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Benjamins J, de Vet E, Haveman-Nies A. Enhancing interprofessional teamwork between youth care professionals using an electronic health record; a mixed methods intervention study. J Interprof Care 2024; 38:553-563. [PMID: 38414288 PMCID: PMC11018063 DOI: 10.1080/13561820.2024.2314461] [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: 05/11/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
We aimed to investigate whether using a shared electronic patient record (EPR-Youth) strengthened interprofessional teamwork among professionals in youth care and child healthcare. Using a mixed-methods design, we compared two partly overlapping samples of professionals, who completed questionnaires before the introduction of EPR-Youth (n = 117) and 24 months thereafter (n = 127). Five components of interprofessional teamwork (interdependence, newly created professional activities, flexibility, collective ownership of goals, and reflection on processes) were assessed for this study. Midway through the study period, focus groups were held with 12 professionals to examine how EPR-Youth contributed to interprofessional teamwork. Professionals reported significantly more flexibility after the introduction of EPR-Youth than before. Professionals scored slightly -but not significantly- more positively on the other components of teamwork. Focus group participants reported that using EPR-Youth strengthened their sense of interdependence and collective ownership of goals, and contributed to newly created professional activities. At baseline, levels of interprofessional teamwork differed between organizations. Focus group participants confirmed these differences and attributed them to differences in facilitation of interprofessional teamwork. Our findings suggest that using EPR-Youth can foster interprofessional teamwork. Organizational differences underline that implementing an EPR alone is inadequate: shared definitions of teamwork and organizational facilities are needed to strengthen interprofessional teamwork.
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Affiliation(s)
- Janine Benjamins
- Icare JGZ, department Jeugdgezondheidszorg, Meppel, the Netherlands
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, the Netherlands
| | - Emely de Vet
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, the Netherlands
| | - Annemien Haveman-Nies
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, the Netherlands
- GGD Noord- en Oost-Gelderland, department Jeugdgezondheid, Warnsveld, the Netherlands
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Musa S, Dergaa I, Al Shekh Yasin R, Singh R. The Impact of Training on Electronic Health Records Related Knowledge, Practical Competencies, and Staff Satisfaction: A Pre-Post Intervention Study Among Wellness Center Providers in a Primary Health-Care Facility. J Multidiscip Healthc 2023; 16:1551-1563. [PMID: 37287690 PMCID: PMC10243608 DOI: 10.2147/jmdh.s414200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
Background The transition to electronic health records (EHR) has improved the quality of health-care delivery and patient safety. However, poor usability and incongruent workflow may impose a significant burden on documentation and time management, resulting in staff burnout. We aimed to (i) evaluate the effectiveness of personalized EHR training on wellness providers' knowledge and practical competencies, and (ii) assess staff satisfaction regarding the EHR usage post-training. Methodology An interventional study was conducted between July 15, 2021, and March 1, 2022, among 14 wellness staff (age: 38 ± 3.9 years; 7 males, 7 females) in the Wellness Center-Rawdat Al-Khail Health Center. Six months of blended training was delivered. The impact of training was assessed using a pre-post survey on the knowledge and practical competencies related to EHR usage. Staff satisfaction was assessed post-training. Results Majority of respondents had improvement in identifying the advantages of EHR: improve confidentiality of care (pre = 35.7% vs post = 100%, p = 0.001), reduce medical errors (pre = 35.7% vs post = 85.7%, p = 0.02), improve quality of health care (pre = 35.7% vs post = 100%, p = 0.001), and reduce wait time (pre = 42.9% vs post = 85.7%, p = 0.03). Time performing these tasks by massage therapists/receptionists was reduced: viewing/editing ambulatory organizer (pre = 20±0 s vs post = 10±0 s), access PM office (pre = 155±136 s vs post = 10±0 s), selection/access patient chart (pre = 75±30 s vs post = 30±20 s), check-in/out (pre = 120±0 s vs post = 60±0 s), and view/edit massage form (pre = 135±75.5 s vs post = 60±0 s). For gym instructors, time to access ambulatory organizer (pre = 30±0 s vs post = 10±0 s), view/edit the gym form (pre = 101±57 s vs post = 71±36 s), view patients' clinical data (pre = 60±70 s vs post = 10±3 s), and place referral orders (pre = 197±144 vs post = 82±23 s) was reduced. A mean percentage score of 65.4±38.7 indicated very good staff satisfaction. Conclusion This tailored, hands-on training has been well received and effectively improved wellness staff knowledge, competencies, and satisfaction relative to EHR functionalities.
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Affiliation(s)
- Sarah Musa
- Department of Preventative Health, Primary Health Care Corporation (PHCC), Doha, Qatar
| | - Ismail Dergaa
- Department of Preventative Health, Primary Health Care Corporation (PHCC), Doha, Qatar
| | - Rawia Al Shekh Yasin
- Department of Quality & Patient Safety, Primary Health Care Corporation (PHCC), Doha, Qatar
| | - Rajvir Singh
- Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar
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Ge S, Song Y, Hu J, Tang X, Li J, Dune L. The development and impact of adopting electronic health records in the United States: A brief overview and implications for nursing education. HEALTH CARE SCIENCE 2022; 1:186-192. [PMID: 38938558 PMCID: PMC11080714 DOI: 10.1002/hcs2.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/23/2022] [Accepted: 09/04/2022] [Indexed: 06/29/2024]
Affiliation(s)
- Song Ge
- Department of Natural Sciences, College of Sciences and TechnologyUniversity of Houston‐DowntownHoustonTexasUSA
| | - Yuting Song
- School of NursingQingdao UniversityQingdaoShandongChina
| | - Jiale Hu
- Department of Nurse Anesthesia, College of Health ProfessionsVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Xianping Tang
- School of NursingXuzhou Medical UniversityXuzhouJiangsuChina
| | - Junxin Li
- School of NursingJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Linda Dune
- Department of Natural Sciences, College of Sciences and TechnologyUniversity of Houston‐DowntownHoustonTexasUSA
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Hannawa AF, Wu AW, Kolyada A, Potemkina A, Donaldson LJ. The aspects of healthcare quality that are important to health professionals and patients: A qualitative study. PATIENT EDUCATION AND COUNSELING 2022; 105:1561-1570. [PMID: 34711447 DOI: 10.1016/j.pec.2021.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Existing quality of care frameworks insufficiently integrate the perspectives of physicians, nurses and patients. We collected narrative accounts from these three groups to explore if their perspectives might add new content to these existing definitions. METHODS Ninety-seven descriptions of "good" and "poor" care episodes were collected from a convenience sample of physicians, nurses and outpatients at eight regional hospitals. Two coders classified the narrative contents into themes related to structures, processes and outcomes of care. RESULTS The physicians, nurses and patients raised the following "quality of care" aspects: Successful communication among staff, with patients and care companions; staff motivation; frequency of knowledge errors; prioritization of patient-preferred outcomes; institutional emphasis on building "quality cultures"; and organizational implementation of fluid system procedures. CONCLUSION Respondents primarily referred to care processes in their descriptions of "quality of care." "Hippocratic pride" (in response to care successes) and "Rapid reactivity" (in response to (near) failures) emerged as two new outcome indicators of high-quality care. PRACTICE IMPLICATIONS This study provides a first qualitative fundament for understanding the components of "quality of care" from a triangulated frontline perspective. Future research needs to validate our findings with quantitative data to explore their usefulness for completing existing quality frameworks.
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Affiliation(s)
- Annegret F Hannawa
- Center for the Advancement of Healthcare Quality & Patient Safety (CAHQS), Faculty of Communication, Culture & Society, Università della Svizzera italiana (USI), Via G. Buffi 13, 6900 Lugano, Switzerland.
| | - Albert W Wu
- Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 653, Baltimore, MD 21205, USA.
| | - Anastasia Kolyada
- Center for the Advancement of Healthcare Quality & Patient Safety (CAHQS), Faculty of Communication, Culture & Society, Università della Svizzera italiana (USI), Via G. Buffi 13, 6900 Lugano, Switzerland.
| | - Anastasia Potemkina
- Center for the Advancement of Healthcare Quality & Patient Safety (CAHQS), Faculty of Communication, Culture & Society, Università della Svizzera italiana (USI), Via G. Buffi 13, 6900 Lugano, Switzerland.
| | - Liam J Donaldson
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
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Sinsky CA, Bavafa H, Roberts RG, Beasley JW. Standardization vs Customization: Finding the Right Balance. Ann Fam Med 2021; 19:171-177. [PMID: 33685879 PMCID: PMC7939702 DOI: 10.1370/afm.2654] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 11/09/2022] Open
Abstract
There is an inherent tension between standardization and customization of care delivery processes. The challenge for health care systems is to achieve the right balance. At its best, standardized work can create efficiencies that generate the additional time needed for personalized care. Similarly, at its best, customization allows the people within a system to accommodate the needs, preferences, and circumstances of the unique individuals and local communities they serve. We provide examples and offer principles to decide when standardization offers the most successful path and when customization may be preferred. We believe that, in sum, the balance has shifted too far toward standardization and that a rebalancing toward customization will benefit patients, clinicians, and the health care system.
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Affiliation(s)
| | - Hessam Bavafa
- Wisconsin School of Business, University of Wisconsin-Madison, Madison, Wisconsin.,School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Richard G Roberts
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - John W Beasley
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Health information technology and hospital performance the role of health information quality in teaching hospitals. Heliyon 2020; 6:e05040. [PMID: 33088935 PMCID: PMC7557885 DOI: 10.1016/j.heliyon.2020.e05040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/29/2020] [Accepted: 09/21/2020] [Indexed: 01/26/2023] Open
Abstract
The research purposed in this paper is to investigate the impact of the health information technology on hospital performance through the health information quality as mediating variable, as new evidence from the teaching hospitals in the north of Jordan. Research design and methodology approach based on a survey that is conducted to collect the requested data to develop a model connect between the health information technologies, health information quality and hospital performance by using the Structural Equation Modeling approach. The research findings show that there is an intertwined and reciprocal relation between Health Information Technologies (HITs), hospital performance, and health information quality. HITs have direct positive impacts on both hospital performance and health information quality. Health information quality has also a direct impact on hospital performance. Besides, health information quality functioned as a partial mediator between HITs and hospital performance. The study did not examine the factors that influence the relationship between HITs, hospital performance and health information quality. This paper is evidence for the investor in the healthcare sector to invest more in HITs and health information quality, where the expected results are productivity improvement, performance leveraging and error reduction. The research originality is to introduce new evidence support literature form the Middle East countries is the main contribution of this paper.
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7
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Healthcare Professional and User Perceptions of eHealth Data and Record Privacy in Dubai. INFORMATION 2020. [DOI: 10.3390/info11090415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Dubai city made a significant leap forward, which aligns with the vision of leadership, in the region’s eHealth services by adopting a unified electronic medical record system across the country. Electronic medical records provide a better, more efficient standard of care and a vital database that will streamline the administrative process and promote better outcomes with less utilization of resources. Medical records form an essential part in patient management and include a variety of patient data information that might be sensitive. Therefore, the primary challenge is to maintain data privacy of the electronic medical records. Objective: Current studies to measure the user and health provider perceptions of electronic medical records data privacy are limited in the region. We aimed to investigate the perceptions of healthcare professionals and healthcare users toward electronic medical records and data privacy in eHealthcare facilities in Dubai. Methods: In this quantitative descriptive study, we explored the perceptions towards electronic medical records and data privacy using an online survey as a data collection tool. The dependent variables were the user and provider perceptions, while the independent variables included gender, nationality, income and age. A random sample of 201 eHealthcare facilities professionals and users was included. Results: The findings of the study revealed that most healthcare professionals and users agreed on the presence of good eHealth data protection practices and privacy principles in Dubai. There was a statistical correlation between the surveyed privacy practice perceptions and gender, nationality and income. However, age had no statistically significant association. Conclusions: These research findings can influence policymakers and stakeholders when developing electronic medical records and data privacy policies and guidelines across the United Arab Emirates’ healthcare facilities, in particular, during the implementation of unified electronic medical records. Future research could investigate the effect of the specific demographic variables on the perception of privacy among eHealthcare facility users that might influence electronic medical records and data privacy.
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Singh A, Jadhav S, Roopashree MR. Factors to Overcoming Barriers Affecting Electronic Medical Record Usage by Physicians. Indian J Community Med 2020; 45:168-171. [PMID: 32905074 PMCID: PMC7467200 DOI: 10.4103/ijcm.ijcm_478_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/02/2020] [Indexed: 11/04/2022] Open
Abstract
Background Hospitals are adopting electronic medical records (EMRs) in larger numbers; however, the barrier to derive its full utility is the low acceptance by physicians. Aims and Objectives This study is done with an objective to identify the factors to overcome the barriers preventing the adoption of EMR by physicians. Materials and Methods This study is cross sectional in natures and a self-administered questionnaire is developed based on the Technology Acceptance Model. Results The four identified factors are positive attitude toward EMR, reliability, difficulty to use, and adaptability, these factors together, have explained 62.54 percent variance in the data set. Conclusion The physician's acceptance for EMRs can be improved by focusing on the identified four factors, which are "positive attitude toward electronic medical records," reliability of electronic medical records," "difficulty level of use," and "adaptability of electronic medical records."
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Affiliation(s)
- Ankit Singh
- Hospital and Healthcare Management, Symbiosis Institute of Health Sciences, Pune, Maharashtra, India
| | - Sammita Jadhav
- Hospital and Healthcare Management, Symbiosis Institute of Health Sciences, Pune, Maharashtra, India
| | - M R Roopashree
- Hospital and Healthcare Management, Symbiosis Institute of Health Sciences, Pune, Maharashtra, India
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Matthews EB. Whose System is it Anyway? How Clients and Providers Evaluate the Impact of Session EHR Use on Communication in Mental Health Treatment. Community Ment Health J 2020; 56:540-548. [PMID: 31802323 DOI: 10.1007/s10597-019-00511-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
Electronic health records are common in mental health settings. While providers often express concern that in-session computing will damage client-provider communication, some work suggests that clients do not share this worry. As the majority of this research has been conducted in medical settings, less is known about how clients evaluate in session computing in mental health treatment, and whether this pattern of discordance persists in this setting. This study describes and compares the perceived impact of in-session computing on communication in mental health treatment from the clients and provider perspective, and examined sources of variation in client ratings. Thirteen providers and 53 clients participated in this study, representing 53 unique client-provider dyads. Results suggest that providers perceived in-session computing as more harmful to communication than clients. Client ratings varied by race, age and visit type but were not influenced by how often the computer was used during session.
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Affiliation(s)
- Elizabeth B Matthews
- Graduate School of Social Service, Fordham University, 113 W. 60th St, New York, NY, 10023, USA.
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10
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Schwarz M, Coccetti A, Draheim M, Gordon G. Perceptions of allied health staff of the implementation of an integrated electronic medical record across regional and metropolitan settings. AUST HEALTH REV 2020; 44:965-972. [DOI: 10.1071/ah19024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 01/29/2020] [Indexed: 11/23/2022]
Abstract
ObjectiveThe aim of this study was to investigate the perceptions of allied health professionals (AHPs) to implementation of an integrated electronic medical record (EMR) across both regional and metropolitan settings.
MethodsThe study was conducted as a cross-sectional electronic survey. AHPs working at three hospital sites within Queensland Health were sent an electronic survey link. Participation was voluntary and recruitment via a snowball sampling technique was encouraged. Responses were analysed descriptively.
ResultsIn all, 104 responders completed the survey. Responders were distributed across three sites within the selected health service, with most (75%; n=78) being at the largest site. Physiotherapy accounted for the largest number of responders (22%). Most responders were female (87%; n=90) and between 20 and 40 years of age (68%; n=71). On a scale from 0 (being anxious) to 100 (being excited), at the time EMR implementation was announced, there was a trend towards excitement (mean score 59). The most commonly reported factor hindering EMR implementation was the opportunity to practice with EMR (34%), whereas clinical ‘change champions’ were reported as the most common facilitators (61%). Overall, 60% of responders were very satisfied or satisfied with the EMR, but limited effects on efficiency and patient care were reported.
ConclusionsThe results suggest an overall positive response to EMR implementation. Minimal staff reported effects such as stress or anxiety in the workplace related to EMR implementation, and a perception of ‘comfort’ was cited once EMR was part of usual practice. However, responders did not report a significant effect on speed, efficiency or quality of patient care following EMR implementation.
What is known about the topic?A growing body of literature exists regarding the perceptions of staff (particularly medical officers) in moving towards EMRs, but there is limited evidence regarding the perceptions of AHPs, and the barriers and facilitators to this change.
What does this paper add?This paper presents a novel perspective regarding the perceptions of AHPs regarding the implementation of an EMR and provides a perspective of the barriers and facilitators that supported a smooth transition at three sites.
What are the implications for practitioners?Despite being a large-scale service change, the introduction of an EMR did not significantly increase AHPs’ subjective feelings of anxiety. Services considering EMR implementation should invest in the provision of timely information, ‘at-elbow’ support and opportunities to practice the new system.
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Electronic Health Information Exchange Opportunities for Self-management of Care: Responses from Older Adults With and Without Cancer History in the United States. Curr Oncol Rep 2018; 20:30. [PMID: 29572671 DOI: 10.1007/s11912-018-0674-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF STUDY Of 15.5 million US cancer survivors, 80% are ≥ 55 years. Supporting older patients in care self-management through electronic health information (EHI) exchange may enhance recovery. We assessed: (1) perceived importance of EHI access to adults ≥ 55 years (incl survivors) and (2) age-related preferences for EHI exchange. RECENT FINDINGS Older adults are one of the fastest-growing user groups for internet/technologies. Most older adults 55-64 years are active internet users, and use among adults ≥ 65 years is growing quickly as baby boomers mature. Understanding EHI patient-provider exchange preferences may provide opportunities for older patients but also begin to address the future needs of other patient populations, including cancer survivors. We observed a "digital divide" for perceived importance of EHI access and EHI exchange interests. Engaging older adults (i.e., ≥ 75 years) to improve comfort/experience with technologies may support EHI use in self-management. Survivors may have distinct EHI needs/preferences than older adults without cancer history.
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12
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Totzkay D, Silk KJ, Sheff SE. The Effect of Electronic Health Record Use and Patient-Centered Communication on Cancer Screening Behavior: An Analysis of the Health Information National Trends Survey. JOURNAL OF HEALTH COMMUNICATION 2017; 22:554-561. [PMID: 28682179 DOI: 10.1080/10810730.2017.1338801] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study used the 2013 Health Information National Trends Survey (N = 3185) to examine the effects of patient-centered communication (PCC) and the use of electronic health records (EHRs) on the likelihood of patients receiving a recommended screening for cancer (i.e., mammogram, PSA test). Self-determination theory, a framework of self-initiated extrinsic behaviors, was applied to test mediation models of PCC and EHR use, respectively, through patient activation. The results demonstrated that PCC and EHR use predicted cancer screening (mediated through patient activation), but only for women recommended for biannual mammograms. The aforementioned relationship was not found for men who are recommended for prostate cancer screening. PCC and EHRs do appear to facilitate a patient's ability to take care of their own health, but only under certain circumstances. It was additionally found that men were more likely to report higher degrees of physician PCC when their physicians maintained an EHR, whereas women reported no difference. Future research should examine more nuanced personality factors that affect the perception of PCC in the presence of EHRs and the relationship between men's activation and likelihood of receiving a cancer screen.
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Affiliation(s)
- Daniel Totzkay
- a Department of Communication , Michigan State University , East Lansing , Michigan , USA
| | - Kami J Silk
- a Department of Communication , Michigan State University , East Lansing , Michigan , USA
| | - Sarah E Sheff
- b Department of Communication , University of Kentucky , Lexington , Kentucky , USA
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Thomas S, Walsh D, Shrotriya S, Aktas A, Hullihen B, Estfan B, Budd GT, Hjermstad MJ, O'Connor B. Symptoms, Quality of Life, and Daily Activities in People With Newly Diagnosed Solid Tumors Presenting to a Medical Oncologist. Am J Hosp Palliat Care 2016; 34:611-621. [PMID: 27217423 DOI: 10.1177/1049909116649948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Symptom and Quality of Life (QOL) data are important patient reported outcomes. Early identification of these is critical for appropriate interventions. Data collection may be helped by modern information technology. AIM This study examined symptoms and QOL in people with solid tumors at their first visit to a medical oncologist. We also evaluated the clinical utility of tablet computers (TC) to collect this data. METHODS This was a prospective study of 105 consecutive patients in the cancer outpatient clinic of a tertiary level academic medical center. Symptom and QOL data was collected by TC with wireless database upload. RESULTS One-third participants had moderate to severe pain; almost half clinically significant pain that interfered with daily activities. Tiredness, anxiety, and drowsiness were common (prevalence - 79%, 63% and 50% respectively). One-third of those who had items identified from the Edmonton System Assessment System also volunteered other symptoms, mostly gastrointestinal problems. Many of those affected also reported impaired Global Wellbeing and low Overall QOL. There was a 98% completion rate, which took on average ten minutes. Direct observation and informal feedback from patients and physicians regarding the acceptability of TC in this setting was uniformly positive. CONCLUSIONS Amongst people with newly diagnosed solid tumors clinically important psychological and physical symptoms, QOL problems and difficulties with daily activities were commonly present in the 24-hour period and in the week before a first Medical Oncology visit. Symptom and QOL data collection by TC in busy outpatient clinics showed good clinical utility.
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Affiliation(s)
- Shirley Thomas
- 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.,2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Declan Walsh
- 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.,2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.,3 The Harry R Horvitz Chair in Palliative Medicine.,4 Faculty of Health Sciences, Trinity College, Dublin 2, Ireland
| | - Shiva Shrotriya
- 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.,2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Aynur Aktas
- 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.,2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Barbara Hullihen
- 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.,2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Bassam Estfan
- 2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - G Thomas Budd
- 2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Marianne Jensen Hjermstad
- 5 Department of Cancer Research and Molecular Medicine, Norway and European Palliative Care Research Centre, Oslo Universitetssykehus, Oslo, Norway.,6 Department of Oncology, Regional Centre for Excellence in Palliative Care, Norwegian University of Science and Technology, Trondheim, Norway
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Busack C, Daskalakis C, Rosen P. Physician and Parent Perspectives on Psychosocial and Emotional Data Entry in the Electronic Medical Record in a Pediatric Setting. J Patient Exp 2016; 3:10-16. [PMID: 28725826 PMCID: PMC5513625 DOI: 10.1177/2374373516636739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: This pilot study was conducted to evaluate physician and patient preferences for documentation of emotional and psychosocial information in the electronic medical record (EMR). Methods: Pediatricians from an academic medical center and parents of patients in an academic pediatric rheumatology practice were surveyed on 10 different elements using Likert-type scale items (1 = not at all important, 10 = extremely important). The importance of the proposed categories was evaluated by means testing and pairwise comparisons of the responses. Results: Responses were obtained from 45 physicians and 35 parents. The overall mean scores for physicians and parents were 7.70 and 7.44, respectively. Scores on personality, friends, and school differed between physicians and parents, but those differences were not significant after adjustment for multiple comparisons (P = .13, .17, and .26, respectively). Fears, special requests, and special needs were in the high-score group for both physicians and parents. Conclusion: Physicians and parents reported that the incorporation of emotional and psychosocial information into the EMR added value to the health care of children.
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Affiliation(s)
- Christopher Busack
- Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Constantine Daskalakis
- Division of Biostatistics, Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA
| | - Paul Rosen
- Nemours/A.I. duPont Hospital for Children, Wilmington, DE, and Thomas Jefferson University, Philadelphia, PA, USA
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Manca DP. Do electronic medical records improve quality of care? Yes. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2015; 61:846-851. [PMID: 26472786 PMCID: PMC4607324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Donna P Manca
- Family physician at the Grey Nuns Family Medicine Centre in Edmonton, Alta, Director of Research in the Department of Family Medicine Research Program at the University of Alberta, and Director of the Northern Alberta Primary Care Research Network, a network contributing data to the Canadian Primary Care Sentinel Surveillance Network project.
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16
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Birtwhistle R, Barber D, Drummond N, Godwin M, Greiver M, Singer A, Lussier MT, Manca D, Natarajan N, Terry A, Wong S, Martin RE, Mangin D. Horses and buggies have some advantages over cars, but no one is turning back. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2015; 61:416-419. [PMID: 25971756 PMCID: PMC4430054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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17
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Lagrew DC, Jenkins TR. The future of obstetrics/gynecology in 2020: a clearer vision. Transformational forces and thriving in the new system. Am J Obstet Gynecol 2015; 212:28-33.e1. [PMID: 25173190 DOI: 10.1016/j.ajog.2014.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/30/2014] [Accepted: 08/19/2014] [Indexed: 10/24/2022]
Abstract
Revamping the delivery of women's health care to meet future demands will require a number of changes. In the first 2 articles of this series, we introduced the reasons for change, suggested the use of the 'Triple Aim' concept to (1) improve the health of a population, (2) enhance the patient experience, and (3) control costs as a guide post for changes, and reviewed the transformational forces of payment and care system reform. In the final article, we discuss the valuable use of information technology and disruptive clinical technologies. The new health care system will require a digital transformation so that there can be increased communication, availability of information, and ongoing assessment of clinical care. This will allow for more cost-effective and individualized treatments as data are securely shared between patients and providers. Scientific advances that radically change clinical practice are coming at an accelerated pace as the underlying technologies of genetics, robotics, artificial intelligence, and molecular biology are translated into tools for diagnosis and treatment. Thriving in the new system not only will require time-honored traits such as leadership and compassion but also will require the obstetrician/gynecologist to become comfortable with technology, care redesign, and quality improvement.
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Campos-Castillo C, Anthony DL. The double-edged sword of electronic health records: implications for patient disclosure. J Am Med Inform Assoc 2014; 22:e130-40. [DOI: 10.1136/amiajnl-2014-002804] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/14/2014] [Indexed: 11/04/2022] Open
Abstract
Abstract
Objective Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients’ global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure.
Materials and methods A nationally representative sample from the 2012 Health Information National Trends Survey was analyzed using bivariate and multivariable logit regressions to examine whether global ratings of care suppress the relationship between EHR provider-use and patient non-disclosure.
Results 13% of respondents reported having ever withheld information from a provider because of privacy/security concerns. Bivariate analysis showed that withholding information was unrelated to whether respondents’ providers used an EHR. Multivariable analysis showed that accounting for respondents’ global ratings of care revealed a positive relationship between having a provider who uses an EHR and withholding information.
Discussion After accounting for global ratings of care, findings suggest that patients may non-disclose to providers to protect against the perceived EHR privacy and security risks. Despite evidence that EHRs inhibit patient disclosure, their advantages for promoting quality of care may outweigh the drawbacks.
Conclusions Clinicians should leverage the EHR's value in quality of care and discuss patients’ privacy concerns during clinic visits, while policy makers should consider how to address the real and perceived privacy and security risks of EHRs.
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Affiliation(s)
| | - Denise L Anthony
- Department of Sociology, Institute for Security, Technology, and Society, Dartmouth College, Hanover, New Hampshire, USA
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