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Misra, S., MB Hargreaves, and JM Blundy. "PHP28 PATIENT SATISFACTION—PATIENT EDUCATION INTERFACE." Value in Health 7, no. 3 (May 2004): 375. http://dx.doi.org/10.1016/s1098-3015(10)62546-6.
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Grossman, Lisa, Steven Feiner, Elliot Mitchell, and Ruth Masterson Creber. "Leveraging Patient-Reported Outcomes Using Data Visualization." Applied Clinical Informatics 09, no. 03 (July 2018): 565–75. http://dx.doi.org/10.1055/s-0038-1667041.
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Background Health care organizations increasingly use patient-reported outcomes (PROs) to capture patients' health status. Although federal policy mandates PRO collection, the challenge remains to better engage patients in PRO surveys, and ensure patients comprehend the surveys and their results. Objective This article identifies the design requirements for an interface that assists patients with PRO survey completion and interpretation, and then builds and evaluates the interface. Methods We employed a user-centered design process that consisted of three stages. First, we conducted qualitative interviews and surveys with 13 patients and 11 health care providers to understand their perceptions of the value and challenges associated with the use of PRO measures. Second, we used the results to identify design requirements for an interface that collects PROs, and designed the interface. Third, we conducted usability testing with 12 additional patients in a hospital setting. Results In interviews, patients and providers reported that PRO surveys help patients to reflect on their symptoms, potentially identifying new opportunities for improved care. However, 6 out of 13 patients reported significant difficultly in understanding PRO survey questions, answer choices and results. Therefore, we identified aiding comprehension as a key design requirement, and incorporated visualizations into our interface design to aid comprehension. In usability testing, patients found the interface highly usable. Conclusion Future interfaces designed to collect PROs may benefit from employing strategies such as visualization to aid comprehension and engage patients with surveys.
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Narus, S. P., S. M. Huff, T. A. Pryor, P. J. Haug, T. Larkin, S. Matney, R. S. Evans, et al. "Building a Comprehensive Clinical Information System from Components." Methods of Information in Medicine 42, no. 01 (2003): 01–07. http://dx.doi.org/10.1055/s-0038-1634203.
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Summary Objectives: To discuss the advantages and disadvantages of an interfaced approach to clinical information systems architecture. Methods: After many years of internally building almost all components of a hospital clinical information system (HELP) at Intermountain Health Care, we changed our architectural approach as we chose to encompass ambulatory as well as acute care. We now seek to interface applications from a variety of sources (including some that we build ourselves) to a clinical data repository that contains a longitudinal electronic patient record. Results: We have a total of 820 instances of interfaces to 51 different applications. We process nearly 2 million transactions per day via our interface engine and feel that the reliability of the approach is acceptable. Interface costs constitute about four percent of our total information systems budget. The clinical database currently contains records for 1.45 m patients and the response time for a query is 0.19sec. Discussion: Based upon our experience with both integrated (monolithic) and interfaced approaches, we conclude that for those with the expertise and resources to do so, the interfaced approach offers an attractive alternative to systems provided by a single vendor. We expect the advantages of this approach to increase as the costs of interfaces are reduced in the future as standards for vocabulary and messaging become increasingly mature and functional.
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Shingole, Nishant, Vinit Patil, Omkar Prabhu, and Aniket Pawar. "Patient Profile & Health Consulting Application." International Journal for Research in Applied Science and Engineering Technology 11, no. 4 (April 30, 2023): 4080–84. http://dx.doi.org/10.22214/ijraset.2023.51193.
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Abstract: The Patient Profile and Health Consulting application is a mobile health tool developed using Android Studio. The application allows patients to create and manage their health profiles, including personal information, medical history, medications, allergies, and vital signs. Additionally, patients can use the application to consult with healthcare professionals remotely. The application's user interface is intuitive and easy to navigate, allowing patients to input and update their health information quickly. The app features secure logins and data encryption to ensure patient privacy and confidentiality. The health consulting feature allows patients to connect with healthcare professionals, including doctors, nurses, and other medical staff, through booking an appointment. Patients can use this feature to ask questions about their health conditions, receive medical advice, and request prescription refills. The application also includes medication reminders and an appointment scheduler to help patients manage their medications and medical appointments efficiently. Furthermore, the app provides personalized health recommendations and resources to help patients maintain a healthy lifestyle. In conclusion, the Patient Profile and Health Consulting application is a comprehensive mobile health tool designed to empower patients to take control of their health. The application's user-friendly interface and remote consulting feature make it a valuable resource for patients seeking convenient and accessible healthcare services
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Alpert, Jordan M., Naga S. Prabhakar Kota, Sanjay Ranka, Tonatiuh V. Mendoza, Laurence M. Solberg, Parisa Rashidi, and Todd M. Manini. "A Simulated Graphical Interface for Integrating Patient-Generated Health Data From Smartwatches With Electronic Health Records: Usability Study." JMIR Human Factors 7, no. 4 (October 30, 2020): e19769. http://dx.doi.org/10.2196/19769.
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Background Wearable technology, such as smartwatches, can capture valuable patient-generated data and help inform patient care. Electronic health records provide logical and practical platforms for including such data, but it is necessary to evaluate the way the data are presented and visualized. Objective The aim of this study is to evaluate a graphical interface that displays patients’ health data from smartwatches, mimicking the integration within the environment of electronic health records. Methods A total of 12 health care professionals evaluated a simulated interface using a usability scale questionnaire, testing the clarity of the interface, colors, usefulness of information, navigation, and readability of text. Results The interface was positively received, with 14 out of the 16 questions generating a score of 5 or greater among at least 75% of participants (9/12). On an 8-point Likert scale, the highest rated features of the interface were quick turnaround times (mean score 7.1), readability of the text (mean score 6.8), and use of terminology/abbreviations (mean score 6.75). Conclusions Collaborating with health care professionals to develop and refine a graphical interface for visualizing patients’ health data from smartwatches revealed that the key elements of the interface were acceptable. The implementation of such data from smartwatches and other mobile devices within electronic health records should consider the opinions of key stakeholders as the development of this platform progresses.
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Gonzalez-Vargas, Jessica M., Courtney Cole, Sandeep Krishnakumar, Kathleen Shatinsky, Everett Hills, and Elizabeth Starkey. "Innovating Walking Speed as a Vital Sign: An Interface Development and Usability Study." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 66, no. 1 (September 2022): 2300–2304. http://dx.doi.org/10.1177/1071181322661555.
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Measuring walking speed is becoming a more useful tool for assessing overall patient health along with the other five vital signs: temperature, blood pressure, pulse, respiratory rate, and pain. Clinicians consider walking speed to be the “sixth vital sign”. Standardization in measuring walking speed remains elusive and current methods may lead to inconsistent and inaccurate results. This study focused on testing an interface prototype that provides the user with a record-based platform for analyzing walking speed. Two usability studies were conducted with two separate iterations of interfaces. This paper focuses on the second interface, which was a refined version of the first interface. Data obtained through usability metrics and verbal protocol analyses (VPAs) was analyzed. Results from this study provided suggestions for improving the second interface’s ease of use and overall task interaction. Future work will address improving the interface prototype and converting it to a fully-programmed version.
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Karni, Liran, Ilir Jusufi, Dag Nyholm, Gunnar Oskar Klein, and Mevludin Memedi. "Toward Improved Treatment and Empowerment of Individuals With Parkinson Disease: Design and Evaluation of an Internet of Things System." JMIR Formative Research 6, no. 6 (June 9, 2022): e31485. http://dx.doi.org/10.2196/31485.
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Background Parkinson disease (PD) is a chronic degenerative disorder that causes progressive neurological deterioration with profound effects on the affected individual’s quality of life. Therefore, there is an urgent need to improve patient empowerment and clinical decision support in PD care. Home-based disease monitoring is an emerging information technology with the potential to transform the care of patients with chronic illnesses. Its acceptance and role in PD care need to be elucidated both among patients and caregivers. Objective Our main objective was to develop a novel home-based monitoring system (named EMPARK) with patient and clinician interface to improve patient empowerment and clinical care in PD. Methods We used elements of design science research and user-centered design for requirement elicitation and subsequent information and communications technology (ICT) development. Functionalities of the interfaces were the subject of user-centric multistep evaluation complemented by semantic analysis of the recorded end-user reactions. The ICT structure of EMPARK was evaluated using the ICT for patient empowerment model. Results Software and hardware system architecture for the collection and calculation of relevant parameters of disease management via home monitoring were established. Here, we describe the patient interface and the functional characteristics and evaluation of a novel clinician interface. In accordance with our previous findings with regard to the patient interface, our current results indicate an overall high utility and user acceptance of the clinician interface. Special characteristics of EMPARK in key areas of interest emerged from end-user evaluations, with clear potential for future system development and deployment in daily clinical practice. Evaluation through the principles of ICT for patient empowerment model, along with prior findings from patient interface evaluation, suggests that EMPARK has the potential to empower patients with PD. Conclusions The EMPARK system is a novel home monitoring system for providing patients with PD and the care team with feedback on longitudinal disease activities. User-centric development and evaluation of the system indicated high user acceptance and usability. The EMPARK infrastructure would empower patients and could be used for future applications in daily care and research.
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Sittig, Dean F., Adam Wright, Enrico Coiera, Farah Magrabi, Raj Ratwani, David W. Bates, and Hardeep Singh. "Current challenges in health information technology–related patient safety." Health Informatics Journal 26, no. 1 (December 11, 2018): 181–89. http://dx.doi.org/10.1177/1460458218814893.
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We identify and describe nine key, short-term, challenges to help healthcare organizations, health information technology developers, researchers, policymakers, and funders focus their efforts on health information technology–related patient safety. Categorized according to the stage of the health information technology lifecycle where they appear, these challenges relate to (1) developing models, methods, and tools to enable risk assessment; (2) developing standard user interface design features and functions; (3) ensuring the safety of software in an interfaced, network-enabled clinical environment; (4) implementing a method for unambiguous patient identification (1–4 Design and Development stage); (5) developing and implementing decision support which improves safety; (6) identifying practices to safely manage information technology system transitions (5 and 6 Implementation and Use stage); (7) developing real-time methods to enable automated surveillance and monitoring of system performance and safety; (8) establishing the cultural and legal framework/safe harbor to allow sharing information about hazards and adverse events; and (9) developing models and methods for consumers/patients to improve health information technology safety (7–9 Monitoring, Evaluation, and Optimization stage). These challenges represent key “to-do’s” that must be completed before we can expect to have safe, reliable, and efficient health information technology–based systems required to care for patients.
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Khosla, Vivek, Phil Davison, Harvey Gordon, and Verghese Joseph. "The interface between general and forensic psychiatry: the present day." Advances in Psychiatric Treatment 20, no. 5 (September 2014): 359–65. http://dx.doi.org/10.1192/apt.bp.109.007336.
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SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.
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Sullivan, Clair, Andrew Staib, Rob Eley, Alan Scanlon, Judy Flores, and Ian Scott. "National Emergency Access Targets metrics of the emergency department–inpatient interface: measures of patient flow and mortality for emergency admissions to hospital." Australian Health Review 39, no. 5 (2015): 533. http://dx.doi.org/10.1071/ah14162.
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Background Movement of emergency patients across the emergency department (ED)–inpatient ward interface influences compliance with National Emergency Access Targets (NEAT). Uncertainty exists as to how best measure patient flow, NEAT compliance and patient mortality across this interface. Objective To compare the association of NEAT with new and traditional markers of patient flow across the ED–inpatient interface and to investigate new markers of mortality and NEAT compliance across this interface. Methods Retrospective study of consecutive emergency admissions to a tertiary hospital (January 2012 to June 2014) using routinely collected hospital data. The practical access number for emergency (PANE) and inpatient cubicles in emergency (ICE) are new measures reflecting boarding of inpatients in ED; traditional markers were hospital bed occupancy and ED attendance numbers. The Hospital Standardised Mortality Ratio (HSMR) for patients admitted via ED (eHSMR) was correlated with inpatient NEAT compliance rates. Linear regression analyses assessed for statistically significant associations (expressed as Pearson R coefficient) between all measures and inpatient NEAT compliance rates. Results PANE and ICE were inversely related to inpatient NEAT compliance rates (r = 0.698 and 0.734 respectively, P < 0.003 for both); no significant relation was seen with traditional patient flow markers. Inpatient NEAT compliance rates were inversely related to both eHSMR (r = 0.914, P = 0.0006) and all-patient HSMR (r = 0.943, P = 0.0001). Conclusions Traditional markers of patient flow do not correlate with inpatient NEAT compliance in contrast to two new markers of inpatient boarding in ED (PANE and ICE). Standardised mortality rates for both emergency and all patients show a strong inverse relation with inpatient NEAT compliance. What is known about the topic? Impaired flow of emergency admissions across the interface between ED and inpatient wards retards achievement of NEAT-compliance rates and adversely affects patient outcomes. Uncertainty exists as to which measures of patient flow and mortality outcomes correlate closely with NEAT-compliance rates for patients admitted from emergency departments. What does this paper add? This study investigates the utility of two new markers of patient flow from ED to inpatient wards. The Practical Access Number for Emergency (PANE) is the number of patients in ED who have had their episode of ED care completed and are awaiting an inpatient bed at a particular point in time. The Inpatient Cubicles in Emergency (ICE) represents the theoretical number of ED cubicles blocked by boarding patients over a specified time interval (in this study 5 weekdays, Monday–Friday), based on the mean time boarders spent in ED during that interval. Both measures were shown to be significantly inversely related to inpatient NEAT compliance rates (i.e. as PANE and ICE increased, NEAT compliance decreased). In contrast, no relation was seen with traditional markers of patient flow (i.e. hospital bed occupancy and ED attendance numbers). HSMR for both all patients and emergency patients only demonstrated a strong inverse relation with inpatient NEAT compliance. What are the implications for practitioners? When pursuing higher NEAT compliance rates, traditional markers of patient flow across the ED–inpatient interface may be misleading and adversely impact bed-management strategies and patient safety. Identifying when hospitals may be at risk of developing, or already in, a state of reduced access to emergency care may be performed more accurately using new flow markers such as PANE and ICE. The inverse relationship between inpatient NEAT compliance and HSMR, whether calculated for all patients or for emergency patients only, underscores the dependence of inpatient mortality on the swift flow of large volumes of emergency admissions across the ED–inpatient interface. This flow may be compromised by imposing additional demands on a limited number of commissionable beds by way of increasing ED demand and/or use of more beds for elective admissions.
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Soong, John Tshon Yit, Derek Bell, and Marcus Eng Hock Ong. "Meeting today’s healthcare needs: Medicine at the interface." Annals of the Academy of Medicine, Singapore 51, no. 12 (December 27, 2022): 787–92. http://dx.doi.org/10.47102/annals-acadmedsg.2022196.
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The demographic of Singapore has undergone dramatic change. Historically, younger patients with communicable diseases predominated, whereas patients are now older with chronic multimorbidity and functional impairment. This shift challenges existing health and social care systems in Singapore, which must pivot to meet the changing need. The consequences of mismatched health and social care to patient needs are the fragmentation of care, dysfunctional acute care utilisation and increasing care costs. In Singapore and internationally, there is an inexorable rise in acute care utilisation, with patients facing the greatest point of vulnerability at transitions between acute and chronic care. Recently, innovative care models have developed to work across the boundaries of traditional care interfaces. These “Interface Medicine” models aim to provide a comprehensive and integrated approach to meet the healthcare needs of today and optimise value with our finite resources. These models include Acute Medical Units, Ambulatory Emergency Care, Extensivist-Comprehensivist Care, Virtual Wards, Hospital-at-Home and Acute Frailty Units. We describe these models of care across the acute care chain and explore how they may apply to the Singapore setting. We discuss how these models have evolved, appraise the evidence for clinical effectiveness, point out gaps in knowledge for further study and make recommendations for future progress. Keywords: Frailty, health services research, integrated care, interface medicine, public health
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Doyle, Sarah, Rebecca Pavlos, Samantha J. Carlson, Katherine Barton, Mejbah Bhuiyan, Bernadett Boeing, Meredith L. Borland, Steven Hoober, and Christopher C. Blyth. "Efficacy of Digital Health Tools for a Pediatric Patient Registry: Semistructured Interviews and Interface Usability Testing With Parents and Clinicians." JMIR Formative Research 6, no. 1 (January 17, 2022): e29889. http://dx.doi.org/10.2196/29889.
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Background Acute respiratory infection (ARI) in childhood is common, but more knowledge on the burden and natural history of ARI in the community is required. A better understanding of ARI risk factors, treatment, and outcomes will help support parents to manage their sick child at home. Digital health tools are becoming more widely adopted in clinical care and research and may assist in understanding and managing common pediatric diseases, including ARI, in hospitals and in the community. We integrated 2 digital tools—a web-based discharge communication system and the REDCap (Research Electronic Data Capture) platform—into the Pragmatic Adaptive Trial for Acute Respiratory Infection in Children to enhance parent and physician engagement around ARI discharge communication and our patient registry. Objective The objective of this study is to determine the efficacy and usability of digital tools integrated into a pediatric patient registry for ARI. Methods Semistructured interviews and software interface usability testing were conducted with 11 parents and 8 emergency department physicians working at a tertiary pediatric hospital and research center in Perth, Western Australia, in 2019. Questions focused on experiences of discharge communication and clinical trial engagement. Responses were analyzed using the qualitative Framework Method. Participants were directly observed using digital interfaces as they attempted predetermined tasks that were then classified as success, failure, software failure, or not observed. Participants rated the interfaces using the System Usability Scale (SUS). Results Most parents (9/11, 82%) indicated that they usually received verbal discharge advice, with some (5/11, 45%) recalling receiving preprinted resources from their physician. Most (8/11, 73%) would also like to receive discharge advice electronically. Most of the physicians (7/8, 88%) described their usual practice as verbal discharge instructions, with some (3/8, 38%) reporting time pressures associated with providing discharge instructions. The digital technology option was preferred for engaging in research by most parents (8/11, 73%). For the discharge communication digital tool, parents gave a mean SUS score of 94/100 (SD 4.3; A grade) for the mobile interface and physicians gave a mean usability score of 93/100 (SD 4.7; A grade) for the desktop interface. For the research data management tool (REDCap), parents gave a mean usability score of 78/100 (SD 11.0; C grade) for the mobile interface. Conclusions Semistructured interviews allowed us to better understand parent and physician experiences of discharge communication and clinical research engagement. Software interface usability testing methods and use of the SUS helped us gauge the efficacy of our digital tools with both parent and physician users. This study demonstrates the feasibility of combining qualitative research methods with software industry interface usability testing methods to help determine the efficacy of digital tools in a pediatric clinical research setting.
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Chatterton, Marie, Alison Blenkinsopp, and Kristian Pollock. "Statins and the interface between patient and community pharmacist." International Journal of Pharmacy Practice 14, no. 4 (December 2006): 255–62. http://dx.doi.org/10.1211/ijpp.14.4.0005.
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Girtsou, Christina, Pantelis Stergiannis, Theoharis Konstantinidis, and Georgios Martinis. "The Personal Electronic Health Folder and the usefulness of electronic systems to improve health services." Hellenic Journal of Nursing Science 13, no. 4 (December 31, 2020): 19–25. http://dx.doi.org/10.24283/hjns.202042.
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Continuity in patient healthcare shows significant gaps and variations, due to reduced communication between healthcare services. The information transfer to all stages of health structures is often inadequate with many variations, especially at the critical stage after discharge from the hospital, in which patients are usually more vulnerable. The major problem of the lack of interconnection between healthcare services occurs mainly among the elderly, the chronically ill and those who take a lot medication. The main effects of this problem are medication side effects, treatment overlap, poor quality of healthcare and financial costs. Enhancing communication, through the electronic interface and the use of the Personal Electronic Health Folder (P.E.H.F.), which will include the individual details of each patient and information about his clinical status, is aiming at the use of best practices for patient recovery by healthcare providers. The thorough literature review, the strategic analysis PESTEL and the control process, pointed out the need to use the P.E.H.F., to achieve substantial improvements in the quality of patient healthcare. With the practical use of P.E.H.F., the healthcare of all patients will be unquestionably, safe, effective, patient-centered, immediate and fair.
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Alwashmi, Meshari F., Beverly Fitzpatrick, Erin Davis, Jamie Farrell, John-Michael Gamble, and John Hawboldt. "Features of a mobile health intervention to manage chronic obstructive pulmonary disease: a qualitative study." Therapeutic Advances in Respiratory Disease 14 (January 2020): 175346662095104. http://dx.doi.org/10.1177/1753466620951044.
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Background: The use of mobile health (mHealth) interventions has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes. Further research is needed to determine which mHealth features are required to potentially enhance COPD self-management. Aim: The aim of this study was to explore the potential features of an mHealth intervention for COPD management with healthcare providers (HCPs) and patients with COPD. It could inform the development and successful implementation of mHealth interventions for COPD management. Methods: This was a qualitative study. We conducted semi-structured individual interviews with HCPs, including nurses, pharmacists and physicians who work directly with patients with COPD. Interviews were also conducted with a diverse sample of patients with COPD. Interview topics included demographics, mHealth usage, the potential use of medical devices and recommendations for features that would enhance an mHealth intervention for COPD management. Results: A total of 40 people, including nurses, physicians and pharmacists, participated. The main recommendations for the proposed mHealth intervention were categorised into two categories: patient interface and HCP interface. The prevalent features suggested for the patient interface include educating patients, collecting baseline data, collecting subjective data, collecting objective data via compatible medical devices, providing a digital action plan, allowing patients to track their progress, enabling family members to access the mHealth intervention, tailoring the features based on the patient’s unique needs, reminding patients about critical management tasks and rewarding patients for their positive behaviours. The most common features of the HCP interface include allowing HCPs to track their patients’ progress, allowing HCPs to communicate with their patients, educating HCPs and rewarding HCPs. Conclusion: This study identifies important potential features so that the most effective, efficient and feasible mHealth intervention can be developed to improve the management of COPD. The reviews of this paper are available via the supplemental material section.
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Thomas, Rhianne, Lawrence Congdon, and Sheva Habel. "Confidentiality at the interface of an adolescent psychotherapy service." BJPsych Open 7, S1 (June 2021): S224—S225. http://dx.doi.org/10.1192/bjo.2021.599.
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AimsAims included to explore how, within a London trust, staff at the interface between patients, relatives and access to services view their understanding of confidentiality, and to determine ways to improve knowledge if needed.BackgroundConfidentiality is essential to the trust and development of clinician-patient relationships. National policies set guidance on how confidential information should be recorded, secured and shared. However, confidentiality breaches are reportedly common within health professions. Working with adolescent patient groups brings additional issues regarding confidentiality. Care-givers who contact services, often desiring containment, may experience a sense of uncertainty when confidentiality policy prevents details being shared about a young person's clinical experience.MethodStakeholders were identified from the multidisciplinary team, with a collaborative rather than ‘top-down’ approach. Administrators in patient-facing roles were surveyed to ascertain current understanding and frequency of involvement in confidentiality issues. Based on feedback, a flowchart prompt was designed, ensuring it reflected best practice. Qualitative and quantitive data were collected before and after a two month implementation period.ResultAll respondents (n = 10) dealt with confidentiality issues at work, with 50% experiencing issues daily. 33% respondents did not feel confident dealing with confidentiality queries at work. The majority (60%) had received confidentiality training, but all respondents thought extra information would be useful. Of possible interventions, 70% supported a flowchart. Following an implementation period, 100% respondents re-surveyed agreed they felt confident dealing with issues related to confidentiality at work. The majority of respondents had used the flowchart and found it useful (83%). Qualitative data gathered suggested rolling-out the project elsewhere.ConclusionA lack of confidence surrounding issues with confidentiality, including information sharing, was identified. This can negatively impact patient engagement and delivery of care. The introduction of the confidentiality flowchart demonstrated improved understanding of, and confidence in, patient confidentiality issues. The small sample size means there are limitations in extrapolating findings to wider contexts. However, it is likely that more confidentiality training and practical information for NHS staff at the interface between patients, clinicians and services would reduce the risk of confidentiality breaches and reinforce positive relationships with services.
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Sanyal, Amit, Sara Mistretta, Morgan Fulton, and Clemens walter Janssen. "Mobile-health tool for timely management of cancer treatment toxicity." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 321. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.321.
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321 Background: Treatment related side effects after chemotherapy are common, with significant toxicities seen in 78.2% to 98.3% of patients allocated to two study arms of a lymphoma trial [1]. While most oncology clinics provide patient education before treatment, onetime delivery of large amounts of information without reiteration of crucial facts results in information gaps, delay in seeking care, culminating in potentially avoidable ED visits and hospitalizations. Technology based symptom monitoring can facilitate early detection of complications, reduce symptom burden and cost of care. Here we update our study [2] of utility of a mobile-health tool for timely management of cancer treatment related toxicities in a community-based oncology practice. Methods: A web-based mobile application consisting of a patient interface, a provider interface and an embedded analytic platform was developed. Patient ‘check-ins’ incorporating a brief introduction and chemotherapy toxicity questionnaires are delivered through automated text or email. Toxicity questionnaires are based on the NCI-PRO-CTCAE ITEMS-ENGLISH form builder. The provider interface incorporates a ‘patient records summary’ page and a ‘tracker’ page, allowing the oncology care team to monitor responses in real-time. Responses exceeding pre-specified thresholds generate a color-coded ‘flag’ and are marked for follow up. Flags result in a phone call followed by in-person evaluation if necessary. All interventions are time stamped. Patient experience is measured concurrently using a Likert-scale as well as free-text response box. Results: 310 patients were enrolled as of January 21, 2021. Median age was 64 years. There were 49% females.8916 check-ins were sent out and 2963 responses recorded for an overall response rate of 33.23%. 531 responses provided by 109 unique patients were flagged for follow up, amounting to 6% of all responses. Fatigue was the most common symptom flagged for follow-up (454), followed by nausea/vomiting or diarrhea (167), abdominal pain (140), cough/dyspnea (140) and numbness/tingling (138). Follow up was prompt, with 60% of patient symptoms followed up on the same day and of these, 84% followed-up within 4 hours of patient reported symptom. Patient experience was consistently favorable. 72% of patients reported an experience score of ≥ 4 (1-5 scale, 5 being the most favorable). Conclusions: Electronic capture of symptoms using connected technology is feasible and can be used for timely management of treatment related complications. References: Bartlett, N.L., et al., Dose-Adjusted EPOCH-R Compared With R-CHOP as Frontline Therapy for Diffuse Large B-Cell Lymphoma: Clinical Outcomes of the Phase III Intergroup Trial Alliance/CALGB 50303. J Clin Oncol, 2019. 37(21): p. 1790-1799. Sanyal, A. Mobile health tool for monitoring cancer treatment complications. 2020. ASCO Quality Care Symposium: American Society of Clinical Oncology.
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McKee, S., T. M. Dugan, S. M. Downs, and V. Anand. "Leveraging Electronic Tablets for General Pediatric Care." Applied Clinical Informatics 06, no. 01 (2015): 1–15. http://dx.doi.org/10.4338/aci-2014-09-ra-0071.
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SummaryBackground: We have previously shown that a scan-able paper based interface linked to a computerized clinical decision support system (CDSS) can effectively screen patients in pediatric waiting rooms and support the physician using evidence based care guidelines at the time of clinical encounter. However, the use of scan-able paper based interface has many inherent limitations including lacking real time communication with the CDSS and being prone to human and system errors. An electronic tablet based user interface can not only overcome these limitations, but may also support advanced functionality for clinical and research use. However, use of such devices for pediatric care is not well studied in clinical settings.Objective: In this pilot study, we enhance our pediatric CDSS with an electronic tablet based user interface and evaluate it for usability as well as for changes in patient questionnaire completion rates.Methods: Child Health Improvement through Computers Leveraging Electronic Tablets or CHICLET is an electronic tablet based user interface. It is developed to augment the existing scan-able paper interface to our CDSS. For the purposes of this study, we deployed CHICLET in one outpatient pediatric clinic. Usability factors for CHICLET were evaluated via caregiver and staff surveys.Results: When compared to the scan-able paper based interface, we observed an 18% increase or 30% relative increase in question completion rates using CHICLET. This difference was statistically significant. Caregivers and staff survey results were positive for using CHICLET in clinical environment.Conclusions: Electronic tablets are a viable interface for capturing patient self-report in pediatric waiting rooms. We further hypothesize that the use of electronic tablet based interfaces will drive advances in computerized clinical decision support and create opportunities for patient engagement.Citation: Anand V, McKee S, Dugan TM, Downs SM. Leveraging electronic tablets for general pediatric care – a pilot study. Appl Clin Inf 2015; 6: 1–15http://dx.doi.org/10.4338/ACI-2014-09-RA-0071
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Lane, C. D., Joan Walton, and E. H. Shortliffe. "Graphical Access to Medical Expert Systems: II. Design of an Interface for Physicians." Methods of Information in Medicine 25, no. 03 (July 1986): 143–50. http://dx.doi.org/10.1055/s-0038-1635464.
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SummaryThe ONCOCIN Interviewer program provides a graphical interface between physicians and an expert system that is designed to assist with therapy selection for patients receiving experimental cancer therapy. A principal goal has been to increase acceptance of advanced computer tools in a clinical setting. The interface has been developed for high-performance Lisp workstations and is tailored to the existing paper forms and practices of the outpatient clinic. To be flexible, the program makes use of a document formatting language to control a raster graphics display of medical forms, traditional paper versions of which have been used to track patient progress. The program utilizes a mouse input device coupled with a software-defined data entry approach that may be customized to the specific environment. The work described suggests ways in which high density graphics interfaces, with pointing devices rather than an emphasis on keyboards, may make decision support tools more useful to physicians and more acceptable to them.
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Maria, Ana Rita J., Helena Serra, Maria G. Castro, and Bruno Heleno. "Interaction at the primary–secondary care interface: Patients’ and physicians’ perceptions of teleconsultations." DIGITAL HEALTH 8 (January 2022): 205520762211336. http://dx.doi.org/10.1177/20552076221133698.
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Introduction Previous qualitative research on teleconsultations has focused on synchronous communication between a patient and a clinician. This study aims to explore physicians' and patients' perceptions of the interaction on the interface between primary care and the Cardiology service of a referral hospital through teleconsultations. Methods This qualitative study was embedded in an organizational case study concerning the introduction and rollout of a new service model that took place at the point of care. The patients and physicians were recruited for semi-structured interviews until thematic saturation was achieved, between September 2019 - January 2020. The interviews were audiorecorded and anonymized. The transcribed interviews were stored, coded, and analyzed in MAXQDA, following the steps for conventional content analysis. Results A total of 29 participants were interviewed. Patients and physicians presented clear views about the role of the GP and the cardiologist and their function in overall structure of healthcare. GPs felt their role was to bring expertise in the patient which could supplement the cardiologists' expertise on the condition. However, GPs had to renegotiate roles in the teleconsultations when they saw themselves in a new situation, together with another physician and the patient. Conclusions Our findings suggest that joint teleconsultations can promote continuity of care for patients in the primary/secondary care interface. Active coordination between physicians with delineation of roles throughout primary-secondary care interface is needed to manage selected patients who may benefit the most from shared care.
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Dubovitskaya, Alevtina, Furqan Baig, Zhigang Xu, Rohit Shukla, Pratik Sushil Zambani, Arun Swaminathan, Md Majid Jahangir, et al. "ACTION-EHR: Patient-Centric Blockchain-Based Electronic Health Record Data Management for Cancer Care." Journal of Medical Internet Research 22, no. 8 (August 21, 2020): e13598. http://dx.doi.org/10.2196/13598.
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Background With increased specialization of health care services and high levels of patient mobility, accessing health care services across multiple hospitals or clinics has become very common for diagnosis and treatment, particularly for patients with chronic diseases such as cancer. With informed knowledge of a patient’s history, physicians can make prompt clinical decisions for smarter, safer, and more efficient care. However, due to the privacy and high sensitivity of electronic health records (EHR), most EHR data sharing still happens through fax or mail due to the lack of systematic infrastructure support for secure, trustable health data sharing, which can also cause major delays in patient care. Objective Our goal was to develop a system that will facilitate secure, trustable management, sharing, and aggregation of EHR data. Our patient-centric system allows patients to manage their own health records across multiple hospitals. The system will ensure patient privacy protection and guarantee security with respect to the requirements for health care data management, including the access control policy specified by the patient. Methods We propose a permissioned blockchain-based system for EHR data sharing and integration. Each hospital will provide a blockchain node integrated with its own EHR system to form the blockchain network. A web-based interface will be used for patients and doctors to initiate EHR sharing transactions. We take a hybrid data management approach, where only management metadata will be stored on the chain. Actual EHR data, on the other hand, will be encrypted and stored off-chain in Health Insurance Portability and Accountability Act–compliant cloud-based storage. The system uses public key infrastructure–based asymmetric encryption and digital signatures to secure shared EHR data. Results In collaboration with Stony Brook University Hospital, we developed ACTION-EHR, a system for patient-centric, blockchain-based EHR data sharing and management for patient care, in particular radiation treatment for cancer. The prototype was built on Hyperledger Fabric, an open-source, permissioned blockchain framework. Data sharing transactions were implemented using chaincode and exposed as representational state transfer application programming interfaces used for the web portal for patients and users. The HL7 Fast Healthcare Interoperability Resources standard was adopted to represent shared EHR data, making it easy to interface with hospital EHR systems and integrate a patient’s EHR data. We tested the system in a distributed environment at Stony Brook University using deidentified patient data. Conclusions We studied and developed the critical technology components to enable patient-centric, blockchain-based EHR sharing to support cancer care. The prototype demonstrated the feasibility of our approach as well as some of the major challenges. The next step will be a pilot study with health care providers in both the United States and Switzerland. Our work provides an exemplar testbed to build next-generation EHR sharing infrastructures.
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Apergi, Lida Anna, Margret V. Bjarnadottir, John S. Baras, Bruce L. Golden, Kelley M. Anderson, Jiling Chou, and Nawar Shara. "Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study." JMIR mHealth and uHealth 9, no. 4 (April 1, 2021): e24646. http://dx.doi.org/10.2196/24646.
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Background Heart failure (HF) is associated with high mortality rates and high costs, and self-care is crucial in the management of the condition. Telehealth can promote patients’ self-care while providing frequent feedback to their health care providers about the patient’s compliance and symptoms. A number of technologies have been considered in the literature to facilitate telehealth in patients with HF. An important factor in the adoption of these technologies is their ease of use. Conversational agent technologies using a voice interface can be a good option because they use speech recognition to communicate with patients. Objective The aim of this paper is to study the engagement of patients with HF with voice interface technology. In particular, we investigate which patient characteristics are linked to increased technology use. Methods We used data from two separate HF patient groups that used different telehealth technologies over a 90-day period. Each group used a different type of voice interface; however, the scripts followed by the two technologies were identical. One technology was based on Amazon’s Alexa (Alexa+), and in the other technology, patients used a tablet to interact with a visually animated and voice-enabled avatar (Avatar). Patient engagement was measured as the number of days on which the patients used the technology during the study period. We used multiple linear regression to model engagement with the technology based on patients’ demographic and clinical characteristics and past technology use. Results In both populations, the patients were predominantly male and Black, had an average age of 55 years, and had HF for an average of 7 years. The only patient characteristic that was statistically different (P=.008) between the two populations was the number of medications they took to manage HF, with a mean of 8.7 (SD 4.0) for Alexa+ and 5.8 (SD 3.4) for Avatar patients. The regression model on the combined population shows that older patients used the technology more frequently (an additional 1.19 days of use for each additional year of age; P=.004). The number of medications to manage HF was negatively associated with use (−5.49; P=.005), and Black patients used the technology less frequently than other patients with similar characteristics (−15.96; P=.08). Conclusions Older patients’ higher engagement with telehealth is consistent with findings from previous studies, confirming the acceptability of technology in this subset of patients with HF. However, we also found that a higher number of HF medications, which may be correlated with a higher disease burden, is negatively associated with telehealth use. Finally, the lower engagement of Black patients highlights the need for further study to identify the reasons behind this lower engagement, including the possible role of social determinants of health, and potentially create technologies that are better tailored for this population.
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Gibb, Jenny L., and Jarrod M. Haar. "e-Business connections in the health sector: IT challenges and the effects of practice size." Journal of Management & Organization 15, no. 4 (September 2009): 500–513. http://dx.doi.org/10.1017/s1833367200002571.
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AbstractThe use of information technology (IT) in the health sector is critically important for enhanced patient care and ultimately cost savings. However, the uptake of IT in health has been slow when compared with other industry sectors, due to the range of issues and IT inconsistencies associated with the needs of its stakeholders. This study explored the challenges experienced by 108 New Zealand medical practitioners in their IT interface with other key primary and secondary health providers. We found IT interface challenges were negatively related to e-business activity (receiving) but held no effect on e-business activity (sending). Further, we tested for and found significant moderating effects of practice size, based on patient numbers. Large practices were able to buffer the negative influence of IT interface challenges on e-business activity (receiving), while small practices were severely hampered by IT interface challenges. The implications of operating in a modular industry structure are discussed.
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Gibb, Jenny L., and Jarrod M. Haar. "e-Business connections in the health sector: IT challenges and the effects of practice size." Journal of Management & Organization 15, no. 4 (September 2009): 500–513. http://dx.doi.org/10.5172/jmo.15.4.500.
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AbstractThe use of information technology (IT) in the health sector is critically important for enhanced patient care and ultimately cost savings. However, the uptake of IT in health has been slow when compared with other industry sectors, due to the range of issues and IT inconsistencies associated with the needs of its stakeholders. This study explored the challenges experienced by 108 New Zealand medical practitioners in their IT interface with other key primary and secondary health providers. We found IT interface challenges were negatively related to e-business activity (receiving) but held no effect on e-business activity (sending). Further, we tested for and found significant moderating effects of practice size, based on patient numbers. Large practices were able to buffer the negative influence of IT interface challenges on e-business activity (receiving), while small practices were severely hampered by IT interface challenges. The implications of operating in a modular industry structure are discussed.
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Levesque, Jean-Frederic, Mark F. Harris, and Grant Russell. "Patient-centred access to health care: conceptualising access at the interface of health systems and populations." International Journal for Equity in Health 12, no. 1 (2013): 18. http://dx.doi.org/10.1186/1475-9276-12-18.
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Staib, Andrew, Clair Sullivan, Cara Joyce Cabilan, Rohan Cattell, and Rob Eley. "Digital transformation of the emergency department-inpatient interface (EDii): integration for future innovation." Australian Health Review 44, no. 5 (2020): 666. http://dx.doi.org/10.1071/ah18176.
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As the focus of clinicians and government shifts from speciality-based care to system-based key performance indicators such as the National Emergency Access Target (NEAT) or the 4-h rule, integration between emergency department (ED) and inpatient clinical workflows and information systems is becoming increasingly necessary. Such system measures drive the implementation of integrated electronic medical records (ieMR) to digitally integrate these workflows. The objective of this case study was to describe the impact of digital transformation of the ED–in-patient interface (EDii) of a large tertiary hospital on process measures and clinical outcomes for patients requiring emergency admission to hospital. Data were collected from routine clinical and administrative information systems to measure process and clinical outcome measures, including ED length of stay, compliance with the 4-h rule and in-patient mortality between 28 November 2014 and 28 February 2017. The 4-h rule compliance for all patients, as well as for the EDii group (admitted to hospital excluding short stay ward), declined after digitisation. There were 55 fewer deaths in the postintervention group (15% relative reduction; P = 0.02) and a 10% relative reduction in adjusted mortality as measured by the Hospital Standardised Mortality Ratio for emergency patients (eHSMR), which did not reach statistical significance. Digital deceleration in ED performance did occur with an ieMR rollout, but worsening of key patient outcomes was not observed. What is known about this topic? Much has been written about the introduction of electronic medical records (EMRs) in emergency departments. This work sits alongside a substantial body of evidence outlining the relationship between process measures of ED performance and important patient outcomes. However, much less is known about the impact of digital transformation on the complex adaptive system that is the EDii and the impact of digitisation on the vulnerable group of patients who require emergency admission to hospital. What does this paper add? The objective of this case study was to describe the effect of a rapid rollout of an integrated EMR. This EMR simultaneously transformed care delivery both in the ED and the inpatient space and impacted on the politically and clinically sensitive performance and outcome measures of the EDii in a large tertiary hospital. The present study is the first that specifically examined the effect of digitisation at the EDii. What are the implications for practitioners? The understanding that digital deceleration will occur, but that with good patient outcome monitoring worsening of key patient outcomes is not likely to occur, now holds a key place in digital transformation planning. The measures of the EDii examined in this case study provide a foundation for this montoring.
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Gordon, William J., Vaishali Patel, William Thornhill, David W. Bates, and Adam Landman. "Characteristics of Patients Using Patient-Facing Application Programming Interface Technology at a US Health Care System." JAMA Network Open 3, no. 10 (October 27, 2020): e2022408. http://dx.doi.org/10.1001/jamanetworkopen.2020.22408.
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Sittig, Dean F., Zhihe Jiang, and Roger W. Jelliffe. "A graphical user interface to facilitate patient-specific drug dosing." Journal of Medical Systems 17, no. 5 (October 1993): 327–33. http://dx.doi.org/10.1007/bf01008534.
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Couture, Brittany, Elizabeth Lilley, Frank Chang, Ann DeBord Smith, Jessica Cleveland, Awatef Ergai, Zachary Katsulis, et al. "Applying User-Centered Design Methods to the Development of an mHealth Application for Use in the Hospital Setting by Patients and Care Partners." Applied Clinical Informatics 09, no. 02 (April 2018): 302–12. http://dx.doi.org/10.1055/s-0038-1645888.
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Introduction Developing an optimized and user-friendly mHealth application for patients and family members in the hospital environment presents unique challenges given the diverse patient population and patients' various states of well-being. Objective This article describes user-centered design methods and results for developing the patient and family facing user interface and functionality of MySafeCare, a safety reporting tool for hospitalized patients and their family members. Methods Individual and group usability sessions were conducted with specific testing scenarios for participants to follow to test the usability and functionality of the tool. Participants included patients, family members, and Patient and Family Advisory Council (PFAC) members. Engagement rounds were also conducted on study units and lessons learned provided additional information to the usability work. Usability results were aligned with Nielsen's Usability Heuristics. Results Eleven patients and family members and 25 PFAC members participated in usability testing and over 250 patients and family members were engaged during research team rounding. Specific themes resulting from the usability testing sessions influenced the changes made to the user interface design, workflow functionality, and terminology. Conclusion User-centered design should focus on workflow functionality, terminology, and user interface issues for mHealth applications. These themes illustrated issues aligned with four of Nielsen's Usability Heuristics: match between system and the real world, consistency and standards, flexibility and efficiency of use, and aesthetic and minimalist design. We identified workflow and terminology issues that may be specific to the use of an mHealth application focused on safety and used by hospitalized patients and their families.
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Silveira, Êndril Castilho da, Rejane Frozza, Daniela Duarte da Silva Bagatini, and Daniela Saccol Peranconi. "Dóris Chatbot: Personal assistant to help indicate a medical specialty." Concilium 23, no. 6 (April 29, 2023): 262–73. http://dx.doi.org/10.53660/clm-1110-23d33.
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Conversational interfaces have gained visibility due to recent technological advances in the use of Artificial Intelligence. In the health area, this type of interface can be very useful for applications that directly interact with the patient, therefore, simulating contact with a health agent. In addition, many patients, when having certain symptoms, usually make a partial self-diagnosis, without a clinical basis, and make an appointment with a specialist doctor, without first asking the opinion of a general practitioner. In this context, the objective of the research was to develop a chatbot platform in the health area, using the agent Dóris, with the functionality of pre-medical consultation to indicate the most appropriate medical specialty for patients with cough. The platform was developed using IBM Watson for natural language processing together with an inference engine for decision making.
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Ashwini M, Bindu K.R, Divya K.K, Aishwarya C, Sindhu Sree M, Pavithra G, T.C.Manjunath, et al. "Intelligent Ambulance – AI and Human Interface Technology." international journal of engineering technology and management sciences 7, no. 1 (2023): 304–8. http://dx.doi.org/10.46647/ijetms.2023.v07i01.045.
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This paper involves the review of papers related to an efficient ambulance management system in this project report we will be going through research papers related to similar topics and find information to improve the process of making an ambulance intelligent. India’s population is increasing as each day is passing. The increase in population puts a lot of strain and management of resources from medical, government services and many more. The strain on the resources results in citizens not getting proper help in the time of need. The main example of this process is ambulance management system which is the first line of help process in time of need. If a patient or a victim does not get an ambulance in time then the patient’s life is surely at risk. So there needs to be proper mechanism to handle this important resource and help patients in time. Latest technologies such as cloud computing, IoT, AI, ML and mobile computing can be used to improve the ambulance management and emergency help services. . Ambulance service is one of the crucial services that gets delayed. Sometimes on-sight doctors are not available, so the patient does not get medical attention immediately. In health monitoring system, the patient's vital health parameters such as ECG, Heart Rate and Body Temperature are monitored. These parameters are sent the hospital server using IoT and cloud technology. In the current era of technology, Artificial Intelligence (AI) is playing a vital role in the health care sector especially cardiac disease detection which is a major cause of sudden death. The work given here is a mini-project that is taken up as a part of the curriculum completed by electronics and communication engineering students in the second year of the electronics & communication engineering department at Dayananda Sagar College of Engineering in Bangalore.
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Mataraso, Samson, Vimig Socrates, Fritz Lekschas, and Nils Gehlenborg. "Design and Development of Halyos: A Patient-Facing Visual EHR Interface for Longitudinal Risk Awareness." ACI Open 06, no. 02 (July 2022): e123-e128. http://dx.doi.org/10.1055/s-0042-1749191.
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Abstract Objectives We have developed Halyos, a visual electronic health record (EHR) web application that complements existing patient portals. Halyos is designed to integrate with existing EHR systems to help patients interpret their health data. Methods The Halyos application utilizes the Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources (SMART on FHIR) platform to create an interoperable interface that provides interactive visualizations of clinically validated risk scores and longitudinal data derived from a patient's clinical measurements. Results These visualizations allow patients to investigate the relationships between clinical measurements and risk over time. Discussion By enabling patients to set hypothetical future values for these clinical measurements, patients can see how changes in their health will impact their risks. Conclusion Using Halyos, patients are provided with the opportunity to actively improve their health based on increased understanding of longitudinal information available in EHRs and to begin a dialogue with their providers.
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Shaya, FT, J. Finkelstein, M. Arora, N. Samant, and S. Scharf. "PMD22 PATIENT PREFERENCES FOR COMPUTER ASSISTED DATA COLLECTION AT THE CLINICAL INTERFACE." Value in Health 7, no. 3 (May 2004): 307. http://dx.doi.org/10.1016/s1098-3015(10)62335-2.
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Cho, Geoffrey W., Shone O. Almeida, Eli S. Gang, Yaron Elad, Ray Duncan, Matthew J. Budoff, and Ronald P. Karlsberg. "Performance and Integration of Smartphone Wireless ECG Monitoring into the Enterprise Electronic Health Record: First Clinical Experience." Clinical Medicine Insights: Case Reports 15 (January 2022): 117954762110691. http://dx.doi.org/10.1177/11795476211069194.
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Introduction: Patient initiated, remote cardiac monitoring has proved to be a significant advance in the diagnosis and management of arrhythmias. Further improvements in ease of use and access to results will further improve health outcomes and cost-effectiveness. Here we describe a proof-of-concept evaluation to assess the feasibility of successfully implementing a cloud-based management system using KardiaPro (KP) for remote electrocardiogram (ECG) monitoring to interface into EPIC, an enterprise electronic health record (EHR) system. Methods: The KP management system was embedded using hypertext markup language (HTML) code directly into the EHR. Encrypted credentials and patient data were bundled with an application programming interface key allowing linkage of remote monitoring from patients’ smartphones. During the time of implementation, a total of 322 patients and 32 179 ECGs were recorded. Results: The KP-EHR interface provided full functionality, allowing detection, interpretation and documentation of atrial fibrillation (AF), flutter events, ventricular tachycardia, and complete heart block. Our study focused on KP’s detection of AF, and 16.7% of tracings were classified as probable AF with only 2.3% of tracings not analyzed by the KP algorithm because of tracings that were too noisy or truncated. Enhanced management was facilitated with clinical information immediately accessible. Blinded physician ECG review validated the KP proprietary algorithm interpretation and ECGs. Conclusions: Direct integration of KP into EHR was successful and practical. It allows for historical, point of care and immediate retrieval of remote ambulatory monitoring data and documentation into the electronic health record. KP EHR integration warrants further study as it has the potential to improve cost-effectiveness and clinical diagnostic value, leading to improvements in delivery of patient care.
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Hodgson, Jennifer, Melissa Welch, Emily Tucker, Thompson Forbes, and Joseph Pye. "Utilization of EHR to Improve Support Person Engagement in Health Care for Patients With Chronic Conditions." Journal of Patient Experience 9 (January 2022): 237437352210775. http://dx.doi.org/10.1177/23743735221077528.
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Innovations in electronic health record (EHR) systems invite new patient and family engagement methods and create opportunities to reduce healthcare disparities. However, many patients and their identified support persons (ie, proxies) are unsure how to interface with the technology. This phenomenological qualitative study served as a pilot study to investigate the patient, proxy, and provider lived experiences utilizing patient-facing EHR portals. Individual interviews and focus groups were utilized to collect qualitative data from 21 patient, proxy, and healthcare provider participants across 3 time points. Colaizzi's phenomenological data analysis method was utilized to interpret the data. Four themes emerged highlighting critical benefits and obstacles for patients and support persons interfacing with a patient portal: (a) agency, (b) connection, (c) support, and (d) technology literacy. Results help highlight strategies and dispel myths essential to advancing patient and family engagement using EHR patient portal systems. The study's outcomes reflect recommendations for onboarding proxies and improving patient/family engagement and family-centered care models.
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Poulos, Christopher J., Kathy Eagar, and Roslyn G. Poulos. "Managing the interface between acute care and rehabilitation — can utilisation review assist?" Australian Health Review 31, no. 5 (2007): 129. http://dx.doi.org/10.1071/ah07s129.
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Aims and methods: We piloted the InterQual Criteria tool in a large regional acute hospital in NSW to determine the utility of this tool in the Australian context. In particular to compare the current ?gold standard? of physician assessment for the selection of patients for rehabilitation and the timing of transfer, with the guidance provided by the tool. Consecutive acute care patients with a diagnosis of stroke, hip fracture or amputation, and patients referred for rehabilitation assessment, were followed using the InterQual Criteria. Results: Results on 242 acute episodes, representing 2698 days in acute care, were analysed. In accordance with overseas studies, we found that high levels of inappropriate days of stay in acute care were suggested by the tool. Using the InterQual Criteria almost all patients were deemed appropriate for transfer to rehabilitation much earlier than current practice. Conclusion: We conclude that the InterQual Criteria may have a useful role in patient selection for rehabilitation, in facilitating the transfer of patients from acute to subacute care, and in improving patient flow within acute care. The reasons for the variation between the results obtained from the tool and current clinical practice requires further investigation, and may indicate a lack of validity of the tool in the Australian setting, inefficiencies in processes of acute care, or the lack of suitable alternative care settings or level of support available in these settings.
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Shende, Achal, Aditi Dahole, Anushka Daigavane, Aditya Thorat, and Prof Priti Kakde. "E- Health Card." International Journal for Research in Applied Science and Engineering Technology 11, no. 4 (April 30, 2023): 163–66. http://dx.doi.org/10.22214/ijraset.2023.49988.
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Abstract: This study focuses on the deployment of smart health cards and E- Healthcare to improve the standard of healthcare services through coordinated healthcare processes and IT. The administration of electronic medical records is made simpler and the privacy protection of sensitive data is improved using smart cards. A web application with a user- friendly interface was developed to store and manage patient medical records on cards and servers, reducing the risk of data loss due to card damage. The project exemplifies real- time database management, providing easy, efficient, and reliable data processing and management for healthcare providers.
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Sreetharan, Sharmila, and Michael Schutz. "Improving Human–Computer Interface Design through Application of Basic Research on Audiovisual Integration and Amplitude Envelope." Multimodal Technologies and Interaction 3, no. 1 (January 22, 2019): 4. http://dx.doi.org/10.3390/mti3010004.
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Quality care for patients requires effective communication amongst medical teams. Increasingly, communication is required not only between team members themselves, but between members and the medical devices monitoring and managing patient well-being. Most human–computer interfaces use either auditory or visual displays, and despite significant experimentation, they still elicit well-documented concerns. Curiously, few interfaces explore the benefits of multimodal communication, despite extensive documentation of the brain’s sensitivity to multimodal signals. New approaches built on insights from basic audiovisual integration research hold the potential to improve future human–computer interfaces. In particular, recent discoveries regarding the acoustic property of amplitude envelope illustrate that it can enhance audiovisual integration while also lowering annoyance. Here, we share key insights from recent research with the potential to inform applications related to human–computer interface design. Ultimately, this could lead to a cost-effective way to improve communication in medical contexts—with signification implications for both human health and the burgeoning medical device industry.
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Syed, Shamsuzzoha B., Viva Dadwal, Julie Storr, Pamela Riley, Paul Rutter, Joyce D. Hightower, Rachel Gooden, Edward Kelley, and Didier Pittet. "Strengthening the evidence-policy interface for patient safety: enhancing global health through hospital partnerships." Globalization and Health 9, no. 1 (2013): 47. http://dx.doi.org/10.1186/1744-8603-9-47.
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Hui, Ka Ho Matthew, Hugh Simon Lam, Cheuk Hin Twinny Chow, Yuen Shun Janice Li, Pok Him Tom Leung, Long Yin Brian Chan, Chui Ping Lee, Celeste Lom Ying Ewig, Yin Ting Cheung, and Tai Ning Teddy Lam. "Using Electronic Health Records for Personalized Dosing of Intravenous Vancomycin in Critically Ill Neonates: Model and Web-Based Interface Development Study." JMIR Medical Informatics 10, no. 1 (January 31, 2022): e29458. http://dx.doi.org/10.2196/29458.
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Background Intravenous (IV) vancomycin is used in the treatment of severe infection in neonates. However, its efficacy is compromised by elevated risks of acute kidney injury. The risk is even higher among neonates admitted to the neonatal intensive care unit (NICU), in whom the pharmacokinetics of vancomycin vary widely. Therapeutic drug monitoring is an integral part of vancomycin treatment to balance efficacy against toxicity. It involves individual dose adjustments based on the observed serum vancomycin concentration (VCs). However, the existing trough-based approach shows poor evidence for clinical benefits. The updated clinical practice guideline recommends population pharmacokinetic (popPK) model–based approaches, targeting area under curve, preferably through the Bayesian approach. Since Bayesian methods cannot be performed manually and require specialized computer programs, there is a need to provide clinicians with a user-friendly interface to facilitate accurate personalized dosing recommendations for vancomycin in critically ill neonates. Objective We used medical data from electronic health records (EHRs) to develop a popPK model and subsequently build a web-based interface to perform model-based individual dose optimization of IV vancomycin for NICU patients in local medical institutions. Methods Medical data of subjects prescribed IV vancomycin in the NICUs of Prince of Wales Hospital and Queen Elizabeth Hospital in Hong Kong were extracted from EHRs, namely the Clinical Information System, In-Patient Medication Order Entry, and electronic Patient Record. Patient demographics, such as body weight and postmenstrual age (PMA), serum creatinine (SCr), vancomycin administration records, and VCs were collected. The popPK model employed a 2-compartment infusion model. Various covariate models were tested against body weight, PMA, and SCr, and were evaluated for the best goodness of fit. A previously published web-based dosing interface was adapted to develop the interface in this study. Results The final data set included EHR data extracted from 207 subjects, with a total of 689 VCs measurements. The final model chosen explained 82% of the variability in vancomycin clearance. All parameter estimates were within the bootstrapping CIs. Predictive plots, residual plots, and visual predictive checks demonstrated good model predictability. Model approximations showed that the model-based Bayesian approach consistently promoted a probability of target attainment (PTA) above 75% for all subjects, while only half of the subjects could achieve a PTA over 50% with the trough-based approach. The dosing interface was developed with the capability to optimize individual doses with the model-based empirical or Bayesian approach. Conclusions Using EHRs, a satisfactory popPK model was verified and adopted to develop a web-based individual dose optimization interface. The interface is expected to improve treatment outcomes of IV vancomycin for severe infections among critically ill neonates. This study provides the foundation for a cohort study to demonstrate the utility of the new approach compared with previous dosing methods.
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Rodrigues, Cláudia Cristiane Filgueira Martins, Viviane Euzébia Pereira Santos, and Paulo Sousa. "Patient safety and nursing: interface with stress and Burnout Syndrome." Revista Brasileira de Enfermagem 70, no. 5 (October 2017): 1083–88. http://dx.doi.org/10.1590/0034-7167-2016-0194.
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ABSTRACT Objective: To analyze studies on stress, Burnout Syndrome, and patient safety in the scope of nursing care in the hospital environment. Method: This was an integrative literature review. Data collection was performed in February 2016 in the following databases: Medical Literature Analysis and Retrieval System Online - PubMed/MEDLINE, Latin American and Caribbean Literature in Health Sciences - LILACS. Results: Ten scientific productions were selected, which listed that factors contributing to stress and Burnout Syndrome of nursing professionals are the work environment as a source of stress, and excessive workload as a source of failures. Conclusion: The analysis found that the stress and Burnout Syndrome experienced by these professionals lead to greater vulnerability and development of unsafe care, and factors such as lack of organizational support can contribute to prevent these failures.
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Rey, Jose A. "The Interface of Multiculturalism and Psychopharmacology." Journal of Pharmacy Practice 19, no. 6 (December 2006): 379–85. http://dx.doi.org/10.1177/0897190007300734.
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The impact of culture and ethnicity on psychopharmacological drug response continues to be a topic of interest and research. Diagnostic issues among patients of different races and cultures and also the influence of race and culture of the treating clinician are factors to consider before pharmacotherapy is even prescribed, although it also appears to affect the type of pharmacotherapy prescribed as well. Culture and ethnicity may also influence the response rates to treatment with pharmacotherapy along with affecting the reporting of adverse effects, compliance with the treatment regimen, and perception of need for such treatments compared to alternative health beliefs. African Americans may be diagnosed with a more severe disorder compared to Caucasians, and African Americans may also receive comparatively different, and higher, doses for the same level of symptoms compared to white patients. Asian patients may require different doses of psychotropics compared to Caucasian patients. Some of these dosing differences may be explained by pharmacogenetic differences, whereas some may be explained by cultural perceptions of illness among the different patient populations. This interface between biology, ethnicity, and cultural issues poses a challenge for the practitioner to pay attention to the multiple factors that may influence an individual's response to pharmacotherapy.
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Johnson, Chris F., Karen Liddell, Claudio Guerri, Paul Findlay, and Alex Thom. "Medicines reconciliation at the community mental health team–general practice interface: quality improvement study." BJPsych Bulletin 44, no. 1 (July 10, 2019): 12–18. http://dx.doi.org/10.1192/bjb.2019.42.
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Aims and methodTo increase the proportion of patients with no psychotropic drug discrepancies at the community mental health team (CMHT)–general practice interface. Three CMHTs participated. Over a 14 month period, quality improvement methodologies were used: individual patient-level feedback to patient's prescribers, run charts and meetings with CMHTs.ResultsOne CMHT improved medicines reconciliation accuracy and demonstrated significant reductions in prescribing discrepancies. One in three (119/356) patients had ≥1 discrepancy involving 20% (166/847) of all prescribed psychotropics. Discrepancies were graded as: ‘fatal’ (0%), ‘serious’ (17%) and ‘negligible/minor harm’ (83%) but were associated with extra avoidable prescribing costs. For medicines routinely supplied by secondary care, 68% were not recorded in general practice electronic prescribing systems.Clinical implicationsImprovements in medicines reconciliation accuracy were achieved for one CMHT. This may have been partly owing to a multidisciplinary team approach to sharing and addressing prescribing discrepancies. Improving prescribing accuracy may help to reduce avoidable drug-related harms to patients.
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Teacoe, Ioana, Mariana Pop, and Diana-Elena Nistor. "Consultation-liaison psychiatry training in Europe: where do we stand?" Romanian Journal of Psychiatry and Psychotherapy 22, no. 4 (December 31, 2020): 126–30. http://dx.doi.org/10.37897/rjpp.2020.4.3.
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Consultation-liaison psychiatry is a subspecialty of psychiatry that focuses on the interface between mental health and general medical care. In Europe, consultation-liaison psychiatry has a long history and is an established field of practice. The primary goal of consultation-liaison psychiatry is to provide psychiatric assessment, diagnosis, and treatment to patients with medical or surgical conditions that impact their mental health. Consultation-liaison psychiatrists work collaboratively with medical teams to manage the psychological and emotional aspects of illness and its treatment. In addition to providing direct patient care, consultation-liaison psychiatrists also participate in research, teaching, and advocacy activities related to the interface between medicine and psychiatry.
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Baker, R., C. Preston, F. Cheater, and H. Hearnshaw. "Measuring patients' attitudes to care across the primary/secondary interface: the development of the patient career diary." Quality and Safety in Health Care 8, no. 3 (September 1, 1999): 154–60. http://dx.doi.org/10.1136/qshc.8.3.154.
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Honey, M., S. Wilson, and K. Monsen. "Meaningful Use of a Standardized Terminology to Support the Electronic Health Record in New Zealand." Applied Clinical Informatics 01, no. 04 (2010): 368–76. http://dx.doi.org/10.4338/aci-2010-06-cr-0035.
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SummaryMeaningful use is a multidimensional concept that incorporates complex processes; workflow; interoperability; decision support; performance evaluation; and quality improvement. Meaningful use is congruent with the overall vision for information management in New Zealand. Health practitioners interface with patient information at many levels, and are pivotal to meaningful use at the interface between service providers, patients, and the electronic health record. Advancing towards meaningful use depends on implementing a meaningful interface terminology within the electronic health record. The Omaha System is an interface terminology that is integrated within Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT®), and has the capacity to disseminate and capture information at the point of care because its codes are simple defined terms. Two community nursing and allied health providers who are considering using the Omaha System in clinical systems for gathering intervention and outcomes data within the personal EHR include Nurse Maude and the Royal New Zealand Plunket Society. Help4U is investigating using the Omaha System as a way to standardise health terminology for consumer use. The Omaha System is also a good fit with the Midwifery and Maternity Providers Organisation (MMPO) existing clinical information system to describe and capture data about interventions currently recorded as free text. As a country that promotes access to affordable primary care and free hospital care, within an environment constrained by resource limitations, maximizing the use of data is key to demonstrating health outcomes for the population.
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Hunt, Elizabeth A., Kristen L. Nelson, and Nicole A. Shilkofski. "Simulation in Medicine: Addressing Patient Safety and Improving the Interface Between Healthcare Providers and Medical Technology." Biomedical Instrumentation & Technology 40, no. 5 (September 1, 2006): 399–404. http://dx.doi.org/10.2345/i0899-8205-40-5-399.1.
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Abstract Medicine, as an industry in which human lives depend on the skill and performance of operators, must create and maintain a culture of safety, in addition to promoting the design of systems to mitigate errors. The use of medical simulation as a mechanism for training healthcare professionals in a safe environment is expanding rapidly. An important component of systems that ensure the safety of patients in the hospital setting is the interface between humans and technology in the hospital. The objective of this paper is to review: (1) the definition and a brief history of medical simulation, (2) examples of how current medical simulation centers are using simulation to address patient safety, and (3) examples of how simulation can be used to enhance patient safety through improvement of the interface between healthcare practitioners and medical technology. Medical simulation and human factors engineering can be used to examine and enhance the interface between health-care practitioners and medical technology, with the potential to make a significant contribution to patient safety.
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Janss, Anna J., Adda Grimberg, Robert Ferry, and Gordon Heller. "Neuro-oncology-endocrinology interface: A patient who earned her salt." Medical and Pediatric Oncology 33, no. 4 (October 1999): 413–17. http://dx.doi.org/10.1002/(sici)1096-911x(199910)33:4<413::aid-mpo17>3.0.co;2-h.
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Lindroth, Heidi L., Yuliya Pinevich, Amelia K. Barwise, Sawsan Fathma, Daniel Diedrich, Brian W. Pickering, and Vitaly Herasevich. "Information and Data Visualization Needs among Direct Care Nurses in the Intensive Care Unit." Applied Clinical Informatics 13, no. 05 (October 2022): 1207–13. http://dx.doi.org/10.1055/s-0042-1758735.
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Abstract Objectives Intensive care unit (ICU) direct care nurses spend 22% of their shift completing tasks within the electronic health record (EHR). Miscommunications and inefficiencies occur, particularly during patient hand-off, placing patient safety at risk. Redesigning how direct care nurses visualize and interact with patient information during hand-off is one opportunity to improve EHR use. A web-based survey was deployed to better understand the information and visualization needs at patient hand-off to inform redesign. Methods A multicenter anonymous web-based survey of direct care ICU nurses was conducted (9–12/2021). Semi-structured interviews with stakeholders informed survey development. The primary outcome was identifying primary EHR data needs at patient hand-off for inclusion in future EHR visualization and interface development. Secondary outcomes included current use of the EHR at patient hand-off, EHR satisfaction, and visualization preferences. Frequencies, means, and medians were calculated for each data item then ranked in descending order to generate proportional quarters using SAS v9.4. Results In total, 107 direct care ICU nurses completed the survey. The majority (46%, n = 49/107) use the EHR at patient hand-off to verify exchanged verbal information. Sixty-four percent (n = 68/107) indicated that current EHR visualization was insufficient. At the start of an ICU shift, primary EHR data needs included hemodynamics (mean 4.89 ± 0.37, 98%, n = 105), continuous IV medications (4.55 ± 0.73, 93%, n = 99), laboratory results (4.60 ± 0.56, 96%, n = 103), mechanical circulatory support devices (4.62 ± 0.72, 90%, n = 97), code status (4.40 ± 0.85, 59%, n = 108), and ventilation status (4.35 + 0.79, 51%, n = 108). Secondary outcomes included mean EHR satisfaction of 65 (0–100 scale, standard deviation = ± 21) and preferred future EHR user-interfaces to be organized by organ system (53%, n = 57/107) and visualized by tasks/schedule (61%, n = 65/107). Conclusion We identified information and visualization needs of direct care ICU nurses. The study findings could serve as a baseline toward redesigning an EHR interface.
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Laranjo, Isabel, Joaquim Macedo, and Alexandre Santos. "Internet of Things for Medication Control." International Journal of Reliable and Quality E-Healthcare 2, no. 3 (July 2013): 1–15. http://dx.doi.org/10.4018/ijrqeh.2013070101.
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The use of Radio Frequency IDentification technology (RFID) in the medical context enables drug identification but also a rapid and, of course, precise identification of patients, physicians, nurses or any other health caregiver. Combining RFID tag identification with structured and secure Internet of Things (IoT) solutions, one can establish a ubiquitous and quick access to any type of medical related records, as long as one can control and adequately secure all the Internet mediated interactions. This paper presents an e-Health service architecture, along with the corresponding Internet of Things prototype implementation that makes use of RFID tags and Electronic Product Codes (EPC) standards, in order to easily establish in a ubiquitous manner a medication control system. The system, presented and tested, has a web interface and allowed for a first evaluation of the e-health proposed service. As the service is mainly focused on elderly Ambient Assisted Living (AAL) solutions, all these technologies - RFID, EPC, Object Naming Service (ONS) and IoT – have been integrated into a suitable system, able to promote better patient/physician, patient/nurse and, generally, any patient/health caregiver, interactions. The whole prototype service, entitled “RFID-based IoT for Medication Control”, and its web interface are presented and evaluated.