Physician communication via Internet-enabled technology: A systematic review

2017 ◽  
Vol 25 (3) ◽  
pp. 919-934 ◽  
Author(s):  
Neil G Barr ◽  
Glen E Randall ◽  
Norman P Archer ◽  
David M Musson
Keyword(s):  
Systematic Review ◽  
Information Exchange ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision ◽  
Computing Machinery ◽  
Information And Communication ◽  
Use Of Internet ◽  
The Impact ◽  
Improve Health Care Delivery

The use of Internet-enabled technology (information and communication technology such as smartphone applications) may enrich information exchange among providers and, consequently, improve health care delivery. The purpose of this systematic review was to gain a greater understanding of the role that Internet-enabled technology plays in enhancing communication among physicians. Studies were identified through a search in three electronic platforms: the Association for Computing Machinery Digital Library, ProQuest, and Web of Science. The search identified 5140 articles; of these, 21 met all inclusion criteria. In general, physicians were satisfied with Internet-enabled technology, but consensus was lacking regarding whether Internet-enabled technology improved efficiency or made a difference to clinical decision-making. Internet-enabled technology can play an important role in enhancing communication among physicians, but the extent of that benefit is influenced by (1) the impact of Internet-enabled technology on existing work practices, (2) the availability of adequate resources, and (3) the nature of institutional elements, such as privacy legislation.

scholarly journals Exploring the role of the Care and Health Information Exchange (CHIE) in clinical decision-making: a realist evaluation

2020 ◽  
Author(s):  
Philip Scott ◽  
Elisavet Andrikopoulou ◽  
Haythem Nakkas ◽  
Paul Roderick
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Social Care ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Health And Social Care ◽  
The Impact

Background: The overall evidence for the impact of electronic information systems on cost, quality and safety of healthcare remains contested. Whilst it seems intuitively obvious that having more data about a patient will improve care, the mechanisms by which information availability is translated into better decision-making are not well understood. Furthermore, there is the risk of data overload creating a negative outcome. There are situations where a key information summary can be more useful than a rich record. The Care and Health Information Exchange (CHIE) is a shared electronic health record for Hampshire and the Isle of Wight that combines key information from hospital, general practice, community care and social services. Its purpose is to provide clinical and care professionals with complete, accurate and up-to-date information when caring for patients. CHIE is used by GP out-of-hours services, acute hospital doctors, ambulance service, GPs and others in caring for patients. Research questions: The fundamental question was How does awareness of CHIE or usage of CHIE affect clinical decision-making? The secondary questions were What are the latent benefits of CHIE in frontline NHS operations? and What is the potential of CHIE to have an impact on major NHS cost pressures? The NHS funders decided to focus on acute medical inpatient admissions as the initial scope, given the high costs associated with hospital stays and the patient complexities (and therefore information requirements) often associated with unscheduled admissions. Methods: Semi-structured interviews with healthcare professionals to explore their experience about the utility of CHIE in their clinical scenario, whether and how it has affected their decision-making practices and the barriers and facilitators for their use of CHIE. The Framework Method was used for qualitative analysis, supported by the software tool Atlas.ti. Results: 21 healthcare professionals were interviewed. Three main functions were identified as useful: extensive medication prescribing history, information sharing between primary, secondary and social care and access to laboratory test results. We inferred two positive cognitive mechanisms: knowledge confidence and collaboration assurance, and three negative ones: consent anxiety, search anxiety and data mistrust. Conclusions: CHIE gives clinicians the bigger picture to understand the patient's health and social care history and circumstances so as to make confident and informed decisions. CHIE is very beneficial for medicines reconciliation on admission, especially for patients that are unable to speak or act for themselves or who cannot remember their precise medication or allergies. We found no clear evidence that CHIE has a significant impact on admission or discharge decisions. We propose the use of recommender systems to help clinicians navigate such large volumes of patient data, which will only grow as additional data is collected.

scholarly journals The Difficult Airway and Aerosol-Generating Procedures in COVID-19: Timeless Principles for Uncertain Times

2020 ◽  
Vol 163 (5) ◽  
pp. 934-937 ◽  
Author(s):  
Joshua D. Smith ◽  
Michelle M. Chen ◽  
Karthik Balakrishnan ◽  
Douglas R. Sidell ◽  
Arianna di Stadio ◽  
...  
Keyword(s):  
Airway Management ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision ◽  
Supraglottic Airway ◽  
Fiberoptic Intubation ◽  
Protective Equipment ◽  
Trade Offs ◽  
Airway Pathology ◽  
The Impact

The impact of the COVID-19 pandemic on otolaryngology practice is nowhere more evident than in acute airway management. Considerations of preventing SARS-CoV-2 transmission, conserving personal protective equipment, and prioritizing care delivery based on acuity have dictated clinical decision making in the acute phase of the pandemic. With transition to a more chronic state of pandemic, heightened vigilance is necessary to recognize how deferral of care in patients with tenuous airways and COVID-19 infection may lead to acute airway compromise. Furthermore, it is critical to respect the continuing importance of flexible laryngoscopy in diagnosis. Safely managing airways during the pandemic requires thoughtful multidisciplinary planning. Teams should consider trade-offs among aerosol-generating procedures involving direct laryngoscopy, supraglottic airway use, fiberoptic intubation, and tracheostomy. We share clinical cases that illustrate enduring principles of acute airway management. As algorithms evolve, time-honored approaches for diagnosis and management of acute airway pathology remain essential in ensuring patient safety.

scholarly journals The benefits of health information exchange: an updated systematic review

2018 ◽  
Vol 25 (9) ◽  
pp. 1259-1265 ◽  
Author(s):  
Nir Menachemi ◽  
Saurabh Rahurkar ◽  
Christopher A Harle ◽  
Joshua R Vest
Keyword(s):  
Systematic Review ◽  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Care Delivery ◽  
The United States ◽  
Current Systematic Review ◽  
Meta Analyses ◽  
The Impact

Abstract Objective Widespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Results Our search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects. Conclusions The current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.

Building platforms for collaborative care and clinical research in testicular cancer (TC): New approaches for care delivery for a model neoplasm.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 308-308
Author(s):  
Craig R. Nichols ◽  
Christian K. Kollmannsberger ◽  
Victoria Demchak ◽  
Ellen Cigan
Keyword(s):  
Clinical Research ◽  
Real Time ◽  
Information Exchange ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision ◽  
Learning System ◽  
Community Partner ◽  
Patient Reported ◽  
Proof Of Principle

308 Background: TC is a “model of a curable neoplasm.” In expert centers, more than 95% of patients are cured and enjoy long, high quality survivorship. Unfortunately, emerging data demonstrate variations in quality outcomes seen in high volume centers. Result are not fully replicated in U.S. community settings, low resources countries or in settings of uneven access. We hypothesize that real time, electronic information exchange in TC can influence favorably clinical decision making, patient-centered outcomes, value and quality of survivorship across business and geographic boundaries. Further, we speculate that aggregated, de-identified clinical/ biological information will serve as a template for a rapid learning system to refine clinical management and advance biological understanding. Methods: Our primary objectives were to (1) Build organizational/administrative capacity. (2) Engage patients/local providers. (3) Develop the information infrastructure to accomplish real time exchange of live patient-permitted clinical data (patient reported inputs, laboratory, imaging) and timely transmission of clinical decision support and ongoing oversight of care delivery in the community. (4) Establish a proof-of-principle demonstration in a community-based, electronically organized care delivery system. Results: Organizational: TC Commons, a nonprofit organization, was founded to house this effort. Leading academic institutions form the knowledge base, initial data sharing network and administrative structure for this electronic cooperative group. Early implementation has utilized cloud-based resources and telepresence. Community Engagement: We are utilizing organized social media efforts and partnering with patient advocacy groups. IT Infrastructure: We are creating public/private collaboratives to house the electronic capacity with appropriate privacy concerns. Proof of Principle: We are selecting community partner organizations and planning grant submissions. Conclusions: Expert platforms to enhance care delivery, patient value and experience, and clinical research can be built using a “bootstapping,” cost-sensitive approach.

scholarly journals The impact of lung ultrasound on clinical-decision making across departments: a systematic review

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Micah L. A. Heldeweg ◽  
Lian Vermue ◽  
Max Kant ◽  
Michelle Brouwer ◽  
Armand R. J. Girbes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Clinical Decision ◽  
Current Evidence ◽  
Substantial Impact ◽  
Thoracic Ultrasound ◽  
Newcastle Ottawa Scale ◽  
The Impact

Abstract Background Lung ultrasound has established itself as an accurate diagnostic tool in different clinical settings. However, its effects on clinical-decision making are insufficiently described. This systematic review aims to investigate the impact of lung ultrasound, exclusively or as part of an integrated thoracic ultrasound examination, on clinical-decision making in different departments, especially the emergency department (ED), intensive care unit (ICU), and general ward (GW). Methods This systematic review was registered at PROSPERO (CRD42021242977). PubMed, EMBASE, and Web of Science were searched for original studies reporting changes in clinical-decision making (e.g. diagnosis, management, or therapy) after using lung ultrasound. Inclusion criteria were a recorded change of management (in percentage of cases) and with a clinical presentation to the ED, ICU, or GW. Studies were excluded if examinations were beyond the scope of thoracic ultrasound or to guide procedures. Mean changes with range (%) in clinical-decision making were reported. Methodological data on lung ultrasound were also collected. Study quality was scored using the Newcastle–Ottawa scale. Results A total of 13 studies were included: five studies on the ED (546 patients), five studies on the ICU (504 patients), two studies on the GW (1150 patients), and one study across all three wards (41 patients). Lung ultrasound changed the diagnosis in mean 33% (15–44%) and 44% (34–58%) of patients in the ED and ICU, respectively. Lung ultrasound changed the management in mean 48% (20–80%), 42% (30–68%) and 48% (48–48%) of patients in the ED, in the ICU and in the GW, respectively. Changes in management were non-invasive in 92% and 51% of patients in the ED and ICU, respectively. Lung ultrasound methodology was heterogeneous across studies. Risk of bias was moderate to high in all studies. Conclusions Lung ultrasound, exclusively or as a part of thoracic ultrasound, has substantial impact on clinical-decision making by changing diagnosis and management in the EDs, ICUs, and GWs. The current evidence level and methodological heterogeneity underline the necessity for well-designed trials and standardization of methodology.

scholarly journals A Systematic Review of the Impact of Physician Implicit Racial Bias on Clinical Decision Making

2017 ◽  
Vol 24 (8) ◽  
pp. 895-904 ◽  
Author(s):  
Erin Dehon ◽  
Nicole Weiss ◽  
Jonathan Jones ◽  
Whitney Faulconer ◽  
Elizabeth Hinton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Racial Bias ◽  
Clinical Decision ◽  
Implicit Racial Bias ◽  
The Impact

Religion and Medicine

2020 ◽  
Author(s):  
Jeff Levin ◽  
Stephen G. Post
Keyword(s):  
Clinical Decision Making ◽  
Well Being ◽  
Clinical Decision ◽  
Religion And Medicine ◽  
Physical And Mental Health ◽  
Faith Based ◽  
Baylor University ◽  
Wide Range ◽  
History Of ◽  
The Impact

In Religion and Medicine, Dr. Jeff Levin, distinguished Baylor University epidemiologist, outlines the longstanding history of multifaceted interconnections between the institutions of religion and medicine. He traces the history of the encounter between these two institutions from antiquity through to the present day, highlighting a myriad of contemporary alliances between the faith-based and medical sectors. Religion and Medicine tells the story of: religious healers and religiously branded hospitals and healthcare institutions; pastoral professionals involved in medical missions, healthcare chaplaincy, and psychological counseling; congregational health promotion and disease prevention programs and global health initiatives; research studies on the impact of religious and spiritual beliefs and practices on physical and mental health, well-being, and healing; programs and centers for medical research and education within major universities and academic institutions; religiously informed bioethics and clinical decision-making; and faith-based health policy initiatives and advocacy for healthcare reform. Religion and Medicine is the first book to cover the full breadth of this subject. It documents religion-medicine alliances across religious traditions, throughout the world, and over the course of history. It summarizes a wide range of material of relevance to historians, medical professionals, pastors and theologians, bioethicists, scientists, public health educators, and policymakers. The product of decades of rigorous and focused research, Dr. Levin has produced the most comprehensive history of these developments and the finest introduction to this emerging field of scholarship.

Clinical Conundrums When Integrating the QbTest into a Standard ADHD Assessment of Children and Young People

2021 ◽  
Author(s):  
Carsten Vogt
Keyword(s):  
Clinical Practice ◽  
Clinical Decision Making ◽  
Ecological Validity ◽  
Neuropsychological Test ◽  
Real Life ◽  
Clinical Decision ◽  
Hyperactivity Disorder ◽  
Standard Clinical Practice ◽  
Novel Method ◽  
The Impact

AbstractThe uptake of the QbTest in clinical practice is increasing and has recently been supported by research evidence proposing its effectiveness in relation to clinical decision-making. However, the exact underlying process leading to this clinical benefit is currently not well established and requires further clarification. For the clinician, certain challenges arise when adding the QbTest as a novel method to standard clinical practice, such as having the skills required to interpret neuropsychological test information and assess for diagnostically relevant neurocognitive domains that are related to attention-deficit hyperactivity disorder (ADHD), or how neurocognitive domains express themselves within the behavioral classifications of ADHD and how the quantitative measurement of activity in a laboratory setting compares with real-life (ecological validity) situations as well as the impact of comorbidity on test results. This article aims to address these clinical conundrums in aid of developing a consistent approach and future guidelines in clinical practice.

scholarly journals Shared clinical decision-making experiences in nursing: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Fen-Fang Chung ◽  
Pao-Yu Wang ◽  
Shu-Chuan Lin ◽  
Yu-Hsia Lee ◽  
Hon-Yen Wu ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Education ◽  
Nursing Staff ◽  
Information Exchange ◽  
Clinical Decision Making ◽  
Medical Center ◽  
Clinical Decision ◽  
Sociocultural Factors ◽  
Patient Centered ◽  
Clinical Nursing

Abstract Background Shared decision making (SDM) is a patient-centered nursing concept that emphasizes the autonomy of patients. SDM is a co-operative process that involves information exchange and communication between medical staff and patients for making treatment decisions. In this study, we explored the experiences of clinical nursing staff participating in SDM. Methods This study adopted a qualitative research design. Semistructured interviews were conducted with 21 nurses at a medical center in northern Taiwan. All interview recordings were transcribed verbatim. Content analysis was performed to analyze the data. Results The findings yielded the following three themes covering seven categories: knowledge regarding SDM, trigger discussion and coordination, and respect of sociocultural factors. Conclusions The results of this study describe the experiences of clinical nursing staff participating in SDM and can be used as a reference for nursing education and nursing administrative supervisors wishing to plan and enhance professional nursing SDM in nursing education.

Sign in / Sign up

Export Citation Format

Share Document