scholarly journals The Use of Telemedicine Access to Schools to Facilitate Expert Assessment of Children with Asthma

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
David A. Bergman ◽  
Paul J. Sharek ◽  
Kathryn Ekegren ◽  
Shannon Thyne ◽  
Michelle Mayer ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Physician ◽  
Expert Assessment ◽  
Asthma Care ◽  
School Based ◽  
Follow Up Care ◽  
Children With Asthma ◽  
Asthma Outcomes ◽  
Improve Access

Research has shown that access to an asthma specialist improves asthma outcomes. We hypothesized that we could improve access to expert asthma care through a telemedicine link between an asthma specialist and a school-based asthma program. We conducted a prospective cohort study in 3 urban schools to ascertain the feasibility of using an asthma-focused telemedicine solution. Each subject was seen by an asthma expert at 0, 8, and 32 weeks. The assessment and recommendations for care were sent to the primary care physician (PCP) and parents were told to contact their physician for follow-up care. Eighty three subjects participated in the study. Subjects experienced improvement (P<.05) in family social activities and the number of asthma attacks. Ninety four percent of subjects rated the program as good or excellent. This study demonstrates the feasibility and acceptance of a school-based asthma program using a telemedicine link to an asthma specialist.

scholarly journals Protocolled practice nurse-led care for children with asthma in primary care: protocol for a cluster randomised trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e022922
Author(s):  
Sara Bousema ◽  
Annemieke J Verwoerd ◽  
Lucas M Goossens ◽  
Arthur M Bohnen ◽  
Patrick J E Bindels ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
General Practitioner ◽  
Asthma Control ◽  
Practice Nurse ◽  
Asthma Care ◽  
Cluster Randomised ◽  
Children With Asthma

IntroductionIn children with asthma, daily symptoms and exacerbations have a significant impact on the quality of life of both children and parents. More effective use of asthma medication and, consequently, better asthma control is advocated, since both overtreatment and undertreatment are reported in primary care. Trials in adults suggest that asthma control is better when patients receive a regular medical review. Therefore, protocolled care by the general practitioner may also lead to better asthma control in children. However, such protocolled care by the general practitioner may be time consuming and less feasible. Therefore, this study aims to determine whether protocolled practice nurse-led asthma care for children in primary care provides more effective asthma control than usual care.Methods and analysisThe study will be a cluster-randomised open-label trial with an 18-month follow-up. Practice nurses will be the units of randomisation and children with asthma the units of analysis. It is planned to include 180 children aged 6–12 years. Primary outcome will be average asthma control during the 18-month follow-up measured by the Childhood Asthma Control Test (C-ACT). Secondary outcomes include C-ACT scores at t=3, t=6, t=12 and t=18 months; the frequency and severity of exacerbations; cost-effectiveness; quality of life; satisfaction with delivered care; forced expiratory volume in 1 s and forced expiratory flow at 75% and the association of high symptoms scores at baseline and baseline characteristics. Besides, we will conduct identical measurements in a non-randomised sample of children.Ethics and disseminationThis will be the first trial to evaluate the effectiveness of protocolled practice nurse-led care for children with asthma in primary care. The results may lead to improvements in asthma care for children and can be directly implemented in revisions of asthma guidelines.The study protocol was approved by the Medical Research Ethics Committee of the Erasmus Medical Centre in Rotterdam.Trial registrationNTR6847.

Oncologist and primary care physician attitudes and practices toward cancer survivor follow-up care in an integrated health system.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 105-105 ◽  
Author(s):  
Bijal A. Balasubramanian ◽  
Katelyn K Jetelina ◽  
Simon Craddock Lee
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Health System ◽  
Care Physician ◽  
Cancer Surveillance ◽  
Attitudes And Practices ◽  
Follow Up Care ◽  
Integrated Health ◽  
Communication And Coordination

105 Background: Previous research using nationally representative data showed significant differences between primary care physician (PCP) and oncologists’ attitudes and practices with respect to care of cancer survivors and called for more effective communication and coordination to improve care. This study compared PCP and oncologists’ attitudes and practices for follow-up cancer care within an integrated health system sharing a common electronic health record and clinical infrastructure to examine whether the integrated setting facilitated communication and coordination between PCPs and oncologists. Methods: 41 PCPs and 24 oncologists (response rate = 52%) affiliated with an integrated safety-net health system completed a validated survey. The survey assessed PCP and oncologists’ preferred models for delivering care, attitudes towards follow-up care, and cancer surveillance practices in this setting. Results: 41% of PCPs preferred an oncologist-led care delivery model as compared to 21% of oncologists. More PCPs than oncologists (73% vs 58%) agreed that PCPs have the skills necessary to initiate cancer surveillance. Yet, PCPs more often disagreed (56% vs 42% of oncologists) that they should have primary responsibility for providing cancer follow-up care. PCPs and oncologists differed significantly over cancer surveillance practices. Oncologists more consistently reported that PCPs ordered tests for cancer surveillance, evaluated patients for cancer recurrence and for adverse physical and psychological effects of cancer or its treatment, as well as managed pain and adverse outcomes of cancer treatment. PCPs, however, did not report equivalent ordering for these services. Conclusions: Even within an integrated health system, we found significant uncertainty as to who is responsible for care of cancer survivors. Oncologists more commonly assigned responsibility for cancer survivorship care to PCPs than PCPs recognized. This imbalance indicates many cancer survivors may not be receiving recommended care. Consensus guidelines are needed to delineate shared responsibilities for cancer survivors between primary care and oncology specialty care physicians.

Integrating the primary care physician into cancer follow-up.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 102-102 ◽  
Author(s):  
Andrew L. Salner ◽  
Deborah Walker ◽  
Amanda Seltzer ◽  
SarahLena Panzer ◽  
Carrie Stricker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

102 Background: After a diagnosis of breast cancer, it can be difficult for patients to understand the role their primary care physician (PCP) should play in their follow up care. Methods: 65 women (mean age 60 years, SD = 10) with breast cancer (stage 0-III) were seen by a nurse practitioner for a 60-90 minute consultative survivorship visit and received a treatment summary and personalized survivorship care plan (SCP) utilizing Carevive Care Planning Systems software. The Carevive system incorporates patient-reported and clinical data to create tailored care plans with personalized recommendations for follow up care and supportive referrals, including direction to follow up with primary care for specific care and health maintenance activities. Approximately 6 weeks following their survivorship care visit, patients completed a survey assessing their use of and satisfaction with the SCP. Patients were advised that the SCP would be mailed to their referring oncologist and primary care physician. Results: Out of 65 sent, 35 surveys have been completed to date. Survivors were diagnosed approximately 10 months prior, and all were within 6 months following completion of treatment. All patients (100%) reported that they read, or planned to read, their survivorship care plan packet carefully. While all care plans included a recommendation to follow up with their PCP, only (71%) of survivors remembered receiving this recommendation. Of those who did, most (74%) had either seen or scheduled an appointment with their PCP. Patients who reported higher anxiety at the time of the survivorship visit were more likely to report that the follow up care plan helped them take action about seeing their PCP (p = .03). Conclusions: Coordination between primary and oncology care providers has previously been shown to improve the quality of care for cancer survivors. SCPs that emphasize the importance of and activities to be undertaken in primary care may help to improve this coordination. Continuation of this research will help to better understand how to integrate the primary care physician into cancer follow up care. Updated data will be shared at time of presentation.

scholarly journals Factors Associated with Meeting the Psychosocial Needs of Cancer Survivors in Nova Scotia, Canada

2020 ◽  
Vol 28 (1) ◽  
pp. 13-25
Author(s):  
Soleil Chahine ◽  
Gordon Walsh ◽  
Robin Urquhart
Keyword(s):  
Primary Care ◽  
Nova Scotia ◽  
Cancer Survivors ◽  
Sociodemographic Factors ◽  
Patient Navigator ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Factors Associated ◽  
Follow Up Care

Purpose: The purpose of this study is to describe the psychosocial needs of cancer survivors and examine whether sociodemographic factors and health care providers accessed are associated with needs being met. Methods: All Nova Scotia survivors meeting specific inclusion and exclusion criteria are identified from the Nova Scotia Cancer Registry and sent an 83-item survey to assess psychosocial concerns and whether and how their needs were met. Descriptive statistics (frequencies, percentages) and Chi-square analyses are used to examine associations between sociodemographic and provider factors and outcomes. Results: Anxiety and fear of recurrence, depression, and changes in sexual intimacy are major areas of concern for survivors. Various sociodemographic factors, such as immigration status, education, employment, and internet use, are associated with reported psychosocial health and having one’s needs met. Having both a specialist and primary care provider in charge of follow-up care is associated with a significantly (p < 0.05) higher degree of psychosocial and informational needs met compared to only one physician or no follow-up physician in charge. Accessing a patient navigator also is significantly associated with a higher degree of needs met. Conclusions: Our study identifies the most prevalent psychosocial needs of cancer survivors and the factors associated with having a higher degree of needs met, including certain sociodemographic factors, follow-up care by both a primary care practitioner and specialist, and accessing a patient navigator.

scholarly journals Does Scheduling a Postdischarge Visit with a Primary Care Physician Increase Rates of Follow-up and Decrease Readmissions?

2019 ◽  
Vol 14 ◽  
pp. e37-e42
Author(s):  
Felippe O Marcondes ◽  
Paawan Punjabi ◽  
Lauren Doctoroff ◽  
Anjala Tess ◽  
Sarah O'Neill ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician

scholarly journals Association of Early Post-Discharge Follow-Up by a Primary Care Physician and 30-Day Rehospitalization Among Older Adults

2014 ◽  
Vol 30 (5) ◽  
pp. 565-571 ◽  
Author(s):  
Terry S. Field ◽  
Jessica Ogarek ◽  
Lawrence Garber ◽  
George Reed ◽  
Jerry H. Gurwitz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician ◽  
Post Discharge

Follow-up care of children identified with ADHD by primary care clinicians: A prospective cohort study

2004 ◽  
Vol 145 (6) ◽  
pp. 767-771 ◽  
Author(s):  
William Gardner ◽  
Kelly J. Kelleher ◽  
Kathleen Pajer ◽  
John V. Campo
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Follow Up Care ◽  
Primary Care Clinicians

Measuring follow-up care between primary care and specialty behavioral health settings for children and adolescents

2019 ◽  
Vol 17 (5) ◽  
pp. 627-638 ◽  
Author(s):  
Sean Lynch ◽  
Whitney Witt ◽  
Mir M. Ali ◽  
Judith Teich ◽  
Ryan Mutter ◽  
...  
Keyword(s):  
Primary Care ◽  
Children And Adolescents ◽  
Behavioral Health ◽  
Follow Up Care

A Decision Support System (DSS) for Colorectal Cancer Follow-Up Program via a Semantic Framework

2015 ◽  
Vol 10 (1) ◽  
pp. 17-38 ◽  
Author(s):  
Kalpdrum Passi ◽  
Hongtao Zhao
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Decision Support ◽  
Cancer Patients ◽  
Support System ◽  
Web Application ◽  
Semantic Framework ◽  
Follow Up Care ◽  
The Web

This paper offers insights into evolving a decision support system (DSS) to aid primary care physicians and/or nurses in the post-surgical care of patients with Colorectal Cancer in a clinical setting. Presently, the oncologists in the cancer center, who are familiar with the Clinical Practice Guidelines (CPGs), are primarily responsible for the provision of follow-up care to their patients on the basis of the CPGs; in contrast, the attending primary care physician and/or nurse assisting the oncologist may be unfamiliar with these guidelines. These caregivers would, therefore, either require hardcopies of the CPGs or can be aided via a DSS for them to be able to provide the appropriate follow-up care for the respective cancer patients. Clearly, the Colorectal Cancer follow-up CPGs have to be analyzed and the ontology representing the knowledge embedded in the guidelines designed prior to realizing such a DSS. The designed ontology is often coded into Web Ontology Language (OWL) as a standard ontology that can be accessed through the Web. The authors' research team designed and presented the semantic framework of the web application, using the designed ontology that combines the current Web technology with database storage to achieve a unified development of the DSS. The authors also designed a user-friendly interface of the Web application to provide medical practitioners the functionality of the CPGs and the flexibility to customize the desired follow-up care schedule. The resulting DSS provides the physicians with follow-up program for the Colorectal Cancer patients based on the CPGs. The system was built using the semantic framework for the follow-up program and queries on the system are executed through SPARQL query engine.

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