Role of Technology in Self-Assessment and Feedback Among Hospitalist Physicians: Semistructured Interviews and Thematic Analysis

Using eHealth Data to Inform CPD for Medical Practitioners: A Scoping Review with a Consultation Exercise with International Experts

INTRODUCTION

eHealth data analytics is widely used in health care research. However, there is limited knowledge on the role of eHealth data analysis to inform continuing professional development (CPD). The aim of this study was to collate available research evidence on the use of eHealth data for the development of CPD programs and plans for medical practitioners.

METHODS

A scoping review was conducted using the six-stage Arksey and O'Malley Framework. A consultation exercise (stage 6) was performed with 15 international experts in the fields of learning and practice analytics to deepen the insights.

RESULTS

Scoping review. The literature searches identified 9876 articles published from January 2010 to May 2022. After screening and full-text review, a total of nine articles were deemed relevant for inclusion. The results provide varied-and at times partial or diverging-answers to the scoping review research questions. Consultation exercise. Research rigor, field of investigation, and developing the field were the three themes emerged from analysis. Participants validated the scoping review methodology and confirmed its results. Moreover, they provided a meta-analysis of the literature, a description of the current CPD ecosystem, and clear indications of what is and should be next for the field.

DISCUSSION

This study shows that there is no formal or well-established correlation between eHealth data and CPD planning and programming. Overall findings fill a gap in the literature and provide a basis for further investigation. More foundational work, multidisciplinary collaborations, and stakeholders' engagement are necessary to advance the use of eHealth data analysis for CPD purposes.

Applications of Medical Digital Technologies for Noncommunicable Diseases for Follow-Up during the COVID-19 Pandemic

BACKGROUND

Noncommunicable chronic diseases (NCDs) are multifaceted, and the health implications of the COVID-19 pandemic are far-reaching, especially for NCDs. Physical distancing and quarantine can lead to the poor management of NCDs because the visual tracking of them has been replaced with medical digital technology, that is, smartphone apps. This study aimed to explore medical digital technology applications for NCDs for follow-up during the COVID-19 pandemic.

METHODS

The participants in this study were 400 adult patients with NCDs; they were selected by systematic random sampling. A descriptive cross-sectional design was used. The study was conducted in the outpatient department of Yanbu General Hospital and primary-care health centers in Yanbu Al-Baher, Al-Madinah Al-Munawwarah, in the Kingdom of Saudi Arabia. The tools used in this study were a structured questionnaire to collect the sociodemographic characteristics of the patients and their health history, an NCD questionnaire to assess follow-up of the patients during the COVID-19 pandemic, and a medical digital technologies questionnaire to explore the medical digital technology applications.

RESULTS

The mean age of the patients was 47.32 ± 14.362 years, and 62.8% of them were female and 372 were male. Of the patients, 69.2% and 57.5% had been diagnosed with diabetes mellitus and hypertension, respectively; 52.4% were followed up monthly, and 29.75% used medical digital technology applications such as Tabeby Online to monitor their health. Furthermore, 71.75% and 75.5% of the patients used the Sehhaty and Tawakkalna medical digital applications, respectively. Overall, 38.7% of the patients were satisfied with using medical digital technology applications used for follow-up during the COVID-19 pandemic.

CONCLUSIONS

The study concluded that the services that use networks, smartphones, and medical digital technology applications on the Saudi Ministry of Health website and mobile applications to improve the quality of the health-care system, and that provide health services for noncommunicable or communicable diseases, are not effective. This is because the patients lack awareness of these services, with most of the chronic patients being elderly with lower levels of education and computer literacy.

Measuring and Quantifying Collateral Information in Psychiatry: Development and Preliminary Validation of the McLean Collateral Information and Clinical Actionability Scale

BACKGROUND

The review of collateral information is an essential component of patient care. Although this is standard practice, minimal research has been done to quantify collateral information collection and to understand how collateral information translates to clinical decision making. To address this, we developed and piloted a novel measure (the McLean Collateral Information and Clinical Actionability Scale [M-CICAS]) to evaluate the types and number of collateral sources viewed and the resulting actions made in a psychiatric setting.

OBJECTIVE

This study aims to test the feasibility of the M-CICAS, validate this measure against clinician notes via medical records, and evaluate whether reviewing a higher volume of collateral sources is associated with more clinical actions taken.

METHODS

For the M-CICAS, we developed a three-part instrument, focusing on measuring collateral sources reviewed, clinical actions taken, and shared decision making between the clinician and patient. To determine feasibility and preliminary validity, we piloted this measure among clinicians providing psychotherapy at McLean Hospital. These clinicians (n=7) completed the M-CICAS after individual clinical sessions with 89 distinct patient encounters. Scales were completed by clinicians only once for each patient during routine follow-up visits. After clinicians completed these scales, researchers conducted chart reviews by completing the M-CICAS using only the clinician's corresponding note from that session. For the analyses, we generated summary scores for the number of collateral sources and clinical actions for each encounter. We examined Pearson correlation coefficients to assess interrater reliability between clinicians and chart reviewers, and simple univariate regression modeling followed by multilevel mixed effects regression modeling to test the relationship between collateral information accessed and clinical actions taken.

RESULTS

The study staff had high interrater reliability on the M-CICAS for the sources reviewed (r=0.98; P<.001) and actions taken (r=0.97; P<.001). Clinician and study staff ratings were moderately correlated and statistically significant on the M-CICAS summary scores for the sources viewed (r=0.24, P=.02 and r=0.25, P=.02, respectively). Univariate regression modeling with a two-tailed test demonstrated a significant association between collateral sources and clinical actions taken when clinicians completed the M-CICAS (β=.27; t₈₇=2.47; P=.02). The multilevel fixed slopes random intercepts model confirmed a significant association even when accounting for clinician differences (β=.23; t₅₇=2.13; P=.04).

CONCLUSIONS

This pilot study established the feasibility and preliminary validity of the M-CICAS in assessing collateral sources and clinical decision making in psychiatry. This study also indicated that reviewing more collateral sources may lead to an increased number of clinical actions following a session.