scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands (Preprint)

2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands

10.2196/24908 ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. e24908
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

Background Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. Objective This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. Methods Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. Results Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ24=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). Conclusions The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

scholarly journals Medical Specialists' Perspectives on the Influence of Electronic Medical Record Use on the Quality of Hospital Care: Semistructured Interview Study (Preprint)

2021 ◽  
Author(s):  
Rube van Poelgeest ◽  
Augustinus Schrijvers ◽  
Albert Boonstra ◽  
Kit Roes
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Decision Support ◽  
Health Care Professionals ◽  
Medical Decision ◽  
Semistructured Interview ◽  
Care Providers ◽  
Major Barrier ◽  
Medical Specialists

BACKGROUND Numerous publications show that electronic medical records (EMRs) may make an important contribution to increasing the quality of care. There are indications that particularly the medical specialist plays an important role in the use of EMRs in hospitals. OBJECTIVE The aim of this study was to examine how, and by which aspects, the relationship between EMR use and the quality of care in hospitals is influenced according to medical specialists. METHODS To answer this question, a qualitative study was conducted in the period of August-October 2018. Semistructured interviews of around 90 min were conducted with 11 medical specialists from 11 different Dutch hospitals. For analysis of the answers, we used a previously published taxonomy of factors that can influence the use of EMRs. RESULTS The professional experience of the participating medical specialists varied between 5 and 27 years. Using the previously published taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimal change processes surrounding implementation were also perceived as a major barrier. A final major problem is related to the categories “social” (their relationships with the patients and fellow care providers), “psychological” (based on their personal issues, knowledge, and perceptions), and “time” (the time required to select, implement, and learn how to use EMR systems and subsequently enter data into the system). However, the medical specialists also identified potential technical facilitators, particularly in the assured availability of information to all health care professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve the quality of care but consider these possibilities currently lacking. CONCLUSIONS The 11 medical specialists shared positive experiences with EMR use when comparing it to formerly used paper records. The fact that involved health care professionals can access patient data at any time they need is considered important. However, in practice, potential quality improvement lags as long as decision support cannot be applied because of the lack of a fully coded patient record.

Health Care Professionals’ Experiences of Facilitating Patient Activation and Empowerment in Chronic Illness using a Person-Centered and Strengths-Based Self-Management Program

2021 ◽  
pp. 174239532110650
Author(s):  
Kristin Heggdal ◽  
Natalie Stepanian ◽  
Bjørg Frøysland Oftedal ◽  
Joshua B. Mendelsohn ◽  
Marie Hamilton Larsen
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Health Care Professionals ◽  
Patient Activation ◽  
Management Program ◽  
Self Management ◽  
Patient Centered ◽  
Individual Interviews ◽  
Qualitative Process Evaluation

Objective Patients with chronic illness who are empowered and activated are more likely to engage in self-management in order to stabilise their condition and enhance their quality of life. This study aimed to explore Health Care Professional's (HCP) assessment of a person-centered intervention called ‘The Bodyknowledging Program’ (BKP) for the facilitation of empowerment and patient activation in the context of chronic illness. Methods This study employed a qualitative process evaluation after programme completion. Data was collected through focus-groups and individual interviews with HCPs and content analysis was used in the analysis. Results Four themes were identified: 1) Shifts towards the patient-perspective, 2) The value of a patient-centered conceptual framework, 3) Patient activation through dialogue based support and 4) Challenging competencies. Discussion: This study introduces ‘The Bodyknowledging Program’ as a useful tool to uncover patients’ needs and to activate and empower them to take more responsibility for their health through self-care management. The usability of the new intervention depends on HCP's ability to develop their counselling skills and changing their approach towards utilising patients’ individual resources in the promotion of their health.

scholarly journals Doctor, what are my options? A prospective cohort study of an individualized care plan for patients with gastrointestinal cancer

2015 ◽  
Vol 22 (3) ◽  
pp. 171 ◽  
Author(s):  
A.E. Hird ◽  
M. Lemke ◽  
M. Turovsky ◽  
V. Malecki ◽  
K. Kumar ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Health Care Professionals ◽  
Prospective Cohort ◽  
Care Plan ◽  
Care Plans ◽  
Individualized Care ◽  
Gi Cancer

BackgroundFor cancer patients, information about their disease and its treatment is often delivered within a short time period, potentially leading to patient misunderstanding, which can impede optimal patient care. In this 3-part clinical study, we investigated the utility of an individualized care plan for patients with gastrointestinal (gi) cancer starting a new treatment.Methods In part 1, a comprehensive literature search identified items for potential inclusion in the care plan. Those items were formatted into a questionnaire. The questionnaire was then administered to patients as a structured interview. In part 2, health care professionals involved in the care of patients with gi cancer evaluated the resulting care plan for content and relevancy. In part 3, a 20-week prospective cohort study (10 weeks using standard of care, 10 weeks using individualized care plans) was conducted. Outcomes were assessed at baseline and at 2–4 weeks after administration of the care plan.Results In part 1, a 73-item questionnaire was developed and completed by 20 patients in semi-structured interviews. In part 2, long and short versions of the care plan were created. Most health care professionals preferred the long version. Based on their comments, a final version of the care plan was created. The part 3 study enrolled 104 patients. Overall satisfaction scores were significantly higher in the intervention group at baseline (p = 0.010) and follow-up (p = 0.005). Compared with control patients, the intervention cohort also reported significantly higher overall quality of life (p = 0.044) and fewer symptoms of anxiety (p = 0.048) at follow-up.Conclusions Provision of an individualized care plan resulted in improvements in outcome measures at both baseline and follow-up. Future studies are needed to confirm these findings.

IMPORTANCE OF SELF – MANAGEMENT OF PATIENTS WITH CARDIOVASCULAR DISEASE ON HEALTH-RELATED QUALITY OF LIFE

2020 ◽  
Vol 30 (6) ◽  
pp. 99-106
Author(s):  
Vilma Rastenienė ◽  
Aurelija Blaževičienė
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Disease ◽  
Health Care ◽  
Health Care Professionals ◽  
Healthy Lifestyle ◽  
Good Practice ◽  
Management Strategies ◽  
Self Management ◽  
Related Quality

The aim of the paper was to find out what is known about how do people effectively manage their illness, heart and cardiovascular diseases, themselves in the advanced sta­ges of their disease. Material and Metods. An integrative review. Results. Promotion of self-managment in patients with a viable health care strategy in order to maintain health and prevent exacerbations. Optimal treatment of care, patients‘ self-managment promotion reduces the finan­cial costs of treating patients. Increasing the patient‘s ability to achieve a healthy lifestyle, the application of medical recommendations to recognize the symptoms and signs of consultations with health care professionals can reduce repeated hospitalization rates. For health care professionals self-managment education promotion is a great strategy to improve patients‘ quality of life. Conclusions. Self management strategies for people with heart and cardiovascular disease should be related to helping them cope with pain and debilitating symp­toms, coping emotionally and adjusting psychosocially to their illness, and alleviating distress associated with symptoms that can not easily be improved. Examples of good practice should be formally evaluated.

Obesity Self-Management Education: A Community-Based Project for an Underserved Population

2013 ◽  
Vol 6 (1) ◽  
pp. 30-38
Author(s):  
Ruth Ann Madden ◽  
Heather Kane ◽  
Reina Eisner
Keyword(s):  
Health Care Professionals ◽  
Food Choices ◽  
Self Management ◽  
Obesity Management ◽  
Lifestyle Modifications ◽  
Community Based ◽  
Portion Control ◽  
Use Of Health Care

Obesity is a disease linked to several cardiovascular and endocrine dysfunctions as well as decreased life expectancy and quality of life. Obesity management is a prevalent and persistent concern in primary care. We implemented an educational intervention to promote self-management for 10 patients in a medically underserved clinic to support patients in addressing weight management through positive self-care behaviors. Lifestyle interventions for these participants resulted in self-reported minimal weight loss with significant and sustained lifestyle modifications, such as healthier food choices, portion control, and increased exercise. Recommendations for the future include the use of health care professionals to educate patients about self-management and goal setting with sustained follow-up in treatment of chronic disease.

scholarly journals Medical Specialists' Perspectives on the Influence of Electronic Medical Record Use on the Quality of Hospital Care: Semistructured Interview Study

10.2196/27671 ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. e27671
Author(s):  
Rube van Poelgeest ◽  
Augustinus Schrijvers ◽  
Albert Boonstra ◽  
Kit Roes
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Decision Support ◽  
Health Care Professionals ◽  
Medical Decision ◽  
Semistructured Interview ◽  
Care Providers ◽  
Major Barrier ◽  
Medical Specialists

Background Numerous publications show that electronic medical records (EMRs) may make an important contribution to increasing the quality of care. There are indications that particularly the medical specialist plays an important role in the use of EMRs in hospitals. Objective The aim of this study was to examine how, and by which aspects, the relationship between EMR use and the quality of care in hospitals is influenced according to medical specialists. Methods To answer this question, a qualitative study was conducted in the period of August-October 2018. Semistructured interviews of around 90 min were conducted with 11 medical specialists from 11 different Dutch hospitals. For analysis of the answers, we used a previously published taxonomy of factors that can influence the use of EMRs. Results The professional experience of the participating medical specialists varied between 5 and 27 years. Using the previously published taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimal change processes surrounding implementation were also perceived as a major barrier. A final major problem is related to the categories “social” (their relationships with the patients and fellow care providers), “psychological” (based on their personal issues, knowledge, and perceptions), and “time” (the time required to select, implement, and learn how to use EMR systems and subsequently enter data into the system). However, the medical specialists also identified potential technical facilitators, particularly in the assured availability of information to all health care professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve the quality of care but consider these possibilities currently lacking. Conclusions The 11 medical specialists shared positive experiences with EMR use when comparing it to formerly used paper records. The fact that involved health care professionals can access patient data at any time they need is considered important. However, in practice, potential quality improvement lags as long as decision support cannot be applied because of the lack of a fully coded patient record.

Problems in the Health Care of Dying Old Men: Complaints by their Widows

1995 ◽  
Vol 31 (2) ◽  
pp. 121-141 ◽  
Author(s):  
Maria M. Talbott
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Medical Care ◽  
Health Care Professionals ◽  
Lack Of Control ◽  
Old Men

Complaints of older widows regarding their husbands' health care are investigated in this study. Sixty-four older widows were interviewed several years after their husbands' deaths. The deaths occurred in the early 1980s. Forty-six percent reported problems in the health care their husbands had received. Widows whose husbands had not known in advance that they were going to die were more likely to complain about their husbands' medical care than widows whose husbands had known in advance. Complaints were also related to the frequency of several symptoms of grief. The widows' complaints about their husbands' care focus on quality of care, perceived insensitivity on the part of health care professionals, lack of control over the death, and the organization of services.

scholarly journals Randomized controlled study of the impact of a participatory patient care plan among primary care patients with common chronic diseases: a one-year follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Tusa ◽  
Hannu Kautiainen ◽  
Pia Elfving ◽  
Sanna Sinikallio ◽  
Pekka Mäntyselkä
Keyword(s):  
Quality Of Life ◽  
Patient Care ◽  
Usual Care ◽  
Care Plan ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Disease Specific

Abstract Backround Chronic diseases and multimorbidity are common in the ageing population and affect the health related quality of life. Health care resources are limited and the continuity of care has to be assured. Therefore it is essential to find demonstrable tools for best treatment practices for patients with chronic diseases. Our aim was to study the influence of a participatory patient care plan on the health-related quality of life and disease specific outcomes related to diabetes, ischemic heart disease and hypertension. Methods The data of the present study were based on the Participatory Patient Care Planning in Primary Care. A total of 605 patients were recruited in the Siilinjärvi Health Center in the years 2017–2018 from those patients who were followed up due to the treatment of hypertension, ischemic heart disease or diabetes. Patients were randomized into usual care and intervention groups. The intervention consisted of a participatory patient care plan, which was formulated in collaboration with the patient and the nurse and the physician during the first health care visit. Health-related quality of life with the 15D instrument and the disease-specific outcomes of body mass index (BMI), low density lipoprotein cholesterol (LDL-C), hemoglobin A1c (HbA1C) and blood pressure were assessed at the baseline and after a one-year follow-up. Results A total of 587 patients with a mean age of 69 years were followed for 12 months. In the intervention group there were 289 patients (54% women) and in the usual care group there were 298 patients (50% women). During the follow-up there were no significant changes between the groups in health-related quality and disease-specific outcomes. Conclusions During the 12-month follow-up, no significant differences between the intervention and the usual care groups were detected, as the intervention and the usual care groups were already in good therapeutic equilibrium at the baseline. Trial registration ClinicalTrials.gov Identifier: NCT02992431. Registered 14/12/2016

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