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Lawrence K, Mann D. Virtual-first care: Opportunities and challenges for the future of diagnostic reasoning. CLINICAL TEACHER 2024; 21:e13720. [PMID: 38221668 DOI: 10.1111/tct.13720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/24/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Katharine Lawrence
- Department of Population Health (DPH) and Medical Center Information Technology (MCIT), New York University Grossman School of Medicine, New York City, New York, USA
| | - Devin Mann
- Department of Population Health (DPH) and Medical Center Information Technology (MCIT), New York University Grossman School of Medicine, New York City, New York, USA
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Saylor KW, Fernandes EQ, Adams M, Paraghamian S, Shalowitz DI. Predictors of germline genetic testing referral and completion in ovarian cancer patients at a Comprehensive Cancer Center. Gynecol Oncol 2024; 186:53-60. [PMID: 38599112 PMCID: PMC11216855 DOI: 10.1016/j.ygyno.2024.03.028] [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: 02/02/2024] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES To identify predictors of referral and completion of germline genetic testing among newly diagnosed ovarian cancer patients, with a focus on geographic social deprivation, oncologist-level practices, and time between diagnosis and completion of testing. METHODS Clinical and sociodemographic data were abstracted from medical records of patients newly diagnosed with ovarian cancer between 2014 and 2019 in the University of North Carolina Health System. Factors associated with referral for genetic counseling, completion of germline testing, and time between diagnosis and test results were identified using multivariable regression. RESULTS 307/459 (67%) patients were referred for genetic counseling and 285/459 (62%) completed testing. The predicted probability of test completion was 0.83 (95% CI: 0.77-0.88) for patients with a referral compared to 0.27 (95% CI: 0.18-0.35) for patients without a referral. The predicted probability of referral was 0.75 (95% CI: 0.69-0.82) for patients at the 25th percentile of ZIP code-level Social Deprivation Index (SDI) and 0.67 (0.60-0.74) for patients at the 75th percentile of SDI. Referral varied by oncologist, with predicted probabilities ranging from 0.47 (95% CI: 0.32-0.62) to 0.93 (95% CI: 0.85-1.00) across oncologists. The median time between diagnosis and test results was 137 days (IQR: 55-248 days). This interval decreased by a predicted 24.46 days per year (95% CI: 37.75-11.16). CONCLUSIONS We report relatively high germline testing and a promising trend in time from diagnosis to results, with variation by oncologist and patient factors. Automated referral, remote genetic counseling and sample collection, reduced out-of-pocket costs, and educational interventions should be explored.
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Affiliation(s)
- Katherine W Saylor
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Elizabeth Q Fernandes
- University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Michael Adams
- Division of Pediatric Genetics and Metabolism, University of North Carolina School of Medicine, Chapel Hill, PA, United States of America
| | - Sarah Paraghamian
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, United States of America
| | - David I Shalowitz
- West Michigan Cancer Center, Kalamazoo, MI, United States of America; Collaborative on Equity in Rural Cancer Care, Kalamazoo, MI, United States of America
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Leeson-Smith M, Geddes L, Johnson H, Pit S, Ramsden R. Prevalence of technology and connectivity issues in general practices in rural New South Wales and their impact on staff capability to perform their job. Aust J Rural Health 2024. [PMID: 38706198 DOI: 10.1111/ajr.13129] [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: 10/15/2023] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 05/07/2024] Open
Abstract
OBJECTIVE To identify the technology and connectivity issues in rural and remote general practices, and the factors independently associated with these issues that negatively impact staff's capability to perform their job. METHODS An annual cross-sectional survey of rural and remote general practice managers. Dependent variables included demographic data, practice size, geographic location, connection type and frequency of connectivity issues. Descriptive statistics are presented, and bivariate logistic regression was undertaken to determine factors independently associated with connectivity issues that negatively impact staff's capability to perform their job. PARTICIPANTS One hundred sixty-eight general practice managers from rural and remote New South Wales. RESULTS The majority of respondents (87%, n = 146) indicated that technology and connectivity issues had impacted staff's capability to perform their job. Internet problems were the most frequently reported issue (36%, n = 61). In bivariate analysis, practices that had a total clinical staff headcount between 5 and 7 (OR 0.27; 95% CI 0.10-0.67; p = 0.005) or between 8 and 11 (OR 0.39; 95% CI 0.16-0.95; p = 0.038) were significantly less likely to report technology and connectivity issues that negatively impact staff's capability to perform their job, compared with practices with a total clinical headcount of less than five. CONCLUSIONS Technology and connectivity issues persist in rural and remote general practices. This is the first study to demonstrate that technology and connectivity issues impact on rural staff's capability to perform their job. Furthermore, smaller practices face more technology and connectivity issues that negatively impact staff's capability to do their job than larger practices. Further research is required to find solutions to address these challenges.
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Affiliation(s)
- Margot Leeson-Smith
- Rural Clinical School, School Of Medicine, Sydney Program, University of Notre Dame Sydney, Chippendale, New South Wales, Australia
| | - Louise Geddes
- Rural Clinical School, School Of Medicine, Sydney Program, University of Notre Dame Sydney, Chippendale, New South Wales, Australia
| | - Heath Johnson
- Rural Doctors Network, St Leonards, New South Wales, Australia
| | - Sabrina Pit
- University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
- School of Medicine, University of Western Sydney, Campbelltown, New South Wales, Australia
- Work Wiser International, Lennox Head, New South Wales, Australia
| | - Robyn Ramsden
- Rural Doctors Network, St Leonards, New South Wales, Australia
- Deakin University, Melbourne, Victoria, Australia
- Charles Sturt University, Bathurst, New South Wales, Australia
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Navarro-Martínez O, Martinez-Millana A, Traver V. Use of tele-nursing in primary care: A qualitative study on its negative and positive aspects. Aten Primaria 2024; 56:102843. [PMID: 38215687 PMCID: PMC10827397 DOI: 10.1016/j.aprim.2023.102843] [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: 10/30/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To analyze the opinions of nursing professionals on the current limitations and future potential of digital tools in healthcare. DESIGN Qualitative and descriptive study. LOCATION The study took place during an asynchronous MOODLE course on the use of ICT in healthcare, specifically aimed at nursing professionals. PARTICIPANTS The number of nurses enrolled in the course was 150. METHODS A qualitative study was conducted focusing on the positive and negative aspects that telenursing can offer in the context of a Moodle training in new technologies for nurses. A thematic analysis was carried out following the method proposed by Braun and Clarke. RESULTS In the end 68 nurses participated in the forum. Their statements, opinions and perceptions were analyzed and 28 descriptive codes were obtained and subsequently categorized into positive and negative aspects. CONCLUSIONS Nurses positively value the usefulness of digital tools and identify a wide range of benefits of telenursing in daily practice. At the same time, they point out crucial limitations that may slow down the adoption of telenursing, pointing to areas for improvement such as training and digital literacy of both patients and professionals. They consider that telenursing can humanise care, but insist on the need to prevent its use from increasing health inequalities.
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Affiliation(s)
- Olga Navarro-Martínez
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Valencia, Spain; Instituto ITACA, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain.
| | - Antonio Martinez-Millana
- Instituto ITACA, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain; Grup de Salut Digital CAMFIC, Barcelona, Spain
| | - Vicente Traver
- Instituto ITACA, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain
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Hwang YI(J, Hagos A, Withall A, Hampton S, Snoyman P, Butler T. Population ageing, incarceration and the growing digital divide: Understanding the effects of digital literacy inequity experienced by older people leaving prison. PLoS One 2024; 19:e0297482. [PMID: 38630834 PMCID: PMC11023396 DOI: 10.1371/journal.pone.0297482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/21/2023] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Digital inequity refers to the inequality and exclusion experienced by those who lack the same opportunities or circumstances to support the development of digital skills as the rest of modern society. One rapidly growing and highly vulnerable group to digital inequity is older people attempting to reintegrate into society after release from prison, where technology access is limited. Inadequate support for digital skills in this population entails widespread consequences for public health, human rights, social welfare and recidivism. This qualitative study is the first to: examine digital inequity experienced by older people who have been incarcerated, understand the effects of this on reintegration to society, and begin informing appropriate solutions. METHOD Semi-structured interviews were conducted with N = 15 older people (mean age = 57) who had been released from an Australian prison in the last two years, regarding their experiences of digital literacy since leaving prison. Reflexive thematic analysis was conducted under a critical realist lens. RESULTS The analysis resulted in six themes that illustrated the extent of digital inequity experienced by this population, and key challenges for improving digital literacy: 'surviving in a digital world', 'stranger in a foreign world', 'questioning the digital divide', 'overcoming your "old" self', 'don't like what you don't know', and 'seeking versus finding help'. CONCLUSIONS The digital inequity that older people experience during and after incarceration creates additional challenges for a growing group who are already medically and socially marginalised. Prioritisation of this group for digital literacy initiatives both during incarceration and in the community will have benefits for their health, social and financial reintegration. Their unique life experiences should be considered in designing and delivering these programs. Simultaneously, prisons should be cognizant of the potential detrimental effects of technology restriction on reintegration and criminogenic outcomes.
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Affiliation(s)
- Ye In (Jane) Hwang
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Amanuel Hagos
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales, Sydney, New South Wales, Australia
| | - Adrienne Withall
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen Hampton
- Justice Health and Forensic Mental Health Network, Matraville, New South Wales, Australia
| | | | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Fisher K, Tapley A, Ralston A, Davey A, Fielding A, van Driel M, Holliday E, Ball J, Dizon J, Spike N, Clarke L, Magin P. Video versus telephone for telehealth delivery: a cross-sectional study of Australian general practice trainees. Fam Pract 2024; 41:198-202. [PMID: 38124491 PMCID: PMC11017778 DOI: 10.1093/fampra/cmad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Remunerated telehealth consultations were introduced in Australia in 2020 in response to the COVID-19 pandemic. Videoconferencing has advantages over telephone-consulting, including improved diagnostic and decision-making accuracy. However, videoconferencing uptake in Australia has been low. This study aimed to establish prevalence and associations of video versus telephone consultations in Australian general practice (GP) registrars' practice. METHODS A cross-sectional analysis of data from 2020 to 2021 (three 6-monthly data-collection rounds) from the Registrars Clinical Encounters in Training (ReCEnT) study. GP registrars record details of 60 consecutive consultations every 6-month term, for a total of 3 terms. Univariable and multivariable logistic regression were performed within the Generalized Estimating Equations framework with the outcome video versus telephone. RESULTS 102,286 consultations were recorded by 1,168 registrars, with 21.4% of consultations performed via telehealth. Of these, telephone accounted for 96.6% (95% CI: 96.3-96.8%) and videoconferencing for 3.4% (95% CI: 3.2-3.7%). Statistically significant associations of using videoconferencing, compared to telephone, included longer consultation duration (OR 1.02, 95% CI: 1.01-1.03 per minute; and mean 14.9 versus 12.8 min), patients aged 0-14 years old (OR 1.29, 95% CI: 1.03-1.62, compared to age 15-34), patients new to the registrar (OR 1.19, 95% CI: 1.04-1.35), part-time registrars (OR 1.84, 95% CI: 1.08-3.15), and areas of less socioeconomic disadvantage (OR 1.27, 95% CI: 1.00-1.62 per decile). CONCLUSIONS Registrars' telehealth consultations were mostly performed via telephone. Telephone use being associated with socioeconomic disadvantage has health equity implications. Future research should explore barriers to videoconferencing use and strategies to increase its uptake.
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Affiliation(s)
- Katie Fisher
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
| | - Amanda Tapley
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
| | - Anna Ralston
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
| | - Andrew Davey
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
| | - Alison Fielding
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
| | - Mieke van Driel
- Faculty of Medicine, General Practice Clinical Unit, University of Queensland, Level 8 Health Sciences Building, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
| | - Jean Ball
- Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton Heights, Australia
| | - Jason Dizon
- Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton Heights, Australia
| | - Neil Spike
- Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, Victoria, Australia
- Department of General Practice and Primary Health Care, University of Melbourne, Berkeley Street, Carlton, Victoria, Australia
- School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Lisa Clarke
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
| | - Parker Magin
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
- Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia
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Chukwusa E, Barclay S, Gulliford M, Harding R, Higginson I, Verne J. General practice service use at the end-of-life before and during the COVID-19 pandemic: a population-based cohort study using primary care electronic health records. BJGP Open 2024; 8:BJGPO.2023.0108. [PMID: 37993135 PMCID: PMC11169988 DOI: 10.3399/bjgpo.2023.0108] [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: 06/09/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Globally, the COVID-19 pandemic has caused unprecedented strain in healthcare systems, but little is known about how it affected patients requiring palliative and end-of-life care from GPs. AIM To evaluate the impact of the pandemic on primary care service use in the last 3 months of life, including consultations and prescribing, and to identify associated factors. DESIGN AND SETTING A retrospective cohort study in UK, using data from the Clinical Practice Research Datalink. METHOD The study cohort included those who died between 2019 and 2020. Poisson regression models using generalised estimation equations were used to examine the association between primary care use and patient characteristics. Adjusted rate ratios (aRRs) and 95% confidence intervals (95% CIs) were estimated. RESULTS A total of 44 534 patients died during the study period. The pandemic period was associated with an 8.9% increase in the rate of consultations from 966.4 to 1052.9 per 1000 person-months, and 14.3% longer telephone consultation duration (from 10.1 to 11.5 minutes), with a switch from face-to-face to telephone or video consultations. The prescription of end-of-life care medications increased by 6.3%, from 1313.7 to 1396.3 per 1000 person-months. The adjusted rate ratios for consultations (aRR = 1.08, 95% CI = 1.06 to 1.10, P<0.001) and prescriptions (aRR 1.05: 95% CI = 1.03 to 1.07, P<0.001) also increased during the pandemic. CONCLUSION The pandemic had a major impact on GP service use, leading to longer consultations, shifts from face-to-face to telephone or video consultations, and increased prescriptions. GP workload-related issues must be addressed urgently to ease the pressure on GPs.
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Affiliation(s)
- Emeka Chukwusa
- King's College London, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, London, UK
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Martin Gulliford
- Department of Population Health Sciences, King's College London, Faculty of Life Science & Medicine, London, UK
| | - Richard Harding
- King's College London, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, London, UK
| | - Irene Higginson
- King's College London, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, London, UK
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Luna A, Elleson N, Forfia A. Diabetes Prevention Program Enrichment Through Video: A Tool to Improve Engagement in Hard-to-Reach Populations. ADCES IN PRACTICE 2024; 12:8-13. [PMID: 38464398 PMCID: PMC10921551 DOI: 10.1177/2633559x241227647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
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Fisher K, Tapley A, Ralston A, Davey A, Fielding A, van Driel M, Holliday E, Ball J, Dizon J, Spike N, Clarke L, Magin P. General practice trainees' telehealth use during the COVID-19 pandemic: a cross-sectional study. Fam Pract 2023; 40:638-647. [PMID: 36882013 PMCID: PMC10745257 DOI: 10.1093/fampra/cmad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Prompted by the COVID-19 pandemic, remuneration was introduced for Australian general practice telehealth consultations. General practitioner (GP) trainees' telehealth use is of clinical, educational, and policy importance. The aim of this study was to assess the prevalence and associations of telehealth versus face-to-face consultations amongst Australian GP registrars (vocational GP trainees). METHODS Cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study, from 2020 to 2021 (three 6-month terms), including registrars in 3 of Australia's 9 Regional Training Organisations. In ReCEnT, GP registrars record details of 60 consecutive consultations, 6 monthly. The primary analysis used univariate and multivariable logistic regression, with outcome of whether the consultation was conducted via telehealth (phone and videoconference) or face-to-face. RESULTS 1,168 registrars recorded details of 102,286 consultations, of which 21.4% (95% confidence interval [CI]: 21.1%-21.6%) were conducted via telehealth. Statistically significant associations of a telehealth consultation included shorter consultation duration (odds ratio [OR] 0.93, 95% CI: 0.93-0.94; and mean 12.9 versus 18.7 min); fewer problems addressed per consultation (OR 0.92, 95% CI: 0.87-0.97); being less likely to seek assistance from a supervisor (OR 0.86, 95% CI: 0.76-0.96) while being more likely to generate learning goals (OR 1.18, 95% CI: 1.02-1.37); and being more likely to arrange a follow-up consultation (OR 1.18, 95% CI: 1.02-1.35). CONCLUSIONS That telehealth consultations were shorter, with higher rates of follow-up, has GP workforce/workload implications. That telehealth consultations were less likely to involve in-consultation supervisor support, but more likely to generate learning goals, has educational implications.
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Affiliation(s)
- Katie Fisher
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW, Australia
| | - Amanda Tapley
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW, Australia
| | - Anna Ralston
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW, Australia
| | - Andrew Davey
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW, Australia
| | - Alison Fielding
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW, Australia
| | - Mieke van Driel
- University of Queensland, Faculty of Medicine, General Practice Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia
| | - Elizabeth Holliday
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
| | - Jean Ball
- Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton Heights, NSW, Australia
| | - Jason Dizon
- Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton Heights, NSW, Australia
| | - Neil Spike
- Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, VIC, Australia
- University of Melbourne, Department of General Practice and Primary Health Care, Berkeley Street, Carlton, VIC, Australia
- Monash University, School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Clayton, VIC, Australia
| | - Lisa Clarke
- General Practice Training Tasmania, Regional Training Organisation, Hobart, TAS, Australia
| | - Parker Magin
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW, Australia
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW, Australia
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Sazon H, Catapan SDC, Rahimi A, Canfell OJ, Kelly J. How do Twitter users feel about telehealth? A mixed-methods analysis of experiences, perceptions and expectations. Health Expect 2023; 27:e13927. [PMID: 38038231 PMCID: PMC10726278 DOI: 10.1111/hex.13927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Telehealth use has increased considerably in the last years and evidence suggests an overall positive sentiment towards telehealth. Twitter has a wide userbase and can enrich our understanding of telehealth use by users expressing their personal opinions in an unprompted way. This study aimed to explore Twitter users' experiences, perceptions and expectations about telehealth over the last 5 years. METHODS Mixed-methods study with sequential complementary quantitative and qualitative phases was used for analysis stages comprising (1) a quantitative semiautomated analysis and (2) a qualitative research-led thematic analysis. A machine learning model was used to establish the data set with relevant English language tweets from 1 September 2017 to 1 September 2022 relating to telehealth using predefined search words. Results were integrated at the end. RESULTS From the initial 237,671 downloaded tweets, 6469 had a relevancy score above 0.8 and were input into Leximancer and 595 were manually analysed. Experiences, perceptions and expectations were categorised into three domains: experience with telehealth consultation, telehealth changes over time and the purpose of the appointment. The most tweeted experience was expectations for telehealth consultation in comparison to in-person consultations. Users mostly mentioned the hope that waiting times for the consultations to start to be less than in-person, more telehealth appointments to be available and telehealth to be cheaper. Perceptions around the use of telehealth in relation to healthcare delivery changes brought about by the COVID-19 pandemic were also expressed. General practitioners were mentioned six times more than other healthcare professionals. CONCLUSION/IMPLICATIONS This study found that Twitter users expect telehealth services to be better, more affordable and more available than in-person consultations. Users acknowledged the convenience of not having to travel for appointments and the challenges to adapt to telehealth. PATIENT OR PUBLIC CONTRIBUTION An open data set with 237,671 tweets expressing users' opinions in an unprompted way was used as a source for telehealth service users, caregivers and members of the public experiences, perceptions and expectations of telehealth.
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Affiliation(s)
- Hannah Sazon
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Soraia de Camargo Catapan
- Centre for Online HealthThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | | | - Oliver J. Canfell
- Queensland Digital Health Centre, Centre for Health Services Research, Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Digital Health Cooperative Research CentreAustralian GovernmentSydneyNew South WalesAustralia
- UQ Business School, Faculty of Business, Economics and LawThe University of QueenslandBrisbaneQueenslandAustralia
| | - Jaimon Kelly
- Centre for Online HealthThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
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Xiao Y, Chen TT, Zhou YL, Zhu SY. Challenges in establishing a strong telemedicine system in China. Postgrad Med J 2023; 99:1-3. [PMID: 36947420 DOI: 10.1093/postmj/qgac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/22/2022] [Accepted: 11/05/2022] [Indexed: 01/12/2023]
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 610036, China
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu 610036, China
| | - Ting-Ting Chen
- Nursing School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Ya-Ling Zhou
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu 610036, China
| | - Shao-Yi Zhu
- Department of Psychiatry, Shantou University Mental Health Center, Shantou 515065, China
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Sheikh Y, Ali A, Khasati A, Hasanic A, Bihani U, Ohri R, Muthukumar K, Barlow J. Benefits and Challenges of Video Consulting for Mental Health Diagnosis and Follow-Up: A Qualitative Study in Community Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2595. [PMID: 36767957 PMCID: PMC9915222 DOI: 10.3390/ijerph20032595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Mental health services continue to experience rising demand that exceeds capacity. The COVID-19 pandemic exacerbated this crisis, with access to services being reduced. Although video consultations (VCs) are a solution, usage in UK community mental healthcare settings remains limited. This study aims to investigate psychiatrists' and general practitioners' (GPs) perceptions of the benefits and challenges of VC for the diagnosis and follow-up of general adult mental health patients in the community during the COVID-19 pandemic. Semi-structured interviews in NHS community mental healthcare settings were conducted. Psychiatrists (n = 11) and GPs (n = 12) were recruited through purposive sampling. An explorative qualitative approach was employed. Data were analysed using thematic analysis. Four key themes were identified: (1) patient access to VC, (2) suitability of VC for mental health consultations, (3) information gathering with VC and (4) clinician satisfaction with VC. This study provides valuable insights into the experiences of psychiatrists and GPs working in the UK during the COVID-19 pandemic. To facilitate a digital-first future for the NHS, greater investment in remote technologies is required, particularly in the context of growing mental healthcare demand. Though face-to-face consultations remain the gold standard, VC provides an efficient way of communicating with patients, particularly those with less severe forms of mental illness.
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Brunelli L, Bussolaro S, Dobrina R, De Vita C, Mazzolini E, Verardi G, Degrassi M, Piazza M, Cassone A, Starec A, Ricci G, Zanchiello S, Stampalija T. Exploring the Needs and Expectations of Expectant and New Parents for an mHealth Application to Support the First 1000 Days of Life: Steps toward a Co-Design Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1227. [PMID: 36673978 PMCID: PMC9858695 DOI: 10.3390/ijerph20021227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 05/05/2023]
Abstract
To improve maternal and child health, it is essential to adhere to health-promoting and preventive measures. However, reliable information as well as effective tools are not easy to identify in this field. Our cross-sectional study investigated the needs and expectations of expectant and new mothers and fathers as potential primary users of a hypothetical application supporting the first 1000 days of life. Between May and August 2022, we recruited expectant and new parents by administering an 83-item 5-point Likert scale questionnaire related to the content, functionalities, and technical features of the hypothetical app. We stratified responses using sociodemographic characteristics and then performed ward hierarchical clustering. The 94 women and 69 men involved in our study generally agreed with the proposed content, but expressed low interest in certain app functionalities or features, including those related to the interaction mechanism and interactivity. Women were generally more demanding than men. Our findings, resulting from the engagement of end-users, may be useful for designers and technology providers to implement mHealth solutions that, in addition to conveying reliable information, are tailored to the needs and preferences of end-users in the first 1000 days of life.
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Affiliation(s)
- Laura Brunelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Sofia Bussolaro
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Raffaella Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | | | - Elena Mazzolini
- Department of Epidemiology, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | - Giuseppa Verardi
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Maura Degrassi
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Maria Piazza
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Andrea Cassone
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | | | - Giuseppe Ricci
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
- Obstetrics and Gynecology Clinic, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | | | - Tamara Stampalija
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
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Laake JP, De Soysa M, Subhaskaran K, Scott J, Baker ISC, Alavala S, Desai D, Hein J, Owen K. Impact of Increased Patient-Clinician Virtual Visits During the COVID-19 Pandemic on Medical Student Enthusiasm for Future General Practice Careers. Fam Med 2023; 55:3-11. [PMID: 36656881 PMCID: PMC10681335 DOI: 10.22454/fammed.55.909451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The COVID-19 pandemic restricted the availability of face-to-face primary care visits. This rapidly increased the proportion of primary care patient-clinician visits conducted virtually and asynchronously (remote consultations via video, telephone, and web-based text/email), altering the educational environment for medical students. Our study explored the impact of the increased proportion of primary care visits conducted virtually and asynchronously, on medical students' self-reported interest in pursuing a career in general (family) practice. METHODS We conducted a cross-sectional survey study of medical students at six universities within England and Wales to explore the impact of the increased proportion of primary care visits conducted virtually and asynchronously on medical students' interest in pursuing a career in general practice. RESULTS One hundred fifty-four medical students were recruited between December 2020 and May 2021; 79 (51%) of the participants reported being less interested in pursuing a career in general practice as a result of the increased proportion of virtual and asynchronous primary care visits during the COVID-19 pandemic. This increased to 104 (68%) of the participants reporting being less interested should primary care visits continue to be delivered virtually or asynchronously by default. Analysis of open-ended survey questions identified a poorer educational experience, concerns regarding the impact on patient care, an isolated working environment and technological challenges as key negative themes. CONCLUSIONS Sociable, supportive working and learning environments and offering equitable care are important motivators for the future workforce. There is a need to develop robust training and assessment in patient-clinician virtual visits and asynchronous communication and to integrate this into curricula.
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Affiliation(s)
- Jean-Pierre Laake
- Warwick Medical School, University of WarwickCoventryUK
- College of Life Sciences, University of LeicesterLeicesterUK
| | | | | | - Jessica Scott
- GKT School of Medical Education, King's College LondonLondonUK
| | | | | | - Deep Desai
- Birmingham Medical School, University of BirminghamBirminghamUK
| | - Jennifer Hein
- Swansea University Medical School, Swansea UniversitySwanseaUK
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15
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Yuan W. Identifying the Effect of Digital Healthcare Products in Metaverse on Mental Health: Studying The Interaction of Cyberchondria and Technophobia. Am J Health Behav 2022; 46:729-739. [PMID: 36721275 DOI: 10.5993/ajhb.46.6.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objectives: Metaverse has emerged as an innovative social media platform and Internet applications which integrates several cutting-edge technologies. It possesses connectedness, hyper spatio-temporality, and several technology attributes. The metaverse also can potentially reinvent health's digital and practical prospects, much as the Internet drastically changed that industry. Major ramifications will follow for both our well-being and the provision of healthcare. In China, after the emergence of the pandemic, there is a substantial need for digital healthcare services since the interaction between hospitals and people requiring consultation is minimal. The current study will examine the impact of digital healthcare products in the metaverse on mental health while considering the moderating effect of cyberchondria and technophobia. The need for more resources and increased demand for healthcare services creates difficulty in promptly delivering services to the needy. Metaverse and its technology can improve the performance of the current healthcare system. Methods: The research utilized a quantitative survey- based method in the healthcare sector among staff members. Of 330 questionnaires distributed, 307 were collected and analyzed through SPSS and AMOS. Results: The analysis signified a strong and significant association between digital healthcare products and mental health in the metaverse, along with the considerable moderation of technophobia. Conclusion: The paper can improve healthcare sector staff members' provision practices and mental health. It can provide cost-effective solutions to the sector.
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Affiliation(s)
- Wang Yuan
- Wang Yuan, Nanjing University, Nanjing' 210093, Jiangsu, China; Xuzhou Medical University, Xuzhou' 221004, Jiangsu, China;
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Qiu CS, Majeed A, Khan S, Watson M. Transforming health through the metaverse. J R Soc Med 2022; 115:484-486. [PMID: 36480946 PMCID: PMC9747900 DOI: 10.1177/01410768221144763] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Connor S Qiu
- School of Public Health, Imperial College London, London SW7 2AZ, UK,Connor S Qiu.
| | - Azeem Majeed
- School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Sadhia Khan
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK
| | - Mando Watson
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK
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