Phone Call at 2 am

AbstractNew communication technologies allow patients to communicate with their physicians from anywhere using computer or smartphone. Adding video to the mere phone call optimizes the personal contact between patient and physicians regardless of distance. Legal and reimbursements requirements must be taken into account, especially only certified software products must be used. In addition, patient consent is needed and confidentiality must be assured. The video patient consultation can be reimbursed by the health insurance companies. As with all new technologies, the introduction of these video consultations faced some challenges. Although patients and physicians have expressed great interest in this technology, it has been rarely used so far. The current COVID crisis increased the need for video consultations resulting in an increasing use of video patient consultation. It can be expected that this demand will still exists after the COVID crisis.

Download Full-text

Post-Hospital Syndrome (PHS) and Potentially Preventable Hospitalizations(PPH) in Adults. MonashWatch adult cohort patient telehealth journeys (Preprint)

10.2196/preprints.11952 ◽

2018 ◽

Cited By ~ 1

Author(s):

Associate Professor Martin ◽

Narelle Hinckley ◽

Keith Stockman ◽

Donadl Campbell

Keyword(s):

Adverse Outcomes ◽

Phone Call ◽

Post Discharge ◽

Patient Journey ◽

Preventable Hospitalizations ◽

Acute Admission ◽

Avoidable Hospitalizations ◽

Self Rated Health ◽

Phone Calls ◽

Potentially Preventable Hospitalizations

BACKGROUND Monash Watch (MW) aims to reduce avoidable hospitalizations in a cohort above a risk ‘threshold’ identified by HealthLinks Chronic Care (HLCC) algorithms using personal, diagnostic, and service data, excluding surgical and psychiatric admissions. MW conducted regular patient monitoring through outbound phone calls using the Patient Journey Record System (PaJR). PaJR alerts are intended to act as a self-reported barometer of health perceptions with more alerts per call indicating greater risk of Potentially Preventable Hospitalizations (PPH) and Post Hospital Syndrome (PHS). Most knowledge of PPH and PHS occurs at a macro-level with little understanding of fine-grained dynamics. OBJECTIVE To describe patterns of self-reported concerns and self-rated health 10 days before and after acute hospital admission in the telehealth intervention cohort of MonashWatch in the context of addressing PPH and PHS. METHODS Participants: 173 who had an acute admission of the of the 232 HLCC cohort with predicted 3+ admissions/year, in MW service arm for >40 days. Measures: Self-reported health and health care status in 764 MW phone call records which were classified into Total Alerts (all concerns - self-reported) and Red Alerts (concerns judged to be higher risk of adverse outcomes/admissions -acute medical and illness symptoms). Acute (non-surgical) admissions from Victorian Admitted Episode database. Analysis: Descriptive Timeseries homogeneity metrics using XLSTAT. RESULTS Self-reported problems (Total Alerts) statistically shifted to a higher level 3 days before an acute admission and stayed at a high level for the 10 days post discharge; reported acute medical and illness symptoms (Red Alerts) increased 1 day prior to admission and but remained at a higher level than before admission. Symptoms of concern did not change before admission or after discharge. Self-rated health and feeling depressed were reported to worsen 5 days post discharge. Patients reported more medication changes up to 2 days before acute admission. CONCLUSIONS These descriptive findings in a cohort of high risk individuals suggest a prehospital phase of what is termed PHS, which persisted on discharge and possibly worsened 5 days after discharge with worse self-rated health and depressive symptoms. Further research is needed. The role and place of community and hospital in such a cohort needs further investigation and research into PPH and PHS.

Download Full-text

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

10.2196/preprints.25150 ◽

2020 ◽

Author(s):

Swati Anand ◽

Amardeep Kalsi ◽

Jonathan Figueroa ◽

Parag Mehta

Keyword(s):

Blood Glucose ◽

Diabetes Management ◽

Positive Impact ◽

The United States ◽

Phone Call ◽

Diabetic Patients ◽

Dietary Compliance ◽

Glucose Levels ◽

Uncontrolled Diabetes ◽

Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

Download Full-text

Tracing or Tracking? A Preliminary Analysis of COVID-19 Outbreak Tracker Apps on Android and User Privacy (Preprint)

10.2196/preprints.19662 ◽

2020 ◽

Author(s):

Alex Akinbi ◽

Ehizojie Ojie

Keyword(s):

Preliminary Analysis ◽

Service Providers ◽

User Participation ◽

Memory Storage ◽

Phone Call ◽

Contact Tracing ◽

Privacy Rights ◽

User Privacy ◽

Android Apps ◽

User Data

BACKGROUND Technology using digital contact tracing apps has the potential to slow the spread of COVID-19 outbreaks by recording proximity events between individuals and alerting people who have been exposed. However, there are concerns about the abuse of user privacy rights as such apps can be repurposed to collect private user data by service providers and governments who like to gather their citizens’ private data. OBJECTIVE The objective of our study was to conduct a preliminary analysis of 34 COVID-19 trackers Android apps used in 29 individual countries to track COVID-19 symptoms, cases, and provide public health information. METHODS We identified each app’s AndroidManifest.xml resource file and examined the dangerous permissions requested by each app. RESULTS The results in this study show 70.5% of the apps request access to user location data, 47% request access to phone activities including the phone number, cellular network information, and the status of any ongoing calls. 44% of the apps request access to read from external memory storage and 2.9% request permission to download files without notification. 17.6% of the apps initiate a phone call without giving the user option to confirm the call. CONCLUSIONS The contributions of this study include a description of these dangerous permissions requested by each app and its effects on user privacy. We discuss principles that must be adopted in the development of future tracking and contact tracing apps to preserve the privacy of users and show transparency which in turn will encourage user participation.

Download Full-text

Recognizing a Crisis

10.1093/oso/9780190697211.003.0006 ◽

2018 ◽

Author(s):

Joshua M. Sharfstein

Keyword(s):

Crisis Management ◽

Daily Activity ◽

Wishful Thinking ◽

Phone Call ◽

First Order ◽

Lasting Change

The first order of business in crisis management is figuring out that there is a crisis. Once a brewing crisis is recognized, health officials can organize a coherent response, limit its impact, and even make an early pivot to achieve long-lasting change. Unfortunately, spotting a crisis early is far easier said than done. It’s the rare crisis that announces itself with a phone call 12 hours in advance. Most crises go unnoticed even as clues emerge, lost in the stream of the daily activity of an agency or hidden by biases, assumptions, and wishful thinking. To be successful, officials and their agencies should pursue a proactive strategy to identify crises early. There are three elements of effective crisis detection: spotting signals, pulling in data and assessing the situation, and developing a space and culture to put the pieces of the puzzle together.

Download Full-text

Patient Education and Sacubitril/Valsartan: A Randomized Comparative Trial

Hospital Pharmacy ◽

10.1177/0018578721999808 ◽

2021 ◽

pp. 001857872199980

Author(s):

Christopher Giuliano ◽

Bradley St. Pierre ◽

Jamie George

Keyword(s):

Controlled Trial ◽

Comparative Trial ◽

Text Messages ◽

Phone Call ◽

Secondary Outcome ◽

Short Term ◽

Phone Calls ◽

Video Education ◽

Pharmacist Education

Objective: To compare video to pharmacist education for patients taking sacubitril/valsartan. Methods: We conducted a randomized controlled trial comparing video to pharmacist education with a second randomized intervention of education delivered through text or phone call at 14 days. The primary outcome compared the change in short term knowledge between groups and the secondary outcome was long term knowledge at 1 month. Results: Forty-three patients were included. Scores improved significantly ( P < .05) in the pharmacist group from 54.1% to 85.9% and from 64.3% to 86.1% in the video education group, although there was no difference between groups (31.8% vs 22.9%, P = .13). At 30 days, scores were significantly higher than baseline (difference 16.5%, P < .05) although did decrease from the posttest (difference 7.4%, P < .05). There was no difference at 30 days between those that received text messages versus phone calls (−10% vs −5.5%, respectively; P = .36). Conclusion: We saw improvements in both short term and long term knowledge for patients receiving education through pharmacist or video education. Neither approach was more effective than the other. Clinicians can use either approach based on patient preference.

Download Full-text

Long-Term Efficacy, Visual Performance and Patient Reported Outcomes with a Trifocal Intraocular Lens: A Six-Year Follow-up

Journal of Clinical Medicine ◽

10.3390/jcm10092009 ◽

2021 ◽

Vol 10 (9) ◽

pp. 2009

Author(s):

Joaquín Fernández ◽

Manuel Rodríguez-Vallejo ◽

Javier Martinez ◽

Noemi Burguera ◽

David P. Piñero

Keyword(s):

Intraocular Lens ◽

Patient Reported Outcomes ◽

Phone Call ◽

Distortion Analysis ◽

Patient Reported ◽

Visual Function Questionnaire ◽

Secondary Objective ◽

Defocus Curve ◽

The Mean

(1) Background: To evaluate the efficacy at 6 years postoperative after the implantation of a trifocal intraocular lens (IOL) AT Lisa Tri 839MP. The secondary objective was to evaluate the contrast sensitivity defocus curve (CSDC), light distortion analysis (LDA), and patient reported outcomes (PROs). (2) Methods: Sixty-two subjects participated in phone call interviews to collect data regarding a visual function questionnaire (VF-14), a patient reported spectacle independence questionnaire (PRSIQ), and questions related to satisfaction and decision to be implanted with the same IOL. Thirty-seven of these subjects were consecutively invited to a study visit for measurement of their visual acuity (VA), CSDC, and LDA. (3) Results: The mean monocular distance corrected VA was −0.05, 0.08, and 0.05 logMAR at far and distances of 67 cm and 40 cm, respectively. These VAs were significantly superior to those reported in previous literature (p < 0.05). The total area under the CSDC was 2.29 logCS/m−1 and the light distortion index 18.82%. The mean VF-14 score was 94.73, with 19.4% of subjects requiring spectacles occasionally for near distances, and 88.9% considering the decision of being operated again; (4) Conclusions: Long-term AT LISA Tri 839MP IOL efficacy results were equal or better than those reported 12 months postoperatively in previous studies. The spectacle independence and satisfaction rates were comparable to those reported in short-term studies.

Download Full-text

Effects of Individual Differences, Attention, and Memory Deficits on Driver Distraction

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641285 ◽

2020 ◽

Vol 64 (1) ◽

pp. 1196-1201

Author(s):

Alejandro A. Arca ◽

Kaitlin M. Stanford ◽

Mustapha Mouloua

Keyword(s):

Individual Differences ◽

Driving Simulator ◽

Memory Deficits ◽

Driving Performance ◽

Driver Distraction ◽

Phone Call ◽

Traffic Density ◽

Attention And Memory ◽

Adhd Diagnosis ◽

Simulated Driving

The current study was designed to empirically examine the effects of individual differences in attention and memory deficits on driver distraction. Forty-eight participants consisting of 37 non-ADHD and 11 ADHD drivers were tested in a medium fidelity GE-ISIM driving simulator. All participants took part in a series of simulated driving scenarios involving both high and low traffic conditions in conjunction with completing a 20-Questions task either by text- message or phone-call. Measures of UFOV, simulated driving, heart rate variability, and subjective (NASA TLX) workload performance were recorded for each of the experimental tasks. It was hypothesized that ADHD diagnosis, type of cellular distraction, and traffic density would affect driving performance as measured by driving performance, workload assessment, and physiological measures. Preliminary results indicated that ADHD diagnosis, type of cellular distraction, and traffic density affected the performance of the secondary task. These results provide further evidence for the deleterious effects of cellphone use on driver distraction, especially for drivers who are diagnosed with attention-deficit and memory capacity deficits. Theoretical and practical implications are discussed, and directions for future research are also presented.

Download Full-text

Management of Comprehensive Care of multiple-birth infants from fetal to infancy period: challenges, training, strategies

BMC Pediatrics ◽

10.1186/s12887-021-02613-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tahereh Changiz ◽

Mahboobeh Namnabati

Keyword(s):

Care Management ◽

Optimal Growth ◽

Comprehensive Care ◽

Multiple Births ◽

Care Plan ◽

Phone Call ◽

Multiple Birth ◽

Discharge Process ◽

Health Providers ◽

Challenges And Strategies

Abstract Background Prematurity escalates the crisis of the infants a susceptible group of the society. Multiple delivery further intensifies the susceptibility of both family and health system. A comprehensive care is, thus, necessary to ensure the optimal growth and development of such multiple-births. Accompanied by trainings, challenges, and strategies, the present study was conducted based on a two-year report of comprehensive care management experience on two sets of multiple infants. Methods A qualitative case study approach was used to survey these two sets of premature infants (quadruplet and quintuplet) and their families. The data were collected through medical files, interviews, questionnaire, field presence, phone call and WhatsApp application, and continued follow-ups. Content analysis was performed based on survey and interventions during a period of two years in Isfahan, Iran (2018–2020). Results Case presentation and comprehensive care management are the main areas resulted from this study. The results of the study were categorized in eight challenging areas (categories) and strategies including sterility and infertility period, transition from the intrauterine to neonatal intensive care unit (NICU), discharge process, physical and developmental status, home visit and home care, development of care plan, socio-economic support, and coronavirus nightmare. Conclusion Based on challenges and strategies during these two years, the situation of the multiple-birth infants and their families’ needs should be identified as the first prerequisites in an inter-professional approach and in collaboration with the health providers. Isfahan University of Medical Sciences, Welfare Organization, and the charities were the parties involved with this process in our study. It was also found that developing a separate specific package of comprehensive care management plan for multiple-births is a necessity.

Download Full-text

Reducing Loneliness in Stationary Geriatric Care with Robots and Virtual Encounters—A Contribution to the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094846 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4846

Author(s):

Andreas Follmann ◽

Franziska Schollemann ◽

Andrea Arnolds ◽

Pauline Weismann ◽

Thea Laurentius ◽

...

Keyword(s):

Nursing Homes ◽

Social Isolation ◽

Nursing Home Residents ◽

Phone Call ◽

Observational Trial ◽

General Acceptance ◽

Frequency Of Use ◽

Geriatric Hospital ◽

Hospital Patients ◽

The Subject

The bans on visiting nursing homes during the COVID-19 pandemic, while intended to protect residents, also have the risk of increasing the loneliness and social isolation that already existed among the older generations before the pandemic. To combat loneliness and social isolation in nursing homes, this trial presents a study during which social networks of nursing home residents and elderly hospital patients were maintained through virtual encounters and robots, respectively. The observational trial included volunteers who were either residents of nursing homes or patients in a geriatric hospital. Each volunteer was asked to fill in a questionnaire containing three questions to measure loneliness. The questionnaire also documented whether video telephony via the robot, an alternative contact option (for example, a phone call), or no contact with relatives had taken place. The aim was to work out the general acceptance and the benefits of virtual encounters using robots for different roles (users, relatives, nursing staff, facilities). Seventy volunteers with three possible interventions (non-contact, virtual encounters by means of a robot, and any other contact) took part in this trial. The frequency of use of the robot increased steadily over the course of the study, and it was regularly used in all facilities during the weeks of visitor bans (n = 134 times). In the hospital, loneliness decreased significantly among patients for whom the robot was used to provide contact (F(1,25) = 7.783, p = 0.01). In the nursing homes, no demonstrable effect could be achieved in this way, although the subject feedback from the users was consistently positive.

Download Full-text