Exploring adolescent and clinician perspectives on Australia’s national digital health record, My Health Record

2021 ◽  
Vol 27 (2) ◽  
pp. 102
Author(s):  
Laura Beaton ◽  
Ian Williams ◽  
Lena Sanci
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Access To Health Care ◽  
School Health ◽  
Digital Health ◽  
Well Being ◽  
Health Record ◽  
Patient Privacy ◽  
Privacy And Security ◽  
School Based

Adolescence is often a time when risk-taking behaviours emerge and attendance at primary health care is low. School-based health services can serve to improve access to health care. Clinicians play a key role in improving adolescents’ health literacy and capacity to make informed care decisions. Australia’s national digital health record, My Health Record (MHR), has posed significant challenges for both clinicians and adolescents in understanding impacts on patient privacy. Guidance is required on how best to communicate about MHR to adolescents. This exploratory qualitative study aims to examine adolescents’ understanding of MHR, clinicians’ knowledge of MHR and their use of MHR with adolescents. Focus groups with students, school health and well-being staff and semistructured interviews with GPs and nurses were undertaken in one regional and one urban secondary school-based health service in Victoria. Transcripts from audio recorded sessions were examined using thematic analysis. Resulting themes include minimal understanding and use of MHR, privacy and security concerns, possible benefits of MHR and convenience. The results suggest opportunities to address gaps in understanding and to learn from adolescents’ preferences for digital health literacy education. This will support primary care clinicians to provide best-practice health care for adolescents.

Digital Health Literacy as a Predictor of Awareness, Engagement, and Use of a National Online Personal Health Record: A Population-based Survey (Preprint)

2021 ◽  
Author(s):  
Christina Cheng ◽  
Emma Gearon ◽  
Melanie Hawkins ◽  
Crystal McPhee ◽  
Lisa Hanna ◽  
...  
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Digital Health ◽  
Fold Increase ◽  
Health Inequities ◽  
Population Based ◽  
Personal Health ◽  
Health Record ◽  
Digital Services ◽  
Population Based Survey

BACKGROUND Online personal health records (PHR) have the potential to improve quality, accuracy, and timeliness of health care. However, uptake of online PHRs internationally has been slow. Populations experiencing disadvantages are also less likely to use online PHRs, potentially widening health inequities within and between countries. OBJECTIVE With limited understanding of the predictors of community uptake and utilization of online PHR, the aim of this study was to determine the predictors of awareness, engagement, and use of the Australian national online PHR, My Health Record (MyHR). METHODS A population-based survey of participants aged over 18 residing in regional Victoria, Australia was undertaken in 2018 using telephone interviews. Logistic regression, adjusted for age, was used to assess the relationship between independent variables including digital health literacy, health literacy, and demographic characteristics and 3 dependent variables of MyHR awareness, engagement, and use. Digital health literacy and health literacy were measured by multidimensional tools, using all 7 scales of the eHealth Literacy Questionnaire (eHLQ) and 4 out of the 9 scales of the Health Literacy Questionnaire (HLQ). RESULTS A total of 998 responses were analyzed. Digital health literacy was found to be a strong statistical predictor of MyHR awareness, engagement, and use. A 1 unit increase in each of the 7 eHLQ scales was associated with a 2- to 4-fold increase in the odds of using MyHR: 1. Using technology to process health information (odd ratio [OR] 4.14, 95% CI 2.34-7.31); 2. Understanding of health concepts and language (OR 2.25, 95% CI 1.08-4.69); 3. Ability to actively engage with digital services (OR 4.44, 95% CI 2.55-7.75); 4. Feel safe and in control (OR 2.36, 95% CI 1.43-3.88); 5. Motivated to engage with digital services (OR 4.24, 95% CI 2.36-7.61); 6. Access to digital services that work (OR2.49, 95% CI 1.32-4.69); 7. Digital services that suit individual needs (OR 3.48, 95% CI 1.97-6.15). The HLQ scales of health care support, actively managing health, and social support were also associated with a 1- to 2-fold increase in the odds of using MyHR. Using the internet to search for health information was another strong predictor but older people and people with less education were less likely to use MyHR. CONCLUSIONS This study provides insights into the predictors of the use of an online PHR. The findings indicate that, while digital skills training is likely to increase uptake and use of online PHR, initiatives to provides access, develop responsive digital services, establish good health care, and social support are also important. Population groups that are likely to be non-users of online PHR were also identified. A holistic approach and targeted solutions are needed to ensure that online PHR can realize its full potential to help reduce health inequities. CLINICALTRIAL Not applicable

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

scholarly journals 31.C. Workshop: Development and implementation of action plans on health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
Action Plan ◽  
Knowledge Society ◽  
Implementation Strategies ◽  
Social Consequences ◽  
Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

Advocacy for a Digital Oral Health That Leaves No One Behind

2021 ◽  
pp. 238008442110266
Author(s):  
N. Giraudeau ◽  
B. Varenne
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Access To Health Care ◽  
Universal Access ◽  
Digital Health ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Central Component ◽  
Health Coverage ◽  
The Impact

During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, the lockdown enforced led to considerable disruption to the activities of dental services, even leading to closures. To mitigate the impact of the lockdowns, systems were quickly put in place in most countries to respond to dental emergencies, giving priority to distance screening, advice to patients by remote means, and treatment of urgent cases while ensuring continuous care. Digital health was widely adopted as a central component of this new approach, leading to new practices and tools, which in turn demonstrated its potential, limitations, and possible excesses. Political leaders must become aware of the universal availability of digital technology and make use of it as an additional, safe means of providing services to the public. In view of the multiple uses of digital technologies in health—health literacy, teaching, prevention, early detection, therapeutics, and public health policies—deployment of a comprehensive program of digital oral health will require the adoption of a multifaceted approach. Digital tools should be designed to reduce, not increase, inequalities in access to health care. It offers an opportunity to improve healthy behavior, lower risk factors common to oral diseases and others noncommunicable diseases, and contribute to reducing oral health inequalities. It can accelerate the implementation of universal health coverage and help achieve the 2030 Sustainable Development Agenda, leaving no one behind. Digital oral health should be one of the pillars of oral health care after COVID-19. Universal access to digital oral health should be promoted globally. The World Health Organization’s mOralHealth program aims to do that. Knowledge Transfer Statement: This position paper could be used by oral health stakeholders to convince their government to implement digital oral health program.

scholarly journals Does better availability mean better accessibility? Spatial inequalities in the care of acute myocardial infarction in Hungary

2020 ◽  
Vol 69 (4) ◽  
pp. 401-418
Author(s):  
Annamária Uzzoli ◽  
Zoltán Egri ◽  
Dániel Szilágyi ◽  
Viktor Pál
Keyword(s):  
Myocardial Infarction ◽  
Health Care ◽  
Acute Myocardial Infarction ◽  
Statistical Analysis ◽  
Health Literacy ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Services ◽  
Spatial Inequalities ◽  
Access To Health

The availability of health care services is an important issue, however, improving availability of health care services does not necessarily mean better accessibility for everybody. The main aim of this study is to find out how better availability in the care of acute myocardial infarction vary with accessibility of patients’ geographical location within Hungary. We applied statistical analysis and interview techniques to unfold the role of spatiality in the conditions of access to health care. Results of statistical analysis indicate significant health inequalities in Hungary. Decreasing national mortality rates of acute myocardial infarction, has been coupled by increasing spatial inequalities within the country especially at micro-regional level. According to in-depth interviews with local health care stakeholders we defined factors that support access to health care as well as important barriers. The supporting factors are related to the improvement of availability (i.e. infrastructural developments), while geographical distance, lack of material and human resources, or low level of health literacy proved to be the most relevant barriers. Main conclusion is that barriers to accessibility and availability are not only spatial but are also based on individual stages of acute myocardial infarction care. The development of cardiac catheter centres in Hungary has improved the short-term chances of infarction survival, but long-term survival chances have worsened in recent years due to deficiencies in rehabilitation care as well as low level of health literacy.

New Patient Centered Approach to Unlock the Individual`s Potential to Adopt Healthy Lifestyles: Health Coaching

2015 ◽  
Vol 5 (4) ◽  
pp. 182-191
Author(s):  
Ayse Basak Cinar
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Promotion ◽  
Oral Health ◽  
Access To Health Care ◽  
Diabetes Management ◽  
Well Being ◽  
Health Coaching ◽  
Healthy Lifestyles ◽  
Oral Health Promotion

Health Coaching (HC), a patient-empowerment focused approach, is guided and supported by the medical professional, to facilitate patient to explore, unlock and activate his/her self-potential to adopt healthy lifestyles. HC, a whole person and also a population-based approach, can be defined as a system-wide innovation aiming positive social change. A NHS review showed that there is promising evidence about HC, particularly for supporting behaviour change. HC in our international intervention project, to our knowledge, is used for the first time as a holistic health promotion approach for oral health and diabetes type 2 (T2DM) management; in line with IDF-FDI (2007) declaration stating that oral health promotion should be part of diabetes management. The aim of the present study is to assess the effectiveness of HC on oral health and T2DM management by use of clinical (HbA1c, periodontal health) and subjective measures (satisfaction with access to health care, frequency of physical activity, toothbrushing and dental visit) among T2DM patients. Our study`s preliminary results show that at post-intervention there was a significant reduction at HbA1c (Turkey:0.7%, Denmark:0.4%, p=0.001) in HC groups. The figures for HE groups were non-significant. Daily toothbrushing was correlated with change at HbA1c and regular physical activity in HC groups. Person-centered approach focusing on multidisciplinary collaboration is essential to improve the whole well-being of individual in daily life, and thereby the society, in line with WHO 2014 Geneva Declaration. HC, a promising new approach, can speak as one of the key implementations/approaches at health care-settings to meet this essentiality.  

Addressing Burnout Syndrome From a Critical Care Specialty Organization Perspective

2020 ◽  
Vol 31 (2) ◽  
pp. 158-166
Author(s):  
Kathryn L. Cochran ◽  
Kathleen Doo ◽  
Allison Squires ◽  
Tina Shah ◽  
Seppo Rinne ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
High Stress ◽  
Well Being ◽  
American Thoracic Society ◽  
Burnout Syndrome ◽  
Health Record ◽  
Cross Sectional ◽  
Electronic Health ◽  
At Home

Background: Health care specialty organizations are an important resource for their membership; however, it is not clear how specialty societies should approach combating stress and burnout on an organizational scale. Objective: To understand the prevalence of burnout syndrome in American Thoracic Society members, identify specialty-specific risk factors, and generate strategies for health care societies to combat burnout. Methods: Cross-sectional, mixed-methods survey in a sample of 2018 American Thoracic Society International Conference attendees to assess levels of burnout syndrome, work satisfaction, and stress. Results: Of the 130 respondents, 69% reported high stress, 38% met burnout criteria, and 20% confirmed chaotic work environments. Significant associations included sex and stress level; clinical time and at-home electronic health record work; and US practice and at-home electronic health record work. There were no significant associations between burnout syndrome and the selected demographics. Participants indicated patient care as the most meaningful aspect of work, whereas the highest contributors to burnout were workload and electronic health record documentation. Importantly, most respondents were unaware of available resources for burnout. Conclusions: Health care specialty societies have access to each level of the health system, creating an opportunity to monitor trends, disseminate resources, and influence the direction of efforts to reduce workplace stress and enhance clinician well-being.

Access to Health Care for Pregnant Arabic-Speaking Refugee Women and Mothers in Germany

2019 ◽  
Vol 30 (3) ◽  
pp. 437-447 ◽  
Author(s):  
Julia Henry ◽  
Christian Beruf ◽  
Thomas Fischer
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Access To Health Care ◽  
Language Skills ◽  
Structured Interviews ◽  
Limited Health Literacy ◽  
Pregnancy And Childbirth ◽  
Refugee Women ◽  
Health Care Experiences ◽  
Access To Health

Refugee women often encounter multiple barriers when accessing ante-, peri-, and postnatal care. The aim of this study was to investigate how premigration experiences, conceptions about pregnancy and childbirth, health literacy, and language skills influence access to health care, experiences of health care, and childbirth. A total of 12 semi-structured interviews with refugee women from Iraq, Syria, and Palestine were conducted in the city of Dresden. Content analysis was applied using Levesque’s access model as a framework. Results indicate that conceptions of pregnancy and childbirth and premigration experiences influence women’s behaviors and experiences of pregnancy and childbirth. They contribute to barriers in accessing health care and lead to negative health outcomes. In view of limited health literacy, poor language skills, lack of information, and missing translators, female relatives in countries of origin remain an important source of information. Improved access to services for refugee women is needed.

scholarly journals The Use of Telehealth in School-Based Health Centers

2019 ◽  
Vol 6 ◽  
pp. 2333794X1988419 ◽  
Author(s):  
Hayley Love ◽  
Nirmita Panchal ◽  
John Schlitt ◽  
Caroline Behr ◽  
Samira Soleimanpour
Keyword(s):  
United States ◽  
Health Care ◽  
Public Schools ◽  
Health Care Access ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Centers ◽  
School Based ◽  
School Based Health Centers

Telehealth is a growing model of delivering health care. School-based health centers (SBHCs) provide access to health care for youth in schools and increasingly use telehealth in care delivery. This article examines the recent growth of telehealth use in SBHCs, and characteristics of SBHCs using telehealth, including provider types, operational characteristics, and schools and students served. The percentage of SBHCs using telehealth grew from 7% in 2007-2008 to 19% in 2016-2017. Over 1 million students in over 1800 public schools have access to an SBHC using telehealth, which represents 2% of students and nearly 2% of public schools in the United States. These SBHCs are primarily in rural communities and sponsored by hospitals. This growing model presents an opportunity to expand health care access to youth, particularly in underserved areas in the United States and globally. Further research is needed to fully describe how telehealth programs are implemented in school settings and their potential impacts.

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