scholarly journals Digital Health for Patients With Multiple Myeloma: An Unmet Need

2021 ◽  
pp. 1096-1105
Author(s):  
Sundar Jagannath ◽  
Joseph Mikhael ◽  
Omar Nadeem ◽  
Noopur Raje
Keyword(s):  
Health Care ◽  
Multiple Myeloma ◽  
Health Care Providers ◽  
Randomized Clinical Trials ◽  
Digital Health ◽  
Unmet Need ◽  
Care Providers ◽  
Patient Journey ◽  
Health Technologies ◽  
Patient Reported

Multiple myeloma (MM) is associated with the highest symptom burden and lowest health-related quality of life (HRQoL) among patients with hematologic malignancies. HRQoL in MM is heterogeneous, varying over the course of disease, with the highest burden at diagnosis and relapse. Patients with MM are increasingly being treated with oral maintenance medications at home. As a result, longitudinal monitoring of medication adherence and patient-reported outcomes, including HRQoL, could inform on disease status, therapeutic tolerability, and satisfaction with care. Digital health technologies, including telemedicine, mobile health, and wearable devices, are poised to become an integral part of modern health care, in part due to the surge in telemedicine necessitated by the COVID-19 pandemic. Although the literature has many reports on the use of digital health technologies in other types of cancers, fewer studies report on their application to MM. In the current narrative review, we survey the applications of digital health for MM. Although there is evidence that some are associated with improved health outcomes, challenges exist that must be met to ensure more widespread adoption. These include the need for increased awareness by patients and health care providers, lack of access by the typical older patient with MM, absence of randomized clinical trials, and low integration with current workflows such as electronic health records. Following our summary of technologies that could benefit patients with MM, we end by describing our vision for how they can be integrated into each phase of the patient journey.

scholarly journals Patient connectivity with healthcare professionals and health insurer using digital health technologies during the COVID-19 pandemic: a German cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Niels Hannemann ◽  
Nina-Alexandra Götz ◽  
Lisa Schmidt ◽  
Ursula Hübner ◽  
Birgit Babitsch
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Providers ◽  
Data Transmission ◽  
Digital Health ◽  
Health Insurance Company ◽  
Insurance Company ◽  
Care Providers ◽  
Cross Sectional ◽  
Health Technologies

Abstract Background Digital health technologies enable patients to make a personal contribution to the improvement of their health by enabling them to manage their health. In order to exploit the potential of digital health technologies, Internet-based networking between patients and health care providers is required. However, this networking and access to digital health technologies are less prevalent in sociodemographically deprived cohorts. The paper explores how the use of digital health technologies, which connect patients with health care providers and health insurers has changed during the COVID-19 pandemic. Methods The data from a German-based cross-sectional online study conducted between April 29 and May 8, 2020, were used for this purpose. A total of 1.570 participants were included in the study. Accordingly, the influence of sociodemographic determinants, subjective perceptions, and personal competencies will affect the use of online booking of medical appointments and medications, video consultations with providers, and the data transmission to health insurers via an app. Results The highest level of education (OR 1.806) and the presence of a chronic illness (OR 1.706) particularly increased the likelihood of using online booking. With regard to data transmission via an app to a health insurance company, the strongest increase in the probability of use was shown by belonging to the highest subjective social status (OR 1.757) and generation Y (OR 2.303). Furthermore, the results show that the higher the subjectively perceived restriction of the subjects' life situation was due to the COVID-19 pandemic, the higher the relative probability of using online booking (OR 1.103) as well as data transmission via an app to a health insurance company (OR 1.113). In addition, higher digital literacy contributes to the use of online booking (OR 1.033) and data transmission via an app to the health insurer (OR 1.034). Conclusions Socially determined differences can be identified for the likelihood of using digital technologies in health care, which persist even under restrictive conditions during the COVID-19 pandemic. Thus, the results indicate a digital divide with regard to the technologies investigated in this study.

scholarly journals “We are very individual”: Anticipated effects on stroke survivors of using their person-generated health data (Preprint)

2019 ◽  
Author(s):  
Gerardo Luis Dimaguila ◽  
Frances Batchelor ◽  
Mark Merolli ◽  
Kathleen Gray
Keyword(s):  
Health Care ◽  
Health Services ◽  
Focus Groups ◽  
Health Care Providers ◽  
Digital Health ◽  
Stroke Care ◽  
Health Data ◽  
Stroke Survivors ◽  
Care Providers ◽  
Patient Reported

BACKGROUND Person-generated health data (PGHD) are produced by people when they use health information technologies. People who use PGHD may have changes in their engagement with their own health care, their relationship with their healthcare providers, and their sense of social support and connectedness. Research into evaluating those reported effects however, has not kept up; thus a method for developing patient-reported outcome measures (PROMs) of utilising PGHD, called the PROM-PGHD Development Method, was previously designed and applied to the exemplar case of Kinect-based stroke rehabilitation systems (K-SRS). A key step of the method ensures that the patient’s voice is included. Allowing stroke survivors to participate in the development and evaluation of health services and treatment can inform health care providers on decisions about stroke care, and thereby improve health outcomes. Moreover, eliciting the input of stroke survivors is important because there could be differences in their perspectives and that of their care providers, regarding treatment and management. OBJECTIVE This paper presents the perspectives of stroke survivors and clinicians on the anticipated effects of stroke survivors’ use of PGHD from a poststroke simulated rehabilitation technology. METHODS This study gathered the perspectives of six stroke survivors and five clinicians through three focus groups and three interviews, recruited for convenience. In the stroke survivors’ focus groups, participants were asked to give their perspectives on how using the PGHD from Jintronix may affect their outcomes; while in the clinicians’ focus group, clinicians were asked for their perspectives on how PGHD use may affect the outcomes of stroke survivors. Participants were also asked questions intended to encourage them to comment on the initial items of the PROM-PGHD. Deductive thematic analysis was performed. RESULTS Survivors and clinicians had varying perspectives in three of the six themes presented, and puts emphasis on the importance of allowing stroke survivors to participate in the evaluation of digital health services. However, the potential for tensions to occur between the needs and preferences of patients and their care providers could be reduced through a similar understanding of health treatment goals. This paper has further demonstrated that outcomes of utilising PGHD can be measured. For instance, stroke survivors described that using PGHD could result in positive, negative, and nil effects on their health behaviours. CONCLUSIONS This study is the first to gather and compare the perspectives of stroke survivors and clinicians, in order to develop a PROM-PGHD for a simulated rehabilitation system. The reported PGHD utilisation outcomes would directly inform the development of a PROM-PGHD for K-SRS, of which this paper is a key step. Additionally, they could help inform health care providers on decisions about stroke care. This is particularly relevant in the area of poststroke simulated rehabilitation technologies.

scholarly journals SAT0640-HPR RHEUMATOLOGY CARE OF MIGRANTS FROM SUB-SAHARAN AFRICA; A QUALITATIVE PILOT STUDY OF PATIENTS’ PERSPECTIVES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1279.1-1279
Author(s):  
Z. Rutter-Locher ◽  
J. Galloway ◽  
H. Lempp
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Health Care Providers ◽  
Unmet Need ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Specialist Care ◽  
Sub Saharan ◽  
The Uk

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

scholarly journals Crossing Knowledge Boundaries: Health Care Providers’ Perceptions and Experiences of What is Important to Achieve More Person-Centered Patient Pathways For Older People

2021 ◽  
Author(s):  
Cecilie Olsen ◽  
Astrid Bergland ◽  
Asta Bye ◽  
Jonas Debesay ◽  
Anne Langaas
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Providers ◽  
Quality Improvement Collaborative ◽  
Patient Journey ◽  
Patient Pathways

Abstract Background: Improving the transitional care of older people, especially hospital-to-home transitions, is a salient concern worldwide. Older people’s patient pathways may be unpredictable and complex, posing significant challenges for health care providers (HCPs). In particular, appropriate follow-up in primary care after discharge is key. Current research in the field endorses person-centered care as crucial to improving the patient pathways of older people. The aim of this study was to explore HCPs’ perceptions and experiences of what is important to achieve more person-centered patient pathways for older people.Methods: This was a qualitative study. We performed individual semistructured interviews with 20 HCPs and three key persons who participated in a Norwegian quality improvement collaborative. In addition, participant observation of 22 meetings in the quality improvement collaborative was performed. Results: A thematic analysis resulted in five themes: 1) Finding common ground through the mapping of the patient journey; 2) the importance of understanding the whole patient pathway; 3) the significance of getting to know the older patient; 4) the key role of home care providers in the patient pathways of older people; and 5) ambiguity toward checklists and practice implementation. Conclusion: To understand the findings, it proved useful to see them in light of knowledge sharing and boundary crossing, which are central concepts in the literature on transitional care. HCPs in the collaborative shared and coproduced new knowledge of the patient pathways of older people based on a patient journey perspective. Mapping the patient journey and asking, “What matters to you?” facilitated the crossing of knowledge boundaries between the HCPs; hence, a new and more holistic view of the patient pathways of older people in the current context emerged. The centrality of getting to know the patient and the special role of providers working in home care services was a central finding. The study adds to existing knowledge by suggesting that the achievement of person-centered patient pathways for older people does not only depend on the crossing of knowledge boundaries among HCPs, but also between HCPs and older persons.

scholarly journals Localized Provoked Vulvodynia-An Ignored Vulvar Pain Syndrome

2021 ◽  
Vol 11 ◽  
Author(s):  
Jorma Paavonen ◽  
David A. Eschenbach
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Randomized Clinical Trials ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Health Care Research ◽  
Treatment Modalities ◽  
Care Providers ◽  
Susceptible Host ◽  
Reproductive Aged Women

Localized provoked vulvodynia (LPV) causes dyspareunia among reproductive aged women. We review the pathogenesis of LPV and suggest that LPV is an inflammatory pain syndrome of the vestibular mucosa triggered by microbial antigens in a susceptible host. Tissue inflammation and hyperinnervation are characteristic findings which explain symptoms and clinical signs. Education of health care providers of LPV is important since this condition is common, often unrecognized, and patients often become frustrated users of health care. Research is needed on the antigen triggers of the syndrome. Randomized clinical trials are needed to evaluate treatment modalities.

scholarly journals Users perceived contribution and usability of mobile health applications and connected objects: patients and health care providers perspectives from an exploratory survey (Preprint)

2018 ◽  
Author(s):  
Christel Saussier ◽  
Frédéric Faurennes ◽  
Hubert Méchin ◽  
Laurent Mignon ◽  
Solène Ponthieu ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Exploratory Study ◽  
Digital Health ◽  
Health Sector ◽  
Real Life ◽  
Potential Contribution ◽  
Care Providers ◽  
Health Technologies ◽  
Connected Health ◽  
Health Applications

BACKGROUND Technology is nowadays omnipresent. Using New Information and Communications Technologies in the health sector is promising and intended to be beneficial, both for patient disease prevention and care. The Lab e-Santé, a French think tank, aims to further advance knowledge of the use and practices of digital health tools, identify obstacles in their use, and issue recommendations. OBJECTIVE The Lab e-Santé conducted an exploratory study in order to get preliminary data regarding the appropriation, satisfaction and global use in real life of health applications and connected objects. This initial survey would allow to explore, within MHCs (Multidisciplinary health centers), the usability and the perceived contribution of the tools from both HCPs and patients’ viewpoints and provide preliminary inputs regarding the barriers and the drivers of connected health. METHODS The Lab e-santé recruited a total of 10 facilities from the exhaustive database of French MHCs. HCPs from those MHC were provided with iPads on which the m-health application was installed. They were also provided with three types of connected devices: weighting scales, blood pressure monitors and activity trackers. VirtualSanté and VirtualSanté Pro applications were especially developed for the survey. VirtualSanté allowed to compile all the patient’s data collected from a connected health device, and share these data with the health professional in their dedicated professional application, VirtualSanté Pro. During a 5-month period, participating health professionals were instructed to include patients with chronic diseases, aged 18 years and above, who agreed to participate. RESULTS This exploratory study addressed the perceived contribution and usability of health technologies from both patients and their HCPs. Our findings as described below suggest that there is a dichotomy between HCPs and patients’ perception about connected health usefulness. HCPs are more confident in a potential contribution of connected health for their patients than the patients themselves. Patients didn’t express any benefit 6 months later and the device became a source of anxiety for some of them. One possible explanation may be the multiple technical issues users faced during the survey including the installation of the applications on non-compatible devices, the initial connection between the object and the application or technical bugs during use. For the same reasons, HCPs found it time-consuming and difficult to integrate in their everyday practice. CONCLUSIONS Today many people are optimistic about the concept of mHealth. However, to use these devices and have high acceptance, both HCPs and patients need to be aware of the existence and usefulness of applications and connected objects then trust them. Tools should be personalized and adaptive, as far as possible, or at least be adapted to the good user profile. The latter should be motivated, properly trained, educated and supported for assuring an appropriate, useful and sustainable use.

scholarly journals Exploring digital health care: eHealth, mHealth, and librarian opportunities

2021 ◽  
Vol 109 (3) ◽  
Author(s):  
Janet Chan
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
The United States ◽  
Security And Privacy ◽  
Care Providers ◽  
Vast Number ◽  
Health Technologies ◽  
Technology Advances

Technology advances in eHealth and mHealth are changing the way that health care consumers and providers communicate, receive and deliver care, and access health information. As electronic health records and smartphones have become ubiquitous in the United States, opportunities and applications for the integration of eHealth and mHealth have increased. In addition to technology advances, the changing health care model is simultaneously adapting to and driving initiatives in digital health care. With these digital initiatives have come challenges, including data overload, security and privacy concerns, deficits in technological and health literacy skills, and sorting through the vast number of choices of digital applications. Navigating this changing landscape can be overwhelming and time consuming for both health care providers and consumers. Librarians are uniquely positioned to assist providers and consumers to break down barriers within the digital health care landscape through data management initiatives, technology and health literacy instruction, and finding and evaluating health information and digital health technologies.

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