Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study (Preprint)

2019 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Professional ◽  
Clinical Setting ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Smartphone App ◽  
Implementation Study ◽  
Pilot Testing ◽  
Effective Implementation

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

scholarly journals Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study

10.2196/15593 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e15593 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Professional ◽  
Clinical Setting ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Smartphone App ◽  
Implementation Study ◽  
Pilot Testing ◽  
Effective Implementation

Background Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. Objective This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. Methods A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. Results A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. Conclusions Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. Trial Registration Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

scholarly journals From “Academic Projectitis” to Partnership: Community Perspectives for Authentic Community Engagement in Health Professional Education

2018 ◽  
Vol 4 (1) ◽  
pp. 79-96 ◽  
Author(s):  
Cathy Kline ◽  
Wafa Asadian ◽  
William Godolphin ◽  
Scott Graham ◽  
Cheryl Hewitt ◽  
...  
Keyword(s):  
Health Care ◽  
Service Learning ◽  
Health Professional ◽  
Community Engagement ◽  
Professional Education ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Common Interest ◽  
Health Professional Education ◽  
Community Based

Health professional education (HPE) has taken a problem-based approach to community service-learning with good intentions to sensitize future health care professionals to community needs and serve the underserved. However, a growing emphasis on social responsibility and accountability has educators rethinking community engagement. Many institutions now seek to improve community participation in educational programs. Likewise, many Canadians are enthusiastic about their health care system and patients, who are “experts by lived experience,” value opportunities to “give back” and improve health care by taking an active role in the education of health professionals. We describe a community-based participatory action research project to develop a mechanism for community engagement in HPE at the University of British Columbia (UBC). In-depth interviews and a community dialogue with leaders from 18 community-based organizations working with vulnerable populations revealed the shared common interest of the community and university in the education of health professionals. Patients and community organizations have a range of expertise that can help to prepare health practitioners to work in partnership with patients, communities, and other professionals. Recommendations are presented to enhance the inclusion of community expertise in HPE by changing the way the community and university engage with each other.

scholarly journals Codesigning and pilot testing a lifestyle-focused text message intervention for women after breast cancer treatment: A mixed-methods study (Preprint)

2021 ◽  
Author(s):  
Anna Singleton ◽  
Rebecca Raeside ◽  
Stephanie R Partridge ◽  
Molly Hayes ◽  
Katherine Maka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Health Professionals ◽  
Text Message ◽  
Breast Cancer Treatment ◽  
Text Messages ◽  
Cancer Information ◽  
Free Text ◽  
Pilot Testing

BACKGROUND Breast cancer is the most common cancer among women worldwide. Recovery from breast cancer treatment can be mentally and physically challenging. Text message programs offer a novel way to provide health information and support but few programs are co-designed with consumer representatives. OBJECTIVE This study aimed to co-design and pilot test a lifestyle-focused text message program to support women’s mental and physical health after treatment. METHODS Iterative mixed-methods three-step process: 1) co-design workshop with consumers, health professionals/researchers with drafting text messages; 2) consumer and health professionals/researchers evaluation plus readability (Flesch-Kincaid score) and 3) pilot testing of message delivery software. For the consumer and health professional review, content was scored (5-point Likert scale) for ease-of-understanding, usefulness and appropriateness and additional free-text responses and semi-structured interviews were conducted RESULTS In Step 1, co-designed text messages (n=189) were semi-personalised and main content themes were: i) physical activity and healthy eating, ii) medications and side effects, iii) mental health and iv) general breast cancer information. In Step 2, consumers (n=14) and health professionals/researchers (n=14) provided 870 reviews of 189 messages and found most messages easy-to-understand (92%), useful (86%) and appropriate (84%) and most (156/189; 83%). However, consumers rated 50 messages differently to health professionals/researchers. Based on evaluations/feedback, 71 messages deleted, 69 edited and 12 new messages were created related to fatigue, self-care and cognition. The final 130 text messages had a mean (SD) Flesch-Kincaid 7.12 (2.8) grade level and 68.9 (15.5) ease-of-reading score representing “standard” reading ease. In Step 3, participants successfully received 16 text messages with no technical issues. CONCLUSIONS Co-designing and evaluating a bank of evidence-based lifestyle-focused text messages with breast cancer survivors, health professionals and researchers was feasible. Consumer evaluations differed from health professionals/researchers and significantly improved the message quality. CLINICALTRIAL N/A

scholarly journals Implementing Web-Based Therapy in Routine Mental Health Care: Systematic Review of Health Professionals’ Perspectives (Preprint)

2019 ◽  
Author(s):  
Fiona Davies ◽  
Heather L Shepherd ◽  
Lisa Beatty ◽  
Brodie Clark ◽  
Phyllis Butow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Mental Health Care ◽  
Organizational Support ◽  
Health Professionals ◽  
Psychological Treatment ◽  
Cochrane Library ◽  
Great Promise ◽  
Web Based

BACKGROUND Web-based therapies hold great promise to increase accessibility and reduce costs of delivering mental health care; however, uptake in routine settings has been low. OBJECTIVE Our objective in this review was to summarize what is known about health care professionals’ perceptions of the barriers to and facilitators of the implementation of web-based psychological treatments in routine care of adults in health care settings. METHODS We searched 5 major databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library) for qualitative, quantitative, or mixed-methods studies exploring health professionals’ views on computer- or internet-based psychological treatment programs. We coded included articles for risk of bias and extracted data using a prepiloted extraction sheet. RESULTS We identified 29 eligible articles: 14 qualitative, 11 quantitative, and 4 mixed methods. We identified the following themes: patient factors, health professional factors, the therapeutic relationship, therapy factors, organizational and system factors, and models of care. Health professionals supported web-based therapies only for patients with relatively straightforward, low-risk diagnoses, strong motivation and engagement, high computer literacy and access, and low need for tailored content. They perceived flexibility with timing and location as advantages of web-based therapy, but preferred blended therapy to facilitate rapport and allow active monitoring and follow-up of patients. They emphasized the need for targeted training and organizational support to manage changed workflows. Health professionals were concerned about the confidentiality and security of client data for web-based programs, suggesting that clear and transparent protocols need to be in place to reassure health professionals before they will be willing to refer. CONCLUSIONS Without health professionals’ support, many people will not access web-based therapies. To increase uptake, it is important to ensure that health professionals receive education, familiarization, and training to support them in incorporating web-based therapies into their practice, and to design systems that support health professionals in this new way of working with patients and addressing their concerns. CLINICALTRIAL PROSPERO CRD42018100869; https://tinyurl.com/y5vaoqsk

Needs and Interest Analysis of Health Professional Clinical Skills Needed Address Patient Vaping/E-Cigarette Use Using Survey and Focus Groups (Preprint)

2021 ◽  
Author(s):  
Mary Metcalf ◽  
Karen Rossie ◽  
Katie Sokes ◽  
Bradley Tanner
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Professional ◽  
Health Effects ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Clinical Skills ◽  
Skills Training ◽  
Cigarette Use ◽  
Wide Range

BACKGROUND The growth of e-cigarette devices, after their initial promotion as safer alternatives to traditional cigarettes, brought about a disturbing trend of youth vaping. Vaping by youth increased recent years and peaking in 2019 with 27.5% of high school students vaping [1–3]. Daily vaping declined for youths the next year by 7 to 9%, but over 3.6 million youths still reported current vaping in a national survey(Miech et. Al, 2020). For adults, vaping devices were often used as treatment alternatives for smoking cessation instead of FDA-approved options[4]. Health professional training and skills development is needed to prevent and address patient vaping and e-cigarette use. OBJECTIVE Develop an understanding of training needs that would help a wide range of health professionals prevent and address vaping and e-cigarette use by their patients. The ultimate goal was to develop online training for health providers focused on vaping/e-cigarette cessation, in a continuing education/continuing medical education format. METHODS We conducted an extensive literature review focused on aspects of vaping/e-cigarette relevant to clinical care. Using the review and our experience as educators on substance abuse, we created an online survey about clinical skills needed in the area of vaping and e-cigarettes, which was completed by two groups of health professionals: 1)self-identified experts on vaping and 2)practicing health professionals who did not self-identify as having expertise. Additionally, we conducted a focus group of clinical staff at an in-patient psychiatric hospital. Finally, we solicited feedback from addiction cessation educators. RESULTS Health professional participants showed a strong interest in the training topics. The top 3 topics of interest were: • Recommended treatments for patients who vape or use e-cigarettes. • How to evaluate and treat health effects in patients who vape or use e-cigarettes. • How to provide brief interventions for patients who vape THC. Interestingly, area of expertise or medical specialty influenced opinion of topic importance. For example, self-identified experts more strongly supported the need for prevention strategies in comparison to other health care professionals. In contrast, health care professionals were far more interested in the “health effects of second-hand vaping” than were the experts. In addition, focus group of in-patient medical staff were more interested in the outcomes of EVALI and the pharmacology of THC than were the other groups. CONCLUSIONS The needs analysis results support interest in clinical skills training related to vaping cessation by health professionals, and provide specific guidance on which topics are most needed. Health professional education on vaping is needed, wanted, and area of practice impacts topic interest significantly.

scholarly journals Patients’ and health professionals’ perceptions of teamwork in primary care

2011 ◽  
Vol 3 (2) ◽  
pp. 128 ◽  
Author(s):  
Susan Pullon ◽  
Eileen McKinlay ◽  
Maria Stubbe ◽  
Lindsay Todd ◽  
Christopher Badenhorst
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professional ◽  
Health Professionals ◽  
Chronic Conditions ◽  
Qualitative Methodology ◽  
Team Leadership ◽  
Health Care Team ◽  
Care Team ◽  
Primary Care Settings

INTRODUCTION: Effective teamwork in primary care settings is integral to the ongoing health of those with chronic conditions. This study compares patient and health professional perceptions about teams, team membership, and team members’ roles. This study aimed to test both the feasibility of undertaking a collaborative method of enquiry as a means of investigating patient perceptions about teamwork in the context of their current health care, and also to compare and contrast these views with those of their usual health professionals in New Zealand suburban general practice settings. METHODS: Using a qualitative methodology, 10 in-depth interviews with eight informants at two practices were conducted and data analysed using inductive thematic analysis. FINDINGS: The methodology successfully elicited confidential interviews with both patients and the health professionals providing their care. Perceptions of the perceived value of team care and qualities facilitating good teamwork were largely concordant. Patient and health professionals differed in their knowledge and understanding about team roles and current chronic care programmes, and had differing perceptions about health care team leadership. CONCLUSION: This study supports the consensus that team-based care is essential for those with chronic conditions, but suggests important differences between patient and health professional views as to who should be in a health care team and what their respective roles might be in primary care settings. These differences are worthy of further exploration, as a lack of common understanding has the potential to consistently undermine otherwise well-intentioned efforts to achieve best possible health for patients with chronic conditions. KEYWORDS: Primary health care; chronic disease; physicians; nurses; patients; patient care team

Health professionals confront the intentional harms of indefinite immigration detention: an Australian overview, evaluation of alternative responses and proposed strategy

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Michael Dudley ◽  
Peter Young ◽  
Louise Newman ◽  
Fran Gale ◽  
Rohanna Stoddart
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Professionals ◽  
Asylum Seekers ◽  
Conflicts Of Interest ◽  
Immigration Detention ◽  
Aggressive Approach ◽  
Content Type ◽  
Indefinite Detention ◽  
Degrading Treatment

Purpose Indefinite immigration detention causes well-documented harms to mental health, and international condemnation and resistance leave it undisrupted. Health care is non-independent from immigration control, compromising clinical ethics. Attempts to establish protected, independent clinical review and subvert the system via advocacy and political engagement have had limited success. The purpose of this study is to examine the following: how indefinite detention for deterrence (exemplified by Australia) injures asylum-seekers; how international legal authorities confirm Australia’s cruel, inhuman and degrading treatment; how detention compromises health-care ethics and hurts health professionals; to weigh arguments for and against boycotting immigration detention; and to discover how health professionals might address these harms, achieving significant change. Design/methodology/approach Secondary data analyses and ethical argumentation were employed. Findings Australian Governments fully understand and accept policy-based injuries. They purposefully dispense cruel, inhuman and degrading treatment and intend suffering that causes measurable harms for arriving asylum-seekers exercising their right under Australian law. Health professionals are ethically conflicted, not wanting to abandon patients yet constrained. Indefinite detention prevents them from alleviating sufferings and invites collusion, potentially strengthening harms; thwarts scientific inquiry and evidence-based interventions; and endangers their health whether they resist, leave or remain. Governments have primary responsibility for detained asylum-seekers’ health care. Health professional organisations should negotiate the minimum requirements for their members’ participation to ensure independence, and prevent conflicts of interest and inadvertent collaboration with and enabling systemic harms. Originality/value Australia’s aggressive approach may become normalised, without its illegality being determined. Health professional colleges uniting over conditions of participation would foreground ethics and pressure governments internationally over this contagious and inexcusable policy.

scholarly journals Digital Health and the Embodying of Professionalism: Avatars as Health Professionals in Sweden

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Johan Hallqvist
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Professionals ◽  
Healthcare Professionals ◽  
Digital Health ◽  
Health Technology ◽  
Patient Choice ◽  
Discourse Theory ◽  
Ethnographic Fieldwork ◽  
Swedish Health Care

This paper explores virtual health professionals (VHPs), digital health technology software, in Swedish health care. The aim is to analyze how health professionalism is (re)negotiated through avatar embodiments of VHPs and to explore the informants’ notions of what a health professional is, behaves and looks like. The paper builds on ethnographic fieldwork with informants working directly or indirectly with questions of digital health technology and professionalism. Discourse theory is used to analyze the material. Subjectification, authenticity, and diversity were found to be crucial for informants to articulate health professionalism when discussing human avatars, professional attire, gendered and ethnified embodiments. The informants attempted to make the VHPs credibly professional but inauthentcally human. A discursive struggle over health professionalism between patient choice and diversity within health care was identified where the patient’s choice of avatars—if based on prejudices—might threaten healthcare professionalism and healthcare professionals by (re)producing racism and sexism.

The Ethical Health Lawyer

2006 ◽  
Vol 34 (4) ◽  
pp. 813-816 ◽  
Author(s):  
William Winslade ◽  
E. Bernadette McKinney
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Care Professional ◽  
Medical Errors ◽  
Medical Error ◽  
Health Professionals ◽  
Professional Relationship ◽  
Patient Health ◽  
Natural Inclination ◽  
The Right

When a health care professional contacts a health care attorney for advice about how to deal with a medical error involving a patient, what is the most ethically appropriate response? Honesty is the best policy; the ethical health lawyer should advise the client to tell the patient the truth. This advice is neither naïve nor impractical, as we will show. More importantly, it is without question the right thing to do for a number of sound reasons. It may not be a natural inclination or an easy task to accomplish; several countervailing factors discourage health professionals from telling patients the truth about medical errors. However, we will argue that resistance to truthful disclosure can and should be overcome by rational arguments that also take into consideration the psychodynamics of the patient-health professional relationship.

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