Research and Design Trends for Exam Room Computing to Enhance Patient Centeredness

2021 ◽  
Vol 65 (1) ◽  
pp. 196-200
Author(s):  
Jason J. Saleem ◽  
Laura G. Militello ◽  
Onur Asan ◽  
Jacob M. Read ◽  
Enid Montague
Keyword(s):  
Patient Communication ◽  
Patient Centeredness ◽  
Patient Centered ◽  
History Of Research ◽  
Room Design ◽  
Exam Room ◽  
History Of ◽  
Recent Trends ◽  
Research And Design ◽  
Improve Patient

While there is an extensive and established history of research that demonstrates the unfortunate capacity of exam room computing and electronic health records (EHRs) to negatively impact provider-patient communication and interaction, recent trends in exam room computing are promising in that there may be an opportunity for the EHR to improve patient engagement. The logical evolution of this research is to flip the narrative to understand strategies for using exam room computing as a mediator or facilitator of provider-patient communication and interaction, rather than simply establishing ways to mitigate the documented barriers. Panelists will present and discuss their latest research and experiences that may contribute to the evolution of using exam room computing as a tool to enhance provider-patient communication and interaction. We will also discuss how a thoughtful exam room design with patient-centered exam room computing technologies and practices may positively impact specific human factors, safety, and bias outcomes.

scholarly journals Field Investigation of Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Pilot Study

2018 ◽  
Vol 62 (1) ◽  
pp. 518-522
Author(s):  
Jason J. Saleem ◽  
Dustin T. Weiler ◽  
Tyler Satterly ◽  
Maury A. Nussbaum ◽  
Neale R. Chumbler ◽  
...  
Keyword(s):  
Pilot Study ◽  
Situation Awareness ◽  
Primary Care Providers ◽  
Field Investigation ◽  
Care Providers ◽  
Patient Centeredness ◽  
Design Standard ◽  
Room Design ◽  
Study Results ◽  
Exam Room

The Department of Veterans Affairs (VA) has developed a new exam room design standard that is intended to facilitate a greater degree of patient centeredness. This new design includes a wall-mounted monitor on an armature system and a moveable table workspace. To date, however, this design has not been formally evaluated in a field setting. We conducted observations and interviews with primary care providers and their patients from three locations within the Phoenix VA Health Care System, in a pilot study comparing the new exam room design standard with the older legacy exam rooms. When using the new exam room layout, providers spent a greater proportion of time focused on the patient, spent more time in screen-sharing activities with the patient, and had a higher degree of self-reported situation awareness. However, the legacy exam rooms were perceived as better facilitating workflow integration. Provider and patient debrief interviews were supportive of the new exam room design. Overall, our field study results suggest that the new exam room design does contribute to a greater degree of patient centeredness, though more thorough evaluations are required to support these preliminary results.

scholarly journals Engaging Patients for Clinical Trials in Africa: Patient-Centered Approaches

2020 ◽  
pp. 942-947
Author(s):  
Miriam Mutebi ◽  
Dicey Scroggins ◽  
Virgil Simons ◽  
Naomi Ohene Oti ◽  
Nazik Hammad
Keyword(s):  
Clinical Trials ◽  
Sub Saharan Africa ◽  
Patient Centered ◽  
Low Resource Settings ◽  
Low Resource ◽  
History Of ◽  
Different Populations ◽  
Sub Saharan ◽  
Best Fit ◽  
Improve Patient

Clinical trials in oncology are an emergent field in sub-Saharan Africa. There is a long history of clinical trials in high-income countries (HICs), with increasing attempts to develop patient-centric approaches and to evaluate patient-centered outcomes. The challenge remains as to how these trends could be adopted in low-resource settings and adapted to best fit the different health ecosystems that coexist on the African continent. Models that evaluate patient-related outcomes and measures and that are used in HICs must be modified, adopted, and adapted to suit the diverse populations and the low-resource settings in most of the continent. Patient engagement in clinical trials in Africa must be well nuanced, and it demands innovation and application of models that consider established but tailored notions/principles of patient and community engagement and the unique sociocultural aspects of different populations. It also must be linked to strategies that aim to improve patient education, health literacy, and access to services and to encourage and protect patient autonomy.

scholarly journals Patient Centeredness from a Perspective of History of the Present: A Genealogical Analysis

2020 ◽  
Vol 7 ◽  
pp. 233339362095024
Author(s):  
Eleni Siouta ◽  
Ulf Olsson
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Policy Documents ◽  
Policy Issues ◽  
History Of ◽  
Transnational Discourse ◽  
Historical Discourses ◽  
Historical Periods

The overall aim of this study, performed in Sweden, was to problematize the contemporary national and transnational discourse on patient centeredness, which during recent decades has become a given, having become established as a dogma in conversations, writing, and thinking about patients and health care. We did that by showing that ideas such as patient centeredness can be seen differently from the way they are depicted in contemporary discourses about health care. In the presented analysis, we drew on Foucault’s concepts of governmentality, ‘history of the present’ and genealogy. This means that we reflected on contemporary conceptions of how phenomena, such as the care seeker, have been constructed within other discourses about health care. Empirically, we used different health policy documents—government reports from three different historical periods. The analysis showed that contemporary narratives about centeredness are neither more, nor less, care seeker-centered than the narratives of yesteryear. Rather, the phenomenon of the care seeker is given different frames and meanings within the framework of different economic and historical discourses about health care. Our analysis raised questions about the contemporary construction of patient centeredness. In a world with such huge economic differences between nations, as well as between citizens within most nations, the contemporary discourse may be limited as it does not problematize structural issues in the same way as previous discourses had done. Perhaps what is needed today are national and international patient-centered or person-centered discourses which also discuss policies and practices that are population- and social group-centered. In the final discussion of the analysis, we identified a new patient-centered discourse, which views the patient as a resource among other resources. The most important limitation of this type of study is that it is only about discourses and policy issues and not about daily practical activities.

scholarly journals Provider Preference in Exam Room Layout Design and Computing

2019 ◽  
Vol 10 (05) ◽  
pp. 972-980
Author(s):  
Jacob M. Read ◽  
Dustin T. Weiler ◽  
Tyler Satterly ◽  
Catarina Soares ◽  
Jason J. Saleem
Keyword(s):  
Health Care Organizations ◽  
Patient Centeredness ◽  
Work Habits ◽  
Patient Interaction ◽  
Room Design ◽  
Semistructured Interviews ◽  
Exam Room ◽  
Provider Perspective ◽  
The One ◽  
Screen Sharing

Abstract Background The introduction of the electronic health record (EHR) has had a significant impact on provider–patient interactions, particularly revolving around patient-centeredness. More research is needed to understand the provider perspective of this interaction. Objectives Our objective was to obtain provider feedback on a new exam room design compared with the one already in use with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning. An additional objective was to understand elements of exam room design and computing that were highly valued. Methods Semistructured interviews were conducted with 28 providers from several health care organizations. Interviews were audio recorded and transcribed for analysis. We used an inductive coding approach to abstract recurrent themes from the data. Results Our analysis revealed several themes organized around exam room layout, exam room computing, and provider workflow. We report frequency of occurrence of the coded data for computer accessories, computing usefulness, computer mobility, documentation habits, form factor, layout preference, patient interaction, screen sharing, and work habits. Conclusion Providers in our study preferred exam room design to promote flexibility, mobility, and body orientation directed toward the patient. Providers also expressed the need for exam room design to support varying work habits and preferences, including whether to share the computer screen or not.

Improving Quality and Value of Cancer Care for Older Adults

2017 ◽  
pp. 383-393
Author(s):  
Erika E. Ramsdale ◽  
Valerie Csik ◽  
Andrew E. Chapman ◽  
Arash Naeim ◽  
Beverly Canin
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Functional Independence ◽  
Models Of Care ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Bundled Payment ◽  
Processes Of Care ◽  
Patients With Cancer ◽  
History Of

The concepts of quality and value have become ubiquitous in discussions about health care, including cancer care. Despite their prominence, these concepts remain difficult to encapsulate, with multiple definitions and frameworks emerging over the past few decades. Defining quality and value for the care of older adults with cancer can be particularly challenging. Older adults are heterogeneous and often excluded from clinical trials, severely limiting generalizable data for this population. Moreover, many frameworks for quality and value focus on traditional outcomes of survival and toxicity and neglect goals that may be more meaningful for older adults, such as quality of life and functional independence. A history of quality and value standards and an evaluation of some currently available standards and frameworks elucidate the potential gaps in application to older adults with cancer. However, narrowing the focus to processes of care presents several opportunities for improving the care of older adults with cancer now, even while further work is ongoing to evaluate outcomes and efficiency. New models of care, including the patient-centered medical home, as well as new associated bundled payment models, would be advantageous for older adults with cancer, facilitating collaboration, communication, and patient-centeredness and minimizing the fragmentation that impairs the current provision of cancer care. Advances in information technology support the foundation for these models of care; these technologies facilitate communication, increase available data, support shared decision making, and increase access to multidisciplinary specialty care. Further work will be needed to define and to continue to tailor processes of care to achieve relevant outcomes for older patients with cancer to fulfill the promise of quality and value of care for this vulnerable and growing population.

History of Research in Mammalian Sexual Behavior

1983 ◽  
Vol 28 (7) ◽  
pp. 545-546
Author(s):  
Rae Silver
Keyword(s):  
Sexual Behavior ◽  
History Of Research ◽  
History Of

Review of early developmental stages of trilobites and agnostids from the Barrandian area (Czech Republic)

2017 ◽  
Vol 186 (1) ◽  
pp. 103-112
Author(s):  
Lukáš Laibl ◽  
Oldřich Fatka
Keyword(s):  
Czech Republic ◽  
Developmental Stages ◽  
History Of Research ◽  
Early Developmental Stages ◽  
History Of ◽  
Barrandian Area ◽  
Early Developmental

This contribution briefly summarizes the history of research, modes of preservation and stratigraphic distribution of 51 trilobite and five agnostid taxa from the Barrandian area, for which the early developmental stages have been described.

Bayesian Inference in Human Time Perception

2017 ◽  
Author(s):  
Darren Rhodes
Keyword(s):  
Time Perception ◽  
Likelihood Function ◽  
Human Perception ◽  
Future Research ◽  
Temporal Properties ◽  
History Of Research ◽  
Psychophysical Testing ◽  
History Of ◽  
Fundamental Dimension ◽  
Perception Of Time

Time is a fundamental dimension of human perception, cognition and action, as the perception and cognition of temporal information is essential for everyday activities and survival. Innumerable studies have investigated the perception of time over the last 100 years, but the neural and computational bases for the processing of time remains unknown. First, we present a brief history of research and the methods used in time perception and then discuss the psychophysical approach to time, extant models of time perception, and advancing inconsistencies between each account that this review aims to bridge the gap between. Recent work has advocated a Bayesian approach to time perception. This framework has been applied to both duration and perceived timing, where prior expectations about when a stimulus might occur in the future (prior distribution) are combined with current sensory evidence (likelihood function) in order to generate the perception of temporal properties (posterior distribution). In general, these models predict that the brain uses temporal expectations to bias perception in a way that stimuli are ‘regularized’ i.e. stimuli look more like what has been seen before. Evidence for this framework has been found using human psychophysical testing (experimental methods to quantify behaviour in the perceptual system). Finally, an outlook for how these models can advance future research in temporal perception is discussed.

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