scholarly journals Perceived limitations of telemedicine from a phenomenological perspective

2020 ◽  
Author(s):  
Michael Knop ◽  
Marius Mueller ◽  
Henrik Freude ◽  
Caroline Ressing ◽  
Bjoern Niehaves
Keyword(s):  
Primary Care ◽  
Communication Technology ◽  
Primary Care Physicians ◽  
Secondary Analysis ◽  
Future Research ◽  
Structured Interviews ◽  
Technological Transformation ◽  
Holistic View ◽  
Phenomenological Perspective ◽  
Information And Communication

In the course of healthcare digitization, the roles of therapists and patients are likely to change. To shape a theoretical based process of technological transformation, a phenomenological perspective on Information and Communication Technology (ICT) is introduced. Therefore, this paper illustrates the benefit of a holistic view on patients and therapists to describe and explain phenomena concerning Human Technology Interaction (HTI). The differentiation between a measurable objective body and a habitual subjective body helps to evaluate and anticipate constituting factors of accepting telemedicine systems. Taking into account findings from a secondary analysis of semi-structured interviews we conducted with primary care physicians, we develop a phenomenological framework for HTI in healthcare. Our aim is to structure future research concerning design implications for ICT and the implementation of telemedicine systems in clinical and primary care.

scholarly journals Adherence factors to paperless primary healthcare: a focus group study

2014 ◽  
Vol 53 (1) ◽  
pp. 42-54
Author(s):  
Rade Iljaz ◽  
Matic Meglič ◽  
Davorina Petek ◽  
Marko Kolšek ◽  
Tonka Poplas Susič
Keyword(s):  
Primary Care ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Primary Healthcare ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Qualitative Methodology ◽  
Background Information ◽  
Focus Group Study ◽  
Information And Communication

Abstract Background: Information and communication technology (ICT) and paperless practices have been shown to improve “existing processes in the workplace” “as well as being an important component of modern primary healthcare”. The aim of our study was to analyse the attitudes of health-care professionals and patients with regard to paperless practice and the most frequently used information and communication technology tools in Slovenian primary healthcare. Methods and participants: Qualitative methodology using focus groups of 22 primary care physicians, 14 nurses and 18 patients. Results: The areas recognised by all participants as important for further information and communication technology development were: computer-supported decision making, accessibility and completeness of personal e-health data, emergency cases, support for chronic disease management, ICT related time savings, e-prescriptions and e-discharge letters. The most important identified barriers impeding the use of ICT were: the heavy workload of primary care physicians and nurses, health insurance reimbursement rules and duplication of work using both paper and electronic health records. Conclusions: This study highlighted a number of strengths of ICT use in primary care as well as numerous areas where changes in procedures and improvement of ICT tools to support them are needed.

scholarly journals Understanding the clinical reasoning processes involved in the management of multimorbidity in an ambulatory setting: study protocol of a stimulated recall research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Reasoning ◽  
Primary Care Physicians ◽  
Video Sequence ◽  
Structured Interview ◽  
Ambulatory Setting ◽  
Structured Interviews ◽  
Stimulated Recall ◽  
Study Results

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.

scholarly journals Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989909
Author(s):  
Eric Apaydin
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Primary Care Physicians ◽  
Theory Approach ◽  
Structured Interviews ◽  
Job Roles ◽  
Face To Face ◽  
Administrative Work ◽  
Job Role ◽  
The Relationship

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

scholarly journals Investigating information-seeking behaviors of primary care physicians who care for older depressed patients and their family caregivers: a pilot study

2005 ◽  
Vol 26 (4) ◽  
pp. 111 ◽  
Author(s):  
Mary Jo Dorsey ◽  
Ellen Detlefsen
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Information Seeking ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Structured Interviews ◽  
Depressed Patients ◽  
Types Of Information ◽  
Primary Care Practices ◽  
Information Seeking Behaviors

Objective – To describe preliminary findings from a study of information-seeking behaviors of primary care physicians who care for elderly and depressed patients, and the correlation between what is sought versus what is provided to the patient and (or) caregiver. Setting – Physicians in two large ambulatory primary care practices throughout urban Pittsburgh, Pennsylvania, who take care of geriatric patients. Methods – Structured interviews, with common questions, will be conducted with 12 primary care physicians to determine patterns of information-seeking behaviors. Environmental scans of physicians' offices for evidence of their existing information behaviors will complement the information obtained from the interviews. Results – This pilot study provides an analysis of the resources primary care physicians use to seek information to provide to patients and caregivers. Analyses show types of information sought, time spent seeking information, and methods used to find information given to patients. Conclusions – With mounting evidence of the Internet being used for patient self care, it is essential to understand if primary care physicians understand the scope and breadth of information readily available to their patients. The primary care physician needs to be aware of the types of information made available to their patients and the caregivers who are inclined to obtain information for the patient.

Physicians’ accounts of frontline tensions when implementing pilot projects to improve primary care

2018 ◽  
Vol 32 (1) ◽  
pp. 39-55 ◽  
Author(s):  
Elizabeth Mansfield ◽  
Onil Bhattacharyya ◽  
Jennifer Christian ◽  
Gary Naglie ◽  
Vicky Steriopoulos ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Care Physicians ◽  
Pilot Project ◽  
Models Of Care ◽  
Structured Interviews ◽  
Pilot Projects ◽  
Additional Time ◽  
Content Type ◽  
The Impact

Purpose Canada’s primary care system has been described as “a culture of pilot projects” with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

scholarly journals Microgrid Cyber-Security: Review and Challenges toward Resilience

2020 ◽  
Vol 10 (16) ◽  
pp. 5649 ◽  
Author(s):  
Bushra Canaan ◽  
Bruno Colicchio ◽  
Djaffar Ould Abdeslam
Keyword(s):  
Power Systems ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Cyber Security ◽  
Relevant Literature ◽  
Research Direction ◽  
Future Research ◽  
Future Research Direction ◽  
Information And Communication ◽  
A Current

The importance of looking into microgrid security is getting more crucial due to the cyber vulnerabilities introduced by digitalization and the increasing dependency on information and communication technology (ICT) systems. Especially with a current academic unanimity on the incremental significance of the microgrid’s role in building the future smart grid, this article addresses the existing approaches attending to cyber-physical security in power systems from a microgrid-oriented perspective. First, we start with a brief descriptive review of the most commonly used terms in the latest relevant literature, followed by a comprehensive presentation of the recent efforts explored in a manner that helps the reader to choose the appropriate future research direction among several fields.

scholarly journals Navigating the tensions in environmental innovation: a paradox perspective

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nadia Di Paola ◽  
Tiziana Russo Spena
Keyword(s):  
Information And Communication Technology ◽  
Communication Technology ◽  
Design Methodology ◽  
Qualitative Comparative Analysis ◽  
Environmental Innovation ◽  
Holistic View ◽  
Content Type ◽  
Specific Attribute ◽  
Information And Communication ◽  
Practical Implications

PurposeThis study aims to investigate the hybrid nature and scope of environmental innovation (EI) by assuming a paradox perspective and developing it empirically. Specifically, the authors raise the questions of how the opposite elements of EI characteristics can be arranged and combined to generate benefits for companies and markets.Design/methodology/approachA fuzzy-set qualitative comparative analysis (fsQCA) is conducted to analyse European companies operating in telecommunications and in information and communication technology (ICT). This method helps us interpret the complexity occurring in the real world, in which the contribution of a specific attribute to the outcome might change according to other interacting and concurring aspects.FindingsBy recognising the conflicting aspects inherent to the complexity of EI, this study addresses how these tensions can be embraced. Specifically, the paradox logic is proposed to open EI strategy to a “both-and” perspective, with the purpose of making EI goals concretely feasible and integrated into a holistic view.Practical implicationsParadoxical resolution denotes purposeful iterations between alternatives to ensure simultaneous attention to them over time. A paradox logic can support managers in making the EI strategy more workable and reconciling the extremes as well as possible.Originality/valueThis study unpacks the multiple enactments of EI by exploring the factors enabling integrated EI benefits. By adopting a paradox approach, the EI strategy may be interpreted in a “both-and” perspective, allowing firms to concretely achieve integrated EI benefits.

Ethical Implications of Cultural Barriers to the Depression Diagnosis: Conversations with Primary Care Physicians

2020 ◽  
Vol 51 (9) ◽  
pp. 683-701
Author(s):  
Diana Cagliero
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Ethical Issues ◽  
Treatment Options ◽  
Cross Cultural ◽  
Cultural Barriers ◽  
Structured Interviews ◽  
Cultural Backgrounds ◽  
Ethical Implications

This article explores ethical issues raised by Primary Care Physicians (PCPs) when diagnosing depression and caring for cross-cultural patients. This study was conducted in three primary care clinics within a major metropolitan area in the Southeastern United States. The PCPs were from a variety of ethnocultural backgrounds including South Asian, Hispanic, East Asian and Caucasian. While medical education training and guidelines aim to teach physicians about the nuances of cross-cultural patient interaction, PCPs report that past experiences guide them in navigating cross-cultural conversations and patient care. In this study, semi-structured interviews were conducted with seven PCPs which were transcribed and underwent thematic analysis to explore how patients’ cultural backgrounds and understanding of depression affected PCPs’ reasoning and diagnosing of depression in patients from different cultural backgrounds. Ethical issues that arose included: limiting treatment options, expressing a patient’s mental health diagnosis in a biomedical sense to reduce stigma, and somatization of mental health symptoms. Ethical implications, such as lack of autonomy, unnecessary testing, and the possible misuse of healthcare resources are discussed.

scholarly journals Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study

BJGP Open ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. bjgpopen18X101621 ◽  
Author(s):  
Herman van Wietmarschen ◽  
Bram Tjaden ◽  
Marja van Vliet ◽  
Marieke Battjes-Fries ◽  
Miek Jong
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Perceived Stress ◽  
Primary Care Physicians ◽  
Mindfulness Training ◽  
Structured Interviews ◽  
Self Reflection ◽  
Self Compassion ◽  
High Workload ◽  
Compassion Scale

BackgroundPrimary care physicians are subjected to a high workload, which can lead to stress and a high incidence of burnout. A mindfulness training course was developed and implemented for primary care physicians to better cope with stress and improve job functioning.AimTo gain insight into the effects of the mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians.Design & settingA pragmatic mixed-methods pre–post design in which physicians received 8 weeks of mindfulness training.MethodParticipants completed validated questionnaires on perceived stress (Perceived Stress Scale [PSS]), self-compassion (Self-Compassion Scale [SCS]), and self-reflection (Groningen Reflection Ability Scale [GRAS]) before the training, directly after, and 6 months later. Semi-structured interviews were conducted with six participants after the training and a content analysis was performed to gain in depth understanding of experiences.ResultsA total of 54 physicians participated in the study. PSS was reduced (mean difference [MD] -4.5, P<0.001), SCS improved (MD = 0.5, P<0.001), and GRAS improved (MD = 3.3, P<0.001), directly after the 8-week training compared with before training. Six months later, PSS was still reduced (MD = -2.9, P = 0.025) and SCS improved (MD = 0.7, P<0.001). GRAS did not remain significant (MD = 2.5, P = 0.120). Qualitative analysis revealed four themes: being more aware of their own feelings and thoughts; being better able to accept situations; experiencing more peacefulness; and having more openness to the self and others.ConclusionMindfulness training might be an effective approach for improving stress resilience, self-compassion, and self-reflection in primary care physicians.

scholarly journals Security implications of the personal information environment

2018 ◽  
Vol 210 ◽  
pp. 04041
Author(s):  
Pavel Valášek
Keyword(s):  
Statistical Methods ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Personal Information ◽  
Information Environment ◽  
Future Research ◽  
Security Applications ◽  
Information And Communication ◽  
Suitable Form ◽  
Preliminary Study

This article discusses a security in a background of the personal information environment. A role and importance of personal information environment and its security is on the rise due to the increasing inclusion of information and communication technology. In many cases, the focus of conducted studies is on the technological part of the problem. In this article, results of the user-oriented study are presented. The main aim was to establish how users perceive security applications. As a preliminary study, a method of survey was utilized. Gathered data were evaluated using common statistical methods. Results of the study are presented in a suitable form with a consideration of a large variety of answers between users. Results show areas of technology and user disagreements. These established differences will be used as a basis of the future research.

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