Experiment. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1301-1307. [PMID: 36736697 PMCID: PMC10956475 DOI: 10.1016/j.jval.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/25/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The aim to this study was to assess preferences for sharing of electronic health record (EHR) and genetic information separately and to examine whether there are different preferences for sharing these 2 types of information. METHODS Using a population-based, nationally representative survey of the United States, we conducted a discrete choice experiment in which half of the subjects (N = 790) responded to questions about sharing of genetic information and the other half (N = 751) to questions about sharing of EHR information. Conditional logistic regression models assessed relative preferences across attribute levels of where patients learn about health information sharing, whether shared data are deidentified, whether data are commercialized, how long biospecimens are kept, and what the purpose of sharing the information is. RESULTS Individuals had strong preferences to share deidentified (vs identified) data (odds ratio [OR] 3.26, 95% confidence interval 2.68-3.96) and to be able to opt out of sharing information with commercial companies (OR 4.26, 95% confidence interval 3.42-5.30). There were no significant differences regarding how long biospecimens are kept or why the data are being shared. Individuals had a stronger preference for opting out of sharing genetic (OR 4.26) versus EHR information (OR 2.64) (P = .002). CONCLUSIONS Hospital systems and regulatory bodies should consider patient preferences for sharing of personal medical records or genetic information. For both genetic and EHR information, patients strongly prefer their data to be deidentified and to have the choice to opt out of sharing information with commercial companies.
Collapse
Affiliation(s)
- Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Felicia Zhang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kerry A Ryan
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Eric Xing
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Paige Nong
- Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jodyn Platt
- Department of Learning Health Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
11
|
Busch-Casler J, Radic M. Trust and Health Information Exchanges: Qualitative Analysis of the Intent to Share Personal Health Information. J Med Internet Res 2023; 25:e41635. [PMID: 37647102 PMCID: PMC10500360 DOI: 10.2196/41635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/12/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Digital health has the potential to improve the quality of care, reduce health care costs, and increase patient satisfaction. Patient acceptance and consent are a prerequisite for effective sharing of personal health information (PHI) through health information exchanges (HIEs). Patients need to form and retain trust in the system(s) they use to leverage the full potential of digital health. Germany is at the forefront of approving digital treatment options with cost coverage through statutory health insurance. However, the German population has a high level of technology skepticism and a low level of trust, providing a good basis to illuminate various facets of eHealth trust formation. OBJECTIVE In a German setting, we aimed to answer the question, How does an individual form a behavioral intent to share PHI with an HIE platform? We discussed trust and informed consent through (1) synthesizing the main influence factor models into a complex model of trust in HIE, (2) providing initial validation of influence factors based on a qualitative study with patient interviews, and (3) developing a model of trust formation for digital health apps. METHODS We developed a complex model of the formation of trust and the intent to share PHI. We provided initial validation of the influence factors through 20 qualitative, semistructured interviews in the German health care setting and used a deductive coding approach to analyze the data. RESULTS We found that German patients show a positive intent to share their PHI with HIEs under certain conditions. These include (perceived) information security and a noncommercial organization as the recipient of the PHI. Technology experience, age, policy and regulation, and a disposition to trust play an important role in an individual's privacy concern, which, combined with social influence, affects trust formation on a cognitive and emotional level. We found a high level of cognitive trust in health care and noncommercial research institutions but distrust in commercial entities. We further found that in-person interactions with physicians increase trust in digital health apps and PHI sharing. Patients' emotional trust depends on disposition and social influences. To form their intent to share, patients undergo a privacy calculus. Hereby, the individual's benefit (eg, convenience), benefits for the individual's own health, and the benefits for public welfare often outweigh the perceived risks of sharing PHI. CONCLUSIONS With the higher demand for timely PHI, HIE providers will need to clearly communicate the benefits of their solutions and their information security measures to health care providers (physicians, nursing and administrative staff) and patients and include them as key partners to increase trust. Offering easy access and educational measures as well as the option for specific consent may increase patients' trust and their intention to share PHI.
Collapse
Affiliation(s)
- Julia Busch-Casler
- Fraunhofer Center for International Management and Knowledge Economy IMW, Leipzig, Germany
| | - Marija Radic
- Fraunhofer Center for International Management and Knowledge Economy IMW, Leipzig, Germany
| |
Collapse
|
12
|
Schulz S, Harzheim L, Hübner C, Lorke M, Jünger S, Woopen C. Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants - a scoping review. BMC Med Ethics 2023; 24:68. [PMID: 37641094 PMCID: PMC10464431 DOI: 10.1186/s12910-023-00945-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals' lifeworlds and need to be considered in implant care and in the course of technical developments. METHODS This scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in patient-centered empirical research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data. RESULTS Sixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability. CONCLUSIONS Empirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in "lived experiences" may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design.
Collapse
Affiliation(s)
- Sabine Schulz
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931, Cologne, Germany.
| | - Laura Harzheim
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931, Cologne, Germany
| | - Constanze Hübner
- Center for Life Ethics, University of Bonn, 53113, Bonn, Germany
| | - Mariya Lorke
- Faculty of Engineering and Mathematics, University of Applied Sciences and Arts (HSBI), 33619, Bielefeld, Germany
| | - Saskia Jünger
- Department of Community Health, University of Applied Health Sciences Bochum, Gesundheitscampus 6-8, 44801, Bochum, Germany
| | | |
Collapse
|
13
|
Esmaeilzadeh P, Mirzaei T. Role of Incentives in the Use of Blockchain-Based Platforms for Sharing Sensitive Health Data: Experimental Study. J Med Internet Res 2023; 25:e41805. [PMID: 37594783 PMCID: PMC10474518 DOI: 10.2196/41805] [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: 08/15/2022] [Revised: 02/02/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Blockchain is an emerging technology that enables secure and decentralized approaches to reduce technical risks and governance challenges associated with sharing data. Although blockchain-based solutions have been suggested for sharing health information, it is still unclear whether a suitable incentive mechanism (intrinsic or extrinsic) can be identified to encourage individuals to share their sensitive data for research purposes. OBJECTIVE This study aimed to investigate how important extrinsic incentives are and what type of incentive is the best option in blockchain-based platforms designed for sharing sensitive health information. METHODS In this study, we conducted 3 experiments with 493 individuals to investigate the role of extrinsic incentives (ie, cryptocurrency, money, and recognition) in data sharing with research organizations. RESULTS The findings highlight that offering different incentives is insufficient to encourage individuals to use blockchain technology or to change their perceptions about the technology's premise for sharing sensitive health data. The results demonstrate that individuals still attribute serious risks to blockchain-based platforms. Privacy and security concerns, trust issues, lack of knowledge about the technology, lack of public acceptance, and lack of regulations are reported as top risks. In terms of attracting people to use blockchain-based platforms for data sharing in health care, we show that the effects of extrinsic motivations (cryptoincentives, money, and status) are significantly overshadowed by inhibitors to technology use. CONCLUSIONS We suggest that before emphasizing the use of various types of extrinsic incentives, the users must be educated about the capabilities and benefits offered by this technology. Thus, an essential first step for shifting from an institution-based data exchange to a patient-centric data exchange (using blockchain) is addressing technology inhibitors to promote patient-driven data access control. This study shows that extrinsic incentives alone are inadequate to change users' perceptions, increase their trust, or encourage them to use technology for sharing health data.
Collapse
Affiliation(s)
- Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Tala Mirzaei
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| |
Collapse
|
14
|
Torales J, O'Higgins M, Barrios I. Addiction psychiatry and psychiatry trainees: a still complicated relationship. Int Rev Psychiatry 2023; 35:503-505. [PMID: 38299656 DOI: 10.1080/09540261.2023.2275699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/23/2023] [Indexed: 02/02/2024]
Affiliation(s)
- Julio Torales
- Department of Medical Psychology, School of Medical Sciences, Universidad Nacional de Asunción, San Lorenzo, Paraguay
- Regional Institute of Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
- School of Medical Sciences, Universidad Sudamericana, Pedro Juan Caballero, Paraguay
| | - Marcelo O'Higgins
- Department of Medical Psychology, School of Medical Sciences, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Iván Barrios
- School of Medical Sciences, Universidad Sudamericana, Pedro Juan Caballero, Paraguay
- Department of Statistics, School of Medical Sciences, Santa Rosa Campus, Universidad Nacional de Asunción, Santa Rosa del Aguaray, Paraguay
| |
Collapse
|
15
|
Son EH, Nahm ES. Adult Patients' Experiences of Using a Patient Portal With a Focus on Perceived Benefits and Difficulties, and Perceptions on Privacy and Security: Qualitative Descriptive Study. JMIR Hum Factors 2023; 10:e46044. [PMID: 37490316 PMCID: PMC10411420 DOI: 10.2196/46044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/07/2023] [Accepted: 06/24/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Patient portals can facilitate patient engagement in care management. Driven by national efforts over the past decade, patient portals are being implemented by hospitals and clinics nationwide. Continuous evaluation of patient portals and reflection of feedback from end users across care settings are needed to make patient portals more user-centered after the implementation. OBJECTIVE The aim of this study was to investigate the lived experience of using a patient portal in adult patients recruited from a variety of care settings, focusing on their perceived benefits and difficulties of using the patient portal, and trust and concerns about privacy and security. METHODS This qualitative descriptive study was part of a cross-sectional digital survey research to examine the comprehensive experience of using a patient portal in adult patients recruited from 20 care settings from hospitals and clinics of a large integrated health care system in the mid-Atlantic area of the United States. Those who had used a patient portal offered by the health care system in the past 12 months were eligible to participate in the survey. Data collected from 734 patients were subjected to descriptive statistics and content analysis. RESULTS The majority of the participants were female and non-Hispanic White with a mean age of 53.1 (SD 15.34) years. Content analysis of 1589 qualitative comments identified 22 themes across 4 topics: beneficial aspects (6 themes) and difficulties (7 themes) in using the patient portal; trust (5 themes) and concerns (4 themes) about privacy and security of the patient portal. Most of the participants perceived the patient portal functions as beneficial for communicating with health care teams and monitoring health status and care activities. At the same time, about a quarter of them shared difficulties they experienced while using those functions, including not getting eMessage responses timely and difficulty finding information in the portal. Protected log-in process and trust in health care providers were the most mentioned reasons for trusting privacy and security of the patient portal. The most mentioned reason for concerns about privacy and security was the risk of data breaches such as hacking attacks and identity theft. CONCLUSIONS This study provides an empirical understanding of the lived experience of using a patient portal in adult patient users across care settings with a focus on the beneficial aspects and difficulties in using the patient portal, and trust and concerns about privacy and security. Our study findings can serve as a valuable reference for health care institutions and software companies to implement more user-centered, secure, and private patient portals. Future studies may consider targeting other patient portal programs and patients with infrequent or nonuse of patient portals.
Collapse
Affiliation(s)
- Elisa H Son
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Eun-Shim Nahm
- Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, United States
| |
Collapse
|
16
|
Le LH, Hoang PA, Pham HC. Sharing health information across online platforms: A systematic review. HEALTH COMMUNICATION 2023; 38:1550-1562. [PMID: 34978235 DOI: 10.1080/10410236.2021.2019920] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Advanced Web 2.0 communication technologies have facilitated health-related information (HRI) sharing on the Internet. Especially, the COVID-19 pandemic and lockdowns around the world have forced more people to turn to the Internet for HRI. A better understanding of users' sharing content and sharing behavior can help communicators improve health literacy, raise community awareness, and facilitate social support exchanges. This paper reports the results of a systematic review of online HRI sharing literature, including key research topics, theories and methods used in past studies, and key factors of sharing behavior across online platforms. Following the PRISMA procedure for a systematic review, 58 articles were identified and analyzed using keyword matching, thematic analysis, and expert review. Guided by the platform theory, our findings differentiated five types of online platforms that differently influenced online users' sharing content and sharing purposes, including micro-blogs, social network sites, online health communities, social question and answer sites, and Wikis. The findings also clarify five main research topics and applicable theories used in each topic, including personal health sharing, health-related knowledge sharing, general health message diffusion, outcomes of HRI sharing, and exploratory research. Key factors of sharing behavior and potential sharing outcomes are also reviewed and summarized in the research framework developed from the motivation theory. Our study contributes to the understanding of online sharing behavior and provides implications for health communicators to develop effective health campaigns. Potential research directions are also identified and discussed.
Collapse
Affiliation(s)
- Long Hoang Le
- School of Business & Management, RMIT University Vietnam
| | | | - Hiep Cong Pham
- School of Business & Management, RMIT University Vietnam
| |
Collapse
|
17
|
Eysenbach G, Hagens S, Kemp J, Roble H, Carter-Langford A, Shen N. Patient Perspectives and Preferences for Consent in the Digital Health Context: State-of-the-art Literature Review. J Med Internet Res 2023; 25:e42507. [PMID: 36763409 PMCID: PMC9960046 DOI: 10.2196/42507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/05/2022] [Accepted: 01/19/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The increasing integration of digital health tools into care may result in a greater flow of personal health information (PHI) between patients and providers. Although privacy legislation governs how entities may collect, use, or share PHI, such legislation has not kept pace with digital health innovations, resulting in a lack of guidance on implementing meaningful consent. Understanding patient perspectives when implementing meaningful consent is critical to ensure that it meets their needs. Consent for research in the context of digital health is limited. OBJECTIVE This state-of-the-art review aimed to understand the current state of research as it relates to patient perspectives on digital health consent. Its objectives were to explore what is known about the patient perspective and experience with digital health consent and provide recommendations on designing and implementing digital health consent based on the findings. METHODS A structured literature search was developed and deployed in 4 electronic databases-MEDLINE, IEEE Xplore, Scopus, and Web of Science-for articles published after January 2010. The initial literature search was conducted in March 2021 and updated in March 2022. Articles were eligible for inclusion if they discussed electronic consent or consent, focused on the patient perspective or preference, and were related to digital health or digital PHI. Data were extracted using an extraction template and analyzed using qualitative content analysis. RESULTS In total, 75 articles were included for analysis. Most studies were published within the last 5 years (58/75, 77%) and conducted in a clinical care context (33/75, 44%) and in the United States (48/75, 64%). Most studies aimed to understand participants' willingness to share PHI (25/75, 33%) and participants' perceived usability and comprehension of an electronic consent notice (25/75, 33%). More than half (40/75, 53%) of the studies did not describe the type of consent model used. The broad open consent model was the most explored (11/75, 15%). Of the 75 studies, 68 (91%) found that participants were willing to provide consent; however, their consent behaviors and preferences were context-dependent. Common patient consent requirements included clear and digestible information detailing who can access PHI, for what purpose their PHI will be used, and how privacy will be ensured. CONCLUSIONS There is growing interest in understanding the patient perspective on digital health consent in the context of providing clinical care. There is evidence suggesting that many patients are willing to consent for various purposes, especially when there is greater transparency on how the PHI is used and oversight mechanisms are in place. Providing this transparency is critical for fostering trust in digital health tools and the innovative uses of data to optimize health and system outcomes.
Collapse
Affiliation(s)
| | | | - Jessica Kemp
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Heba Roble
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Nelson Shen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
18
|
Itzhaki M, Koren E, Abu Hussein K, Levy L, Gantz I, Barnoy S. Use of Health Information Exchange in the Continuity of Care as Viewed by Patients and Nurses: A Cross-Sectional Study. COMPUTERS, INFORMATICS, NURSING : CIN 2023; 41:39-45. [PMID: 35363630 DOI: 10.1097/cin.0000000000000861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Patients' attitudes toward sharing their personal health information are critical for implementation of health information exchange. Nurses contribute significantly to information sharing within the care continuum in hospitals and community. This study aimed to examine the awareness and readiness of patients with chronic illness and nurses to the use health information exchange. A cross-sectional study was conducted among 314 inpatients with a chronic illness, 110 nurses working in internal wards, and 55 contact nurses working in a large health maintenance organization. The findings showed that the mean level of awareness was low across all three groups. Contact nurses expressed more positive attitudes than internal ward nurses or patients and were more willing than patients to share information with healthcare workers. Knowledge, attitudes, and being a nurse predicted the intention to share information with medical healthcare providers and with agents not involved in direct care. Before implementation of a health information exchange system, it is important to raise awareness, readiness, and intention to use it among the public, nurses, and other medical staff. Policy makers should organize national campaigns under the auspices of the Ministry of Health to present the advantages and provide detailed information about the system.
Collapse
Affiliation(s)
- Michal Itzhaki
- Author Affiliations: Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University (Drs Itzhaki and Barnoy), Ramat-Aviv; Ziva Tal Academic Nursing School affiliated to Tel Aviv University, Sheba Medical Center (Dr Koren), Ramat Gan; Department of CoC & Integrative Care, Maccabi Healthcare Services (Mr Abu Hussien), Tel Aviv; Maccabi's Telehealth Center, Maccabi Health Service, The Gertner Institute For Epidemiology and Health Policy Research, Sheba Medical Center (Mrs Levy), Ramat Gan; and Obstetrics and Gynecology Basic Nursing Studies, Meir Nursing School-Meir Medical Center (Mrs Gantz), Kefar Sava, Israel
| | | | | | | | | | | |
Collapse
|
19
|
Webb SM, Kristensen J, Nordenström A, Vitali D, Amodru V, Wiehe LK, Bolz-Johnson M. Patient journey experiences may contribute to improve healthcare for patients with rare endocrine diseases. Endocr Connect 2022; 11:e220385. [PMID: 36228311 PMCID: PMC9716367 DOI: 10.1530/ec-22-0385] [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: 09/08/2022] [Accepted: 10/13/2022] [Indexed: 11/08/2022]
Abstract
Patient journeys are instruments developed by EURORDIS, The Voice of Rare Disease Patients in Europe, to collect patients' experiences; they may identify gaps and areas deserving improvement, as well as elements positively considered by affected persons. As with other patient-reported experiences, they can complete the clinical evaluation and management of a specific disease, improving the often long diagnostic delay, therapy, patient education and access to knowledgeable multidisciplinary teams. This review discusses the utility of such patient-reported experience measures and summarises the experiences of patients with acromegaly, Addison's disease and congenital adrenal hyperplasia from different European countries. Despite rare endocrine diseases being varied and presenting differently, feelings of not having been taken seriously by health professionals, family and friends was a common patient complaint. Empathy and a positive patient-centred environment tend to improve clinical practice by creating a trustworthy and understanding atmosphere, where individual patient needs are considered. Offering access to adequate patient information on their disease, treatments and outcome helps to adapt to living with a chronic disease and what to expect in the future, contemplating the impact of a disease on patients' everyday life, not only clinical outcome but also social, financial, educational, family and leisure issues is desirable; this facilitates more realistic expectancies for patients and can even lead to a reduction in health costs. Patient empowerment with patient-centred approaches to these complex or chronic diseases should be contemplated more and more, not only for the benefit of those affected but also for the entire health system.
Collapse
Affiliation(s)
- Susan M Webb
- IIB-Sant Pau, Research Center for Pituitary Diseases, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII, Spain
- Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jette Kristensen
- ePAG & Chair of Danish Addison Patient Association, Aarhus, Denmark
| | - Anna Nordenström
- Pediatric Endocrinology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Diana Vitali
- ePAG & Chair SOD ITALIA - Italian Patients Organization for Septo Optic Dysplasia and other Neuroendocrine Conditions, Rome, Italy
| | - Vincent Amodru
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics, Institut MarMaRa, Marseille, France
| | | | | |
Collapse
|
20
|
Trkman M, Popovič A, Trkman P. The roles of privacy concerns and trust in voluntary use of governmental proximity tracing applications. GOVERNMENT INFORMATION QUARTERLY 2022. [DOI: 10.1016/j.giq.2022.101787] [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: 12/24/2022]
|
21
|
Zhang X, Zhang R. Factors influencing patients' opt-in intention of exchanging health information. Front Public Health 2022; 10:907141. [PMID: 36388302 PMCID: PMC9645240 DOI: 10.3389/fpubh.2022.907141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/26/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Health information exchange (HIE) exhibits tremendous benefits in improving the quality of healthcare and reducing healthcare costs. However, it also poses challenges related to data security, data privacy, patient engagement, etc. Objective This study aimed to explore the factors affecting patients' opt-in intention to HIE by using an empirical study based on the theory of planned behavior. Methods A Web-based survey was conducted involving 501 valid participants in China (69% validity rate). Results Information sensitivity and perceived HIE transparency affected the patients' opt-in intention to HIE through the mediation of perceived behavior control and trust in HIE. Information sensitivity negatively influenced perceived behavior control (-0.551, P < 0.001) and trust in HIE (-0.489, P < 0.001). Perceived transparency of HIE positively influenced perceived behavior control (0.396, P < 0.001) and trust in HIE (0.471, P < 0.001). Moreover, patients' opt-in intention to HIE can be positively affected by perceived HIE transparency (0.195, P < 0.001) and trust in HIE (0.294, P < 0.001). In addition, the moderating effect of health status was positive and significant between trust in HIE and opt-in intention to HIE but not between the perceived behavior control and opt-in intention to HIE. Conclusion This study contributes to the theory of planned behavior and enriches the literature on HIE efforts. HIE administrators should design personalized health services on the basis of these different health statuses to successfully achieve patients' opt-in intention to HIE.
Collapse
|
22
|
Parks RF, Wigand RT, Benjamin Lowry P. Balancing information privacy and operational utility in healthcare: proposing a privacy impact assessment (PIA) framework. EUR J INFORM SYST 2022. [DOI: 10.1080/0960085x.2022.2103044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Rachida F Parks
- Computer Information Systems, Quinnipiac University, Hamden, Quinnipiac, USA
| | - Rolf T Wigand
- Emeritus College at Arizona State University, Scottsdale, Arizona, USA
| | - Paul Benjamin Lowry
- Pamplin College of Business Department of Business Information Technology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| |
Collapse
|
23
|
Corman A, Canaway R, Culnane C, Teague V. Public comprehension of privacy protections applied to health data shared for research: an Australian cross-sectional study. Int J Med Inform 2022; 167:104859. [DOI: 10.1016/j.ijmedinf.2022.104859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/10/2022] [Accepted: 08/22/2022] [Indexed: 10/31/2022]
|
24
|
The online website privacy disclosure behavior of users based on concerns-outcomes model. Soft comput 2022. [DOI: 10.1007/s00500-022-07369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
25
|
Awareness regarding Teledentistry among Dental Professionals in Malaysia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3750556. [PMID: 35909481 PMCID: PMC9328987 DOI: 10.1155/2022/3750556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022]
Abstract
Objective. Teledentistry is considered to be a technological advancement in providing dental care to patients while effectively addressing the time management. Furthermore, the pandemic of COVID-19 has been here for quite long now, forcing the dental practitioners to ponder upon other methods of healthcare delivery apart from the traditional in-office direct clinical examination. The aim of this study was to explore the perceptions of dental professionals of Malaysia regarding teledentistry, which can act as a future pedestal for improvements in virtual dental practice and patient care. Materials and Methods. It was a descriptive, cross-sectional study involving an electronic survey of a sample of dental professionals of Malaysia. A prevalidated, 26-item, 5-point Likert-scale questionnaire was used in assessing the perceptions of dental professionals regarding teledentistry in four domains: existing concerns about teledentistry use, the potential of teledentistry in improving practice, usefulness of teledentistry for dental practice, and its usefulness for patients. Statistical analyses involved descriptive statistics which included frequency distributions. Results. An overall response rate of 31.0% was observed with 310 dental practitioners participating in the survey. More than 60% of respondents agreed that teledentistry would benefit the dental practice through enhancement of communication with peers, guidance, and new patients’ referral. However, a substantial proportion of practitioners (70-80%) expressed uncertainty with accuracy of diagnosis, technical reliability, and privacy. Conclusion. Generally, the results of this study point towards the readiness of dental professionals of Malaysia to engage in teledentistry practice. However, further work needs to be done to assess the commercial feasibility of teledentistry, not only in Malaysia but also in other parts of the world. To start with, directed campaigns in reference to teledentistry are necessary to educate dentists and the public about the technology and its potential.
Collapse
|
26
|
Williams KS, Grannis SJ. Patient-Centered Data Home: A Path Towards National Interoperability. Front Digit Health 2022; 4:887015. [PMID: 35911616 PMCID: PMC9328272 DOI: 10.3389/fdgth.2022.887015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objective National interoperability is an agenda that has gained momentum in health care. Although several attempts to reach national interoperability, an alerting system through interconnected network of Health Information Exchange (HIE) organizations, Patient-Centered Data Home (PCDH), has seen preliminary success. The aim was to characterize the PCDH initiative through the Indiana Health Information Exchange's participation in the Heartland Region Pilot, which includes HIEs in Indiana, Ohio, Michigan, Kentucky, and Tennessee. Materials and Methods Admission, Discharge, and Transfer (ADT) transactions were collected between December 2016 and December 2017 among the seven HIEs in the Heartland Region. ADTs were parsed and summarized. Overlap analyses and patient matching software were used to characterize the PCDH patients. R software and Microsoft Excel were used to populate descriptive statistics and visualization. Results Approximately 1.5 million ADT transactions were captured. Majority of patients were female, ages 56–75 years, and were outpatient visits. Top noted reasons for visit were labs, screening, and abdominal pain. Based on the overlap analysis, Eastern Tennessee HIE was the only HIE with no duplicate service areas. An estimated 80 percent of the records were able to be matched with other records. Discussion The high volume of exchange in the Heartland Region Pilot established that PCDH is practical and feasible to exchange data. PCDH has the posture to build better comprehensive medical histories and continuity of care in real time. Conclusion The value of the data gained extends beyond clinical practitioners to public health workforce for improved interventions, increased surveillance, and greater awareness of gaps in health for needs assessments. This existing interconnection of HIEs has an opportunity to be a sustainable path toward national interoperability.
Collapse
Affiliation(s)
- Karmen S. Williams
- Department of Health Policy and Management, Population Health Informatics, City University of New York, New York, NY, United States
- *Correspondence: Karmen S. Williams
| | - Shaun J. Grannis
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States
- Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States
- Indiana University School of Medicine, Indiana University, Indianapolis, IN, United States
| |
Collapse
|
27
|
Wilkowska W, Offermann J, Spinsante S, Poli A, Ziefle M. Analyzing technology acceptance and perception of privacy in ambient assisted living for using sensor-based technologies. PLoS One 2022; 17:e0269642. [PMID: 35789340 PMCID: PMC9255774 DOI: 10.1371/journal.pone.0269642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
People increasingly use various technologies that enable them to ease their everyday lives in different areas. Not only wearable devices are gaining ground, but also sensor-based ambient devices and systems are increasingly perceived as beneficial in supporting users. Especially older and/or frail persons can benefit from the so-called lifelogging technologies assisting the users in different activities and supporting their mobility and autonomy. This paper empirically investigates users’ technology acceptance and privacy perceptions related to sensor-based applications implemented in private environments (i.e., passive infrared sensors for presence detection, humidity and temperature sensors for ambient monitoring, magnetic sensors for user-furniture interaction). For this purpose, we designed an online survey entitled “Acceptance and privacy perceptions of sensor-based lifelogging technologies” and collected data from N = 312 German adults. In terms of user acceptance, statistical analyses revealed that participants strongly agree on the benefits of such sensor-based ambient technologies, also perceiving these as useful and easy to use. Nevertheless, their intention to use the sensor-based applications was still rather limited. The evaluation of privacy perceptions showed that participants highly value their privacy and hence require a high degree of protection for their personal data. The potential users assessed the collection of data especially in the most intimate spaces of domestic environments, such as bathrooms and bedrooms, as critical. On the other hand, participants were also willing to provide complete data transparency in case of an acute risk to their health. Our results suggest that users’ perceptions of personal privacy largely affect the acceptance and successful adoption of sensor-based lifelogging in home environments.
Collapse
Affiliation(s)
- Wiktoria Wilkowska
- Human-Computer Interaction Center, RWTH Aachen University, Aachen, Germany
- * E-mail:
| | - Julia Offermann
- Human-Computer Interaction Center, RWTH Aachen University, Aachen, Germany
| | - Susanna Spinsante
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Angelica Poli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Martina Ziefle
- Human-Computer Interaction Center, RWTH Aachen University, Aachen, Germany
| |
Collapse
|
28
|
Information sharing across mental health service providers and criminal legal system stakeholders: Perspectives of people with serious mental illnesses and their family members. Soc Sci Med 2022; 307:115178. [PMID: 35816835 DOI: 10.1016/j.socscimed.2022.115178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred information-sharing initiatives to transmit information between mental health service providers and criminal legal system stakeholders with the goal of improving resources and streamlining access to care. However, no research to date has examined the perspectives of people with mental illnesses who have their information shared across these systems or the perspectives of their family members. This study examined the perspectives on mental health-criminal legal system information sharing among people with serious mental illnesses and a history of arrest, as well as their family members. METHODS Researchers interviewed 24 clients with serious mental illnesses and a history of arrest who are enrolled in a randomized, controlled trial of a police-mental health Linkage System as well as 11 of their family members. Participants were recruited and interviewed between November 2020 and February 2021. A thematic analysis was used to code and analyze all interview transcripts. RESULTS Study participants articulated perceived benefits and concerns around cross-system information sharing. There was strong support for information sharing in both directions, with the anticipation that such information sharing can prevent unnecessary arrest and/or incarceration, promote positive and safe interactions with criminal legal system professionals, and foster greater understanding and access to treatment. Concerns were more limited and largely related to perceived stigma around mental illnesses and the potential consequences of such stigma. CONCLUSIONS While concerns about information sharing should be considered, study participants overwhelmingly perceived the sharing of information between mental health providers and criminal legal stakeholders as a positive intervention. Such perspectives can be understood as a pragmatic choice in the face of criminal legal system contact and additional research could guide programmatic and policy changes.
Collapse
|
29
|
Assessing the Use of Data Systems to Estimate Return-on-Investment of Behavioral Healthcare Interventions: Opportunities and Barriers. J Behav Health Serv Res 2022; 50:80-94. [PMID: 35415803 DOI: 10.1007/s11414-022-09794-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
Abstract
To improve access to and quality of affordable behavioral healthcare, there is a need for more research to identify which interventions can generate long-term, societal return-on-investment (ROI). Barriers to ROI studies in the behavioral health sector were explored by conducting semi-structured interviews with individuals from key stakeholder groups at state and national behavioral health-related organizations. Limited operating budgets, state-based payer systems, the lack of financial support, privacy laws, and other unique experiences of behavioral health providers and patients were identified as important factors that affect the collection and utilization of data. To comprehensively assess ROI of interventions, it is necessary to improve standardization and data infrastructure across multiple health and non-health systems and clarify or address legal, regulatory, and commercial conflicts.
Collapse
|
30
|
Xiao Y, Du N. Depression Screening will be Included in Chinese Students’ Health Check-Ups. Int J Qual Health Care 2022; 34:6555635. [PMID: 35349696 PMCID: PMC9383636 DOI: 10.1093/intqhc/mzac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/28/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yu Xiao
- Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Na Du
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
| |
Collapse
|
31
|
Esmaeilzadeh P. Benefits and concerns associated with blockchain-based health information exchange (HIE): a qualitative study from physicians' perspectives. BMC Med Inform Decis Mak 2022; 22:80. [PMID: 35346176 PMCID: PMC8962111 DOI: 10.1186/s12911-022-01815-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Blockchain technology has the potential to revolutionize information sharing in companies. Many studies suggest using blockchain-powered platforms to replace existing mechanisms for health information exchange (HIE) across healthcare organizations. However, very few blockchain-based projects have been implemented in the healthcare sector. This study takes a qualitative approach to explore benefits, concerns, and barriers to the rollout of blockchain in HIE projects from physicians' perspectives. METHODS The Promoting Action on Research Implementation in Health Services (PARIHS) framework was used to help us better understand root causes, existing problems, perceived risks, perceived benefits, and suggestions. In-depth interviews have been conducted with 38 physicians in six months. The data were analyzed and coded using NVIVO to classify conceptually similar themes mentioned by the interviewees. RESULTS In total, seven themes have been identified. The key benefits are categorized into three themes: innovative technological features, collaborative ecosystem, and system performance. The main concerns and risks are categorized into four themes: individual, organizational, technological, and market-related issues. The findings can contribute to knowledge by highlighting key values expected from blockchain technology in HIEs. The results also explore obstacles to leveraging the blockchain in healthcare from the perspectives of an important stakeholder (physicians). CONCLUSIONS The results show that although blockchain technology may create several benefits (e.g., innovative technological features, collaborative ecosystem, and system performance), its applications in healthcare are still in their early stages. The perceptions of the individual issues (e.g., lack of knowledge), organizational issues (e.g., implementation issues), technological issues (e.g., blockchain model types), and market-related issues (e.g., regulatory concerns) indicate that blockchain-based applications in healthcare continue to be an emerging field. This study has practical implications as understanding these concerns can help developers and healthcare managers identify potential issues in the planning, developing, and implementing blockchain-based HIE systems. Addressing these barriers would support the widespread use of blockchain-based HIEs in different healthcare settings and facilitate interoperability and connectivity in regional and community health information networks.
Collapse
Affiliation(s)
- Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, College of Business, Florida International University (FIU), Modesto A. Maidique Campus, 11200 S.W. 8th St, RB 261B, Miami, FL, 33199, USA.
| |
Collapse
|
32
|
Signorini L, Ceruso FM, Aiello E, Zullo MJ, De Vito D. Vaccine Efficacy Denial: A Growing Concern Affecting Modern Science, and Impacting Public Health. Endocr Metab Immune Disord Drug Targets 2022; 22:935-943. [PMID: 35306998 DOI: 10.2174/1871530322666220318092909] [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: 11/17/2021] [Revised: 01/29/2022] [Accepted: 02/04/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The discovery of the vaccination technique has been revealed by Edward Jenner in 1796: undoubtedly, it represents the first scientific attempt to control an infectious disease by vaccines, followed by other important studies carried out by Pasteur and Koch, and Sabin, who developed the first technique to attenuate the virus. In recent decades, numerous scholars have begun to create dangerous theories against the effectiveness of vaccines through scientifically invalid or fraudulent studies. AIM This critical review of the literature aims to analyse the main factors that have undermined the credibility of vaccines in the general population, to disprove false information and, on the other hand, emphasize the benefits of vaccines over the last 200 years. DISCUSSIONS Unfortunately, several studies have been carried out without the proper scientific rigour. The most impacting example is the study published by Andrew Wakefield in the Lancet journal that tried to correlate vaccines with the development of autism: this publication was withdrawn from the journal a few years after its publication, but the impact of incorrect scientific studies, fake news, and ambiguous healthcare policies has led to an adverse general opinion about the effectiveness of vaccines. CONCLUSION The excess of uncontrolled information is a serious concerning in the Coronavirus pandemic. The modern science must tackle this problem with a better willingness to communicate even the clinical studies to those people not able to understand the medical information autonomously. Nevertheless, a reliable science must also limit the dissemination of studies that do not meet the basic criteria of a methodological rigor and certainty of results, in order not to feed confusion in the scientific community.
Collapse
Affiliation(s)
- Luca Signorini
- Private practice, Rome, Italy; Professor, Saint Camillus University of Health Science, 00100 Rome, Italy
| | - Francesco Maria Ceruso
- Department of Dentistry, "Fra G.B. Orsenigo-Ospedale San Pietro F.B.F.", 00100 Rome, Italy
| | - Elisabetta Aiello
- Marrelli Health - Tecnologica Research institute - Via E. Fermi, 88900 Crotone, Italy; Azienda Ospedaliera Pugliese Ciaccio, Catanzaro, Italy
| | - Maria Josephine Zullo
- Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Danila De Vito
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy
| |
Collapse
|
33
|
Assessing patient readiness for a patient portal implementation in the UAE. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2022. [DOI: 10.1108/jstpm-05-2021-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper proposes a Web-based patient portal based on the electronic medical record. Such a portal can allow patients to manage their own health care, reduce health-care visits and significantly improve the quality of their health care.
Design/methodology/approach
A patient portal prototype and an accompanying online survey were distributed to assess the adoption readiness among a group of people in the United Arab Emirates (UAE).
Findings
The results from 470 survey participants demonstrated an enhanced awareness of this technology, and support the study hypotheses indicating that both intrinsic and extrinsic factors are important when considering the implementation of a patient portal in the UAE.
Originality/value
This study adds value to the few research studies undertaken in the Middle East discussing online health information technology and its adoption and usage among the population at large. The extended technology acceptance model, which contains two additional constructs, had not been previously validated in terms of a patient portal in the UAE, according to the author’s knowledge, adding more value. The UAE’s health-care system must use the benefits from the available IT infrastructure to provide a user-friendly online portal to encourage patients to manage their health care and health information.
Collapse
|
34
|
Kunwar B, Dhungana A, Aryal B, Gaire A, Adhikari AB, Ojha R. Cross‐sectional study on knowledge and attitude of telemedicine in medical students of Nepal. Health Sci Rep 2022; 5:e532. [PMID: 35224226 PMCID: PMC8855682 DOI: 10.1002/hsr2.532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Bijay Kunwar
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Ayushma Dhungana
- Department of Medicine National Medical College, National Medical College and Teaching Hospital Birgunj Nepal
| | - Binay Aryal
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Arjun Gaire
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Aramva Bikram Adhikari
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Rajeev Ojha
- Department of Neurology Tribhuvan University Institute of Medicine Maharajgunj Nepal
| |
Collapse
|
35
|
Shen N, Kassam I, Chen S, Ma C, Wang W, Boparai N, Jankowicz D, Strudwick G. Canadian perspectives of digital mental health supports: Findings from a national survey conducted during the COVID-19 pandemic. Digit Health 2022; 8:20552076221102253. [PMID: 35646379 PMCID: PMC9131389 DOI: 10.1177/20552076221102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives The impact of the COVID-19 pandemic on population mental health has highlighted the potential for digital mental health to support the needs of those requiring care. This study sought to understand the digital mental health experiences and priorities of Canadians affected by mental health conditions (i.e. seekers, patients, and care partners). Methods A national cross-sectional electronic survey of Canadians was administered through a market research firm's survey panel. Seekers, patients, and care partners were asked about their digital mental health experiences (e.g. uptake, barriers to access) and priorities. Survey responses were summarized using descriptive statistics. Results Overall, 1003 participants completed the survey. 70.2% of participants routinely use digital mental health supports to support themselves or those they care for; however, only 28.6% of participants are satisfied with the available digital mental health supports. Most participants (73.3%) have encountered some barriers when accessing digital mental health supports. Awareness of digital mental health supports was a top barrier identified by participants. The top digital mental health priorities consisted of digital mental health curation, navigation, and a digital mental health passport. Conclusions Most participants use digital mental health supports for themselves or others, however, many are unaware of digital mental health supports available. Efforts to improve navigating access to digital and in-person mental health services are seen as a top priority, highlighting the need to enable seekers, patients, and care partners to find the appropriate support and make decisions on how to best improve their mental health.
Collapse
Affiliation(s)
- Nelson Shen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Iman Kassam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Clement Ma
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Navi Boparai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Damian Jankowicz
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
36
|
Ploug T, Holm S. Right to Contest AI Diagnostics. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
37
|
Pendergrass J, Ranganathan C. Institutional factors affecting the electronic health information exchange by ambulatory providers. HEALTH POLICY AND TECHNOLOGY 2021. [DOI: 10.1016/j.hlpt.2021.100569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
38
|
Pattanaik P, Himanshu U, Bhushan B, Thakur M, Pani AK. A study of the adoption behaviour of an Electronic Health Information Exchange System for a Green economy. INTERNATIONAL JOURNAL OF LOGISTICS-RESEARCH AND APPLICATIONS 2021. [DOI: 10.1080/13675567.2021.2008336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
39
|
Oshni Alvandi A, Bain C, Burstein F. Understanding digital health ecosystem from Australian citizens' perspective: A scoping review. PLoS One 2021; 16:e0260058. [PMID: 34780547 PMCID: PMC8592460 DOI: 10.1371/journal.pone.0260058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/30/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. MATERIALS AND METHODS A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. RESULTS Of 3811 articles, 98 articles met the inclusion criteria with research-based articles-as opposed to review articles or white papers- comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were "consumer/user", "health care", "technology", "use and usability", "data and information". These elements were further found to be associated with 127 subcategories. CONCLUSIONS This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens' perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens' experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.
Collapse
Affiliation(s)
| | - Chris Bain
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Frada Burstein
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
40
|
Fuentes-Ramirez A, Laverde-Contreras OL. Nursing intervention to meet the family members' needs during the surgery waiting time. Rev Lat Am Enfermagem 2021; 29:e3483. [PMID: 34730762 PMCID: PMC8570248 DOI: 10.1590/1518-8345.5028.3483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 05/03/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: to assess the effect of a care intervention focused on meeting the needs of
family members of surgical patients during the surgery waiting time, when
compared to conventional care. Method: a study with a quasi-experimental design that was developed from December
2019 to February 2020 and included 313 family members (Intervention
Group=149 and Control Group=164) from a private hospital. The intervention
consisted in four moments: “knowing the surgical environment and process”,
“information when the surgery starts”, “information when the surgery ends”,
and “family-patient reunion”. The “satisfaction” variable was assessed
through the “Patient Satisfaction with Nursing Care Quality Questionnaire”
instrument. The data were analyzed using descriptive and analytical
statistics. The study observed the ethical principles in research. Results: the family members in the Intervention Group presented greater satisfaction
with Nursing care, 90.07(9.8), when compared to the Comparison Group,
78.72(16.38), with an 11.35-point increase(p=0.000). Conclusion: the results showed that the families that received the intervention on the
patient’s status during the surgery waiting time were more satisfied with
Nursing care in comparison to the conventional intervention.
Collapse
|
41
|
Rowan W, O'Connor Y, Lynch L, Heavin C. Comprehension, Perception, and Projection. J ORGAN END USER COM 2021. [DOI: 10.4018/joeuc.286766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health social networks (HSNs) allow individuals with health information needs to connect and discuss health-related issues online. Political-technology intertwinement (e.g. GDPR and Digital Technology) highlights that users need to be aware, understand, and willing to provide electronic consent (eConsent) when sharing personal information online. The objective of this study is to explore the ‘As-Is’ factors which impact individuals’ decisional autonomy when consenting to the privacy policy (PP) and Terms and Conditions (T&Cs) on a HSN. We use a Situational Awareness (SA) lens to examine decision autonomy when providing eConsent. A mixed-methods approach reveals that technical and privacy comprehension, user perceptions, and projection of future consequences impact participants’ decision autonomy in providing eConsent. Without dealing with the privacy paradox at the outset, decision awareness and latterly decision satisfaction is negatively impacted. Movement away from clickwrap online consent to customised two-way engagement is the way forward for the design of eConsent.
Collapse
|
42
|
Fernández L, Fossa A, Dong Z, Delbanco T, Elmore J, Fitzgerald P, Harcourt K, Perez J, Walker J, DesRoches C. Words Matter: What Do Patients Find Judgmental or Offensive in Outpatient Notes? J Gen Intern Med 2021; 36:2571-2578. [PMID: 33528782 PMCID: PMC8390578 DOI: 10.1007/s11606-020-06432-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/09/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sharing outpatient notes with patients may bring clinically important benefits, but notes may sometimes cause patients to feel judged or offended, and thereby reduce trust. OBJECTIVE As part of a larger survey examining the effects of open notes, we sought to understand how many patients feel judged or offended due to something they read in outpatient notes, and why. DESIGN We analyzed responses from a large Internet survey of adult patients who used secure patient portals and had at least 1 visit note available in a 12-month period at 2 large academic medical systems in Boston and Seattle, and in a rural integrated health system in Pennsylvania. PARTICIPANTS Adult ambulatory patients with portal accounts in health systems that offered open notes for up to 7 years. APPROACH (1) Quantitative analysis of 2 dichotomous questions, and (2) qualitative thematic analysis of free-text responses on what patients found judgmental or offensive. KEY RESULTS Among 22,959 patient respondents who had read at least one note and answered the 2 questions, 2,411 (10.5%) reported feeling judged and/or offended by something they read in their note(s). Patients who reported poor health, unemployment, or inability to work were more likely to feel judged or offended. Among the 2,411 patients who felt judged and/or offended, 2,137 (84.5%) wrote about what prompted their feelings. Three thematic domains emerged: (1) errors and surprises, (2) labeling, and (3) disrespect. CONCLUSIONS One in 10 respondents reported feeling judged/offended by something they read in an outpatient note due to the perception that it contained errors, surprises, labeling, or evidence of disrespect. The content and tone may be particularly important to patients in poor health. Enhanced clinician awareness of the patient perspective may promote an improved medical lexicon, reduce the transmission of bias to other clinicians, and reinforce healing relationships.
Collapse
Affiliation(s)
- Leonor Fernández
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Alan Fossa
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Zhiyong Dong
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
| | - Tom Delbanco
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Joann Elmore
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Patricia Fitzgerald
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
| | - Kendall Harcourt
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
| | - Jocelyn Perez
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
| | - Jan Walker
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Catherine DesRoches
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
43
|
Do personal health concerns and trust in healthcare providers mitigate privacy concerns? Effects on patients' intention to share personal health data on electronic health records. Soc Sci Med 2021; 283:114146. [PMID: 34242891 DOI: 10.1016/j.socscimed.2021.114146] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 04/19/2021] [Accepted: 06/13/2021] [Indexed: 11/21/2022]
Abstract
RATIONALE Health digitalization raises important challenges for personal health-data management. Particularly, the advantages underlying the implementation of Electronic Health Record (EHR) remain limited in many countries due to patients' privacy concerns. OBJECTIVE Drawing on the privacy calculus theory, the objective of this research is to introduce personal health concerns and trust in healthcare providers as new predictors, beyond the constituent variables of the privacy calculus model - the perceived benefits and risk. We propose and test a conceptual model that investigates simultaneously the effects of these four variables on patients' privacy concerns and intention to share personal health-data on EHR. METHOD A cross-sectional study using an on online survey was administered from December 2019 to February 2020 in France to both users and non-users of EHR. A structural equation modelling was used to assess the reliability and validity of the measurement as well as to test the research hypotheses. RESULTS The results confirm the positive effects of personal health concerns and trust in healthcare providers on (a) the intention to create an EHR and (b) to share personal health-data. In the same vein, we do not find any significant effect of patients' privacy concerns on the intention to create an EHR and intention to share personal health-data. Furthermore, the patients' perceived benefits outweigh the perceived risks for EHR using. CONCLUSIONS This research provides a more holistic understanding of patients' privacy concerns. Particularly, we highlight the key role of personal health concerns and trust in healthcare providers with the intention to create an EHR and to share personal health data. Empirical evidence underlines the importance to involve all the stakeholders in the implementation process. Findings are discussed according to existing literature and practical guidelines are suggested to the health policymakers and healthcare providers.
Collapse
|
44
|
Shen N, Kassam I, Zhao H, Chen S, Wang W, Wickham S, Strudwick G, Carter-Langford A. Foundations for Meaningful Consent in Canada’s Digital Health Ecosystem: Findings from a Pan-Canadian Survey (Preprint). JMIR Med Inform 2021; 10:e30986. [PMID: 35357318 PMCID: PMC9015739 DOI: 10.2196/30986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/17/2021] [Accepted: 01/31/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Nelson Shen
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Iman Kassam
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Haoyu Zhao
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sheng Chen
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Wei Wang
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
- College of Public Health, University of South Florida, Tampa, FL, United States
| | | | - Gillian Strudwick
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
45
|
Chiruvella V, Guddati AK. Ethical Issues in Patient Data Ownership. Interact J Med Res 2021; 10:e22269. [PMID: 34018968 PMCID: PMC8178732 DOI: 10.2196/22269] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/23/2020] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Patient data have conventionally been thought to be well protected by the privacy laws outlined in the United States. The increasing interest of for-profit companies in acquiring the databases of large health care systems poses new challenges to the protection of patients' privacy. It also raises ethical concerns of sharing patient data with entities that may exploit it for commercial interests and even target vulnerable populations. Recognizing that every breach in the confidentiality of large databases exposes millions of patients to the potential of being exploited is important in framing new rules for governing the sharing of patient data. Similarly, the ethical aspects of data voluntarily and altruistically provided by patients for research, which may be exploited for commercial interests due to patient data sharing between health care entities and third-party companies, need to be addressed. The rise of technologies such as artificial intelligence and the availability of personal data gleaned by data vendor companies place American patients at risk of being exploited both intentionally and inadvertently because of the sharing of their data by their health care provider institutions and third-party entities.
Collapse
|
46
|
Webb SM, Kristensen J, Vitali D, van Klink S, van Beuzekom C, Santos A, Nordenström A. EndoERN patient survey on their perception of health care experience and of unmet needs for rare endocrine diseases. Endocrine 2021; 71:569-577. [PMID: 33544353 DOI: 10.1007/s12020-021-02625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/09/2021] [Indexed: 11/30/2022]
Abstract
Patients' perceptions on quality of care and gaps in diagnosis/management of rare endocrine diseases (RED) were collected in a 21-item questionnaire, answered on-line in the patients' language. There were 598 (66% females) responses from 29 countries reflecting pituitary, adrenal, thyroid, parathyroid, gonadal, genetic and autoimmune diseases. While in 36% a diagnosis was made in <1 year, in 28% it took >5 years. In 64% it took 2-7 professionals for a correct diagnosis, after which in >50% a specialist/specific treatment was available within 1 month; 60% were satisfied with current treatment. Most (59-67%) would have liked access to psychological support, social worker, dietician or physiotherapist/rehabilitation specialists. Half were satisfied with information received, treatment and health care follow-up; 87% contacted patient/support groups; 78% agreed that "The personal limitations related to the disease, impact on my everyday quality of life". Conclusion: Diagnostic delay in RED is still unsatisfactory in Europe, as well as specific needs impacting QoL.
Collapse
Affiliation(s)
- Susan M Webb
- Hospital S Pau, Dept Medicine/Endocrinology, IIB-Sant Pau, Research Center for Pituitary Diseases, 08025, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII; Universitat Autònoma de Barcelona (UAB), Pare Claret 167, 08025, Barcelona, Spain.
| | - Jette Kristensen
- ePAG & Chair of Danish Addison Patient Association, Aarhus, Denmark
| | - Diana Vitali
- ePAG & Chair of Associazione Italiana Displasia Setto Ottica e Ipopituitarismo Congenito (SOD/CH), Rome, Italy
| | - Sandra van Klink
- Endo-ERN Coordinating Center, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Alicia Santos
- Hospital S Pau, Dept Medicine/Endocrinology, IIB-Sant Pau, Research Center for Pituitary Diseases, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII; Universitat Autònoma de Barcelona (UAB), Pare Claret 167, 08025, Barcelona, Spain
| | - Anna Nordenström
- Pediatric Endocrinology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, 17176, Stockholm, Sweden
| |
Collapse
|
47
|
Shermohammed M, Goren A, Lanyado A, Yesharim R, Wolk DM, Doyle J, Meyer MN, Chabris CF. Informing patients that they are at high risk for serious complications of viral infection increases vaccination rates. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.02.20.21252015. [PMID: 33655258 PMCID: PMC7924279 DOI: 10.1101/2021.02.20.21252015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
For many vaccine-preventable diseases like influenza, vaccination rates are lower than optimal to achieve community protection. Those at high risk for infection and serious complications are especially advised to be vaccinated to protect themselves. Using influenza as a model, we studied one method of increasing vaccine uptake: informing high-risk patients, identified by a machine learning model, about their risk status. Patients (N=39,717) were evenly randomized to (1) a control condition (exposure only to standard direct mail or patient portal vaccine promotion efforts) or to be told via direct mail, patient portal, and/or SMS that they were (2) at high risk for influenza and its complications if not vaccinated; (3) at high risk according to a review of their medical records; or (4) at high risk according to a computer algorithm analysis of their medical records. Patients in the three treatment conditions were 5.7% more likely to get vaccinated during the 112 days post-intervention (p < .001), and did so 1.4 days earlier (p < .001), on average, than those in the control group. There were no significant differences among risk messages, suggesting that patients are neither especially averse to nor uniquely appreciative of learning their records had been reviewed or that computer algorithms were involved. Similar approaches should be considered for COVID-19 vaccination campaigns.
Collapse
Affiliation(s)
- Maheen Shermohammed
- Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822, USA
| | - Amir Goren
- Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822, USA
| | | | | | - Donna M. Wolk
- Department of Laboratory Medicine, Diagnostic Medicine Institute, Geisinger Health System, Danville, PA, USA
| | - Joseph Doyle
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - Michelle N. Meyer
- Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822, USA
- Center for Translational Bioethics and Health Care Policy, Geisinger Health System, Danville, PA 17822, USA
| | - Christopher F. Chabris
- Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822, USA
- Autism and Developmental Medicine Institute, Geisinger Health System, Lewisburg, PA 17837, USA
| |
Collapse
|
48
|
Chandrasekaran R, Sankaranarayanan B, Pendergrass J. Unfulfilled promises of health information exchange: What inhibits ambulatory clinics from electronically sharing health information? Int J Med Inform 2021; 149:104418. [PMID: 33640839 DOI: 10.1016/j.ijmedinf.2021.104418] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE This study seeks to understand the key inhibitors for health information exchange (HIE) by ambulatory (outpatient) clinics. We examine the key technological, organizational and environmental factors that inhibit an ambulatory clinic from electronically exchanging health information with external clinics and hospitals. METHODS We utilize survey data from 1285 ambulatory clinics in the US state of Minnesota. Using logistic regressions, we assess if the ambulatory clinic's HIE with external clinics and external hospitals are associated with fourteen inhibitors from technological, organizational and environmental contexts in which ambulatory clinics operate. RESULTS Among the technological inhibitors, we find lack of adequate technological infrastructure, difficulties in integrating external data with electronic medical record systems, and security concerns to inhibit ambulatory clinics' HIE with both clinics and hospitals. Inadequate technical support was a barrier for HIE with hospitals, whereas inadequate training of staff was an inhibitor for clinic-to-clinic HIE. Of the environmental variables, legal concerns and complexity in framing HIE agreements with partners were found to inhibit ambulatory clinics' HIE with both external clinics and hospitals. Lack of partner readiness and ability was an inhibiting factor for clinic-to-hospital HIE whereas issues in patient consent, and problems in choosing the right vendor with a good fit were inhibiting ambulatory clinics' HIE with other clinics. Among the organizational variables, lack of adequate senior leadership support and complexity of workflow changes inhibited clinic-to-clinic health data sharing, whereas unclear return on investment (ROI) for HIE was a deterrent for ambulatory clinics' HIE with hospitals. CONCLUSIONS This study throws light on electronic HIE practices and its key inhibitors in ambulatory clinics, an understudied area in digital health. This paper provides unique insights into specific inhibitors that deter clinic-to-clinic health information sharing versus those that affect and clinic-to-hospital health information exchange.
Collapse
Affiliation(s)
| | - Balaji Sankaranarayanan
- Department of IT and Supply Chain Management, University of Wisconsin at Whitewater, United States.
| | - John Pendergrass
- Department of Operations Management and Information Systems, Northern Illinois University, United States.
| |
Collapse
|
49
|
Öztürk H, Torun Kılıç Ç, Kahriman İ, Meral B, Çolak B. Assessment of nurses' respect for patient privacy by patients and nurses: A comparative study. J Clin Nurs 2021; 30:1079-1090. [PMID: 33432684 DOI: 10.1111/jocn.15653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/28/2020] [Accepted: 12/31/2020] [Indexed: 11/27/2022]
Abstract
AIMS To determine whether nurses respect or violate patient privacy by comparing nurses' and patients' opinions. BACKGROUND Although nurses want to respect patient privacy, they can sometimes violate patient privacy or not pay enough attention. METHOD This comparative and cross-sectional study was conducted with 357 patients and 305 nurses in 12 public hospitals in Trabzon, Turkey. Data were collected with an information form and the Patient Privacy Scale. Reporting is consistent with the STROBE checklist for cross-sectional studies. RESULTS The total mean score of the patient privacy scale was 4.6 ± 0.39 for nurses and 4.5 ± 0.41 for patients, and no significant difference was found between their scores (U = 52999.0; p = .554). Further, the nurses (U = 14358.0; p = .000) and the patients (U = 13272.5; p = .006) in the public hospitals had statistically significantly higher overall privacy scores than those in the training and research hospitals. The overall privacy scale scores were higher and more statistically significant in the patients hospitalised in surgical clinics than those hospitalised in clinics for internal diseases (U = 8514.0; p = .005) and in single compared to married patients (U = 12364.5; p = .034). CONCLUSION Nurses respected patient privacy highly according to both nurses and patients, and there was no significant difference between their views. However, nurses working in training and research hospitals and internal diseases clinics need to improve their approaches to patient privacy. RELEVANCE TO CLINICAL PRACTICE The results of this study could be used to reduce patient privacy vulnerabilities in complex hospitals and clinics such as training and research hospitals and to improve institutional policies and activities regarding patient privacy. By comparing the results of patients and nurses, the study provided more consistent and accurate data about patient privacy.
Collapse
Affiliation(s)
- Havva Öztürk
- Nursing Department of Health Science Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Çiğdem Torun Kılıç
- Nursing Department of Health Science Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - İlknur Kahriman
- Nursing Department of Health Science Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Buket Meral
- Nursing Department of Health Science Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Bahar Çolak
- Nursing Department of Health Science Faculty, Karadeniz Technical University, Trabzon, Turkey
| |
Collapse
|
50
|
Baghaei R, Razmara Iranagh S, Ghasemzadeh N, Moradi Y. Observation of Patients' Privacy by Physicians and Nurses and Its Relationship with Patient Satisfaction. Hosp Top 2021; 99:171-177. [PMID: 33522878 DOI: 10.1080/00185868.2021.1877096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The present study was conducted to determine the extent of observation of patients' privacy by physicians and nurses and its relationship with patient satisfaction. This descriptive correlational study was conducted on 600 patients selected by convenience sampling. Based on the patients' points of view, the level of observation of patients' privacy and its dimensions, especially the psychosocial dimension, were reported to be higher in nurses than in physicians. Pearson's correlation coefficient showed a direct and significant relationship between the observation of privacy by the nurses and physicians and different dimensions of patient satisfaction.
Collapse
Affiliation(s)
- Rahim Baghaei
- Patient Safety Research Center, Clinical Research Institute, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Nazafarin Ghasemzadeh
- Faculty of Medicine, Department of Medical Ethics, Urmia University of Medical Sciences, Urmia, Iran
| | - Yaser Moradi
- Patient Safety Research Center, Clinical Research Institute, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|