scholarly journals Health Care Professionals’ Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Ann Catrine Eldh ◽  
Annette Sverker ◽  
Preben Bendtsen ◽  
Evalill Nilsson

BACKGROUND Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care. OBJECTIVE The objective of our study was to describe health care staff’s experience with a digital communication system intended for patient-staff encounters via a digital route in primary care. METHODS In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis. RESULTS While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient’s voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service—at least for a while—if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers. CONCLUSIONS A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.

10.2196/21698 ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. e21698
Author(s):  
Ann Catrine Eldh ◽  
Annette Sverker ◽  
Preben Bendtsen ◽  
Evalill Nilsson

Background Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care. Objective The objective of our study was to describe health care staff’s experience with a digital communication system intended for patient-staff encounters via a digital route in primary care. Methods In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis. Results While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient’s voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service—at least for a while—if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers. Conclusions A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.


Author(s):  
Indiara Sartori Dalmolin ◽  
Ivonete Teresinha Schülter Buss Heidemann

Objective: to understand the use of integrative and complementary practices as a health promotion action. Method: qualitative study, action-participant type, with the application of Paulo Freire’s Research Itinerary, in which 30 Primary Health Care professionals participated. Thematic research was developed with two Primary Care Units, one that used integrative and complementary practices in daily life and another that focused more on allopathic concepts of assistance. To carry out the three stages of the method used, seven Culture Yarning Circles took place. The critical unveiling took place concurrently with the participation of those surveyed. Results: integrative and complementary practices constitute a form of health care, with the purpose of understanding the human being in the health-disease process, making it possible to work with the different aspects that involve them. In this way, they reduce damages resulting from the excessive use of medications, stimulate comprehensiveness and promote health. Conclusion: integrative and complementary practices are resources for health promotion, through comprehensive care and reducing the use of medications.


2020 ◽  
Vol 9 (9) ◽  
pp. 2991
Author(s):  
Karolina Lisy ◽  
Jennifer Kent ◽  
Jodi Dumbrell ◽  
Helana Kelly ◽  
Amanda Piper ◽  
...  

Survivorship care that is shared between oncology and primary care providers may be a suitable model to effectively and efficiently care for the growing survivor population, however recommendations supporting implementation are lacking. This qualitative study aimed to explore health care professionals’ (HCPs) perceived facilitators and barriers to the implementation, delivery and sustainability of shared survivorship care. Data were collected via semi-structured focus groups and analysed by inductive thematic analysis. Results identified four overarching themes: (1) considerations for HCPs; (2) considerations regarding patients; (3) considerations for planning and process; and (4) policy implications. For HCPs, subthemes included general practitioner (GP, primary care physician) knowledge and need for further training, having clear protocols for follow-up, and direct communication channels between providers. Patient considerations included identifying patients suitable for shared care, discussing shared care with patients early in their cancer journey, and patients’ relationships with their GPs. Regarding process, subthemes included rapid referral pathways back to hospital, care coordination, and ongoing data collection to inform refinement of a dynamic model. Finally, policy implications included development of policy to support a consistent shared care model, and reliable and sustainable funding mechanisms. Based on study findings, a set of recommendations for practice and policy were developed.


2021 ◽  
Author(s):  
Enric Aragonès ◽  
Germán López-Cortacans ◽  
Narcís Cardoner ◽  
Catarina Tomé-Pires ◽  
Daniel Porta-Casteràs ◽  
...  

Abstract Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care program for the management of depression in primary health care centers across Catalonia. The aim of this qualitative study was to evaluate a trial implementation of the program to identify barriers, facilitators, and proposals for improvement. Methods: One year after the implementation of the INDI program in 18 public primary health care centers we performed a qualitative study in which the opinions and experiences of 23 primary care doctors and nurses from the participating centers were explored in focus groups. We performed thematic content analysis of the focus group transcripts. Results: The results were organized into three categories: facilitators, barriers, and proposals for improvement as perceived by the health care professionals involved. The most important facilitator identified was the perception that the INDI collaborative care program could be a useful tool for reorganizing processes and improving the management of depression in primary care, currently viewed as deficient. The main barriers identified were of an organizational nature: heavy workloads, lack of time, high staff turnover and shortages, and competing demands. Additional obstacles were inertia and resistance to change among health care professionals. Proposals for improvement included institutional buy-in to guarantee enduring support and the organizational changes needed for successful implementation.Conclusions: The INDI program is perceived as a useful, viable program for improving the management of depression in primary care. Uptake by primary care centers and health care professionals, however, was poor. The identification and analysis of barriers and facilitators will help refine the strategy to achieve successful, widespread implementation.Trial registration: ClinicalTrials.gov identifier: NCT03285659; Registered 18th September, 2017.


2020 ◽  
Vol 23 (2) ◽  
pp. 318-327
Author(s):  
Patrice Alain Ngangue ◽  
Catherine Forgues ◽  
Tu Nguyen ◽  
Maxime Sasseville ◽  
Frances Gallagher ◽  
...  

2017 ◽  
Vol 76 (2) ◽  
pp. 147-155 ◽  
Author(s):  
V. V. Naumenko ◽  
A. V. Totsky ◽  
S. K. Pidchenko ◽  
J. T. Astola ◽  
O. A. Polotska

Appetite ◽  
2007 ◽  
Vol 48 (2) ◽  
pp. 241-247 ◽  
Author(s):  
Eva Landström ◽  
Birgitta Sidenvall ◽  
Ulla-Kaisa Koivisto Hursti ◽  
Maria Magnusson

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1294.1-1294
Author(s):  
C. Helin Hollstrand ◽  
K. Nilke Nordlund

Background:With the launch of The Swedish Young Rheumatics Report in April of 2018, we also presented new way of thinking and a tool called the Dreamscale, our complement to the traditional VAS scale used to assess pain. In October of 2018, we organized a workshop together with communication consults where we invited some of our members in different ages and health care professionals working with children, youths and young adults with rheumatic diseases, to try and reach a joint definition of what the Dreamscale is and could be, as we saw its huge potential. This is where the idea of the Dreamcatcher was born.Objectives:The objective is to create an innovative digital tool for young people with rheumatic disease. It takes its starting point in what is healthy and what is possible, rather than focusing on sickness and limitations. Using behavioral science, nudging and social functions, the Dreamcatcher has the potential to lower the barriers to living an active lifestyle, while also serving as a tool for dialogue with health care professionals, resulting in more efficient meetings, better resource planning and the gathering of valuable data to the national quality registers. It is also a digital tool with a big potential for development thanks to its open source code and its focus on enabling activity and participation, there is an obvious potential to develop its functions to also serve other actors and patient groups.Methods:We teamed up with communication bureau Gullers Grupp, pharmaceutical company Pfizer, and two health care clinics in Stockholm, one for children and youths with rheumatic disease and one for adults, and received funding for one year of development from Vinnova, the Swedish innovation authority, in April of 2019. We started the project by conducting a study to try and narrow down what focuses the Dreamcatcher should have. The pilot study contains both workshops with patients, both children, youths and young adults, and with teams of health care professionals, as well as more in-depth interviews with both patients and health care professionals. Based on the study, we will develop a prototype of what the Dreamcatcher could look like, and it will most likely be an application used for smartphones.Results:The study narrows down the Dreamcatcher into three things: the Dreamscale, Dream data, and the Dream collective.The Dreamscaleis as previously explained a complement to the traditional pain-scale and a tool for patients to set goals towards their dreams, and for patients and health care professionals to co-plan care and medical treatment based on what’s most important to the patient.Dream datais where patients can self-track their disease, data which is also available for the health care to view and therefore to be better prepared before meeting with the patient. It is also a goal to have the Dream data transferred to the national quality registers.The Dream collectiveis a social function where patients using the app can connect and get inspired by each other. It is a place to share your dreams and build a community to show that rheumatic disease isn’t something that should ever stop you from going after your dreams!Conclusion:The prototype of the Dreamcatcher will be presented in May of 2020 and we think this it has great potential to help shift focus withing health care, to not just focusing on sickness and limitations but rather on dreams, joy of life and possibilities!References:[1]https://ungareumatiker.se/nytt-digitalt-patientverktyg-unga-reumatiker-tar-fram-dromfangaren/[2]https://www.youtube.com/watch?v=zD6PwSKeb8IDisclosure of Interests:None declared


2005 ◽  
Vol 50 (3) ◽  
pp. 177-183 ◽  
Author(s):  
Janet L. Engstrom ◽  
Marlene G. S. Sefton ◽  
Jolie Kim Matheson ◽  
Kristine M. Healy

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