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O'Connor S, Vercell A, Wong D, Yorke J, Fallatah FA, Cave L, Anny Chen LY. The application and use of artificial intelligence in cancer nursing: A systematic review. Eur J Oncol Nurs 2024; 68:102510. [PMID: 38310664 DOI: 10.1016/j.ejon.2024.102510] [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: 10/05/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Artificial Intelligence is being applied in oncology to improve patient and service outcomes. Yet, there is a limited understanding of how these advanced computational techniques are employed in cancer nursing to inform clinical practice. This review aimed to identify and synthesise evidence on artificial intelligence in cancer nursing. METHODS CINAHL, MEDLINE, PsycINFO, and PubMed were searched using key terms between January 2010 and December 2022. Titles, abstracts, and then full texts were screened against eligibility criteria, resulting in twenty studies being included. Critical appraisal was undertaken, and relevant data extracted and analysed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS Artificial intelligence was used in numerous areas including breast, colorectal, liver, and ovarian cancer care among others. Algorithms were trained and tested on primary and secondary datasets to build predictive models of health problems related to cancer. Studies reported this led to improvements in the accuracy of predicting health outcomes or identifying variables that improved outcome prediction. While nurses led most studies, few deployed an artificial intelligence based digital tool with cancer nurses in a real-world setting as studies largely focused on developing and validating predictive models. CONCLUSION Electronic cancer nursing datasets should be established to enable artificial intelligence techniques to be tested and if effective implemented in digital prediction and other AI-based tools. Cancer nurses need more education on machine learning and natural language processing, so they can lead and contribute to artificial intelligence developments in oncology.
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Affiliation(s)
- Siobhan O'Connor
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Amy Vercell
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom.
| | - David Wong
- Leeds Institute for Health Informatics, University of Leeds, Leeds, United Kingdom.
| | - Janelle Yorke
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom.
| | - Fatmah Abdulsamad Fallatah
- Department of Nursing Affairs, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Louise Cave
- NHS Transformation Directorate, NHS England, England, United Kingdom.
| | - Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Hosseini A, Emami H, Sadat Y, Paydar S. Integrated personal health record (PHR) security: requirements and mechanisms. BMC Med Inform Decis Mak 2023; 23:116. [PMID: 37430242 DOI: 10.1186/s12911-023-02225-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 07/03/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Personal Health Records (PHRs) are designed to fulfill the goals of electronic health (eHealth) and empower the individual in the process of self-care. Integrated PHR can improve the quality of care, strengthen the patient-healthcare provider relationship, and reduce healthcare costs. Still, the process of PHR acceptance and use has been slow and mainly hindered by people's concerns about the security of their personal health information. Thus, the present study aimed to identify the Integrated PHR security requirements and mechanisms. METHODS In this applied study, PHR security requirements were identified with a literature review of (library sources, research articles, scientific documents, and reliable websites). The identified requirements were classified, and a questionnaire was developed accordingly. Thirty experts completed the questionnaire in a two-round Delphi technique, and the data were analyzed by descriptive statistics. RESULTS The PHR security requirements were identified and classified into seven dimensions confidentiality, availability, integrity, authentication, authorization, non-repudiation, and right of access, each dimension having certain mechanisms. On average, the experts reached an agreement about the mechanisms of confidentiality (94.67%), availability (96.67%), integrity (93.33%), authentication (100%), authorization (97.78%), non-repudiation (100%), and right of access (90%). CONCLUSION Integrated PHR security is a requirement for its acceptance and use. To design a useful and reliable integrated PHR, system designers, health policymakers, and healthcare organizations must identify and apply security requirements to guarantee the privacy and confidentiality of data.
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Affiliation(s)
- Azamossadat Hosseini
- Health Information Management (HIM), Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Emami
- Management of Technology, Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Sadat
- Health Information Management (HIM), Department of Health Information Technology, Faculty of Paramedicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Somayeh Paydar
- Health Information Management (HIM), Department of Health Information Technology, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Viana Pereira F, Tavares J, Oliveira T. Adoption of video consultations during the COVID-19 pandemic. Internet Interv 2023; 31:100602. [PMID: 36694630 PMCID: PMC9852263 DOI: 10.1016/j.invent.2023.100602] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/20/2022] [Accepted: 01/19/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Video consultations have the potential to play a significant role for the future of healthcare by solving some of the imminently arising healthcare challenges, as pointed by the European Commission in Europe and the National Academy of Medicine in the United States of America. This technology can improve quality, efficiency, and enhance access to healthcare. OBJECTIVE The aim of this study is to explore and understand individual video consultations acceptance drivers. METHODS An extended technology acceptance model was created based on the diffusion of innovation theory (DOI), unified theory of acceptance and use of technology (UTAUT), health belief model (HBM), and concerns for information privacy framework (CFIP). 346 valid responses were collected through an online questionnaire, and the partial least squares (PLS) modeling approach was used to test the model. RESULTS The model explained 77.6 % (R2) of the variance on intention to use, and 71.4 % (R2) of the variance in attitude. The predictors of intention to use are attitude (beta = 0.504, p-value<0.001), performance expectancy (beta = 0.196, p-value = 0.002), and COVID-19 (beta = 0.151, p-value<0.001). The predictors of attitude are performance expectancy (beta = 0.643, p-value>0.001), effort expectancy (beta = 0.138, p-value = 0.001), and COVID-19 (beta = 0.170, p-value<0.001). CONCLUSIONS This research model highlights the importance of creating extended acceptance models to capture the specificities of each technology in healthcare. The model created helps to understand the most important drivers of video consultation acceptance, highlighting the importance of the COVID-19 pandemic and perceived health risks.
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Steinhauser S, Raptis G. Design propositions for nudging in healthcare: Adoption of national electronic health record systems. Digit Health 2023; 9:20552076231181208. [PMID: 37325075 PMCID: PMC10262653 DOI: 10.1177/20552076231181208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/24/2023] [Indexed: 06/17/2023] Open
Abstract
Objectives Electronic health records (EHRs) are considered important for improving efficiency and reducing costs of a healthcare system. However, the adoption of EHR systems differs among countries and so does the way the decision to participate in EHRs is presented. Nudging is a concept that deals with influencing human behaviour within the research stream of behavioural economics. In this paper, we focus on the effects of the choice architecture on the decision for the adoption of national EHRs. Our study aims to link influences on human behaviour through nudging with the adoption of EHRs to investigate how choice architects can facilitate the adoption of national information systems. Methods We employ a qualitative explorative research design, namely the case study method. Using theoretical sampling, we selected four cases (i.e., countries) for our study: Estonia, Austria, the Netherlands, and Germany. We collected and analyzed data from various primary and secondary sources: ethnographic observation, interviews, scientific papers, homepages, press releases, newspaper articles, technical specifications, publications from governmental bodies, and formal studies. Results The findings from our European case studies show that designing for EHR adoption should encompass choice architecture elements (i.e., defaults), technical elements (i.e., choice granularity and access transparency), and institutional elements (i.e., regulations for data protection, information campaigns, and financial incentives) in combination. Conclusions Our findings provide insights on the design of the adoption environments of large-scale, national EHR systems. Future research could estimate the magnitude of effects of the determinants.
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Affiliation(s)
- Stefanie Steinhauser
- Health Economy and Entrepreneurship, Technical University of Applied Sciences Amberg-Weiden, Weiden, Germany
| | - Georgios Raptis
- Computer Science / eHealth, OTH Regensburg, University of Applied Sciences, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, Regensburg, Germany
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Ruhi U, Chugh R. Utility, Value, and Benefits of Contemporary Personal Health Records: Integrative Review and Conceptual Synthesis. J Med Internet Res 2021; 23:e26877. [PMID: 33866308 PMCID: PMC8120425 DOI: 10.2196/26877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/30/2021] [Accepted: 04/15/2021] [Indexed: 12/30/2022] Open
Abstract
Background Contemporary personal health record (PHR) technologies offer a useful platform for individuals to maintain a lifelong record of personally reported and clinically sourced data from various points of medical care. Objective This paper presents an integrative review and synthesis of the extant literature on PHRs. This review draws upon multiple lenses of analysis and deliberates value perspectives of PHRs at the product, consumer, and industry levels. Methods Academic databases were searched using multiple keywords related to PHRs for the years 2001-2020. Three research questions were formulated and used as selection criteria in our review of the extant literature relevant to our study. Results We offer a high-level functional utility model of PHR features and functions. We also conceptualize a consumer value framework of PHRs, highlighting the applications of these technologies across various health care delivery activities. Finally, we provide a summary of the benefits of PHRs for various health care constituents, including consumers, providers, payors, and public health agencies. Conclusions PHR products offer a myriad of content-, connectivity-, and collaboration-based features and functions for their users. Although consumers benefit from the tools provided by PHR technologies, their overall value extends across the constituents of the health care delivery chain. Despite advances in technology, our literature review identifies a shortfall in the research addressing consumer value enabled by PHR tools. In addition to scholars and researchers, our literature review and proposed framework may be especially helpful for value analysis committees in the health care sector that are commissioned for the appraisal of innovative health information technologies such as PHRs.
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Affiliation(s)
- Umar Ruhi
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Ritesh Chugh
- School of Engineering & Technology, Central Queensland University, Melbourne, Australia
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Kim H, Mahmood A, Carlton E, Goldsmith J, Chang C, Bhuyan S. Access to Personal Health Records and Screening for Breast and Cervical Cancer Among Women with a Family History of Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1128-1134. [PMID: 31264113 DOI: 10.1007/s13187-019-01568-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
It is essential for at-risk women to be screened for breast and cervical cancer in a timely manner. Despite a growing interest in the role of health information technology including personal health records (PHRs) to improve quality and outcomes in health care, less is known about the effectiveness of PHRs to promote breast and cervical cancer screening among women with a family history of cancer (FHC). We examined the association between access to PHRs and the use of a recommended mammography and a Pap smear testing among women with a FHC using data from the 2015 Health Information National Trends Survey (HINTS 4-cycle 4) and the 2016 Area Health Resource Files. The study sample was comprised of 1250 women aged 20-75 years with a FHC, a subsample of 3677 survey respondents. Of the 1250 women, 64.96% received a mammogram, and 75.44% underwent a Pap testing. Among women with a FHC, there was a significant and positive association between access to PHRs and the receipt of a mammogram (adjusted odds ratio (aOR) 4.20; 95% CI, 2.23-7.94; p < .001) and a Pap testing (aOR 3.13; 95% CI, 1.56-6.28; p < .01). Our findings suggest that at-risk women can benefit from greater access to PHRs. Policymakers should consider incentivizing providers and healthcare organizations who provide access to PHRs to their patients as well as developing programs that can help improve access to PHRs among at-risk women.
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Affiliation(s)
- Hyunmin Kim
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, 3825 DesSoto Ave., Memphis, TN, 38152, USA.
| | - Asos Mahmood
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, 3825 DesSoto Ave., Memphis, TN, 38152, USA
| | - Erik Carlton
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, 3825 DesSoto Ave., Memphis, TN, 38152, USA
| | - Joy Goldsmith
- Department of Communication & Film, College of Communication and Fine Arts, University of Memphis, Memphis, TN, 38152, USA
| | - Cyril Chang
- The Methodist and Le Bonheur Center for Healthcare Economics, Memphis, TN, 38152, USA
- Department of Economics, The Fogelman College of Business and Economics, University of Memphis, Memphis, TN, 38152, USA
| | - Soumitra Bhuyan
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, 3825 DesSoto Ave., Memphis, TN, 38152, USA
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Dionisi S, Di Simone E, Alicastro GM, Angelini S, Giannetta N, Iacorossi L, Di Muzio M. Nursing Summary: designing a nursing section in the Electronic Health Record. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:293-299. [PMID: 31580318 PMCID: PMC7233749 DOI: 10.23750/abm.v90i3.7411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022]
Abstract
The introduction of new information technologies in healthcare led to major changes in the field of tools for managing and evaluating the assistance. In Italy, an example of applying new technologies to the healthcare context is the realization of Fascicolo Sanitario Elettronico (FSE). The FSE is a tool that collects online data and health and socio-health information that make up the patient’s clinical history. The aim of this review is to analyze which components are needed to organize and structure the information and data within the “Nursing Summary”. Literature searches were conducted using the following available online Databases: CINAHL, PubMed and Cochrane Library. The searches were conducted by analyzing publications from the last five years (2012-2016). The process of selection of articles led to the choice of 14 research studies. Additionally, national guidelines were analyzed, concerning official documents and technical specifications for the development of projects of FSE. The analysis of the scientific literature showed that nursing data in the EHR can be used to develop some Clinical Decision Support Systems. Relevant were also used to clarify how the nursing data could be structured in the “Nursing Summary”. The research findings have identified which could be the main components of a possible nursing section to integrate the FSE. This project is proposed as a preliminary study that needs further development. (www.actabiomedica.it)
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Affiliation(s)
- Sara Dionisi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy.
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Kim JW, Ryu B, Cho S, Heo E, Kim Y, Lee J, Jung SY, Yoo S. Impact of Personal Health Records and Wearables on Health Outcomes and Patient Response: Three-Arm Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e12070. [PMID: 30609978 PMCID: PMC6682299 DOI: 10.2196/12070] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/14/2018] [Accepted: 11/22/2018] [Indexed: 12/21/2022] Open
Abstract
Background Although using the technologies for a variety of chronic health conditions such as personal health record (PHR) is reported to be acceptable and useful, there is a lack of evidence on the associations between the use of the technologies and the change of health outcome and patients’ response to a digital health app. Objective This study aimed to examine the impact of the use of PHR and wearables on health outcome improvement and sustained use of the health app that can be associated with patient engagement. Methods We developed an Android-based mobile phone app and used a wristband-type activity tracker (Samsung Charm) to collect data on health-related daily activities from individual patients. Dietary record, daily step counts, sleep log, subjective stress amount, blood pressure, and weight values were recorded. We conducted a prospective randomized clinical trial across 4 weeks on those diagnosed with obstructive sleep apnea (OSA) who had visited the outpatient clinic of Seoul National University Bundang Hospital. The trial randomly assigned 60 patients to 3 subgroups including 2 intervention groups: (1) mobile app and wearable device users (n=20), (2) mobile app–only users (n=20), and (3) controls (n=20). The primary outcome measure was weight change. Body weights before and after the trial were recorded and analyzed during clinic visits. Changes in OSA–related respiratory parameters such as respiratory disturbance, apnea-hypopnea, and oxygenation desaturation indexes and snoring comprised the secondary outcome and were analyzed for each participant. Results We collected the individual data for each group during the trial, specifically anthropometric measurement and laboratory test results for health outcomes, and the app usage logs for patient response were collected and analyzed. The body weight showed a significant reduction in the 2 intervention groups after intervention, and the mobile app–only group showed more weight loss compared with the controls (P=.01). There were no significant changes in sleep-related health outcomes. From a patient response point of view, the average daily step counts (8165 steps) from the app plus wearable group were significantly higher than those (6034 steps) from the app-only group because they collected step count data from different devices (P=.02). The average rate of data collection was not different in physical activity (P=.99), food intake (P=.98), sleep (P=.95), stress (P=.70), and weight (P=.90) in the app plus wearable and app-only groups, respectively. Conclusions We tried to integrate PHR data that allow clinicians and patients to share lifelog data with the clinical workflow to support lifestyle interventions. Our results suggest that a PHR–based intervention may be successful in losing body weight and improvement in lifestyle behavior. Trial Registration ClinicalTrials.gov NCT03200223; https://clinicaltrials.gov/ct2/show/NCT03200223 (Archived by WebCite at http://www.webcitation.org/74baZmnCX).
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Affiliation(s)
- Jeong-Whun Kim
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Borim Ryu
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seoyoon Cho
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunyoung Heo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yoojung Kim
- Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Republic of Korea
| | - Joongseek Lee
- Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Republic of Korea
| | - Se Young Jung
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Lancaster K, Abuzour A, Khaira M, Mathers A, Chan A, Bui V, Lok A, Thabane L, Dolovich L. The Use and Effects of Electronic Health Tools for Patient Self-Monitoring and Reporting of Outcomes Following Medication Use: Systematic Review. J Med Internet Res 2018; 20:e294. [PMID: 30563822 PMCID: PMC6315271 DOI: 10.2196/jmir.9284] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/18/2018] [Accepted: 09/14/2018] [Indexed: 11/13/2022] Open
Abstract
Background Electronic health (eHealth) tools are becoming increasingly popular for helping patients’ self-manage chronic conditions. Little research, however, has examined the effect of patients using eHealth tools to self-report their medication management and use. Similarly, there is little evidence showing how eHealth tools might prompt patients and health care providers to make appropriate changes to medication use. Objective The objective of this systematic review was to determine the impact of patients’ use of eHealth tools on self-reporting adverse effects and symptoms that promote changes to medication use. Related secondary outcomes were also evaluated. Methods MEDLINE, EMBASE, and CINAHL were searched from January 1, 2000, to April 25, 2018. Reference lists of relevant systematic reviews and included articles from the literature search were also screened to identify relevant studies. Title, abstract, and full-text review as well as data extraction and risk of bias assessment were performed independently by 2 reviewers. Due to high heterogeneity, results were not meta-analyzed and instead presented as a narrative synthesis. Results A total of 14 studies, including 13 randomized controlled trials (RCTs) and 1 open-label intervention, were included, from which 11 unique eHealth tools were identified. In addition, 14 RCTs found statistically significant increases in positive medication changes as a result of using eHealth tools, as did the single open-label study. Moreover, 8 RCTs found improvement in patient symptoms following eHealth tool use, especially in adolescent asthma patients. Furthermore, 3 RCTs showed that eHealth tools might improve patient self-efficacy and self-management of chronic disease. Little or no evidence was found to support the effectiveness of eHealth tools at improving medication recommendations and reconciliation by clinicians, medication-use behavior, health service utilization, adverse effects, quality of life, or patient satisfaction. eHealth tools with multifaceted functionalities and those allowing direct patient-provider communication may be more effective at improving patient self-management and self-efficacy. Conclusions Evidence suggests that the use of eHealth tools may improve patient symptoms and lead to medication changes. Patients generally found eHealth tools useful in improving communication with health care providers. Moreover, health-related outcomes among frequent eHealth tool users improved in comparison with individuals who did not use eHealth tools frequently. Implementation issues such as poor patient engagement and poor clinician workflow integration were identified. More high-quality research is needed to explore how eHealth tools can be used to effectively manage use of medications to improve medication management and patient outcomes.
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Affiliation(s)
- Karla Lancaster
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Aseel Abuzour
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Manmeet Khaira
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.,School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Annalise Mathers
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - April Chan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Vivian Bui
- Pharmacy Department, Sunnybrook Health Sciences, Toronto, ON, Canada
| | - Annie Lok
- Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Lisa Dolovich
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Fylan F, Caveney L, Cartwright A, Fylan B. Making it work for me: beliefs about making a personal health record relevant and useable. BMC Health Serv Res 2018; 18:445. [PMID: 29898730 PMCID: PMC6001055 DOI: 10.1186/s12913-018-3254-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/29/2018] [Indexed: 12/30/2022] Open
Abstract
Background A Personal Health Record (PHR) is an electronic record that individuals use to manage and share their health information, e.g. data from their medical records and data collected by apps. However, engagement with their record can be low if people do not find it beneficial to their health, wellbeing or interactions with health and other services. We have explored the beliefs potential users have about a PHR, how it could be made personally relevant, and barriers to its use. Methods A qualitative design comprising eight focus groups, each with 6–8 participants. Groups included adults with long-term health conditions, young people, physically active adults, data experts, and members of the voluntary sector. Each group lasted 60–90 min, was audio recorded and transcribed verbatim. We analysed the data using thematic analysis to address the question “What are people’s beliefs about making a Personal Health Record have relevance and impact?” Results We found four themes. Making it work for me is about how to encourage individuals to actively engage with their PHR. I control my information is about individuals deciding what to share and who to share it with. My concerns is about individuals’ concerns about information security and if and how their information will be acted upon. Potential impact shows the potential benefits of a PHR such as increasing self-efficacy, uptake of health-protective behaviours, and professionals taking a more holistic approach to providing care and facilitating behaviour change. Conclusions Our research shows the functionality that a PHR requires in order for people to engage with it. Interactive functions and integration with lifestyle and health apps are particularly important. A PHR could increase the effectiveness of behaviour change apps by specifying evidence-based behaviour change techniques that apps should incorporate. A PHR has the potential to increase health-protective behaviours and facilitate a more person-driven health and social care system. It could support patients to take responsibility for self-managing their health and treatment regimens, as well as helping patients to play a more active role when care transfers across boundaries of responsibility.
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Affiliation(s)
- Fiona Fylan
- Brainbox Research, 46 Town Street, Gildersome, Leeds, LS27 7AA, UK. .,Leeds Sustainability Institute, Leeds Beckett University, Leeds, LS1 3HE, UK.
| | - Lauren Caveney
- Brainbox Research, 46 Town Street, Gildersome, Leeds, LS27 7AA, UK
| | - Alastair Cartwright
- NHS Leeds North Clinical Commissioning Group, Leafield House, 107-109 King Lane, Leeds, LS17 5BP, UK
| | - Beth Fylan
- Brainbox Research, 46 Town Street, Gildersome, Leeds, LS27 7AA, UK.,School of Pharmacy, Faculty of Life Sciences, University of Bradford, Bradford, BD7 1DP, UK
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11
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Elkind EC, Higgins KM. Patient portal considerations. Nurs Manag (Harrow) 2018; 49:9-11. [PMID: 29485465 DOI: 10.1097/01.numa.0000530430.91645.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Elizabeth C Elkind
- Elizabeth C. Elkind is an associate clinical professor at Northern Arizona University, Phoenix Campus, in Phoenix, Ariz. Kathleen M. Higgins is an acute care cardiology NP at the University of Pennsylvania, Penn-Presbyterian Campus, in Philadelphia, Pa
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Rantanen MM, Koskinen J. PHR, We’ve Had a Problem Here. THIS CHANGES EVERYTHING – ICT AND CLIMATE CHANGE: WHAT CAN WE DO? 2018. [DOI: 10.1007/978-3-319-99605-9_28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Abstract
Hospitals, patient-centered medical homes, and provider practices have either introduced or are in the process of planning for patient portals. The NP plays an important role in the patient engagement initiative. This article explores patient portal strategies and resources to support this technology integration and practice change.
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Affiliation(s)
- Elizabeth C Elkind
- Elizabeth C. Elkind is an associate clinical professor at Northern Arizona University, Phoenix Campus, Phoenix, Ariz. Kathleen M. Higgins is an acute care cardiology NP at the University of Pennsylvania, Penn-Presbyterian Campus, Philadelphia, Pa
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Roehrs A, da Costa CA, Righi RDR, de Oliveira KSF. Personal Health Records: A Systematic Literature Review. J Med Internet Res 2017; 19:e13. [PMID: 28062391 PMCID: PMC5251169 DOI: 10.2196/jmir.5876] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 09/16/2016] [Accepted: 12/18/2016] [Indexed: 02/07/2023] Open
Abstract
Background Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients’ health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. Objective This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. Methods The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. Results As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches, and thoroughly surveyed the health care field related to PHRs. We developed an updated taxonomy and identified challenges, open questions, and current data types, related standards, main profiles, input strategies, goals, functions, and architectures of the PHR. Conclusions All of these results contribute to the achievement of a significant degree of coverage regarding the technology related to PHRs.
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Affiliation(s)
- Alex Roehrs
- Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
| | - Cristiano André da Costa
- Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
| | - Rodrigo da Rosa Righi
- Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
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Cooley ME, Siefert ML. Assessment of Multiple Co-Occurring Cancer Symptoms in the Clinical Setting. Semin Oncol Nurs 2016; 32:361-372. [PMID: 27776830 DOI: 10.1016/j.soncn.2016.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To discuss multiple co-occurring cancer symptoms, review symptom assessment instruments, identify innovative methods to integrate symptom assessment and management in the clinical setting, and examine barriers and facilitators for implementation of symptom assessment and use of clinical practice guidelines. DATA SOURCES Peer-reviewed articles, guidelines, systematic reviews, and web-based resources. CONCLUSION Despite the availability of brief, reliable, and valid instruments, symptom assessment has not been integrated as a routine aspect of clinical care. New technologies and changes in health policy provide an optimal environment to integrate electronic symptom assessment and management into cancer care. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses play a key role in early identification and management of distressing symptoms.
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Wu PY, Cheng CW, Kaddi CD, Venugopalan J, Hoffman R, Wang MD. -Omic and Electronic Health Record Big Data Analytics for Precision Medicine. IEEE Trans Biomed Eng 2016; 64:263-273. [PMID: 27740470 DOI: 10.1109/tbme.2016.2573285] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Rapid advances of high-throughput technologies and wide adoption of electronic health records (EHRs) have led to fast accumulation of -omic and EHR data. These voluminous complex data contain abundant information for precision medicine, and big data analytics can extract such knowledge to improve the quality of healthcare. METHODS In this paper, we present -omic and EHR data characteristics, associated challenges, and data analytics including data preprocessing, mining, and modeling. RESULTS To demonstrate how big data analytics enables precision medicine, we provide two case studies, including identifying disease biomarkers from multi-omic data and incorporating -omic information into EHR. CONCLUSION Big data analytics is able to address -omic and EHR data challenges for paradigm shift toward precision medicine. SIGNIFICANCE Big data analytics makes sense of -omic and EHR data to improve healthcare outcome. It has long lasting societal impact.
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Abstract
Real-world data is that collected outside the constraints of controlled clinical trials and is increasingly informing decision-making in healthcare. The landscape of real-world data in the United Kingdom is set to evolve over the coming months as the government plans to build on databases currently in place by collecting patient data from all family practices and linking this information with hospital records. This initiative, called care.data, has the potential to be an invaluable resource. However, the programme has been criticized on grounds of data privacy, which has led to an extended delay in its implementation and the expectation that a large number of people will opt out. Opt-outs may introduce substantial biases to the dataset, and understanding how to account for these presents a significant challenge for researchers. For the scope and quality of real-world evidence in the United Kingdom to be realised, and for this information to be used effectively, it is essential to address this challenge.
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Affiliation(s)
- Laura McDonald
- Evidera, Metro Building, 6th Floor, 1 Butterwick, W6 8DL, London, UK
| | - Dimitra Lambrelli
- Evidera, Metro Building, 6th Floor, 1 Butterwick, W6 8DL, London, UK
| | - Radek Wasiak
- Evidera, Metro Building, 6th Floor, 1 Butterwick, W6 8DL, London, UK
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18
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Dalal AK, Dykes PC, Collins S, Lehmann LS, Ohashi K, Rozenblum R, Stade D, McNally K, Morrison CRC, Ravindran S, Mlaver E, Hanna J, Chang F, Kandala R, Getty G, Bates DW. A web-based, patient-centered toolkit to engage patients and caregivers in the acute care setting: a preliminary evaluation. J Am Med Inform Assoc 2016; 23:80-7. [PMID: 26239859 PMCID: PMC7814931 DOI: 10.1093/jamia/ocv093] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/06/2015] [Accepted: 06/03/2015] [Indexed: 11/14/2022] Open
Abstract
We implemented a web-based, patient-centered toolkit that engages patients/caregivers in the hospital plan of care by facilitating education and patient-provider communication. Of the 585 eligible patients approached on medical intensive care and oncology units, 239 were enrolled (119 patients, 120 caregivers). The most common reason for not approaching the patient was our inability to identify a health care proxy when a patient was incapacitated. Significantly more caregivers were enrolled in medical intensive care units compared with oncology units (75% vs 32%; P < .01). Of the 239 patient/caregivers, 158 (66%) and 97 (41%) inputted a daily and overall goal, respectively. Use of educational content was highest for medications and test results and infrequent for problems. The most common clinical theme identified in 291 messages sent by 158 patients/caregivers was health concerns, needs, preferences, or questions (19%, 55 of 291). The average system usability scores and satisfaction ratings of a sample of surveyed enrollees were favorable. From analysis of feedback, we identified barriers to adoption and outlined strategies to promote use.
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Affiliation(s)
- Anuj K Dalal
- Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
| | - Patricia C Dykes
- Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
| | - Sarah Collins
- Harvard Medical School, Boston, Massachusetts, USA Partners HealthCare, Boston, Massachusetts, USA
| | - Lisa Soleymani Lehmann
- Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
| | - Kumiko Ohashi
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ronen Rozenblum
- Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
| | - Diana Stade
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kelly McNally
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | | - Eli Mlaver
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - John Hanna
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Frank Chang
- Partners HealthCare, Boston, Massachusetts, USA
| | | | | | - David W Bates
- Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Partners HealthCare, Boston, Massachusetts, USA
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19
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Otte-Trojel T, de Bont A, Rundall TG, van de Klundert J. What do we know about developing patient portals? a systematic literature review. J Am Med Inform Assoc 2015; 23:e162-8. [PMID: 26335985 DOI: 10.1093/jamia/ocv114] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/29/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Numerous articles have reported on the development of patient portals, including development problems and solutions. We review these articles to inform future patient portal development efforts and to provide a summary of the evidence base that can guide future research. MATERIALS AND METHODS We performed a systematic review of relevant literature to answer 5 questions: (1) What categories of problems related to patient portal development have been defined? (2) What causal factors have been identified by problem analysis and diagnosis? (3) What solutions have been proposed to ameliorate these causal factors? (4) Which proposed solutions have been implemented and in which organizational contexts? (5) Have implemented solutions been evaluated and what learning has been generated? Through searches on PubMed, ScienceDirect and LISTA, we included 109 articles. RESULTS We identified 5 main problem categories: achieving patient engagement, provider engagement, appropriate data governance, security and interoperability, and a sustainable business model. Further, we identified key factors contributing to these problems as well as solutions proposed to ameliorate them. While about half (45) of the 109 articles proposed solutions, fewer than half of these solutions (18) were implemented, and even fewer (5) were evaluated to generate learning about their effects. DISCUSSION Few studies systematically report on the patient portal development processes. As a result, the review does not provide an evidence base for portal development. CONCLUSION Our findings support a set of recommendations for advancement of the evidence base: future research should build on existing evidence, draw on principles from design sciences conveyed in the problem-solving cycle, and seek to produce evidence within various different organizational contexts.
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Affiliation(s)
- Terese Otte-Trojel
- Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
| | - Antoinette de Bont
- Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
| | - Thomas G Rundall
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Joris van de Klundert
- Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
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20
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Raingruber B, Wolf T. Nurse Perspectives Regarding the Meaningfulness of Oncology Nursing Practice. Clin J Oncol Nurs 2015; 19:292-6. [DOI: 10.1188/15.cjon.292-296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dehling T, Gao F, Schneider S, Sunyaev A. Exploring the Far Side of Mobile Health: Information Security and Privacy of Mobile Health Apps on iOS and Android. JMIR Mhealth Uhealth 2015; 3:e8. [PMID: 25599627 PMCID: PMC4319144 DOI: 10.2196/mhealth.3672] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 10/21/2014] [Accepted: 11/03/2014] [Indexed: 12/18/2022] Open
Abstract
Background Mobile health (mHealth) apps aim at providing seamless access to tailored health information technology and have the potential to alleviate global health burdens. Yet, they bear risks to information security and privacy because users need to reveal private, sensitive medical information to redeem certain benefits. Due to the plethora and diversity of available mHealth apps, implications for information security and privacy are unclear and complex. Objective The objective of this study was to establish an overview of mHealth apps offered on iOS and Android with a special focus on potential damage to users through information security and privacy infringements. Methods We assessed apps available in English and offered in the categories “Medical” and “Health & Fitness” in the iOS and Android App Stores. Based on the information retrievable from the app stores, we established an overview of available mHealth apps, tagged apps to make offered information machine-readable, and clustered the discovered apps to identify and group similar apps. Subsequently, information security and privacy implications were assessed based on health specificity of information available to apps, potential damage through information leaks, potential damage through information manipulation, potential damage through information loss, and potential value of information to third parties. Results We discovered 24,405 health-related apps (iOS; 21,953; Android; 2452). Absence or scarceness of ratings for 81.36% (17,860/21,953) of iOS and 76.14% (1867/2452) of Android apps indicates that less than a quarter of mHealth apps are in more or less widespread use. Clustering resulted in 245 distinct clusters, which were consolidated into 12 app archetypes grouping clusters with similar assessments of potential damage through information security and privacy infringements. There were 6426 apps that were excluded during clustering. The majority of apps (95.63%, 17,193/17,979; of apps) pose at least some potential damage through information security and privacy infringements. There were 11.67% (2098/17,979) of apps that scored the highest assessments of potential damages. Conclusions Various kinds of mHealth apps collect and offer critical, sensitive, private medical information, calling for a special focus on information security and privacy of mHealth apps. In order to foster user acceptance and trust, appropriate security measures and processes need to be devised and employed so that users can benefit from seamlessly accessible, tailored mHealth apps without exposing themselves to the serious repercussions of information security and privacy infringements.
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Affiliation(s)
- Tobias Dehling
- Department of Information Systems, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
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22
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Korhonen ES, Nordman T, Eriksson K. Technology and its ethics in nursing and caring journals: An integrative literature review. Nurs Ethics 2014; 22:561-76. [PMID: 25335921 DOI: 10.1177/0969733014549881] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Over the past 20 years, the impact of technology has increased significantly in health care. The diversity of technology is growing and its knowledge scattered. The concept of technology is ambiguous in caring and nursing sciences and its ethics remains unidentified. AIM To find evidence on how the concept of technology and its ethics are defined in caring and nursing sciences and practice. The purpose of this study is to describe and summarize the concept of technology and its ethics in the past nursing and caring literature. METHOD The integrative literature review of the past nursing and caring literature. The data were collected from caring and nursing journal articles from 2000 to 2013 focusing on technology and its ethics.The results were summarized and themed. RESULTS Technology as a concept has three implications. First, technology is devices and products, including ICT and advanced, simple and assistive technology. Second, technology refers to a process consisting of methods for helping people. Third, technology as a service indicates the production of care by technology. The ethics of technology has not been established as a guiding principle. Some studies excluded ethical reflection completely. Many studies discussed the ethics of technology as benefits such as improved communication and symptoms management, and the simple use of e-health services whilst others remained critical presenting ethical problems such as unwillingness and the inability to use technology, or conflicts with human aspects or questions of inequality. CONCLUSION In conclusion, this study indicates that technology as a concept is described diversely. The relation between technology and ethics is not a truism. Despite some evidence, more is needed to promote ethical care when using technology.
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Affiliation(s)
- Eila-Sisko Korhonen
- Åbo Akademi University, Finland; Helsinki Metropolia University of Applied Sciences, Finland
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23
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Severson C, Renstrom C, Fitzhugh M. Health promotion, risk stratification, and treatment options to decrease hospitalization rates for community-acquired pneumonia in adults. J Am Assoc Nurse Pract 2014; 26:537-49. [PMID: 24170698 PMCID: PMC7166367 DOI: 10.1002/2327-6924.12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 07/12/2012] [Indexed: 11/10/2022]
Abstract
PURPOSE Community-acquired pneumonia (CAP) is a serious illness and hospitalization for this illness is expensive. There is much the nurse practitioner (NP) can do to prevent and manage this illness. DATA SOURCES Review of current literature, medical/nursing references, and data from the healthcare utilization project (HCUP). CONCLUSIONS The use of health promotion, risk stratification, and current evidence-based treatment guidelines can help to decrease hospitalization rates for CAP for adults. IMPLICATIONS FOR PRACTICE NPs are experts at health promotion and evidence-based practice. Adhering to these practices and using risk stratification, NPs can help to further decrease hospitalization rates for CAP lowering healthcare costs related to this serious illness.
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Affiliation(s)
| | | | - Meg Fitzhugh
- College of Nursing and Allied Health, Northwestern State UniversityShreveportLouisiana
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24
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Cipriano PF, Bowles K, Dailey M, Dykes P, Lamb G, Naylor M. The importance of health information technology in care coordination and transitional care. Nurs Outlook 2014; 61:475-89. [PMID: 24409517 DOI: 10.1016/j.outlook.2013.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Care coordination and transitional care services are strategically important for achieving the priorities of better care, better health, and reduced costs embodied in the National Strategy for Quality Improvement in Health Care (National Quality Strategy [NQS]). Some of the most vulnerable times in a person’s care occur with changes in condition as well as movement within and between settings of care. The American Academy of Nursing (AAN) believes it is essential to facilitate the coordination of care and transitions by using health information technology (HIT) to collect, share, and analyze data that communicate patient-centered information among patients, families, and care providers across communities. HIT makes information accessible, actionable, timely, customizable, and portable. Rapid access to information also creates efficiencies in care by eliminating redundancies and illuminating health history and prior care. The adoption of electronic health records (EHRs) and information systems can enable care coordination to be more effective but only when a number of essential elements are addressed to reflect the team-based nature of care coordination as well as a focus on the individual’s needs and preferences. To that end, the AAN offers a set of recommendations to guide the development of the infrastructure, standards, content, and measures for electronically enabled care coordination and transitions in care as well as research needed to build the evidence base to assess outcomes of the associated interventions.
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25
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Free Web-based personal health records: an analysis of functionality. J Med Syst 2013; 37:9990. [PMID: 24221916 DOI: 10.1007/s10916-013-9990-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/08/2013] [Indexed: 12/28/2022]
Abstract
This paper analyzes and assesses the functionality of free Web-based PHRs as regards health information, user actions and connection with other tools. A systematic literature review in Medline, ACM Digital Library, IEEE Digital Library and ScienceDirect was used to select 19 free Web-based PHRs from the 47 PHRs identified. The results show that none of the PHRs selected met 100% of the 28 functions presented in this paper. Two free Web-based PHRs target a particular public. Around 90 % of the PHRs identified allow users throughout the world to create their own profiles without any geographical restrictions. Only half of the PHRs selected provide physicians with user actions. Few PHRs can connect with other tools. There was considerable variability in the types of data included in free Web-based PHRs. Functionality may have implications for PHR use and adoption, particularly as regards patients with chronic illnesses or disabilities. Support for standard medical document formats and protocols are required to enable data to be exchanged with other stakeholders in the health care domain. The results of our study may assist users in selecting the PHR that best fits their needs, since no significant connection exists between the number of functions of the PHRs identified and their popularity.
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26
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Schreiber JA. Electronic health records: current issues in oncology. Oncol Nurs Forum 2012; 40:14-6. [PMID: 23269763 DOI: 10.1188/13.onf.14-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Judy A Schreiber
- School of Nursing, University of Louisville in Kentucky, KY, USA.
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Carrión Señor I, Fernández-Alemán JL, Toval A. Are personal health records safe? A review of free web-accessible personal health record privacy policies. J Med Internet Res 2012; 14:e114. [PMID: 22917868 PMCID: PMC3510685 DOI: 10.2196/jmir.1904] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 01/03/2012] [Accepted: 05/30/2012] [Indexed: 11/16/2022] Open
Abstract
Background Several obstacles prevent the adoption and use of personal health record (PHR) systems, including users’ concerns regarding the privacy and security of their personal health information. Objective To analyze the privacy and security characteristics of PHR privacy policies. It is hoped that identification of the strengths and weaknesses of the PHR systems will be useful for PHR users, health care professionals, decision makers, and designers. Methods We conducted a systematic review using the principal databases related to health and computer science to discover the Web-based and free PHR systems mentioned in published articles. The privacy policy of each PHR system selected was reviewed to extract its main privacy and security characteristics. Results The search of databases and the myPHR website provided a total of 52 PHR systems, of which 24 met our inclusion criteria. Of these, 17 (71%) allowed users to manage their data and to control access to their health care information. Only 9 (38%) PHR systems permitted users to check who had accessed their data. The majority of PHR systems used information related to the users’ accesses to monitor and analyze system use, 12 (50%) of them aggregated user information to publish trends, and 20 (83%) used diverse types of security measures. Finally, 15 (63%) PHR systems were based on regulations or principles such as the US Health Insurance Portability and Accountability Act (HIPAA) and the Health on the Net Foundation Code of Conduct (HONcode). Conclusions Most privacy policies of PHR systems do not provide an in-depth description of the security measures that they use. Moreover, compliance with standards and regulations in PHR systems is still low.
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Affiliation(s)
- Inmaculada Carrión Señor
- Department of Informatics and Systems, Faculty of Computer Science, University of Murcia, Murcia, Spain.
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28
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De la Torre-Díez I, Antón-Rodríguez M, Díaz-Pernas FJ, Perozo-Rondón FJ. Comparison of response times of a mobile-web EHRs system using PHP and JSP languages. J Med Syst 2012; 36:3945-53. [PMID: 22706897 DOI: 10.1007/s10916-012-9866-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 06/05/2012] [Indexed: 11/28/2022]
Abstract
Performance evaluation is highly important in the Electronic Health Records (EHRs) system implementation. Response time's measurement can be considered as one manner to make that evaluation. In the e-health field, after the creation of EHRs available through different platforms such as Web and/or mobile, a performance evaluation is necessary. The operation of the system in the right way is essential. In this paper, a comparison of the response times for the MEHRmobile system is presented. The first version uses PHP language with a MySQL database and the second one employs JSP with an eXist database. Both versions have got the same functionalities. In addition to the technological aspects, a significant difference is the way the information is stored. The main goal of this paper is choosing the version which offers better response times. We have created a new benchmark to calculate the response times. Better results have been obtained for the PHP version. Nowadays, this version is being used for specialists from Fundación Intras, Spain.
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Affiliation(s)
- Isabel De la Torre-Díez
- Department of Signal Theory and Communications, Telematics Engineering University of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain.
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Bose-Brill S, Pressler TR. Commentary: opportunities for innovation and improvement in advance care planning using a tethered patient portal in the electronic health record. J Prim Care Community Health 2012; 3:285-8. [PMID: 23804174 DOI: 10.1177/2150131911435525] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In the last 20 years, progress has been made to develop resources for advance care planning (ACP). Several ACP delivery tools have demonstrated progress, but more are needed to improve ACP delivery systems. Providers continue to indicate that increasing patient volume, increasing patient complexity, and an increasing paperwork burden have adversely affected quality ACP delivery. An increasing and ubiquitous use of health information technology, such as electronic health records and electronic health record-tethered patient portals, affords opportunities for innovation to streamline communication methods between providers and patients. In a medical culture that provides only limited time for physician and patient interactions, physician-patient communication using electronic health record-tethered patient portals may provide a time-efficient, low-cost mechanism for effective ACP.
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Affiliation(s)
- Seuli Bose-Brill
- Division of General Internal Medicine, Department of Internal Medicine, Ohio State University, Columbus, Ohio
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Abstract
OBJECTIVES Consumer empowerment in health and rapid change in health information and communication technologies have their roots in broader social trends. This article reviews the activities at the intersection of consumer empowerment and technology. DATA SOURCES Technical reports, white papers, books, journal articles, and Web sites. CONCLUSION Social trends are visible in the integration of information and communication technologies into health care, in both searching for and sharing information on the Internet, in the use of social media to create new types of interactions with family, providers, and peers, and in the e-patient, who integrates these new roles and new technologies. IMPLICATIONS FOR NURSING PRACTICE Changes in both patients and technology will impact oncology nursing practice as new, patient-centered, interactions emerge.
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