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Bleijenbergh R, Mestdagh E, Timmermans O, Van Rompaey B, Kuipers YJ. Digital adaptability competency for healthcare professionals: a modified explorative e-Delphi study. Nurse Educ Pract 2023; 67:103563. [PMID: 36758264 DOI: 10.1016/j.nepr.2023.103563] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/05/2023] [Accepted: 01/14/2023] [Indexed: 02/01/2023]
Abstract
AIM To establish items of the digital adaptability competency for healthcare professionals. BACKGROUND While the application and deployment of eHealth has continued at a rapid pace, healthcare professionals are expected to keep up and join the digital evolution. The implementation of eHealth requires a change in the healthcare professionals' competencies of which the ability to adapt to technological change is fundamental. There's more needed than just ICT skills, overall competencies to be digitally adaptable between patientcare and the use of eHealth are needed. Today, a distinct and relevant list of items for healthcare professionals related to the competency of digital adaptability is missing. DESIGN An exploratory modified e-Delphi study. METHODS This study was conducted in Flanders, Belgium. An expert group (n = 12) consisting of 2 policymakers of the Belgian federal government, 3 eHealth managers of large organizations in the Belgian healthcare sector, 1 nurse, 1 midwife, 2 health service users and 3 researchers specialized in eHealth research. Through a literature review an initial list of items was developed, consisting of 67 statements. A two-round Delphi survey was performed where experts could rate the relevance of each item. The third round comprised an online meeting, where the expert group discussed the remaining items until agreement was reached to retain, modify, or eliminate the item. RESULTS In round 1, eleven items were included to the final document. In round 2, ten items were included. In round 3, the panel unanimously agreed to add six items, one item was modified into two separate items. In total, 29 items were included in the final document. CONCLUSIONS The rather abstract concept of digital adaptability is now transformed into a more pragmatic concept of 29 items, reflecting the practical competencies of healthcare professionals necessary to be digital adaptable.
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Affiliation(s)
- Roxanne Bleijenbergh
- School of Health and Social Care, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium; Centre for Research and Innovation in Care, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Eveline Mestdagh
- School of Health and Social Care, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium; Centre for Research and Innovation in Care, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Olaf Timmermans
- Centre for Research and Innovation in Care, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Research Group Healthy Region, HZ University of Applied Sciences, Edisonweg 4, 4382 NW Vlissingen, The Netherlands.
| | - Bart Van Rompaey
- Family Medicine and Population Health, University of Antwerp, Fort VI straat 226 -262, 2610 Antwerp, Belgium.
| | - Yvonne J Kuipers
- School of Health and Social Care, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium; Centre for Research and Innovation in Care, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Edinburgh Napier University, School of Health and Social Care, Edinburgh, Scotland, UK.
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White J, Byles J, Walley T. The qualitative experience of telehealth access and clinical encounters in Australian healthcare during COVID-19: implications for policy. Health Res Policy Syst 2022; 20:9. [PMID: 35033107 PMCID: PMC8760598 DOI: 10.1186/s12961-021-00812-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 12/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background Adaptive models of healthcare delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential healthcare services during the COVID-19 pandemic. However, there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region, and general practitioners (GP), including barriers, enablers and opportunities. Methods An interpretative qualitative study involving in-depth interviews explored the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region of Australia, and GPs, including barriers, enablers and opportunities. Data were analysed using an inductive thematic approach with constant comparison. Results Individual interviews were conducted with 10 specialists and five GPs. Key themes were identified: (1) transition to telehealth has been valuable but challenging; (2) persisting telehealth process barriers need to be addressed; (3) establishing when face-to-face consults are essential; (4) changes in workload pressures and potential for double-up; (5) essential modification of work practices; and (6) exploring what is needed going forward. Conclusions While there is a need to rationalize and optimize health access during a pandemic, we suggest that more needs to be done to improve telehealth going forward. Our results have important policy implications. Specifically, there is a need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.
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Affiliation(s)
- Jennifer White
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Locked Bag 1000, New Lambton, NSW, 2305, Australia.
| | - Julie Byles
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Locked Bag 1000, New Lambton, NSW, 2305, Australia
| | - Tom Walley
- Hunter Medical Research Institute, Newcastle, NSW, Australia
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Jimenez G, Spinazze P, Matchar D, Koh Choon Huat G, van der Kleij RMJJ, Chavannes NH, Car J. Digital health competencies for primary healthcare professionals: A scoping review. Int J Med Inform 2020; 143:104260. [PMID: 32919345 DOI: 10.1016/j.ijmedinf.2020.104260] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite digital health providing opportunities to enhance the quality, efficiency and safety of primary healthcare, the adoption of digital tools and technologies has been slow, partly because of poor digital health literacy. For primary healthcare systems to take full advantage of these technologies, a capable, digitally literate workforce is necessary. Still, the essential digital health competencies (DHCs) for primary healthcare have not been explored. This review aims to examine the broad literature on DHCs as it applies to Primary Care (PC) settings. METHODS We performed a scoping review on all types of research linking DHCs to PC. We searched all major databases including Medline, Embase, CINAHL, and Cochrane Library in November 2019. Concurrently, a thorough grey literature search was performed through OpenGrey, ResearchGate, Google Scholar, and key government and relevant professional associations' websites. Screening and selection of studies was performed in pairs, and data was analysed and presented using a narrative, descriptive approach. Thematic analysis was performed to identify key DHC domains. RESULTS A total of 28 articles were included, most of them (54 %) published before 2005. These articles were primarily aimed at PC physicians or general practitioners, and focused on improving knowledge about information technologies and medical informatics, basic computer and information literacy, and optimal use of electronic medical records. We identified 17 DHC domains, and important knowledge gaps related to digital health education and curriculum integration, the need for evidence of the impact of services, and the importance of wider support for digital health. CONCLUSIONS Literature explicitly linking DHCs to PC was mostly published over a decade ago. There is a need for an updated and current set of DHCs for PC professionals to more consistently reap the benefits of digital technologies. This review identified key DHC domains and statements that may be used to guide on the development of a set of DHC for PC, and critical knowledge gaps and needs to be considered. Such a DHC set may be used for curricula development and for ensuring that the essential DHC for PC are met at a clinical or organizational level, and eventually improve health outcomes.
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Affiliation(s)
- Geronimo Jimenez
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.
| | - Pier Spinazze
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| | - David Matchar
- Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore.
| | | | | | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.
| | - Josip Car
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
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Harvey J, Powell J. Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation. BMC Med Inform Decis Mak 2019; 19:134. [PMID: 31311522 PMCID: PMC6636105 DOI: 10.1186/s12911-019-0869-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/04/2019] [Indexed: 01/08/2023] Open
Abstract
Background A large provider of community health services (an NHS Trust in England) deployed Apple iPads to its front-line community-based healthcare clinicians (predominantly nurses) to enable them to increase responsiveness to patients’ and their families’ needs. We conducted a participatory formative evaluation of this iPad initiative among different users and the informatics teams implementing it, to establish how such initiatives can sustain adoption and achieve their stated benefits. Methods We used a participatory approach involving a partnership between study investigators and key decision-makers of the initiative to engage stakeholders in the study. Methods included focus groups and group discussion, meetings with key personnel and analysis of documents related to the initiative. Using a participatory technique, members of the organisation identified practical challenges to inform the on-going process of implementation and adoption in the Trust. Results Healthcare professionals identified many benefits associated with having iPads to support care delivery, including streamlined workflows and accessible information at the point-of-care in the community. However, challenges that interfered with implementation were also reported by both the team implementing the initiative (IT team) and early users. Challenges reported by IT team are: adopter clinicians’ scepticism and suspicion; clinician non-compliance with training and operational guidance procedures; and managing adopter expectations. Challenges reported by users are: setting-up and maintaining the devices on a long-term basis; blurring of personal and professional boundaries; and disconnection from the IT team. Results show that these challenges could be overcome if there were more informal ‘socialised’ interactions between adopters and between adopters and the IT team. Conclusions We suggest that similar initiatives require increased ongoing dialogue between different levels of stakeholder groups, in the form of socialised engagements, to avoid common misunderstandings and to promote the processes involved in co-constructing the initiative on a generally-agreed and sustainable basis. Electronic supplementary material The online version of this article (10.1186/s12911-019-0869-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jasmine Harvey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, England. .,Division of Primary Care, School of Medicine, University of Nottingham, Tower Building, NG7 2RD, Nottingham, England.
| | - John Powell
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, England
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List BA, Saxon R, Lehman D, Frank C, Toole KP. Improving Telehealth Knowledge in Nurse Practitioner Training for Rural and Underserved Populations. J Nurs Educ 2019; 58:57-60. [DOI: 10.3928/01484834-20190103-10] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/19/2018] [Indexed: 11/20/2022]
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Henry BW, Block DE, Ciesla JR, McGowan BA, Vozenilek JA. Clinician behaviors in telehealth care delivery: a systematic review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2017; 22:869-888. [PMID: 27696102 DOI: 10.1007/s10459-016-9717-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 09/26/2016] [Indexed: 06/06/2023]
Abstract
Literature on telehealth care delivery often addresses clinical, cost, technological, system, and organizational impacts. Less is known about interpersonal behaviors such as communication patterns and therapeutic relationship-building, which may have workforce development considerations. The purpose of this study was to conduct a systematic literature review to identify interpersonal health care provider (HCP) behaviors and attributes related to provider-patient interaction during care in telehealth delivery. Electronic searches were conducted using five indexes/databases: CINAHL, ERIC, PsychInfo, ProQuest Dissertations, PubMed; with hand-searching of the immediate past 10 years of five journals. Search concepts included: communication, telehealth, education, and health care delivery. Of 5261 unique article abstracts initially identified, 338 full-text articles remained after exclusion criteria were applied and these were reviewed for eligibility. Finally, data were extracted from 45 articles. Through qualitative synthesis of the 45 articles, we noted that papers encompassed many disciplines and targeted care to people in many settings including: home care, primary and specialist care, mental health/counseling, and multi-site teams. Interpersonal behaviors were observed though not manipulated through study designs. Six themes were identified: HCP-based support for telehealth delivery; provider-patient interactions during the telehealth event; environmental attributes; and guidelines for education interventions or evaluation of HCP behaviors. Although unable to identify current best practices, important considerations for practice and education did emerge. These include: perceptions of the utility of telehealth; differences in communication patterns such as pace and type of discourse, reliance on visual cues by both provider and patient especially in communicating empathy and building rapport; and confidentiality and privacy in telehealth care delivery.
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Affiliation(s)
- Beverly W Henry
- Northern Illinois University, Wirtz Hall Room 227, Dekalb, IL, USA.
| | - Derryl E Block
- Dean College of Health and Human Sciences, Northern Illinois University, Dekalb, IL, USA
| | - James R Ciesla
- College of Health and Human Sciences, Northern Illinois University, Dekalb, IL, 60115, USA
| | - Beth Ann McGowan
- Northern Illinois University Libraries, Northern Illinois University, 1425 Lincoln Hwy, Dekalb, IL, 60115, USA
| | - John A Vozenilek
- Jump Simulation and Education Center, 1306 N Berkeley Ave, Peoria, IL, 61603, USA
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Engineering sustainable mHealth: the role of Action Research. AI & SOCIETY 2017. [DOI: 10.1007/s00146-015-0640-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Although the use of technology is growing, little is known about how patients perceive technology in the form of tools used by health professionals. The prevailing view in the literature is that technology is cold, compared with the warm hands of nurses, but research regarding nurses' use of technology such as tablets is scarce. Even scarcer is research on how patients perceive the use of technological tools. This study examines patients' perspectives on the use of iPads by home care nurses. Semistructured interviews were conducted with seven participants who were receiving home care in Denmark, aged 62 to 90 years, with different backgrounds and experiences with technology. Participants viewed nurses' use of iPads as an everyday occurrence, reflecting societal growth in the use of technology, and some perceived it as a sign of professionalism with the potential to enhance care. Their perceptions varied somewhat according to their baseline knowledge and experience with the technology. Although nurses may view technology as cold, the findings suggest that patients have a slightly warmer view of it. More patient-centered research into the use of technology in healthcare is needed.
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Dalton JA, Rodger DL, Wilmore M, Skuse AJ, Humphreys S, Flabouris M, Clifton VL. "Who's afraid?": attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information. Women Birth 2014; 27:168-73. [PMID: 25070730 DOI: 10.1016/j.wombi.2014.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage. AIM The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care. METHODS Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data. FINDINGS Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client. CONCLUSION Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts.
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Affiliation(s)
- J A Dalton
- Faculty of Health Sciences, School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, SA 5005, Australia; The Robinson Research Institute, Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia
| | - D L Rodger
- Faculty of Humanities and Social Sciences, School of Social Sciences, Discipline of Anthropology and Development Studies, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - M Wilmore
- Faculty of Humanities and Social Sciences, School of Humanities, Discipline of Media, The University of Adelaide, Adelaide, SA 5005, Australia
| | - A J Skuse
- Faculty of Humanities and Social Sciences, School of Social Sciences, Discipline of Anthropology and Development Studies, The University of Adelaide, Adelaide, SA 5005, Australia
| | - S Humphreys
- Faculty of Humanities and Social Sciences, School of Humanities, Discipline of Media, The University of Adelaide, Adelaide, SA 5005, Australia
| | - M Flabouris
- Faculty of Humanities and Social Sciences, School of Humanities, Discipline of Media, The University of Adelaide, Adelaide, SA 5005, Australia
| | - V L Clifton
- Faculty of Health Sciences, School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, SA 5005, Australia; The Robinson Research Institute, Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia
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Abstract
The use of mobile phones in care delivery has the potential to improve the way in which care is delivered. When implemented effectively, mobile technologies can empower patients and enhance communication between patients and their health-care providers. When barriers are recognised and addressed, mobile technologies can change working lives, facilitating rapid access to information and supporting efficiency in practice.
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Affiliation(s)
- Holly Blake
- Division of Nursing, School of Health Sciences, University of Nottingham
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