scholarly journals Towards a shared service centre for telemedicine: Telemedicine in Denmark, and a possible way forward

2016 ◽  
Vol 22 (4) ◽  
pp. 815-827 ◽  
Author(s):  
Simon Bo Larsen ◽  
Nanna Skovgaard Sørensen ◽  
Matilde Grøndahl Petersen ◽  
Gitte Friis Kjeldsen
Keyword(s):  
Participatory Design ◽  
Electronic Monitoring ◽  
Healthcare Services ◽  
Service Centre ◽  
Health Authorities ◽  
Shared Service ◽  
Internet Portals ◽  
Regional Health Authorities ◽  
Multi Stakeholder ◽  
Information And Technology

Although evidence of the effectiveness of telemedicine is accumulating, knowledge of how to make best use of telemedicine is limited. This article presents results from a multi-stakeholder project that developed a new concept, a ‘shared service centre’ for telemedicine that is envisioned as working across different telemedical initiatives to support the implementation and wider adoption of telemedicine. One year of participatory design and analysis of the shared service centre concept involved stakeholders, such as clinicians, patients, technicians, policy makers, lawyers, economists and information technology architects. More than 100 people contributed to the findings. Most of the ideas generated for potential centre support for telemedicine could be categorised under four service categories. The need for such support services was verified in the cases investigated, and by agreement among stakeholders from regional health authorities, municipalities, and general practice. Therefore, it is probable that a shared service centre could help enable the wider deployment of telemedicine. Definitions In this article, we use ‘telemedicine’ as an umbrella term for all the ‘tele-’ labels that are sometimes used rather indiscriminately to denote the use of information and technology to support healthcare services, including ‘telehealth’, ‘telemonitoring’, ‘telehomecare’, ‘e-health’, and so on. As per our definition, telemedicine may be synchronous and/or asynchronous, and may apply to any information and technology-based means of connecting healthcare actors and the patient, such as video communication, e-mail, electronic monitoring equipment, and Internet portals. Furthermore, the term ‘telemedical initiative’ covers projects in which telemedicine is conducted by a temporary project organisation, as well as self-contained telemedicine services used in daily, clinical practice in existing organisations.

scholarly journals Persuasion Tactics in the Implementation of Large-Scale EHR Suites in Public Healthcare

2021 ◽  
Author(s):  
Gunnar Ellingsen ◽  
Bente Christensen ◽  
Morten Hertzum
Keyword(s):  
Large Scale ◽  
Healthcare Services ◽  
Governance Structure ◽  
Public Healthcare ◽  
Technical Literature ◽  
Health Authorities ◽  
To Come ◽  
Regional Health Authorities ◽  
Entrepreneurial Role ◽  
The U.S

Large-scale electronic health record (EHR) suites have the potential to cover a broad range of use needs across various healthcare domains. However, a challenge that must be solved is the distributed governance structure of public healthcare: Regional health authorities regulate hospitals, municipalities are responsible for first-line healthcare services, and general practitioners (GPs) have an independent entrepreneurial role. In such settings, EHR program owners cannot enforce municipalities and GPs to come on board. Thus, we examine what tactics owners of large-scale EHR suite programs apply to persuade municipalities to participate, how strongly these tactics are enforced, and the consequences. Empirically, we focus on the Health Platform program in Central Norway where the goal is to implement the U.S. Epic EHR suite in 2022. Theoretically, the paper is positioned in the socio-technical literature.

The role of regional health systems on the waiting time inequalities in health care services: Evidences from Italy

2020 ◽  
pp. 095148482092830
Author(s):  
Stefano Landi ◽  
Enrico Ivaldi ◽  
Angela Testi
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Waiting Time ◽  
Health Care Access ◽  
Health Care Services ◽  
Waiting Times ◽  
Healthcare Services ◽  
Regional Health ◽  
Health Authorities ◽  
Regional Health Authorities

Inequalities in effective access to healthcare are present among countries and within the same country. Despite in Italy exist the principle of equity in access to health system, there are evidence of different access rates in the form of unequal waiting time within the country. Waiting times are an instruments to ration healthcare services dealing with resource scarsity. Theoretically, it is a fair tool because waiting times should depend only on health needs and not on the ability to pay. However, a growing literature has pointed out that belonging to a particular socioeconomic status leads to waiting times inequalities for healthcare services. Many countries have socioeconomic disparities among regions, and healthcare organizations need to take into account these differences. The increasing power of Regional Health Authorities in decentralized health systems, as in the case of Italy, has generated different organizational ways to provide health care, possibly leading to different access rates in the form of unequal waiting time within the country. This paper aims to understand if the administrative area (Regional Health Authorities) in charge of health services affects waiting times lowering or strengthening health care access inequalities. Using a series of logistic regression models, this work suggests the presence of two vectors: socioeconomic inequalities and regional inequalities. Health organizations need to implement different kinds of answers for each vectors of inequalities.

scholarly journals Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Graffigna ◽  
S Barello ◽  
L Palamenghi ◽  
M Savarese ◽  
G Castellini
Keyword(s):  
Healthcare Services ◽  
Cross Sectional Study ◽  
Health Prevention ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Health Authorities ◽  
Patient Health ◽  
Public Health Authorities ◽  
High Level ◽  
Restrictive Measures

Abstract Background At the end of February 2020 a new case was diagnosed with COVID-19 in north Italy, suddenly followed by new cases. Italian health authorities decided to enforce restrictive measures. Northern areas of Italy were identified as “red areas” to slow down the epidemic and its impact on the healthcare system. From this perspective, the COVID-19 epidemic in Italy constitutes a testing ground for the assessment of the ability of consumers to cope with this health risk. Methods A cross-sectional study on a representative sample of 1000 Italian citizens was conducted over the period 27 February- 5 March exploring the following hypotheses: 1) less engaged individuals are more concerned for the health emergency and feel more vulnerable; 2) less engaged have higher probability to develop negative attitudes and dysfunctional behaviors. Results only the 16% the interviewees presented a high level of engagement. Lower levels of engagement were measured in the southern parts of Italy (not yet touched by the epidemics at the time of data collection). People with lowers levels of engagement reported higher fears for the contagion and sense of vulnerability. Furthermore, they showed the lower levels of trust in the Public Health Authorities, in medical research and in vaccines. Finally, they appeared more dismissive in their preventive behaviors and more disorganized in the fruition of the healthcare services. Conclusions A psychological analysis of processes of attitudinal and role change in the direction of becoming more engaged in health prevention is worthy in order to forecast potential dysfunctional reactions to restrictive health prevention measures and to orient personalized education initiatives to consumers with different level of engagement. Key messages Profiling based on the levels of health engagement is important in order to plan more effective healthcare measures during epidemics. Targeted educational initiatives should take into account citizens' engagement profiles.

scholarly journals Recruitment into psychiatry

1996 ◽  
Vol 20 (3) ◽  
pp. 177-177 ◽  
Author(s):  
David Storer
Keyword(s):  
Advisory Committee ◽  
Manpower Planning ◽  
Regional Health ◽  
Senior Registrar ◽  
Adequate Supply ◽  
Health Authorities ◽  
Joint Planning ◽  
Regional Health Authorities

The major problem of manpower planning in psychiatry has until fairly recently been one of securing enough posts in the training grades to place doctors wishing to train in psychiatry and to ensure an adequate supply of applicants for consultant posts. Numerous consultant vacancies and a ‘bottleneck’ between registrar and senior registrar grades was the frustrating combination largely consequent upon the failure of some regional health authorities to fund the posts which Joint Planning Advisory Committee (JPAC) had approved.

Immersive Virtual Reality Exergames for People Living with Dementia: Working Through a User-Centered Co-Creation Process as a Multi-Stakeholder Team During the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
John Muñoz ◽  
Samira Mehrabi ◽  
Yirou Li ◽  
Aysha Basharat ◽  
Jennifer Boger ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Collaborative Design ◽  
Participatory Design ◽  
Healthy Lifestyle ◽  
Lessons Learned ◽  
Term Care ◽  
Design Elements ◽  
Complex Needs ◽  
Activity Promotion ◽  
Multi Stakeholder

BACKGROUND Advancements in supporting personalized healthcare and wellbeing using virtual reality (VR) has created opportunities to use immersive games to support a healthy lifestyle for persons living with dementia (PLWD) and mild cognitive impairment (MCI). Collaboratively designing exercise-video games (exergames) as a multi-stakeholder team is fundamental to creating games that are attractive, effective, and accessible. OBJECTIVE This research explores the use of participatory design methods that involve PLWD in long-term care facilitates, exercise professionals, content developers, game designers, and researchers in the creation of VR exergames targeting physical activity promotion for PLWD/MCI. METHODS Conceptualization, collaborative design, and playtesting activities were carried out to design VR exergames to engage PLWD in exercises to promote upper-limb flexibility, strength and aerobic endurance RESULTS Our results demonstrate how different stakeholders contribute to the design of VR exergames that consider/complement complex needs, preferences, and motivators of an underrepresented group of end-users as well as game design elements that reflect feedback for therapists and researchers. CONCLUSIONS This study provides evidence that collaborative multi-stakeholder design results in more tailored and context-aware VR games for PLWD. The insights and lessons learned in from this research can be used by others to co-design games, including remote engagement techniques that were used during the COVID-19 pandemic.

Designing an eHealth Breastfeeding Resource With Young Mothers Using a Participatory Design

2020 ◽  
pp. 104365962095706
Author(s):  
Jennifer Abbass-Dick ◽  
Barbara Chyzzy ◽  
Amber Newport ◽  
Joanne Huizinga ◽  
Fangli Xie
Keyword(s):  
Health Care Providers ◽  
Participatory Design ◽  
Participatory Approach ◽  
Phase Iii ◽  
Learning Needs ◽  
Young Mothers ◽  
Care Providers ◽  
Breastfeeding Support ◽  
Health Authorities ◽  
Three Phase

Introduction Breastfeeding rates among young mothers are low and do not meet recommendations from health authorities, putting the health of young mothers and their infants at risk. Young mothers require breastfeeding support that meets their learning needs and preferred mode for accessing information. The objective of this study was to work collaboratively with young mothers in order to cocreate an eHealth breastfeeding resource. Methodology A three-phase exploratory study was conducted in Ontario, Canada. In Phases I and II, young mothers and health care providers (HCPs) were recruited and preferences for an eHealth breastfeeding resource were explored. In Phase III, feedback from young mothers and HCPs about the new resource was collected. Results Participants found the breastfeeding eHealth resource visually appealing, engaging, and informative. Discussion Cocreating a tailored breastfeeding eHealth resource with young mothers and HCPs using a participatory approach ensured that the resource design and content met the learning needs of young mothers.

scholarly journals A qualitative study of the work experiences of midwives performing obstetric ultrasound in Norway

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Magnhild Reiso ◽  
Berit Langli ◽  
Eva Sommerseth ◽  
Aud Johannessen
Keyword(s):  
Qualitative Study ◽  
Health Sector ◽  
Holistic Approach ◽  
Organizational Factors ◽  
Positive Influence ◽  
Work Experiences ◽  
Obstetric Ultrasound ◽  
Individual Interviews ◽  
Health Authorities ◽  
Regional Health Authorities

Abstract Background Performing obstetric ultrasound is part of midwifery practice in Norway. Knowledge of these midwives’ working situation can enhance understanding of what their work involves and the challenges they encounter in their practice. The aim of this study was to gain insight into how midwife sonographers perceive their work in obstetric ultrasound. Methods A qualitative study with individual interviews was conducted in 2018. Midwives (n = 13) with a postgraduate ultrasound qualification who performed obstetric ultrasound in private clinics and/or the public health sector were included. All four regional health authorities in Norway were represented. The data gathered were analysed using content analysis. Results The analysis resulted in three main themes. (1) Working as a midwife sonographer involves a holistic approach. By practising their competence, in both midwifery and sonography, they could answer questions and reassure pregnant women. The participants also had a feeling of great responsibility in their work. (2) Being part of a professional environment in obstetric ultrasound was important for professional interaction, belonging and learning. (3) Developing and maintaining competence as a midwife sonographer had a positive influence on midwives’ motivation and confidence, and allowed for more variety in their work. Conclusions Holistic care of the pregnant woman, her partner and the unborn baby was an important part of the participants’ work. They wanted to meet colleagues within their field, develop their expertise and have influence over their work situation. Organizational factors seemed to affect the participants’ overall ability to practise their skills and thus also their job satisfaction.

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