scholarly journals Identifying and describing a model region to evaluate the impact of telemedicine

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Harst ◽  
S Oswald ◽  
P Timpel
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Rural Areas ◽  
Demographic Data ◽  
Care Providers ◽  
Age Related ◽  
Model Region ◽  
The Impact

Abstract Background Telemedicine solutions providing patient-centered care over distance need to be integrated into the regional setting. The acceptance by both providers and patients hat to be continuously evaluated using methods of participatory implementation research. In controlled trials, often taking place in laboratory settings, these methods cannot be applied. In the following, research in progress is presented. Methods Based on socio-demographic data, epidemiology prevalence of age-related chronic diseases and data on the value of health care provision in Saxony, Germany a model region was chosen. Then, a focus group (n = 6) was conducted to differentiate the results and analyze the health networks of patients. For this, network maps putting the individual in the middle and his/her sources of information and support in case of illness in concentric circles around it, were used. The focus group was audiotaped, transcribed and analyzed by two researchers using MaxQDA. Results With a mean age of 47.8 years (n = 17,431), high prevalence of diabetes (>15.85 %) and hypertension (>39.1%) and an expected shortage of primary physicians in 2030, the town of Kamenz is a mirror image of the current health care challenges in rural areas of Saxony. Participants of the focus groups also stated problems in finding a primary physician or a dentist. Compensatory behavior, such as traveling large distances, relying on self-researched online diagnoses and immediately going to the emergency room for medical support was described. According to the network maps, primary sources of support in case of illness are partners and relatives, yet there is little connection between those and health care providers, as well as between different medical specialists. Conclusions The results will lead to potential use cases of telemedicine to be included into a standardized questionnaire for the assessment of telemedicine readiness in the model region. Key messages Telemedicine implementation in a rural area can be studied using a participatory approach. Focus groups and network maps are useful qualitative methods for participatory research and can inform the design of quantitative measurements.

scholarly journals Healthcare Engagement and Encounters in a Rural State: A Focus Group Study

2018 ◽  
Vol 9 (1) ◽  
pp. 5
Author(s):  
Reshmi Singh ◽  
Heather Scott ◽  
Kem Krueger ◽  
Erin J Bush
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care Providers ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
Conflicts Of Interest ◽  
Healthcare Providers ◽  
Original Research ◽  
Care Providers ◽  
Healthcare Experiences

Introduction: Rural populations have many barriers to quality health care including lack of access to primary care and specialty care and a greater likelihood to be underinsured or uninsured. They are also less likely to use preventive screening, or to participate in self-care and engage in their health when compared to urban residents. The purpose of this paper was to describe patients’ healthcare experiences in a rural western state focusing on their healthcare expectations and engagement. Methods: This qualitative study was conducted using a focus group protocol to elicit rural patients’ healthcare experiences. A purposeful sample of English speaking adult residents from a single county who were willing to discuss their healthcare experiences was included. Patients and community members (21 years and older) were recruited through a local hospital as well as via flyers posted throughout the community. Each audio-recorded group took about two hours. A total of 15 focus groups were conducted to obtain sufficient text for theoretical saturation and thematic analysis. Each group had a range of 3-8 participants. A $25 visa gift card and lunch were provided for each participant as an incentive. Results: ‘Encounters with Healthcare Professionals’ and ‘Engagement in Health’ were the two dominant dimensions with two themes each. Themes centered around what characterized the best or worst encounters. Trust and Communication - both were based on time spent with the provider and establishment of rapport with the providers. The best encounters were those with health care providers or pharmacists who had sufficient time, adequately explained a diagnosis and new medications did not dismiss patient concerns, and treated individuals with respect. Typical responses describing the worst encounters included examples of misdiagnosis, dismissing patient’s symptoms, healthcare professionals whose attention was not focused on the patient, pushing too many medications, rushed encounters, and providers with poor bedside manner. ‘Engagement in Health’ dimension included the theme of Self-management Process such as taking things one day at a time, taking medication daily, and good stress management. The second theme was Barriers to Engagement and included issues regarding inclement weather, lack of sidewalks, stress, lack of time and the financial constraints for eating healthy, going to a gym, and/or problems with payer source. Participants also described a number of technological tools they utilized to engage with their healthcare including appointment reminders, health-based websites, symptom trackers, online portal systems for health care records, and online bill pay. Many used apps on smart phones to track calories and exercise as well as online community groups to encourage fitness. Conclusions: The results from this study highlighted some of the gaps in healthcare for rural areas. A large number of participants indicated a lack of trust of their providers and only a few had any communicative interaction with their pharmacist. Future studies could evaluate training designed to teach healthcare providers and pharmacists how to engage patients in their own care. Use of technology by healthcare providers might be another way to improve healthcare engagement. Conflict of Interest "We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties". Acknowledgements: This study was funded by the University of Wyoming College of Health Sciences (UW CHS) Faculty Seed Grant awarded to first author Dr. Singh in April 2015. Interim results of this study have been presented at the Health Literacy Research Conference (HARC) in November 2015. Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

scholarly journals Impact of Users’ Experience with a Web-Based Reporting Portal on Timeliness and Quality of Reporting ABSTRACT BODY:

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Lixuan Wang ◽  
Nina Rothschild ◽  
David Lee
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care Providers ◽  
Difficulty Level ◽  
Care Providers ◽  
Quality Of Data ◽  
Data Submission ◽  
Phone Calls ◽  
The Impact

Objective: As part of New York City Department of Health and Mental Hygiene’s (NYC DOHMH) efforts to improve provider reporting, the Division of Disease Control surveyed and conducted focus groups with users of a web-based reporting portal called Reporting Central (RC) to learn about their experience with submitting provider reports through RC and the impact of their experience on data submissionIntroduction: The New York City Department of Health and Mental Hygiene’s (NYC DOHMH) Division of Disease Control (DDC) conducts surveillance of more than 90 specific diseases and conditions and relies on both provider reports and electronic laboratory reports for data. While laboratory reports provide vital laboratory data and represent the majority of the surveillance data that DOHMH receives, they are not always timely or sufficient to confirm a case. Provider reports, in contrast, contain data often not available in laboratory reports and can be more prompt than laboratory reports. Health care providers submit provider reports through multiple channels, including through mailing or faxing paper forms, phone calls, and Reporting Central (RC). In 2016, providers used RC to submit ~51,000 provider reports.Methods: In June 2017, we used phone calls and messages posted on RC’s homepage to recruit a convenience sample of ~50 RC users who agreed to participate in a survey and focus group. Participants were assigned to one of five focus groups based on the type and size of the facility where they worked at the time of recruitment: large outpatient facilities (n=2), small outpatient facilities (n=1) and inpatient facilities (n=2). Participants were asked to complete a 14-question paper survey before the focus group. Using a discussion guide informed by DOHMH surveillance subject matter experts, a moderator facilitated discussions on 1) facilitators of/barriers to using RC and 2) recommendations for improving RC. Each focus group lasted ~90 minutes. The discussions were audio- and video-recorded and transcribed. Survey results were descriptively summarized with Excel. Focus group data were thematically analyzed with Nvivo by two coders.Results: Forty-seven participants responded to the survey, and 45 individuals from a total of 37 health care facilities joined the focus groups.About 70% of survey participants rated the difficulty level of RC as 3 or less on a 1-7 scale (with 7 being the most difficult), and 30% of participants rated the difficulty level as 1. Participants from inpatient facilities rated RC as more difficult to use (mean rating=3.2) compared with participants from large outpatient facilities (mean rating=2.5) and participants from small outpatient facilities (mean rating=1.8). Survey respondents from inpatient facilities reported taking 3-30 minutes (mean=11.4) to submit one report using RC, compared with 3-15 minutes (mean=7.8) for survey respondents from large outpatient facilities and 3-10 minutes (mean=4.4) for survey respondents from small outpatient facilities.In subsequent focus group discussions, the majority of participants said that RC is intuitive, the section flow is easy to follow, and training new users requires little effort. Participants with experience using paper forms stated that reporting through RC is quicker and easier than reporting via paper forms.Two themes emerged from the analysis of focus group data, revealing the impact of participants’ experiences with submitting provider reports on timeliness and quality of data reporting.Timeliness of Data SubmissionParticipants noted that flawed functionalities (e.g., lack of auto-save functionality and insufficient time before automatically getting logged out of RC) lead to delayed data submission. Participants from inpatient facilities demonstrated more familiarity with time requirements for reporting and acknowledged the priority of submitting reports in their daily work routine. Participants from outpatient facilities, by contrast, did not acknowledge this priority when describing their reporting workflow and showed less understanding of the importance of timely reporting. Participants from small outpatient facilities questioned the necessity of requiring providers to report because DOHMH is also receiving data from laboratories.Quality of Data SubmissionParticipants noted the complexity of selecting the correct data from a long drop-down menu that populates from previous saved entries as a possible contributor to erroneous data entry. Lack of access to some required data and the omission of fields in RC for capturing some relevant data such as patient’s gender, housing status, etc. also compromise quality.Conclusions: The majority of participants stated that RC is intuitive and easy to use compared to paper forms. This finding encourages us to promote RC adoption among health care providers who currently use paper reports or do not report.Focus group participants’ proposed enhancements to RC to facilitate timeliness, and quality of data submission include 1) enabling auto-save or save function to reduce data loss in case of crash and automatic log-out, and 2) increasing the amount of time for completing the report, including the amount of time during which the computer is inactive, before automatic log-out. This second enhancement might be particularly helpful for inpatient facilities that frequently report complex cases.The findings also suggest the potential value of educating health care providers, especially at small outpatient clinics, about the importance and necessity of timely data submission.

scholarly journals Leveraging a Consumer-Based Product to Develop a Cancer-Specific Mobile Meditation App: Prototype Development Study (Preprint)

2021 ◽  
Author(s):  
Jennifer Huberty ◽  
Nishat Bhuiyan ◽  
Taylor Neher ◽  
Lynda Joeman ◽  
Ruben Mesa ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Online Survey ◽  
Fear Of Recurrence ◽  
Care Providers ◽  
Form And Function ◽  
Prototype Development

BACKGROUND Mobile meditation apps may offer a long-term, accessible, and effective solution for ongoing symptom management in cancer patients/survivors. However, there are currently no commercial cancer-specific meditation apps that reflect cancer specialist expertise, input from cancer patients/survivors, and features and content specific to cancer patients’/survivors’ needs. OBJECTIVE The aim of this study was to gain insight (via surveys, daily journals, and focus groups) from cancer patients/survivors, health care providers, and current subscribers of Calm (a consumer-based mobile meditation app) who were patients/survivors to develop a prototype of a mobile meditation app specifically designed for cancer patients/survivors. METHODS Participants were recruited via prior partnerships, word-of-mouth referrals, and recruitment posts on Facebook and Instagram. Cancer patients/survivors and health care providers were instructed to download and use the Calm app for at least 10 minutes a day for 7 days, complete an online daily journal for 7 days, and participate in a virtual focus group (one for cancer patients/survivors and one for providers). Current Calm subscribers who were cancer patients/survivors completed an online survey about different aspects of the Calm app and participated in a third virtual focus group. Data were qualitatively analyzed using a combination of deductive and inductive coding. RESULTS A total of 27 participants (11 cancer patients/survivors, 10 health care providers, 6 current Calm subscribers) completed the study. Similar themes and subthemes were found across surveys, daily journals, and focus groups, and fell into two major categories, content and functionality, with cancer-specific and noncancer-specific themes identified within each category. The majority of content preferences and suggestions that arose were cancer-specific, such as content related to negative emotions or feelings (eg, anxiety, grief, trauma/posttraumatic stress disorder, fear of recurrence, isolation), positive feelings and finding meaning (eg, gratitude, storytelling, acceptance), scenarios and experiences (eg, waiting, treatment-specific mediations), type and stage of cancer journey, and movement modifications. Some of the noncancer-specific themes under app content included sleep, music, and visualizations. In terms of app functionality, the majority of participants expressed interest in having a section/tab/area of the app that was specifically geared toward cancer patients/survivors. Preferences and suggestions for cancer-specific functionality features included options based on symptoms or journey, being able to communicate with other patients or survivors to share suggestions for specific meditations, and having an emergency toolkit for patients/survivors. CONCLUSIONS Findings from cancer patients/survivors, health care providers, and current Calm subscribers who were patients/survivors to be incorporated into the development of the prototype fell into two major categories: (1) content of the app and (2) functionality of the app. The prototype’s form and function will be pilot-tested among 30 cancer patients/survivors in a 4-week study, and the resulting feasibility data will be used to inform the final app design and an efficacy study.

scholarly journals Leveraging a Consumer-Based Product to Develop a Cancer-Specific Mobile Meditation App: Prototype Development Study

10.2196/32458 ◽  
2022 ◽  
Vol 6 (1) ◽  
pp. e32458
Author(s):  
Jennifer Huberty ◽  
Nishat Bhuiyan ◽  
Taylor Neher ◽  
Lynda Joeman ◽  
Ruben Mesa ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Online Survey ◽  
Fear Of Recurrence ◽  
Care Providers ◽  
Form And Function ◽  
Prototype Development

Background Mobile meditation apps may offer a long-term, accessible, and effective solution for ongoing symptom management in cancer patients/survivors. However, there are currently no commercial cancer-specific meditation apps that reflect cancer specialist expertise, input from cancer patients/survivors, and features and content specific to cancer patients’/survivors’ needs. Objective The aim of this study was to gain insight (via surveys, daily journals, and focus groups) from cancer patients/survivors, health care providers, and current subscribers of Calm (a consumer-based mobile meditation app) who were patients/survivors to develop a prototype of a mobile meditation app specifically designed for cancer patients/survivors. Methods Participants were recruited via prior partnerships, word-of-mouth referrals, and recruitment posts on Facebook and Instagram. Cancer patients/survivors and health care providers were instructed to download and use the Calm app for at least 10 minutes a day for 7 days, complete an online daily journal for 7 days, and participate in a virtual focus group (one for cancer patients/survivors and one for providers). Current Calm subscribers who were cancer patients/survivors completed an online survey about different aspects of the Calm app and participated in a third virtual focus group. Data were qualitatively analyzed using a combination of deductive and inductive coding. Results A total of 27 participants (11 cancer patients/survivors, 10 health care providers, 6 current Calm subscribers) completed the study. Similar themes and subthemes were found across surveys, daily journals, and focus groups, and fell into two major categories, content and functionality, with cancer-specific and noncancer-specific themes identified within each category. The majority of content preferences and suggestions that arose were cancer-specific, such as content related to negative emotions or feelings (eg, anxiety, grief, trauma/posttraumatic stress disorder, fear of recurrence, isolation), positive feelings and finding meaning (eg, gratitude, storytelling, acceptance), scenarios and experiences (eg, waiting, treatment-specific mediations), type and stage of cancer journey, and movement modifications. Some of the noncancer-specific themes under app content included sleep, music, and visualizations. In terms of app functionality, the majority of participants expressed interest in having a section/tab/area of the app that was specifically geared toward cancer patients/survivors. Preferences and suggestions for cancer-specific functionality features included options based on symptoms or journey, being able to communicate with other patients or survivors to share suggestions for specific meditations, and having an emergency toolkit for patients/survivors. Conclusions Findings from cancer patients/survivors, health care providers, and current Calm subscribers who were patients/survivors to be incorporated into the development of the prototype fell into two major categories: (1) content of the app and (2) functionality of the app. The prototype’s form and function will be pilot-tested among 30 cancer patients/survivors in a 4-week study, and the resulting feasibility data will be used to inform the final app design and an efficacy study.

scholarly journals Comparing the current status with desired situation of the quality ofeducation and improvement for rural health workers in Iran

2021 ◽  
Vol 10 (1) ◽  
pp. 1-1
Author(s):  
Beheshteh Shamsaee ◽  
Mehdi Bagheri ◽  
Nader Gholi Ghourchian ◽  
Parivash Jafari
Keyword(s):  
Health Care ◽  
Health System ◽  
Rural Health ◽  
Health Care Providers ◽  
Rural Areas ◽  
Health Workers ◽  
Current Status ◽  
Care Providers ◽  
Fuzzy Delphi ◽  
The Impact

Background: Rural health workers (Behvarz) are considered health- care pioneers standing at the forefront of providing services for rural areas. Those health providers need to be optimally educated throughout the country. What can serve this purpose is an integrated high quality "education". Methods: The current descriptive research compared two situations of education quality. To this end 300, rural health workers completed researcher-made questionnaires, including 2 dimensions,7 components and, 80 questions obtained from the analysis of the qualitative process through the fuzzy Delphi method. Results: The results indicated a gap between the current status and desirable situations of qualitative improvement components of rural health workers’ education. The findings also showed that the highest standardized coefficient in the area of education was related to the variable of learning and transfer of education with a coefficient of 0.971. In the area of optimization, the highest standard coefficient for the desirable situation belonged to the interpersonal and functional relationship variable, with the value of 0.978, while the lowest standardized coefficient was related to the variable of information and communication technology (ICT) development as 0.956. Conclusion: In brief, optimal education for the health- care providers is considered an integral part of the health system; therefore, the impact of education on the general health of the people should be taken into consideration. Therefore, there is a need for theoretical and practical exploration of qualitative education towards health system improvement and promotion.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One

2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Suicide Survivors ◽  
Loved One ◽  
Life Patterns ◽  
Survivors Of Suicide ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

The Use of and Attitude Towards Telehealth in Rural Communities

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Routine Practice ◽  
Care Providers ◽  
Urban Hospital ◽  
Primary Health ◽  
The Impact ◽  
Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part I. Historical Perspective

2018 ◽  
Vol 13 (02) ◽  
pp. 109-115 ◽  
Author(s):  
Frederick M. Burkle ◽  
Adam L. Kushner ◽  
Christos Giannou ◽  
Mary A. Paterson ◽  
Sherry M. Wren ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Armed Conflict ◽  
Historical Perspective ◽  
Geneva Convention ◽  
World Health ◽  
International Humanitarian Law ◽  
Humanitarian Law ◽  
Care Providers ◽  
The Impact

AbstractSince 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations–World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2019;13:109–115)

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