Health-care marketing in an omni-channel environment

2019 ◽  
Vol 13 (4) ◽  
pp. 602-618 ◽  
Author(s):  
Eric L. Swan ◽  
Andrew J. Dahl ◽  
James W. Peltier
Keyword(s):  
Decision Making ◽  
Social Media ◽  
Technology Acceptance ◽  
Shared Decision Making ◽  
Information Exchange ◽  
Shared Decision ◽  
Content Type ◽  
Digital Service ◽  
Health Decision Making ◽  
Health Decision

Purpose Consumers have increased access to digital health tools such as social media, websites and marketer-controlled platforms for information sharing. Telemedicine (TM) represents an emerging omni-channel touchpoint for consumers to exchange information and inform health decision-making at a time and place of their choosing. While TM offers great potential, consumer adoption has been slower than expected. This paper aims to investigate attitudinal factors that influence adoption and usage of TM within consumers’ omni-channel decision-making environment. Design/methodology/approach Surveys from 869 patients were analyzed using multiple linear regression to examine the relationships between health decision-making, TM access benefits and omni-channel touchpoints (social media, website and internal health digital channels usage) on TM usage likelihood. Findings Attitudinal constructs related to TM’s benefits including access and health decision-making have the strongest impact on future TM usage. The study also empirically demonstrates a link between consumers’ omni-channel information seeking and TM usage. Research limitations/implications Increasing consumers’ involvement across omni-channel touchpoints has an additive effect on perceived benefits for engaging consumers in using digital offerings like TM. Future research is needed that examines the interrelationships on consumers’ health decision-making across generational cohorts and the post-adoption effects of digital service offerings. Practical implications Omni-channel touchpoints such as TM provide new opportunities to enhance shared decision-making. However, marketers need to adopt strategies that accommodate consumers’ evolving omni-channel preferences for access and information exchange to synergize digital service offerings with interpersonal touchpoints. Originality/value This study integrates shared decision-making, technology acceptance and omni-channel marketing literature to explore TM acceptance and usage within the context of consumers’ omni-channel decision process.

Expanding the concept of shared decision making for mental health: systematic search and scoping review of interventions

2017 ◽  
Vol 22 (3) ◽  
pp. 191-213 ◽  
Author(s):  
Yaara Zisman-Ilani ◽  
Erin Barnett ◽  
Juliette Harik ◽  
Anthony Pavlo ◽  
Maria O’Connell
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Information Exchange ◽  
Skills Training ◽  
Essential Elements ◽  
Central Component ◽  
Shared Decision ◽  
Content Type ◽  
Patient Motivation

Purpose Much of the existing literature on shared decision making (SDM) in mental health has focused on the use of decision aids (DAs). However, DAs tend to focus on information exchange and neglect other essential elements to SDM in mental health. The purpose of this paper is to expand the review of SDM interventions in mental health by identifying important components, in addition to information exchange, that may contribute to the SDM process in mental health. Design/methodology/approach The authors conducted a systematic literature search using the Ovid-Medline database with supplementary scoping search of the literature on SDM in mental health treatment. To be eligible for inclusion, studies needed to describe (in a conceptual work or development paper) or evaluate (in any type of research design) a SDM intervention in mental health. The authors included studies of participants with a mental illness facing a mental health care decision, their caregivers, and providers. Findings A final sample of 31 records was systematically selected. Most interventions were developed and/or piloted in the USA for adults in community psychiatric settings. Although information exchange was a central component of the identified studies, important additional elements were: eliciting patient preferences and values, providing patient communication skills training, eliciting shared care planning, facilitating patient motivation, and eliciting patient participation in goal setting. Originality/value The review indicates that additional elements, other than information exchange such as sufficient rapport and trusting relationships, are important and needed as part of SDM in mental health. Future SDM interventions in mental health could consider including techniques that aim to increase patient involvement in activities such as goal settings, values, and preference clarification, or facilitating patient motivation, before and after presenting treatment options.

scholarly journals Measurement issues of shared decision making in mental health: challenges and opportunities

2017 ◽  
Vol 22 (3) ◽  
pp. 214-232 ◽  
Author(s):  
Lilisbeth Perestelo-Perez ◽  
Amado Rivero-Santana ◽  
Yolanda Alvarez-Perez ◽  
Yaara Zisman-Ilani ◽  
Emma Kaminskiy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Mental Health Care ◽  
Shared Decision Making ◽  
Self Report ◽  
Psychometric Validation ◽  
Shared Decision ◽  
Deliberative Process ◽  
Content Type

Purpose Shared decision making (SDM) is a model of health care in which patients are involved in the decision-making process about their treatment, considering their preferences and concerns in a deliberative process with the health care provider. Many existing instruments assess the antecedents, process, or the outcomes of SDM. The purpose of this paper is to identify the SDM-related measures applied in a mental health context. Design/methodology/approach The authors performed a systematic review in several electronic databases from 1990 to October 2016. Studies that assessed quantitatively one or more constructs related to SDM (antecedents, process, and outcomes) in the field of mental health were included. Findings The authors included 87 studies that applied 48 measures on distinct SDM constructs. A large majority of them have been developed in the field of physical diseases and adapted or directly applied in the mental health context. The most evaluated construct is the SDM process in consultation, mainly by patients’ self-report but also by external observer measures, followed by the patients’ preferences for involvement in decision making. The most applied instrument was the Autonomy Preference Index, followed by the Observing Patient Involvement in Decision Making (OPTION) and the Control Preferences Scale (CPS). The psychometric validation in mental health samples of the instruments identified is scarce. Research limitations/implications The bibliographic search is comprehensive, but could not be completely exhaustive. Effort should be invested in the development of new SDM for mental health tools that will reflect the complexity and specific features of mental health care. Originality/value The authors highlight several limitations and challenges for the measurement of SDM in mental health care.

The Internet, Social Media, and Health Decision-Making

2016 ◽  
pp. 335-355 ◽  
Author(s):  
Amanda L. Graham ◽  
Caroline O. Cobb ◽  
Nathan K. Cobb
Keyword(s):  
Decision Making ◽  
Social Media ◽  
The Internet ◽  
Health Decision Making ◽  
Health Decision

Can the current hypodontia care pathway promote shared decision-making?

2019 ◽  
Vol 46 (2) ◽  
pp. 126-136 ◽  
Author(s):  
Sophy Barber ◽  
Sue Pavitt ◽  
David Meads ◽  
Balvinder Khambay ◽  
Hilary Bekker
Keyword(s):  
Decision Making ◽  
Young People ◽  
Shared Decision Making ◽  
Information Exchange ◽  
Care Pathway ◽  
Information Provision ◽  
Alternative Methods ◽  
Teaching Hospitals ◽  
Shared Decision ◽  
Cross Sectional

Objective: To determine the extent to which the current care pathway in hypodontia promotes shared decision-making (SDM). Design: Exploratory cross-sectional study using qualitative methods. Setting: Orthodontic department of two NHS teaching hospitals in Yorkshire. Participants: Young people aged 12–16 years with hypodontia of any severity and at any stage of treatment, and their parents and guardians. Methods: (1) Observation and audio-recording of interdisciplinary consultation in hypodontia clinics (n = 5) without any researcher interference; (2) short, structured interviews with young people with hypodontia (n = 8) and their parent (n = 8) using a topic guide to explore themes around decision-making. Audio-recordings were transcribed and analysed using a thematic framework. Results: Consultations were used as an opportunity for interdisciplinary discussion, information provision and treatment planning. Evidence of good communication was observed but patient engagement was low. The decision to be made was usually stated and treatment options discussed, but time constraints limited the scope for adequate information exchange and assessment of understanding. No methods were used to establish patient and family preferences or values. Interviews suggested parents expect the dental team to make decisions and young people rely on parental advocacy. Despite little evidence of SDM, participants reported satisfaction with their treatment. Conclusions: The current care pathway for hypodontia does not support clinicians in the steps of SDM. Recommendations for improving SDM processes include support to identify preference-based decisions, greater access to comprehensive and accessible patient information to enable preparation for consultation, alternative methods for effective communication of complex information and use of preference elicitation tools to aid value-driven decision-making.

Patient involvement in consultation for atrial fibrillation – the cardiologists’ perspective

2019 ◽  
Vol 32 (4) ◽  
pp. 765-776 ◽  
Author(s):  
Ulla Hellström Muhli ◽  
Jan Trost ◽  
Eleni Siouta
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Content Analysis ◽  
Shared Decision Making ◽  
Patient Involvement ◽  
Qualitative Content Analysis ◽  
Medical Consultation ◽  
Shared Decision ◽  
Consultation Process ◽  
Content Type

Purpose The purpose of this paper is to analyse the accounts of Swedish cardiologists concerning patient involvement in consultations for atrial fibrillation (AF). The questions were: how cardiologists handle and provide scope for patient involvement in medical consultations regarding AF treatment and how cardiologists describe their familiarity with shared decision-making. Design/methodology/approach A descriptive study was designed. Ten interviews with cardiologists at four Swedish hospitals were held, and a qualitative content analysis was performed on the collected data. Findings The analysis shows cardiologists’ accounts of persuasive practice, protective practice, professional role and medical craftsmanship when it comes to patient involvement and shared decision-making. The term “shared decision-making” implies a concept of not only making one decision but also ensuring that it is finalised with a satisfactory agreement between both parties involved, the patient as well as the cardiologist. In order for the idea of patient involvement to be fulfilled, the two parties involved must have equal power, which can never actually be guaranteed. Research limitations/implications Methodologically, this paper reflects the special contribution that can be made by the research design of descriptive qualitative content analysis (Krippendorff, 2004) to reveal and understand cardiologists’ perspectives on patient involvement and participation in medical consultation and shared decision-making. The utility of this kind of analysis is to find what cardiologists said and how they arrived at their understanding about patient involvement. Accordingly, there is no quantification in this type of research. Practical implications Cardiologists should prioritise patient involvement and participation in decision-making regarding AF treatment decisions in consultations when trying to meet the request of patient involvement. Originality/value Theoretically, the authors have learned that the patient involvement and shared decision-making requires the ability to see patients as active participants in the medical consultation process.

scholarly journals Key issues in the process of implementing shared decision making (DM) in mental health practice

2017 ◽  
Vol 22 (3) ◽  
pp. 257-274 ◽  
Author(s):  
Shulamit Ramon ◽  
Helen Brooks ◽  
Sarah Rae ◽  
Mary-Jane O’Sullivan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Health Services ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Health Practice ◽  
Mental Health Practice ◽  
Content Type ◽  
Key Issues

Purpose This review paper will look at internationally existing publications in the English language on mental health shared decision making (SDM) implementation of a variety of interventions, including different methodologies and research methods, age groups and countries. The purpose of this paper is to provide an overview of: process, degree and outcomes of implementation; barriers and facilitators; perspectives on implementation by different stakeholders; analysis of the process of implementation in mental health services through the lenses of the normalisation process theory (NPT). Design/methodology/approach Following a targeted literature search the data were analysed in order to provide an overview of methodologies and methods applied in the articles, as well as of the variables listed above. Three different types of information were included: a content analysis of key issues, reflective understanding coming out of participating in implementation of an SDM project in the form of two narratives written by two key participants in an SDM pilot project and an NPT analysis of the process of implementation. Findings Only a minority of mental health SDM research focuses on implementation in everyday practice. It is possible and often desirable to achieve SDM in mental health services; it requires a low level of technology, it can save time once routinized, and it is based on enhancing therapeutic alliance, as well as service users’ motivation. Implementation requires an explicit policy decision, a clear procedure, and regular adherence to the aims and methods of implementation by all participants. These necessary and sufficient conditions are rarely met, due to the different levels of commitment to SDM and its process by the different key stakeholders, as well as due to competing providers’ objectives and the time allocated to achieving them. Originality/value The review indicates both the need to take into account the complexity of SDM, as well as future strategies for enhancing its implementation in everyday mental health practice. Perhaps because applying SDM reflects a major cultural change in mental health practice, current value attached to SDM among clinicians and service managers would need to be more positive, prominent and enduring to enable a greater degree of implementation.

Organizational context and the learning and change readiness climate for implementing an evidence-based shared decision-making aid in US rheumatology clinics

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Larry Hearld ◽  
Allyson Hall ◽  
Reena Joseph Kelly ◽  
Aizhan Karabukayeva ◽  
Jasvinder Singh
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Organizational Context ◽  
Organizational Factors ◽  
The United States ◽  
Change Readiness ◽  
Evidence Based ◽  
Shared Decision ◽  
Content Type ◽  
Learning And Change

PurposeThe purpose of this study was to examine the organizational context that may support learning and change readiness climates that previous research has found to be conducive to implementing evidence-based interventions.Design/methodology/approachAn exploratory, mixed method evaluation that included 15 rheumatology clinics throughout the United States was performed. Quantitative data were collected using a web-based survey completed by 135 clinic members. Qualitative data were collected via semi-structured interviews with 88 clinic members.FindingsIn general, clinics reported strong, positive learning and change readiness climates. More complex organizations (e.g. multispecialty, academic medical centers) with rational/hierarchical cultures and members with longer tenure were associated with less supportive learning and change readiness climates. The authors’ findings highlight opportunities for organizational leaders and evidence-based intervention sponsors to focus their attention and allocate resources to settings that may be most susceptible to implementation challenges.Originality/valueFirst, the authors address a deficit in previous research by describing both the level and strength of the learning and change readiness climates for implementing an evidence-based shared decision-making aid (SDMA) and examine how these vary as a function of the organizational context. Second, the study examines a broader set of factors to assess the organizational context (e.g. organizational culture, organizational structure, ownership) than previous research, which may be especially salient for shaping the climate in smaller specialty clinics like those we study. Third, the authors utilize a mixed methods analysis to provide greater insights into questions of how and why organizational factors such as size and structure may influence the learning and change readiness climate.

Professional identity and shared decision making among psychiatry residents: designing a brief teaching module

2018 ◽  
Vol 13 (2) ◽  
pp. 112-123
Author(s):  
Kia J. Bentley ◽  
Cory R. Cummings ◽  
Rachel C. Casey ◽  
Christopher P. Kogut
Keyword(s):  
Decision Making ◽  
Professional Identity ◽  
Shared Decision Making ◽  
Future Research ◽  
Shared Decision ◽  
Psychiatry Residents ◽  
Training Module ◽  
Content Type ◽  
Brief Training ◽  
The Relationship

Purpose The purpose of this paper is to increase awareness of shared decision making, the initial aim of the study was to understand how psychiatrists-in-training defined themselves as unique among physicians with an eye on how professional identity might shape approach to care. The second aim was to use those definitions and descriptions related to professional identity and tailor a brief training module to promote awareness of the shared decision making model. Design/methodology/approach The authors do this by first conducting focus groups to ascertain how psychiatric residents characterize their professional identity and unique disciplinary characteristics. The authors then designed a brief training session that exploits the relationship between how they define themselves as physicians and how they approach clinical decision making with patients. Findings Three major themes that emerged from the focus group data: the central role of societal and treatment contexts in shaping their professional identity and approaches to care, a professional identity characterized by a great sense of pride, and a strong commitment to systematic decision-making processes in practice. While the assessment of the training module is preliminary and lacks rigor for any generalizability or statements of causality, responses likely affirm the training tailored around professional identity as a possible vehicle for effective exposure to the concept of shared decision making and served as a useful avenue for self-reflection about needed changes to more fully embrace the practice. Research limitations/implications More inquiry may be needed into the association between trust, relationship longevity and power and paternalism, as a way to bring greater insight into the adoption of shared decision making. Future research will have to investigate whether or not including identity-related content is empirically connected to successful training on shared decision making. Likewise, future research should also look at the reciprocal impact of effectively using shared decision making on the affirmation of professional identity among psychiatrists, and indeed all who embrace patient-centered care. Originality/value This is the one of the first papers to investigate issues of professional identity among psychiatry residents, and also among the first papers to consider the relationship between professional identity and use of shared decision making.

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