scholarly journals Current Developments in Delivering Customized Care: A Scoping Review

2020 ◽  
Author(s):  
Etienne Minvielle ◽  
Aude Fourcade ◽  
Tom Ricketts ◽  
Mathias waelli
Keyword(s):  
Quality Of Care ◽  
Scoping Review ◽  
Data Extraction ◽  
Healthcare Delivery ◽  
Delivery Systems ◽  
Added Value ◽  
Individualized Care ◽  
Healthcare Delivery Systems ◽  
Segmentation Analysis

Abstract Background In recent years, there has been a growing interest in healthcare personalization and customization (e.g. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for healthcare delivery systems. Objective The present study undertakes a scoping review of current developments for delivering customized care, according to theoretical and practical guidelines for customization delivery approaches. Methods Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PyscINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included “care customization”, “personalized service and healthcare”, individualized care” and “targeting population” in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. Results We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed they often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A minority of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n= 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. Conclusions There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customized development concept in healthcare delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. It would allow them to use customization to reduce costs and improve quality of care.

scholarly journals Current developments in delivering customized care: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Etienne Minvielle ◽  
Aude Fourcade ◽  
Thomas Ricketts ◽  
Mathias Waelli
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Scoping Review ◽  
Care Delivery ◽  
Patient Characteristics ◽  
Delivery Systems ◽  
Segmentation Analysis ◽  
Health Care Delivery Systems

Abstract Background In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. Methods Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included “care customization”, “personalized service and health care”, individualized care” and “targeting population” in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. Results We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. Conclusions There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.

scholarly journals Doctors of chiropractic working with or within integrated healthcare delivery systems: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043754
Author(s):  
Eric J. Roseen ◽  
Bolanle Aishat Kasali ◽  
Kelsey Corcoran ◽  
Kelsey Masselli ◽  
Lance Laird ◽  
...  
Keyword(s):  
Scoping Review ◽  
Healthcare Delivery ◽  
Implementation Strategies ◽  
Chiropractic Care ◽  
Delivery Systems ◽  
Community Based ◽  
Integrated Healthcare ◽  
Web Based ◽  
Medical Settings ◽  
Healthcare Delivery Systems

IntroductionBack and neck pain are the leading causes of disability worldwide. Doctors of chiropractic (DCs) are trained to manage these common conditions and can provide non-pharmacological treatment aligned with international clinical practice guidelines. Although DCs practice in over 90 countries, chiropractic care is rarely available within integrated healthcare delivery systems. A lack of DCs in private practice, particularly in low-income communities, may also limit access to chiropractic care. Improving collaboration between medical providers and community-based DCs, or embedding DCs in medical settings such as hospitals or community health centres, will improve access to evidence-based care for musculoskeletal conditions.Methods and analysesThis scoping review will map studies of DCs working with or within integrated healthcare delivery systems. We will use the recommended six-step approach for scoping reviews. We will search three electronic data bases including Medline, Embase and Web of Science. Two investigators will independently review all titles and abstracts to identify relevant records, screen the full-text articles of potentially admissible records, and systematically extract data from selected articles. We will include studies published in English from 1998 to 2020 describing medical settings that have established formal relationships with community-based DCs (eg, shared medical record) or where DCs practice in medical settings. Data extraction and reporting will be guided by the Proctor Conceptual Model for Implementation Research, which has three domains: clinical intervention, implementation strategies and outcome measurement. Stakeholders from diverse clinical fields will offer feedback on the implications of our findings via a web-based survey.Ethics and disseminationEthics approval will not be obtained for this review of published and publicly accessible data, but will be obtained for the web-based survey. Our results will be disseminated through conference presentations and a peer-reviewed publication. Our findings will inform implementation strategies that support the adoption of chiropractic care within integrated healthcare delivery systems.

scholarly journals Instruments for measuring nursing research competence: a protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042325
Author(s):  
Qirong Chen ◽  
Chongmei Huang ◽  
Aimee R Castro ◽  
Siyuan Tang
Keyword(s):  
Scoping Review ◽  
Data Extraction ◽  
Target Population ◽  
Measurement Properties ◽  
Nursing Research ◽  
Measurement Instruments ◽  
Health Measurement ◽  
Research Competence ◽  
Scoping Reviews

IntroductionNursing research competence of nursing personnel has received much attention in recent years, as nursing has developed as both an independent academic discipline and an evidence-based practiing profession. Instruments for appraising nursing research competence are important, as they can be used to assess nursing research competence of the target population, showing changes of this variable over time and measuring the effectiveness of interventions for improving nursing research competence. There is a need to map the current state of the science of the instruments for nursing research competence, and to identify well validated and reliable instruments. This paper describes a protocol for a scoping review to identify, evaluate, compare and summarise the instruments designed to measure nursing research competence.Methods and analysisThe scoping review will be conducted following Arksey and O’Malley’s methodological framework and Levac et al’s additional recommendations for applying this framework. The scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The protocol is registered through the Open Science Framework (https://osf.io/ksh43/). Eight English databases and two Chinese databases will be searched between 1 December 2020 and 31 December 2020 to retrieve manuscripts which include instrument(s) of nursing research competence. The literature screening and data extraction will be conducted by two researchers, independently. A third researcher will be involved when consensus is needed. The COnsensus-based Standards for the selection of health Measurement INstruments methodology will be used to evaluate the methodological quality of the included studies on measurement properties of the instruments, as well as the quality of all the instruments identified.Ethics and disseminationEthical approval is not needed. We will disseminate the findings through a conference focusing on nursing research competence and publication of the results in a peer-reviewed journal.

National Healthcare Delivery Systems Influence Lung Transplant Outcomes for Cystic Fibrosis

2015 ◽  
Vol 15 (7) ◽  
pp. 1948-1957 ◽  
Author(s):  
C. A. Merlo ◽  
S. C. Clark ◽  
G. J. Arnaoutakis ◽  
N. Yonan ◽  
D. Thomas ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Transplant ◽  
Healthcare Delivery ◽  
Delivery Systems ◽  
Transplant Outcomes ◽  
National Healthcare ◽  
Healthcare Delivery Systems

Healthcare Delivery Systems

2018 ◽  
pp. 473-528
Author(s):  
A. Ravi Ravindran ◽  
Paul M. Griffin ◽  
Vittaldas V. Prabhu
Keyword(s):  
Healthcare Delivery ◽  
Delivery Systems ◽  
Healthcare Delivery Systems

scholarly journals The impact of asynchronous e-visits on clinical outcomes and healthcare delivery: A systematic review (Preprint)

2021 ◽  
Author(s):  
Oliver T. Nguyen ◽  
Amir Alishahi Tabriz ◽  
Jinhai Huo ◽  
Karim Hanna ◽  
Christopher M. Shea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Antibiotic Prescribing ◽  
Infection Management ◽  
The Impact

BACKGROUND E-visits involve asynchronous communication between providers and patients through a secure web-based platform, such as a patient portal, to elicit symptoms and determine a diagnosis and treatment plan. E-visits are now reimbursable through Medicare due to the COVID-19 pandemic. The state of the evidence regarding e-visits, such as the impact on clinical outcomes and healthcare delivery, is unclear. OBJECTIVE To address this gap, this systematic review examines how e-visits have impacted clinical outcomes and healthcare quality, access, utilization, and costs. METHODS MEDLINE, Embase, and Web of Science were searched from January 2000 through October 2020 for peer-reviewed studies that assessed e-visits’ impact on clinical and healthcare delivery outcomes. RESULTS Out of 1,858 papers, 19 studies met the inclusion criteria. E-visit usage was associated with improved or comparable clinical outcomes, especially for chronic disease management (e.g., diabetes care, blood pressure management). The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions but variable quality was observed in infection management (e.g., appropriate antibiotic prescribing). Similarly, the impact on healthcare utilization varied across conditions (e.g., lower utilization for dermatology) but mixed impact in primary care. Healthcare costs were lower for e-visits for a wide-range of conditions (e.g., dermatology and acute visits). No studies examined the impact of e-visits on healthcare access. Available studies are observational in nature and it is difficult to draw firm conclusions about effectiveness or impact on care delivery. CONCLUSIONS Overall, the evidence suggests e-visits may provide comparable clinical outcomes to in-person care and reduce healthcare costs for certain healthcare conditions. At the same time, there is mixed evidence on healthcare quality, especially regarding infection management (e.g., sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (e.g., clinical decision support for antibiotic prescribing) and to assess which conditions are amenable to e-visits and which conditions require in-person or face-to-face care (e.g., virtual visit). CLINICALTRIAL not applicable

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