scholarly journals A Validated Questionnaire to Evaluate Primary Care Pediatrician Satisfaction With the Use of Teledermatology

Iproceedings ◽  
10.2196/35438 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35438
Author(s):  
Juan Carlos Palazón Cabanes ◽  
G Juan Carpena ◽  
L Berbegal García ◽  
T Martínez Miravete ◽  
B Palazón Cabanes ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Patient Privacy ◽  
Cutaneous Lesions ◽  
Technical Problems ◽  
Face To Face ◽  
Health Area ◽  
Validated Questionnaire ◽  
Time Required

Background Teledermatology (TD) is a branch of telemedicine focused on the evaluation of cutaneous lesions by dermatologists remotely, in order to avoid unnecessary in-person consults that could be otherwise resolved by this method, and to shorten the time required for prompt evaluation of cutaneous diseases. Objective This study aimed to create and validate a questionnaire to evaluate satisfaction with the use of TD among primary care pediatricians (PCPs) and to test the questionnaire in our health area before performing an intervention for the optimization of TD. Methods We first created a questionnaire based on previous publications. Then, an expert consultation was made before drafting the final version of the questionnaire. We tested it twice among pediatricians of different health areas, with a 1-month gap between both evaluations. Internal consistency, reproducibility, and validity of the questionnaire were evaluated. Finally, the validated questionnaire was tested among the PCPs of our health area, to analyze their responses. Results We registered 38 questionnaire responses. In all, 30 (78.9%) PCPs actively used TD several times within a month or a year; none of them used TD daily. Technical and health care quality of TD was mostly considered as good or very good. TD was regarded as similar or even better than face-to-face evaluation for most PCPs, whereas 7.9% (3/38) of PCPs thought TD was worse than conventional consults. Most PCPs considered TD as an effective, self-learning, and trustable tool, and 10.5% (4/38) of them identified that pictures captured by mobile phones were a barrier for its use, as it affects patient privacy. Technical problems, absence of exclusive devices for image taking, and delayed answers are some other barriers for TD that need to be overcome. Nonetheless, all PCPs were satisfied with TD, and all of them reported they would continue or start to use this tool. Conclusions TD has demonstrated to be an efficient tool, as it reduces waiting time and costs for dermatology evaluation, and it increases satisfaction among professionals. With our proposed questionnaire, we validated that quality, usability, efficacy, and satisfaction related to TD in our health area had a positive consideration among PCPs in general, but there still are barriers to overcome. Conflict of Interest None declared.

scholarly journals A Validated Questionnaire to Evaluate Primary Care Pediatrician Satisfaction With the Use of Teledermatology (Preprint)

2021 ◽  
Author(s):  
Juan Carlos Palazón Cabanes ◽  
G Juan Carpena ◽  
L Berbegal García ◽  
T Martínez Miravete ◽  
B Palazón Cabanes ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Patient Privacy ◽  
Cutaneous Lesions ◽  
Technical Problems ◽  
Face To Face ◽  
Health Area ◽  
Validated Questionnaire ◽  
Time Required

BACKGROUND Teledermatology (TD) is a branch of telemedicine focused on the evaluation of cutaneous lesions by dermatologists remotely, in order to avoid unnecessary in-person consults that could be otherwise resolved by this method, and to shorten the time required for prompt evaluation of cutaneous diseases. OBJECTIVE This study aimed to create and validate a questionnaire to evaluate satisfaction with the use of TD among primary care pediatricians (PCPs) and to test the questionnaire in our health area before performing an intervention for the optimization of TD. METHODS We first created a questionnaire based on previous publications. Then, an expert consultation was made before drafting the final version of the questionnaire. We tested it twice among pediatricians of different health areas, with a 1-month gap between both evaluations. Internal consistency, reproducibility, and validity of the questionnaire were evaluated. Finally, the validated questionnaire was tested among the PCPs of our health area, to analyze their responses. RESULTS We registered 38 questionnaire responses. In all, 30 (78.9%) PCPs actively used TD several times within a month or a year; none of them used TD daily. Technical and health care quality of TD was mostly considered as good or very good. TD was regarded as similar or even better than face-to-face evaluation for most PCPs, whereas 7.9% (3/38) of PCPs thought TD was worse than conventional consults. Most PCPs considered TD as an effective, self-learning, and trustable tool, and 10.5% (4/38) of them identified that pictures captured by mobile phones were a barrier for its use, as it affects patient privacy. Technical problems, absence of exclusive devices for image taking, and delayed answers are some other barriers for TD that need to be overcome. Nonetheless, all PCPs were satisfied with TD, and all of them reported they would continue or start to use this tool. CONCLUSIONS TD has demonstrated to be an efficient tool, as it reduces waiting time and costs for dermatology evaluation, and it increases satisfaction among professionals. With our proposed questionnaire, we validated that quality, usability, efficacy, and satisfaction related to TD in our health area had a positive consideration among PCPs in general, but there still are barriers to overcome.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.

2020 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsaw ◽  
Phanuwich kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Structural Equation ◽  
Health Care Services ◽  
Chronic Care ◽  
Care Quality ◽  
Equation Modeling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients on the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 27 primary care units and 11 hospital Non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed at home using a validated questionnaire of the Patient Assessment of Chronic Illness Care (PACIC+). It contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model including assess, advise, agree, assist, and arrange subscales. Upgraded primary care unit (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics.Results There was an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.46-1.85; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts of the providers (ORs:1.53-1.99; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.48-2.10 times compared to those for patients attending hospital NCD clinics (p<0.05). Conclusions The training and allocation of family physician approach in PCU may not satisfy the patients’ perception on quality of chronic care. Further studies might focus on other factors such as mismatch between health workforce and workload as a key factor influencing the success of the policy implementation.

scholarly journals Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care

2019 ◽  
Vol 69 (686) ◽  
pp. e595-e604 ◽  
Author(s):  
Victoria Hammersley ◽  
Eddie Donaghy ◽  
Richard Parker ◽  
Hannah McNeilly ◽  
Helen Atherton ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Technical Problems ◽  
Face To Face ◽  
Information Giving ◽  
Care Services ◽  
Primary Care Services ◽  
Quasi Experimental ◽  
Primary Care Clinicians

BackgroundGrowing demands on primary care services have led to policymakers promoting video consultations (VCs) to replace routine face-to-face consultations (FTFCs) in general practice.AimTo explore the content, quality, and patient experience of VC, telephone (TC), and FTFCs in general practice.Design and settingComparison of audio-recordings of follow-up consultations in UK primary care.MethodPrimary care clinicians were provided with video-consulting equipment. Participating patients required a smartphone, tablet, or computer with camera. Clinicians invited patients requiring a follow-up consultation to choose a VC, TC, or FTFC. Consultations were audio-recorded and analysed for content and quality. Participant experience was explored in post-consultation questionnaires. Case notes were reviewed for NHS resource use.ResultsOf the recordings, 149/163 were suitable for analysis. VC recruits were younger, and more experienced in communicating online. FTFCs were longer than VCs (mean difference +3.7 minutes, 95% confidence interval [CI] = 2.1 to 5.2) or TCs (+4.1 minutes, 95% CI = 2.6 to 5.5). On average, patients raised fewer problems in VCs (mean 1.5, standard deviation [SD] 0.8) compared with FTFCs (mean 2.1, SD 1.1) and demonstrated fewer instances of information giving by clinicians and patients. FTFCs scored higher than VCs and TCs on consultation-quality items.ConclusionVC may be suitable for simple problems not requiring physical examination. VC, in terms of consultation length, content, and quality, appeared similar to TC. Both approaches appeared less ‘information rich’ than FTFC. Technical problems were common and, though patients really liked VC, infrastructure issues would need to be addressed before the technology and approach can be mainstreamed in primary care.

scholarly journals PRIMARY CARE QUALITY FROM PROFESSIONALS’ PERSPECTIVE: HEALTH OF CHILDREN AND ADOLESCENTS WITH HIV

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Graziela Piovesan ◽  
Cristiane Cardoso de Paula ◽  
Luis Felipe Dias Lopes ◽  
Stela Maris de Mello Padoin ◽  
Raquel Einloft Kleinubing ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Children And Adolescents ◽  
Health Care Quality ◽  
Health Care Service ◽  
Care Quality ◽  
Integration Of Care ◽  
Primary Health ◽  
Care Assessment

ABSTRACT Objective: evaluate, based on the professionals’ experience, the primary health care quality in home cities of children and adolescents with HIV, treated at a specialized service. Method: cross-sectional study involving 527 professionals in 25 interior cities in Rio Grande do Sul, Brazil, in the first semester of 2014. The Primary Care Assessment Tool was applied. Pearson’s chi-square Test, the Mann Whitney Test and the Poisson Regression were used. Results: the Estratégia Saúde da Família and the primary health care service presented a high score related to the essential attributes: longitudinality (7.17 and 6.74), coordination-integration of care (6.87 and 7.03) and coordination-information systems (8.24 and 8.19); and a low score for the attribute access (3.96 and 3.8). The variables: female gender (0.009), education as general practitioner (<0.001), statutory staff (0.029), coordinator position (0.087) and not having another job (0.027) were also associated with the high score. Conclusion: the coverage of the Estratégia Saúde da Família needs to be expanded and structural and organizational shortages in the access need to be overcome.

A comparative analysis of attribution methods for newly diagnosed cancer patients to hospitals in oncology care.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 60-60
Author(s):  
Anamika Chaudhuri
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Services ◽  
Health Care Quality ◽  
Care Quality ◽  
Administrative Databases ◽  
Claims Database ◽  
Study Results ◽  
Specific Care ◽  
Care Surgery

60 Background: Attribution is the term that describes how payers and employers determine which provider is responsible for a member’s care, when prospective patient selection is not available. Several claims-based attribution models exist for primary care. The challenges of attribution become salient in oncology because cancer care is often multidisciplinary—involving medical oncologists, surgeons, and radiation oncologists—rendering it difficult to discern which practice should be held accountable. Given the uniqueness of the population the generic primary care attribution model does not fit well. Methods: The objective of this study was to propose and compare methods that attribute patients to hospitals using administrative databases. The models were defined as pre-specified rules that determine the specific patients, types of health care services, and the duration of care for which providers are responsible. Both National Medicare database and Statewide All Payers Claims Database (2014-2015) were used for the purpose to analyze Medicare and commercial population. Two different methods with 6 and 12-months episodes were compared. Method 1 defined episode trigger as first diagnosis of cancer and Method 2 as first treatment of cancer, both with no prior 12 months of cancer diagnosis. Patients were attributed to a hospital based on plurality of claims (including both outpatient and inpatient) with a minimum threshold of 2 claims from the same hospital. Ties were broken with the most recent visit, if not, the highest cost. Success measure was defined as highest attribution rate vs. lowest feasible unassigned rate. Results: A total of 1.7 million patients were included in the Medicare cohort and 98,005 from All Payers Claims database (APCD). Results suggested for a 6 months episode, Method 1 vs. Method 2 attributed 94% vs. 98% to a hospital. For a 12-months episode, Method 1 vs. Method 2 attributed 96% vs. 98% to a hospital. Similar results were evident from APCD. It was evident attribution of patients were higher towards their first diagnosed hospital. Also, longer the duration of care, better the attribution. The outcome of the study was a tool in tableau. Conclusions: Attribution is not a problem to be solved and left alone; it requires ongoing work, enhancements. This study results in a framework for attribution that can be used as a mechanism to link indicators of patient-level health care quality and spending to specific providers for the purpose of profiling and accountability. Better systems will seek to identify specific care for a condition based on the types of doctors a patient is seeing (chemotherapy), and identify who is delivering most of that care vs. who is delivering different types of care (surgery, radiation, primary care).

Interactive videoconferencing in the redesign of a health-care quality improvement workshop for the coronavirus disease 2019 pandemic

2020 ◽  
pp. 201010582096179
Author(s):  
Yee Ting Seow ◽  
Shao Chu Teo ◽  
William Yap ◽  
Zann Foo ◽  
Kok Hian Tan
Keyword(s):  
Quality Improvement ◽  
Health Care Quality ◽  
Interactive Video ◽  
Video Conferencing ◽  
Disease Outbreak ◽  
Care Quality ◽  
Face To Face ◽  
Significant Difference ◽  
E Learning ◽  
Virtual Interactive

Introduction: The Blended Quality Improvement (QI) Workshop is a programme designed to provide learners with basic tools and techniques in QI using a combination of e-learning and face-to-face classroom interactions. To adapt to the coronavirus disease 2019 (COVID-19) situation for safe social distancing since the end of January 2020, SingHealth Duke-NUS Institute for Patient Safety & Quality (IPSQ) suspended all face-to-face workshops. However, the need for effective QI training remains. Objective: The aim was to develop an effective virtual interactive Blended QI Workshop through videoconferencing. Methods: The workshop was redesigned by reviewing the curriculum and incorporating the use of interactive functions. The new workshop took place virtually via a video conferencing platform and incorporated the use of interactive polling, game, videos and case study. A total of 23 learners attended the two pilot runs that took place on 28 April 2020 and 22 May 2020. A survey assessed learners’ reactions and satisfaction with the training and preference in using video conferencing tools during disease and non-disease outbreak situations, while the quizzes assessed learners’ learning in QI knowledge. The results on the improvement in QI knowledge were compared to the original blended e-learning and face-to-face workshop ( n=63) that took place before the COVID-19 pandemic. Results: The gain in QI knowledge from virtual and from face-to-face Blended QI Workshops was statistically significant ( p<0.01, n=86). However, there was no statistically significant difference in the gain in QI knowledge with both content delivery approaches ( p=0.13). All 23 learners agreed that the video conferencing platform was convenient, 20 (87.0%) felt that the platform was effective in delivering content and 18 (78.3%) were keen to use video conferencing tools for QI workshops during disease outbreak situations. Remarkably, a substantial number of learners ( n=11; 47.8%) preferred the use of interactive video conferencing to supplement face-to-face classroom-based Blended QI Workshops for non-disease outbreak situations. Conclusion: The virtual interactive Blended QI Workshop was as effective as the face-to-face Blended QI Workshop based on learners’ views and gains in QI knowledge post workshop. The success of virtual QI workshops makes them a new norm in the post-COVID-19 environment.

Usability Study of a Novel Collaborative Health IT in a Pediatric Intensive Care Unit

2021 ◽  
Vol 10 (1) ◽  
pp. 83-90
Author(s):  
Avishek Choudhury ◽  
Onur Asan ◽  
Mathew Scanlon
Keyword(s):  
Health Care Quality ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Care Quality ◽  
Team Approach ◽  
X Rays ◽  
Structured Interviews ◽  
Patient Centered ◽  
Technical Problems ◽  
Adoption Research

Non-mandated technologies hold the promise of increasing health care quality by rendering care that is patient-centered, collaborative, and team approach-driven. Large Customizable Interactive Monitor (LCIM), a non-mandated collaborative health information technology (HIT), is a flat panel touch screen monitor that displays validated patient information from the electronic health record (EHR), including vital signs, laboratory results, medications, X-rays, and interventions. The present study conducts semi-structured interviews with 33 parents and 36 providers to address gaps in post-adoption research on collaborative inpatient LCIM in pediatric settings. The study identified 15 usability issues experienced by doctors and patients’ families while using LCIM. The themes were surrounded around data display characteristics, intuition, physical properties, features supporting or opposing the user’s mental model, and technical problems. Filling these gaps produces scientific knowledge about how providers and patients’ family members perceive LCIM technology’s usability.

scholarly journals Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
José María Pego-Reigosa ◽  
Carlos Peña-Gil ◽  
David Rodríguez-Lorenzo ◽  
Irene Altabás-González ◽  
Naír Pérez-Gómez ◽  
...  
Keyword(s):  
Primary Care ◽  
Program Implementation ◽  
Waiting Times ◽  
Careful Analysis ◽  
Response Delay ◽  
Face To Face ◽  
Process Indicators ◽  
Health Area ◽  
Specific Guideline ◽  
Innovative Program

Abstract Objective To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study. Methods The context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined. Eight process indicators were established and measured before and 32 months after the program implementation. Results The program, which includes IT circuits, algorithms based on response to specific guideline-based checklists, e-consultation, and appointments based on priority, was fully implemented in our health area after a pilot study in two PC centers. After implementation, 6185 rheumatology referrals showed an e-consultation response delay of 8.95 days, and to first face-to-face visit (after e-consultation) of 12.6 (previous delay before program implementation was 83.1 days). Resolution by e-consultation reached 20% (1195 patients did not need seeing the rheumatologist to have the problem solved), and 1369 patients (32%) were discharged after the first visit. The overall resolution rate was 44.0% (2564 discharges/5830 e-consultations). From a random sample of 100 visits, only 10% of patients needed additional complementary tests to make a diagnosis and decision by Rheumatology (20.9% decrease from previous period). Conclusion A careful analysis of the situation and processes, with implementation of simple IT circuits, allows for the improvement of the efficiency and resolution of problems in Rheumatology.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.

2021 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsaw ◽  
Phanuwich kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Structural Equation ◽  
Chronic Care ◽  
Care Quality ◽  
Equation Modeling ◽  
Patient Assessment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients about the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered with 27 primary care units and 11 hospital non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed using a validated questionnaire of the Patient Assessment of Chronic Illness Care. Upgraded primary care units (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect logistic models were employed to examine the association of subscales (high vs low score) of patient perception of the care quality with type of PCUs.Results Compared to hospital NCD clinics, ordinary PCUs were the best in the odds of receiving high score for every CCM subscale (ORs: 1.46-1.85; p<0.05), whereas the trained upgraded PCUs were better in terms of follow-up (ORs:1.37; p <0.05), and the upgraded PCU did not differ in all domains. According to the 5 A model subscales, patient assessment also revealed better performance of ordinary PCUs in all domains compared to hospital NCD clinics whereas upgraded PCUs and trained upgraded PCUs did so in some domains. Seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts with the providers (ORs:1.53-1.99; p<0.05) were found beneficial using CCM subscales and the 5A model subscales. However, patient assessment by both subscales did not demonstrate a statistically significant association across health insurance status.Conclusions The policy implementation might not satisfy the patients’ perception on quality of chronic care according to the CCM and the 5A model subscale. However, the arrangement of chronic care with patients seeing the same doctors or patients having telephone contact with healthcare providers may satisfy the patients’ perceived needs.

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