scholarly journals The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review

10.2196/15380 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15380 ◽  
Author(s):  
Micheal O'Cathail ◽  
M Ananth Sivanandan ◽  
Claire Diver ◽  
Poulam Patel ◽  
Judith Christian
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Outcome Measures ◽  
Health Care Professionals ◽  
Care Setting ◽  
Care Staff ◽  
Health Care Staff ◽  
Routine Practice ◽  
Over Time

Background The National Health Service (NHS) Long-Term Plan has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. Objective This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. Methods We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. Results The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. Conclusions Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.

scholarly journals The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Micheal O'Cathail ◽  
M Ananth Sivanandan ◽  
Claire Diver ◽  
Poulam Patel ◽  
Judith Christian
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Outcome Measures ◽  
Health Care Professionals ◽  
Care Setting ◽  
Care Staff ◽  
Health Care Staff ◽  
Routine Practice ◽  
Over Time

BACKGROUND The National Health Service (NHS) <i>Long-Term Plan</i> has set out a vision of enabling patients to access digital interactions with health care professionals within 5 years, including by video link. OBJECTIVE This review aimed to examine the extent and nature of the use of patient-facing teleconsultations within a health care setting in the United Kingdom and what outcome measures have been assessed. METHODS We conducted a systematic scoping review of teleconsultation studies following the Joanna Briggs Institute methodology. PubMed, Scopus, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched up to the end of December 2018 for publications that reported on the use of patient-facing teleconsultations in a UK health care setting. RESULTS The search retrieved 3132 publications, of which 101 were included for a full review. Overall, the studies were heterogeneous in design, in the specialty assessed, and reported outcome measures. The technology used for teleconsultations changed over time with earlier studies employing bespoke, often expensive, solutions. Two-thirds of the studies, conducted between 1995 and 2005, used this method. Later studies transitioned to Web-based commercial solutions such as Skype. There were five outcome measures that were assessed: (1) technical feasibility, (2) user satisfaction, (3) clinical effectiveness, (4) cost, (5) logistical and operational considerations. Due to the changing nature of technology over time, there were differing technical issues across the studies. Generally, teleconsultations were acceptable to patients, but this was less consistent among health care professionals. However, among both groups, face-to-face consultations were still seen as the gold standard. A wide range of clinical scenarios found teleconsultations to be clinically useful but potentially limited to more straightforward clinical interactions. Due to the wide array of study types and changes in technology over time, it is difficult to draw definitive conclusions on the cost involved. However, cost savings for health care providers have been demonstrated by the goal-directed implementation of teleconsultations. The integration of technology into routine practice represents a complex problem with barriers identified in funding and hospital reimbursement, information technologies infrastructure, and integration into clinicians’ workflow. CONCLUSIONS Teleconsultations appear to be safe and effective in the correct clinical situations. Where offered, it is likely that patients will be keen to engage, although teleconsultations should only be offered as an option to support traditional care models rather than replace them outright. Health care staff should be encouraged and supported in using teleconsultations to diversify their practice. Health care organizations need to consider developing a digital technology strategy and implementation groups to assist health care staff to integrate digitally enabled care into routine practice. The introduction of new technologies should be assessed after a set period with service evaluations, including feedback from key stakeholders.

scholarly journals The Future of Health Care: Protocol for Measuring the Potential of Task Automation Grounded in the National Health Service Primary Care System (Preprint)

2018 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Care Staff ◽  
Primary Health ◽  
The Future

BACKGROUND Recent advances in technology have reopened an old debate on which sectors will be most affected by automation. This debate is ill served by the current lack of detailed data on the exact capabilities of new machines and how they are influencing work. Although recent debates about the future of jobs have focused on whether they are at risk of automation, our research focuses on a more fine-grained and transparent method to model task automation and specifically focus on the domain of primary health care. OBJECTIVE This protocol describes a new wave of intelligent automation, focusing on the specific pressures faced by primary care within the National Health Service (NHS) in England. These pressures include staff shortages, increased service demand, and reduced budgets. A critical part of the problem we propose to address is a formal framework for measuring automation, which is lacking in the literature. The health care domain offers a further challenge in measuring automation because of a general lack of detailed, health care–specific occupation and task observational data to provide good insights on this misunderstood topic. METHODS This project utilizes a multimethod research design comprising two phases: a qualitative observational phase and a quantitative data analysis phase; each phase addresses one of the two project aims. Our first aim is to address the lack of task data by collecting high-quality, detailed task-specific data from UK primary health care practices. This phase employs ethnography, observation, interviews, document collection, and focus groups. The second aim is to propose a formal machine learning approach for probabilistic inference of task- and occupation-level automation to gain valuable insights. Sensitivity analysis is then used to present the occupational attributes that increase/decrease automatability most, which is vital for establishing effective training and staffing policy. RESULTS Our detailed fieldwork includes observing and documenting 16 unique occupations and performing over 130 tasks across six primary care centers. Preliminary results on the current state of automation and the potential for further automation in primary care are discussed. Our initial findings are that tasks are often shared amongst staff and can include convoluted workflows that often vary between practices. The single most used technology in primary health care is the desktop computer. In addition, we have conducted a large-scale survey of over 156 machine learning and robotics experts to assess what tasks are susceptible to automation, given the state-of-the-art technology available today. Further results and detailed analysis will be published toward the end of the project in early 2019. CONCLUSIONS We believe our analysis will identify many tasks currently performed manually within primary care that can be automated using currently available technology. Given the proper implementation of such automating technologies, we expect considerable staff resources to be saved, alleviating some pressures on the NHS primary care staff. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11232

Renewing the National Health Service: Labour's Agenda for a Healthier Britain

1996 ◽  
Vol 26 (2) ◽  
pp. 269-308 ◽  
Author(s):  
Rae Barrantes
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Professionals ◽  
Current Status ◽  
Patient Centered ◽  
Labour Government ◽  
Point Of Use ◽  
Tier System

In this report the Labour Party gives its view of the current status of the British National Health Service (NHS), and outlines its plans for the NHS under a Labour government. The values underlying the NHS—comprehensive health care, free at the point of use, based on need rather than ability to pay—have been betrayed. The truly national health service, created by a Labour government in 1948, has been replaced by a market-based service led by accountants. Patients are suffering, health care professionals are dissatisfied, some of the nation's finest hospitals are closing, community care is in chaos, and NHS dentistry has all but been privatized. Under the Tories, the NHS faces a future of privatization, competition, and markets, money wasted on bureaucracy, and the unfairness of a two-tier system. Under Labour, the NHS faces modernization, planned progress, money spent on frontline services, and excellence for all. Labour will follow a model of health care that is patient centered and community led, a properly coordinated and efficient public service.

scholarly journals DEMENTIA CARE AND BEHAVIORAL HEALTH WORKFORCE DEVELOPMENT: INNOVATIONS IN TRAINING ACROSS SETTINGS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S379-S379
Author(s):  
Mary F Wyman ◽  
Verena R Cimarolli ◽  
Robyn Stone
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Behavioral Health ◽  
Workforce Development ◽  
Health Care Professionals ◽  
Professional Training ◽  
Outpatient Setting ◽  
Direct Care ◽  
Care Staff ◽  
Health Care Staff

Abstract It is well-established that there is a critical shortage of trained health care staff who can deliver high-quality behavioral health services to persons with dementia. The development of innovative professional training curricula, and effectively implementing and sustaining such programs, is a key element in addressing this workforce crisis. This symposium highlights cutting-edge efforts being conducted across the continuum of care, to train health care professionals to support optimal behavioral health for persons with dementia. In the outpatient setting, Wyman et al. present data from a survey of mental health clinicians on their perspectives about working with persons with dementia and caregivers, revealing critical gaps in knowledge and skills to target in continuing education programming. Wray and colleagues focus on integrated behavioral health in primary care, discussing how geriatric experts can most effectively contribute to improved assessment and treatment within this setting. Koepp presents an innovative program to transform outpatient mental health care for persons with dementia through provider training and consultation. In the residential care setting, Reinhardt and colleagues report on the implementation of a comprehensive approach to the alleviation of behavioral health problems through training direct care staff in person-directed care in nursing homes. Finally, Karel et al share how VA interprofessional nursing home teams learn and sustain an evidence-based program to address behavioral concerns among residents with dementia. The discussant will lend a deep expertise in research and policy related to the geriatric workforce to her remarks on the presentations.

scholarly journals Working Atmosphere and Job Satisfaction of Health Care Staff in Kenya: An Exploratory Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Katja Goetz ◽  
Michael Marx ◽  
Irmgard Marx ◽  
Marc Brodowski ◽  
Maureen Nafula ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Health Care Professionals ◽  
Quality Management System ◽  
Linear Regression Analysis ◽  
Individual Characteristics ◽  
Care Staff ◽  
Health Care Staff ◽  
Good Opportunity ◽  
Overall Job Satisfaction

Background. Job satisfaction and working atmosphere are important for optimal health care delivery. The study aimed to document working atmosphere and job satisfaction of health care professionals in Kenya and to explore associations between job satisfaction, staff characteristics, and working atmosphere.Methods. Data from the integrated quality management system (IQMS) for the health sector in Kenya were used. Job satisfaction was measured with 10 items and with additional 5 items adapted to job situation in Kenya. Working atmosphere was measured with 13 item questionnaire. A stepwise linear regression analysis was performed with overall job satisfaction and working atmosphere, aspects of job satisfaction, and individual characteristics.Results. Out of 832 questionnaires handed out, 435 questionnaires were completed (response rate: 52.3%). Health care staff indicated high commitment to provide quality services and low levels regarding the adequacy and functionality of equipment at their work station. The aspect “support of the ministry of health” (β= 0.577) showed the highest score of explained variance (32.9%) regarding overall job satisfaction.Conclusions. IQMS which also evaluates job satisfaction and working atmosphere of health care staff provides a good opportunity for strengthening the recruitment and retention of health care staff as well as improving the provision of good quality of care.

Is the English National Health Service meeting the needs of mentally distressed Chinese women?

2002 ◽  
Vol 7 (4) ◽  
pp. 216-221 ◽  
Author(s):  
Gill Green ◽  
Hannah Bradby ◽  
Anita Chan ◽  
Maggy Lee ◽  
Kimmy Eldridge
Keyword(s):  
Mental Health ◽  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Professionals ◽  
Service Providers ◽  
Chinese Women ◽  
Institutional Racism ◽  
Care Group

Objectives: To identify barriers to communication between health care workers and Chinese women living in England, a group who are known to use the National Health Service (NHS) less than other ethnic groups; to consider whether such barriers lead to inequitable access to NHS mental health treatment; and to determine the extent to which this results from institutional racism. Method: A purposive sample of 42 Chinese women living in South-East England aged 29-60 years derived from a primary care group, two secondary mental health service providers and three Chinese associations. Subjects had all consulted a general practitioner and had either experienced mental distress ( n = 24) and/or had used traditional Chinese medicine ( n = 25). Results: Communication with health care professionals was hindered by a lack of common language and an absence of shared concepts concerning the causes and manifestations of health and illness, particularly mental health. This lack of communication resulted in delayed diagnoses, misunderstood treatment regimens and deterred women from (re-)presenting to the NHS. Among our informants, these types of problem were more acute for those women who were most marginalised from English-language culture. Conclusions: Linguistic and conceptual problems explain Chinese women's relatively poor access to mental health services. The continuing failure to tackle systematically these communication problems through the routine provision of interpretation and advocacy services lays the health care system open to the charge of 'institutional racism'.

scholarly journals Improving the Usefulness and Use of Patient Survey Programs: National Health Service Interview Study (Preprint)

2017 ◽  
Author(s):  
Kelsey Flott ◽  
Ara Darzi ◽  
Sarah Gancarczyk ◽  
Erik Mayer
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Patient Experience ◽  
National Health ◽  
Care Quality ◽  
Barriers And Facilitators ◽  
Care Staff ◽  
Health Care Staff ◽  
Service Improvement ◽  
Patient Reported

BACKGROUND A growing body of evidence suggests a concerning lag between collection of patient experience data and its application in service improvement. This study aims to identify what health care staff perceive to be the barriers and facilitators to using patient-reported feedback and showcase successful examples of doing so. OBJECTIVE This study aimed to apply a systems perspective to suggest policy improvements that could support efforts to use data on the frontlines. METHODS Qualitative interviews were conducted in eight National Health Service provider locations in the United Kingdom, which were selected based on National Inpatient Survey scores. Eighteen patient-experience leads were interviewed about using patient-reported feedback with relevant staff. Interviews were transcribed and underwent thematic analysis. Staff-identified barriers and facilitators to using patient experience feedback were obtained. RESULTS The most frequently cited barriers to using patient reported feedback pertained to interpreting results, understanding survey methodology, presentation of data in both national Care Quality Commission and contractor reports, inability to link data to other sources, and organizational structure. In terms of a wish list for improved practice, staff desired more intuitive survey methodologies, the ability to link patient experience data to other sources, and more examples of best practice in patient experience improvement. Three organizations also provided examples of how they successfully used feedback to improve care. CONCLUSIONS Staff feedback provides a roadmap for policy makers to reconsider how data is collected and whether or not the national regulations on surveys and patient experience data are meeting the quality improvement needs of local organizations.

scholarly journals Teaching Anatomy to Neuroscientific Health-Care Professionals: Are They Receiving the Best Anatomical Education?

2019 ◽  
Vol 30 (1) ◽  
pp. 41-45
Author(s):  
Francesco Latini ◽  
Mats Ryttlefors
Keyword(s):  
Health Care ◽  
White Matter ◽  
Medical Students ◽  
Health Care Professionals ◽  
Brain Connectivity ◽  
Care Staff ◽  
Health Care Staff ◽  
Brain Anatomy ◽  
Brain White Matter ◽  
White Matter Anatomy

Abstract University neuroanatomical courses seldom teach the anatomical-functional connectivity of the brain. White matter dissection improves understanding of brain connectivity, but until now has been restricted to neurosurgeons and in some cases to medical students, never to health-care non-medical professionals. Our aim was to teach white matter anatomy to medical and non-medical students to evaluate this technique in groups with different education. A standardized lab demonstration of white matter anatomy was performed with high appreciation rate in both groups, suggesting a suboptimal neuroanatomical education provided by basic course. We encourage to include this technique of teaching brain anatomy into basic neuroanatomical courses to improve the level of comprehension and competence in all health-care staff within the field of neuroscience.

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