Tassie's Tele-rrific Telehealth Network: Linking Primary Health Care Services for Better Rural Health Outcomes

2000 ◽  
Vol 6 (4) ◽  
pp. 108 ◽  
Author(s):  
Judi Walker ◽  
Ros Hill ◽  
Lorraine Green
Keyword(s):  
Primary Care ◽  
Information Technology ◽  
Policy Development ◽  
Health Care Services ◽  
Service Providers ◽  
Diabetes Education ◽  
Wound Management ◽  
Design Development ◽  
Care Services ◽  
Primary Care Services

The Telehealth Tasmania Network is a statewide network covering a range of primary care services including Wound Management, Diabetes Education and Support, Specialist Clinics, Mental Health, Palliative Care, and health professional support and education. The Tasmanian Department of Health and Human Services instigated the Telehealth Network in conjunction with the Commonwealth Department of Communications, Information Technology and the Arts. The Network is built on a community development and primary care model. It is unique in that consultation with service providers and clients has determined the sites and services. Integration with other agencies is a key feature, with shared infrastructure ensuring viability and sustainability. Evaluation is an integral part of the design, development and implementation of the Network. It is a forward-looking process to guide program and policy development. Although the take-up rate has been relatively slow and uneven, the evaluation findings demonstrate how Information Technology and Advanced Telecommunications are being used effectively to link primary care services with each other and with acute care and institutional services. Key external factors for success and failure have been identified, showing that what works well in one place may well fail in another.

Evaluating models of working at the interface between mental health services and primary care

1997 ◽  
Vol 170 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Linda Gask ◽  
Bonnie Sibbald ◽  
Francis Creed
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Psychiatric Nurses ◽  
Local Health ◽  
Care Services ◽  
Secondary Health Care

BackgroundThis paper examines the feasibility of evaluating innovative models of working at the interface between primary care and secondary mental health services.MethodMethodological problems relevant to evaluation of innovative models of working at the interface are discussed.ResultsAlthough there is some evidence that neurotic disorders can be more cost-effectively treated in primary care, many general practitioners (GPs), and possibly some patients, prefer referral to community mental health teams and community psychiatric nurses, which are provided by the secondary health care services. Since the latter are provided with the intention of improving serious mental illness their involvement in the care of neurotic illness can lead to tensions between GPs, local health authorities and service providers. There is little evidence to suggest that psychiatrists working in health centres using the ‘shifted out-patient’ model have eased this problem. By contrast the ‘consultation-liaison’ (C-L) model has a number of theoretical advantages; referrals to secondary care should be limited to those most in need of this level of expertise and GP management skills should improve, so leading to better quality of care for patients who are not referred.ConclusionStudies comparing the different models of service delivery are required to address the tensions that have arisen following changes in government policy. Further work is also needed to develop the necessary research tools.

scholarly journals Nursing in Australian general practice: directions and perspectives

2005 ◽  
Vol 29 (2) ◽  
pp. 156 ◽  
Author(s):  
Elizabeth J Halcomb ◽  
Patricia M Davidson ◽  
John P Daly ◽  
Rhonda Griffiths ◽  
Julie Yallop ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Policy Development ◽  
Health Care Services ◽  
Future Research ◽  
Australian Health ◽  
Care Services ◽  
Nurse Role ◽  
Australian General Practice ◽  
Role Of Nursing

Primary health care services, such as general practices, are the first point of contact for many Australian health care consumers. Until recently, the role of nursing in Australian primary care was poorly defined and described in the literature. Changes in policy and funding have given rise to an expansion of the nursing role in primary care. This paper provides a review of the literature and seeks to identify the barriers and facilitators to implementation of the practice nurse role in Australia and identifies strategic directions for future research and policy development.

scholarly journals Taxonomy of the form and function of primary care services in or alongside emergency departments: concepts paper

2019 ◽  
Vol 36 (10) ◽  
pp. 625-630 ◽  
Author(s):  
Alison Cooper ◽  
Michelle Edwards ◽  
Janet Brandling ◽  
Andrew Carson-Stevens ◽  
Matthew Cooke ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Service Providers ◽  
Routine Data ◽  
Emergency Department Patient ◽  
Classification Systems ◽  
Care Services ◽  
Primary Care Services ◽  
And Function

Primary care services in or alongside emergency departments look and function differently and are described using inconsistent terminology. Research to determine effectiveness of these models is hampered by outdated classification systems, limiting the opportunity for data synthesis to draw conclusions and inform decision-making and policy. We used findings from a literature review, a national survey of Type 1 emergency departments in England and Wales, staff interviews, other routine data sources and discussions from two stakeholder events to inform the taxonomy. We categorised the forms inside or outside the emergency department: inside primary care services may be integrated with emergency department patient flow or may run parallel to that activity; outside services may be offered on site or off site. We then describe a conceptual spectrum of integration: identifying constructs that influence how the services function—from being closer to an emergency medicine service or to usual primary care. This taxonomy provides a basis for future evaluation of service models that will comprise the evidence base to inform policy-making in this domain. Commissioners and service providers can consider these constructs in characterising and designing services depending on local circumstances and context.

A health profile of adults with multiple sclerosis living in the community

2008 ◽  
Vol 14 (8) ◽  
pp. 1099-1105 ◽  
Author(s):  
R Vazirinejad ◽  
J Lilley ◽  
C Ward
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Health Care Services ◽  
Community Sample ◽  
Vital Role ◽  
Postal Survey ◽  
Service Needs ◽  
Related Services ◽  
Care Services ◽  
Primary Care Services

Objective To describe the frequency of impairments, disabilities, and related services used in a community sample of adults with multiple sclerosis (MS) to estimate the service needs of this population. Methods A community-based postal survey conducted using a self-completion questionnaire consisting of MSQOL-54 questionnaire, Nottingham Extended Activities of Daily Living (NEADL) and some demographic items as well as items to ask about MS-related symptoms and/or problems and using available services. Adults with a diagnosis of MS confirmed by a neurologist were recruited via primary care services in Southern Derbyshire, UK. Results Questionnaires were sent to 310 adults with MS and 201 completed questionnaires were returned – a response rate of 65%. The most commonly reported symptoms and/or problems were fatigue, sexual problems, urinary problems, and painful muscle spasms. Most respondents reported at least one contact with their general practitioner (GP) during the previous 12 months. However, contacts with other services potentially able to alleviate specific symptoms and/or problems were low. Conclusions The findings suggest under-use of existing health care services by those who experience potentially treatable symptoms and/or problems associated with MS. More needs to be done to raise awareness among people with MS and their carers about the services available to them. Given the very high proportion of people with MS known to make contact with primary care services, GPs have a vital role in providing this information.

scholarly journals A model of culturally‐informed integrated diabetes education and eye screening in indigenous primary care services and specialist diabetes clinics: Study protocol

2021 ◽  
Vol 77 (3) ◽  
pp. 1578-1590
Author(s):  
Sharon Atkinson‐Briggs ◽  
Alicia Jenkins ◽  
Anthony Keech ◽  
Christopher Ryan ◽  
Laima Brazionis ◽  
...  
Keyword(s):  
Primary Care ◽  
Study Protocol ◽  
Diabetes Education ◽  
Care Services ◽  
Culturally Informed ◽  
Primary Care Services ◽  
Eye Screening

scholarly journals Age-Friendly Primary Health Care: An Assessment of Current Service Provision for Older Adults in Hong Kong

2013 ◽  
Vol 6 ◽  
pp. HSI.S12434 ◽  
Author(s):  
Jean Woo ◽  
Benise Mak ◽  
Fannie Yeung
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Hong Kong ◽  
Older People ◽  
Service Providers ◽  
Care Needs ◽  
Care Services ◽  
Primary Care Services ◽  
Aging Populations ◽  
Training Community

There has been no study evaluating whether primary care services are sufficiently oriented towards the older population in Hong Kong, particularly those with increasing frailty. Since primary care is a key first interface in promotion and maintenance of health in older people, an assessment of the age-friendliness of service provisions is of critical importance in optimizing the health of aging populations. The age-friendliness of primary care services for older people was assessed using focus groups of elderly people and also of service providers who care for them. Discussion content was based on the WHO guidelines for age-friendly primary care in the following areas: Information, education and training, community-based health care management systems, and the physical environment. Desirable improvements were identified in all domains. The findings underscore the need for wider dissemination of health care needs of older people in the primary care setting.

scholarly journals Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Thomas A. Odeny ◽  
Jeremy Penner ◽  
Jayne Lewis-Kulzer ◽  
Hannah H. Leslie ◽  
Starley B. Shade ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Health Care Services ◽  
Wait Time ◽  
Hiv Care ◽  
Hiv Education ◽  
Hiv Services ◽  
Care Services ◽  
Primary Care Services ◽  
Rural Kenya

HIV departments within Kenyan health facilities are usually better staffed and equipped than departments offering non-HIV services. Integration of HIV services into primary care may address this issue of skewed resource allocation. Between 2008 and 2010, we piloted a system of integrating HIV services into primary care in rural Kenya. Before integration, we conducted a survey among returning adults ≥18-year old attending the HIV clinic. We then integrated HIV and primary care services. Three and twelve months after integration, we administered the same questionnaires to a sample of returning adults attending the integrated clinic. Changes in patient responses were assessed using truncated linear regression and logistic regression. At 12 months after integration, respondents were more likely to be satisfied with reception services (adjusted odds ratio, aOR 2.71, 95% CI 1.32–5.56), HIV education (aOR 3.28, 95% CI 1.92–6.83), and wait time (aOR 1.97 95% CI 1.03–3.76). Men's comfort with receiving care at an integrated clinic did not change (aOR = 0.46 95% CI 0.06–3.86). Women were more likely to express discomfort after integration (aOR 3.37 95% CI 1.33–8.52). Integration of HIV services into primary care services was associated with significant increases in patient satisfaction in certain domains, with no negative effect on satisfaction.

Accessing primary health care services for transition-aged young adults with cerebral palsy; perspectives of young adults, parents, and physicians

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Erin Brandon ◽  
Marilyn Ballantyne ◽  
Melanie Penner ◽  
Andrea Lauzon ◽  
Erin McCarvill
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Young Adults ◽  
Health Care Services ◽  
Adult Health ◽  
Care Needs ◽  
Medical Needs ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Health Care Services

AbstractBackgroundYoung adults with childhood-onset disabilities experience challenges with accessing age appropriate primary health care services as they transition from pediatric to adult health care services. They often experience a negative impact on their health with associated long-term health and social concerns, disease complications and increased use of emergency services once transitioned to adult services. This is particularly challenging for youth with cerebral palsy (CP) due the complexity of their medical needs. The aim of this study was to explore experiences with accessing or providing primary care services for transitioned-aged young adults with CP from young adult, parent, pediatrician and primary care physician perspectives.MethodsA qualitative descriptive design was conducted to identify the challenges and facilitators for transitioned aged young adults with accessing primary, adult care services. Semi-structured interviews were conducted with 16 participants within the circle of care (4 adults with CP, 4 parents, 4 pediatricians and 4 primary healthcare physicians) for individuals with CP in Toronto, Canada. Interviews were audio-recorded and transcribed verbatim. Qualitative analysis guided both the data collection and the data analysis processes.ResultsData analysis revealed that all participant groups reported transition challenges with respect to accessibility, the suitability of some primary care environments for caring for individuals with complex care needs, gaps in seamless care, and limited time and funding when receiving or providing primary care services to young adults with CP.DiscussionThere is a greater demand for adult healthcare providers now to deliver services for adults with childhood onset disabilities. Transition-aged young adults with CP and complex medical needs have increased challenges with accessing primary care services. Considering the following would improve primary care services transition for this population with complex medical needs: ongoing partnering between pediatric and adult health care streams to promote seamless care; connection to team-based primary care services where family physicians, subspecialties and interprofessional practitioners work together to provide joint care planning; salary compensation for increased service needs due to medical complexity; accessible sites; and development of guidelines for transitioning youth/young adults with complex care needs.

scholarly journals Improving Well-Being Among Trainees: A Partnership to Reduce Barriers to Primary Care Services

2020 ◽  
Vol 12 (2) ◽  
pp. 203-207
Author(s):  
Christelle Tan ◽  
Catherine Kuhn ◽  
John Anderson ◽  
Alexander Borun ◽  
David A. Turner ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Services ◽  
Primary Care Physicians ◽  
Health Care Services ◽  
Well Being ◽  
Post Intervention ◽  
Care Services ◽  
Primary Care Services ◽  
Survey Results

ABSTRACT Background Improved well-being is a focus for graduate medical education (GME) programs. Residents and fellows often express difficulty with visiting primary care physicians, and this issue has not been thoroughly investigated. Objective We reported implementation and utilization of a primary care concierge scheduling service and a primary care video visit service for GME trainees. Methods GME leaders collaborated with Duke Primary Care to offer trainees a concierge scheduling service and opportunity for primary care video visits. This quantitative evaluation included (1) analysis of the institutional GME survey results pre- and post-intervention, and (2) review of use of the concierge scheduling line. Results Comparison of the 2018 and 2019 internal GME surveys showed a decrease in perceived barriers accessing primary care (58% to 31%, P < .0001), a decrease in perceived delays to access primary care (27% to 21%, P = .023), and an increase in respondents who reported needing health care services in the past year (37% to 62%, P < .0001). Although increased need for health services was reported, there was no difference in the proportion reporting use of health services (63% and 65%, P = .43). Of the 142 concierge line calls reviewed, 127 (87%) callers requested clinic appointments, and 15 (10%) callers requested video appointments. Of callers requesting clinic appointments, 99 (80%) were scheduled. Conclusions Providing resources to connect trainees to primary care greatly reduces their perception of barriers to health care and may provide a convenient mechanism to schedule flexible primary care appointments.

scholarly journals Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study

2017 ◽  
Vol 5 (1) ◽  
pp. 8-14
Author(s):  
Sanjeev Davey ◽  
Pradeep K Kapoor ◽  
Meenu Bala ◽  
Jai V Singh ◽  
Santosh K Raghav ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Evaluation Study ◽  
Medical College ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Care Approach

ABSTRACT Introduction The community-oriented primary care (COPC) services model is an approach prescribed by the Medical Council of India for existing medical colleges in India from their respective urban and rural health training centers (RHTCs). However, the evidence of whether it is better as compared with pure primary health care approach in the Indian context is lacking in the literature. Therefore, it becomes imperative to study this area for its further expansion. Materials and methods The study was done in the catchment area of RHTC and neighboring primary health center (PHC; Makhiyali) attached to the medical college in the district of Western Uttar Pradesh in India. Three surveyed villages out of six villages from July 1, 2016, to December 31, 2016, were taken in this study. Finally, the COPC vs primary health care approach comparison was done on four outcome parameters. Results The utilization of COPC services from RHTC area as compared with primary health care services from PHC area was significantly better for all diseases combined (p < 0.005) and also in the category of management of upper respiratory tract infections (p < 0.0001) and nutritional deficiencies (p < 0.05). On further applying COPC services model, it was also found that RHTC services were significantly better as compared with PHC services in terms of socioeconomic impact on health from services (p < 0.0000), identification of health needs from services (p < 0.0000), and participation in health care services (p < 0.05). Conclusion The COPC services model appears to be successful in the delivery of health care services from RHTC of a medical college as compared with pure primary health care approach delivered from a PHC. However, authors suggest more in-depth multicentric studies on this issue before generalization of COPD model usage across the world. How to cite this article Davey S, Kapoor PK, Bala M, Singh JV, Raghav SK, Singh N. Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study. Int J Res Foundation Hosp Healthc Adm 2017;5(1):8-14.

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