Evaluation of a telemedicine demonstration project in the Magdalene Islands

2003 ◽  
Vol 9 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Jean-Paul Fortin ◽  
Marie-Pierre Gagnon ◽  
Alain Cloutier ◽  
Françoise Labbé
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Real Life ◽  
Care Providers ◽  
Medical Specialties ◽  
Psychosocial Services ◽  
Regional Medical ◽  
Store And Forward ◽  
Medical Referral ◽  
Structured Approach

The Magdalene Islands are an archipelago located in the middle of the Gulf of St Lawrence, more than 1000 km away from supra-regional medical referral centres. We have implemented and evaluated a telemedicine network for the local hospital on the Magdalene Islands. During a 13-month study period, 118 transmissions were made. Orthopaedics and radiology were the medical specialties that used telemedicine most frequently. Store-and-forward imaging was the technique used most often because of the large number of transmissions in orthopaedics and radiology. Various medical specialties and psychosocial services used videoconferencing, while realtime imaging (ultrasound) was used in gynaecology and obstetrics. A combination of videoconferencing and imaging was used for otolaryngology. A total of 101 individual patients benefited from a teleconsultation during the study period. Eight emergency transfers were avoided and 15 patients who would have required elective transfer were managed locally by telemedicine. For health-care providers, telemedicine seemed to be an acceptable way of delivering specialized services. Nevertheless, demonstration projects in telemedicine are quite different to 'real life' telemedicine utilization. Deployment of telemedicine in the health-care system as a whole will require a more structured approach.

scholarly journals Evaluating usability, effectiveness, and usage of telehealth technologies

2014 ◽  
Author(s):  
◽  
Mirna Becevic
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Care Providers ◽  
New Technologies ◽  
Care Delivery ◽  
Traditional Approach ◽  
Additional Stress ◽  
Care Providers ◽  
Medical Specialties ◽  
Number Of Patients

Affordable Care Act (ACA) has allowed more patients that did not previously have health care insurance to have coverage and access to care. This increase in the number of patients seeking medical care will only add additional stress to the existing disproportion of supply and demand for health care providers. In addition, rising health care costs have major effect on how, where, and even if consumers will get needed care. This study examined three different telehealth platforms in three different medical specialties in order to evaluate the perception that they would be appropriate vehicles for increasing access to care. I also wanted to find out what the users' perceptions of these technologies are, as that can be a driving factor in adoption of new technologies. The first study examined the usability and acceptance of new mobile application in teledermatology clinic. The second study focused on usability and acceptance of ICU Robots in a medical ICU. Finally, the third study evaluated if children and youth currently using telepsychiatry as a care delivery method would have other in-person options if telehealth was not available. The results of these three studies point at the complexity and richness of telehealth. The adoption and acceptance of mHealth was very fast and streamlined. In the same fashion, children might not have other appropriate options for care if telepsychiatry was not available in rural Missouri. Interestingly, though, the provider acceptance of ICU Robots was slow, with some provider disengagements observed. This research contributes to the field of health informatics and medical informatics by evaluating adoption and usability of technologies from the provider perspective, vs. the more traditional approach of examining patient satisfaction, or even provider satisfaction without fully understanding the implications of attitudes on the adoption itself. This study has focused purposefully on different groups of providers using different types of telehealth technologies so we could try to see the bigger picture of how telehealth actually contributes to the health care organizational structure.

Knowledge and attitudes of permanent chemotherapy-induced alopecia among health care providers.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 142-142
Author(s):  
Jenna Rose Stoehr ◽  
Cory Kosche ◽  
Jennifer N. Choi
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Care Providers ◽  
Chi Square ◽  
Hospital System ◽  
Medical Specialties ◽  
General Internal ◽  
Correct Definition ◽  
Significant Difference

142 Background: Reports of permanent chemotherapy-induced alopecia (PCIA) are increasing in the field of oncodermatology, but there is a dearth of information regarding how it is recognized and managed by health care providers (HCPs) across different medical specialties. Methods: An electronic survey was distributed to HCPs (resident physicians, attending physicians, and nurse practitioners) in the departments of dermatology, oncology, and general internal medicine (GIM) within one Midwestern hospital system. Results: Of the 62 participants (response rate: 13%), there were 19 from dermatology, 20 from oncology, and 23 from GIM. Responses were analyzed with descriptive statistics, and chi-square and ANOVA tests. There was a significant difference in the number of subjects that had heard of PCIA prior to starting the survey (Derm: 79%, Onc: 30%, GIM: 22%, p<0.05). A larger percentage of dermatology and oncology HCPs knew the correct definition of the condition (alopecia persisting >6 months) than GIM (42% and 45% vs. 17%) and significantly more had encountered patients with the condition (47% and 45% vs. 17%). More providers in dermatology and GIM knew how to diagnose PCIA compared to oncology (84% and 83% vs. 70%). Dermatology HCPs were the only participants who had attempted to treat patients with PCIA. Most providers across the three specialties believed that patients would accept PCIA treatment that was topical, oral, injectable, and required frequent administration or monitoring, but not treatment that was expensive or high risk. A majority of HCPs surveyed (94%) agreed that the diagnosis of PCIA is important. However, there was a significant difference in the confidence of HCPs in diagnosing and managing PCIA. A minority of dermatology providers (2/19) specified that they would refer to an alopecia or oncodermatology specialist, while the majority of oncology and GIM providers would refer to dermatology. Conclusions: The results of this survey identify knowledge gaps about PCIA amongst health care providers. Therefore, education and multidisciplinary engagement should be pursued in order to improve awareness, diagnosis, referral, and management of PCIA as part of survivorship care.

CancerLinQ and the Future of Cancer Care

2013 ◽  
pp. 430-434 ◽  
Author(s):  
George W. Sledge ◽  
Robert S. Miller ◽  
Robert Hauser
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Cancer Care ◽  
Treatment Options ◽  
Tumor Biology ◽  
Real Life ◽  
Care Providers ◽  
The Right ◽  
Care System

Patients, health care providers, and payers all have a similar interest in a health care system that is both efficient and intelligent. The attributes of such a system are widely recognized: we want a system that provides widespread access to consistently high-quality, science-based medical care; we want that system to be efficient, avoiding unnecessary waste, while delivering the right treatments to the right patients in a timely fashion; we want a system that allows us to both learn from our experience and generate new knowledge that will inform future treatment options; and we want a system that is compassionate and caring. What we want from a health care system often runs up against real-life obstacles and challenges: a fragmented delivery system, varying levels (or lack of) insurance, a growing burden of regulation and paperwork, and an increasingly complex understanding of tumor biology and the therapeutic approaches derived from this biology. New challenges are on the horizon—emerging genomic and imaging technology, with their enormous cognitive and data burdens, and a looming demographic challenge, where inadequate personnel resources face an aging population and an explosion of new treatments. Not all problems have technologic solutions, but many of the issues described above have potential solutions related to information technology. ASCO's CancerLinQ, described in this article, is an evolving attempt by the Society to improve the quality and efficiency of cancer care, while supporting education and research in the cancer field.

scholarly journals A Theoretical Twist on the Transparency of Open Notes: Qualitative Analysis of Health Care Professionals’ Free-Text Answers

10.2196/14347 ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. e14347
Author(s):  
Gudbjörg Erlingsdóttir ◽  
Lena Petersson ◽  
Karin Jonnergård
Keyword(s):  
Health Care ◽  
Real Time ◽  
Health Care Providers ◽  
Actual Practice ◽  
Free Text ◽  
Care Organization ◽  
Care Providers ◽  
Medical Specialties ◽  
Positive Effects ◽  
Trade Offs

Background The New Public Management movement strove for transparency so that policy makers and citizens could gain insight into the work and performance of health care. As the use of the electronic health record (EHR) started to diffuse, a foundation was laid for enhanced transparency within and between health care organizations. Now we appear to be experiencing a new kind of transparency in the health care sector. Many health care providers offer their patients online access to their EHRs (here referred to as Open Notes). The Open Notes system enables and strives for transparency between the health care organization and the patient. Hence, this study investigates health care professional (HCP) perceptions of Open Notes and deepens the understanding of the transparency that Open Notes implies. Objective Based on two survey studies of HCP perceptions of Open Notes, this paper aims to deepen the academic writing on the type of transparency that is connected to Open Notes. Methods HCPs in adult psychiatry in Region Skåne, Sweden, were surveyed before and after implementation of Open Notes. The empirical material presented consists of 1554 free-text answers from two Web surveys. A qualitative content analysis was performed. Results The theoretically informed analysis pivots around the following factors connected to transparency: effectiveness; trust; accountability; autonomy and control; confidentiality, privacy, and anonymity; fairness; and legitimacy. The results show that free-text answers can be sorted under these factors as trade-offs with transparency. According to HCPs, trade-offs affect their work, their relationship with patients, and not least, their work tool, the EHR. However, since many HCPs also state that they have not met many patients, and in some cases none, who have read their EHRs, these effects seem to be more connected to the possibility (or threat) of transparency than to the actual effectuated transparency. Conclusions The implementation (or reform) of Open Notes is policy driven while demanding real-time transparency on behalf of citizens/patients and not the authorities, which makes this particular form of transparency quite unique and interesting. We have chosen to call it governed individual real-time transparency. The effects of Open Notes may vary between different medical specialties relative to their sensitivity to both total and real-time transparency. When HCPs react by changing their ways of writing notes, Open Notes can affect the efficiency of the work of HCPs and the service itself in a negative manner. HCP reactions are aimed primarily at protecting patients and their relatives as well as their own relationship with the patients and secondly at protecting themselves. Thus, governed individual real-time transparency that provides full transparency of an actual practice in health care may have the intended positive effects but can also result in negative trade-offs between transparency and efficiency of the actual practice. This may imply that full transparency is not always most desirable but that other options can be considered on a scale between none and full transparency.

scholarly journals Differences in Online Consumer Ratings of Health Care Providers Across Medical, Surgical, and Allied Health Specialties: Observational Study of 212,933 Providers (Preprint)

2017 ◽  
Author(s):  
Timothy Daskivich ◽  
Michael Luu ◽  
Benjamin Noah ◽  
Garth Fuller ◽  
Jennifer Anger ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Allied Health ◽  
The United States ◽  
Health Providers ◽  
Care Providers ◽  
Medical Specialties ◽  
Consumer Ratings ◽  
Online Ratings ◽  
Online Consumer

BACKGROUND Health care consumers are increasingly using online ratings to select providers, but differences in the distribution of scores across specialties and skew of the data have the potential to mislead consumers about the interpretation of ratings. OBJECTIVE The objective of our study was to determine whether distributions of consumer ratings differ across specialties and to provide specialty-specific data to assist consumers and clinicians in interpreting ratings. METHODS We sampled 212,933 health care providers rated on the Healthgrades consumer ratings website, representing 29 medical specialties (n=128,678), 15 surgical specialties (n=72,531), and 6 allied health (nonmedical, nonnursing) professions (n=11,724) in the United States. We created boxplots depicting distributions and tested the normality of overall patient satisfaction scores. We then determined the specialty-specific percentile rank for scores across groupings of specialties and individual specialties. RESULTS Allied health providers had higher median overall satisfaction scores (4.5, interquartile range [IQR] 4.0-5.0) than physicians in medical specialties (4.0, IQR 3.3-4.5) and surgical specialties (4.2, IQR 3.6-4.6, P<.001). Overall satisfaction scores were highly left skewed (normal between –0.5 and 0.5) for all specialties, but skewness was greatest among allied health providers (–1.23, 95% CI –1.280 to –1.181), followed by surgical (–0.77, 95% CI –0.787 to –0.755) and medical specialties (–0.64, 95% CI –0.648 to –0.628). As a result of the skewness, the percentages of overall satisfaction scores less than 4 were only 23% for allied health, 37% for surgical specialties, and 50% for medical specialties. Percentile ranks for overall satisfaction scores varied across specialties; percentile ranks for scores of 2 (0.7%, 2.9%, 0.8%), 3 (5.8%, 16.6%, 8.1%), 4 (23.0%, 50.3%, 37.3%), and 5 (63.9%, 89.5%, 86.8%) differed for allied health, medical specialties, and surgical specialties, respectively. CONCLUSIONS Online consumer ratings of health care providers are highly left skewed, fall within narrow ranges, and differ by specialty, which precludes meaningful interpretation by health care consumers. Specialty-specific percentile ranks may help consumers to more meaningfully assess online physician ratings.

scholarly journals Importance and Opportunities of Telemedicine in Resource-Poor Countries during Epidemic Situation

2021 ◽  
pp. 1-9
Author(s):  
Mohammed Alshakka ◽  
Wafa F. S. Badulla ◽  
Nazeh Al-Abd ◽  
Mohamed Izham Mohamed Ibrahim
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Healthcare Access ◽  
Primary Concern ◽  
Care Providers ◽  
Quality Health Care ◽  
Medical Specialties ◽  
Poor Countries ◽  
Wide Range ◽  
Quality Health

This review article aims to present a general picture of what telemedicine entails and the importance of providing quality health care in various medical aspects. The field of telemedicine has noticeably grown-up, with a growing number of applications and a diversity of technologies in different medical specialties and clinical situations by using electronic signals to transfer the medical data from one place to another. At present, health authorities have high anticipation for telemedicine. It addresses several significant challenges to advancing healthcare access to overwhelm the scarcity of specialists tackling epidemic diseases. The article starts with a brief introduction to the evolution of telemedicine and its importance in the health care system. Then, we provide a conceptual context for the proliferation of related concepts, such as telehealth, e-health, and m-health. Our primary concern is to focus on telemedicine's role in epidemic situations, emphasizing the current pandemic Coronavirus Disease 2019 (covid-19 ) and demonstrating how it can be used to provide definitive information about the actual effects of telemedicine in terms of cost, quality, and access. However, there is an emergent interest among government authorities, health care providers and medical professionals to enhance the efficiency of providing a wide range of medical services in terms of cost and time. Thus, the effective use of telemedicine and related technologies will be able to assist with it. We conclude that telemedicine should be considered as a potential tool to react to an emergency. Therefore, further research should be conducted to understand better how telemedicine could be applied wisely in epidemic situations.

Evaluation of a Distance Consulting Service Based on Interactive Video and Integrated Computerized Technology

1995 ◽  
Vol 1 (2) ◽  
pp. 69-78 ◽  
Author(s):  
P A Jennett ◽  
W G Hall ◽  
J E Morin ◽  
M Watanabe
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Wide Spectrum ◽  
Rural Site ◽  
Care Providers ◽  
Telemedicine System ◽  
Medical Specialties ◽  
Access To Health ◽  
The Impact

Telemedicine equipment was installed at a rural site in Drumheller and at Calgary, 85 miles (136 km) away. It allowed consultation between health-care providers at Drumheller and specialists and subspecialists at the Faculty of Medicine in Calgary. The efficacy of the system in providing more equitable access to health care for persons living in geographically remote sites was evaluated during a 12-month pilot project. Seventy-five encounters were attempted during the study. A total of 55 encounters (42 clinical and 13 non-clinical) were completed. The completed clinical encounters were distributed across a wide spectrum of medical specialties. Users of the system reported favourably on the impact of the telemedicine system on access to health services for rural patients, on diagnostic, investigative and management decisions, on patient and physician travel times, on feelings of professional isolation and educational opportunities and on overall patient health status. The study provides new knowledge and demonstrates the success of the technology in this project. As expected, other problems were raised and addressed in a preliminary manner including: the potential for health-provider education; acquisition and retention of rural physicians; ethical, legal and patient confidentiality issues; minimum acceptable technology; and network management issues.

scholarly journals ARIA 2019 Care Pathways for Allergic Rhinitis in the Kuwait Health Care System

2020 ◽  
Vol 30 (4) ◽  
pp. 320-330
Author(s):  
Mona Al-Ahmad ◽  
Jasmina Nurkic ◽  
Claus Bachert ◽  
Oliver Pfaar ◽  
Holger J. Schunemann ◽  
...  
Keyword(s):  
Health Care ◽  
Allergic Rhinitis ◽  
Health Care System ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Real Life ◽  
International Health ◽  
Care Pathways ◽  
Care Providers ◽  
Care System

A worldwide increase in prevalence of allergic diseases has led to adaptations in national and international health care systems. ARIA (Allergic Rhinitis and Its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. In collaboration with international initiatives, ARIA offers updates of real-life integrated care pathways (ICPs) for digitally assisted, integrated, and individualized treatment of allergic rhinitis (AR). This article presents certain aspects of the health care system in Kuwait with reference to the management of AR and the objective of introducing ICPs and adopting the latest ARIA recommendations. Guidelines for ICPs include aspects of patients and health care providers and cover key areas of management of AR. This model of guidelines supports real-life health care better than traditional models. ARIA recommendations will be locally integrated in the health care system with the aim of improving both pharmacotherapy and allergy immunotherapy.

The Store-and-Forward Telemedicine Service User-satisfaction Questionnaire: Development and validation of a questionnaire to monitor and assess health care providers' experiences

2021 ◽  
pp. 1357633X2110324
Author(s):  
Esmée Tensen ◽  
Johan van Buggenum ◽  
Leonard Witkamp ◽  
Monique WM Jaspers ◽  
Linda WP Peute
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
User Satisfaction ◽  
Service User ◽  
Phase 1 ◽  
Phase 2 ◽  
Care Providers ◽  
Telemedicine Service ◽  
Satisfaction Questionnaire ◽  
Store And Forward

Introduction With wider adoption of store-and-forward telemedicine accelerating, particularly post-coronavirus disease 2019, it is essential to understand health care providers’ (HCPs) satisfaction with digital solutions offered by telemedicine organizations to (continuously) guarantee service quality. We developed the Store-and-Forward Telemedicine Service User-satisfaction Questionnaire to monitor and assess HCPs’ experiences with contracted telemedicine organizations. Methods Questionnaire construction (phase 1) consisted of exploratory literature search on validated telemedicine satisfaction questionnaires, a telemedicine domain and human factors expert focus group, stakeholder focus group (customer service employee and telemedicine account managers), and two pre-testing rounds among 18 HCPs. The pilot questionnaire (phase 2) was sent to 2179 HCPs for validity and reliability assessment. Results Phase 1: Two validated questionnaires (73 items overall) were used as input for Store-and-Forward Telemedicine Service User-satisfaction Questionnaire. Revisions resulted in 61 items. Phase 2: the pilot 61-item Store-and-Forward Telemedicine Service User-satisfaction Questionnaire instrument was completed by 181 of 2179 invited HCPs. Forty-one mandatory items of the pilot Store-and-Forward Telemedicine Service User-satisfaction Questionnaire rated on a 5-point Likert scale were included in psychometric analyses and resulted in six reliable scales: training, communication, organization policy and strategy, interaction platform, usage platform, and working conditions. Discussion The Store-and-Forward Telemedicine Service User-satisfaction Questionnaire is a reliable and valid questionnaire for measuring HCPs’ satisfaction with store-and-forward telemedicine services as part of a continuous quality improvement cycle. Reimbursement questions were excluded due to low response. As adoption of telemedicine may be impeded by financial compensation issues, this requires consideration in future telemedicine questionnaires. Store-and-Forward Telemedicine Service User-satisfaction Questionnaire including video consultation items is needed to monitor also synchronous services as these expanded in the coronavirus disease 2019 pandemic.

scholarly journals The GoodHope Ehlers Danlos Syndrome Clinic: development and implementation of the first interdisciplinary program for multi-system issues in connective tissue disorders at the Toronto General Hospital

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nimish Mittal ◽  
Daniel Santa Mina ◽  
Laura McGillis ◽  
Aliza Weinrib ◽  
P. Maxwell Slepian ◽  
...  
Keyword(s):  
Health Care ◽  
Connective Tissue ◽  
Health Care Providers ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
Connective Tissue Disorders ◽  
Ehlers Danlos Syndrome ◽  
Medical Specialties ◽  
Organ Systems ◽  
Danlos Syndrome

AbstractEhlers-Danlos Syndrome (EDS) are a heterogeneous group of genetic connective tissue disorders, and typically manifests as weak joints that subluxate/dislocate, stretchy and/or fragile skin, organ/systems dysfunction, and significant widespread pain. Historically, this syndrome has been poorly understood and often overlooked. As a result, people living with EDS had difficulty obtaining an accurate diagnosis and appropriate treatment, leading to untold personal suffering as well as ineffective health care utilization. The GoodHope EDS clinic addresses systemic gaps in the diagnosis and treatment of EDS. This paper describes a leap forward—from lack of awareness, diagnosis, and treatment—to expert care that is tailored to meet the specific needs of patients with EDS. The GoodHope EDS clinic consists of experts from various medical specialties who work together to provide comprehensive care that addresses the multi-systemic nature of the syndrome. In addition, EDS-specific self-management programs have been developed that draw on exercise science, rehabilitation, and health psychology to improve physical and psychosocial wellbeing and overall quality of life. Embedded into the program are research initiatives to shed light on the clinical presentation, underlying mechanisms of pathophysiology, and syndrome management. We also lead regular educational activities for community health care providers to increase awareness and competence in the interprofessional management of EDS beyond our doors and throughout the province and country.

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