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Elkefi S. Supporting patients' workload through wearable devices and mobile health applications, a systematic literature review. ERGONOMICS 2024; 67:954-970. [PMID: 37830977 DOI: 10.1080/00140139.2023.2270780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 08/25/2023] [Indexed: 10/14/2023]
Abstract
Patients face a challenging workload in their course of care. In this study, we investigate the impact of using mobile health technologies in supporting this workload and identify the system challenges of its application through a systematic review of the literature published in the last two decades following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines PRISMA guidelines. Twenty-two studies that satisfied the inclusion criteria were included. The review revealed various mobile health and wearable devices used to support mental demand, physical demand, frustration, and performance. Better outcomes were related to mobile health use in healthcare for patients in different settings. There were no applications of health that supported the temporal demand of patients. Some populations, such as cancer patients, need more than only physical demand. Mhealth devices are important in supporting the patients' workload in their daily activities and clinical settings.Practitioner summary: This review study shows the importance of mHealth and wearables in supporting patients' workload (physical, mental, emotional) but not the temporal load.
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Affiliation(s)
- Safa Elkefi
- Nursing School, Columbia University, New York, NY, USA
- HPHACTORS Lab, NYC, USA
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Liu J, Zhou Y, Tang Y, Chen J, Li J. Patient engagement during the transition from nondialysis-dependent chronic kidney disease to dialysis: A meta-ethnography. Health Expect 2023; 26:2191-2204. [PMID: 37641530 PMCID: PMC10632643 DOI: 10.1111/hex.13850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Patient engagement, encompassing both patient experience and opportunities for involvement in care, has been associated with increased patient satisfaction and the overall quality of care. Despite its importance, there is limited knowledge regarding patient engagement in the transition from nondialysis-dependent chronic kidney disease (CKD) to dialysis-dependent treatment. This systematic review employs meta-ethnography to synthesize findings from qualitative studies examining patients' experiences of engagement during this transition, with the aim of developing a comprehensive theoretical understanding of patient engagement in the transition from nondialysis-dependent CKD to dialysis. METHODS A systematic search of six databases, namely the Cochrane Library, PsycINFO, Scopus, Embase, PubMed and Web of Science was conducted to identify eligible articles published between 1990 and 2022. Meta-ethnography was utilized to translate and synthesize the findings and develop a novel theoretical interpretation of 'patient engagement' during the transition to dialysis. RESULTS A total of 24 articles were deemed eligible for review, representing 21 studies. Patient engagement during a transition to dialysis was found to encompass three major domains: psychosocial adjustment, decision-making and engagement in self-care. These three domains could be experienced as an iterative and mutually reinforcing process, guiding patients toward achieving control and proficiency in their lives as they adapt to dialysis. Additionally, patient engagement could be facilitated by factors including patients' basic capability to engage, the provision of appropriate education, the establishment of supportive relationships and the alignment with values and resources. CONCLUSIONS The findings of this review underscore the necessity of involving patients in transitional dialysis care, emphasizing the need to foster their engagement across multiple domains. Recommendations for future interventions include the provision of comprehensive support to enhance patient engagement during this critical transition phase. Additional research is warranted to explore the effects of various facilitators at different levels. PATIENT OR PUBLIC CONTRIBUTION The studies included in our review involved 633 participants (547 patients, 14 family members, 63 healthcare providers and 9 managers). Based on their experiences, views and beliefs, we developed a deeper understanding of patient engagement and how to foster it in the future.
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Affiliation(s)
- Jinjie Liu
- School of NursingSun Yat‐sen UniversityGuangzhouChina
| | - Yujun Zhou
- The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Yanyao Tang
- School of NursingSun Yat‐sen UniversityGuangzhouChina
| | - Jieling Chen
- School of NursingSun Yat‐sen UniversityGuangzhouChina
| | - Jianying Li
- The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
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van der Storm SL, Hensen N, Schijven MP. Patient satisfaction with stoma care and their expectations on mobile apps for supportive care. Colorectal Dis 2023; 25:1852-1862. [PMID: 37507846 DOI: 10.1111/codi.16658] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/25/2023] [Accepted: 05/17/2023] [Indexed: 07/30/2023]
Abstract
AIM Self-efficacy in stoma care is essential, as it reduces morbidity and psychosocial problems. Mobile applications (apps) may optimise patients' self-efficacy. This article investigates patients' satisfaction with stoma care, their attitudes towards a supporting app aiming to promote self-efficacy and evaluate which functionalities are desired. METHOD A survey was sent to members of the two stoma-related patient associations in the Netherlands. Associations between patient characteristics, satisfaction concerning received stoma care, and willingness to use an app were evaluated. RESULTS The survey was completed by 1868 patients. Overall satisfaction was scored as 6.6, with shortfalls reported in the preoperative information provision, stoma site selection, and postoperative care. Patients of older age, who were unaware of getting a stoma, had an ileostomy, a low quality of life or psychosocial problems, were less satisfied. An app was expected to be of added value by 59.4% of the patients having a stoma for less than three years, compared to the significantly lower 43.8% expectation rate of the remaining study population (p < 0.001). Moreover, patients with a high frequency of physical or psychosocial problems expressed higher levels of interest. CONCLUSION Patients were only moderately satisfied with their received stoma care. A supportive app is most likely beneficial for patients who had a stoma for less than three years, were in an acute situation, and/or have stoma-related problems. Most patients prefer information via internet or on paper, although apps may offer additional benefits. It is important to acknowledge digital literacy and to council patients appropriately about the benefits and help them to use apps.
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Affiliation(s)
- Sebastiaan L van der Storm
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Nikita Hensen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
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Cozad MJ, Crum M, Tyson H, Fleming PR, Stratton J, Kennedy AB, Lindley LC, Horner RD. Mobile Health Apps for Patient-Centered Care: Review of United States Rheumatoid Arthritis Apps for Engagement and Activation. JMIR Mhealth Uhealth 2022; 10:e39881. [PMID: 36469397 PMCID: PMC9764152 DOI: 10.2196/39881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a highly dynamic and individualized disease in terms of its patterns of symptomatic flare-ups and periods of remission. Patient-centered care (PCC) aligns patients' lifestyle goals with their preferences for managing symptoms and side effects through the selection of therapies appropriate for disease management. Mobile health (mHealth) apps have the potential to engage and activate patients in PCC. mHealth apps can provide features that increase disease knowledge, collect patient-generated health indicators and behavioral metrics, and highlight goals for disease management. However, little evidence-based guidance exists as to which apps contain functionality essential for supporting the delivery of PCC. OBJECTIVE The objective of this study was to evaluate the patient-centeredness of United States-based rheumatoid arthritis mobile apps in terms of patient engagement and activation. METHODS A search of mobile apps on 2 major United States app stores (Apple App Store and Google Play) was conducted from June 2020 to July 2021 to identify apps designed for use by patients with RA by adapting the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines for mobile health app screening based on the literature. Reviewers conducted a content analysis of mobile app features to evaluate their functionality for patient engagement and activation. Engagement and activation were assessed using the Mobile Application Rating Scale (MARS) and social cognitive theory, respectively. Apps were ranked by their ability to facilitate PCC care along 2 dimensions: engagement and activation. RESULTS A total of 202 mobile apps were initially identified, and 20 remained after screening. Two apps emerged with the greatest ability to facilitate PCC. Both apps were scored as having acceptable or good patient engagement according to the MARS. These 2 apps also had high patient activation according to social cognitive theory, with many features within those apps representing theoretical constructs such as knowledge, perceived self-efficacy, and expectations about outcomes that support behavioral management of RA. CONCLUSIONS We found very few mobile apps available within the United States that have functionality that both engages and activates the patient to facilitate PCC. As the prevalence of mobile apps expands, the design of mobile apps needs to integrate patients to ensure that their functionality promotes engagement and activation. More research is needed to understand how mobile app use impacts patient engagement and activation, and ultimately, treatment decisions and disease trajectory.
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Affiliation(s)
- Melanie J Cozad
- Health Services Research and Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Marissa Crum
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Hannah Tyson
- Business and Accounting Department, Furman University, Greenville, SC, United States
| | - Perry R Fleming
- School of Medicine Greenville, University of South Carolina, Columbia, SC, United States
| | - Jeanine Stratton
- Business and Accounting Department, Furman University, Greenville, SC, United States
| | - Ann Blair Kennedy
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Lisa C Lindley
- College of Nursing, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Ronnie D Horner
- Health Services Research and Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
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Duffy A, Christie GJ, Moreno S. The Challenges Toward Real-world Implementation of Digital Health Design Approaches: Narrative Review. JMIR Hum Factors 2022; 9:e35693. [PMID: 36083628 PMCID: PMC9508664 DOI: 10.2196/35693] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/19/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Digital health represents an important strategy in the future of health care delivery. Over the past decade, mobile health has accelerated the agency of health care users. Despite prevailing excitement about the potential of digital health, questions remain on efficacy, uptake, usability, and patient outcome. This challenge is confounded by 2 industries, digital and health, which have vastly different approaches to research, design, testing, and implementation. In this regard, there is a need to examine prevailing design approaches, weigh their benefits and challenges toward implementation, and recommend a path forward that synthesizes the needs of this complex stakeholder group. OBJECTIVE In this review, we aimed to study prominent digital health intervention design approaches that mediate the digital health space. In doing so, we sought to examine the origins, perceived benefits, contrasting nuances, challenges, and typical use-case scenarios of each methodology. METHODS A narrative review of digital health design approaches was performed between September 2020 and April 2021 by referencing keywords such as "digital health design," "mHealth design," "e-Health design," "agile health," and "agile healthcare." The studies selected after screening were those that discussed the design and implementation of digital health design approaches. A total of 120 studies were selected for full-text review, of which 62 (51.6%) were selected for inclusion in this review. RESULTS A review identifying the 5 overarching digital health design approaches was compiled: user-centered design, person-based design, human-centered design, patient-centered design, and patient-led design. The findings were synthesized in a narrative structure discussing the origins, advantages, disadvantages, challenges, and potential use-case scenarios. CONCLUSIONS Digital health is experiencing the growing pains of rapid expansion. Currently, numerous design approaches are being implemented to harmonize the needs of a complex stakeholder group. Whether the end user is positioned as a person, patient, or user, the challenge to synthesize the constraints and affordances of both digital design and health care, built equally around user satisfaction and clinical efficacy, remains paramount. Further research that works toward a transdisciplinarity in digital health may help break down friction in this field. Until digital health is viewed as a hybridized industry with unique requirements rather than one with competing interests, the nuances that each design approach posits will be difficult to realize in a real-world context. We encourage the collaboration of digital and health experts within hybrid design teams, through all stages of intervention design, to create a better digital health culture and design ethos.
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Affiliation(s)
- Anthony Duffy
- School of Interactive Arts & Technology, Simon Fraser University, Surrey, BC, Canada
| | | | - Sylvain Moreno
- School of Interactive Arts & Technology, Simon Fraser University, Surrey, BC, Canada
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Information Technology Ambidexterity-Driven Patient Agility, Patient Service- and Market Performance: A Variance and fsQCA Approach. SUSTAINABILITY 2022. [DOI: 10.3390/su14074371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Modern hospitals are on the brink of a monumental change. They are currently exploring their options to digitally transform their clinical procedures and overall patient engagement. This work thoroughly investigates how hospital departments in the Netherlands can simultaneously leverage their strategic exploration of new IT resources and practices and exploit their current IT practices, i.e., IT ambidexterity, to drive digital transformation. Specifically, we investigate IT ambidexterity’s role in shaping patient agility at the departmental level, i.e., the ability to sense patients’ needs and respond accordingly. In this study, we use the dynamic capability view as our theoretical lens to develop a theoretical model with associated hypotheses and test it using cross-sectional survey data from 90 clinical hospital departments in the Netherlands. We use partial least squares (PLS) structural equation modeling (SEM) and a Fuzzy-set qualitative comparative analysis (fsQCA) approach for our analyses. This study shows that IT ambidexterity positively influences patient agility, providing a foundation for the achievement of high patient service and market performance. Furthermore, this study’s outcomes show that IT ambidexterity is present in each configuration following the fsQCA analyses, showcasing the vital role of a dual strategic approach to IT practices. The study outcomes support the theorized model and the subsequently developed IT-driven patient agility framework and illuminate how to transform clinical practice and drive patient agility.
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Multidimensional Study on Users’ Evaluation of the KRAKEN Personal Data Sharing Platform. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Recent advances in the design of blockchain-based personal data sharing platforms bring the benefit of empowering users with more control and privacy-preserving measures in sharing data products. However, so far very little is known about users’ intentions to adopt such platforms for providing or consuming data products. Objective: This study aims to investigate users’ main expectations, preferences, and concerns regarding the adoption of blockchain-based personal data sharing platforms in the health and education domains. Methods: Fifteen participants were involved in a multidimensional evaluation of a prototyped release of the KRAKEN blockchain-based data sharing platform and asked to assess it in the health or education pilot domains. Data collected during online group interviews with participants were analyzed by applying the micro interlocutor technique to provide a descriptive overview of participant responses. Results: Participants showed a marginal acceptance of the prototype usability, asking for some improvements of the user experience and for a more transparent presentation of the platform security and privacy preserving capabilities. Participants expressed interest in using the platform as data providers and consumers as well as setting privacy policies for sharing data products with third parties, including the possibility of revoking access to data. Conclusions: Blockchain-based data sharing platforms are more likely to engage target users when technical design is informed by a deeper knowledge of their needs, expectations, and relevant concerns.
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Bardach NS, Lam R, Jasik CB. Assessment of automated clinical trial recruitment and enrolment using patient-facing technology. BMJ Health Care Inform 2021; 28:bmjhci-2019-100076. [PMID: 33504589 PMCID: PMC7843354 DOI: 10.1136/bmjhci-2019-100076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 03/13/2020] [Accepted: 06/12/2020] [Indexed: 11/17/2022] Open
Abstract
Objective Interactive patient care systems (IPCS) at the bedside are becoming increasingly common, but evidence is limited as to their potential for innovative clinical trial implementation. The objective of this study was to test the hypothesis that the IPCS could feasibly be used to automate recruitment and enrolment for a clinical trial. Methods In medical-surgical units, we used the IPCS to randomise, recruit and consent eligible subjects. For participants not interacting with IPCS study materials within 48 hours, study staff-initiated recruitment in-person. Eligible study population included all caregivers and any patients >6 years old admitted to medical-surgical units and oncology units September 2015 to January 2016. Outcomes: randomisation assessed using between-group comparisons of patient characteristics; recruitment success assessed by rates of consent; paperless implementation using successful acquisition of electronic signature and email address. We used χ2 analysis to assess success of randomisation and recruitment. Results Randomisation was successful (n=1012 randomised, p>0.05 for all between-group comparisons). For the subset of eligible, randomised patients who were recruited, IPCS-only recruitment (consented: 2.4% of n=213) was less successful than in-person recruitment (61.4% of n=87 eligible recruited, p<0.001). For those consenting (n=61), 96.7% provided an electronic signature and 68.9% provided email addresses. Conclusions Our results suggest that as a tool at the bedside, the IPCS offers key efficiencies for study implementation, including randomisation and collecting e-consent and contact information, but does not offer recruitment efficiencies. Further research could assess the value that interactive technologies bring to recruitment when paired with in-person efforts, potentially focusing on more intensive user-interface testing for recruitment materials. Trial registration number NCT02491190.
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Affiliation(s)
- Naomi S Bardach
- Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Regina Lam
- School of Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA
| | - Carolyn B Jasik
- Research Unit, Omada Health, San Francisco, California, USA.,Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
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Szilagyi PG, Valderrama R, Vangala S, Albertin C, Okikawa D, Sloyan M, Lopez N, Lerner CF. Pediatric patient portal use in one health system. J Am Med Inform Assoc 2021; 27:444-448. [PMID: 31841146 DOI: 10.1093/jamia/ocz203] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/04/2019] [Accepted: 11/14/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The study sought to assess, for children in one large health system, (1) characteristics of active users of the patient portal (≥1 use in prior 12 months), (2) portal use by adolescents, and (3) variations in pediatric patient portal use. MATERIALS AND METHODS We analyzed data from the electronic health record regarding pediatric portal use during 2017-2018 across a health system (39 871 pediatric patients). RESULTS Altogether, 63.5% of pediatric patients were active portal users. Children (proxies) who were boys, privately insured, white, and spoke English were more likely to be active users. Common uses involved messaging with physicians, medications, allergies, letters, and laboratory results. By 15 years of age, >50% of adolescents used the portal by themselves (without a proxy). Pediatric portal use varied widely across practices. DISCUSSION Pediatric or adolescent portal use is quite high, but large variations exist. CONCLUSION Use of the portal for pediatric care may reflect varying pediatric patient engagement.
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Affiliation(s)
- Peter G Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
| | - Rebecca Valderrama
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
| | - Sitaram Vangala
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Christina Albertin
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
| | - David Okikawa
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Michael Sloyan
- Department of Information Services and Solutions, UCLA Health System, Los Angeles, California, USA
| | - Nathalie Lopez
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
| | - Carlos F Lerner
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
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Lu C, Batista D, Hamouda H, Lemieux V. Consumers' Intentions to Adopt Blockchain-Based Personal Health Records and Data Sharing: Focus Group Study. JMIR Form Res 2020; 4:e21995. [PMID: 33151149 PMCID: PMC7677023 DOI: 10.2196/21995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/06/2020] [Accepted: 10/26/2020] [Indexed: 01/23/2023] Open
Abstract
Background Although researchers are giving increased attention to blockchain-based personal health records (PHRs) and data sharing, the majority of research focuses on technical design. Very little is known about health care consumers’ intentions to adopt the applications. Objective This study aims to explore the intentions and concerns of health care consumers regarding the adoption of blockchain-based personal health records and data sharing. Methods Three focus groups were conducted, in which 26 participants were shown a prototype of a user interface for a self-sovereign blockchain-based PHR system (ie, a system in which the individual owns, has custody of, and controls access to their personal health information) to be used for privacy and secure health data sharing. A microinterlocutor analysis of focus group transcriptions was performed to show a descriptive overview of participant responses. NVivo 12.0 was used to code the categories of the responses. Results Participants did not exhibit a substantial increase in their willingness to become owners of health data and share the data with third parties after the blockchain solution was introduced. Participants were concerned about the risks of losing private keys, the resulting difficulty in accessing care, and the irrevocability of data access on blockchain. They did, however, favor a blockchain-based PHR that incorporates a private key recovery system and offers a health wallet hosted by government or other positively perceived organizations. They were more inclined to share data via blockchain if the third party used the data for collective good and offered participants nonmonetary forms of compensation and if the access could be revoked from the third party. Conclusions Health care consumers were not strongly inclined to adopt blockchain-based PHRs and health data sharing. However, their intentions may increase when the concerns and recommendations demonstrated in this study are considered in application design.
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Affiliation(s)
- Chang Lu
- Blockchain@UBC, University of British Columbia, Vancouver, BC, Canada
| | - Danielle Batista
- School of Information, University of British Columbia, Vancouver, BC, Canada
| | - Hoda Hamouda
- School of Information, University of British Columbia, Vancouver, BC, Canada
| | - Victoria Lemieux
- School of Information, University of British Columbia, Vancouver, BC, Canada
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Rexhepi H, Moll J, Huvila I. Online electronic healthcare records: Comparing the views of cancer patients and others. Health Informatics J 2020; 26:2915-2929. [DOI: 10.1177/1460458220944727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study investigates differences in attitudes towards, and experiences with, online electronic health records between cancer patients and patients with other conditions, highlighting what is characteristic to cancer patients. A national patient survey on online access to electronic health records was conducted, where cancer patients were compared with all other respondents. Overall, 2587 patients completed the survey (response rate 0.61%). A total of 347 respondents (13.4%) indicated that they suffered from cancer. Results showed that cancer patients are less likely than other patients to use online electronic health records due to general interest (p < 0.001), but more likely for getting an overview of their health history (p = 0.001) and to prepare for visits (p < 0.001). Moreover, cancer patients rate benefits of accessing their electronic health records online higher than other patients and see larger positive effects regarding improved communication with and involvement in healthcare.
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Affiliation(s)
| | - Jonas Moll
- Örebro University School of Business, Sweden
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Hospitalized Patients Accessing Information on Prescribed Medications from the Bedside Terminal: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134850. [PMID: 32640532 PMCID: PMC7369892 DOI: 10.3390/ijerph17134850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022]
Abstract
Studies have documented the impact of various types of health care information technology (HIT) on patient outcomes. However, literature on the HIT products is largely for outpatients and little is known about those for hospitalized patients. In 2014, a Korean hospital developed an inpatient portal known as the Smart Bedside Station (SBS). A retrospective cross-sectional study was conducted to evaluate the associated factors for accessing the medication view menu (Today’s Medication) on the SBS using data from October 2018 through September 2019. A root cause analysis with expert review was conducted to identify additional barriers for accessing the medication view menu. Approximately 92.58% of the study population accessed the SBS at least once during their hospital stay. However, 99.20% of accessed patients used the SBS for entertainment purposes (e.g., television) and 40.16% viewed the medication information. Younger age, higher education, and certain jobs were significant associated factors for accessing the medication information. In conclusion, this study revealed strong associations between accessing the medication view menu on the SBS and a number of associated factors. Based on the results, further research is warranted to suggest new items to access the medication view menu by hospitalized patients.
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Rosenthal S, Das S, Hsueh PYS, Barker K, Chen CH. Efficient goal attainment and engagement in a care manager system using unstructured notes. JAMIA Open 2020; 3:ooaa001. [PMID: 32142137 PMCID: PMC7309242 DOI: 10.1093/jamiaopen/ooaa001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/22/2019] [Accepted: 01/28/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To improve efficient goal attainment of patients by analyzing the unstructured text in care manager (CM) notes (CMNs). Our task is to determine whether the goal assigned by the CM can be achieved in a timely manner. MATERIALS AND METHODS Our data consists of CM structured and unstructured records from a private firm in Orlando, FL. The CM data is based on phone interactions between the CM and the patient. A portion of the data has been manually annotated to indicate engagement. We present 2 machine learning classifiers: an engagement model and a goal attainment model. RESULTS We can successfully distinguish automatically between engagement and lack of engagement. Subsequently, incorporating engagement and features from textual information from the unstructured notes significantly improves goal attainment classification. DISCUSSION Two key challenges in this task were the time-consuming annotation effort for engagement classification and the limited amount of data for the more difficult goal attainment class (specifically, for people who take a long time to achieve their goals). We successfully explore domain adaptation and transfer learning techniques to improve performance on the under-represented classes. We also explore the value of using features from unstructured notes to improve the model and interpretability. CONCLUSIONS Unstructured CMNs can be used to improve accuracy of our classification models for predicting patient self-management goal attainment. This work can be used to help identify patients who may require special attention from CMs to improve engagement in self-management.
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Affiliation(s)
| | - Subhro Das
- MIT-IBM Watson AI Lab, IBM Research, Cambridge, Massachusetts, USA
| | | | - Ken Barker
- IBM Research, Yorktown Heights, New York, USA
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Adejare AA, Eckman MH. Automated Tool for Health Utility Assessments: The Gambler II. MDM Policy Pract 2020; 5:2381468320914307. [PMID: 32215320 PMCID: PMC7081474 DOI: 10.1177/2381468320914307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background. The Gambler II is a web-based utility assessment tool supporting visual analogue scale (VAS), standard gamble (SG), and time trade-off (TTO) utility assessments. It contains novel features, including an easy to use project development authoring tool and use of multimedia clips for health state descriptions. Objectives. Evaluate the usability and understandability of the patient-facing side of The Gambler. Investigate the feasibility of using The Gambler and evaluate its impact on patient knowledge regarding the relevant health states. Materials and Methods. We used The Gambler to assess utilities on a convenience sample of 55 users for common long-term complications of type 2 diabetes mellitus: diabetic neuropathy, diabetic retinopathy, and diabetic foot infection requiring transmetatarsal amputation. Using VAS, SG, and TTO, we collected metadata, such as time spent on each assessment and the entire assessment process. We evaluated usability with an adaptation of the System Usability Scale survey and understandability. We evaluated impact on knowledge gained through knowledge assessments about these complications before and after use of The Gambler. Results. Overall satisfaction with The Gambler was high, 4.02 on a 5-point scale. Usability rated highly at 84.93 on a normalized scale between 0 and 100. Knowledge scores increased significantly following use of The Gambler from pretest mean of 68% to posttest mean of 76% (P < 0.01). Average time using the software: ∼7½ minutes. Conclusions. The Gambler is an easy to use and understand computer-based tool for utility assessment. It is feasible to use within clinical encounters to support shared decision making, and it has unique features that make it a powerful tool for investigators interested in research on health utilities.
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Affiliation(s)
- Adeboye A. Adejare
- Department of Biomedical Informatics, University of Cincinnati, Cincinnati, Ohio
| | - Mark H. Eckman
- Division of General Internal Medicine and the Center for Clinical Effectiveness, University of Cincinnati, Cincinnati, Ohio
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Aldekhyyel RN, Bakker CJ, Pitt MB, Melton GB. The Impact of Patient Interactive Systems on the Management of Pain in an Inpatient Hospital Setting: A Systematic Review. Appl Clin Inform 2019; 10:580-596. [PMID: 31412381 PMCID: PMC6693998 DOI: 10.1055/s-0039-1694002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 06/19/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND While some published literature exists on the use of interactive patient care systems, the effectiveness of these systems on the management of pain is unclear. To fill this gap in knowledge, we aimed to understand the impact and outcomes of pain management patient interactive systems in an inpatient setting. METHODS A systematic literature review was conducted across seven databases, and results were independently screened by two researchers. To extract relevant data, critical appraisal forms were developed and each paper was examined by two experts. Information included patient interactive system category, patient population and number of participants/samples, experiment type, and specific outcome measures. RESULTS Out of 58 full-text articles assessed for eligibility, 18 were eligible and included in the final qualitative synthesis. Overall, there were two main types of pain management interactive systems within the inpatient setting (standalone systems and integrated platform systems). While systems were diverse especially for integrated platforms, most reported systems were entertainment distraction systems. Reports examined a variety of outcome measures, including changes in patient-reported pain levels, patient engagement, user satisfaction, changes in clinical workflow, and changes in documentation. In the 13 systems measuring pain scores, 12 demonstrated a positive impact on pain level scores. CONCLUSION Pain management systems appear to be effective in lowering patient level scores, but research comparing the effectiveness and efficacy of one type of interactive system versus another in the management of pain is needed. While not conclusive, pain management systems integrated with other technology platforms show potentially promising effects with improving patient communication, education, and self-reporting.
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Affiliation(s)
- Raniah N. Aldekhyyel
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, United States
- Medical Education Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Caitlin J. Bakker
- Health Sciences Libraries, University of Minnesota, Minneapolis, Minnesota, United States
| | - Michael B. Pitt
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States
| | - Genevieve B. Melton
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, United States
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States
- University of Minnesota Physicians, University of Minnesota, Minneapolis, Minnesota, United States
- Fairview Health Services, Minneapolis, Minnesota, United States
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16
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den Bakker CM, Schaafsma FG, van der Meij E, Meijerink WJ, van den Heuvel B, Baan AH, Davids PH, Scholten PC, van der Meij S, van Baal WM, van Dalsen AD, Lips DJ, van der Steeg JW, Leclercq WK, Geomini PM, Consten EC, Schraffordt Koops SE, de Castro SM, van Kesteren PJ, Cense HA, Stockmann HB, Ten Cate AD, Bonjer HJ, Huirne JA, Anema JR. Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development. J Med Internet Res 2019; 21:e9938. [PMID: 30724740 PMCID: PMC6381532 DOI: 10.2196/jmir.9938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/16/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention (“ikherstel” intervention or “I recover” intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures. Objective This study aimed to further develop the “ikherstel” eHealth intervention using Intervention Mapping (IM) to fit a broader patient population. Methods The IM protocol was used to guide further development of the “ikherstel” intervention. First, patients’ needs were identified using (1) the information of a process evaluation of the earlier performed “ikherstel” study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed. Results The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as “achieving earlier recovery including return to normal activities and work.” The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands. Conclusions The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed. Trial Registration Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686
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Affiliation(s)
- Chantal M den Bakker
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Frederieke G Schaafsma
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands
| | - Eva van der Meij
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Baukje van den Heuvel
- Department of Operation Rooms, Radboud University Medical Center, Nijmegen, Netherlands
| | - Astrid H Baan
- Department of Surgery, Amstelland Ziekenhuis, Amstelveen, Netherlands
| | - Paul Hp Davids
- Department of Surgery, Diakonessenhuis, Utrecht, Netherlands
| | - Petrus C Scholten
- Department of Obstetrics and Gynaecology, Diakonessenhuis, Utrecht, Netherlands
| | | | - W Marchien van Baal
- Department of Obstetrics and Gynaecology, Flevoziekenhuis, Almere, Netherlands
| | | | - Daniel J Lips
- Department of Surgery, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
| | - Jan Willem van der Steeg
- Department of Obstetrics and Gynaecology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
| | | | - Peggy Maj Geomini
- Department of Obstetrics and Gynaecology, Máxima Medisch Centrum, Veldhoven, Netherlands
| | - Esther Cj Consten
- Department of Surgery, Meander Medisch Centrum, Amersfoort, Netherlands
| | | | - Steve Mm de Castro
- Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Paul Jm van Kesteren
- Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Huib A Cense
- Department of Surgery, Rode Kruis Ziekenhuis, Beverwijk, Netherlands
| | | | - A Dorien Ten Cate
- Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Haarlem, Netherlands
| | - Hendrik J Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Judith Af Huirne
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | - Johannes R Anema
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands
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den Bakker CM, Huirne JA, Schaafsma FG, de Geus C, Bonjer HJ, Anema JR. Electronic Health Program to Empower Patients in Returning to Normal Activities After Colorectal Surgical Procedures: Mixed-Methods Process Evaluation Alongside a Randomized Controlled Trial. J Med Internet Res 2019; 21:e10674. [PMID: 30694205 PMCID: PMC6371072 DOI: 10.2196/10674] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Long-term recovery takes longer than expected despite improved surgical techniques and Enhanced Recovery After Surgery programs. An electronic health (eHealth) care program ("ikherstel") was developed to partially substitute perioperative care for patients undergoing colorectal surgical procedures. Successfully tested eHealth programs are not always implemented in usual care, and it is, therefore, important to evaluate the process to optimize future implementation. OBJECTIVE The aim of this study was to evaluate whether the eHealth intervention was executed as planned. METHODS A mixed-methods process evaluation was carried out alongside a multicenter randomized controlled trial (RCT). This evaluation was performed using the Linnan and Steckler framework for the quantitative part of this study, measuring the components reach, dose delivered, dose received, fidelity, and participants' attitudes. Total implementation scores were calculated using the averaging approach, in which the sum of all data points is divided by the number of data points and the total adherence to the protocol is measured. For the qualitative part, the Unified Theory of Acceptance and Use of Technology framework was used. The quantitative data were based on participants' questionnaires, a logistic database, a weblog, and participants' medical files and were obtained by performing semistructured interviews with participants of the RCT. RESULTS A total of 151 participants of 340 eligible patients were included in the RCT, of which 73 participants were allocated to the intervention group. On the basis of the quantitative process data, total implementation scores for the website, mobile app, electronic consult, and activity tracker were 64%, 63%, 44%, and 67%, respectively. Participants in the qualitative part experienced the program as supportive and provided guidance on their recovery process after colorectal surgery. Most frequently mentioned barriers were the limited interaction with and feedback from health care professionals and the lack of tailoring of the convalescence plan in case of a different course of recovery. CONCLUSIONS The intervention needs more interaction with and feedback from health care professionals and needs more tailored guidance in case of different recovery or treatment courses. To ensure a successful implementation of the program in daily practice, some adjustments are required to optimize the program in a blended care form. TRIAL REGISTRATION Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC= 5686 (Archieved by WebCite at http://www.webcitation.org/75LrJaHrr).
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Affiliation(s)
- Chantal M den Bakker
- Department of Occupational and Public Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands.,Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Judith Af Huirne
- Department of Gynecology, VU University Medical Center, Amsterdam, Netherlands
| | - Frederieke G Schaafsma
- Department of Occupational and Public Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Charlotte de Geus
- Department of Occupational and Public Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hendrik J Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Johannes R Anema
- Department of Occupational and Public Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
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18
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den Bakker CM, Schaafsma FG, Huirne JAF, Consten ECJ, Stockmann HBAC, Rodenburg CJ, de Klerk GJ, Bonjer HJ, Anema JR. Cancer survivors' needs during various treatment phases after multimodal treatment for colon cancer - is there a role for eHealth? BMC Cancer 2018; 18:1207. [PMID: 30514325 PMCID: PMC6278104 DOI: 10.1186/s12885-018-5105-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 11/16/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND More colon cancer patients are expected to fully recover after treatment due to earlier detection of cancer and improvements in general health- and cancer care. The objective of this study was to gather participants' experiences with full recovery in the different treatment phases of multimodal treatment and to identify their needs during these phases. The second aim was to propose and evaluate possible solutions for unmet needs by the introduction of eHealth. METHODS A qualitative study based on two focus group discussions with 22 participants was performed. The validated Supportive Care Needs Survey and the Cancer Treatment Survey were used to form the topic list. The verbatim transcripts were analyzed with Atlas.ti. 7th version comprising open, axial and selective coding. The guidelines of the consolidated criteria for reporting qualitative research (COREQ) were used. RESULTS Experiences with the treatment for colon cancer were in general positive. Most important unmet needs were 'receiving information about the total duration of side effects', 'receiving information about the minimum amount of chemo needed to overall survival' and 'receiving a longer aftercare period (with additional attention for psychological guidance)'. More provision of information online, a chat function with the oncological nurse specialist via a website, and access to scientific articles regarding the optimal dose of chemotherapy were often mentioned as worthwhile additions to the current health care for colon cancer. CONCLUSIONS Many of the unmet needs of colon cancer survivors occur during the adjuvant treatment phase and thereafter. To further optimize recovery and cancer care, it is necessary to have more focus on these unmet needs. More attention for identifying patients' problems and side-effects during chemotherapy; and identifying patients' supportive care needs after finishing chemotherapy are necessary. For some of these needs, eHealth in the form of blended care will be a possible solution.
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Affiliation(s)
- C M den Bakker
- Department of Occupational and Public Health, VU University Medical Center, Amsterdam Public health institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
| | - F G Schaafsma
- Department of Occupational and Public Health, VU University Medical Center, Amsterdam Public health institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - J A F Huirne
- Department of Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - E C J Consten
- Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands
| | | | - C J Rodenburg
- Department of Medical Oncology, Meander Medical Center, Amersfoort, The Netherlands
| | - G J de Klerk
- Department of Medical Oncology, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - H J Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - J R Anema
- Department of Occupational and Public Health, VU University Medical Center, Amsterdam Public health institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Tiase VL, Hull SC, Troseth M, Schnall R. Development and psychometric testing of the Readiness to Engage with Patient-Facing Health Information Technology Tools (RE-PHIT) scale. Int J Med Inform 2018; 118:1-4. [DOI: 10.1016/j.ijmedinf.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/26/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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20
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Asan O, Holden RJ, Flynn KE, Murkowski K, Scanlon MC. Providers' assessment of a novel interactive health information technology in a pediatric intensive care unit. JAMIA Open 2018; 1:32-41. [PMID: 31528847 PMCID: PMC6746319 DOI: 10.1093/jamiaopen/ooy020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective To explore perceptions of critical care providers about a novel collaborative inpatient health information technology (HIT) in a pediatric intensive care unit (PICU) setting. Methods This cross-sectional, concurrent mixed methods study was conducted in the PICU of a large midwestern children's hospital. The technology, the Large Customizable Interactive Monitor (LCIM), is a flat panel touch screen monitor that displays validated patient information from the electronic health record. It does not require a password to login and is available in each patient's room for viewing and interactive use by physicians, nurses, and families. Quantitative data were collected via self-administered, standardized surveys, and qualitative data via in-person, semistructured interviews between January and April 2015. Data were analyzed using descriptive statistics and inductive thematic analysis. Results The qualitative analysis showed positive impacts of the LCIM on providers' workflow, team interactions, and interactions with families. Providers reported concerns regarding perceived patient information overload and associated anxiety and burden for families. Sixty percent of providers thought that LCIM was useful for their jobs at different levels, and almost 70% of providers reported that LCIM improved information sharing and communication with families. The average overall satisfaction score was 3.4 on a 0 to 6 scale, between "a moderate amount" and "pretty much." Discussion and Conclusion This study provides new insight into collaborative HIT in the inpatient pediatric setting and demonstrates that using such technology has the potential to improve providers' experiences with families and just-in-time access to EHR information in a format more easily shared with families.
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Affiliation(s)
- Onur Asan
- Department of Medicine, Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Richard J Holden
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, Indiana, USA
| | - Kathryn E Flynn
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kathy Murkowski
- Department of Pediatrics, Division of Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Matthew C Scanlon
- Department of Pediatrics, Division of Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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21
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Wass S, Vimarlund V. Same, same but different: Perceptions of patients’ online access to electronic health records among healthcare professionals. Health Informatics J 2018; 25:1538-1548. [DOI: 10.1177/1460458218779101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In this study, we explore how healthcare professionals in primary care and outpatient clinics perceive the outcomes of giving patients online access to their electronic health records. The study was carried out as a case study and included a workshop, six interviews and a survey that was answered by 146 healthcare professionals. The results indicate that professionals working in primary care perceive that an increase in information-sharing with patients can increase adherence, clarify important information to the patient and allow the patient to quality-control documented information. Professionals at outpatient clinics seem less convinced about the benefits of patient accessible electronic health records and have concerns about how patients manage the information that they are given access to. However, the patient accessible electronic health record has not led to a change in documentation procedures among the majority of the professionals. While the findings can be connected to the context of outpatient clinics and primary care units, other contextual factors might influence the results and more in-depth studies are therefore needed to clarify the concerns.
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Coffey MJ, Coffey CE. The emerging story of emerging technologies in neuropsychiatry. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 27489452 PMCID: PMC4969699 DOI: 10.31887/dcns.2016.18.2/jcoffey] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The growth of new technologies in health care is exponential, and the impact of such rapid technological innovation on health care delivery is substantial. This review describes two emerging technologies—mobile applications and wearable technologies—and uses a virtual case report to illustrate the impact of currently available technologies on the health care experience of a patient with neuropsychiatric illness.
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Affiliation(s)
- M Justin Coffey
- Vice President and Chief Information OfficerF; Medical Director of Brain Stimulation; The Menninger Clinic, Houston Texas, USA; Associate Professor of Psychiatry
| | - C Edward Coffey
- President and CEO; The Menninger Clinic, Houston Texas, USA ; Professor of Psychiatry and of Neurology, Baylor College of Medicine, Houston, Texas, USA
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23
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Rathbone AL, Prescott J. The Use of Mobile Apps and SMS Messaging as Physical and Mental Health Interventions: Systematic Review. J Med Internet Res 2017; 19:e295. [PMID: 28838887 PMCID: PMC5590007 DOI: 10.2196/jmir.7740] [Citation(s) in RCA: 238] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/05/2017] [Accepted: 05/25/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The initial introduction of the World Wide Web in 1990 brought around the biggest change in information acquisition. Due to the abundance of devices and ease of access they subsequently allow, the utility of mobile health (mHealth) has never been more endemic. A substantial amount of interactive and psychoeducational apps are readily available to download concerning a wide range of health issues. mHealth has the potential to reduce waiting times for appointments; eradicate the need to meet in person with a clinician, successively diminishing the workload of mental health professionals; be more cost effective to practices; and encourage self-care tactics. Previous research has given valid evidence with empirical studies proving the effectiveness of physical and mental health interventions using mobile apps. Alongside apps, there is evidence to show that receiving short message service (SMS) messages, which entail psychoeducation, medication reminders, and links to useful informative Web pages can also be advantageous to a patient's mental and physical well-being. Available mHealth apps and SMS services and their ever improving quality necessitates a systematic review in the area in reference to reduction of symptomology, adherence to intervention, and usability. OBJECTIVE The aim of this review was to study the efficacy, usability, and feasibility of mobile apps and SMS messages as mHealth interventions for self-guided care. METHODS A systematic literature search was carried out in JMIR, PubMed, PsychINFO, PsychARTICLES, Google Scholar, MEDLINE, and SAGE. The search spanned from January 2008 to January 2017. The primary outcome measures consisted of weight management, (pregnancy) smoking cessation, medication adherence, depression, anxiety and stress. Where possible, adherence, feasibility, and usability outcomes of the apps or SMS services were evaluated. Between-group and within-group effect sizes (Cohen d) for the mHealth intervention method group were determined. RESULTS A total of 27 studies, inclusive of 4658 participants were reviewed. The papers included randomized controlled trials (RCTs) (n=19), within-group studies (n=7), and 1 within-group study with qualitative aspect. Studies show improvement in physical health and significant reductions of anxiety, stress, and depression. Within-group and between-group effect sizes ranged from 0.05-3.37 (immediately posttest), 0.05-3.25 (1-month follow-up), 0.08-3.08 (2-month follow-up), 0.00-3.10 (3-month follow-up), and 0.02-0.27 (6-month follow-up). Usability and feasibility of mHealth interventions, where reported, also gave promising, significant results. CONCLUSIONS The review shows the promising and emerging efficacy of using mobile apps and SMS text messaging as mHealth interventions.
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Affiliation(s)
- Amy Leigh Rathbone
- School of Education and Psychology, University of Bolton, Bolton, United Kingdom
| | - Julie Prescott
- School of Education and Psychology, University of Bolton, Bolton, United Kingdom
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Morrow D, Hasegawa-Johnson M, Huang T, Schuh W, Azevedo RFL, Gu K, Zhang Y, Roy B, Garcia-Retamero R. A multidisciplinary approach to designing and evaluating Electronic Medical Record portal messages that support patient self-care. J Biomed Inform 2017; 69:63-74. [PMID: 28347856 PMCID: PMC5492515 DOI: 10.1016/j.jbi.2017.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 03/13/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
We describe a project intended to improve the use of Electronic Medical Record (EMR) patient portal information by older adults with diverse numeracy and literacy abilities, so that portals can better support patient-centered care. Patient portals are intended to bridge patients and providers by ensuring patients have continuous access to their health information and services. However, they are underutilized, especially by older adults with low health literacy, because they often function more as information repositories than as tools to engage patients. We outline an interdisciplinary approach to designing and evaluating portal-based messages that convey clinical test results so as to support patient-centered care. We first describe a theory-based framework for designing effective messages for patients. This involves analyzing shortcomings of the standard portal message format (presenting numerical test results with little context to guide comprehension) and developing verbally, graphically, video- and computer agent-based formats that enhance context. The framework encompasses theories from cognitive and behavioral science (health literacy, fuzzy trace memory, behavior change) as well as computational/engineering approaches (e.g., image and speech processing models). We then describe an approach to evaluating whether the formats improve comprehension of and responses to the messages about test results, focusing on our methods. The approach combines quantitative (e.g., response accuracy, Likert scale responses) and qualitative (interview) measures, as well as experimental and individual difference methods in order to investigate which formats are more effective, and whether some formats benefit some types of patients more than others. We also report the results of two pilot studies conducted as part of developing the message formats.
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Affiliation(s)
- Daniel Morrow
- University of Illinois at Urbana-Champaign, Department of Educational Psychology, Champaign, IL, United States.
| | - Mark Hasegawa-Johnson
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, IL, United States
| | - Thomas Huang
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, IL, United States
| | - William Schuh
- Carle Foundation Hospital, Urbana, IL, United States
| | | | - Kuangxiao Gu
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, IL, United States
| | - Yang Zhang
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, IL, United States
| | - Bidisha Roy
- University of Illinois at Urbana-Champaign, Department of Educational Psychology, Champaign, IL, United States
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van der Meij E, Huirne JA, Bouwsma EV, van Dongen JM, Terwee CB, van de Ven PM, den Bakker CM, van der Meij S, van Baal WM, Leclercq WK, Geomini PM, Consten EC, Schraffordt Koops SE, van Kesteren PJ, Stockmann HB, Ten Cate AD, Davids PH, Scholten PC, van den Heuvel B, Schaafsma FG, Meijerink WJ, Bonjer HJ, Anema JR. Substitution of Usual Perioperative Care by eHealth to Enhance Postoperative Recovery in Patients Undergoing General Surgical or Gynecological Procedures: Study Protocol of a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e245. [PMID: 28003177 PMCID: PMC5215129 DOI: 10.2196/resprot.6580] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/21/2016] [Accepted: 10/22/2016] [Indexed: 01/28/2023] Open
Abstract
Background Due to the strong reduction in the length of hospital stays in the last decade, the period of in-hospital postoperative care is limited. After discharge from the hospital, guidance and monitoring on recovery and resumption of (work) activities are usually not provided. As a consequence, return to normal activities and work after surgery is hampered, leading to a lower quality of life and higher costs due to productivity loss and increased health care consumption. Objective With this study we aim to evaluate whether an eHealth care program can improve perioperative health care in patients undergoing commonly applied abdominal surgical procedures, leading to accelerated recovery and to a reduction in costs in comparison to usual care. Methods This is a multicenter randomized, single-blinded, controlled trial. At least 308 patients between 18 and 75 years old who are on the waiting list for a laparoscopic cholecystectomy, inguinal hernia surgery, or laparoscopic adnexal surgery for a benign indication will be included. Patients will be randomized to an intervention or control group. The intervention group will have access to an innovative, perioperative eHealth care program. This intervention program consists of a website, mobile phone app, and activity tracker. It aims to improve patient self-management and empowerment by providing guidance to patients in the weeks before and after surgery. The control group will receive usual care and will have access to a nonintervention (standard) website consisting of the digital information brochure about the surgical procedure being performed. Patients are asked to complete questionnaires at 5 moments during the first 6 months after surgery. The primary outcome measure is time to return to normal activities based on a patient-specific set of 8 activities selected from the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning item bank version 1.2. Secondary outcomes include social participation, self-rated health, duration of return to work, physical activity, length of recovery, pain intensity, and patient satisfaction. In addition, an economic evaluation alongside this randomized controlled trial will be performed from the societal and health care perspective. All statistical analyses will be conducted according to the intention-to-treat principle. Results The enrollment of patients started in September 2015. The follow-up period will be completed in February 2017. Data cleaning and analyses have not begun as of the time this article was submitted. Conclusions We hypothesize that patients receiving the intervention program will resume their normal activities sooner than patients in the control group and costs will be lower. ClinicalTrial Netherlands Trial Registry NTC4699; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4699 (Archived by WebCite at http://www.webcitation.org/6mcCBZmwy)
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Affiliation(s)
- Eva van der Meij
- EMGO+ Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | - Judith Af Huirne
- EMGO+ Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | - Esther Va Bouwsma
- EMGO+ Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Lokatie Oost, Amsterdam, Netherlands
| | - Johanna M van Dongen
- EMGO+ Institute for Health and Care Research, Department of Health Sciences, Vrije Universiteit, Faculty of Earth and Life Sciences, Amsterdam, Netherlands
| | - Caroline B Terwee
- EMGO+ Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Peter M van de Ven
- EMGO+ Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Chantal M den Bakker
- EMGO+ Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | | | - W Marchien van Baal
- Department of Obstetrics and Gynaecology, Flevo Ziekenhuis, Almere, Netherlands
| | | | - Peggy Maj Geomini
- Department of Obstetrics and Gynaecology, Maxima Medisch Centrum, Veldhoven, Netherlands
| | - Esther Cj Consten
- Department of Surgery, Meander Medisch Centrum, Amersfoort, Netherlands
| | | | - Paul Jm van Kesteren
- Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Lokatie Oost, Amsterdam, Netherlands
| | | | - A Dorien Ten Cate
- Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Haarlem, Netherlands
| | - Paul Hp Davids
- Department of Surgery, Diakonessenhuis, Utrecht, Netherlands
| | - Petrus C Scholten
- Department of Obstetrics and Gynaecology, Diakonessenhuis, Utrecht, Netherlands
| | | | - Frederieke G Schaafsma
- EMGO+ Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands
| | | | - H Jaap Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Johannes R Anema
- EMGO+ Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands
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Patmon FL, Gee PM, Rylee TL, Readdy NL. Using Interactive Patient Engagement Technology in Clinical Practice: A Qualitative Assessment of Nurses' Perceptions. J Med Internet Res 2016; 18:e298. [PMID: 27836817 PMCID: PMC5124111 DOI: 10.2196/jmir.5667] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 07/01/2016] [Accepted: 10/30/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has shown patients who are more engaged in their care are likely to have better health outcomes and reduced health care costs. Health care organizations are now focusing their efforts in finding ways to improve patient engagement. At the forefront of this movement are patient engagement technology systems. In this paper, these emerging systems are described as interactive patient engagement technologies (iPET). OBJECTIVE The objective of this descriptive study was to gain an understanding of the perceptions of nurses who are integrating these iPET systems into their daily clinical practice. METHODS The research team interviewed 38 nurses from 2 California-based hospitals using a focused rapid ethnographic evaluation methodology to gather data. RESULTS The study participants reported that using iPET systems may enhance clinical nursing practice. The 4 key findings of iPET were that it (1) is effective for distraction therapy, (2) has functionality that affects both patients and nurses, (3) has implications for clinical practice, and (4) may require additional training to improve usage. CONCLUSIONS With sufficient training on the iPET system, nurses believed they could use these technologies as an enhancement to their clinical practice. Additionally, nurses perceived these systems served as distraction therapy for patients. Initial findings suggest that iPET is beneficial, but more research is required to examine the usefulness of iPET systems in the inpatient settings.
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Affiliation(s)
- Frances L Patmon
- Nursing Research and Analytics, Dignity Health, Phoenix, AZ, United States
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Perry M Gee
- Nursing Research and Analytics, Dignity Health, Phoenix, AZ, United States
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Tina L Rylee
- Nursing Research and Analytics, Dignity Health, Phoenix, AZ, United States
- Department of Psychology, California State University, Sacramento, CA, United States
| | - Noriann L Readdy
- Patient Care Services, Dignity Health, San Francisco, CA, United States
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27
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van der Meij E, Anema JR, Otten RHJ, Huirne JAF, Schaafsma FG. The Effect of Perioperative E-Health Interventions on the Postoperative Course: A Systematic Review of Randomised and Non-Randomised Controlled Trials. PLoS One 2016; 11:e0158612. [PMID: 27383239 PMCID: PMC4934874 DOI: 10.1371/journal.pone.0158612] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/17/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND E-health interventions have become increasingly popular, including in perioperative care. The objective of this study was to evaluate the effect of perioperative e-health interventions on the postoperative course. METHODS We conducted a systematic review and searched for relevant articles in the PUBMED, EMBASE, CINAHL and COCHRANE databases. Controlled trials written in English, with participants of 18 years and older who underwent any type of surgery and which evaluated any type of e-health intervention by reporting patient-related outcome measures focusing on the period after surgery, were included. Data of all included studies were extracted and study quality was assessed by using the Downs and Black scoring system. FINDINGS A total of 33 articles were included, reporting on 27 unique studies. Most studies were judged as having a medium risk of bias (n = 13), 11 as a low risk of bias, and three as high risk of bias studies. Most studies included patients undergoing cardiac (n = 9) or orthopedic surgery (n = 7). All studies focused on replacing (n = 11) or complementing (n = 15) perioperative usual care with some form of care via ICT; one study evaluated both type of interventions. Interventions consisted of an educational or supportive website, telemonitoring, telerehabilitation or teleconsultation. All studies measured patient-related outcomes focusing on the physical, the mental or the general component of recovery. 11 studies (40.7%) reported outcome measures related to the effectiveness of the intervention in terms of health care usage and costs. 25 studies (92.6%) reported at least an equal (n = 8) or positive (n = 17) effect of the e-health intervention compared to usual care. In two studies (7.4%) a positive effect on any outcome was found in favour of the control group. CONCLUSION Based on this systematic review we conclude that in the majority of the studies e-health leads to similar or improved clinical patient-related outcomes compared to only face to face perioperative care for patients who have undergone various forms of surgery. However, due to the low or moderate quality of many studies, the results should be interpreted with caution.
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Affiliation(s)
- Eva van der Meij
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- * E-mail:
| | - Johannes R. Anema
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Judith A. F. Huirne
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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