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Goldhaber NH, Jacobs MB, Laurent LC, Knight R, Zhu W, Pham D, Tran A, Patel SP, Hogarth M, Longhurst CA. Integrating clinical research into electronic health record workflows to support a learning health system. JAMIA Open 2024; 7:ooae023. [PMID: 38751411 PMCID: PMC11095974 DOI: 10.1093/jamiaopen/ooae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/30/2023] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
Objective Integrating clinical research into routine clinical care workflows within electronic health record systems (EHRs) can be challenging, expensive, and labor-intensive. This case study presents a large-scale clinical research project conducted entirely within a commercial EHR during the COVID-19 pandemic. Case Report The UCSD and UCSDH COVID-19 NeutraliZing Antibody Project (ZAP) aimed to evaluate antibody levels to SARS-CoV-2 virus in a large population at an academic medical center and examine the association between antibody levels and subsequent infection diagnosis. Results The project rapidly and successfully enrolled and consented over 2000 participants, integrating the research trial with standing COVID-19 testing operations, staff, lab, and mobile applications. EHR-integration increased enrollment, ease of scheduling, survey distribution, and return of research results at a low cost by utilizing existing resources. Conclusion The case study highlights the potential benefits of EHR-integrated clinical research, expanding their reach across multiple health systems and facilitating rapid learning during a global health crisis.
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Affiliation(s)
- Nicole H Goldhaber
- Department of Surgery, University of California San Diego Health, La Jolla, CA 92037, United States
| | - Marni B Jacobs
- Department of Obstetrics, Gynecology and Reproductive Services, University of California San Diego Health, La Jolla, CA 92037, United States
| | - Louise C Laurent
- Department of Obstetrics, Gynecology and Reproductive Services, University of California San Diego Health, La Jolla, CA 92037, United States
| | - Rob Knight
- Department of Pediatrics, University of California San Diego Health, La Jolla, CA 92037, United States
- Department of Computer Science and Engineering, Center for Microbiome Innovation, University of California San Diego, La Jolla, CA 92037, United States
- Department of Bioengineering, Center for Microbiome Innovation, University of California San Diego, La Jolla, CA 92037, United States
| | - Wenhong Zhu
- Information Services, University of California San Diego Health, La Jolla, CA 92037, United States
| | - Dean Pham
- Information Services, University of California San Diego Health, La Jolla, CA 92037, United States
| | - Allen Tran
- Information Services, University of California San Diego Health, La Jolla, CA 92037, United States
| | - Sandip P Patel
- Division of Oncology, Department of Medicine, University of San Diego Health, La Jolla, CA 92037, United States
| | - Michael Hogarth
- Division of Biomedical Informatics, Department of Medicine, University of San Diego Health, La Jolla, CA 92037, United States
| | - Christopher A Longhurst
- Department of Pediatrics, University of California San Diego Health, La Jolla, CA 92037, United States
- Division of Biomedical Informatics, Department of Medicine, University of San Diego Health, La Jolla, CA 92037, United States
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Xiao Y, Fulda KG, Young RA, Hendrix ZN, Daniel KM, Chen KY, Zhou Y, Roye JL, Kosmari L, Wilson J, Espinoza AM, Sutcliffe KM, Pitts SI, Arbaje AI, Chui MA, Blair S, Sloan D, Jackson M, Gurses AP. Patient Partnership Tools to Support Medication Safety in Community-Dwelling Older Adults: Protocol for a Nonrandomized Stepped Wedge Clinical Trial. JMIR Res Protoc 2024; 13:e57878. [PMID: 38684080 PMCID: PMC11091807 DOI: 10.2196/57878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Preventable harms from medications are significant threats to patient safety in community settings, especially among ambulatory older adults on multiple prescription medications. Patients may partner with primary care professionals by taking on active roles in decisions, learning the basics of medication self-management, and working with community resources. OBJECTIVE This study aims to assess the impact of a set of patient partnership tools that redesign primary care encounters to encourage and empower patients to make more effective use of those encounters to improve medication safety. METHODS The study is a nonrandomized, cross-sectional stepped wedge cluster-controlled trial with 1 private family medicine clinic and 2 public safety-net primary care clinics each composing their own cluster. There are 2 intervention sequences with 1 cluster per sequence and 1 control sequence with 1 cluster. Cross-sectional surveys will be taken immediately at the conclusion of visits to the clinics during 6 time periods of 6 weeks each, with a transition period of no data collection during intervention implementation. The number of visits to be surveyed will vary by period and cluster. We plan to recruit patients and professionals for surveys during 405 visits. In the experimental periods, visits will be conducted with two partnership tools and associated clinic process changes: (1) a 1-page visit preparation guide given to relevant patients by clinic staff before seeing the provider, with the intention to improve communication and shared decision-making, and (2) a library of short educational videos that clinic staff encourage patients to watch on medication safety. In the control periods, visits will be conducted with usual care. The primary outcome will be patients' self-efficacy in medication use. The secondary outcomes are medication-related issues such as duplicate therapies identified by primary care providers and assessment of collaborative work during visits. RESULTS The study was funded in September 2019. Data collection started in April 2023 and ended in December 2023. Data was collected for 405 primary care encounters during that period. As of February 15, 2024, initial descriptive statistics were calculated. Full data analysis is expected to be completed and published in the summer of 2024. CONCLUSIONS This study will assess the impact of patient partnership tools and associated process changes in primary care on medication use self-efficacy and medication-related issues. The study is powered to identify types of patients who may benefit most from patient engagement tools in primary care visits. TRIAL REGISTRATION ClinicalTrials.gov NCT05880368; https://clinicaltrials.gov/study/NCT05880368. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57878.
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Affiliation(s)
- Yan Xiao
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
- College of Engineering, University of Texas at Arlington, Arlington, TX, United States
| | - Kimberley G Fulda
- Department of Family Medicine and Osteopathic Manipulative Medicine and North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Richard A Young
- Family Medicine Residency Program, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Z Noah Hendrix
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Kathryn M Daniel
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Kay Yut Chen
- College of Business, University of Texas at Arlington, Arlington, TX, United States
| | - Yuan Zhou
- College of Engineering, University of Texas at Arlington, Arlington, TX, United States
| | - Jennifer L Roye
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Ludmila Kosmari
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Joshua Wilson
- College of Liberal Arts, University of Texas at Arlington, Arlington, TX, United States
| | - Anna M Espinoza
- Department of Family Medicine and Osteopathic Manipulative Medicine and North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Kathleen M Sutcliffe
- Carey Business School, Johns Hopkins University, Baltimore, MD, United States
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Samantha I Pitts
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Alicia I Arbaje
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Michelle A Chui
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Somer Blair
- Office of Clinical Research, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Dawn Sloan
- Family Medicine Residency Program, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Masheika Jackson
- Family Medicine Residency Program, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Ayse P Gurses
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
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3
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Stults CD, Mazor KM, Cheung M, Ruo B, Li M, Walker A, Saphirak C, Vaida F, Singh S, Fisher KA, Rosen R, Yood R, Garber L, Longhurst C, Kallenberg G, Yu E, Chan A, Millen M, Tai-Seale M. Patients' Perspectives on Plans Generated During Primary Care Visits and Self-Reported Adherence at 3 Months: Data From a Randomized Trial. J Particip Med 2024; 16:e50242. [PMID: 38483458 PMCID: PMC10979329 DOI: 10.2196/50242] [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: 08/15/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Effective primary care necessitates follow-up actions by the patient beyond the visit. Prior research suggests room for improvement in patient adherence. OBJECTIVE This study sought to understand patients' views on their primary care visits, the plans generated therein, and their self-reported adherence after 3 months. METHODS As part of a large multisite cluster randomized pragmatic trial in 3 health care organizations, patients completed 2 surveys-the first within 7 days after the index primary care visit and another 3 months later. For this analysis of secondary outcomes, we combined the results across all study participants to understand patient adherence to care plans. We recorded patient characteristics and survey responses. Cross-tabulation and chi-square statistics were used to examine bivariate associations, adjusting for multiple comparisons when appropriate. We used multivariable logistic regression to assess how patients' intention to follow, agreement, and understanding of their plans impacted their plan adherence, allowing for differences in individual characteristics. Qualitative content analysis was conducted to characterize the patient's self-reported plans and reasons for adhering (or not) to the plan 3 months later. RESULTS Of 2555 patients, most selected the top box option (9=definitely agree) that they felt they had a clear plan (n=2011, 78%), agreed with the plan (n=2049, 80%), and intended to follow the plan (n=2108, 83%) discussed with their provider at the primary care visit. The most common elements of the plans reported included reference to exercise (n=359, 14.1%), testing (laboratory, imaging, etc; n=328, 12.8%), diet (n=296, 11.6%), and initiation or adjustment of medications; (n=284, 11.1%). Patients who strongly agreed that they had a clear plan, agreed with the plan, and intended to follow the plan were all more likely to report plan completion 3 months later (P<.001) than those providing less positive ratings. Patients who reported plans related to following up with the primary care provider (P=.008) to initiate or adjust medications (P≤.001) and to have a specialist visit were more likely to report that they had completely followed the plan (P=.003). Adjusting for demographic variables, patients who indicated intent to follow their plan were more likely to follow-through 3 months later (P<.001). Patients' reasons for completely following the plan were mainly that the plan was clear (n=1114, 69.5%), consistent with what mattered (n=1060, 66.1%), and they were determined to carry through with the plan (n=887, 53.3%). The most common reasons for not following the plan were lack of time (n=217, 22.8%), having decided to try a different approach (n=105, 11%), and the COVID-19 pandemic impacted the plan (n=105, 11%). CONCLUSIONS Patients' initial assessment of their plan as clear, their agreement with the plan, and their initial willingness to follow the plan were all strongly related to their self-reported completion of the plan 3 months later. Patients whose plans involved lifestyle changes were less likely to report that they had "completely" followed their plan. TRIAL REGISTRATION ClinicalTrials.gov NCT03385512; https://clinicaltrials.gov/study/NCT03385512. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/30431.
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Affiliation(s)
- Cheryl D Stults
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, United States
| | - Kathleen M Mazor
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Michael Cheung
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Bernice Ruo
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Martina Li
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, United States
| | - Amanda Walker
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
| | - Cassandra Saphirak
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Florin Vaida
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Sonal Singh
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Kimberly A Fisher
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Rebecca Rosen
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
| | - Robert Yood
- Research Department, Reliant Medical Group, Worcester, MA, United States
| | - Lawrence Garber
- Research Department, Reliant Medical Group, Worcester, MA, United States
| | - Christopher Longhurst
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Gene Kallenberg
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
| | - Edward Yu
- Department of Family Medicine, Palo Alto Medical Foundation, Sutter Health, Mountain View, CA, United States
| | - Albert Chan
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, United States
- Digital Team, Sutter Health, Sacramento, CA, United States
- Department of Medicine, Division of Biomedical Informatics Research, Stanford University, Stanford, CA, United States
| | - Marlene Millen
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Ming Tai-Seale
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States
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Powell DS, Wu MMJ, Nothelle S, Gleason K, Oh E, Lum HD, Reed NS, Wolff JL. The Annual Wellness Visit Health Risk Assessment: Potential of Patient Portal-Based Completion and Patient-Oriented Education and Support. Innov Aging 2024; 8:igae023. [PMID: 38618518 PMCID: PMC11010311 DOI: 10.1093/geroni/igae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Indexed: 04/16/2024] Open
Abstract
Background and Objectives Patient portals are secure online platforms that allow patients to perform electronic health management tasks and engage in bidirectional information exchange with their care team. Some health systems administer Medicare Annual Wellness Visit (AWV) health risk assessments through the patient portal. Scalable opportunities from portal-based administration of risk assessments are not well understood. Our objective is 2-fold-to understand who receives vs misses an AWV and health risk assessment and explore who might be missed with portal-based administration. Research Design and Methods This is an observational study of electronic medical record and patient portal data (10/03/2021-10/02/2022) for 12 756 primary care patients 66+ years from a large academic health system. Results Two-thirds (n = 8420) of older primary care patients incurred an AWV; 81.0% of whom were active portal users. Older adults who were active portal users were more likely to incur AWV than those who were not, though portal use was high in both groups (81.0% with AWV vs 76.8% without; p < .001). Frequently affirmative health risk assessment categories included falls/balance concerns (44.2%), lack of a documented advanced directive (42.3%), sedentary behaviors (39.9%), and incontinence (35.1%). Mean number of portal messages over the 12-month observation period varied from 7.2 among older adults affirmative responses to concerns about safety at home to 13.8 for older adults who reported difficulty completing activities of daily living. Portal messaging varied more than 2-fold across affirmative health risk categories and were marginally higher with greater number affirmative (mean = 13.8 messages/year no risks; 19.6 messages/year 10+ risks). Discussion and Implications Most older adults were active portal users-a group more likely to have incurred a billed AWV. Efforts to integrate AWV risk assessments in the patient portal may streamline administration and scalability for dissemination of tailored electronically mediated preventive care but must attend to equity issues.
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Affiliation(s)
- Danielle S Powell
- Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland, USA
| | - Mingche M J Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stephanie Nothelle
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kelly Gleason
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Esther Oh
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hillary D Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer L Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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5
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Bevilacqua KG, Tuchler AM, Carvajal DN. Provider perspectives on a point-of-care tool to facilitate patient-centered contraceptive care among Latina/x patients in Baltimore, MD. PEC INNOVATION 2023; 3:100190. [PMID: 37502428 PMCID: PMC10368902 DOI: 10.1016/j.pecinn.2023.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/12/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023]
Abstract
Objectives To explore clinician perspectives on the development, utility, and feasibility of a provider-facing point-of-care tool to assist in provision of patient-centered contraceptive care for Latina/x patients in Baltimore, MD. Methods We conducted 25 semi-structured qualitative interviews with a sample of clinicians who provide contraceptive care to Latina/x patients. An interview guide was developed based on prior research related to patient-centered care and extant point-of-care tools. Transcripts were independently coded by two study team members and analyzed using a directed content analysis approach. Results Four themes emerged from the data: (1) clinician perception of a need for a tool to facilitate patient-centered contraceptive care, (2) concern for tool burden and burnout, (3) desire for tool ease of use, and (4) a need for cultural awareness during tool development to avoid bias and typecasting. Conclusions A provider-facing, point-of-care tool to facilitate patient-centered contraceptive counseling was acceptable among providers, provided the tool is easy to use and promotes cultural awareness. Innovation In the current era of more limited reproductive choice across the U.S., the need and support for non-coercive, patient-centered contraceptive care is timely. A provider-facing, point-of-care tool can facilitate the provision of patient-centered care among clinicians proving contraceptive counseling to Latina/s.
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Affiliation(s)
- Kristin G. Bevilacqua
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Diana N. Carvajal
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, USA
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6
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Yin M, Zhang W, Evans R, Zhu C, Wang L, Song J. Violence on the front line: a qualitative comparative analysis of the causes of patient violence towards medical staff in China during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2023:1-21. [PMID: 37359625 PMCID: PMC9979127 DOI: 10.1007/s12144-023-04456-w] [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] [Accepted: 02/22/2023] [Indexed: 03/06/2023]
Abstract
COVID-19, reduced funding and a shortage of healthcare workers has led to growing international concern about patient violence towards medical staff in medical settings. As the number of reported physical and verbal assaults increases, many medical staff are considering leaving their positions due to the resulting impact on their mental and physical wellbeing, creating a critical need to understand the causes for violence towards medical staff working on the front line. This study aims to examine the causes for patient violence towards medical staff in China during the COVID-19 pandemic. A case library was created containing twenty reported incidents of patient violence towards medical staff during the pandemic in China. Based on the Triadic Reciprocal Determinism (TRD) theory, we identify the personal, environmental, and behavioral factors, that cause incidents of violence towards medical staff. The outcome was set as 'Medical Staff Casualties', referring to whether, due to the violence experienced, the medical staff member was injured or died, or only experienced threatening or insulting behavior. Data was analyzed using Qualitative Comparative Analysis (QCA) to clarify the relationship between the different conditions and their relationship with the outcome. The study's results reveal that Relationship Closeness is a necessary condition for patient violence in the presence of outcome. Secondly, four distinct types of causes for patient violence towards medical staff were identified: Strong Relationship Oriented Violence, Healthcare Resources and Services Mismatched Violence, Violence caused by Ineffective Patient-Physician Communication, and Ineffective Communication Superimposed Low Patient Compliance Violence. Scientific guidance is provided for the creation of measures to prevent future violence towards medical staff from occurring. Strict precautions should be taken for preventing violence to protect a healthy society and harmonious medical environment, emphasizing the need for joint governance of multiple participants.
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Affiliation(s)
- Mengmeng Yin
- School of Medicine and Health Management, Huazhong University of Science and Technology, 13# Hangkong Road, Qiaokou District, Wuhan, China
| | - Wei Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, 13# Hangkong Road, Qiaokou District, Wuhan, China
| | - Richard Evans
- Faculty of Computer Science, Dalhousie University, 6050 University Avenue, PO BOX 15000, B3H 4R2 Halifax, NS Canada
| | - Chengyan Zhu
- School of Political Science and Public Administration, Wuhan University, 299# Bayi Road, Wuchang District, Wuhan, Hubei Province China
| | - Longwen Wang
- School of International Studies, Sichuan University, 24# South Section 1, Yihuan Road, Chengdu, Sichuan China
| | - Jun Song
- Xiangyang Hospital of Traditional Chinese Medicine, 24 # Changzheng Road, Xiangyang, Hubei China
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7
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Giovannoni G, Alvarez E, Tutton E, Hoffmann O, Xu Y, Vermersch P, Oreja-Guevara C, Trojano M, Gold R, Robles-Cedeño R, Khwaja M, Stadler B, Vandercappellen J, Ziemssen T. Development and usability testing of your MS questionnaire: A patient-based digital tool to monitor symptoms of multiple sclerosis. Digit Health 2023; 9:20552076231173531. [PMID: 37205165 PMCID: PMC10185975 DOI: 10.1177/20552076231173531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 04/14/2023] [Indexed: 05/21/2023] Open
Abstract
Objectives We describe the development of Your Multiple Sclerosis Questionnaire and present the real-world usability testing results of Your Multiple Sclerosis Questionnaire. Methods The Your Multiple Sclerosis Questionnaire tool was developed in four stages to collect feedback from people living with MS (plwMS), patient organizations, and clinicians on content, format, and applicability. To assess its usability, 13 clinicians across 7 countries completed an online survey after using the tool with plwMS in a total of 261 consultations from September, 2020 to July, 2021. Results The initial Your Multiple Sclerosis Questionnaire version was based on findings from previous research developing MSProDiscuss™, a clinician-completed tool. Subsequently, insights from plwMS obtained during cognitive debriefing, patient councils and advisory boards led to changes including the addition of mood and sexual problems and the definition of relapse. All 13 clinicians completed the individual survey, whereas 10 clinicians completed the final survey. Clinicians "strongly agreed" or "agreed" that Your Multiple Sclerosis Questionnaire was easy to use and understand (98.5%; 257/261 patient consultations). The clinicians were willing to use the tool again with the same patient (98.1%; 256/261 patient consultations). All clinicians who completed the final survey (100%; 10/10) reported the tool to have a positive influence on their clinical practice, helped patients engage with their MS, facilitated discussion with patients, and complemented neurological assessment. Conclusion Your Multiple Sclerosis Questionnaire benefits both plwMS and clinicians by facilitating a structured discussion and engaging the plwMS to self-monitor and self-manage. Your Multiple Sclerosis Questionnaire is compatible with telemedicine practice and integration of the tool into electronic health records would enable tracking of the disease evolution and individual monitoring of MS symptoms over time.
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Affiliation(s)
- Gavin Giovannoni
- Blizard Institute, Barts and The London
School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | - Olaf Hoffmann
- Department of Neurology, Alexianer St
Josefs Hospital, Potsdam, Germany
- Brandenburg Medical School Theodor
Fontane, Neuruppin, Germany
| | - Yan Xu
- Multiple Sclerosis Center, Department
of Neurology, Peking Union Medical College Hospital, Peking Union Medical College,
Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Patrick Vermersch
- University of Lille, Inserm UMR U1172
LilNCog, CHU Lille, FHU Precise, Lille, France
| | | | - Maria Trojano
- Department of Basic Medical Science,
Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Ralf Gold
- Department of Neurology, St
Josef-Hospital/Ruhr-University Bochum, Bochum, Germany
| | | | | | | | | | - Tjalf Ziemssen
- Center of Clinical Neuroscience,
Department of Neurology, Carl Gustav Carus University Clinic, Technische Universität
Dresden, Dresden, Germany
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8
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Lewis MA, Bustillo D. Patient Perspective: Importance and How to Elicit. Med Clin North Am 2022; 106:569-576. [PMID: 35725224 DOI: 10.1016/j.mcna.2022.01.013] [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] [Indexed: 10/18/2022]
Abstract
The authors present models for patient care, reflecting on its modernization. A review of technology including electronic health records is provided, noting its benefits and constraints on the patient-clinician relationship. Keeping in mind the fact that patients are the "end users" of health care systems, several approaches to improving patient experience are shared.
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Affiliation(s)
- Mark A Lewis
- Intermountain Healthcare, 5171 S. Cottonwood Street, Building 1, Suite. 610, Murray, UT 84107, USA.
| | - David Bustillo
- University of California Irvine School of Medicine, 1001 Health Sciences Road, Irvine, CA 92697, USA
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