Real-time Communication With Health Care Providers Through an Online Respiratory Pathogen Laboratory Report

Abstract We implemented a real-time report to distribute respiratory pathogen data for our 8-hospital system to anyone with an Internet connection and a web browser. Real-time access to accurate regional laboratory observation data during an epidemic influenza season can guide diagnostic and therapeutic strategies.

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Perceptions of People Living with HIV and HIV Healthcare Providers on Real-Time Measuring and Monitoring of Antiretroviral Adherence Using Ingestible Sensors: A Qualitative Study

AIDS Research and Treatment ◽

10.1155/2020/1098109 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Susan Kamal ◽

Marc I. Rosen ◽

Christina Lazar ◽

Lisa Siqueiros ◽

Yan Wang ◽

...

Keyword(s):

Medication Adherence ◽

Real Time ◽

Health Care Providers ◽

Thematic Analysis ◽

People Living With Hiv ◽

Care Providers ◽

Convenience Sample ◽

Antiretroviral Adherence ◽

Advantages And Disadvantages ◽

Living With Hiv

Objective. To describe and analyze the perception and attitudes of people living with HIV (PLWH) and HIV HCPs towards medication adherence with a focus on a digital medicine program (DMP) with ingestible sensors (ISs). Methods. This is a qualitative analysis pilot study of PLWH who were using DMP recruited by purposive sampling. A convenience sample of HCPs was interviewed. Semistructured interviews were conducted, and thematic analysis was performed. Results. Fifteen PLWH were interviewed, and thematic analysis resulted in three main themes: self-identified medication adherence patterns, experiences with the DMP, and recommending the DMP to others. Six health care providers (HCPs) described barriers and facilitators to adherence, as well as advantages and disadvantages of using or recommending the DMP to PLWH. Conclusion. This study evaluated participant and provider responses to DMP, which is a novel technology for real-time measuring and monitoring adherence with the IS. Participant and provider responses were mixed, highlighting both the advantages and limitations of the technology. Practice Implications. Taking PLWH experiences into consideration will enhance the development of this and other useful tools that clinicians and researchers can use for enhanced patient care.

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Knowledge and attitudes of permanent chemotherapy-induced alopecia among health care providers.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.142 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 142-142

Author(s):

Jenna Rose Stoehr ◽

Cory Kosche ◽

Jennifer N. Choi

Keyword(s):

Health Care ◽

Health Care Providers ◽

Nurse Practitioners ◽

Care Providers ◽

Chi Square ◽

Hospital System ◽

Medical Specialties ◽

General Internal ◽

Correct Definition ◽

Significant Difference

142 Background: Reports of permanent chemotherapy-induced alopecia (PCIA) are increasing in the field of oncodermatology, but there is a dearth of information regarding how it is recognized and managed by health care providers (HCPs) across different medical specialties. Methods: An electronic survey was distributed to HCPs (resident physicians, attending physicians, and nurse practitioners) in the departments of dermatology, oncology, and general internal medicine (GIM) within one Midwestern hospital system. Results: Of the 62 participants (response rate: 13%), there were 19 from dermatology, 20 from oncology, and 23 from GIM. Responses were analyzed with descriptive statistics, and chi-square and ANOVA tests. There was a significant difference in the number of subjects that had heard of PCIA prior to starting the survey (Derm: 79%, Onc: 30%, GIM: 22%, p<0.05). A larger percentage of dermatology and oncology HCPs knew the correct definition of the condition (alopecia persisting >6 months) than GIM (42% and 45% vs. 17%) and significantly more had encountered patients with the condition (47% and 45% vs. 17%). More providers in dermatology and GIM knew how to diagnose PCIA compared to oncology (84% and 83% vs. 70%). Dermatology HCPs were the only participants who had attempted to treat patients with PCIA. Most providers across the three specialties believed that patients would accept PCIA treatment that was topical, oral, injectable, and required frequent administration or monitoring, but not treatment that was expensive or high risk. A majority of HCPs surveyed (94%) agreed that the diagnosis of PCIA is important. However, there was a significant difference in the confidence of HCPs in diagnosing and managing PCIA. A minority of dermatology providers (2/19) specified that they would refer to an alopecia or oncodermatology specialist, while the majority of oncology and GIM providers would refer to dermatology. Conclusions: The results of this survey identify knowledge gaps about PCIA amongst health care providers. Therefore, education and multidisciplinary engagement should be pursued in order to improve awareness, diagnosis, referral, and management of PCIA as part of survivorship care.

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A Theoretical Twist on the Transparency of Open Notes: Qualitative Analysis of Health Care Professionals’ Free-Text Answers

Journal of Medical Internet Research ◽

10.2196/14347 ◽

2019 ◽

Vol 21 (9) ◽

pp. e14347

Author(s):

Gudbjörg Erlingsdóttir ◽

Lena Petersson ◽

Karin Jonnergård

Keyword(s):

Health Care ◽

Real Time ◽

Health Care Providers ◽

Actual Practice ◽

Free Text ◽

Care Organization ◽

Care Providers ◽

Medical Specialties ◽

Positive Effects ◽

Trade Offs

Background The New Public Management movement strove for transparency so that policy makers and citizens could gain insight into the work and performance of health care. As the use of the electronic health record (EHR) started to diffuse, a foundation was laid for enhanced transparency within and between health care organizations. Now we appear to be experiencing a new kind of transparency in the health care sector. Many health care providers offer their patients online access to their EHRs (here referred to as Open Notes). The Open Notes system enables and strives for transparency between the health care organization and the patient. Hence, this study investigates health care professional (HCP) perceptions of Open Notes and deepens the understanding of the transparency that Open Notes implies. Objective Based on two survey studies of HCP perceptions of Open Notes, this paper aims to deepen the academic writing on the type of transparency that is connected to Open Notes. Methods HCPs in adult psychiatry in Region Skåne, Sweden, were surveyed before and after implementation of Open Notes. The empirical material presented consists of 1554 free-text answers from two Web surveys. A qualitative content analysis was performed. Results The theoretically informed analysis pivots around the following factors connected to transparency: effectiveness; trust; accountability; autonomy and control; confidentiality, privacy, and anonymity; fairness; and legitimacy. The results show that free-text answers can be sorted under these factors as trade-offs with transparency. According to HCPs, trade-offs affect their work, their relationship with patients, and not least, their work tool, the EHR. However, since many HCPs also state that they have not met many patients, and in some cases none, who have read their EHRs, these effects seem to be more connected to the possibility (or threat) of transparency than to the actual effectuated transparency. Conclusions The implementation (or reform) of Open Notes is policy driven while demanding real-time transparency on behalf of citizens/patients and not the authorities, which makes this particular form of transparency quite unique and interesting. We have chosen to call it governed individual real-time transparency. The effects of Open Notes may vary between different medical specialties relative to their sensitivity to both total and real-time transparency. When HCPs react by changing their ways of writing notes, Open Notes can affect the efficiency of the work of HCPs and the service itself in a negative manner. HCP reactions are aimed primarily at protecting patients and their relatives as well as their own relationship with the patients and secondly at protecting themselves. Thus, governed individual real-time transparency that provides full transparency of an actual practice in health care may have the intended positive effects but can also result in negative trade-offs between transparency and efficiency of the actual practice. This may imply that full transparency is not always most desirable but that other options can be considered on a scale between none and full transparency.

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Providing real-time resources in support of LGBTQ+ and HIV+ populations as information experts on the ECHO hub team: a case report

Journal of the Medical Library Association JMLA ◽

10.5195/jmla.2021.1262 ◽

2021 ◽

Vol 109 (4) ◽

Author(s):

Laura Menard ◽

Chelsea Misquith

Keyword(s):

Health Care ◽

Real Time ◽

Health Care Providers ◽

Value Added ◽

Local Health ◽

Care Providers ◽

Team Members ◽

Project Echo ◽

Information Professionals

Background: Project ECHO (Extension for Community Healthcare Outcomes) is a telehealth initiative that aims to reduce disparities in delivery of health care by leveraging technology and local expertise to provide guidance on specialized subjects to health care providers across the world. In 2018, a new ECHO hub convened in Indianapolis with a focus on health care for individuals in the lesbian, gay, bisexual, trans, and queer (LGBTQ+) populations. This ECHO iteration was one of the first of its kind and would soon be followed by a new human immunodeficiency virus (HIV) ECHO as well.Case Presentation: In a novel approach, information professionals participated in the early planning stages of the formation of these ECHO teams, which enabled the provision of real-time medical evidence and resources at the point-of-need once the teams were launched. This case study demonstrates proof of concept for including health sciences librarians and/or information professionals in the ECHO as hub team members. In this case study, the authors describe and quantify the value added to the HIV and LGBTQ+ ECHO sessions by the medical librarians, as well as provide a template for how other telehealth initiatives can collaborate with their local health information professionals.Conclusions: Librarian involvement in Project ECHO over the past three years has been enthusiastically received. The librarians have contributed hundreds of resources to ECHO participants, helped build and curate resource repositories, and expanded the embedded librarian program to an additional two ECHO iterations. ECHO hub team members report high rates of satisfaction with the performance of embedded librarians and appreciate the provision of point-of-need evidence to ECHO participants.

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Detection of SARS-CoV-2 by Real-Time PCR under challenging pre-analytical conditions reveals independence of swab media and cooling chain

10.1101/2020.07.21.20158154 ◽

2020 ◽

Author(s):

Sabrina Summer ◽

Ralf Schmidt ◽

Anna Nele Herdina ◽

Isabella Krickl ◽

Julia Madner ◽

...

Keyword(s):

Real Time ◽

Health Care Providers ◽

Real Time Pcr ◽

Influenza A ◽

Storage Temperature ◽

Respiratory Viruses ◽

Storage Conditions ◽

Care Providers ◽

Viral Transport ◽

Syncytial Virus

AbstractWith global demand for SARS-CoV-2 testing ever rising, shortages in commercially available viral transport media pose a serious problem for laboratories and health care providers. For reliable diagnosis of SARS-CoV-2 and other respiratory viruses, executed by Real-time PCR, the quality of respiratory specimens, predominantly determined by transport and storage conditions, is crucial. Therefore, our aim was to explore the reliability of minimal transport media, comprising saline and the CDC recommended Viral Transport Media (HBSS VTM), for the diagnosis of SARS-CoV-2 and other respiratory viruses (influenza A, respiratory syncytial virus, adenovirus, rhinovirus and human metapneumovirus) compared to commercial products, such as the Universal Transport Media (UTM). We question the assumptions, that the choice of medium and temperature for storage and transport affect the accuracy of viral detection by RT-PCR. Both alternatives to the commercial transport medium (UTM), namely the CDC viral transport media (HBSS VTM) and saline, allow adequate detection of SARS-CoV-2 and other respiratory viruses, regardless of the storage temperature and time.Our study revealed the high resilience of SARS-CoV-2 and other respiratory viruses, enabling proper detection in clinical specimens even after long-time storage at high temperatures, independent of the transport medium’s composition.

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“I Like the Idea of It…But Probably Wouldn’t Use It” - Health Care Provider Perspectives on Heart Failure mHealth: Qualitative Study (Preprint)

10.2196/preprints.18101 ◽

2020 ◽

Author(s):

Jennifer Dickman Portz ◽

Kelsey Lynett Ford ◽

Kira Elsbernd ◽

Christopher E Knoepke ◽

Kelsey Flint ◽

...

Keyword(s):

Heart Failure ◽

Health Care ◽

Qualitative Study ◽

Real Time ◽

Health Care Providers ◽

Patient Reported Outcomes ◽

Care Providers ◽

Time Data ◽

Patient Reported ◽

Real Time Data

BACKGROUND Many mobile health (mHealth) technologies exist for patients with heart failure (HF). However, HF mhealth lacks evidence of efficacy, caregiver involvement, and clinically useful real-time data. OBJECTIVE We aim to capture health care providers’ perceived value of HF mHealth, particularly for pairing patient–caregiver-generated data with clinical intervention to inform the design of future HF mHealth. METHODS This study is a subanalysis of a larger qualitative study based on interviewing patients with HF, their caregivers, and health care providers. This analysis included interviews with health care providers (N=20), focusing on their perceived usefulness of HF mHealth tools and interventions. RESULTS A total of 5 themes emerged: (1) bio-psychosocial-spiritual monitoring, (2) use of sensors, (3) interoperability, (4) data sharing, and (5) usefulness of patient-reported outcomes in practice. Providers remain interested in mHealth technologies for HF patients and their caregivers. However, providers report being unconvinced of the clinical usefulness of robust real-time patient-reported outcomes. CONCLUSIONS The use of assessments, sensors, and real-time data collection could provide value in patient care. Future research must continually explore how to maximize the utility of mHealth for HF patients, their caregivers, and health care providers.

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Perspectives of Health Care Providers in an Integrated Health Care Delivery Network on Inpatient Electronic Consultation (e-Consult) Use During the COVID-19 Pandemic

Journal of Patient Experience ◽

10.1177/23743735211007696 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110076

Author(s):

Nitin Bhanot ◽

George Dimitriou ◽

Lori McAninch ◽

Caitlan Rossi ◽

Diane Thompson ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Care Delivery ◽

Care Providers ◽

Academic Hospital ◽

Hospital System ◽

Inadequate Information ◽

Patient Care Delivery ◽

Improving Patient Care ◽

Scale Data

A large academic hospital system (Allegheny Health Network) introduced inpatient electronic consultations (e-Consults) during the COVID-19 crisis. Providers were invited to complete an anonymous survey on their perceptions of e-Consults. Descriptive statistics were used to analyze Likert-scale data. Cronbach’s alpha was used to assess internal consistency. Ninety-five providers completed the survey. Requesting and consulting providers agreed that e-Consults were easy to use (100% and 96.2%, respectively). Both groups also concurred that e-Consults either decreased or did not significantly impact their workload (81% and 74%, respectively) and that training was appropriate (77.8% and 86.8%, respectively). The advantage and barrier selected most frequently by specialists was “timelier completion of the consult versus in-person” and “inadequate information to complete the consult,” respectively. The disadvantage selected most frequently by requesting physicians was “lack of communication between providers.” Open-ended comments were categorized into themes. Concerns were raised regarding whether provider–provider communication via this platform offered enough information to make recommendations compared to traditional encounters. The perceived benefits and barriers of e-Consults should be further explored with the goal of improving patient care delivery and provider satisfaction.

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Implementation of an open-source robotic platform for SARS-CoV-2 testing by real-time RT-PCR

PLoS ONE ◽

10.1371/journal.pone.0252509 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0252509

Author(s):

José Luis Villanueva-Cañas ◽

Eva Gonzalez-Roca ◽

Aitor Gastaminza Unanue ◽

Esther Titos ◽

Miguel Julián Martínez Yoldi ◽

...

Keyword(s):

Open Source ◽

Real Time ◽

Health Care Providers ◽

Clinical Care ◽

Laboratory Diagnostics ◽

Care Providers ◽

Rt Pcr ◽

Supply Chain Disruptions ◽

Commercial Laboratory ◽

Multi Stage

The current global pandemic due to the SARS-CoV-2 has pushed the limits of global health systems across all aspects of clinical care, including laboratory diagnostics. Supply chain disruptions and rapidly-shifting markets have resulted in flash-scarcity of commercial laboratory reagents; this has motivated health care providers to search for alternative workflows to cope with the international increase in demand for SARS-CoV-2 testing. The aim of this study is to present a reproducible workflow for real time RT-PCR SARS-CoV-2 testing using OT-2 open-source liquid-handling robots (Opentrons, NY). We have developed a framework that includes a code template which is helpful for building different stand-alone robotic stations, capable of performing specific protocols. Such stations can be combined together to create a complex multi-stage workflow, from sample setup to real time RT-PCR. Using our open-source code, it is easy to create new stations or workflows from scratch, adapt existing templates to update the experimental protocols, or to fine-tune the code to fit specific needs. Using this framework, we developed the code for two different workflows and evaluated them using external quality assessment (EQA) samples from the European Molecular Genetics Quality Network (EMQN). The affordability of this platform makes automated SARS-CoV-2 PCR testing accessible for most laboratories and hospitals with qualified bioinformatics personnel. This platform also allows for flexibility, as it is not dependent on any specific commercial kit, and thus it can be quickly adapted to protocol changes, reagent, consumable shortages, or any other temporary material constraints.

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A case study: emerging role of telehealth and local health practitioners during COVID-19 pandemic

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20211787 ◽

2021 ◽

Vol 8 (5) ◽

pp. 2537

Author(s):

Absar Husain ◽

Ajoke Akinola ◽

S. M. Akhtar

Keyword(s):

Real Time ◽

Health Care Providers ◽

Urban Areas ◽

Healthcare Delivery ◽

Medical Emergency ◽

Local Health ◽

Care Providers ◽

Health Practitioners

This case study investigates the experiences of planning and strategies to respond to a medical emergency and healthcare delivery during the COVID-19 pandemic, the local health practitioners from rural and urban areas of northern India; we included the experiences of telemedicine among the practitioners of Allopathic medicine System, Indian medicine System, and Allied health services. The case study recorded descriptive telephonic interviews about the situation, task, and action towards telehealth. The 35 respondents from Uttar Pradesh, Madhya Pradesh, Delhi, and Rajasthan. Find the results approximately 10-90% of telehealth services increase in clinical and non-clinical facilities. Approximately 95% of healthcare providers adapted telehealth delivery in the pandemic situation. The observation of preparedness in telehealth services and continued effort to address the situation by local health care providers. The status of real-time response to the prevention and control of new incidents. The role of telehealth setting in COVID-19, situation disembarrass through Voice call, text message, picture/video message, and all other possible measures were employed to accumulate maximum clinical information in real-time.

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In-house modification and improvement of the CDC real-time PCR diagnostic assay for SARS-CoV-2 detection.

10.1101/2020.07.10.20150771 ◽

2020 ◽

Author(s):

Srirupa Das ◽

Candice Dowell-Martino ◽

Lisa Arrigo ◽

Paul N. Fiedler ◽

Sandra Lobo

Keyword(s):

Real Time ◽

Health Care Providers ◽

Real Time Pcr ◽

Diagnostic Tests ◽

Limit Of Detection ◽

World Health ◽

Diagnostic Assay ◽

Care Providers ◽

Rt Pcr ◽

The World

The world is currently facing an unprecedented pandemic caused by the novel coronavirus SARS-CoV-2 (COVID-19) which was first reported in late 2019 by China to the World Health Organization (WHO). The containment strategy for COVID-19, which has non-specific flu-like symptoms and where upwards of 80% of the affected has either mild or no symptoms, is critically centered upon diagnostic testing, tracking and isolation. Thus, the development of specific and sensitive diagnostic tests for COVID-19 is key towards the first successful step of disease management. Public health organizations like the WHO and the US-based Centers for Disease Control and Prevention (CDC) have developed real-time PCR (RT-PCR) based diagnostic tests to aid in the detection of acute infection. In this study we sought to modify the CDC RT-PCR diagnostic assay protocol to increase its sensitivity and to make the assay directly portable to health care providers in a community-based hospital setting. A number of modifications to the original protocol were tested. Increasing the RT-PCR annealing temperature by 7°C to 62°C was associated with the most significant improvement in sensitivity, wherein the cycle-threshold (Ct) value for the N2 assay was reduced by ~3 units, in effect both reducing the overall number of inconclusive results and yielding N1/N2 assays to have similar Ct values. The limit of detection of the modified assay was also improved (0.86 RNA copies/μl for both nCoV 2019_N1/N2 assays) compared to the CDC RT-PCR diagnostic assay (1 and 3.16 RNA copies/μl for nCoV 2019_N1 and N2 assay, respectively). Using this modification, there was no significant effect on SARS-CoV-2 detection rate when viral RNA extraction was performed either manually or through an automated extraction method. We believe this modified protocol allows for more sensitive detection of the virus which in turn will be useful for pandemic management.

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