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Santarossa S, Baber M, Hussein J, Oley C, Slangerup K, Murphy D, Kippen KE. Using action research and a community-academic partnership to understand clinical trial participation: a patient-centered perspective. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:61. [PMID: 38872195 DOI: 10.1186/s40900-024-00593-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Clinical trials that are patient-centered appear to be more successful (e.g., clinical outcomes, improved communication, mutual empowerment, changed attitudes), thus, action research may be a field of importance. The current study explores the Formation and Execution of Activities phases of a community-academic partnership (CAP). METHODS Members consisted of industry stakeholders, a healthcare/academic institution, and patients/families with lived experiences as cancer survivors and/or caregivers. Retrospectively, CAP members described the facilitating and/or hindering factors present in the partnership development. A document review process was used. Field notes from three CAP meetings, which focused on understanding clinical trial participation, were analyzed using a thematic approach. RESULTS Seven facilitating and three hindering factors were present. Interpersonal (vs. operational) processes were referenced as influential facilitating factors more often. Themes that emerged included 'trials as a treatment option', 'leaving a legacy', and 'timing is critical.' CONCLUSION This study provides a patient-centered perspective on barriers/challenges of clinical trial participation and how to improve future perceptions.
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Affiliation(s)
- Sara Santarossa
- Henry Ford Health System, Department of Public Health Sciences, Patient-Engaged Research Center, Detroit, MI, USA.
| | - Michele Baber
- AstraZeneca, Inc, 1 MedImmune Way, Gaithersburg, MD, USA
| | - Janine Hussein
- Henry Ford Health System, Department of Public Health Sciences, Patient-Engaged Research Center, Detroit, MI, USA
| | - Chrystal Oley
- AstraZeneca, Inc, 1 MedImmune Way, Gaithersburg, MD, USA
| | | | - Dana Murphy
- Henry Ford Health System, Department of Public Health Sciences, Patient-Engaged Research Center, Detroit, MI, USA
| | - Karen E Kippen
- Henry Ford Health System, Department of Public Health Sciences, Patient-Engaged Research Center, Detroit, MI, USA
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Brown P, Singh H, Su E, Sirisegaram L, Munce SEP, Eaton AD, Zhabokritsky A, McKinlay S, Kokorelias KM. Understanding the use of co-design methods for research involving older adults living with HIV: A scoping review protocol. PLoS One 2024; 19:e0303580. [PMID: 38814951 PMCID: PMC11139262 DOI: 10.1371/journal.pone.0303580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/25/2024] [Indexed: 06/01/2024] Open
Abstract
There is a growing population of adults aged 50 years or older living with HIV, facing unique challenges in care due to age, minority status, and stigma. Co-design methodologies, aligning with patient-centered care, have potential for informing interventions addressing the complex needs of older adults with HIV. Despite challenges, co-design has shown promise in empowering older individuals to actively participate in shaping their care experiences. The scoping review outlined here aims to identify gaps in existing co-design work with this population, emphasizing the importance of inclusivity based on PROGRESS-Plus characteristics for future patient-oriented research. This scoping review protocol is informed by the Joanna Briggs Institute Manual to explore co-design methods in geriatric HIV care literature. The methodology encompasses six stages: 1) developing research questions, 2) creating a search strategy, 3) screening and selecting evidence, 4) data extraction, 5) data analysis using content analysis, and 6) consultation with key stakeholders, including community partners and individuals with lived experience. The review will involve a comprehensive literature search, including peer-reviewed databases and gray literature, to identify relevant studies conducted in the past 20 years. The inclusive criteria focus on empirical data related to co-design methods in HIV care for individuals aged 50 or older, aiming to inform future research and co-design studies in geriatric HIV care. The study will be limited by the exclusion of papers not published or translated to English. Additionally, the varied terminology used to describe co-design across different research may result in the exclusion of articles using alternative terms. The consultation with key stakeholders will be crucial for translating insights into meaningful co-design solutions for virtual HIV care, aiming to provide a comprehensive synthesis that informs evidence-based strategies and addresses disparities in geriatric HIV care.
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Affiliation(s)
- Paige Brown
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
- Undergraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hardeep Singh
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Esther Su
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
| | - Luxey Sirisegaram
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
| | - Sarah E. P. Munce
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Andrew D. Eaton
- Faculty of Social Work–Saskatoon Campus, University of Regina, Regina, SK, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alice Zhabokritsky
- Infectious Diseases, Department of Medicine, University Health Network, Toronto, ON, Canada
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Stuart McKinlay
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
- Undergraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kristina M. Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Yu K, Jiang H, Liu M, Wu S, Jordan-Marsh M, Chi I. Chinese Immigrant Caregivers: Understanding Their Unmet Needs and the Co-Design of an mHealth App. Can J Aging 2024:1-8. [PMID: 38757195 DOI: 10.1017/s0714980824000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials. OBJECTIVE This study employed a design thinking framework to examine Chinese immigrant caregivers' (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs. METHODS Nineteen semi-structured interviews were conducted in conceptual design and prototype co-design phases. FINDINGS Participants reported unmet self-care needs influenced by psychological and social barriers, immigrant status, and caregiving tasks. They expressed the need to learn to keep healthy boundaries with the care recipient and respond to emergencies. Gaining knowledge was the main benefit that drew CICs' interest in using the self-care app. However, potential barriers to use included issues of curriculum design, technology anxiety, limited free time, and caregiving burdens. DISCUSSION The co-design process appears to be beneficial in having participants voice both barriers and preferences.
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Affiliation(s)
- Kexin Yu
- NIA-Layton Aging and Alzheimer's Disease Center, and Oregon Center for Aging & Technology, Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
| | - Haojun Jiang
- Tourism and Social Administration College, Nanjing Xiaozhuang University, Nanjing, China
| | - Mandong Liu
- Research Institute of Social Development, Southwestern University of Finance and Economics, Sichuan, China
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Maryalice Jordan-Marsh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
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Novak D. A Serious Game (MyDiabetic) to Support Children's Education in Type 1 Diabetes Mellitus: Iterative Participatory Co-Design and Feasibility Study. JMIR Serious Games 2024; 12:e49478. [PMID: 38713496 PMCID: PMC11109855 DOI: 10.2196/49478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/24/2023] [Accepted: 02/13/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Serious games, which are gaming applications used for purposes beyond entertainment to educate users on, and address, specific issues, may present a timely approach to promote healthy diabetes management behaviors among children with type 1 diabetes mellitus (T1DM). The lasting benefits associated with these serious games encompass improved patient education; enhanced glycemic control; the reinforcement of bonds within the community of people with diabetes; the facilitation of meaningful dialogues with caregivers, especially within the familial setting; and a significant reduction in the economic burdens associated with subsequent complications. OBJECTIVE This paper primarily aims to provide a detailed overview of the iterative design process and the associated evaluation methods used in the development of the educational game. Furthermore, this study aims to enhance motivation for sustained and extended engagement with the game over time. The MyDiabetic game design aims to educate children on various aspects, including the connections among food, insulin, and physical activity. Furthermore, it seeks to impart knowledge related to the operation of a glucometer and an insulin pen, as well as more advanced technologies such as administering glucagon, measuring ketoacidosis, and continuous glucose monitoring. METHODS The co-design methodology was applied, involving interviews, design workshops, and prototype feedback sessions. A combination of several approaches, such as tailoring, observational learning, social and family support, decision-making practice, and reward systems, was used to support children's compliance. Moreover, incorporating the literature, guidelines, and current practices into the design ensured that the game was aligned with established health care pathways and included relevant information and best practices for diabetes management. RESULTS The game was tested on 32 children in 3 iterations. Positive responses were received from children who tested the game as well as their parents. The game was also presented to 5 schoolmates of children with T1DM who appreciated a better understanding of the disease and the opportunity to support their friends more efficiently in T1DM compensation. The involvement of children and clinicians in participatory co-design contributed to to the game's high acceptance. With regard to the game's impact on education, 1 week of testing revealed an enhancement in educational outcomes. CONCLUSIONS The game is especially suitable for children newly diagnosed with T1DM because it acquaints them in a fun way with new terminology; for example, they can try to measure glycemia levels in an interactive way. The game also caters to children who still need to develop reading skills by including an audio guide. The guide ensures that children of all literacy levels can benefit from the game's educational content and interactive experiences. The game is available for download on Google Play and the Apple App Store.
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Affiliation(s)
- Daniel Novak
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
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5
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O'Sullivan-Steben K, Galarneau L, Judd S, Laizner AM, Williams T, Kildea J. Design and implementation of a prototype radiotherapy menu in a patient portal. J Appl Clin Med Phys 2024; 25:e14201. [PMID: 37942985 DOI: 10.1002/acm2.14201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/10/2023] [Accepted: 10/31/2023] [Indexed: 11/10/2023] Open
Abstract
PURPOSE Radiotherapy patients often face undue anxiety due to misconceptions about radiation and their inability to visualize their upcoming treatments. Access to their personal treatment plans is one way in which pre-treatment anxiety may be reduced. But radiotherapy data are quite complex, requiring specialized software for display and necessitating personalized explanations for patients to understand them. Therefore, our goal was to design and implement a novel radiotherapy menu in a patient portal to improve patient access to and understanding of their radiotherapy treatment plans. METHODS A prototype radiotherapy menu was developed in our institution's patient portal following a participatory stakeholder co-design methodology. Customizable page templates were designed to render key radiotherapy data in the portal's patient-facing mobile phone app. DICOM-RT data were used to provide patients with relevant treatment parameters and generate pre-treatment 3D visualizations of planned treatment beams, while the mCODE data standard was used to provide post-treatment summaries of the delivered treatments. A focus group was conducted to gather initial patient feedback on the menu. RESULTS Pre-treatment: the radiotherapy menu provides patients with a personalized treatment plan overview, including a personalized explanation of their treatment, along with an interactive 3D rendering of their body, and treatment beams for visualization. Post-treatment: a summary of the delivered radiotherapy is provided, allowing patients to retain a concise personal record of their treatment that can easily be shared with future healthcare providers. Focus group feedback was overwhelmingly positive. Patients highlighted how the intuitive presentation of their complex radiotherapy data would better prepare them for their radiation treatments. CONCLUSIONS We successfully designed and implemented a prototype radiotherapy menu in our institution's patient portal that improves patient access to and understanding of their radiotherapy data. We used the mCODE data standard to generate post-treatment summaries in a way that is easily shareable and interoperable.
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Affiliation(s)
| | - Luc Galarneau
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
| | - Susie Judd
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Andrea M Laizner
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Tristan Williams
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
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6
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Parsell MC, Greenleaf MN, Kombara GG, Sukhatme VP, Lam WA. Engaging Cancer Care Physicians in Off-Label Drug Clinical Trials: Human-Centered Design Approach. JMIR Form Res 2024; 8:e51604. [PMID: 38358789 PMCID: PMC10905356 DOI: 10.2196/51604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/20/2023] [Accepted: 11/22/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Using a human-centered design (HCD) approach can provide clinical trial design teams with a better understanding of the needs, preferences, and attitudes of clinical trial stakeholders. It can also be used to understand the challenges and barriers physician stakeholders face in initiating and completing clinical trials, especially for using off-label drugs (OLDs) to treat unmet clinical needs in cancer treatment. However, the HCD approach is not commonly taught in the context of clinical trial design, and few step-by-step guides similar to this study are available to demonstrate its application. OBJECTIVE This study aims to demonstrate the feasibility and process of applying an HCD approach to creating clinical trial support resources for physician stakeholders to overcome barriers to pursuing clinical trials for OLDs to treat cancer. METHODS An HCD approach was used to develop OLD clinical trial support concepts. In total, 45 cancer care physicians were contacted, of which 15 participated in semistructured interviews to identify barriers to prescribing OLDs or participating in cancer OLD clinical trials. Design research is qualitative-it seeks to answer "why" and "how" questions; thus, a sample size of 15 was sufficient to provide insight saturation to address the design problem. The team used affinity mapping and thematic analysis of qualitative data gathered from the interviews to inform subsequent web-based co-design sessions, which included creative matrix exercises and voting to refine and prioritize the ideas used in the final 3 recommended concepts. RESULTS The findings demonstrate the potential of HCD methods to uncover important insights into the barriers physicians face in participating in OLD clinical trials or prescribing OLDs, such as recruitment challenges, low willingness to prescribe without clinical data, and stigma. Notably, only palliative care participants self-identified as "frequent prescribers" of OLDs, despite high national OLD prescription rates among patients with cancer. Participants found the HCD approach engaging, with 60% (9/15) completing this study; scheduling conflicts caused most of the dropouts. Over 150 ideas were generated in 3 co-design sessions, with the groups voting on 15 priority ideas that the design team then refined into 3 final recommendations, especially focused on increasing the participation of physicians in OLD clinical trials. CONCLUSIONS Using participatory HCD methods, we delivered 3 concepts for clinical trial support resources to help physician stakeholders overcome barriers to pursuing clinical trials for OLDs to treat cancer. Overall, integrating the HCD approach can aid in identifying important stakeholders, such as prescribing physicians; facilitating their engagement; and incorporating their perspectives and needs into the solution design process. This paper highlights the process, methods, and potential of HCD to improve cancer clinical trial design. Future work is needed to train clinical trial designers in the HCD approach and encourage adoption in the field.
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Affiliation(s)
- Maren C Parsell
- Georgia Clinical and Translational Science Alliance, Emory University School of Medicine, Emory University, Atlanta, GA, United States
- Emory School of Medicine, Emory University, Atlanta, GA, United States
| | - Morgan N Greenleaf
- Georgia Clinical and Translational Science Alliance, Emory University School of Medicine, Emory University, Atlanta, GA, United States
- Emory School of Medicine, Emory University, Atlanta, GA, United States
- Center for the Advancement of Diagnostics for a Just Society (ADJUST), Emory University, Atlanta, GA, United States
| | - Greeshma G Kombara
- Emory School of Medicine, Emory University, Atlanta, GA, United States
- The Morningside Center for Innovative and Affordable Medicine, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Vikas P Sukhatme
- Emory School of Medicine, Emory University, Atlanta, GA, United States
- The Morningside Center for Innovative and Affordable Medicine, Emory University School of Medicine, Emory University, Atlanta, GA, United States
- Departments of Medicine and Hematology and Medical Oncology, Emory University, Atlanta, GA, United States
| | - Wilbur A Lam
- Georgia Clinical and Translational Science Alliance, Emory University School of Medicine, Emory University, Atlanta, GA, United States
- Emory School of Medicine, Emory University, Atlanta, GA, United States
- Center for the Advancement of Diagnostics for a Just Society (ADJUST), Emory University, Atlanta, GA, United States
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA, United States
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Ma Y, Achiche S, Pomey MP, Paquette J, Adjtoutah N, Vicente S, Engler K, Laymouna M, Lessard D, Lemire B, Asselah J, Therrien R, Osmanlliu E, Zawati MH, Joly Y, Lebouché B. Adapting and Evaluating an AI-Based Chatbot Through Patient and Stakeholder Engagement to Provide Information for Different Health Conditions: Master Protocol for an Adaptive Platform Trial (the MARVIN Chatbots Study). JMIR Res Protoc 2024; 13:e54668. [PMID: 38349734 PMCID: PMC10900097 DOI: 10.2196/54668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Artificial intelligence (AI)-based chatbots could help address some of the challenges patients face in acquiring information essential to their self-health management, including unreliable sources and overburdened health care professionals. Research to ensure the proper design, implementation, and uptake of chatbots is imperative. Inclusive digital health research and responsible AI integration into health care require active and sustained patient and stakeholder engagement, yet corresponding activities and guidance are limited for this purpose. OBJECTIVE In response, this manuscript presents a master protocol for the development, testing, and implementation of a chatbot family in partnership with stakeholders. This protocol aims to help efficiently translate an initial chatbot intervention (MARVIN) to multiple health domains and populations. METHODS The MARVIN chatbots study has an adaptive platform trial design consisting of multiple parallel individual chatbot substudies with four common objectives: (1) co-construct a tailored AI chatbot for a specific health care setting, (2) assess its usability with a small sample of participants, (3) measure implementation outcomes (usability, acceptability, appropriateness, adoption, and fidelity) within a large sample, and (4) evaluate the impact of patient and stakeholder partnerships on chatbot development. For objective 1, a needs assessment will be conducted within the setting, involving four 2-hour focus groups with 5 participants each. Then, a co-construction design committee will be formed with patient partners, health care professionals, and researchers who will participate in 6 workshops for chatbot development, testing, and improvement. For objective 2, a total of 30 participants will interact with the prototype for 3 weeks and assess its usability through a survey and 3 focus groups. Positive usability outcomes will lead to the initiation of objective 3, whereby the public will be able to access the chatbot for a 12-month real-world implementation study using web-based questionnaires to measure usability, acceptability, and appropriateness for 150 participants and meta-use data to inform adoption and fidelity. After each objective, for objective 4, focus groups will be conducted with the design committee to better understand their perspectives on the engagement process. RESULTS From July 2022 to October 2023, this master protocol led to four substudies conducted at the McGill University Health Centre or the Centre hospitalier de l'Université de Montréal (both in Montreal, Quebec, Canada): (1) MARVIN for HIV (large-scale implementation expected in mid-2024), (2) MARVIN-Pharma for community pharmacists providing HIV care (usability study planned for mid-2024), (3) MARVINA for breast cancer, and (4) MARVIN-CHAMP for pediatric infectious conditions (both in preparation, with development to begin in early 2024). CONCLUSIONS This master protocol offers an approach to chatbot development in partnership with patients and health care professionals that includes a comprehensive assessment of implementation outcomes. It also contributes to best practice recommendations for patient and stakeholder engagement in digital health research. TRIAL REGISTRATION ClinicalTrials.gov NCT05789901; https://classic.clinicaltrials.gov/ct2/show/NCT05789901. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54668.
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Affiliation(s)
- Yuanchao Ma
- Department of Biomedical Engineering, Polytechnique Montréal, Montreal, QC, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC, Canada
- Chronic Viral Illness Service, Division of Infectious Disease, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Sofiane Achiche
- Department of Biomedical Engineering, Polytechnique Montréal, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC, Canada
- Centre of Excellence on Partnership with Patients and the Public, Montreal, QC, Canada
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Nesrine Adjtoutah
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Serge Vicente
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC, Canada
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Mathematics and Statistics, University of Montreal, Montreal, QC, Canada
| | - Kim Engler
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Moustafa Laymouna
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC, Canada
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - David Lessard
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC, Canada
- Chronic Viral Illness Service, Division of Infectious Disease, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Benoît Lemire
- Chronic Viral Illness Service, Division of Infectious Disease, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Jamil Asselah
- Department of Medicine, Division of Medical Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Rachel Therrien
- Research Centre of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Esli Osmanlliu
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Ma'n H Zawati
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Yann Joly
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC, Canada
- Chronic Viral Illness Service, Division of Infectious Disease, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Weis J, Wolf LR, Boerries M, Kassahn D, Boeker M, Dresch C. Identification of the Needs and Preferences of Patients With Cancer for the Development of a Clinic App: Qualitative Study. JMIR Cancer 2023; 9:e40891. [PMID: 37498653 PMCID: PMC10415940 DOI: 10.2196/40891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) tools were developed during the past decades and are increasingly used by patients in cancer care too. Scientific research in the development of mHealth services is required in order to meet the various needs of patients and test usability. OBJECTIVE The aim of this study is to assess patients' needs, preferences, and usability of an app (My University Clinic [MUC] app) developed by the Comprehensive Cancer Center Freiburg (CCCF) Germany. METHODS Based on a qualitative cross-sectional approach, we conducted semistructured interviews with patients with cancer, addressing their needs, preferences, and usability of the designed MUC app. Patients treated by the CCCF were recruited based on a purposive sampling technique focusing on age, sex, cancer diagnoses, and treatment setting (inpatient, outpatient). Data analysis followed the qualitative content analysis according to Kuckartz and was performed using computer-assisted software (MAXQDA). RESULTS For the interviews, 17 patients with cancer were selected, covering a broad range of sampling parameters. The results showed that patients expect benefits in terms of improved information about the disease and communication with the clinic staff. Demands for additional features were identified (eg, a list of contact persons and medication management). The most important concerns referred to data security and the potential restriction of personal contacts with health care professionals of the clinical departments of the CCCF. In addition, some features for improving the design of the MUC app with respect to usability or for inclusion of interacting tools were suggested by the patients. CONCLUSIONS The results of this qualitative study were discussed within the multidisciplinary team and the MUC app providers. Patients' perspectives and needs will be included in further development of the MUC app. There will be a second study phase in which patients will receive a test version of the MUC app and will be asked about their experiences with it. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00022162; https://drks.de/search/de/trial/DRKS00022162.
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Affiliation(s)
- Joachim Weis
- Chair for Self-Help Research, Comprehensive Cancer Center, Medical Faculty, University Clinic Freiburg, Freiburg, Germany
| | - Lucy Raphaela Wolf
- Chair for Self-Help Research, Comprehensive Cancer Center, Medical Faculty, University Clinic Freiburg, Freiburg, Germany
| | - Melanie Boerries
- Institut für Medizinische Bioinformatik und Systemmedizin, Medical Faculty University Freiburg, University Clinic Freiburg, Freiburg, Germany
| | - Daniela Kassahn
- Institut für Medizinische Bioinformatik und Systemmedizin, Medical Faculty University Freiburg, University Clinic Freiburg, Freiburg, Germany
| | - Martin Boeker
- Institute of Artificial Intelligence and Informatics in Medicine, Medical Center rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Kechagioglou P. Big Data in Oncology: The Electronic Patient Record Transformation Program. Semin Oncol Nurs 2023; 39:151430. [PMID: 37137769 DOI: 10.1016/j.soncn.2023.151430] [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: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES There is a vast amount of real-world data collected daily in oncology through diagnostic, therapeutic, and patient-reported outcome measures. The challenge arises with linking data together to create structured and meaningful databases, which are representative of the general population, free of bias, and of good quality to be able to draw meaningful conclusions. Real-world data that are linked together within trusted cancer research environments could represent the next generation of big data strategy in cancer. DATA SOURCES Patient and public involvement initiatives and expert opinion. CONCLUSION Collaboration among specialist cancer data analysts, academic researchers, and clinicians within cancer institutions is key to standardizing the design and evaluation of real-world databases. Digital transformation efforts must include implementation of integrated care records and patient-facing portals, in combination with training and education of clinicians in digital skills and health leadership. As part of the Electronic Patient Record Transformation Program, our experience with patient and public involvement in the development of a cancer patient-facing portal linked to an oncology electronic health record at University Hospitals Coventry and Warwickshire has given us useful insights into patient needs and priorities. IMPLICATIONS FOR NURSING PRACTICE The growth of electronic health records and patient portals is an opportunity to gather big data in oncology at a population level to help clinicians and researchers with the development of predictive and preventive algorithms and new models for personalized care.
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Affiliation(s)
- Penny Kechagioglou
- Consultant Clinical Oncologist, Chief Clinical Information Officer, and Deputy Chief Medical Officer, University Hospitals Coventry and Warwickshire, Clifford Bridge road, Coventry, CV2 2DX.
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10
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Davoody N, Eghdam A, Koch S, Hägglund M. Evaluation of an Electronic Care and Rehabilitation Planning Tool With Stroke Survivors With Aphasia: Usability Study. JMIR Hum Factors 2023; 10:e43861. [PMID: 37067848 PMCID: PMC10152385 DOI: 10.2196/43861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Patients with chronic illnesses with physical and cognitive disabilities, particularly stroke survivors with aphasia, are often not involved in design and evaluation processes. As a consequence, existing eHealth services often do not meet the needs of this group of patients, which has resulted in a digital divide. OBJECTIVE The aim of this study was to examine the effectiveness and user satisfaction of an electronic care and rehabilitation planning tool from the perspective of stroke survivors with aphasia. This would help us gain knowledge on how such a tool would need to be adapted for these patients for further development. METHODS Usability tests were conducted with 9 postdischarge stroke survivors with aphasia. Effectiveness was measured using task-based tests, and user satisfaction was studied through qualitative interviews at the end of each test. All tests were audio recorded, and each test lasted approximately 1 hour. The data were analyzed using qualitative content analysis. As the tool can be used by stroke survivors either independently or with some support from their next of kin or care professionals, the research group decided to divide the participants into 2 groups. Group 1 did not receive any support during the tests, and group 2 received some minor support from the moderator. RESULTS The results showed that the care and rehabilitation planning tool was not effective for stroke survivors with aphasia, as many participants in group 1 did not accomplish the tasks successfully. Despite several usability problems and challenges in using the tool because of patients' disabilities, the participants were positive toward using the tool and found it useful for their care and rehabilitation journey. CONCLUSIONS There is a need to involve patients with chronic illnesses more in the design and evaluation processes of health information systems and eHealth services. eHealth services and health information systems designed for this group of patients should be more adaptable and flexible to provide them with appropriate functionalities and features, meet their needs, and be useful and easy to use. In addition, the design and evaluation processes should be adapted, considering the challenges of this patient group.
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Affiliation(s)
- Nadia Davoody
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Aboozar Eghdam
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Sabine Koch
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hägglund
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Gerido LH, Griggs JJ, Resnicow K, Kidwell KM, Delacroix E, Austin S, Hanson EN, Bacon E, Koeppe E, Goodall S, Demerath M, Rizzo EA, Weiner S, Hawley ST, Uhlmann WR, Roberts JS, Stoffel EM. The Michigan Genetic Hereditary Testing (MiGHT) study's innovative approaches to promote uptake of clinical genetic testing among cancer patients: a study protocol for a 3-arm randomized controlled trial. Trials 2023; 24:105. [PMID: 36765432 PMCID: PMC9911941 DOI: 10.1186/s13063-023-07125-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/28/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Although most cancers are sporadic, germline genetic variants are implicated in 5-10% of cancer cases. Clinical genetic testing identifies pathogenic germline genetic variants for hereditary cancers. The Michigan Genetic Hereditary Testing (MiGHT) study is a three-arm randomized clinical trial that aims to test the efficacy of two patient-level behavioral interventions on uptake of cancer genetic testing. METHODS The two interventions being tested are (1) a virtual genetics navigator and (2) motivational interviewing by genetic health coaches. Eligible participants are adults with a diagnosis of breast, prostate, endometrial, ovarian, colorectal, or pancreatic cancer who meet the National Comprehensive Cancer Network (NCCN) criteria for genetic testing. Participants are recruited through community oncology practices affiliated with the Michigan Oncology Quality Consortium (MOQC) and have used the Family Health History Tool (FHHT) to determine testing eligibility. The recruitment goal is 759 participants, who will be randomized to usual care or to either the virtual genetics navigator or the motivational interviewing intervention arms. The primary outcome will be the proportion of individuals who complete germline genetic testing within 6 months. DISCUSSION This study addresses patient-level factors which are associated with the uptake of genetic testing. The study will test two different intervention approaches, both of which can help address the shortage of genetic counselors and improve access to care. TRIAL REGISTRATION This study has been approved by the Institutional Review Board of the University of Michigan Medical School (HUM00192898) and registered in ClinicalTrials.gov (NCT05162846).
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Affiliation(s)
| | - Jennifer J Griggs
- University of Michigan School of Public Health, Ann Arbor, USA
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
- University of Michigan School of Medicine, Ann Arbor, USA
| | - Ken Resnicow
- University of Michigan School of Public Health, Ann Arbor, USA
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - Kelley M Kidwell
- University of Michigan School of Public Health, Ann Arbor, USA
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - Emerson Delacroix
- University of Michigan School of Public Health, Ann Arbor, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Sarah Austin
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - Erika N Hanson
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Elizabeth Bacon
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Erika Koeppe
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | | | | | | | - Shayna Weiner
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - Sarah T Hawley
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - Wendy R Uhlmann
- University of Michigan School of Medicine, Ann Arbor, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - J Scott Roberts
- University of Michigan School of Public Health, Ann Arbor, USA
| | - Elena M Stoffel
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
- University of Michigan School of Medicine, Ann Arbor, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
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12
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Cwintal M, Ranjbar H, Bandamiri P, Guadagno E, Osmanlliu E, Poenaru D. A rapid review for developing a co-design framework for a pediatric surgical communication application. J Pediatr Surg 2023; 58:879-890. [PMID: 36805140 DOI: 10.1016/j.jpedsurg.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND The exponential growth in the use of mobile health (mHealth) applications in patient care has highlighted the importance of understanding end-users' needs for successful interventions, achievable through the process of co-design. This review aims to summarize previously published uses of co-design in mHealth applications. It will inform the development of a local mHealth tool in pediatric surgery. METHODS The rapid review was conducted following Cochrane Rapid Review guidelines. We searched four databases from inception until August 2021 for collaborative design in mHealth apps. Two reviewers independently screened titles and abstracts using Rayyan, with a third reviewer resolving any conflicts. Studies were excluded if they were non-empirical or in other languages than English. RESULTS Out of 984 records screened, 175 were included for full-text screening, and 27 met all eligibility criteria. The purpose of the studies related to care support, communication, self-management or information management. All interventions involved their target audience in the co-design process, and 85% included healthcare professionals for expert opinion. Stakeholder participation was solicited via interviews, surveys, focus groups, design sessions, and prototype evaluation. To initiate the process, 15 studies included needs identification, 8 did background research, and 7 performed literature reviews. CONCLUSION Co-design has a positive impact on mHealth development, research processes and outcomes. Its success relies on a clearly identified framework of terminology, activities involved, and evaluation techniques. The findings of this review will be integrated into a novel co-design framework, which will be used to inform the development of a pediatric surgery mHealth application. LEVEL OF EVIDENCE This review uses manuscripts that are rated level III-V.
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Affiliation(s)
- Michelle Cwintal
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College Ave, Montreal, Quebec, H3A 1G1, Canada
| | - Hamed Ranjbar
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de La Montagne, Montréal, Quebec, H3G 2M1, Canada
| | - Parsa Bandamiri
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de La Montagne, Montréal, Quebec, H3G 2M1, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, 1001 Decarie Blvd, Room B04.2028, Montreal, Quebec H4A 3J1, Canada
| | - Esli Osmanlliu
- Department of Pediatrics, Division of Emergency Medicine, Montreal Children's Hospital, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada
| | - Dan Poenaru
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de La Montagne, Montréal, Quebec, H3G 2M1, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, 1001 Decarie Blvd, Room B04.2028, Montreal, Quebec H4A 3J1, Canada.
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13
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Johnson AM, Brimhall AS, Johnson ET, Hodgson J, Didericksen K, Pye J, Harmon GJC, Sewell KB. A systematic review of the effectiveness of patient education through patient portals. JAMIA Open 2023; 6:ooac085. [PMID: 36686972 PMCID: PMC9847535 DOI: 10.1093/jamiaopen/ooac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 09/01/2022] [Accepted: 10/18/2022] [Indexed: 01/19/2023] Open
Abstract
Objective The objective of this study was to systematically review all literature studying the effect of patient education on patient engagement through patient portals. Introduction Patient portals provide patients access to health records, lab results, medication refills, educational materials, secure messaging, appointment scheduling, and telehealth visits, allowing patients to take a more active role in their health care decisions and management. A debate remains around whether these additional aids actually improve patient engagement and increase their ability to manage their own health conditions. This systematic review looks specifically at the effect of educational materials included in patient portals. Materials and Methods In accordance with PRISMA guidelines, the literature search was mapped across 5 databases (PubMed, CINAHL, Scopus, PsychINFO, Embase), and implemented on June 2, 2020. Results Fifty-two studies were included in the review. Forty-six (88.5%) reported rates of patient utilization of educational resources in the patient portal. Thirty (57.9%) shared patients' perceptions of the usefulness of the education materials. Twenty-one (40.4%) reported changes in health outcomes following educational interventions through the patient portal. This review found that efforts are indeed being made to raise awareness of educational resources in patient portals, that patients are increasingly utilizing these resources, that patients are finding them useful, and that they are improving health outcomes. Conclusion It seems that patient portals are becoming a powerful tool for patient education and engagement, and show promise as a means of achieving the quadruple aim of healthcare. Moving forward, research should establish more uniform methods of measurement in order to strengthen the literature surrounding the effectiveness of patient education through patient portals.
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Affiliation(s)
- Adam M Johnson
- Corresponding Author: Adam M. Johnson, MS, Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA;
| | - Andrew S Brimhall
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Erica T Johnson
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Jennifer Hodgson
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Katharine Didericksen
- Department of Human Development & Family Science, East Carolina University, Greenville, North Carolina, USA
| | - Joseph Pye
- Department of Family Medicine, ECU Health, Greenville, North Carolina, USA
| | - G J Corey Harmon
- Laupus Library, East Carolina University, Greenville, North Carolina, USA
| | - Kerry B Sewell
- Laupus Library, East Carolina University, Greenville, North Carolina, USA
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14
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Van Baelen F, De Regge M, Larivière B, Verleye K, Schelfout S, Eeckloo K. Role of Social and App-Related Factors in Behavioral Engagement With mHealth for Improved Well-being Among Chronically Ill Patients: Scenario-Based Survey Study. JMIR Mhealth Uhealth 2022; 10:e33772. [PMID: 36018618 PMCID: PMC9463618 DOI: 10.2196/33772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 05/30/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background
The last decade has seen a considerable increase in the number of mobile health (mHealth) apps in everyday life. These mHealth apps have the potential to significantly improve the well-being of chronically ill patients. However, behavioral engagement with mHealth apps remains low.
Objective
The aim of this study was to describe the behavioral engagement of chronically ill patients with mHealth apps by investigating (1) how it is affected by social factors (ie, physician recommendation) and app-related factors (ie, app integration) and (2) how it affects patient well-being. This study also considers the moderating effect of attachment to traditional health care and the mobile app experience among patients.
Methods
We carried out a scenario-based survey study of chronically ill patients (N=521). A Bayesian structural equation modeling with mediation and moderation analysis was conducted in MPlus.
Results
Both physician recommendations for mHealth app use and app integration have positive effects on the behavioral engagement of chronically ill patients with mHealth apps. Higher behavioral engagement positively affects the hedonic well-being (extent of pleasure) and the eudaemonic well-being (extent of self-efficacy) of chronically ill patients. Mobile app experience, however, positively moderates the relationship between app integration and behavioral engagement, whereas patient attachment to traditional care does not moderate the relationship between physician recommendation and behavioral engagement. Taken together, the proportion of variance explained (R²) equals 21% for behavioral engagement and 52.8% and 62.2% for hedonic and eudaemonic well-being, respectively, thereby providing support for the strong influence of app integration and physician recommendation via the mediation of the patients’ behavioral engagement on both patients’ hedonic and eudaemonic well-being.
Conclusions
Physician recommendation and app integration enable behavioral engagement and promote well-being among chronically ill patients. It is thus important to take social and app-related factors into consideration during and after the development of mHealth apps.
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Affiliation(s)
- Freek Van Baelen
- School of Business and Management, University College Ghent, Ghent, Belgium
| | - Melissa De Regge
- Strategic Policy Cell, Ghent University Hospital, Ghent, Belgium
- Department of Marketing, Innovation and Organisation, Faculty of Economics and Business Administration, Ghent University, Ghent, Belgium
| | - Bart Larivière
- Department of Marketing, Faculty of Economics and Business, Catholic University of Leuven, Leuven, Belgium
- Center for Service Intelligence, Ghent University, Ghent, Belgium
| | - Katrien Verleye
- Department of Marketing, Innovation and Organisation, Faculty of Economics and Business Administration, Ghent University, Ghent, Belgium
| | - Sam Schelfout
- Multidisciplinary Pain Center, Ghent University Hospital, Ghent, Belgium
| | - Kristof Eeckloo
- Strategic Policy Cell, Ghent University Hospital, Ghent, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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15
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Lessard D, Engler K, Ma Y, Rodriguez Cruz A, Vicente S, Kronfli N, Barkati S, Brouillette MJ, Cox J, Kildea J, Hijal T, Pomey MP, Bartlett SJ, Asselah J, Lebouché B. Remote Follow-up of Self-isolating Patients With COVID-19 Using a Patient Portal: Protocol for a Mixed Methods Pilot Study (Opal-COVID Study). JMIR Res Protoc 2022; 11:e35760. [PMID: 35820054 PMCID: PMC9390833 DOI: 10.2196/35760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background People with COVID-19 are instructed to self-isolate at home. During self-isolation, they may experience anxiety and insufficient care. Patient portals can allow patients to self-monitor and remotely share their health status with health care professionals, but little data are available on their feasibility. Objective This paper presents the protocol of the Opal-COVID Study. Its objectives are to assess the implementation of the Opal patient portal for distance monitoring of self-isolating patients with COVID-19, identify influences on the intervention’s implementation, and describe service and patient outcomes of this intervention. Methods This mixed methods pilot study aims to recruit 50 patient participants with COVID-19 tested at the McGill University Health Centre (Montreal, Canada) for 14 days of follow-up. With access to an existing patient portal through a smartphone app, patients will complete a daily self-assessment of symptoms, vital signs, and mental health monitored by a nurse, and receive teleconsultations as needed. Study questionnaires will be administered to collect data on sociodemographic characteristics, medical background, implementation outcomes (acceptability, usability, and respondent burden), and patient satisfaction. Coordinator logbook entries will inform on feasibility outcomes, namely, on recruitment, retention, and fidelity, as well as on the frequency and nature of contacts with health care professionals. The statistical analyses for objectives 1 (implementation outcomes), 3 (service outcomes), and 4 (patient outcomes) will evaluate the effects of time and sociodemographic characteristics on the outcomes. For objectives 1 (implementation outcomes) and 4 (patient outcomes), the statistical analyses will also examine the attainment of predefined success thresholds. As for the qualitative analyses, for objective 2 (influences on implementation), semistructured qualitative interviews will be conducted with 4 groups of stakeholders (ie, patient participants, health care professionals, technology developers, and study administrators) and submitted for content analysis, guided by the Consolidated Framework for Implementation Research to help identify barriers to and facilitators of implementation. For objective 3 (service outcomes), reasons for contacting health care professionals through Opal will also be submitted for content analysis. Results Between December 2020 and March 2021, a total of 51 patient participants were recruited. Qualitative interviews were conducted with 39 stakeholders from April to September 2021. Delays were experienced owing to measures taken at the McGill University Health Centre to address COVID-19. The quantitative and qualitative analyses began in May 2022. As of June 2022, a total of 2 manuscripts (on the implementation and the patient outcomes) were being prepared, and 3 conference presentations had been given on the study’s methods. Conclusions This protocol is designed to generate multidisciplinary knowledge on the implementation of a patient portal–based COVID-19 care intervention and will lead to a comprehensive understanding of feasibility, stakeholder experience, and influences on implementation that may prove useful for scaling up similar interventions. Trial Registration ClinicalTrials.gov NCT04978233; https://clinicaltrials.gov/ct2/show/NCT04978233 International Registered Report Identifier (IRRID) DERR1-10.2196/35760
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Affiliation(s)
- David Lessard
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Kim Engler
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments,
| | - Yuanchao Ma
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, QC, Canada
| | - Adriana Rodriguez Cruz
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Serge Vicente
- See Acknowledgments, .,Department of Mathematics and Statistics, Université de Montréal, Montreal, QC, Canada
| | | | - Nadine Kronfli
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Marie-Josée Brouillette
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Psychiatry Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Joseph Cox
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Tarek Hijal
- Department of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | | | - Susan J Bartlett
- Department of Medicine, Divisions of Experimental Medicine, Clinical Epidemiology, Respiratory Medicine, and Rheumatology, McGill University, Montreal, QC, Canada
| | - Jamil Asselah
- Department of Medicine, Division of Medical Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Bertrand Lebouché
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
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16
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Bager SL, Düdder B, Henglein F, Hébert JM, Wu H. Event-Based Supply Chain Network Modeling: Blockchain for Good Coffee. FRONTIERS IN BLOCKCHAIN 2022. [DOI: 10.3389/fbloc.2022.846783] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Blockchain and distributed ledger technology (BC/DLT) provides distributed databases with decentralized governance, tamper-proof recording, high availability and non-copyable digital assets, which have made it a natural technological basis for supply chain management. In this paper, we introduce REALISTIC, a novel event-based modeling framework for supply chain networks (SCNs) that includes production processes. It extends McCarty’s Resources-Events-Agents (REA) accounting model with secure transformations, which, across the entire SCN, guarantee that certified output resources cannot be digitally produced ex nihilo, but require certified input resources of at least the same amount as what is produced. This generalizes the no-double-spend guarantee of current BC/DLT to (digital twins of) physical resources and their production. Authenticated human or robotic Internet of Things (IoT) actors digitally sign and cryptographically commit to the veracity of real-world events on an immutable database, without having to take responsibility for their aggregate consequences. User-specifiable interpretations, corresponding to queries and analytical functions in database systems, provide auditable aggregate information computed from recorded events across the entire SCN. This includes fine-grained and trustworthy tracing of final products through multiple stages of production processes, semi-finished products, quality certifications and transportation all the way back to their raw materials. We present a case study for an end-to-end coffee supply chain that tracks fine-grained and detailed information from a farmer’s coffee cherries to retail coffee bags, involving all its actors. Our model handles product provenance; auditable sustainability, quality and trade information; production processes from parchment via green to roasted coffee; product quality tests; farmer certifications; and transportation across the entire coffee supply chain. It is based on field work involving farmers, cooperatives, processors, traders, importers, and a major roasting company stretching from Colombia to Scandinavia. Its REALISTIC-based modeling is the foundation for the design of our prototype implementation, which includes Ethereum blockchain code, RDBMS-based server code and a web app client. Their source code is publicly available on GitHub.
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17
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Striving to Fill in Gaps between Clinical Practice and Standards: The Evolution of a Pan-Canadian Approach to Patient-Reported Outcomes Use. Curr Oncol 2022; 29:3698-3707. [PMID: 35621686 PMCID: PMC9140091 DOI: 10.3390/curroncol29050296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/26/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Despite the known importance and necessity of the standardized collection and use of patient-reported outcomes (PROs), there remain challenges to successful clinical implementation. Facilitated through a quality improvement initiative spearheaded by the Canadian Partnership for Quality Radiotherapy (CPQR), and now guided by the Canadian Association of Radiation Oncology (CARO)’s Quality and Standards Committee, patient representatives and early-adopter radiation treatment programs continue to champion the expansion of PROs initiatives across the country. The current review discusses the evolution of a pan-Canadian approach to PROs use, striving to fill in gaps between clinical practice and guideline recommendations through multi-centre and multidisciplinary collaboration.
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18
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Lin Y, Lemos M, Neuschaefer-Rube C. Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App. JMIR MEDICAL EDUCATION 2022; 8:e34042. [PMID: 35475980 PMCID: PMC9096631 DOI: 10.2196/34042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/28/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed. OBJECTIVE We aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app's features, functions, content, and associated concerns. METHODS An open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logopäd*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated. RESULTS Of the 164 participants, an overwhelming majority (n=162, 98.8%) indicated readiness to use such an app, and most participants (n=159, 96.9%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8%), receive and manage push notifications (130/164, 79.3%), and report technical issues (160/164, 97.6%) positively. However, significant variance was noted across professions (H3=8.006; P=.046) and generations (H3=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H3=9.098; P=.03) and therapy (H3=21.236; P<.001). Concerns included technical challenges, data protection, quality of the included resources, and sustainability of the proposed app. CONCLUSIONS This investigation demonstrated that professionals and students show initial readiness to engage in the co-design and use of an interdisciplinary digital learning toolbox app. Specifically, this app could support effective access, sharing, evaluation, and knowledge management in a digital age of rapid change. Formalized digital skills education in the field of CSD is just a part of the solution. It will be crucial to explore flexible, adaptive strategies collaboratively for managing digital resources and tools to optimize targeted selection and use of relevant, high-quality evidence in a world of bewildering data.
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Affiliation(s)
- Yuchen Lin
- Clinic for Phoniatrics, Pedaudiology & Communication Disorders, University Hospital and Medical Faculty, Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany
| | - Martin Lemos
- Audiovisual Media Center (AVMZ), University Hospital and Medical Faculty, Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany
| | - Christiane Neuschaefer-Rube
- Clinic for Phoniatrics, Pedaudiology & Communication Disorders, University Hospital and Medical Faculty, Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany
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Chu D, Lessard D, Laymouna MA, Engler K, Schuster T, Ma Y, Kronfli N, Routy JP, Hijal T, Lacombe K, Sheehan N, Rougier H, Lebouché B. Understanding the Risks and Benefits of a Patient Portal Configured for HIV Care: Patient and Healthcare Professional Perspectives. J Pers Med 2022; 12:jpm12020314. [PMID: 35207803 PMCID: PMC8880024 DOI: 10.3390/jpm12020314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Like other chronic viral illnesses, HIV infection necessitates consistent self-management and adherence to care and treatment, which in turn relies on optimal collaboration between patients and healthcare professionals (HCPs), including physicians, nurses, pharmacists, and clinical care coordinators. By providing people living with HIV (PLHIV) with access to their personal health information, educational material, and a communication channel with HCPs, a tailored patient portal could support their engagement in care. Our team intends to implement a patient portal in HIV-specialized clinics in Canada and France. We sought to understand the perceived risks and benefits among PLHIV and HCPs of patient portal use in HIV clinical care. Methods: This qualitative study recruited PLHIV and HIV-specialized HCPs, through maximum variation sampling and purposeful sampling, respectively. Semi-structured focus group discussions (FGDs) were held separately with PLHIV and HCPs between August 2019 and January 2020. FGDs were recorded, transcribed, coded using NVivo 12 software, and analyzed using content analysis. Results: A total of twenty-eight PLHIV participated in four FGDs, and thirty-one HCPs participated in six FGDs. PLHIV included eighteen men, nine women, and one person identifying as other; while, HCPs included ten men, twenty women, and one person identifying as other. A multi-disciplinary team of HCPs were included, involving physicians, nurses, pharmacists, social workers, and clinical coordinators. Participants identified five potential risks: (1) breach of confidentiality, (2) stress or uncertainty, (3) contribution to the digital divide, (4) dehumanization of care, and (5) increase in HCPs’ workload. They also highlighted four main benefits of using a patient portal: (1) improvement in HIV self-management, (2) facilitation of patient visits, (3) responsiveness to patient preferences, and (4) fulfillment of current or evolving patient needs. Conclusion: PLHIV and HCPs identified both risks and benefits of using a patient portal in HIV care. By engaging stakeholders and understanding their perspectives, the configuration of a patient portal can be optimized for end-users and concerns may be mitigated during its implementation.
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Affiliation(s)
- Dominic Chu
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
| | - David Lessard
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Moustafa A. Laymouna
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
| | - Kim Engler
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
| | - Yuanchao Ma
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, QC H3C 3A7, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Jean-Pierre Routy
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
| | - Tarek Hijal
- Division of Radiation Oncology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Karine Lacombe
- Faculté de Médecine, Sorbonne Université, Inserm IPLESP, Hôpital St Antoine, APHP, 75012 Paris, France;
| | - Nancy Sheehan
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
- Faculté de Pharmacie, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Hayette Rougier
- IMEA, Institut de Médecine et d’Épidémiologie Appliquée, F75018 Paris, France;
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (M.A.L.); (T.S.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC H4A 3J1, Canada; (D.L.); (K.E.); (Y.M.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Department of Medicine, Division of Infectious Diseases and Chronic and Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (J.-P.R.); (N.S.)
- Correspondence: ; Tel.: +1-514-843-2090
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Rackerseder J, Hornbach C, Dicks P, Kerek-Bodden H, Krieger T. Designing a Patient-Friendly Website for Newly Diagnosed Cancer Patients with the Participatory Health Research Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1969. [PMID: 35206155 PMCID: PMC8872440 DOI: 10.3390/ijerph19041969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023]
Abstract
High-quality and user-friendly patient information material (PIM) is essential for understanding and accepting a new care programme. When optimising the PIM of the integrated, cross-sectoral psycho-oncological (isPO) care programme, the design of the fifth element of the patient information strategy-the patient-friendly website-was still pending. In this paper, the iterative design process of the patient-friendly isPO website is described. We applied the participatory health research (PHR) approach to enable high levels of participation of its respective end-users (e.g., cancer survivors), service providers, and experts. The design included six steps: (1) initiation, (2) planning, (3) initial idea exploration, (4) creation of a first working version, (5) three optimisation loops, and (6) dissemination. An exploratory mixed-methods design has been used. Qualitative data collection included document analysis, interviews, and participatory action research (PAR) loops with focus groups. Finally, the quality of the newly designed website was quantitatively assessed with the UPIM-Check, a user-friendly instrument for assessing and optimising PIM. The PHR approach was indispensable for the design of our needs-oriented, patient-friendly website. Participants' high levels of participation strongly contributed to the products' quality. The final descriptive statistical evaluation shows that the final website was rated very good on average by its end-users.
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Affiliation(s)
- Juliane Rackerseder
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (C.H.); (T.K.)
| | - Carolin Hornbach
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (C.H.); (T.K.)
| | - Peter Dicks
- Vocational School University Hospital Aix-la-Chapelle, Pauwelstr. 30, 52074 Aix-la-Chapelle, Germany;
- District Association of Larynx Operated Aachen e.V., Lörschpülgen 24, 52134 Herzogenrath, Germany
| | - Hedy Kerek-Bodden
- House of the Cancer Patient Support Associations of Germany (HKSH-BV), Thomas-Mann-Str. 40, 53111 Bonn, Germany;
| | - Theresia Krieger
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (C.H.); (T.K.)
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21
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Cestari VRF, Florêncio RS, Garces TS, Souza LCD, Negreiros FDDS, Pessoa VLMDP, Moreira TMM. CODESING DE APLICATIVO CUIDATIVO-EDUCACIONAL PARA PESSOAS COM INSUFICIÊNCIA CARDÍACA: IDEAÇÃO, PROTOTIPAGEM E CO-IMPLANTAÇÃO. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0163pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
RESUMO Objetivo descrever o processo de ideação, prototipagem e co-implantação do protótipo de aplicativo cuidativo-educacional à pessoa com insuficiência cardíaca em vulnerabilidade, seus familiares/cuidadores e equipe de saúde. Método estudo metodológico, com cinco fases: Constructo; Ideação; Prototipagem; Co-implantação e Adequação, realizadas de setembro de 2020 a julho de 2021. A equipe do Codesign envolveu 72 atores (15 pacientes com IC, 19 familiares/cuidadores, 35 profissionais da saúde, dois pesquisadores e um designer e desenvolvedor), que contribuíram com dados linguísticos e visuais. Resultados foi produzido o protótipo InCare®, representado pelo fluxograma de interação do usuário e esboços estruturais. Foram definidas cores para composição das telas e escolhidos recursos do protótipo, com delineamento da descrição, proposta e requisitos funcionais. O aplicativo envolveu temáticas relevantes (definição da doença e vulnerabilidade, etiologia, classificação, sinais e sintomas, cuidados diários e abordagens paliativistas, tratamentos, alimentação, atividade física e redes de suporte, benefícios) e aglutinou funcionalidades conforme necessidades e preferências da equipe, sendo considerado inovador e um incentivo ao autocuidado. Conclusão O Codesign permitiu a ideação de recursos, conteúdos, esboços das telas, fluxo do usuário, prototipagem e nome do protótipo, em processo criativo e participativo, para promoção da saúde da pessoa com insuficiência cardíaca em situação de vulnerabilidade em saúde.
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Lo B, Charow R, Laberge S, Bakas V, Williams L, Wiljer D. Why are Patient Portals Important in the Age of COVID-19? Reflecting on Patient and Team Experiences From a Toronto Hospital Network. J Patient Exp 2022; 9:23743735221112216. [PMID: 35899103 PMCID: PMC9310255 DOI: 10.1177/23743735221112216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has changed how care is being delivered in Canada. With
conventional in-person care being transitioned to virtual care, the approach that patients
are able to engage and access their care has dramatically changed. At the University
Health Network (UHN), which is Canada's largest academic and teaching hospital network, we
expanded the myUHN Patient Portal in 2017 after its early adopter phase to enable patients
and family members to view parts of their clinical notes and test results. As the pandemic
progressed, we observed high adoption of myUHN to support virtual care and rapid delivery
of COVID-19 test results in real time. In this article, we share and reflect on our
experience of adapting myUHN to support the demands of the pandemic, including portal
adoption outcomes across multiple waves of the pandemic, the impetus for increased patient
experience staff dedicated for myUHN support, and patients’ perceptions of the value of
the portal and virtual care. Based on these reflections, we outline our perspectives on
the future role of patient portals to support patient care and experience in a
post-pandemic environment.
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Affiliation(s)
- Brian Lo
- UHN Digital, University Health Network, Toronto, ON, Canada
- Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Rebecca Charow
- UHN Digital, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sarah Laberge
- myUHN Patient Portal, Patient Experience, University Health Network, Toronto, ON, Canada
| | - Vasiliki Bakas
- myUHN Patient Portal, Patient Experience, University Health Network, Toronto, ON, Canada
| | - Laura Williams
- myUHN Patient Portal, Patient Experience, University Health Network, Toronto, ON, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - David Wiljer
- UHN Digital, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Cestari VRF, Florêncio RS, Garces TS, Souza LCD, Negreiros FDDS, Pessoa VLMDP, Moreira TMM. CODESIGN OF A CARE-EDUCATIONAL APP FOR PEOPLE WITH HEART FAILURE: DESIGN, PROTOTYPING AND CO-IMPLEMENTATION. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0163en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
ABSTRACT Objective to describe the process corresponding to the design, prototyping and co-implementation of a care-educational app prototype for vulnerable people with heart failure, their family members/caregivers and the health team. Method a methodological study with five phases: Construct, Design, Prototyping, Co-implementation and Adaptation, all performed from September 2020 to July 2021. The Codesign team involved 72 actors (15 patients with HF, 19 family members/caregivers, 35 health professionals, two researchers and a designer and developer), who contributed with linguistic and visual data. Results the InCare® prototype was produced, represented by the flowchart corresponding to the user's interaction and structural sketches. Colors were defined to compose the screens and the prototype resources were chosen, outlining the description, proposal and functional requirements. The app involved relevant themes (definition of the disease and vulnerability, etiology, classification, signs and symptoms, daily care measures and palliative approaches, treatments, diet, physical activity and support networks, benefits) and gathered functionalities according to the team's needs and preferences, being considered innovative and encouraging for self-care. Conclusion codesign allowed designing resources, contents, screen sketches, user flow, prototyping and prototype name, in a creative and participatory process to promote the health of people with heart failure in vulnerable health situations.
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Engler K, Vicente S, Ma Y, Hijal T, Cox J, Ahmed S, Klein M, Achiche S, Pant Pai N, de Pokomandy A, Lacombe K, Lebouché B. Implementation of an electronic patient-reported measure of barriers to antiretroviral therapy adherence with the Opal patient portal: Protocol for a mixed method type 3 hybrid pilot study at a large Montreal HIV clinic. PLoS One 2021; 16:e0261006. [PMID: 34969046 PMCID: PMC8717992 DOI: 10.1371/journal.pone.0261006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adherence to antiretroviral therapy (ART) remains problematic. Regular monitoring of its barriers is clinically recommended, however, patient-provider communication around adherence is often inadequate. Our team thus decided to develop a new electronically administered patient-reported outcome measure (PROM) of barriers to ART adherence (the I-Score) to systematically capture this data for physician consideration in routine HIV care. To prepare for a controlled definitive trial to test the I-Score intervention, a pilot study was designed. Its primary objectives are to evaluate patient and physician perceptions of the I-Score intervention and its implementation strategy. METHODS This one-arm, 6-month study will adopt a mixed method type 3 implementation-effectiveness hybrid design and be conducted at the Chronic Viral Illness Service of the McGill University Health Centre (Montreal, Canada). Four HIV physicians and 32 of their HIV patients with known or suspected adherence problems will participate. The intervention will involve having patients complete the I-Score through a smartphone application (Opal), before meeting with their physician. Both patients and physicians will have access to the I-Score results, for consideration during the clinic visits at Times 1, 2 (3 months), and 3 (6 months). The implementation strategy will focus on stakeholder involvement, education, and training; promoting the intervention's adaptability; and hiring an Application Manager to facilitate implementation. Implementation, patient, and service outcomes will be collected (Times 1-2-3). The primary outcome is the intervention's acceptability to patients and physicians. Qualitative data obtained, in part, through physician focus groups (Times 2-3) and patient interviews (Times 2-3) will help evaluate the implementation strategy and inform any methodological adaptations. DISCUSSION This study will help plan a definitive trial to test the efficacy of the I-Score intervention. It will generate needed data on electronic PROM interventions in routine HIV care that will help improve understanding of conditions for their successful implementation. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04702412; https://clinicaltrials.gov/.
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Affiliation(s)
- Kim Engler
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Serge Vicente
- Department of Mathematics and Statistics, University of Montreal, Montreal, Quebec, Canada
| | - Yuanchao Ma
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Tarek Hijal
- Department of Radiation Oncology, Cedars Cancer Center, McGill University Health Centre, Montreal, Quebec, Canada
| | - Joseph Cox
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Sara Ahmed
- School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Marina Klein
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sofiane Achiche
- Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Nitika Pant Pai
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Alexandra de Pokomandy
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Karine Lacombe
- Sorbonne Université, Inserm IPLESP, Hôpital St Antoine, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - Bertrand Lebouché
- Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Infectious Disease, Department of Medicine, Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
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Santos AD, Caine V, Robson PJ, Watson L, Easaw JC, Petrovskaya O. Oncology Patients' Experiences With Novel Electronic Patient Portals to Support Care and Treatment: Qualitative Study With Early Users and Nonusers of Portals in Alberta, Canada. JMIR Cancer 2021; 7:e32609. [PMID: 34822338 PMCID: PMC8663539 DOI: 10.2196/32609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 02/06/2023] Open
Abstract
Background With the current proliferation of clinical information technologies internationally, patient portals are increasingly being adopted in health care. Research, conducted mostly in the United States, shows that oncology patients have a keen interest in portals to gain access to and track comprehensive personal health information. In Canada, patient portals are relatively new and research into their use and effects is currently emerging. There is a need to understand oncology patients’ experiences of using eHealth tools and to ground these experiences in local sociopolitical contexts of technology implementation, while seeking to devise strategies to enhance portal benefits. Objective The purpose of this study was to explore the experiences of oncology patients and their family caregivers when using electronic patient portals to support their health care needs. We focused on how Alberta’s unique, 2-portal context shapes experiences of early portal adopters and nonadopters, in anticipation of a province-wide rollout of a clinical information system in oncology facilities. Methods This qualitative descriptive study employed individual semistructured interviews and demographic surveys with 11 participants. Interviews were audio-recorded and transcribed verbatim. Data were analyzed thematically. The study was approved by the University of Alberta Human Research Ethics Board. Results Participants currently living with nonactive cancer discussed an online patient portal as one among many tools (including the internet, phone, videoconferencing, print-out reports) available to make sense of their diagnosis and treatment, maintain connections with health care providers, and engage with information. In the Fall of 2020, most participants had access to 1 of 2 of Alberta’s patient portals and identified ways in which this portal was supportive (or not) of their ongoing health care needs. Four major themes, reflecting the participants’ broader concerns within which the portal use was occurring, were generated from the data: (1) experiencing doubt and the desire for transparency; (2) seeking to become an informed and active member of the health care team; (3) encountering complexity; and (4) emphasizing the importance of the patient–provider relationship. Conclusions Although people diagnosed with cancer and their family caregivers considered an online patient portal as beneficial, they identified several areas that limit how portals support their oncology care. Providers of health care portals are invited to recognize these limitations and work toward addressing them.
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Affiliation(s)
- Amanda D Santos
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Vera Caine
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Paula J Robson
- Cancer Care Alberta, Alberta Health Services, Edmonton, AB, Canada.,School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Linda Watson
- Cancer Care Alberta, Alberta Health Services, Edmonton, AB, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Jacob C Easaw
- Faculty of Medicine, Department of Medical Oncology, University of Alberta, Edmonton, AB, Canada.,Cross Cancer Institute, Alberta Health Services, Edmonton, AB, Canada
| | - Olga Petrovskaya
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.,School of Nursing, University of Victoria, Victoria, BC, Canada
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Hopstaken JS, Verweij L, van Laarhoven CJHM, Blijlevens NMA, Stommel MWJ, Hermens RPMG. Effect of Digital Care Platforms on Quality of Care for Oncological Patients and Barriers and Facilitators for Their Implementation: Systematic Review. J Med Internet Res 2021; 23:e28869. [PMID: 34559057 PMCID: PMC8501408 DOI: 10.2196/28869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/17/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Oncological health care services are challenged by the increasing number of cancer survivors, long-term follow-up care, and fragmentation of care. Digital care platforms are potential tools to deliver affordable, patient-centered oncological care. Previous reviews evaluated only one feature of a digital care platform or did not evaluate the effect on enhancement of information, self-efficacy, continuity of care, or patient- and health care provider-reported experiences. Additionally, they have not focused on the barriers and facilitators for implementation of a digital care platform in oncological care. OBJECTIVE The aim of this systematic review was to collect the best available evidence of the effect of a digital care platform on quality of care parameters such as enhancement of available information, self-efficacy, continuity of care, and patient- and health care provider-reported experiences. Additionally, barriers and facilitators for implementation of digital care platforms were analyzed. METHODS The PubMed (Medline), Embase, CINAHL, and Cochrane Library databases were searched for the period from January 2000 to May 2020 for studies assessing the effect of a digital care platform on the predefined outcome parameters in oncological patients and studies describing barriers and facilitators for implementation. Synthesis of the results was performed qualitatively. Barriers and facilitators were categorized according to the framework of Grol and Wensing. The Mixed Methods Appraisal Tool was used for critical appraisal of the studies. RESULTS Seventeen studies were included for final analysis, comprising 8 clinical studies on the effectiveness of the digital care platform and 13 studies describing barriers and facilitators. Usage of a digital care platform appeared to enhance the availability of information and self-efficacy. There were no data available on the effect of a digital care platform on the continuity of care. However, based on focus group interviews, digital care platforms could potentially improve continuity of care by optimizing the exchange of patient information across institutes. Patient-reported experiences such as satisfaction with the platform were considerably positive. Most barriers for implementation were identified at the professional level, such as the concern for increased workload and unattended release of medical information to patients. Most facilitators were found at the patient and innovation levels, such as improved patient-doctor communication and patient empowerment. There were few barriers and facilitators mentioned at the economic and political levels. CONCLUSIONS The use of digital care platforms is associated with better quality of care through enhancement of availability of information and increased self-efficacy for oncological patients. The numerous facilitators identified at the patient level illustrate that patients are positive toward a digital care platform. However, despite these favorable results, robust evidence concerning the effectiveness of digital care platforms, especially from high-quality studies, is still lacking. Future studies should therefore aim to further investigate the effectiveness of digital care platforms, and the barriers and facilitators to their implementation at the economic and political levels.
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Affiliation(s)
- Jana S Hopstaken
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lynn Verweij
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Cees J H M van Laarhoven
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martijn W J Stommel
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
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van Rijt AM, Hulter P, Weggelaar-Jansen AM, Ahaus K, Pluut B. Mental Health Care Professionals' Appraisal of Patients' Use of Web-Based Access to Their Electronic Health Record: Qualitative Study. J Med Internet Res 2021; 23:e28045. [PMID: 34448705 PMCID: PMC8433850 DOI: 10.2196/28045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Patients in a range of health care sectors can access their medical health records using a patient portal. In mental health care, the use of patient portals among mental health care professionals remains low. Mental health care professionals are concerned that patient access to electronic health records (EHRs) will negatively affect the patient's well-being and privacy as well as the professional's own workload. OBJECTIVE This study aims to provide insights into the appraisal work of mental health care professionals to assess and understand patient access to their EHRs through a patient portal. METHODS We conducted a qualitative study that included 10 semistructured interviews (n=11) and a focus group (n=10). Participants in both the interviews and the focus group were mental health care professionals from different professional backgrounds and staff employees (eg, team leaders and communication advisors). We collected data on their opinions and experiences with the recently implemented patient portal and their attempts to modify work practices. RESULTS Our study provides insights into mental health care professionals' appraisal work to assess and understand patient access to the EHR through a patient portal. A total of four topics emerged from our data analysis: appraising the effect on the patient-professional relationship, appraising the challenge of sharing and registering delicate information, appraising patient vulnerability, and redefining consultation routines and registration practices. CONCLUSIONS Mental health care professionals struggle with the effects of web-based patient access and are searching for the best ways to modify their registration and consultation practices. Our participants seem to appraise the effects of web-based patient access individually. Our study signals the lack of systematization and communal appraisal. It also suggests various solutions to the challenges faced by mental health care professionals. To optimize the effects of web-based patient access to EHRs, mental health care professionals need to be involved in the process of developing, implementing, and embedding patient portals.
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Affiliation(s)
| | - Pauline Hulter
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Anne Marie Weggelaar-Jansen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands.,Eindhoven University of Technology, Eindhoven, Netherlands
| | - Kees Ahaus
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Bettine Pluut
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
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Ledermann K, Abou Khaled O, Caon M, Berger T, Chabwine JN, Wicht J, Martin-Soelch C. An Ecological Monitoring and Management App (EMMA) for Older Adults With Chronic Pain: Protocol for a Design and Feasibility Study. JMIR Res Protoc 2021; 10:e26930. [PMID: 34435969 PMCID: PMC8430865 DOI: 10.2196/26930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Chronic pain is a complex problem for many older adults that affects both physical functioning and psychological well-being. Mobile health (mHealth) technologies have shown promise in supporting older persons in managing chronic conditions. Cognitive behavior therapy is recommended for older people with chronic pain. However, web-based treatment programs for chronic pain are not aimed at the needs of older people and offer standard therapies without providing tailored treatment for this population. Objective To address this problem, we aim to develop a psychological web-based intervention for ecological monitoring of daily life experiences with chronic pain called EMMA to support self-management of chronic pain in older adults. Methods The key clinical and engagement features of the intervention were established through the integration of evidence-based material from cognitive behavioral therapy for the treatment of chronic pain in older adults. The development process uses a co-design approach and actively involves end-users in the design process by incorporating feedback from focus groups with older adults in order to inform a user-centered intervention design. For the co-design process, we will include 10 older adults with chronic pain, who will discuss the requirements for the app in workshops in order to ensure suitability of the app for older adults with chronic pain. In order to test the feasibility and acceptability of the intervention, we will include a sample of 30 older adults with chronic pain who will test all features of the intervention for a period of 8 consecutive weeks. After the trial period, validated instruments will be used to assess usability and acceptability, as well as influence on pain levels and associated physical and psychological symptoms. Participants will be invited to take part in a semistructured telephone interviews after the trial period to explore their experiences using the app. Results Digitalization of the pain diary and psychotherapeutic content has started. Recruitment of participants for the co-design workshops will start as soon as we have a functioning prototype of the electronic pain diary and EMMA intervention, which is expected to be in September 2021. The feasibility study will start as soon as the co-design process is finished and required changes have been implemented into the pain diary and the EMMA intervention. We expect to start the feasibility study early in 2022. Conclusions Required changes to assure usability and acceptability will be directly implemented in the app. EMMA brings together a strong body of evidence using cognitive behavioral and self-management theory with contemporary mHealth principles, allowing for a cost-effective intervention that can be used to target chronic pain anywhere and anytime by older adults. Given the ubiquity of mHealth interventions for chronic conditions, the results of this study may serve to inform the development of tailored self-management interventions. International Registered Report Identifier (IRRID) PRR1-10.2196/26930
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Affiliation(s)
- Katharina Ledermann
- Department of Consiliar and Liaison Psychiary, University Hospital Zurich, Zurich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Omar Abou Khaled
- Human Tech Institute, School of Engineering, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Maurizio Caon
- Digital Business Center, School of Management, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Berne, Berne, Switzerland
| | - Joelle N Chabwine
- Division of Neurorehabilitation, Fribourg Hospital, Fribourg, Switzerland.,Neurology Unit, Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Joachim Wicht
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
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Jackson J, Leziak K, Niznik CM, Yee LM. Health Care Providers' Utilization of and Perspectives on Mobile Health Technology for Diabetes and Pregnancy Support. Diabetes Spectr 2021; 34:257-267. [PMID: 34511852 PMCID: PMC8387606 DOI: 10.2337/ds20-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Mobile health (mHealth) technology can be an effective tool to deliver behavioral interventions to improve health outcomes for individuals with diabetes. However, there is limited evidence on mHealth for pregnant women managing diabetes or for the role of health care providers (HCPs) in delivering mHealth tools. To prepare for the development of a pregnancy-specific mHealth intervention for diabetes, we sought to understand HCPs' acceptance, utilization, and design recommendations for how mHealth technology can best be used to support the management of diabetes during pregnancy. METHODS Focus groups and individual interviews were conducted with clinical HCPs (obstetricians, nurses, diabetes educators, dietitians, and lactation counselors) who care for low-income pregnant women with diabetes. Data were analyzed using the constant comparative method. RESULTS Participants (n = 29) generated five themes and 14 subthemes. Knowledge and acceptance themes included utilization of mobile resources and barriers to HCPs' adoption. Knowledge of popular pregnancy applications (apps) dominated, while familiarity with and use of diabetes apps varied by profession and proximity to continued education. Technology adoption barriers included lack of credibility, dependence on Internet resources, and reliance on knowledge networks. Design themes addressed user-centered design, responsive and practical education, and clinical integration. Clinicians recommended patient-participatory design, customizable features, data-tracking features, motivational feedback, and bidirectional communication capabilities. CONCLUSION Although HCPs strongly embraced mHealth tools as an adjunct to obstetric care for women with diabetes, they also expressed limited knowledge and apprehension about patient engagement. HCP recommendations and concerns must critically inform the development of meaningful tools for this population.
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The perspectives of stroke survivors and health professionals on the use of augmented reality for inpatient stroke rehabilitation: an anticipatory exploration. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background:
Augmented reality is a novel technology with potential to overlay aspects or objects from the home environment into hospital-based training, which may increase relevance and motivation for hospital-based rehabilitation. Consultation with people with lived experience and clinician stakeholders is an important step when exploring possibilities for use of new technology in the hospital environment.
Aims:
This study sought to understand the need and acceptability of augmented reality from the perspectives of health professionals and stroke survivors during inpatient stroke rehabilitation.
Methods:
This qualitative descriptive study included stroke survivors (n = 4) and health professionals (n = 10) from a large metropolitan hospital. Data collection was undertaken via focus groups which were transcribed verbatim and analysed using qualitative content analysis.
Results:
Inductive content analysis revealed three themes: everything is computerised these days; the possibilities are endless…but what about?; and bringing the outside into the hospital. Participants were open to the use of augmented reality for stroke rehabilitation; however there was uncertainty with pragmatic concerns and stroke survivors describing possible applications in building confidence and self-efficacy, and sharing experiences to enhance caregivers understanding.
Conclusion:
This research identified that there is potential acceptability for augmented reality in stroke rehabilitation. The needs identified by the participants may inform development of current and future technology.
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Abstract
Introduction: The implementation of people-centred care requires strategies that respond to local conditions and contexts, with the participation of local stakeholders in collaborative approaches such as co-design. Within this framework, the authors performed a literature review to identify the most implemented practices in health and social care services for co-designing digital solutions. Methods: The literature review was conducted following five steps: (i) Definition of the Keywords and their relations; (ii) Definition of the selection criteria; (iii) Search in PubMed; (iv) Selection of papers; and (v) Analysis of the selected papers. Results: 20 papers addressed to co-design health digital solutions with stakeholders were analysed in terms of the activities implemented and participants involved. Discussion: Previous studies using co-design methods for the deployment of health digital solutions employed a wide range of activities, most of them combining activities and/or mixed target groups. Conclusion: Co-design is the key to deliver people-centred care as it allows to involve stakeholders in the development of health digital solutions. Implementing one or more of the co-design methods identified in this literature review should be considered to better address the needs and specific projects and target groups.
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Nøst TH, Faxvaag A, Steinsbekk A. Participants' views and experiences from setting up a shared patient portal for primary and specialist health services- a qualitative study. BMC Health Serv Res 2021; 21:171. [PMID: 33627122 PMCID: PMC7903028 DOI: 10.1186/s12913-021-06188-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/17/2021] [Indexed: 01/05/2023] Open
Abstract
Background Recently, there has been an increasing focus among healthcare organisations on implementing patient portals. Previous studies have mainly focussed on the experiences of patient portal use. Few have investigated the processes of deciding what content and features to make available, in particular for shared portals across healthcare domains. The aim of the study was to investigate views on content and experiences from the configuration process among participants involved in setting up a shared patient portal for primary and specialist health services. Methods A qualitative study including 15 semi-structured interviews with persons participating in patient portal configuration was conducted from October 2019 to June 2020. Results Whether a shared patient portal for all the health services in the region should be established was not questioned by any of the informants. It was experienced as a good thing to have numerous participants present in the discussions on configuration, but it also was said to increase the complexity of the work. The informants considered a patient portal to be of great value for patient care, among other things because it would lead to improvements in patient follow-up and increased patient empowerment. Nevertheless, some informants advocated caution as they thought the patient portal possibly could lead to an increase in healthcare providers’ workloads and to anxiety and worries, as well as to inequality in access to health care among patients. The findings were categorized into the themes ‘A tool for increased patient involvement’, ‘Which information should be available for the patient’, ‘Concerns about increased workload’, ‘Too complex to use versus not interesting enough’, ‘Involving all services’ and ‘Patient involvement’. Conclusions Establishing a shared patient portal for primary and specialist health services was considered unproblematic. There was, however, variation in opinions on which content and features to include. This variation was related to concerns about increasing the workload for health care providers, causing anxiety and inequality among patients, and ensuring that the solution would be interesting enough to adopt.
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Affiliation(s)
- Torunn Hatlen Nøst
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491, Trondheim, Norway.
| | - Arild Faxvaag
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Orthopaedy, Rheumatology and Dermatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Digital Health Care Unit, Norwegian Centre for E-Health Research, Tromsø, Norway
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Chu D, Schuster T, Lessard D, Mate K, Engler K, Ma Y, Abulkhir A, Arora A, Long S, de Pokomandy A, Lacombe K, Rougier H, Cox J, Kronfli N, Hijal T, Kildea J, Routy JP, Asselah J, Lebouché B. Acceptability of a Patient Portal (Opal) in HIV Clinical Care: A Feasibility Study. J Pers Med 2021; 11:jpm11020134. [PMID: 33669439 PMCID: PMC7920437 DOI: 10.3390/jpm11020134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/30/2021] [Accepted: 02/11/2021] [Indexed: 11/16/2022] Open
Abstract
Opal (opalmedapps.com), a patient portal in use at the Cedars Cancer Centre of the McGill University Health Centre (MUHC) (Montreal, Canada), gives cancer patients access to their medical records, collects information on patient-reported outcome measures (PROMs), and has demonstrated patient satisfaction with care. This feasibility study aims to evaluate Opal's potential acceptability in the context of HIV care. People living with HIV (PLWH) and their healthcare providers (HCPs) completed cross-sectional surveys from August 2019 to February 2020 at large HIV centers, including the Chronic Viral Illness Service of the MUHC, and other HIV clinical sites in Montreal and Paris, France. This study comprised 114 PLWH (mean age 48 years old, SD = 12.4), including 74% men, 24% women, and 2% transgender or other; and 31 HCPs (mean age 46.5 years old, SD = 11.4), including 32% men, 65% women, and 3% other. Ownership of smartphones and tablets was high (93% PLWH, 96% HCPs), and participants were willing to use Opal (74% PLWH, 68% HCPs). Participants were interested in most Opal functions and PROMs, particularly PROMs capturing quality of life (89% PLWH, 77% HCPs), experience of healthcare (86% PLWH, 97% HCPs), and HIV self-management (92% PLWH, 97% HCPs). This study suggests Opal has high acceptability and potential usefulness as perceived by PLWH and HCPs.
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Affiliation(s)
- Dominic Chu
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
| | - David Lessard
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Kedar Mate
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
| | - Kim Engler
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Yuanchao Ma
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Ayoub Abulkhir
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
| | - Anish Arora
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
| | - Stephanie Long
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Karine Lacombe
- AP-HP, Hôpital Saint-Antoine, Service des Maladies Infectieuses et Tropicales, 75012 Paris, France; (K.L.); (H.R.)
| | - Hayette Rougier
- AP-HP, Hôpital Saint-Antoine, Service des Maladies Infectieuses et Tropicales, 75012 Paris, France; (K.L.); (H.R.)
- IMEA, Institut de Médecine et d’Epidémiologie Appliquée, F75018 Paris, France
| | - Joseph Cox
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Nadine Kronfli
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Tarek Hijal
- Department of Radiation Oncology, Cedars Cancer Centre, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (T.H.); (J.A.)
| | - John Kildea
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada;
| | - Jean-Pierre Routy
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Jamil Asselah
- Department of Radiation Oncology, Cedars Cancer Centre, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (T.H.); (J.A.)
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada; (D.C.); (T.S.); (A.A.); (A.A.); (S.L.); (A.d.P.); (N.K.)
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV, Montreal, QC K1A 0W9, Canada; (D.L.); (K.M.); (K.E.); (Y.M.); (J.C.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S9, Canada
- Chronic and Viral Illness Service, Division of Infectious Disease, McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
- Correspondence: ; Tel.: +1-514-843-2090
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McCrea Z, Power K, Kiersey R, White M, Breen A, Murphy S, Healy L, Kearney H, Dunleavy B, O'Donoghue S, Lambert V, Delanty N, Doherty C, Fitzsimons M. Coproducing health and well-being in partnership with patients, families, and healthcare providers: A qualitative study exploring the role of an epilepsy patient portal. Epilepsy Behav 2021; 115:107664. [PMID: 33334718 DOI: 10.1016/j.yebeh.2020.107664] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Coproduced epilepsy care sees people with epilepsy (PwE), their care-proxies, and healthcare providers (HCPs), working together as partners to build strong relationships, improve communication, trust, and share decision-making. Coproduction underpins good quality patient- and family-centered care (PFCC) that is responsive to individual patient needs, preferences, and values. By facilitating information sharing and exchange between partners, electronic patient portals (ePortal) can enable coproduction. This paper explores what HCPs, PwE, and their care-proxies value from their user experience of PiSCES, the Irish epilepsy ePortal. METHODS A purposeful sample of actors involved in the receipt and delivery of epilepsy care and services were recruited via adult epilepsy centers at St James's and Beaumont Hospitals in Dublin. Interactive codesign sessions, surveys, and focus groups were used to elicit perspectives from PwE, care-proxies, and HCPs to understand their perception of how PiSCES could enhance or inhibit the epilepsy care process. RESULTS Results illustrate that participants welcome the role PiSCES can play in: empowering PwE/care-proxies, strengthening confidence in the healthcare system; aiding memory; advancing health literacy, motivating PwE to understand their condition better; acting as a passport of care between different clinical settings; and creating a foundation for stronger coproduction partnerships. PiSCES was generally embraced; however, some HCPs expressed plausible concerns about how clinical implementation might impact their work practices. CONCLUSION "Nothing about me without me" is a core value of the PiSCES initiative, recognizing that people need to be included in the planning of their own treatment and care. Our data show that PwE, their care-proxies, and HCPs value PiSCES potential, particularly in bolstering healthcare partnerships that foster inclusion, confidence, and trust.
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Affiliation(s)
- Zita McCrea
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kevin Power
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rachel Kiersey
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maire White
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Annette Breen
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Sinead Murphy
- Department of Neurology, Beaumont Hospital, Dublin, Ireland; Epilepsy Ireland, 249 Crumlin Rd, Crumlin, Dublin, Ireland
| | - Laura Healy
- Academic Unit of Neurology, St. James's Hospital, Dublin, Ireland
| | - Hugh Kearney
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Brendan Dunleavy
- ERGO IT Solutions, 1st Floor, Block T, East Point Business Park, Dublin 3, Ireland
| | - Sean O'Donoghue
- ERGO IT Solutions, 1st Floor, Block T, East Point Business Park, Dublin 3, Ireland
| | - Veronica Lambert
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Norman Delanty
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Neurology, Beaumont Hospital, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences (PBS), The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Colin Doherty
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland; Academic Unit of Neurology, St. James's Hospital, Dublin, Ireland
| | - Mary Fitzsimons
- FutureNeuro SFI Research Centre, For Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences (PBS), The Royal College of Surgeons in Ireland, Dublin, Ireland.
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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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Mohsen K, Kildea J, Lambert SD, Laizner AM. Exploring Cancer Patients' Perceptions of Accessing and Experience with Using the Educational Material in the Opal Patient Portal. Support Care Cancer 2021; 29:4365-4374. [PMID: 33415366 DOI: 10.1007/s00520-020-05900-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Opal is a new patient-centered mobile application that gives cancer patients access to their real time medical data in conjunction with disease- and treatment-specific patient education material. Few studies have focused on patients' experiences with such mobile applications. This study's objectives were to (1) explore cancer patients' perceptions of accessing the educational materials through Opal and (2) explore their experiences using these educational materials. METHODS A qualitative descriptive design was used. Patients were invited to participate in the study via Opal itself. Semi-structured individual interviews were done in person or over the phone, transcribed verbatim and analyzed using qualitative content analysis. RESULTS Nine women were interviewed. Three themes were identified as participants spoke about their perceptions of and experiences with Opal. First, Opal makes me feel like I have more control, conveying how learning more about their diagnosis and treatments allowed patients to advocate for themselves and plan their care. Second, Opal tends to reassure me, illustrating that having access to information was reassuring. Lastly, Opal is just starting to have information which could help meet my needs, reflecting patients' belief Opal is on the right track but could provide more of their medical record, treating team contact information and education material. CONCLUSION Patients can feel more empowered when using patient-centered mobile applications, and mobile applications have potential for improving collaboration with healthcare professionals and care coordination. Healthcare professionals, including oncologists and nurses, should support patients' use of mobile applications and integrate them in their patient interactions.
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Affiliation(s)
- Katherine Mohsen
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - John Kildea
- Medical Physics Unit - Gerald Bronfman, Department of Oncology, McGill University, Montréal, Québec, Canada
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
- St. Mary's Research Centre, Montréal, Québec, Canada
| | - Andréa M Laizner
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
- Nursing Directorate, McGill University Health Centre, Montréal, Québec, Canada.
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Weinberger N, Weis A, Pohlmann S, Brändle C, Zentek T, Ose D, Szecsenyi J. A New Method for Structured Integration of User Needs in Two Health Technology Development Projects: Action Sheets. Inform Health Soc Care 2021; 46:113-125. [PMID: 33406954 DOI: 10.1080/17538157.2020.1865968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
An early integration of users and stakeholders is needed for a successful innovation process. Nonetheless, the integration of users is often hard to realize - especially when dealing with persons with chronic diseases. In addition, patients or users in general often are not able to formulate the requirements in a technical manner. Therefore, even if user requirements are collected, it is not certain that the developers know or understand 'what is really wanted'. To overcome these 'gaps', we have developed so-called Action Sheets (AS). This article presents the use of AS in two projects: the development of health technologies for people with cancer (INFOPAT) and dementia (QuartrBack). Depending on the project context, group sessions were conducted with different stakeholders to identify the needs of (potential) users. Within the INFOPAT project, ten focus groups were conducted with patients, physicians and other healthcare professionals. In QuartrBack stakeholders like e.g. care professionals, technical assistance organizations and citizens participated in two focus groups and three world cafés. Their requirements were then 'fed' into the technology development by the use of AS. AS appear to be a promising tool to make user needs based on social values more tangible and implementable into technology development processes. In addition, it shows up that four phases seem to be necessary for transferring identified user and stakeholder needs into AS, which can therefore be seen as essential to translate non-technically formulated requirements into technically feasible ones. The case study shows as lessons learned that despite the successful integration of user needs, context-sensitive adjustments are still necessary.
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Affiliation(s)
- Nora Weinberger
- Institute for Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Aline Weis
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Sabrina Pohlmann
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Claudia Brändle
- Institute for Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Tom Zentek
- Center for Telemedicine e.V., Bad Kissingen, Germany
| | - Dominik Ose
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.,Department of Population Health, University of Utah, Salt Lake City, USA
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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Ormel I, Magalhaes M, Josephson D, Tracey L, Law S. How to know what to know: Information challenges for women in the diagnostic phase of breast cancer. PATIENT EDUCATION AND COUNSELING 2021; 104:179-185. [PMID: 32646774 DOI: 10.1016/j.pec.2020.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 06/03/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore how women describe efforts to seek, appraise and interpret information during the diagnostic phase of her breast cancer care. METHODS Qualitative interviews with 35 women with breast cancer across Canada, using audio/video recording. Thematic analysis was used to identify topics important to participants (original results published: www.healthexperiences.ca). Secondary analysis of transcripts to identify how women described information flow, content, and management strategies. RESULTS Women adopt different strategies to optimize access to information, while acknowledging the negative effects of information overload and lack of relevant information. They propose small steps towards gathering and managing information, and to focus initially on understanding their illness. CONCLUSION Different strategies can help to ensure that women have the right information, in the right format, at the right time. Some of these strategies include developing guidance on how to 'handle' information, helping healthcare professionals identify patient's information preferences, improving the availability, quality and access to experiential information, and facilitating acces to electronic information that can tailor information. Further research to understand how women handle information can inform strategies to help newly-diagnosed patients navigate available information. PRACTICE IMPLICATIONS Healthcare professionals can work in partnership with patients to tailor reliable information to support informed decision-making.
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Affiliation(s)
- Ilja Ormel
- St. Mary's Research Centre, St. Mary's Hospital, 3880 Avenue Lacombe, Hayes Pavillon, Suite 4720, Montreal, QC, H3T 1M5, Canada.
| | - Mona Magalhaes
- St. Mary's Research Centre, St. Mary's Hospital, 3880 Avenue Lacombe, Hayes Pavillon, Suite 4720, Montreal, QC, H3T 1M5, Canada.
| | - Debbie Josephson
- St. Mary's Hospital, c/o St. Mary's Hospital, 3830 Avenue Lacombe, Montréal, QC, H3T 1M5, Canada.
| | - Linda Tracey
- St. Mary's Hospital, c/o St. Mary's Hospital, 3830 Avenue Lacombe, Montréal, QC, H3T 1M5, Canada.
| | - Susan Law
- St. Mary's Research Centre, St. Mary's Hospital, 3880 Avenue Lacombe, Hayes Pavillon, Suite 4720, Montreal, QC, H3T 1M5, Canada; Department of Family Medicine, McGill University, 5858 Côte-des-Neiges Rd, Montreal, QC, H3S 1Z1, Canada.
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Siedlikowski M, Rauch F, Tsimicalis A. Giving Children With Osteogenesis Imperfecta a Voice: Participatory Approach for the Development of the Interactive Assessment and Communication Tool Sisom OI. J Med Internet Res 2020; 22:e17947. [PMID: 32960176 PMCID: PMC7539168 DOI: 10.2196/17947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/05/2020] [Accepted: 04/10/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Children with osteogenesis imperfecta (OI) experience acute and chronic symptoms that expose them to physical, mental, and social challenges. Empowering these children by involving them in their care can help them to cope with OI. Sisom is an interactive assessment and communication tool designed to help children aged 6-12 years with chronic illnesses express their symptoms. This tool has not yet been adapted to the unique needs of OI. OBJECTIVE The aim of this study was to develop a Sisom OI paper prototype by seeking the perspectives of end users. METHODS A participatory approach was adopted to develop the prototype overseen by an expert panel of 9 clinicians at a university-affiliated pediatric hospital. Purposive sampling was used to recruit 12 children with OI who were aged 6-12 years. The study was carried out over the course of 3 feedback cycles. Data were deductively interpreted using content analysis techniques. RESULTS Overall, 64% (57/89) of the Sisom symptoms were deemed relevant for inclusion in Sisom OI, with 42% (37/89) directly incorporated and 22% (20/89) incorporated with changes. In total, 114 symptoms were used to create the prototype, of which 57 were newly generated. The relevant symptoms addressed children's thoughts and feelings about hospitalization and their wishes for participation in their own care. The new symptoms addressed fractures, body image, and social isolation related to difficulties with accessibility and intimidation. CONCLUSIONS Once developed, Sisom OI will offer clinicians an innovative and child-centered approach to capture children's perspectives on their condition.
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Affiliation(s)
- Maia Siedlikowski
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Frank Rauch
- Shriners Hospitals for Children - Canada, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Shriners Hospitals for Children - Canada, Montreal, QC, Canada
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Gorfinkel I, Lexchin J. Enabling Patient Portals to Access Primary Care Medical Records: Maximizing Collaboration in Care between Patients and Providers. ACTA ACUST UNITED AC 2020; 14:21-27. [PMID: 31322111 PMCID: PMC7008679 DOI: 10.12927/hcpol.2019.25859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Portals to allow patients to access their primary care medical records are necessary to achieve true collaborative care between doctors and patients. In this article, we outline a practical approach to achieving this goal that involves Ministries of Health, electronic medical record vendors, physicians and patients. Patient portals to primary care records could make possible an entirely new world of on-the-spot, customized learning. Patient portals ideally should be designed with the goal of optimizing patients' to better their ability to help themselves. Delaying implementation of these portals exacts a continued financial and personal hardship on patients and their families.
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Affiliation(s)
| | - Joel Lexchin
- Professor Emeritus, Faculty of Health, York University, Toronto, ON
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Patrick HM, Hijal T, Souhami L, Freeman C, Parker W, Joly L, Kildea J. A Canadian Response to the Coronavirus Disease 2019 (COVID-19) Pandemic: Is There a Silver Lining for Radiation Oncology Patients? Adv Radiat Oncol 2020; 5:774-776. [PMID: 32775791 PMCID: PMC7323646 DOI: 10.1016/j.adro.2020.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Haley M Patrick
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
| | - Tarek Hijal
- Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Luis Souhami
- Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carolyn Freeman
- Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - William Parker
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
| | - Lise Joly
- Division of Radiation Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, Quebec, Canada
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Thor M, Oh JH, Apte AP, Deasy JO. Registering Study Analysis Plans (SAPs) Before Dissecting Your Data—Updating and Standardizing Outcome Modeling. Front Oncol 2020; 10:978. [PMID: 32670879 PMCID: PMC7327097 DOI: 10.3389/fonc.2020.00978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022] Open
Abstract
Public preregistration of study analysis plans (SAPs) is widely recognized for clinical trials, but adopted to a much lesser extent in observational studies. Registration of SAPs prior to analysis is encouraged to not only increase transparency and exactness but also to avoid positive finding bias and better standardize outcome modeling. Efforts to generally standardize outcome modeling, which can be based on clinical trial and/or observational data, have recently spurred. We suggest a three-step SAP concept in which investigators are encouraged to (1) Design the SAP and circulate it among the co-investigators, (2) Log the SAP with a public repository, which recognizes the SAP with a digital object identifier (DOI), and (3) Cite (using the DOI), briefly summarize and motivate any deviations from the SAP in the associated manuscript. More specifically, the SAP should include the scope (brief data and study description, co-investigators, hypotheses, primary outcome measure, study title), in addition to step-by-step details of the analysis (handling of missing data, resampling, defined significance level, statistical function, validation, and variables and parameterization).
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Chen SCI, Liu C, Wang Z, McAdam R, Brennan M, Davey S, Cheng TY. How Geographical Isolation and Aging in Place Can Be Accommodated Through Connected Health Stakeholder Management: Qualitative Study With Focus Groups. J Med Internet Res 2020; 22:e15976. [PMID: 32459181 PMCID: PMC7287745 DOI: 10.2196/15976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/27/2019] [Accepted: 04/10/2020] [Indexed: 01/09/2023] Open
Abstract
Background In remote areas, connected health (CH) is needed, but as local resources are often scarce and the purchasing power of residents is usually poor, it is a challenge to apply CH in these settings. In this study, CH is defended as a technological solution for reshaping the direction of health care to be more proactive, preventive, and precisely targeted—and thus, more effective. Objective The objective of this study was to explore the identity of CH stakeholders in remote areas of Taiwan and their interests and power in order to determine ideal strategies for applying CH. We aimed to explore the respective unknowns and discover insights for those facing similar issues. Methods Qualitative research was conducted to investigate and interpret the phenomena of the aging population in a remote setting. An exploratory approach was employed involving semistructured interviews with 22 participants from 8 remote allied case studies. The interviews explored perspectives on stakeholder arrangements, including the power and interests of stakeholders and the needs of all the parties in the ecosystem. Results Results were obtained from in-depth interviews and focus groups that included identifying the stakeholders of remote health and determining how they influence its practice, as well as how associated agreements bring competitive advantages. Stakeholders included people in government sectors, industrial players, academic researchers, end users, and their associates who described their perspectives on their power and interests in remote health service delivery. Specific facilitators of and barriers to effective delivery were identified. A number of themes, such as government interests and power of decision making, were corroborated across rural and remote services. These themes were broadly grouped into the disclosure of conflicts of interest, asymmetry in decision making, and data development for risk assessment. Conclusions This study contributes to current knowledge by exploring the features of CH in remote areas and investigating its implementation from the perspectives of stakeholder management. It offers insights into managing remote health through a CH platform, which can be used for preliminary quantitative research. Consequently, these findings could help to more effectively facilitate diverse stakeholder engagement for health information sharing and social interaction.
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Affiliation(s)
| | - Chenglian Liu
- School of Computing, Neusoft Institute of Guangdong, Foshan, China
| | - Zhenyuan Wang
- Faculty of Economics and Management, East China Normal University, Shanghai, China.,Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
| | - Rodney McAdam
- Ulster Business School, Ulster University, Newtownabbey, United Kingdom
| | - Michael Brennan
- Ulster Business School, Ulster University, Newtownabbey, United Kingdom
| | - Shirley Davey
- Ulster Business School, Ulster University, Newtownabbey, United Kingdom
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Hulter P, Pluut B, Leenen-Brinkhuis C, de Mul M, Ahaus K, Weggelaar-Jansen AM. Adopting Patient Portals in Hospitals: Qualitative Study. J Med Internet Res 2020; 22:e16921. [PMID: 32427110 PMCID: PMC7268003 DOI: 10.2196/16921] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Theoretical models help to explain or predict the adoption of electronic health (eHealth) technology and illustrate the complexity of the adoption process. These models provide insights into general factors that influence the use of eHealth technology. However, they do not give hospitals much actionable knowledge on how to facilitate the adoption process. OBJECTIVE Our study aims to provide insights into patient portal adoption processes among patients and hospital staff, including health care professionals (HCPs), managers, and administrative clerks. Studying the experiences and views of stakeholders answers the following question: How can hospitals encourage patients and HCPs to adopt a patient portal? METHODS We conducted 22 semistructured individual and group interviews (n=69) in 12 hospitals and four focus groups with members of national and seminational organizations and patient portal suppliers (n=53). RESULTS The effort hospitals put into adopting patient portals can be split into three themes. First, inform patients and HCPs about the portal. This communication strategy has four objectives: users should (1) know about the portal, (2) know how the portal works, (3) know that action on the portal is required, and (4) know where to find help with the portal. Second, embed the patient portal in the daily routine of HCPs and management. This involves three forms of support: (1) hospital policy, (2) management by monitoring the numbers, and (3) a structured implementation strategy that includes all staff of one department. Third, try to adjust the portal to meet patients' needs to optimize user-friendliness in two ways: (1) use patients' feedback and (2) focus on optimizing for patients with special needs (eg, low literacy and low digital skills). CONCLUSIONS Asking stakeholders what they have learned from their efforts to stimulate patient portal use in hospitals elicited rich insights into the adoption process. These insights are missing in the theoretical models. Therefore, our findings help to translate the relatively abstract factors one finds in theoretical models to the everyday pragmatics of eHealth projects in hospitals.
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Affiliation(s)
- Pauline Hulter
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Bettine Pluut
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | | | - Marleen de Mul
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Kees Ahaus
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Anne Marie Weggelaar-Jansen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands.,Eindhoven University of Technology, Eindhoven, Netherlands
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Abstract
BACKGROUND What is the role of nursing in the digital health transformation of the 21st century? The answer to this critical question may rely on how prepared nursing is to enter into design processes associated with this evolution. AIMS The purpose of this paper is to introduce foundational terminology and tools to support increased nursing participation in user-centred design. Situated within a six-step design process, this includes a new analytic framework combining the disciplinary expertise of computer science with the nursing methodology Interpretive Description. METHODS The analytic framework and recommended research process were developed over the course of two projects each employing a similar collaborative mixed-methods design. Primary methodological drivers were drawn from the software development life-cycle and Interpretive Description in these digital health intervention studies. RESULTS Using aspects of software development practice, an analytic framework was conceived as part of an interdisciplinary research process allowing nurses to integrate their disciplinary expertise in user-centred digital design. The framework allows nurses to parse collected data into a robust set of functional and non-functional requirements for software developers while still engaging in a fulsome interpretive analysis. CONCLUSION There is a need for nursing to occupy a more significant role in the advancement of technology innovation in healthcare. However, a lack of familiarity with design-thinking and associated practical experience impedes nursing voices in this area. Tools and processes are introduced to enhance an existing nursing methodology as a means to extend our disciplinary design capacity.
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Affiliation(s)
- Tracie L Risling
- Associate Professor, College of Nursing, University of Saskatchewan, Canada
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Foster B, Krasowski MD. The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study. J Med Internet Res 2019; 21:e13791. [PMID: 31254335 PMCID: PMC6625217 DOI: 10.2196/13791] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/14/2019] [Accepted: 06/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients. OBJECTIVE The study aimed to assess patient portal utilization by ED patients at an academic medical center using account activation rates along with the rates of access of diagnostic test results (laboratory results and radiology reports), analyzing the impact of age, gender, and self-reported patient race. METHODS This institutional review board-approved retrospective study was performed at a 60,000-visits-per-year university-based ED. We utilized EHR data reporting tools to examine EHR portal activation and utilization for all patients who had at least one ED encounter with one or more diagnostic tests performed between October 1, 2016, and October 1, 2017. The total dataset for laboratory testing included 208,635 laboratory tests on 25,361 unique patients, of which 9482 (37.39%) had active portal accounts. The total dataset for radiologic imaging included 23,504 radiology studies on 14,455 unique patients, of which 5439 (37.63%) had an active portal account. RESULTS Overall, 8.90% (18,573/208,635) of laboratory tests and 8.97% (2019/22,504) of radiology reports ordered in the ED were viewed in the patient portal. The highest rates of viewing of laboratory and radiology results were seen for those who were female, were aged 0 to 11 years (parent or guardian viewing by proxy) and 18 to 60 years, and self-reported their race as Caucasian or Asian. The lowest rates were for those who were teenagers, aged older than 81 years, African American/black, and Hispanic/Latino. Infectious disease, urinalysis, and pregnancy testing constituted the highest number of laboratory tests viewed. Magnetic resonance imaging reports were viewed at higher rates than computed tomography or x-ray studies (P<.001). Approximately half of all the diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9904/18,573, 53.32% and radiology reports: 971/2019, 48.1%). On the other extreme, 19.9% (3701/18,573) of laboratory results and 31.6% (639/2019) of radiology reports were viewed more than 2 weeks after availability in the portal. CONCLUSIONS The data highlight the relatively low use of a patient portal by ED patients and existing disparities between patient groups. There can be wide lag time (months) between result/report availability and access by patients. Opportunities for improvement exist for both activation and more robust utilization of patient portals by ED patients.
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Affiliation(s)
- Brody Foster
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Matthew David Krasowski
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Understanding the EMR-Related Experiences of Pregnant Japanese Women to Redesign Antenatal Care EMR Systems. INFORMATICS 2019. [DOI: 10.3390/informatics6020015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Woman-centered antenatal care necessitates Electronic Medical Record (EMR) systems that respect women’s preferences. However, women’s preferences regarding EMR systems in antenatal care remain unknown. This work aims to understand the EMR-related experiences that pregnant Japanese women want. First, we conducted a field-based observational study at an antenatal care clinic at a Japanese university hospital. We analyzed the data following a thematic analysis approach and found multiple EMR-related experiences that pregnant women encounter during antenatal care. Based on the observations’ findings, we administered a web survey to 413 recently pregnant Japanese women to understand their attitudes regarding the EMR-related experiences. Our results show that pregnant Japanese women want accessible, exchangeable, and biopsychosocial EMRs. They also want EMR-enabled explanations and summaries. Interestingly, differences in their demographics and stages of pregnancy affected their attitudes towards some EMR-related experiences. To respect their preferences, we propose amplifying the roles of EMR systems as tools that promote communication and woman-centeredness in antenatal care. We also propose expanding the EMR design mindset from a biomedical to a biopsychosocial-oriented one. Finally, to accommodate the differences in individual needs and preferences, we propose the design of adaptable person-centered EMR systems.
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