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Jiang Y, Hwang M, Cho Y, Friese CR, Hawley ST, Manojlovich M, Krauss JC, Gong Y. The Acceptance and Use of Digital Technologies for Self-Reporting Medication Safety Events After Care Transitions to Home in Patients With Cancer: Survey Study. J Med Internet Res 2024; 26:e47685. [PMID: 38457204 PMCID: PMC10960221 DOI: 10.2196/47685] [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: 03/29/2023] [Revised: 09/18/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in adopting digital technologies and engaging in self-reporting medication safety events during transitions of care have not been fully understood. OBJECTIVE We aim to assess oncology patients' perceptions of medication and communication safety during care transitions and their willingness to use digital technologies for self-reporting medication safety events and to identify factors associated with their technology acceptance. METHODS A cross-sectional survey study was conducted with adult patients with breast, prostate, lung, or colorectal cancer (N=204) who had experienced care transitions from hospitals or clinics to home in the past 1 year. Surveys were conducted via phone, the internet, or email between December 2021 and August 2022. Participants' perceptions of medication and communication safety and perceived usefulness, ease of use, attitude toward use, and intention to use a technology system to report their medication safety events from home were assessed as outcomes. Potential personal, clinical, and psychosocial factors were analyzed for their associations with participants' technology acceptance through bivariate correlation analyses and multiple logistic regressions. RESULTS Participants reported strong perceptions of medication and communication safety, positively correlated with medication self-management ability and patient activation. Although most participants perceived a medication safety self-reporting system as useful (158/204, 77.5%) and easy to use (157/204, 77%), had a positive attitude toward use (162/204, 79.4%), and were willing to use such a system (129/204, 63.2%), their technology acceptance was associated with their activation levels (odds ratio [OR] 1.83, 95% CI 1.12-2.98), their perceptions of communication safety (OR 1.64, 95% CI 1.08-2.47), and whether they could receive feedback after self-reporting (OR 3.27, 95% CI 1.37-7.78). CONCLUSIONS In general, oncology patients were willing to use digital technologies to report their medication events after care transitions back home because of their high concerns regarding medication safety. As informed and activated patients are more likely to have the knowledge and capability to initiate and engage in self-reporting, developing a patient-centered reporting system to empower patients and their families and facilitate safety health communications will help oncology patients in addressing their medication safety concerns, meeting their care needs, and holding promise to improve the quality of cancer care.
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Affiliation(s)
- Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States
| | - Misun Hwang
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Youmin Cho
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Christopher R Friese
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Sarah T Hawley
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, United States
| | | | - John C Krauss
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Yang Gong
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Moreira AG, Husain A, Knake LA, Aziz K, Simek K, Valadie CT, Pandillapalli NR, Trivino V, Barry JS. A clinical informatics approach to bronchopulmonary dysplasia: current barriers and future possibilities. Front Pediatr 2024; 12:1221863. [PMID: 38410770 PMCID: PMC10894945 DOI: 10.3389/fped.2024.1221863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
Bronchopulmonary dysplasia (BPD) is a complex, multifactorial lung disease affecting preterm neonates that can result in long-term pulmonary and non-pulmonary complications. Current therapies mainly focus on symptom management after the development of BPD, indicating a need for innovative approaches to predict and identify neonates who would benefit most from targeted or earlier interventions. Clinical informatics, a subfield of biomedical informatics, is transforming healthcare by integrating computational methods with patient data to improve patient outcomes. The application of clinical informatics to develop and enhance clinical therapies for BPD presents opportunities by leveraging electronic health record data, applying machine learning algorithms, and implementing clinical decision support systems. This review highlights the current barriers and the future potential of clinical informatics in identifying clinically relevant BPD phenotypes and developing clinical decision support tools to improve the management of extremely preterm neonates developing or with established BPD. However, the full potential of clinical informatics in advancing our understanding of BPD with the goal of improving patient outcomes cannot be achieved unless we address current challenges such as data collection, storage, privacy, and inherent data bias.
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Affiliation(s)
- Alvaro G Moreira
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Ameena Husain
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Lindsey A Knake
- Department of Pediatrics, University of Iowa, Iowa City, IA, United States
| | - Khyzer Aziz
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, United States
| | - Kelsey Simek
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Charles T Valadie
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX, United States
| | | | - Vanessa Trivino
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX, United States
| | - James S Barry
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
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Yu J, Shen N, Conway S, Hiebert M, Lai-Zhao B, McCann M, Mehta RR, Miranda M, Putterman C, Santisteban JA, Thomson N, Young C, Chiuccariello L, Hunter K, Hill S. A holistic approach to integrating patient, family, and lived experience voices in the development of the BrainHealth Databank: a digital learning health system to enable artificial intelligence in the clinic. FRONTIERS IN HEALTH SERVICES 2023; 3:1198195. [PMID: 37927443 PMCID: PMC10625404 DOI: 10.3389/frhs.2023.1198195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023]
Abstract
Artificial intelligence, machine learning, and digital health innovations have tremendous potential to advance patient-centred, data-driven mental healthcare. To enable the clinical application of such innovations, the Krembil Centre for Neuroinformatics at the Centre for Addiction and Mental Health, Canada's largest mental health hospital, embarked on a journey to co-create a digital learning health system called the BrainHealth Databank (BHDB). Working with clinicians, scientists, and administrators alongside patients, families, and persons with lived experience (PFLE), this hospital-wide team has adopted a systems approach that integrates clinical and research data and practices to improve care and accelerate research. PFLE engagement was intentional and initiated at the conception stage of the BHDB to help ensure the initiative would achieve its goal of understanding the community's needs while improving patient care and experience. The BHDB team implemented an evolving, dynamic strategy to support continuous and active PFLE engagement in all aspects of the BHDB that has and will continue to impact patients and families directly. We describe PFLE consultation, co-design, and partnership in various BHDB activities and projects. In all three examples, we discuss the factors contributing to successful PFLE engagement, share lessons learned, and highlight areas for growth and improvement. By sharing how the BHDB navigated and fostered PFLE engagement, we hope to motivate and inspire the health informatics community to collectively chart their paths in PFLE engagement to support advancements in digital health and artificial intelligence.
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Affiliation(s)
- Joanna Yu
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Health and Technology, Vector Institute for Artificial Intelligence, Toronto, ON, Canada
| | - Nelson Shen
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- AMS Healthcare, Toronto, ON, Canada
| | - Susan Conway
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Melissa Hiebert
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Benson Lai-Zhao
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Miriam McCann
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Rohan R. Mehta
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Morena Miranda
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Connie Putterman
- Centre for Addictions and Mental Health, Toronto, ON, Canada
- CanChild, Hamilton, ON, Canada
- CHILD-BRIGHT Network, Montreal, QC, Canada
- Kids Brain Health Network, Burnaby, ON, Canada
- Province of Ontario Neurodevelopmental (POND) Network, Toronto, ON, Canada
| | - Jose Arturo Santisteban
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nicole Thomson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Courtney Young
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | | | - Kimberly Hunter
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Sean Hill
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Health and Technology, Vector Institute for Artificial Intelligence, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Ben-Tzur D, Sabovich S, Hutzler Y, Rimon J, Zach S, Epstein M, Vadasz B, Diniz CV, Nabutovsky I, Klempfner R, Eilat-Adar S, Gabizon I, Menachemi DM, Grosman-Rimon L. Advances in Technology Promote Patient-Centered Care in Cardiac Rehabilitation. Cardiol Rev 2023:00045415-990000000-00144. [PMID: 37607080 DOI: 10.1097/crd.0000000000000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Patient-centered health care (PCC) is a framework of clinical care focused on the patient's individual health care needs. In particular, it emphasizes the development of a partnership between the patient, physician, and healthcare workers to actively involve and empower the patient in their health care decisions. Additionally, PCC goals include ensuring access to care, emotional support, engaging patient support systems, physical comfort, and continuity of care. Technology also provides a platform to engage patients and their families in their care and can be a useful tool to gauge their level of interest, knowledge, and motivations to adequately educate them on the many factors that contribute to their disease, including diet, exercise, medication adherence, psychological support, and early symptom detection. In this article, we summarize the importance of technology in promoting PCC in cardiac rehabilitation and the impact technology may have on the different aspects of patient and physician relationships. Modern technological devices including smartphones, tablets, wearables, and other internet-enabled devices have been shown to help patient-staff communication, cater to patients' individual needs, increase access to health care, and implement aspects of PCC domains.
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Affiliation(s)
- Dana Ben-Tzur
- From the The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Solomon Sabovich
- University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Yeshayahu Hutzler
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
| | - Jordan Rimon
- Faculty of Health, York University, Toronto, Ontario, Canada
| | - Sima Zach
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
| | - Maor Epstein
- Department of Cardiology, Soroka Medical Center, Ben-Gurion University, Negev, Beer Sheva, Israel
| | - Brian Vadasz
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago
| | - Camilla V Diniz
- University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Irene Nabutovsky
- Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Israel, Faculty of Medicine, Tel Aviv University, Israel
| | - Robert Klempfner
- Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Israel, Faculty of Medicine, Tel Aviv University, Israel
| | - Sigal Eilat-Adar
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
| | - Itzhak Gabizon
- Department of Cardiology, Soroka Medical Center, Ben-Gurion University, Negev, Beer Sheva, Israel
| | - Doron M Menachemi
- Internal Medicine and Heart Failure Services, Wolfson UMC Holon, Tel-Aviv University, Israel
| | - Liza Grosman-Rimon
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
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Almutairi N, Vlahu-Gjorgievska E, Win KT. Persuasive features for patient engagement through mHealth applications in managing chronic conditions: A systematic literature review and meta-analysis. Inform Health Soc Care 2023; 48:267-291. [PMID: 36650714 DOI: 10.1080/17538157.2023.2165083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Patient engagement is currently considered the cornerstone of a revolution in healthcare for its positive impact on health outcomes, health behaviors and healthcare costs. Patient engagement is focused on personalized care to consumers through providing knowledge, skills and confidence. Mobile health (mHealth) applications are an innovative means to facilitate patient engagement. Nevertheless, the extent to which the current mHealth applications are designed to engage patients in managing their chronic diseases is unclear. This paper aims to identify the Persuasive System Design (PSD) features present in current mHealth applications that increased the engagement of patients with chronic diseases. This review also aims to identify patient engagement-related outcomes of these features. This paper conducted a systematic literature review and meta-analysis to find relevant studies published from all years up to 2020 through six databases: PubMed, Scopus, Web of Science, Cinahl plus with full text, MEDLINE with full text, and Cochrane Library (Central register of controlled trials). The database search returned 4939 articles; after applying the inclusion and exclusion criteria, the number of included articles for the final review was 13. A qualitative content analysis was performed to identify PSD model features and their patient engagement-related outcomes. The quality assessment has been done through the Cochrane Risk of Bias tool for RCTs. The systematic literature review and meta-analysis identified eleven PSD features that can increase patient engagement through using mHealth applications. The identified PSD features have been shown to have various patient engagement-related outcomes. Behavior Change Techniques (BCTs) were combined with the identified PSD features. This paper identified persuasive features of mHealth application design that influence the engagement of patients with chronic diseases toward changing their behavior. The impact of these features is also analyzed in this review. The results show that an mHealth technology-mediated patient engagement model is needed.
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Affiliation(s)
- Nawaf Almutairi
- Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Faculty of Public Health and Health Informatics, University of Hail, Hail, Saudi Arabia
| | - Elena Vlahu-Gjorgievska
- Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Khin Than Win
- Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
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6
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Hyde Z, Roura R, Varanasi K, McGinn T, Evans J, Verschoore B, Yang C, Labrique A, Ricketts EP, Rothman RE, Latkin CA, Hsieh YH. Human-centered design development of mHealth patient-to-peer referral tool in the emergency department. Digit Health 2022; 8:20552076221143238. [PMID: 36544538 PMCID: PMC9761213 DOI: 10.1177/20552076221143238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022] Open
Abstract
Background Given the steady increase of emergency department (ED) visits related to opioid overdoses, this study aims to determine the design and usability of an ED-centered mHealth patient-to-peer referral prototype tool that allows patients to refer peers to comprehensive HIV/HCV and opioid misuse prevention services. Methods Two iterative focus group discussion (FDG) sessions and one use-case session were conducted. Eligible participants who were ≥18 years, had a history of injection drug use (IDU), and had utilized the ED in the past year were recruited through the distribution of flyers at the study institution, including the study ED. Human-centered design process was completed by using participant feedback on perceived utility, usability/accessibility, tool design, and clarity/readability to fine-tune prototype version and drive subsequent discussion sessions. Results Sixteen consented individuals participated in at least one of the sessions. Feedback revealed that participants favored the inclusion of the webpage link on the referral card as means to bypass QR code if needed, more descriptions highlighting the exact services offered, and the fact that no personal information was required to complete the referral process. The prototype underwent several adjustments between user-centered FDG sessions, which ultimately ended in including features such as an online webpage with educational videos, SMS text-message communication system, and QR code usage into the final patient-to-peer referral tool prototype. Conclusion The findings of this study suggest a human-centered designed patient-to-peer referral tool could be a feasible approach to linking community members at risk of IDU to HIV/HCV and opioid use-related preventive services from ED patients.
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Affiliation(s)
- Zak Hyde
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Raúl Roura
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Kesav Varanasi
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Tanner McGinn
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Julie Evans
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Benjamin Verschoore
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Cui Yang
- Department of Health, Behavior and Society,
Johns Hopkins
University Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Alain Labrique
- Department of International Health, Johns Hopkins Bloomberg School
of Public Health, Baltimore, MD, USA
| | - Erin P Ricketts
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA
| | - Carl A Latkin
- Department of Health, Behavior and Society,
Johns Hopkins
University Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, USA,Yu-Hsiang Hsieh, Johns Hopkins University
Department of Emergency Medicine, 5801 Smith Avenue, Suite 3220 Davis Building,
Baltimore, MD 21209, USA.
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Heginbotham L, Baugh G, Lefeber T, Friehling L, Barnhart C, Miller LA, Moore L, Cottrell L. A parent-led, patient-centered medical home model instruction for interprofessional undergraduate and graduate learning opportunities. MEDICAL EDUCATION ONLINE 2022; 27:2012105. [PMID: 34919018 PMCID: PMC8725748 DOI: 10.1080/10872981.2021.2012105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/14/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Despite national efforts to establish patient-centered medical homes (PCMH), 57.3% of children with special health care needs are receiving care that does not meet medical home criteria. Project DOCC, a national curriculum designed by parents of children with disabilities or chronic disease, has shown documented strengths in medical resident learner education of children with special health care needs from the parent perspectives for over a decade. Because of the importance of PCMH and the need to provide compassionate care, our team adapted the curriculum to incorporate team-based learning in the rural setting. MATERIALS AND METHODS Reading materials were distributed to learners prior to an in-person workshop at which time, learners reviewed a video and discussed PCMH materials to identify elements of the PCMH. Learners then engaged with parent mentors across three breakout sessions. A final group reflection was completed to review and discuss efforts providers would take to establish and maintain the PCMH in their own practice. Baseline and post-workshop PCMH perceptions and parent mentor reflections were collected and compared using t-test comparisons. RESULTS Learner knowledge, perceptions, and comfort significantly increased after the workshop. Parent mentor comments also highlighted an increased understanding for the provider. Discussion: The adapted PCMH curriculum significantly impacted learner outcomes using a feasible approach that fit nicely within health professional curricula and limited resources of the rural setting. Parents enjoyed the opportunity to serve as mentors and valued the instruction format.
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Affiliation(s)
- Lori Heginbotham
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
| | - Gina Baugh
- Director of the Wv Office of Interprofessional Education, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Timothy Lefeber
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - Linda Friehling
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - Christy Barnhart
- Nursing Workshop, West Virginia University Adult Health Department
| | - Lee Ann Miller
- West Virginia University, Patient Safety Simulation Center (WV STEPS), Morgantown, WV, USA
| | - Lucas Moore
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
| | - Lesley Cottrell
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
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8
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Knaub RJ, Evans J, Yang C, Roura R, McGinn T, Verschoore B, Ricketts EP, Rothman RE, Latkin CA, Hsieh YH. A pilot study of a mixed-method approach to design an ED-based peer mHealth referral tool for HIV/HCV and opioid overdose prevention services. Drug Alcohol Depend 2022; 238:109585. [PMID: 35926299 PMCID: PMC9620482 DOI: 10.1016/j.drugalcdep.2022.109585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The intersecting epidemics of opioid misuse, injection drug use, and HIV/HCV have resulted in record overdose deaths and sustained high levels of HIV/HCV transmissions. Literature on social networks suggests opportunities to connect people who use drugs (PWUD) and their peers to HIV/HCV and opioid overdose prevention services. However, little evidence exists on how to design such peer referral interventions in emergency department (ED) settings. METHODS A mixed-method study was conducted to assess the feasibility of an mHealth-facilitated 'patient to peer social network referral program' for PWUD. In-depth interviews (IDIs) and quantitative surveys were conducted with urban ED patients (n = 15), along with 3 focus group discussions (FGDs) (n = 19). RESULTS Overall, 34 participants were enrolled (71 % males, 53 % Black). 13/15 IDI participants reported a history of opioid overdose; all had witnessed overdose events; all received HIV/HCV testing. From survey responses, most would invite their peers for HIV/HCV testing and naloxone training; and anticipated peers to accept referrals (HIV: 60 %, HCV: 73 %, naloxone: 93 %). Qualitative data showed PWUD shared health-related information with each other but preferred word of mouth rather than text messages. Participants used smartphones regularly and suggested using Internet advertising for prevention services. Participants expressed enthusiasm for ED-based peer mHealth referral platform to prevention services, as well as referring their peers to proposed services, with monetary incentives. CONCLUSION ED-based peer referral intervention to HIV/HCV testing and naloxone training was viewed favorably by PWUD. Frequent smartphone use among PWUD suggests that the medium could be a promising mode for peer referral.
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Affiliation(s)
- Ross J. Knaub
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Julie Evans
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, U.S.A
| | - Raúl Roura
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Tanner McGinn
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Benjamin Verschoore
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Erin P. Ricketts
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Richard E. Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Carl A. Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, U.S.A
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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9
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Jacobsohn GC, Leaf M, Liao F, Maru AP, Engstrom CJ, Salwei ME, Pankratz GT, Eastman A, Carayon P, Wiegmann DA, Galang JS, Smith MA, Shah MN, Patterson BW. Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments. HEALTHCARE (AMSTERDAM, NETHERLANDS) 2022; 10:100598. [PMID: 34923354 PMCID: PMC8881336 DOI: 10.1016/j.hjdsi.2021.100598] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 11/04/2022]
Abstract
Of the 3 million older adults seeking fall-related emergency care each year, nearly one-third visited the Emergency Department (ED) in the previous 6 months. ED providers have a great opportunity to refer patients for fall prevention services at these initial visits, but lack feasible tools for identifying those at highest-risk. Existing fall screening tools have been poorly adopted due to ED staff/provider burden and lack of workflow integration. To address this, we developed an automated clinical decision support (CDS) system for identifying and referring older adult ED patients at risk of future falls. We engaged an interdisciplinary design team (ED providers, health services researchers, information technology/predictive analytics professionals, and outpatient Falls Clinic staff) to collaboratively develop a system that successfully met user requirements and integrated seamlessly into existing ED workflows. Our rapid-cycle development and evaluation process employed a novel combination of human-centered design, implementation science, and patient experience strategies, facilitating simultaneous design of the CDS tool and intervention implementation strategies. This included defining system requirements, systematically identifying and resolving usability problems, assessing barriers and facilitators to implementation (e.g., data accessibility, lack of time, high patient volumes, appointment availability) from multiple vantage points, and refining protocols for communicating with referred patients at discharge. ED physician, nurse, and patient stakeholders were also engaged through online surveys and user testing. Successful CDS design and implementation required integration of multiple new technologies and processes into existing workflows, necessitating interdisciplinary collaboration from the onset. By using this iterative approach, we were able to design and implement an intervention meeting all project goals. Processes used in this Clinical-IT-Research partnership can be applied to other use cases involving automated risk-stratification, CDS development, and EHR-facilitated care coordination.
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Affiliation(s)
- Gwen Costa Jacobsohn
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
| | - Margaret Leaf
- Applied Data Science, Enterprise Analytics, UW Health, Madison, WI, USA.
| | - Frank Liao
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Applied Data Science, Enterprise Analytics, UW Health, Madison, WI, USA.
| | - Apoorva P. Maru
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Collin J. Engstrom
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA,Department of Computer Science, Winona State University, Rochester, MN, USA
| | - Megan E. Salwei
- Department of Industrial and Systems Engineering, University of Wisconsin, Madison, Wisconsin, USA,Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin, USA,Center for Research and Innovation in Systems Safety, Departments of Anesthesiology and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gerald T Pankratz
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Alexis Eastman
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Pascale Carayon
- Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI, USA; Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, WI, USA.
| | - Douglas A. Wiegmann
- Department of Industrial and Systems Engineering, University of Wisconsin, Madison, Wisconsin, USA,Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Joel S. Galang
- Applied Data Science, Enterprise Analytics, UW Health, Madison, Wisconsin, USA
| | - Maureen A. Smith
- Health Innovation Program, University of Wisconsin-Madison, Madison, Wisconsin, USA,Department of Population Health Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Manish N. Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA,Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA,Department of Population Health Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Brian W. Patterson
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA,Health Innovation Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
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10
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Shen N, Kassam I, Chen S, Ma C, Wang W, Boparai N, Jankowicz D, Strudwick G. Canadian perspectives of digital mental health supports: Findings from a national survey conducted during the COVID-19 pandemic. Digit Health 2022; 8:20552076221102253. [PMID: 35646379 PMCID: PMC9131389 DOI: 10.1177/20552076221102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives The impact of the COVID-19 pandemic on population mental health has highlighted the potential for digital mental health to support the needs of those requiring care. This study sought to understand the digital mental health experiences and priorities of Canadians affected by mental health conditions (i.e. seekers, patients, and care partners). Methods A national cross-sectional electronic survey of Canadians was administered through a market research firm's survey panel. Seekers, patients, and care partners were asked about their digital mental health experiences (e.g. uptake, barriers to access) and priorities. Survey responses were summarized using descriptive statistics. Results Overall, 1003 participants completed the survey. 70.2% of participants routinely use digital mental health supports to support themselves or those they care for; however, only 28.6% of participants are satisfied with the available digital mental health supports. Most participants (73.3%) have encountered some barriers when accessing digital mental health supports. Awareness of digital mental health supports was a top barrier identified by participants. The top digital mental health priorities consisted of digital mental health curation, navigation, and a digital mental health passport. Conclusions Most participants use digital mental health supports for themselves or others, however, many are unaware of digital mental health supports available. Efforts to improve navigating access to digital and in-person mental health services are seen as a top priority, highlighting the need to enable seekers, patients, and care partners to find the appropriate support and make decisions on how to best improve their mental health.
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Affiliation(s)
- Nelson Shen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Iman Kassam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Clement Ma
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Navi Boparai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Damian Jankowicz
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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11
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Rajamani G, Rodriguez Espinosa P, Rosas LG. Intersection of Health Informatics Tools and Community Engagement in Health-Related Research to Reduce Health Inequities: Scoping Review. J Particip Med 2021; 13:e30062. [PMID: 34797214 PMCID: PMC8663666 DOI: 10.2196/30062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/29/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background The exponential growth of health information technology has the potential to facilitate community engagement in research. However, little is known about the use of health information technology in community-engaged research, such as which types of health information technology are used, which populations are engaged, and what are the research outcomes. Objective The objectives of this scoping review were to examine studies that used health information technology for community engagement and to assess (1) the types of populations, (2) community engagement strategies, (3) types of health information technology tools, and (4) outcomes of interest. Methods We searched PubMed and PCORI Literature Explorer using terms related to health information technology, health informatics, community engagement, and stakeholder involvement. This search process yielded 967 papers for screening. After inclusion and exclusion criteria were applied, a total of 37 papers were analyzed for key themes and for approaches relevant to health information technology and community engagement research. Results This analysis revealed that the communities engaged were generally underrepresented populations in health-related research, including racial or ethnic minority communities such as Black/African American, American Indian/Alaska Native, Latino ethnicity, and communities from low socioeconomic backgrounds. The studies focused on various age groups, ranging from preschoolers to older adults. The studies were also geographically spread across the United States and the world. Community engagement strategies included collaborative development of health information technology tools and partnerships to promote use (encompassing collaborative development, use of community advisory boards, and focus groups for eliciting information needs) and use of health information technology to engage communities in research (eg, through citizen science). The types of technology varied across studies, with mobile or tablet-based apps being the most common platform. Outcomes measured included eliciting user needs and requirements, assessing health information technology tools and prototypes with participants, measuring knowledge, and advocating for community change. Conclusions This study illustrates the current landscape at the intersection of health information technology tools and community-engaged research approaches. It highlights studies in which various community-engaged research approaches were used to design culturally centered health information technology tools, to promote health information technology uptake, or for engagement in health research and advocacy. Our findings can serve as a platform for generating future research upon which to expand the scope of health information technology tools and their use for meaningful stakeholder engagement. Studies that incorporate community context and needs have a greater chance of cocreating culturally centered health information technology tools and better knowledge to promote action and improve health outcomes.
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Affiliation(s)
- Geetanjali Rajamani
- Department of Human Biology, Stanford University, Stanford, CA, United States
| | - Patricia Rodriguez Espinosa
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, CA, United States
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, CA, United States
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12
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Shen N, Jankowicz D, Strudwick G. Patient and Family Engagement Approaches for Digital Health Initiatives: Protocol for a Case Study. JMIR Res Protoc 2021; 10:e24274. [PMID: 34287212 PMCID: PMC8339977 DOI: 10.2196/24274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/31/2021] [Accepted: 05/13/2021] [Indexed: 01/04/2023] Open
Abstract
Background Digital health initiatives such as patient portals, virtual care platforms, and smartphone-based apps are being implemented at a rapid pace in health care organizations worldwide. This is often done to improve access beyond traditional in-person care and enhance care quality. Recent studies have indicated that better outcomes of using these initiatives and technologies may be achieved when patients and their family members are engaged in all aspects of planning, implementation, use, and evaluation. However, little guidance exists for how health care administrators can achieve effective engagement in digital health initiatives specifically. Objective The objective of this study is to document processes related to planning and implementing patient and family engagement (PFE) in digital health initiatives. This information will be used to develop tangible resources (eg, a field guide) that other organizations can use to implement PFE approaches for digital health initiatives in their organizations. Methods A previously developed multidimensional conceptual framework for PFE in health and health care contexts will be used to guide this work. To understand the intricacies involved in using PFE approaches in digital health strategies, a case study will be conducted. More specifically, this work will employ an embedded single-case design with PFE in digital health initiatives at a large Canadian mental health and addictions teaching hospital. Multiple digital health projects being undertaken at the study site will be explored to better understand where the PFE is intended to support the design, implementation, and operation of the digital health platform or technology. These projects will form the individual units of analysis. Data collection will involve field notes and artifact collection by a participant observer and interviews with the various digital health project teams. Data analysis will include a content and thematic analysis, triangulation of the findings, and a chronological mapping of data to a PFE process. Results Funding for this work was provided by the Canadian Institutes of Health Research (CIHR), via a Health System Impact Fellowship. As of August 2020, digital health projects that will form the case study units have been identified, and the participant observer has started to embed themselves into these projects. Although the development and collection of field notes and artifacts, respectively, have begun, interviews have not been conducted. The study is expected to conclude in September 2021. Once this study is complete, the development of a field guide and resources to support the uptake of PFE strategies in digital health will begin. Conclusions By better understanding the processes involved in PFE in digital health projects, guidance can be provided to relevant stakeholders and organizations about how to do this work in an effective manner. It is then anticipated that with the increasing use of PFE approaches, there may be improved uptake, experience, and outcomes associated with using digital health technologies. International Registered Report Identifier (IRRID) PRR1-10.2196/24274
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Affiliation(s)
- Nelson Shen
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Gillian Strudwick
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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13
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Sheikh A, Anderson M, Albala S, Casadei B, Franklin BD, Richards M, Taylor D, Tibble H, Mossialos E. Health information technology and digital innovation for national learning health and care systems. Lancet Digit Health 2021; 3:e383-e396. [PMID: 33967002 DOI: 10.1016/s2589-7500(21)00005-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/24/2020] [Accepted: 01/04/2021] [Indexed: 01/01/2023]
Abstract
Health information technology can support the development of national learning health and care systems, which can be defined as health and care systems that continuously use data-enabled infrastructure to support policy and planning, public health, and personalisation of care. The COVID-19 pandemic has offered an opportunity to assess how well equipped the UK is to leverage health information technology and apply the principles of a national learning health and care system in response to a major public health shock. With the experience acquired during the pandemic, each country within the UK should now re-evaluate their digital health and care strategies. After leaving the EU, UK countries now need to decide to what extent they wish to engage with European efforts to promote interoperability between electronic health records. Major priorities for strengthening health information technology in the UK include achieving the optimal balance between top-down and bottom-up implementation, improving usability and interoperability, developing capacity for handling, processing, and analysing data, addressing privacy and security concerns, and encouraging digital inclusivity. Current and future opportunities include integrating electronic health records across health and care providers, investing in health data science research, generating real-world data, developing artificial intelligence and robotics, and facilitating public-private partnerships. Many ethical challenges and unintended consequences of implementation of health information technology exist. To address these, there is a need to develop regulatory frameworks for the development, management, and procurement of artificial intelligence and health information technology systems, create public-private partnerships, and ethically and safely apply artificial intelligence in the National Health Service.
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Affiliation(s)
- Aziz Sheikh
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
| | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Sarah Albala
- UCL Institute for Innovation and Public Purpose, University College London, London, UK
| | - Barbara Casadei
- Radcliffe Department of Medicine, BHF Centre for Research Excellence, NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Bryony Dean Franklin
- UCL School of Pharmacy, University College London, London, UK; NIHR Imperial Patient Safety Translational Research Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Mike Richards
- Department of Health Policy, London School of Economics and Political Science, London, UK; The Health Foundation, London, UK
| | - David Taylor
- UCL School of Pharmacy, University College London, London, UK
| | - Holly Tibble
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, UK; Institute of Global Health Innovation, Imperial College London, London, UK
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14
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Giannouchos TV, Ferdinand AO, Ilangovan G, Ragan E, Nowell WB, Kum HC, Schmit CD. Identifying and prioritizing benefits and risks of using privacy-enhancing software through participatory design: a nominal group technique study with patients living with chronic conditions. J Am Med Inform Assoc 2021; 28:1746-1755. [PMID: 34010404 DOI: 10.1093/jamia/ocab073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE While patients often contribute data for research, they want researchers to protect their data. As part of a participatory design of privacy-enhancing software, this study explored patients' perceptions of privacy protection in research using their healthcare data. MATERIALS AND METHODS We conducted 4 focus groups with 27 patients on privacy-enhancing software using the nominal group technique. We provided participants with an open source software prototype to demonstrate privacy-enhancing features and elicit privacy concerns. Participants generated ideas on benefits, risks, and needed additional information. Following a thematic analysis of the results, we deployed an online questionnaire to identify consensus across all 4 groups. Participants were asked to rank-order benefits and risks. Themes around "needed additional information" were rated by perceived importance on a 5-point Likert scale. RESULTS Participants considered "allowance for minimum disclosure" and "comprehensive privacy protection that is not currently available" as the most important benefits when using the privacy-enhancing prototype software. The most concerning perceived risks were "additional checks needed beyond the software to ensure privacy protection" and the "potential of misuse by authorized users." Participants indicated a desire for additional information with 6 of the 11 themes receiving a median participant rating of "very necessary" and rated "information on the data custodian" as "essential." CONCLUSIONS Patients recognize not only the benefits of privacy-enhancing software, but also inherent risks. Patients desire information about how their data are used and protected. Effective patient engagement, communication, and transparency in research may improve patients' comfort levels, alleviate patients' concerns, and thus promote ethical research.
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Affiliation(s)
- Theodoros V Giannouchos
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA.,Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Alva O Ferdinand
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA.,Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Gurudev Ilangovan
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Eric Ragan
- Department of Computer and Information Science and Engineering, University of Florida, Gainesville, Florida, USA
| | - W Benjamin Nowell
- Patient-Centered Research, Global Healthy Living Foundation, Upper Nyack, New York, USA
| | - Hye-Chung Kum
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA.,Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Cason D Schmit
- Population Informatics Lab, School of Public Health, Texas A&M University, College Station, Texas, USA.,Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA
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15
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Beswick DM, Saavedra MT. Stakeholder feedback informs investigations for chronic rhinosinusitis in cystic fibrosis. Int Forum Allergy Rhinol 2020; 11:79-80. [PMID: 32996261 DOI: 10.1002/alr.22705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Daniel M Beswick
- Department of Otolaryngology, University of Colorado, Aurora, CO.,Division of Specialty Services, National Jewish Health, Denver, CO
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16
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Lo B, Zhang T, Leung K, Mehta R, Kuziemsky C, Booth RG, Chyjek A, Rossetti SC, McLean D, Borycki E, McLay D, Noble J, Carter S, Strudwick G. Identifying best approaches for engaging patients and family members in health informatics initiatives: a case study of the Group Priority Sort technique. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:25. [PMID: 32477591 PMCID: PMC7236324 DOI: 10.1186/s40900-020-00203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Patient engagement strategies in health service delivery have become more common in recent years. However, many healthcare organizations are challenged in identifying the best methods to engage patients in health information technology (IT) initiatives. Engaging with important stakeholders to identify effective opportunities can inform the development of a resource that addresses this issue and supports organizations in their endeavors. The purpose of this paper is to share our experience and lessons learned from applying a novel consensus-building technique in order to identify key elements for effective patient engagement in health IT initiatives. This will be done through a case study approach. METHODS Patients, family members of patients, health professionals, researchers, students, vendor representatives and individuals who work in health IT roles in health organizations were engaged through a one-day symposium in Toronto, Canada in September, 2018. During the symposium, the Group Priority Sort technique was used to obtain structured feedback from symposium attendees in the context of small group discussions. Descriptive statistics and a content analysis were undertaken to analyze the data collected through the Group Priority Sort as well as participant feedback following the symposium. RESULTS A total of 37 participants attended the symposium from a variety of settings and organizations. Using the Group Priority Sort technique, 30 topics were classified by priority to be included in a future resource. Participant feedback pertaining to the symposium and research methods was largely positive. Several areas of improvement, such as clarity of items, were identified from this case study. CONCLUSIONS The Group Priority Sort technique was an efficient method for obtaining valuable suggestions from a diverse group of stakeholders, including patients and family members. The specific priorities and feedback obtained from the symposium will be incorporated into a resource for healthcare organizations to aid them in engaging patients in health IT initiatives. Additionally, five important considerations were identified when conducting future work with the Group Priority Sort technique and are outlined in this paper.
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Affiliation(s)
- Brian Lo
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, M6J 1H4 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 1P8 ON Canada
| | - Timothy Zhang
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, M6J 1H4 ON Canada
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, N2L 3G1 ON Canada
| | - Kevin Leung
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, M6J 1H4 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 1P8 ON Canada
| | - Rohan Mehta
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, M6J 1H4 ON Canada
| | - Craig Kuziemsky
- Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, K1N 6N5 ON Canada
| | - Richard G. Booth
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond Street, London, N6A 3K7 ON Canada
| | - Anna Chyjek
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, M6J 1H4 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 1P8 ON Canada
| | - Sarah Collins Rossetti
- Department of Biomedical Informatics and School of Nursing, Columbia University, 622 W. 168th Street, Presbyterian Building 20th Floor, New York, 10032 NY USA
| | - Drew McLean
- McMaster University, 1280 Main Street West, Hamilton, L8S 4L8 ON Canada
| | - Elizabeth Borycki
- School of Health Information Science, University of Victoria, Human & Social Development Building A202, 3800 Finnerty Road (Ring Road), Victoria, V8P 5C2 BC Canada
| | - David McLay
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 1P8 ON Canada
| | - Justin Noble
- Canada Health Infoway, 150 King Street West Suite 1300, Toronto, M5H 1J9 ON Canada
| | - Shawn Carter
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon Street West, Whitby, L1N 5S9 ON Canada
| | - Gillian Strudwick
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, M6J 1H4 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 1P8 ON Canada
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17
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Ross EL, Jamison RN, Nicholls L, Perry BM, Nolen KD. Clinical Integration of a Smartphone App for Patients With Chronic Pain: Retrospective Analysis of Predictors of Benefits and Patient Engagement Between Clinic Visits. J Med Internet Res 2020; 22:e16939. [PMID: 32297871 PMCID: PMC7193441 DOI: 10.2196/16939] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/15/2020] [Accepted: 01/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background Although many pain-related smartphone apps exist, little attention has been given to understanding how these apps are used over time and what factors contribute to greater compliance and patient engagement. Objective This retrospective analysis was designed to help identify factors that predicted the benefits and future use of a smartphone pain app among patients with chronic pain. Methods An app designed for both Android and iOS devices was developed by Brigham and Women’s Hospital Pain Management Center (BWH-PMC) for users with chronic pain to assess and monitor pain and communicate with their providers. The pain app offered chronic pain assessment, push notification reminders and communication, personalized goal setting, relaxation sound files, topics of interest with psychological and medical pain management strategies, and line graphs from daily assessments. BWH-PMC recruited 253 patients with chronic pain over time to use the pain app. All subjects completed baseline measures and were asked to record their progress every day using push notification daily assessments. After 3 months, participants completed follow-up questionnaires and answered satisfaction questions. We defined the number of completed daily assessments as a measure of patient engagement with the pain app. Results The average age of participants was 51.5 years (SD 13.7, range 18-92), 72.8% (182/253) were female, and 36.8% (78/212) reported the low back as their primary pain site. The number of daily assessments ranged from 1 to 426 (average 62.0, SD 49.9). The app was easy to introduce among patients, and it was well accepted. Those who completed more daily assessments (greater patient engagement) throughout the study were more likely to report higher pain intensity, more activity interference, and greater disability and were generally overweight compared with others. Patients with higher engagement with the app rated the app as offering greater benefit in coping with their pain and expressed more willingness to use the app in the future (P<.05) compared with patients showing lower engagement. Patients completing a small number of daily assessments reported less pain intensity, less daily activity interference, and less pain-related disability on average and were less likely to use the two-way messaging than those who were more engaged with the pain app (P<.05). Conclusions Patients with chronic pain who appeared to manage their pain better were less likely to report benefits of a smartphone pain app designed for chronic pain management. They demonstrated lower patient engagement in reporting their daily progress, in part, owing to the perceived burden of regularly using an app without a perceived benefit. An intrinsically different pain app designed and targeted for individuals based on early identification of user characteristics and adapted for each individual would likely improve compliance and app-related patient engagement.
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Affiliation(s)
- Edgar L Ross
- Brigham and Women's Hospital, Department of Anesthesiology, Pain Management Center, Chestnut Hill, MA, United States
| | - Robert N Jamison
- Brigham and Women's Hospital, Harvard Medical School, Pain Management Center, Chestnut Hill, MA, United States
| | | | | | - Kim D Nolen
- Pfizer, Inc, New York City, NY, United States
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