scholarly journals Telemedicine in Community Cancer Care: How Technology Helps Patients With Cancer Navigate a Pandemic

2021 ◽  
Vol 17 (1) ◽  
pp. e11-e15
Author(s):  
Debra A. Patt ◽  
Lalan Wilfong ◽  
Sara Toth ◽  
Stephanie Broussard ◽  
Kristen Kanipe ◽  
...  
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Healthcare Delivery ◽  
Psychosocial Care ◽  
Broadband Access ◽  
Healthcare Delivery System ◽  
Care Needs ◽  
Patients With Cancer ◽  
Qualitative Feedback ◽  
Policy Priority

COVID-19 places unprecedented demands on the oncology ecosystem. The extensive pressure of managing health care during the pandemic establishes the need for rapid implementation of telemedicine. Across our large statewide practice of 640 practitioners at 221 sites of service, an aggressive multidisciplinary telemedicine strategy was implemented in March by coordinating and training many different parts of our healthcare delivery system. From March to September, telemedicine grew to serve 15%-20% of new patients and 20%-25% of established patients, permitting the practice to implement safety protocols and reduce volumes in clinic while continuing to manage the acute and chronic care needs of our patient population. We surveyed practice leaders, queried for qualitative feedback, and established 76% were satisfied with the platform. The common challenges for patients were the first-time use and technology function, and patients were, in general, grateful and happy to have the option to visit their clinicians on a telemedicine platform. In addition to conducting new and established visits remotely, telemedicine allows risk assessments, avoidance of hospitalization, family education, psychosocial care, and improved pharmacy support. The implementation has limitations including technical complexity; increased burden on patients and staff; and broadband access, particularly in rural communities. For telemedicine to improve as a solution to enhance the longitudinal care of patients with cancer, payment coverage policies need to continue after the pandemic, technologic adoption needs to be easy for patients, and broadband access in rural areas needs to be a policy priority. Further research to optimize the patient and clinician experience is required to continue to make progress.

scholarly journals Psychological Support and Telehealth Options for Patients with Cancer during the Covid-19 Pandemic in Saudi Arabia

2021 ◽  
Vol 8 ◽  
Author(s):  
Manal Banaser ◽  
Sami Alshammary
Keyword(s):  
Cancer Patients ◽  
Support Groups ◽  
Cancer Care ◽  
Healthcare Delivery ◽  
Psychosocial Care ◽  
Multidisciplinary Care ◽  
Psychological Support ◽  
Registry Data ◽  
Cancer Center ◽  
Healthcare Delivery System

Background: COVID-19 concerns are associated with an increase in symptoms of depression and anxiety among cancer patients. Telehealth services hold incredible potential for providing psychological support to cancer patients. In a technology-assisted intervention for telehealth, hotline services are a valuable tool to provide psychosocial care. This paper examines the use of hotline services to offer psychological support to cancer patients. Methods: A retrospective analysis of hotline calls patient registry data was conducted. Data were collected from a single cancer center in Riyadh, from May 2020 to March 2021, with a random sample of 877 callers to cancer hotline services. Responses of a satisfaction questionnaire were linked to call-related concerns of registry data.  Results: A total of 877 calls were received, the majority of which came from Riyadh locals. Patient disease complaints accounted for 210 calls (24%), while retake medicine requests accounted for 251 calls (28.62%). 143 (16.31%) calls were about scheduled new appointments, 261 calls (29.76%) were about psychological issues induced by Covid-19, such as worry, fear, and anxiety symptoms, and 12 calls (1.37%) having to do with Covid-19. Seven hundred seventy-two callers (88 %) indicated satisfaction with the services call attended. Discussion: Hotline services in cancer care have been identified as a key resource telehealth service that positively influences patient satisfaction and meets cancer patient needs in the face of the pandemic. This study also highlighted the need for other telehealth services, such as mental health mobile applications, virtual multidisciplinary care, and online support groups, which can provide an excellent option for providing psychological support to cancer patients. Conclusion: This study found that providing Cancer Care Hotline services during a pandemic improves patient-centered care and a more efficient healthcare delivery system. 

Universal hepatitis B screening and management in patients with cancer who received immunosuppressive chemotherapy

2019 ◽  
Vol 26 (5) ◽  
pp. 1141-1146
Author(s):  
Lisa A Thompson ◽  
Lauren J Heath ◽  
Heather Freml ◽  
Thomas Delate
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Healthcare Delivery ◽  
Hbv Reactivation ◽  
Healthcare Delivery System ◽  
Patients With Cancer ◽  
Management Protocol ◽  
B Virus ◽  
Hepatitis B Screening

Background Clinical data to guide management of patients with cancer and hepatitis B virus (HBV) infection who are treated with immunosuppressive chemotherapy are lacking. The purpose of this study was to describe HBV+ rates in a population of patients with cancer and evaluate a risk-stratified management protocol for the prevention of HBV reactivation (HBVr). Methods This was a descriptive study conducted in an integrated healthcare delivery system. Patients with cancer and hepatitis B virus infection who received immunosuppressive chemotherapy between 1 January 2014 and 31 January 2016 were included. A risk-stratified management protocol that continued for six months after chemotherapy completion or 12 months after completion of B-cell targeted chemotherapy was assessed. Outcomes included the proportion of patients who were HBV+ and amongst patients who initiated immunosuppressive therapy, proportions who received hepatitis B virus monitoring or anti-hepatitis B virus prophylaxis, or experienced HBVr or hepatitis B virus-related complications. Results There were 2463 patients with cancer screened for hepatitis B virus with 114 (4.6%) HBV+ of whom 59 (51.8%) initiated chemotherapy. Included patients were primarily older, male, and white with gastrointestinal or hematologic cancers and initiated intermediate/low-risk cytotoxic chemotherapy. During follow-up, 41 (69.5%) received hepatitis B virus DNA monitoring and 17 (28.8%) initiated anti-hepatitis B virus prophylaxis. No HBVr was observed. ALT and AST abnormalities were common but mostly Grade 1 and primarily related to the patient’s malignancy or medications. Conclusions Universal hepatitis B virus screening coupled with a risk-stratified management strategy utilizing HBVr monitoring and anti-hepatitis B virus prophylaxis in HBV+ patients receiving immunosuppressive chemotherapy for cancer may prevent HBVr.

scholarly journals Opportunities and Challenges for First-mile Development in Rural Hawaiian Communities

2013 ◽  
Vol 10 (2) ◽  
Author(s):  
Jenifer Sunrise Winter ◽  
Wayne Buente ◽  
Patricia Amaral Buskirk
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Cultural Preservation ◽  
Self Determination ◽  
Critical Infrastructures ◽  
Broadband Access ◽  
High Quality ◽  
Cultural Contexts ◽  
Remote Locations ◽  
Planning Approach

The islands of Hawaiʻi are the most geographically remote locations on earth and connect to the global Internet via expensive submarine fiber. While citizens in densely populated areas such as Honolulu have several options for broadband coverage, there are gaps throughout the state. Many of those living in rural areas, including indigenous Hawaiian communities, suffer from a lack of critical infrastructures. For indigenous Hawaiians trying to gain equal access to educational and economic opportunities, health care, and linguistic and cultural preservation, this disparity is particularly troubling. We describe challenges faced by Native Hawaiian communities in developing affordable, high-quality broadband access and describe initiatives, to date, that seek to address them. We suspect that the conventional planning approach to broadband development is incongruent to the unique economic, social and cultural contexts present in Hawaiian rural communities. Our investigation explores the potential for community-initiated broadband projects that will enable indigenous Hawaiians more self-determination in the planning and management of broadband networks and services.

scholarly journals Ghanaian views of short-term medical missions: The pros, the cons, and the possibilities for improvement

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Efua Esaaba Mantey ◽  
Daniel Doh ◽  
Judith N. Lasker ◽  
Sirry Alang ◽  
Peter Donkor ◽  
...  
Keyword(s):  
Rural Communities ◽  
Healthcare Delivery ◽  
Medical Missions ◽  
Healthcare Provision ◽  
Short Term ◽  
Care Needs ◽  
Health Service Provision ◽  
Study Approach ◽  
Regulatory Bodies

Abstract Background Various governments in Ghana have tried to improve healthcare in the country. Despite these efforts, meeting health care needs is a growing concern to government and their citizens. Short term medical missions from other countries are one of the responses to meet the challenges of healthcare delivery in Ghana. This research aimed to understand Ghanaian perceptions of short-term missions from the narratives of host country staff involved. The study from which this paper is developed used a qualitative design, which combined a case study approach and political economy analysis involving in-depth interviews with 28 participants. Result Findings show short term medical mission programs in Ghana were largely undertaken in rural communities to address shortfalls in healthcare provision to these areas. The programs were often delivered free and were highly appreciated by communities and host institutions. While the contributions of STMM to health service provision have been noted, there were challenges associated with how they operated. The study found concerns over language and how volunteers effectively interacted with communities. Other identified challenges were the extent to which volunteers undermined local expertise, using fraudulent qualifications by some volunteers, and poor skills and lack of experience leading to wrong diagnoses sometimes. The study found a lack of awareness of rules requiring the registration of practitioners with national professional regulatory bodies, suggesting non enforcement of volunteers’ need for local certification. Conclusion Short Term Medical Missions appear to contribute to addressing some of the critical gaps in healthcare delivery. However, there is an urgent need to address the challenges of ineffective utilisation and lack of oversight of these programs to maximise their benefits.

scholarly journals PLANNING FOR AGING IN PLACE IN RURAL AREAS: PERCEPTIONS AND NEEDS OF OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S252-S252
Author(s):  
Raven H Weaver ◽  
Cory Bolkan
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Rural Areas ◽  
Chronic Conditions ◽  
Family Care ◽  
Computer Assisted ◽  
Service Access ◽  
Community Resources ◽  
Care Needs ◽  
Age In Place

Abstract Most individuals prefer to live independently in their homes, but will need support to age-in-place safely. Rural-dwelling individuals historically have worse health, limited income, and restricted access to adequate services/supports compared to their urban counterparts. Community-based aging services organizations (i.e., Area Agency on Aging; AAA) offer in-home health, social support, and information/referral to community resources that support older adults in both urban and rural communities. A representative sample of adults aged 60+ (N=253, mean age=74) were surveyed via computer-assisted-telephone interviews about their health status, needs, and service utilization. Over half (54%) lived in rural counties, which was significantly associated with receiving insufficient health care services (X2=9.227, p=.002). Insufficient service access was also associated with experiencing a fall (X2=7.315, p=.007). While 53% reported having chronic conditions, most individuals still reported good health and their top reported needs included: yard work, interior/exterior house repairs, and housework. Content analysis of open-ended survey responses regarding future care needs revealed participants anticipate help from family/friends or neighbors; reliance on physicians for referrals; and expect insurance to cover their needs. Participants had varying awareness levels of available community resources and identified concerns about adequacy of services (e.g., mental health; transportation) and health insurance barriers (e.g., reimbursement; vision/dental coverage). Preparing for future needs and anticipating changing functional capacity is critical, especially among rural-dwelling older adults with chronic conditions. To improve ability for adults with diverse needs to age-in-place, preventive services/supports that span the continuum of care needs and that complement informal family care are necessary.

scholarly journals Attitudes of rural communities towards the use of technology for health purposes in New Zealand: a focus group study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037892
Author(s):  
Duncan R Babbage ◽  
Kirsten van Kessel ◽  
Agnes Terraschke ◽  
Juliet Drown ◽  
Hinemoa Elder
Keyword(s):  
New Zealand ◽  
Rural Communities ◽  
Rural Areas ◽  
Technology Use ◽  
Health Centre ◽  
Healthcare Delivery ◽  
Local Health ◽  
Youth Workers ◽  
Health And Wellness ◽  
Focus Group Study

ObjectivesExamine attitudes to using online health and wellness services, and determine what barriers may exist to this in two rural communities in New Zealand.DesignA thematic analysis informed by a social constructivist paradigm explored the attitudes of youth and adults to give voice to these communities. Eighteen focus groups—nine in each region—were held for an hour each, with between three and nine participants in each group.SettingTwo rural areas at the Northern and Southern ends of New Zealand were chosen. In each area, we partnered with a local health centre providing primary care services. Three localities were identified within each region where we conducted the data collection.ParticipantsParticipants were youth aged 12–15 years, aged 16–20 years and adults over 21 years. Overall, 74 females and 40 males were recruited. Recruitment occurred through schools, community organisations or personal contacts of the facilitators, who were youth workers in their respective communities. Ethnicity of the participants was representative of each area, with a higher percentage of Māori participants in Northland.ResultsEight themes were identified which described participants’ attitudes to technology use in healthcare. Themes covered accessibility, cost, independence, anonymity and awareness issues: technology makes health information easily accessible; access to technology can be limited in rural communities; technology can reduce the cost of healthcare but it is too expensive for some; technology increases independence and autonomy of people’s own health; independent healthcare decisions come with risks; anonymity encourages people to seek help online; technology can help raise awareness and provide peer-support for people with health issues; technology impacts on social relationships.ConclusionsParticipants—particularly youth—were generally positive about the role of technology in healthcare delivery, and interested in ways technology could improve autonomy and access to health and wellness services.

scholarly journals Collaboration, culture and communication: Preparing the next generation to provide rural primary health care

2021 ◽  
Vol 11 (6) ◽  
pp. 50
Author(s):  
Tami L. Thomas ◽  
Michelle Caldera ◽  
Derrick Glymph
Keyword(s):  
Health Care ◽  
Nursing Students ◽  
Rural Communities ◽  
Rural Areas ◽  
Primary Care Providers ◽  
Care Providers ◽  
Rural Healthcare ◽  
Care Needs ◽  
Healthcare Needs ◽  
Project Model

Background and objective: In an ever-changing landscape of health care needs and demands, the ability to provide care for rural communities is often overwhelming. Rural health care in a new decade demands targeted programs to improve recruitment, training, and sustained employment of primary care providers. This project served to address rural primary healthcare needs by the development of a project model to recruit, train, educate and evaluate Advanced Practice Registered Nurse students (APRN) students who were rigorously selected for a rural traineeship and practiced in rural counties. The evaluation of preceptors was also done to assist in retention and increased numbers of rural preceptors and clinical sites. This program was designed collaboratively and implemented with rural community partners and rural healthcare leaders.Methods: Graduate nursing students completed both a paper application and in person interviews to be selected for a rigorous 16-week clinical traineeship in the rural communities. Qualitative data were collected during interview and feedback sessions during their traineeship. Quantitative Data were collected on Process and Outcome Measures focused on learning objectives during their rural traineeship. These data were analyzed and evaluated to measure the effectiveness of program goals, outcomes, and sustainability of the program. Results and conclusions: The results support the structured process for selecting graduate students and with an innovative program design focused on rural culture and accessing resources for patients in these same rural areas. Both students and preceptors had improved performance and satisfaction over time. The results provide a road map to recreate programs with high clinical impact and increasing numbers of rural healthcare providers. Current follow-up data with APRN post program completion demonstrated increase in employment within rural areas post-graduation.

scholarly journals Scope of mobile health in Indian health care system – the way forward

2017 ◽  
Vol 4 (4) ◽  
pp. 875 ◽  
Author(s):  
Farhad Ahamed ◽  
Sarika Palepu ◽  
Mahasweta Dubey ◽  
Baridalyne Nongkynrih
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Mobile Technology ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Smart Phone ◽  
Health Care Utilisation ◽  
Health Care Facilities ◽  
Healthcare Delivery System ◽  
Care Needs

India is currently undergoing increased urbanisation and population growth. The existing health care facilities and health care personnel are not able to cater to the health care needs of the population. Hence, a demand-supply gap is prevailing in the country. Improper functioning of three tier health care delivery, inaccessibility of secondary and tertiary government health services are the other major hurdles in effective health care utilisation. Technological interventions like tele-consultation strived continuously to tackle this crisis but had attained limited success. Other technological advancements as mobile based interventions (mHealth) have been emerging in the recent times. mHealth includes the use of telecommunication and multimedia technologies integrated with mobile and wireless healthcare delivery system. With success stories round the globe, it can be marked that mobile technology in the present scenario has gained substantial effects on health outcomes. Using mobile technology offers a tremendous opportunity for developing countries as India to advance in health care delivery by effectively utilising scarce resources. The vastly underserved healthcare market combined with high mobile phone penetration and rapidly growing smart phone adoption creates enabling environment condition for mHealth adoption in India. mHealth, being user friendly and cost effective, would be an interesting initiative in developing world. Customised application and sustainable financial models which could suit the existing local healthcare delivery networks would yield beneficial outcomes. 

Vehicle Maintenance Contracting in Developing Economies: The Role of Social Enterprise

2020 ◽  
Author(s):  
Li Chen ◽  
Sang-Hyun Kim ◽  
Hau L. Lee
Keyword(s):  
Rural Communities ◽  
Operations Management ◽  
Rural Areas ◽  
Social Enterprise ◽  
Developing Economies ◽  
Effective Means ◽  
Healthcare Delivery ◽  
Problem Definition ◽  
Solution Approach ◽  
Social Mission

Problem definition: Difficulties in healthcare delivery in developing economies arise from poor road infrastructure of rural communities, where the bulk of the population resides. Although motorcycles are an effective means for delivering healthcare products, governments in developing economies lack expertise in proper maintenance, resulting in frequent vehicle breakdowns. Riders for Health, a nonprofit social enterprise (SE), has developed specialized capabilities that enable significant enhancements in vehicle maintenance. Riders for Health has engaged with the governments and provided its services using different contracting approaches. However, the effect of such practice on improving vehicle availability—the main social mission of Riders for Health—is not well understood. Academic/practical relevance: This paper presents one of the first rigorous analyses of how SEs achieve their goals through innovations in operations. Our analysis highlights the relationship between a social mission objective and a service contract choice, contrasting it with the choice by a profit-maximizing organization traditionally assumed in the service contracting literature in operations management. Methodology: We construct and analyze a stylized model that combines the elements of reliability theory and contract theory, explicitly accounting for the SE’s social mission in her objective function. Results: We find that the “total solution” approach of providing all aspects of vehicle maintenance, including fleet ownership, is a preferred choice for an SE that prioritizes improving vehicle availability; by contrast, an organization that focuses on profit maximization would find this approach less attractive. Moreover, we show that the total solution approach induces the SE to exert more efforts on failure prevention and repair lead time reduction in equilibrium. Our analysis also suggests that the SE could further improve vehicle availability by the total solution approach if it manages a large fleet that consists of vehicles with high resale values. Managerial implications: Our findings provide theoretical support for Riders for Health’s recent move toward the total solution approach as it expands its service into wider rural areas in many countries. The insights obtained from our analysis offer actionable guidelines to other SEs operating in developing economies.

Sign in / Sign up

Export Citation Format

Share Document