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El Yaman N, Zeitoun J, Diab R, Mdaihly M, Diab R, Kobeissi L, Abou Ljoud S, Antoun J, Bardus M. Utilization of patient portals: a cross-sectional study investigating associations with mobile app quality. BMC Med Inform Decis Mak 2023; 23:177. [PMID: 37670277 PMCID: PMC10481578 DOI: 10.1186/s12911-023-02252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/28/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Mobile apps facilitate patients' access to portals and interaction with their healthcare providers. The COVID-19 pandemic accelerated this trend globally, but little evidence exists on patient portal usage in the Middle East, where internet access and digital literacy are limited. Our study aimed to explore how users utilize a patient portal through its related mobile app (MyChart by EPIC). METHODS We conducted a cross-sectional survey of MyChart users, recruited from a tertiary care center in Lebanon. We collected MyChart usage patterns, perceived outcomes, and app quality, based on the Mobile Application Rating Scale (user version, uMARS), and sociodemographic factors. We examined associations between app usage, app quality, and sociodemographic factors using Pearson's correlations, Chi-square, ANOVA, and t-tests. RESULTS 428 users completed the survey; they were primarily female (63%), aged 41.3 ± 15.6 years, with a higher education level (87%) and a relatively high crowding index of 1.4 ± 0.6. Most of the sample was in good and very good health (78%) and had no chronic illnesses (67%), and accessed the portal through MyChart once a month or less (76%). The most frequently used features were accessing health records (98%), scheduling appointments (67%), and messaging physicians (56%). According to uMARS completers (n = 200), the objective quality score was 3.8 ± 0.5, and the subjective quality was 3.6 ± 0.7. No significant association was found between overall app usage and the mobile app quality measured via uMARS. Moreover, app use frequency was negatively associated with education, socioeconomic status, and perceived health status. On the other hand, app use was positively related to having chronic conditions, the number of physician visits and subjective app quality. CONCLUSION The patient portal usage was not associated with app quality but with some of the participants' demographic factors. The app offers a user-friendly, good-quality interface to patient health records and physicians, appreciated chiefly by users with relatively low socioeconomic status and education. While this is encouraging, more research is needed to capture the usage patterns and perceptions of male patients and those with even lower education and socioeconomic status, to make patient portals more inclusive.
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Affiliation(s)
- Noha El Yaman
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jad Zeitoun
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rawan Diab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamad Mdaihly
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Razan Diab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lynn Kobeissi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Salwa Abou Ljoud
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jumana Antoun
- Department of Family Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Marco Bardus
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
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Chee A, Abdel-Rasoul M, Zoretich K, Diaz K, Noria SF. Bariatric Patient Engagement in a Pre-surgery Virtual Patient Navigation Platform (VPNP). Obes Surg 2023; 33:2770-2779. [PMID: 37434020 DOI: 10.1007/s11695-023-06558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND This study analyzed patient engagement with a virtual patient navigation platform (VPNP) designed to help guide bariatric surgery candidates through the complex pre-operative workup for surgery. METHODS Data on baseline sociodemographic and medical history was collected on patients enrolled in the bariatric program at a single academic institution between March and May 2021. The System Usability Scale (SUS) survey was administered to assess VPNP usability. Two groups emerged: "engaged" (ENG; n = 30) who activated their accounts and completed the SUS, and "not-engaged" (NEG; n = 35) who did not activate their accounts (n = 13) or did not use the app (n = 22) and were therefore ineligible for the SUS survey. RESULTS Analyses demonstrated that only insurance status differed between groups (private insurance: 60% versus 34.3% for ENG versus NEG, respectively; p = 0.038). SUS survey analysis demonstrated high perceived usability (median score = 86.3), corresponding to the 97th percentile of usability. The top three reasons for disengagement included being too busy (22.9%), not being interested (20%), and being unsure about the purpose of the app (20%). CONCLUSIONS The VPNP scored in the 97th percentile of usability. However, given a majority of patients did not engage with the app, and engagement was associated with completing pre-surgery requirements faster (unpublished), future work will focus on mitigating identified reasons for patients not engaging.
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Affiliation(s)
- Anna Chee
- College of Medicine, The Ohio State University, Columbus, OH, 43201, USA
| | - Mahmoud Abdel-Rasoul
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, 43201, USA
| | - Kaeli Zoretich
- College of Medicine, The Ohio State University, Columbus, OH, 43201, USA
| | - Kayla Diaz
- Department of Surgery, Division of General and GI Surgery, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, N718 Doan Hall, 410 W 10th Avenue, Columbus, OH, 43210, USA
| | - Sabrena F Noria
- Department of Surgery, Division of General and GI Surgery, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, N718 Doan Hall, 410 W 10th Avenue, Columbus, OH, 43210, USA.
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Leung T, Kwan YH, Yoon S, Goh H, Yee WQ, Tan CS, Low LL. Digital Intergenerational Program to Reduce Loneliness and Social Isolation Among Older Adults: Realist Review. JMIR Aging 2023; 6:e39848. [PMID: 36598801 PMCID: PMC9850285 DOI: 10.2196/39848] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/03/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is a compelling need for an innovative and creative approach to promote social connectedness among older adults to optimize their well-being and quality of life. One possible solution may be through a digital intergenerational program. OBJECTIVE This realist review aimed to identify existing digital intergenerational programs that were used to reduce loneliness or social isolation among older adults and analyze them in terms of strategy, context, mechanisms, and outcomes. METHODS We performed a realist review with an extensive search of published and gray literature. For scholarly literature, we searched PubMed, Embase, CINAHL, PsycINFO (Ovid), and Social Sciences Citation Index databases for articles published between January 2000 to August 2020. A grey literature search was performed using the Google search engine, and the search was completed in May 2021. We included programs that evaluated digital intergenerational programs for older adults, which described outcomes of loneliness or social isolation. We included quantitative, mixed methods, and qualitative studies, as well as relevant theoretical papers, policy documents, and implementation documents. The studies were appraised based on their relevance and rigor. We synthesized the available evidence from the literature into Strategy-Context-Mechanism-Outcome (S-C-M-O) configurations to better understand what, when, and how programs work. RESULTS A total of 31 documents reporting 27 digital intergenerational programs were reviewed. Our final results identified 4 S-C-M-O configurations. For S-C-M-O configuration 1, we found that for community-dwelling older adults, provision of access to and training in digital technology may increase older adults' self-efficacy in digital devices and therefore increase the use of digital communication with family. In S-C-M-O configuration 2, digital psychosocial support and educational interventions from nurses were found to be useful in reducing loneliness among community-dwelling older adults. In S-C-M-O configuration 3, a video call with a student or family was found to reduce loneliness among older adults residing in long-term residential care facilities. Finally, for S-C-M-O configuration 4, we found that behavioral activation provided through videoconferencing by a lay coach may be useful in reducing loneliness among older adults who are lonely. However, as almost half (11/27, 41%) of the included programs only reported quantitative results, this review focused on screening the discussion section of publications to identify author opinions or any qualitative information to elucidate the mechanisms of how programs work. CONCLUSIONS This review identified the key strategy, context, and mechanism influencing the success of programs that promote intergenerational interaction through digital means. This review revealed that different strategies should be adopted for different groups of older adults (eg, older adults who are lonely, older adults who reside in long-term residential care facilities, and community-dwelling older adults). The S-C-M-O configurations should be considered when designing and implementing digital intergenerational programs for older adults.
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Affiliation(s)
| | - Yu Heng Kwan
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, SingHealth, Singapore, Singapore.,Health Systems and Services Research, Duke-NUS Medical School, Singapore, Singapore.,Department of Pharmacy, National University of Singapore, Singapore, Singapore.,Internal Medicine Residency, SingHealth residency, Singapore, Singapore
| | - Sungwon Yoon
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, SingHealth, Singapore, Singapore.,Health Systems and Services Research, Duke-NUS Medical School, Singapore, Singapore
| | - Hendra Goh
- Health Systems and Services Research, Duke-NUS Medical School, Singapore, Singapore
| | - Wan Qi Yee
- Population Health & Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Lian Leng Low
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, SingHealth, Singapore, Singapore.,Population Health & Integrated Care Office, Singapore General Hospital, Singapore, Singapore.,Department of Family Medicine & Continuing Care, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine, Duke-NUS Medical School, Singapore, Singapore.,Outram Community Hospital, SingHealth Community Hospitals, Singapore, Singapore
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Abdulrahman A, Richards D, Bilgin AA. Exploring the influence of a user-specific explainable virtual advisor on health behaviour change intentions. AUTONOMOUS AGENTS AND MULTI-AGENT SYSTEMS 2022; 36:25. [PMID: 35401031 PMCID: PMC8977831 DOI: 10.1007/s10458-022-09553-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
Virtual advisors (VAs) are being utilised almost in every service nowadays from entertainment to healthcare. To increase the user's trust in these VAs and encourage the users to follow their advice, they should have the capability of explaining their decisions, particularly, when the decision is vital such as health advice. However, the role of an explainable VA in health behaviour change is understudied. There is evidence that people tend to change their intentions towards health behaviour when the persuasion message is linked to their mental state. Thus, this study explores this link by introducing an explainable VA that provides explanation according to the user's mental state (beliefs and goals) rather than the agent's mental state as commonly utilised in explainable agents. It further explores the influence of different explanation patterns that refer to beliefs, goals, or beliefs&goals on the user's behaviour change. An explainable VA was designed to advise undergraduate students how to manage their study-related stress by motivating them to change certain behaviours. With 91 participants, the VA was evaluated and the results revealed that user-specific explanation could significantly encourage behaviour change intentions and build good user-agent relationship. Small differences were found between the three types of explanation patterns.
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Affiliation(s)
- Amal Abdulrahman
- School of Computing, Macquarie University, Balaclava Road, Sydney, 2109 NSW Australia
| | - Deborah Richards
- School of Computing, Macquarie University, Balaclava Road, Sydney, 2109 NSW Australia
| | - Ayse Aysin Bilgin
- School of Mathematical and Physical Sciences, Macquarie University, Balaclava Road, Sydney, 2109 NSW Australia
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5
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Otter CEM, Keers JC, Smit J, Schoonhoven L, de Man-van Ginkel JM. 'Nurses' self-management support to hospitalised patients: A scoping review. J Clin Nurs 2022; 32:2270-2281. [PMID: 35118738 DOI: 10.1111/jocn.16242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/10/2021] [Accepted: 01/12/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To review the current literature to map and explore the interventions that have been considered or used by nurses to support adult patients' self-management during hospitalisation. BACKGROUND Nurses can play an important role in supporting patients' self-management. Currently, however, it is unclear how nurses perform this task during a patient's stay in hospital. Traditionally, nurses take the primary role in managing patients' care during hospitalisation. Ideally, patients should have the opportunity to continue applying strategies to manage their health conditions as much as possible while in the hospital. This can increase patients' self-efficacy and decrease unnecessary readmissions. DESIGN Scoping review informed by the Joanna Briggs Institute methodology. METHODS A database search was undertaken using Pubmed, CINAHL, PsycInfo, Cochrane, Embase and grey literature sources. Data from the included studies were mapped and summarised in a narrative summary. To synthesise the information that was given about each intervention, we conducted a qualitative inductive content analysis. Results are reported in accordance with the guidelines for reporting Items for systematic review and meta-analyses extension for scoping review (PRISMA-ScR) (Supplementary File 1). RESULTS 83 documents were included in this review. Based on the information about the interventions, three themes were identified: 'self-management support activities', 'focus of self-management support' and the 'intervention procedure'. Five self-management support activities can be distinguished: 'giving education', 'counselling and coaching', 'enhancing responsibility', 'engaging family-caregivers' and 'supporting transition from hospital to home'. The interventions focused on improving disease-related knowledge and on strengthening several self-management skills. Information about the procedure, development and the theoretical underpinning of the intervention was often limited. CONCLUSIONS Most activities within the nursing interventions to support adult patients' self-management during hospitalisation are the part of regular nursing care. However, the transfer of responsibility for care task to the patient is relatively new. Further research could focus on developing interventions addressing all aspects of self-management and that are embedded in the patient's care pathway across settings. RELEVANCE TO CLINICAL PRACTICE Clinical nurses may improve nursing care by supporting all aspects of patients' self-management and facilitate patients as much as possible for taking responsibility for self-management tasks during hospitalisation.
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Affiliation(s)
| | | | - Jakobus Smit
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Lisette Schoonhoven
- Nursing Science, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands.,School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Janneke M de Man-van Ginkel
- Nursing Science, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands
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Duarte JDJL, de Carvalho HEF, Campelo V, Feitosa LGGC, Moura LKB, Hartz Z, Ribeiro IP. Investigation of Contacts for Latent Mycobacterium Tuberculosis Infection: Application Software Development. Open Nurs J 2021. [DOI: 10.2174/1874434602115010380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Tuberculosis is a pathology that continues to be worthy of special attention from health professionals and society due to its high prevalence, proving to be a crucial public health problem.
Objectives:
To describe the development of an application for family health strategy professionals’ investigation of tuberculosis contacts for Latent Mycobacterium tuberculosis Infection.
Methods:
This study is applied research on an application software developed according to three of the five phases described by Falkembach for developing digital educational materials, which include analysis and planning, modeling, and implementation.
Results:
The application is dynamic; that is, it guides health professionals through sequenced screens according to professionals’ self-informed answers. This functionality helps them deciding whether to proceed to the treatment of the patient with Latent Mycobacterium tuberculosis Infection or returning to the initial stage of a tuberculosis contact.
The screens of the application follow the flowchart presented in the Ministry of Health’s Manual of recommendations for tuberculosis control in Brazil of 2018.
Conclusion:
The application developed to guide Family Health Strategy professionals regarding Latent Infection by Mycobacterium Tuberculosis can prevent human errors and increase the care quality when assessing tuberculosis contacts.
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In Search of Embodied Conversational and Explainable Agents for Health Behaviour Change and Adherence. MULTIMODAL TECHNOLOGIES AND INTERACTION 2021. [DOI: 10.3390/mti5090056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Conversational agents offer promise to provide an alternative to costly and scarce access to human health providers. Particularly in the context of adherence to treatment advice and health behavior change, they can provide an ongoing coaching role to motivate and keep the health consumer on track. Due to the recognized importance of face-to-face communication and establishment of a therapist-patient working alliance as the biggest single predictor of adherence, our review focuses on embodied conversational agents (ECAs) and their use in health and well-being interventions. The article also introduces ECAs who provide explanations of their recommendations, known as explainable agents (XAs), as a way to build trust and enhance the working alliance towards improved behavior change. Of particular promise, is work in which XAs are able to engage in conversation to learn about their user and personalize their recommendations based on their knowledge of the user and then tailor their explanations to the beliefs and goals of the user to increase relevancy and motivation and address possible barriers to increase intention to perform the healthy behavior.
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Haldar S, Khelifi M, Mishra SR, Apodaca C, Beneteau E, Pollack AH, Pratt W. Designing Inpatient Portals to Support Patient Agency and Dynamic Hospital Experiences. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2021; 2020:524-533. [PMID: 33936426 PMCID: PMC8075428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Inpatient portals could help patients engage in their hospital care, yet several design, usability, and adoption issues prevent this technology from fulfilling its potential. Despite patients having needs that extend beyond the scope of existing inpatient portals, we know less about how to design such portals that support them. To learn about effective designs, we created three mid-fidelity prototypes representing novel approaches for inpatient portal design. Then, we conducted interviews with 21 pediatric and adult inpatients to gather their feedback on these prototypes. Participants shared how the prototypes addressed the following needs: forming active partnerships, navigating relationships and power dynamics with clinicians, understanding complexity of care, contextualizing health information, increasing efficiency of communication, and preventing lost information. We discuss two key implications-supporting patients' agency and dynamic needs throughout their hospital care-for the future of inpatient portal designs.
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Affiliation(s)
- Shefali Haldar
- University of Washington, Seattle, WA
- Northwestern University, Evanston, IL
| | | | | | | | | | - Ari H Pollack
- University of Washington, Seattle, WA
- Seattle Children's Hospital, Seattle, WA
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Roberts S, Chaboyer W, Hopper Z, Marshall AP. Using Technology to Promote Patient Engagement in Nutrition Care: A Feasibility Study. Nutrients 2021; 13:nu13020314. [PMID: 33499271 PMCID: PMC7910973 DOI: 10.3390/nu13020314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
Empowering patients to participate in nutrition care during hospitalisation may improve their dietary intakes and associated outcomes. This study tested the acceptability and feasibility of a technology-based intervention to engage hospital patients in nutrition care at a tertiary teaching hospital in Australia. The hospital used an electronic foodservice system (EFS), by which patients ordered meals via bedside computers. Adults at nutritional risk received the nutrition technology (NUTRI-TEC) intervention, involving nutrition assessment, education on nutrition requirements and training on using the EFS to enter food intakes and monitor nutrition goals. Acceptability was assessed using patient satisfaction and engagement surveys. Feasibility was assessed by evaluating the intervention delivery/fidelity and patient recruitment/retention. Patients’ dietary intakes were observed daily to indicate the intervention’s effects and assess the accuracy of the patient-recorded intakes. Descriptive and inferential statistics were used to analyse the data. Of the 71 patients recruited, 49 completed the study (55% male; median (IQR) age 71 (65–78) years; length of stay 10 (7–14) days). Patient satisfaction with NUTRI-TEC was high. Intervention delivery and fidelity targets were met but recruitment (≥50%) and retention (≥75%) targets were not; only 31% of patients agreed to participate and 69% completed the study (mostly due to unexpected/early discharge). Patient- and researcher-recorded dietary intakes correlated strongly, indicating patients can record food intakes accurately using technology. This study highlights the important role technology is likely to play in facilitating patient engagement and improving care during hospitalisation.
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Affiliation(s)
- Shelley Roberts
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; (W.C.); (A.P.M.)
- Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia;
- Correspondence: ; Tel.: +61-7-5552-9557
| | - Wendy Chaboyer
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; (W.C.); (A.P.M.)
- School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4222, Australia
| | - Zane Hopper
- Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia;
| | - Andrea P. Marshall
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; (W.C.); (A.P.M.)
- Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia;
- School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4222, Australia
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10
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Understanding cancer patients' use and perceptions of inpatient portal: A case study at a tertiary hospital in Saudi Arabia. Int J Med Inform 2021; 148:104398. [PMID: 33571744 DOI: 10.1016/j.ijmedinf.2021.104398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/19/2020] [Accepted: 01/19/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Inpatient portals have been introduced into tertiary hospitals to meet patients' information and communication needs, to increase their awareness of health care, and to facilitate their transition after discharge. However, there is inadequate knowledge about hospitalised oncology patients' use and perceptions of these technologies. OBJECTIVE To explore cancer patients' use and perceptions of an inpatient portal in a tertiary hospital and to identify the main benefits and barriers for patients in using the portal. METHOD A qualitative case study was conducted in a tertiary hospital in Riyadh, Saudi Arabia. Only cancer patients were invited to participate. Twenty-two semi-structured interviews were conducted in the patient's room in a cancer care centre in January 2020. Interviews were audio-recorded, fully transcribed, and analysed using a thematic analysis method. RESULTS Most patients used the portal for the first time. The most used features were entertainment, watching fall prevention videos and viewing medication lists. Although the majority of patients were positive towards the portal, and considered it to be useful and easy to use, only a small number of them used the key clinical feature of the system such as pain assessment, health education, and discharge preparation. The patients would like to see further improvement in usability of the portal, appropriate user training, adding further information, and incorporating more services and features in the portal. CONCLUSION The introduction of the inpatient portal is successful in improving cancer patients' hospitalisation experience. It helped cancer patients to acquire knowledge about their own health, to actively engage in their care processes, and to request and acquire electronic services, in addition to providing entertainment. Future research on which factors inspire patients' use of the portal and how the influence is achieved is needed for the successful integration of the portal into the patients' hospital care process.
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Roberts S, Chaboyer W, Marshall AP. Hospital patients' perceptions of using a technology-based intervention to participate in their nutrition care: A qualitative descriptive study. Clin Nutr ESPEN 2020; 39:79-86. [PMID: 32859333 DOI: 10.1016/j.clnesp.2020.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/22/2020] [Accepted: 07/20/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Promoting patient participation in health care is a worldwide health care priority. When patients participate in their nutrition care during hospitalisation, they are more likely to meet their dietary needs. Patient participation is a potential solution to hospital malnutrition, for which inadequate dietary intake is the major modifiable risk factor. Our team developed a health information technology (HIT) intervention aiming to improve patients' dietary intakes during hospitalisation by engaging them in their nutrition care. The aim of this study was to explore patient perceptions and acceptability of the intervention. METHODS This qualitative descriptive study was conducted at a tertiary teaching hospital in Australia. Participants were a subset of patients from a larger feasibility study, selected using maximum variation purposive sampling to include a broad representation of patients in terms of age, gender and experience with technology. All patients had used the HIT intervention to participate in their nutrition care in hospital, through nutritional goal setting and dietary intake monitoring. A semi-structured interview guide was used to collect qualitative data on patients' perceptions of the intervention, focusing on acceptability. Data were analysed thematically. FINDINGS 11 patients participated in interviews, from which two main themes emerged. The first captured patients' experiences and perceptions of using technology to participate in their nutrition care. Patients found it easy to use, useful and valuable, but still valued interaction with researchers and hospital staff. The second theme portrayed the spectrum of participation, from simply learning about nutrition, to self-monitoring and evaluating, to changing behaviour. Participants enjoyed gaining new knowledge and awareness around nutrition. Most self-monitored their food intake and evaluated their goals, and some changed what foods they ordered based on what they had learned. CONCLUSIONS Patients responded positively to the intervention, likely because they found it valuable and easy to use. These findings are promising for potential future use of HIT to engage hospital patients in care. Future research should investigate the effects of HIT interventions on patient-centred outcomes in hospital.
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Affiliation(s)
- Shelley Roberts
- School of Allied Health Sciences, Griffith University, Australia; Gold Coast Hospital and Health Service, Australia; Menzies Health Institute Queensland, Australia.
| | - Wendy Chaboyer
- Menzies Health Institute Queensland, Australia; School of Nursing and Midwifery, Griffith University, Australia
| | - Andrea P Marshall
- Gold Coast Hospital and Health Service, Australia; Menzies Health Institute Queensland, Australia; School of Nursing and Midwifery, Griffith University, Australia
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12
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Roberts S, Hopper Z, Chaboyer W, Gonzalez R, Banks M, Desbrow B, Marshall AP. Engaging hospitalised patients in their nutrition care using technology: development of the NUTRI-TEC intervention. BMC Health Serv Res 2020; 20:148. [PMID: 32106848 PMCID: PMC7045423 DOI: 10.1186/s12913-020-5017-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 02/20/2020] [Indexed: 01/07/2023] Open
Abstract
Background Nutrition is vital for health and recovery during hospitalisation, however most patients fail to meet minimum dietary requirements and up to 50% of patients are malnourished in hospital. When patients participate in nutrition care, their dietary intakes are improved. Advances in health information technology (HIT) have broadened the ways by which patients can participate in care. Our team has developed an innovative, HIT-based intervention (called NUTRI-TEC; engaging patients in their nutrition care using technology), facilitating patient participation in their nutrition care in hospital. This paper aims to describe the systematic and iterative process by which the intervention was developed. Methods NUTRI-TEC development was informed by the Medical Research Council guidance for developing complex interventions and underpinned by theoretical frameworks and concepts (i.e. integrated knowledge translation and patient participation in care), existing evidence and a rigorous program of research. The intervention was co-developed by the multidisciplinary research team and stakeholders, including health consumers (patients), health professionals and industry partners. We used an iterative development and evaluation cycle and regularly tested the intervention with hospital patients and clinicians. Results The NUTRI-TEC intervention involves active patient participation in their nutrition care during hospitalisation. It has two components: 1) Patient education and training; and 2) Guided nutrition goal setting and patient-generated dietary intake tracking. The first component includes brief education on the importance of meeting energy/protein requirements in hospital; and training on how to use the hospital’s electronic foodservice system, accessed via bedside computer screens. The second component involves patients recording their food intake after each meal on their bedside computer and tracking their intakes relative to their goals. This is supported with brief, daily goal-setting sessions with a health care professional. Conclusions NUTRI-TEC is a HIT intervention designed to enable patient participation in their nutrition care in hospital. As research on HIT interventions to engage patients in health care in the hospital setting is in its infancy, and as gaps and inconsistencies in the development of such interventions exist, this paper will inform future development of HIT-based interventions in the hospital setting.
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Affiliation(s)
- Shelley Roberts
- School of Allied Health Sciences, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia. .,Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia. .,Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.
| | - Zane Hopper
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Wendy Chaboyer
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.,School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Ruben Gonzalez
- School of Information and Communication Technology, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Merrilyn Banks
- Royal Brisbane and Women's Hospital, Cnr Butterfield St and Bowen Bridge Road, Herston, QLD, 4029, Australia
| | - Ben Desbrow
- School of Allied Health Sciences, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Andrea P Marshall
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.,School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
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13
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Greysen SR, Magan Y, Rosenthal J, Jacolbia R, Auerbach AD, Harrison JD. Patient Recommendations to Improve the Implementation of and Engagement With Portals in Acute Care: Hospital-Based Qualitative Study. J Med Internet Res 2020; 22:e13337. [PMID: 31934868 PMCID: PMC6996719 DOI: 10.2196/13337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/09/2019] [Accepted: 08/19/2019] [Indexed: 11/24/2022] Open
Abstract
Background The inclusion of patient portals into electronic health records in the inpatient setting lags behind progress in the outpatient setting. Objective The aim of this study was to understand patient perceptions of using a portal during an episode of acute care and explore patient-perceived barriers and facilitators to portal use during hospitalization. Methods We utilized a mixed methods approach to explore patient experiences in using the portal during hospitalization. All patients received a tablet with a brief tutorial, pre- and postuse surveys, and completed in-person semistructured interviews. Qualitative data were coded using thematic analysis to iteratively develop 18 codes that were integrated into 3 themes framed as patient recommendations to hospitals to improve engagement with the portal during acute care. Themes from these qualitative data guided our approach to the analysis of quantitative data. Results We enrolled 97 participants: 53 (53/97, 55%) women, 44 (44/97, 45%) nonwhite with an average age of 48 years (19-81 years), and the average length of hospitalization was 6.4 days. A total of 47 participants (47/97, 48%) had an active portal account, 59 participants (59/97, 61%) owned a smartphone, and 79 participants (79/97, 81%) accessed the internet daily. In total, 3 overarching themes emerged from the qualitative analysis of interviews with these patients during their hospital stay: (1) hospitals should provide both access to a device and bring-your-own-device platform to access the portal; (2) hospitals should provide an orientation both on how to use the device and how to use the portal; and (3) hospitals should ensure portal content is up to date and easy to understand. Conclusions Patients independently and consistently identified basic needs for device and portal access, education, and usability. Hospitals should prioritize these areas to enable successful implementation of inpatient portals to promote greater patient engagement during acute care. Trial Registration ClinicalTrials.gov NCT00102401; https://clinicaltrials.gov/ct2/show/NCT01970852
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Affiliation(s)
- S Ryan Greysen
- Section of Hospital Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Yimdriuska Magan
- School of Medicine, University of California, Davis, Davis, CA, United States
| | - Jamie Rosenthal
- School of Medicine, Boston University, Boston, MA, United States
| | - Ronald Jacolbia
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew D Auerbach
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - James D Harrison
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, United States
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14
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Vink S, Fareed N, MacEwan SR, McAlearney AS. An Exploration of the Association between Inpatient Access to Tablets and Patient Satisfaction with Hospital Care. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2019; 16:1i. [PMID: 31908632 PMCID: PMC6931050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Patient-centered care seeks to improve healthcare quality by engaging patients in their health management. Hospitals are employing strategies to enhance patient engagement to improve care quality, as measured by patient satisfaction through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Tablets are one tool hospitals use to increase patient engagement during hospitalization, as tablets can provide patients with access to both entertainment options and personal health information through patient portals. To explore the association between tablet access and patient satisfaction, data on tablet provisioning were linked to patient HCAHPS scores. Patients who were provided a tablet had higher HCAHPS scores in a subset of satisfaction measures, as compared with patients who were not provided a tablet, suggesting that tablets could positively influence patients' satisfaction with their hospital stay. Future studies are warranted to understand the specific ways in which tablet use improves the patient experience during hospitalization.
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Affiliation(s)
- Shonda Vink
- The Ohio State University Medical Center in Columbus, OH
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15
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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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Dumitrascu AG, Burton MC, Dawson NL, Thomas CS, Nordan LM, Greig HE, Aljabri DI, Naessens JM. Patient portal use and hospital outcomes. J Am Med Inform Assoc 2019; 25:447-453. [PMID: 29300961 DOI: 10.1093/jamia/ocx149] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 11/30/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives To determine whether use of a patient portal during hospitalization is associated with improvement in hospital outcomes, 30-day readmissions, inpatient mortality, and 30-day mortality. Materials and Methods We performed a retrospective propensity score-matched study that included all adult patients admitted to Mayo Clinic Hospital in Jacksonville, Florida, from August 1, 2012, to July 31, 2014, who had signed up for a patient portal account prior to hospitalization (N = 7538). Results Out of the admitted patients with a portal account, 1566 (20.8%) accessed the portal while in the hospital. Compared to patients who did not access the portal, patients who accessed the portal were younger (58.8 years vs 62.3 years), had fewer elective admissions (54.2% vs 64.1%), were more frequently admitted to medical services (45.8% vs 35.2%), and were more likely to have liver disease (21.9% vs 12.9%) and higher disease severity scores (0.653 vs 0.456). After propensity score matching, there was no statistically significant difference between the 2 cohorts with respect to 30-day readmission (P = .13), inpatient mortality (P = .82), or 30-day mortality (P = .082). Conclusion Use of the patient portal in the inpatient setting may not improve hospital outcomes. Future research should examine the association of portal use with more immediate inpatient health outcomes such as patient experience, patient engagement, medication reconciliation, and prevention of adverse events.
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Affiliation(s)
- Adrian G Dumitrascu
- Department of Medicine, Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - M Caroline Burton
- Department of Medicine, Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nancy L Dawson
- Department of Medicine, Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Colleen S Thomas
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | - Lisa M Nordan
- Robert D and Patricia E Kern Center for Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA
| | - Hope E Greig
- Administration, Mayo Clinic, Jacksonville, FL, USA
| | - Duaa I Aljabri
- Robert D and Patricia E Kern Center for Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA
| | - James M Naessens
- Robert D and Patricia E Kern Center for Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA.,Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
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17
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Chow R, Viehweger J, Kanmodi KK. Many hours of watching medical TV shows is associated with greater medical knowledge. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0026/ijamh-2018-0026.xml. [PMID: 30205660 DOI: 10.1515/ijamh-2018-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 02/19/2018] [Indexed: 11/15/2022]
Abstract
Television (TV) is a popular and effective media in the formation of behaviours, beliefs and emotions. Watching TV is a main hobby in people's lives, and has become an increasingly more common hobby for children nowadays as opposed to several decades ago. However, while many studies have reported the negative effects, there have been little to no studies investigating whether a positive effect may exist. The aim of this study was to determine whether individuals who watch medical dramas are generally more knowledgeable about medicine than those who do not watch medical dramas. This was a cross-sectional survey of adolescents and young adults using an e-questionnaire. The questionnaire had four sections - a consent form, demographics of respondents, TV show(s) respondents watched and assessment of medical knowledge. Questionnaires were circulated to the international community, with a focus on respondents in Canada, the US and Nigeria. Responses were analysed using statistical analysis software. Between August and December 2017, a total of 746 consenting respondents completed the questionnaire. The average knowledge score of all respondents on medical terminologies was 6.80 out of 10. For respondents who had a history of watching medical TV shows, they were more knowledgeable than those without such a history (p = 0.0008). Additionally, those who watched more than one season of TV were more knowledgeable than those who had watched less than one season (p < 0.0001). The results suggest that people who have a history of watching TV shows are more knowledgeable than those without such a history, and also that those who watch more hours of medical TV shows are more knowledgeable than those who watch only a few hours. Future studies could investigate whether medical TV shows causes higher knowledge (as this study suggests association), and to ultimately determine whether it can be an essential component of increasing medical knowledge of the population, and in turn, patients.
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Affiliation(s)
- Ronald Chow
- Infinitas Research Group, London, Ontario, Canada
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18
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Aljabri D, Dumitrascu A, Burton MC, White L, Khan M, Xirasagar S, Horner R, Naessens J. Patient portal adoption and use by hospitalized cancer patients: a retrospective study of its impact on adverse events, utilization, and patient satisfaction. BMC Med Inform Decis Mak 2018; 18:70. [PMID: 30053809 PMCID: PMC6062873 DOI: 10.1186/s12911-018-0644-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 06/26/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Portal use has been studied among outpatients, but its utility and impact on inpatients is unclear. This study describes portal adoption and use among hospitalized cancer patients and investigates associations with selected safety, utilization, and satisfaction measures. METHODS A retrospective review of 4594 adult hospitalized cancer patients was conducted between 2012 and 2014 at Mayo Clinic in Jacksonville, Florida, comparing portal adopters, who registered for a portal account prior to hospitalization, with nonadopters. Adopters were classified by their portal activity during hospitalization as active or inactive inpatient users. Univariate and several logistic and linear regression models were used for analysis. RESULTS Of total patients, 2352 (51.2%) were portal adopters, and of them, 632 (26.8%) were active inpatient users. Portal adoption was associated with patients who were young, female, married, with higher income, and had more frequent hospitalizations (P < .05). Active inpatient use was associated with patients who were young, married, nonlocals, with higher disease severity, and were hospitalized for medical treatment (P < .05). In univariate analyses, self-management knowledge scores were higher among adopters vs nonadopters (84.3 and 80.0, respectively; P = .01) and among active vs inactive inpatient users (87.0 and 83.3, respectively; P = .04). In regression models adjusted for age and disease severity, the association between portal behaviors and majority of measures were not significant (P > .05). CONCLUSIONS Over half of our cancer inpatients adopted a portal prior to hospitalization, with increased adoption associated with predisposing and enabling determinants (eg: age, sex, marital status, income), and increased inpatient use associated with need (eg: nonlocal residence and disease severity). Additional research and greater effort to expand the portal functionality is needed to impact inpatient outcomes.
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Affiliation(s)
- Duaa Aljabri
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL USA
| | - Adrian Dumitrascu
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL USA
| | - M. Caroline Burton
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL USA
| | - Launia White
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL USA
| | - Mahmud Khan
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC USA
| | - Sudha Xirasagar
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC USA
| | - Ronnie Horner
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC USA
| | - James Naessens
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA
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19
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Kurahashi AM, Stinson JN, van Wyk M, Luca S, Jamieson T, Weinstein P, Cafazzo JA, Lokuge B, Cohen E, Rapoport A, Husain A. The Perceived Ease of Use and Usefulness of Loop: Evaluation and Content Analysis of a Web-Based Clinical Collaboration System. JMIR Hum Factors 2018; 5:e2. [PMID: 29317386 PMCID: PMC5780614 DOI: 10.2196/humanfactors.7882] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/27/2017] [Accepted: 11/16/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with complex health care needs require the expertise of many health care providers. Communication, collaboration, and patient-centered care positively impact care quality and patient outcomes. Few technologies exist that facilitate collaboration between providers across settings of care and also engage the patient. We developed a Web-based clinical collaboration system, Loop, to address this gap. The likelihood of a technological system's uptake is associated with its perceived ease of use and perceived usefulness. We engaged stakeholders in the conceptualization and development of Loop in an effort to maximize its intuitiveness and utility. OBJECTIVE This study aimed to report end users' perceptions about the ease of use and usefulness of Loop captured during usability tests of Loop. METHODS Participants represented three user types (patients, caregivers, and health care providers) recruited from three populations (adults with cancer, adolescents and young adults with cancer, and children with medical complexity). We conducted usability testing over three iterative cycles of testing and development in both laboratory-based and off-site environments. We performed a content analysis of usability testing transcripts to summarize and describe participant perceptions about the ease of use and usefulness of Loop. RESULTS Participants enjoyed testing Loop and were able to use the core functions-composing, posting, and reading messages-with little difficulty. They had difficulty interpreting certain visual cues and design elements or the purpose of some features. This difficulty negatively impacted perceived ease of use but was primarily limited to auxiliary features. Participants predicted that Loop could improve the efficiency and effectiveness of communication between care team members; however, this perceived usefulness could be compromised by disruptions to personal workflow such as additional time or task requirements. CONCLUSIONS Loop was perceived to have value as a collaboration system; however, usability testing findings indicate that some design and functional elements need to be addressed to improve ease of use. Additionally, participant concerns highlight the need to consider how a system can be implemented so as to minimize impact on workflow and optimize usefulness.
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Affiliation(s)
- Allison M Kurahashi
- The Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada
| | - Jennifer N Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Margaret van Wyk
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie Luca
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Trevor Jamieson
- Division of General Internal Medicine, St. Michael's Hospital, Toronto, ON, Canada.,Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Weinstein
- Healthcare Human Factors, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Joseph A Cafazzo
- Healthcare Human Factors, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Bhadra Lokuge
- The Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Adam Rapoport
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada.,Emily's House Children's Hospice, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Amna Husain
- The Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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20
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Barra DCC, Paim SMS, Sasso GTMD, Colla GW. MÉTODOS PARA DESENVOLVIMENTO DE APLICATIVOS MÓVEIS EM SAÚDE: REVISÃO INTEGRATIVA DA LITERATURA. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072017002260017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: identificar nas publicações nacionais e internacionais indexadas nas bases de dados os principais métodos adotados pelos pesquisadores para o desenvolvimento de aplicativos móveis em saúde. Método: revisão integrativa da literatura de estudos publicados nas bases de dados MEDLINE/PubMed, Scopus, Web of Science, CINAHL e SciELO, no período de 2012 a 2016. Foram selecionados para análise 21 artigos. Resultados: os principais métodos para desenvolvimento de aplicativos móveis na área da saúde descritos nos artigos foram: design instrucional sistemático, design instrucional contextualizado, design centrado no usuário e ciclo de vida de desenvolvimento de sistemas. Conclusão: independentemente do método de desenvolvimento escolhido, as etapas devem ser bem definidas e estruturadas, a fim de que o aplicativo móvel desenvolvido seja útil ao usuário final.
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21
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Spooner AJ, Aitken LM, Chaboyer W. Barriers and facilitators to the implementation of an evidence-based electronic minimum dataset for nursing team leader handover: A descriptive survey. Aust Crit Care 2017; 31:278-283. [PMID: 29153960 DOI: 10.1016/j.aucc.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/06/2017] [Accepted: 09/17/2017] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. OBJECTIVES The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. METHODS The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia. An established tool was modified to the intensive care nursing handover context and a survey of all 63 nursing team leaders was undertaken. Survey statements were rated using a 6-point Likert scale with selections from 'strongly disagree' to 'strongly agree', and open-ended questions. Descriptive statistics were used to summarise results. RESULTS AND DISCUSSION A total of 39 team leaders responded to the survey (62%). Team leaders used general intensive care work unit guidelines to inform practice however they were less familiar with the intensive care handover work unit guideline. Barriers to minimum dataset uptake included: a tool that was not user friendly, time consuming and contained too much information. Facilitators to minimum dataset adoption included: a tool that was user friendly, saved time and contained relevant information. Identifying the complexities of a healthcare setting prior to the implementation of an intervention assists researchers and clinicians to integrate new knowledge into healthcare settings. CONCLUSION Barriers and facilitators to knowledge use focused on usability, content and efficiency of the electronic minimum dataset and can be used to inform tailored strategies to optimise team leaders' adoption of a minimum dataset for handover.
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Affiliation(s)
- Amy J Spooner
- School of Nursing and Midwifery, Griffith University, Nathan, Australia.
| | - Leanne M Aitken
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Australia; Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Australia; School of Health Sciences, City University London, London, United Kingdom
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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22
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Roberts S, Chaboyer W, Gonzalez R, Marshall A. Erratum to: Using technology to engage hospitalised patients in their care: a realist review. BMC Health Serv Res 2017; 17:650. [PMID: 28903721 PMCID: PMC5598032 DOI: 10.1186/s12913-017-2577-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Shelley Roberts
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia
| | - Ruben Gonzalez
- School of Information and Communication Technology, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia
| | - Andrea Marshall
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.,Nursing and Midwifery Education and Research Unit, Gold Coast University Hospital, Southport, QLD, 4215, Australia
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23
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Roberts S, Marshall A, Chaboyer W. Hospital staffs' perceptions of an electronic program to engage patients in nutrition care at the bedside: a qualitative study. BMC Med Inform Decis Mak 2017; 17:105. [PMID: 28693472 PMCID: PMC5504779 DOI: 10.1186/s12911-017-0495-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/28/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Advancements in technology are enabling patients to participate in their health care through self-monitoring and self-management of diet, exercise and chronic disease. Technologies allowing patients to participate in hospital care are still emerging but show promise. Our team is developing a program by which hospitalised patients can participate in their nutrition care. This study explores hospital staffs' perceptions of using this technology to engage patients in their care. METHODS This qualitative study involved semi-structured interviews with hospital staff providing routine nutrition care to patients (i.e. dietitians, nutrition assistants, nurses, doctors and foodservice staff) from five wards at a tertiary metropolitan teaching hospital in Australia. The hospital currently uses an electronic foodservice system (EFS) for patient meal ordering, accessed through personal screens at the bedside. Participants were shown the EFS program on an iPad and asked about their perceptions of the program, with questions from a semi-structured interview guide. Staff were interviewed individually or in small focus groups. Interviews lasted 15-30 min and were audio recorded and later transcribed. Data were analysed using thematic analysis. RESULTS Nineteen staff participated in interviews. Overall, they expressed positive views of the EFS program and wanted it to be implemented in practice. Their responses formed three themes, each with a number of subthemes: 1) Enacting patient participation in practice; 2) Optimising nutrition care; and 3) Considerations for implementing an EFS program in practice. Staff thought the program would improve various aspects of nutrition care and enable patient participation in care. Whilst they raised some concerns, they focused on overcoming barriers and facilitating implementation if the program were to be adopted into practice. CONCLUSIONS Staff found an EFS program designed to engage patients in their nutrition care acceptable, as they saw benefits to using it for both patients and staff. Staff recognised characteristics of the program itself, as well as allocation of roles and responsibilities in operationalising it, were pivotal for successful implementation in practice. Their perspectives will inform program and intervention design, and implementation and evaluation strategies.
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Affiliation(s)
- Shelley Roberts
- National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD 4222 Australia
| | - Andrea Marshall
- Gold Coast Hospital and Health Service and School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Gold Coast, QLD 4222 Australia
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD 4222 Australia
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