scholarly journals Barriers and facilitators for implementation of electronic consultations (eConsult) to enhance access to specialist care: a scoping review

2019 ◽  
Vol 4 (5) ◽  
pp. e001629 ◽  
Author(s):  
Mohamed A Osman ◽  
Kara Schick-Makaroff ◽  
Stephanie Thompson ◽  
Liza Bialy ◽  
Robin Featherstone ◽  
...  
Keyword(s):  
Health Information ◽  
Grey Literature ◽  
Primary Care Providers ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
Quadruple Aim ◽  
Adoption And Implementation ◽  
Scoping Reviews ◽  
Patient Health ◽  
Patient Health Information

IntroductionElectronic consultation (eConsult)—provider-to-provider electronic asynchronous exchanges of patient health information at a distance—is emerging as a potential tool to improve the interface between primary care providers and specialists. Despite growing evidence that eConsult has clinical benefits, it is not widely adopted. We investigated factors influencing the adoption and implementation of eConsult services.MethodsWe applied established methods to guide the review, and the recently published Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews to report our findings. We searched five electronic databases and the grey literature for relevant studies. Two reviewers independently screened titles and full texts to identify studies that reported barriers to and/or facilitators of eConsult (asynchronous (store-and-forward) use of telemedicine to exchange patient health information between two providers (primary and secondary) at a distance using secure infrastructure). We extracted data on study characteristics and key barriers and facilitators were analysed thematically and classified using the Quadruple Aim framework taxonomy. No date or language restrictions were applied.ResultsAmong the 2579 publications retrieved, 130 studies met eligibility for the review. We identified and summarised key barriers to and facilitators of eConsult adoption and implementation across four domains: provider, patient, healthcare system and cost. Key barriers were increased workload for providers, privacy concerns and insufficient reimbursement for providers. Main facilitators were remote residence location, timely responses from specialists, utilisation of referral coordinators, addressing medicolegal concerns and incentives for providers to use eConsult.ConclusionThere are multiple barriers to and facilitators of eConsult adoption across the domains of Quadruple Aim framework. Our findings will inform the development of practice tools to support the wider adoption and scalability of eConsult implementation.

scholarly journals Barriers and facilitators for implementation of electronic consultations (eConsult) to enhance specialist access to care: a scoping review protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022733 ◽  
Author(s):  
Mohamed A Osman ◽  
Kara Schick-Makaroff ◽  
Stephanie Thompson ◽  
Robin Featherstone ◽  
Liza Bialy ◽  
...  
Keyword(s):  
Access To Care ◽  
Scoping Review ◽  
Grey Literature ◽  
Primary Care Providers ◽  
Barriers And Facilitators ◽  
Cochrane Library ◽  
Care Providers ◽  
Adoption And Implementation ◽  
Scoping Reviews ◽  
Study Characteristics

IntroductionElectronic consultations (eConsult), asynchronous exchanges of patient health information at a distance, are increasingly used as an option to facilitate patient care and collaboration between primary care providers and specialists. Although eConsult has demonstrated success in increasing efficiency in the referral process and enhancing access to care, little is known about the factors influencing its wider adoption and implementation by end users. In this paper, we describe a protocol to conduct a scoping review of the literature on the barriers and facilitators to a wider adoption and implementation of eConsult service.Methods and analysisThis scoping review will be based on the framework pioneered by Arksey and O’Malley and later developed by Levacet al. We will use the guidance for scoping reviews developed by the Joanna Briggs Institute to report our findings. In addition to several electronic databases (Medline, Embase, Cochrane Library, CINAHL, EBSCOhost and PsycINFO) studies will be identified by including relevant grey literature. Two reviewers will independently screen titles and full texts for inclusion. Studies reporting on barriers and/or facilitators in settings similar to eConsult will be included. Data on study characteristics and key barriers and facilitators will be extracted. Data will be analysed thematically and classified using the Quadruple Aim framework.Ethics and disseminationApproval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will be used to inform future studies and the development of practice tools to support the wider adoption and success of eConsult implementation. We plan to publish our findings in a peer-reviewed journal and develop a useful and accessible summary of the results.

HIPAA Compliance: Lessons from the Repeal of Hawaii's Patient Privacy Law

2002 ◽  
Vol 30 (2) ◽  
pp. 309-312
Author(s):  
Curly Kelly
Keyword(s):  
Health Care ◽  
Health Information ◽  
Health Care Providers ◽  
Care Providers ◽  
Patient Privacy ◽  
Privacy Law ◽  
Department Of Health ◽  
Patient Health ◽  
Final Rule ◽  
Patient Health Information

In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA), which required the enactment of new regulations to protect confidential patient health information. In December 2000, the U.S. Department of Health and Human Services (DHHS) published the agency's final rule on patient privacy and the proper use of privileged health information. The HIPAA privacy regulations cover all health-care providers that handle medical records or other identifiable patient health information. Most health-care organizations have until April 14,2003, to comply with HIPPA.

TRUU-Lab: Methods for Optimizing Test Names for Understanding and Utilization

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S120-S121
Author(s):  
J Wang ◽  
E Garnett ◽  
I Singh ◽  
C Bierl ◽  
B Jackson
Keyword(s):  
Identity Development ◽  
Laboratory Test ◽  
Guideline Development ◽  
Primary Care Providers ◽  
Second Phase ◽  
Care Providers ◽  
Current Test ◽  
Adoption And Implementation ◽  
Clinical Scenarios ◽  
National Initiative

Abstract Introduction/Objective Poor understandability of laboratory test names increases the risk for inappropriate test utilization and medical errors. Yet, human understandability has not been a major consideration in existing laboratory test names or naming guidelines. TRUU-Lab (Test Renaming for Understanding and Utilization for Laboratory Test Names) is a national initiative that now has more than 45 members representing more than 20 academic and industry organizations, the CDC, and the FDA. The goals of the initiative include: 1) Identify root causes and challenges in understanding and using laboratory test names; 2) Share resources related to potential solutions; 3) Develop consensus guidelines for laboratory test naming; 4) Establish consensus names for existing laboratory tests; and 5) Promote the adoption and implementation of consensus laboratory test names. Methods We previously addressed the first two goals of this initiative by identifying problematic test names and features of test names that contribute to misutilization. We also identified the advantages and limitations of current test naming guidelines and previous standardization efforts. This current study addresses goals 3 and 4. We developed an iterative process of guideline development. This process includes collecting feedback on consensus names to improve guidelines, which then informs the improvement of the consensus names. Results By analyzing test name characteristics, we found that the requirements for understandability vary with respect to the clinical scenario and provider background. We have used these results to design a 30-min long survey to test candidate names. The survey will be distributed through the Brand Institute, which offers expertise in pharmaceutical name and brand identity development. This pilot survey will be sent to primary care providers to assesses intuitive name preferences given a short and specific prompt. The second phase will take place in a simulated electronic medical record environment to present clinical scenarios where physicians will select an appropriate test. Conclusion We expect that results from survey studies will directly inform the development of TRUU-Lab naming guidelines, in turn permitting development of better-optimized laboratory test names. This process represents a new strategy for the intentional design of laboratory test names that are understandable and promote correct provider utilization.

scholarly journals Blockchain Based Remote Patient Monitoring System

2019 ◽  
Vol 8 (2) ◽  
pp. 111-118
Author(s):  
Bashayer Al-Ahmadi Bashayer Al-Ahmadi
Keyword(s):  
Health Information ◽  
Monitoring System ◽  
Patient Monitoring ◽  
Health Providers ◽  
Remote Patient Monitoring ◽  
Rpm System ◽  
Patient Health ◽  
Patient Monitoring System ◽  
Remote Patient ◽  
Patient Health Information

Remote Patient Monitoring system is an approach of a health care system that enables the patient-user of performing a remote periodical check-up. Unfortunately, these types of systems usually don't provide the advantages of securely sharing the patient health information among different health providers. Many types of research aimed to solve this issue by applying the blockchain technique to the existing patient health information records at hospitals. However; none was found regarding the remote patient monitoring system's generated data. Therefore, this proposal aims to integrate the advantages of blockchain and the Remote Patient Monitoring (RPM) system by building a secure blockchain based RPM system.

Big data or big risk: general practitioner, practice nurse and practice manager attitudes to providing de-identified patient health data from electronic medical records to researchers

2020 ◽  
Vol 26 (6) ◽  
pp. 466
Author(s):  
Timothy Monaghan ◽  
Jo-Anne Manski-Nankervis ◽  
Rachel Canaway
Keyword(s):  
Primary Care ◽  
Health Information ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Data ◽  
Positive Effects ◽  
Patient Consent ◽  
Patient Health ◽  
General Practices ◽  
Patient Health Information

Research utilising de-identified patient health information extracted from electronic medical records (EMRs) from general practices has steadily grown in recent years in response to calls to increase use of health data for research and other secondary purposes in Australia. Little is known about the views of key primary care personnel on this issue, which are important, as they may influence whether practices agree to provide EMR data for research. This exploratory qualitative study investigated the attitudes and beliefs of general practitioners (GPs), practice managers (PMs) and practice nurses (PNs) around sharing de-identified EMR patient health information with researchers. Semi-structured interviews were conducted with 11 participants (6 GPs, 3 PMs and 2 PNs) recruited via purposive sampling from general practices in Victoria, Australia. Transcripts were coded and thematically analysed. Participants were generally enthusiastic about research utilising de-identified health information extracted from EMRs for altruistic reasons, including: positive effects on primary care research, clinical practice and population health outcomes. Concerns raised included patient privacy and data breaches, third-party use of extracted data and patient consent. These findings can provide guidance to researchers and policymakers in designing and implementing projects involving de-identified health information extracted from EMRs.

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