System-level factors drive telephone and video visit use: Survey of safety-net clinicians during the early phase of COVID-19. (Preprint)

2021 ◽  
Author(s):  
Anjana E. Sharma ◽  
Elaine C. Khoong ◽  
Maribel Sieera ◽  
Natalie A. Rivadeneira ◽  
Malini A. Nijagal ◽  
...  
Keyword(s):  
Safety Net ◽  
Urgent Care ◽  
System Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Device Use ◽  
Major Factors ◽  
Publicly Insured ◽  
Personal Devices

BACKGROUND COVID-19 prompted safety-net healthcare systems to rapidly implement telemedicine services with little prior experience. OBJECTIVE To assess health system-level factors and their impact on telephone and video visit use to inform future telemedicine practices. METHODS We conducted a cross-sectional survey among ambulatory care clinicians at a hospital-linked ambulatory clinic network serving a diverse, publicly insured patient population between May 28 2020-July 14 2020. We conducted bivariate analyses assessing healthcare system-level factors associated with 1) Regular phone adoption (4 or more visits on average per half-day); and 2) video visit adoption (at least 1 video visit on average per half-day). RESULTS We collected 311 responses from 643 eligible clinicians, for a response rate of 48.4%. Clinician respondents (N=311) included 34.7% (N=108) primary/urgent care, 35.1% (N=109) medical, and 7.4% (N=23) surgical specialties. Our sample included 178 (57.2%) telephone adopters and 81 (26.05%) video adopters. Primary/urgent care had the highest proportion of telephone adoption (84.3%; vs. 50.4% medical, 37.5% surgical, P <0.001); medical specialties had the highest proportion of video adoption (39.1%; vs. 14.8% primary care, 12.5% % surgical, P <0.001). Among telephone adopters, 72.2% utilized personal devices for telemedicine (versus 59.0% non-regular telephone adopters, P=0.04). Video non-adopters requested more training in technical aspects than adopters (49.6% vs. 27.2%, P =0.0005). CONCLUSIONS Clinical specialty type, personal device use, and desire for technical training were major factors driving telephone and video visit adoption among safety-net clinicians. Department-level support, distribution of devices, and clinician trainings are priorities for safety-net systems.

scholarly journals Understanding physicians’ preferences for telemedicine in the time of COVID (Preprint)

2020 ◽  
Author(s):  
Iman Sharif ◽  
Shae Patel ◽  
Melissa Shafer ◽  
Laura Longman ◽  
Laura Longman
Keyword(s):  
Health Center ◽  
Behavioral Health ◽  
Urgent Care ◽  
Resource Poor Setting ◽  
Health Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Federally Qualified Health Center ◽  
The Future

BACKGROUND In contrast to the current broad dissemination of telemedicine across medical specialties, previous research focused on the effectiveness of telemedicine in special populations and for behavioral health encounters; demonstrating that both physician and patient factors impact the efficacious use of telemedicine. OBJECTIVE We evaluated physician perceptions of the appropriateness of telemedicine for patients attending the primary care practices of a federally qualified health center in New York City. METHODS Anonymous cross-sectional survey including closed and open-ended questions. We used chi-square to test whether providers from certain specialties were more likely to state they would use telemedicine in the future. We used t-test to compare age between those who would vs. would not use telemedicine. Then, we used logistic regression to test whether age and specialty were both correlated with desire to use telemedicine in the future. We used thematic content analysis to describe the reasons providers felt they would not want to use telemedicine in the future, and to describe the situations for which they felt telemedicine would be appropriate. RESULTS Of 272 FHC providers who were sent the electronic survey, 159(58%) responded within the 2-week survey time frame. Mean age of providers was 45 years (range 28-75). Overall, 81% stated they would use telemedicine in the future. Compared to the Family Medicine, Internal Medicine, Behavioral Health, Dental, and OB/GYN specialties, providers from Pediatrics, Med-Peds, Subspecialties and Surgery [Pro-telemedicine specialties] were more likely to believe telemedicine would be useful post pandemic (94% vs. 72%, p<0.05). Providers who reported they would use telemedicine in the future were younger [mean age 44(42-46) vs. 50(46-55), p<0.01). In regression analysis, both pro-telemedicine specialties and age were significantly associated with odds of reporting they would use telemedicine in the future [specialties: 5.2(1.7-16.2); age: 0.95(0.92-0.99)]. Providers who did not want to use telemedicine in the future cited concerns about inadequate patient care, lack of physical patient interaction, technology issues, and lack of necessity. Providers who felt telemedicine would be useful cited the following situations: follow up visits, medication refills, urgent care, patient convenience, and specific conditions such has behavioral health, dermatology visits, and chronic care management. CONCLUSIONS The majority of health providers in this resource poor setting in a federally qualified health center believed that telemedicine would be useful for providing care after the pandemic is over.

scholarly journals Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017757 ◽  
Author(s):  
Ingrid Hjulstad Johansen ◽  
Valborg Baste ◽  
Judith Rosta ◽  
Olaf G Aasland ◽  
Tone Morken
Keyword(s):  
Relative Risk ◽  
Workplace Violence ◽  
Medical Specialty ◽  
Cross Sectional Survey ◽  
Work Time ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Work Settings ◽  
Representative Samples ◽  
Violence Against Doctors

ObjectivesThe aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades.DesignRepeated cross-sectional survey.SettingAll healthcare levels and medical specialties in Norway.ParticipantsRepresentative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158).Main outcome measuresRelative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty.ResultsThere were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95).ConclusionsA substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors’ education and within work settings.

scholarly journals A cross sectional survey of internet use among a highly socially disadvantaged population of tobacco smokers

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Sam McCrabb ◽  
Laura Twyman ◽  
Kerrin Palazzi ◽  
Ashleigh Guillaumier ◽  
Christine Paul ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Internet Use ◽  
Internet Access ◽  
The Internet ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Disadvantaged Population ◽  
Socially Disadvantaged ◽  
Frequent Use ◽  
Device Use

Abstract Background Tobacco smoking is highest among population groups which are the most socially disadvantaged. Internet-based smoking cessation programs have been found to be effective, though rates of internet access are not well known in these groups. This study describes the rates of internet use and types of technology used to access the internet by a population of socially disadvantaged smokers. The study also examined relationships between sociodemographic and smoking behaviours with amount of internet use and type of device used. Methods A cross-sectional survey of 369 clients (response rate 77%) from two non-government community service organisations in metropolitan New South Wales, Australia was conducted using touchscreen computers. Descriptive statistics and logistic regressions were used to examine results. Results Eligible participants ranged from 19 to 88 years old current tobacco users. Over half (58%) of the participants reported weekly or more frequent use of the internet with less than a third (28%) not having any access. The odds of using the internet at least weekly decreased with age and as heaviness of smoking increased (OR = 0.94, p < 0.001; OR = 0.81, p = 0.022, respectively). Odds of internet use were higher as income increased (OR = 2.74, p < 0.001 for individuals earning $201–$400 per week; OR = 2.83, p = 0.006 for individuals earning > $400 per week). Device use differed for age and income. Conclusions Internet-based interventions appear to reach the majority of socially disadvantaged populations. It is expected that this reach will continue to grow, making internet-based interventions a potential platform for providing care to low socioeconomic individuals who smoke, however inequalities may be exacerbated for those individual without internet access. Implications Internet use among socially disadvantaged tobacco users is moderate (58%). An internet-based smoking cessation intervention for socially disadvantaged tobacco users may be an effective intervention however, older, heavier tobacco users may not benefit as easily due to limited internet access and therefore acknowledging these limitations when developing an intervention can help to acknowledge limitation of intervention reach.

The Most Commonly Treated Acupuncture Indications in the United States: A Cross-Sectional Study

2018 ◽  
Vol 46 (07) ◽  
pp. 1387-1419 ◽  
Author(s):  
Haiyi Wang ◽  
Guanhu Yang ◽  
Shaobai Wang ◽  
Xin Zheng ◽  
Wei Zhang ◽  
...  
Keyword(s):  
United States ◽  
Health Management ◽  
Frozen Shoulder ◽  
Gastrointestinal Diseases ◽  
The United States ◽  
Therapeutic Effects ◽  
Cross Sectional Survey ◽  
Full Spectrum ◽  
Cross Sectional ◽  
Medical Specialties

Acupuncture has been a popular alternative medicine in the United States for several decades. Its therapeutic effects on pain have been validated by both basic and clinical researches, and it is currently emerging as a unique non-pharmaceutical choice for pain against opioid crisis. However, the full spectrum of acupuncture indications remains unexplored. In this study, we conducted a cross-sectional survey among 419 acupuncturists nation-wide to investigate the top 10 and top 99 acupuncture indications in private clinics in the United States. We found the top 10 indications to be: lower back pain, depression, anxiety, headache, arthritis, allergies, general pain, female infertility, insomnia, neck pain and frozen shoulder. Among the top 99 indications, pain represents the largest category; and mental health management, especially for mood disorders, is in greatest demand. The following popular groups are: immune system dysfunctions, gastrointestinal diseases, gynecology and neurology. In addition, specialty index, commonality index, and the potential to become medical specialties were estimated for each indication. Demographic analysis suggests that China trained acupuncturists tend to have broader indication spectrums, but the top conditions treated are primarily decided by local needs. Also, gender, resident states, age and clinical experience all affect indication distributions. Our data for the first time outlines the profile of acupuncture treatable conditions in the US and is valuable for strategic planning in acupuncture training, healthcare administration and public education.

Handheld electronic device use in patient care: the emergency department patient perspective—a cross-sectional survey

2020 ◽  
pp. emermed-2019-209010
Author(s):  
Nicholas Tilbury ◽  
Graham D Johnson ◽  
Zoe Rusk ◽  
Carol Byrne ◽  
Maleasha Shergill ◽  
...  
Keyword(s):  
Data Collection ◽  
Electronic Device ◽  
Healthcare Setting ◽  
Emergency Department Patient ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Day Of The Week ◽  
Collection Period ◽  
Device Use ◽  
Handheld Electronic Devices

BackgroundStaff use of smartphones and tablets in the healthcare setting is increasingly prevalent, but little is known about whether this use is acceptable to patients. Staff are concerned that the use of handheld electronic devices (HEDs) may be negatively misconstrued by patients. The HED can be a valuable tool, offering the emergency clinician access to a wealth of resources; it is therefore vital that patient views are addressed during their widespread adoption into clinical practice.MethodsPatients, or those accompanying them, within the ED of the Royal Derby Hospital between April and June 2017 were asked to complete a survey consisting of 22 questions. Data collection took place to include all times of day and every day of the week. Every eligible individual within the department during a data collection period was approached.ResultsA total of 438 respondents successfully completed the survey with a response rate of 92%. Only 2% of those who observed staff using HEDs during their ED visit thought that they were being used for non-clinical purposes. 339 (78%) agreed that staff should be allowed to use HEDs in the workplace. Concerns expressed by respondents included devices being used for non-clinical purposes and data security. The main suggestion by respondents was that the purpose of the HEDs should be explained to patients to avoid misinterpretation.ConclusionOur survey shows that the majority of survey respondents felt that clinical staff should be allowed to use HEDs in the workplace and that many of the concerns raised could be addressed with adequate patient information and clear governance.

scholarly journals Pattern of use of biologics in psoriasis among Indian dermatologists – A cross sectional survey

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Shekhar Neema ◽  
Disha Dabbas ◽  
S. Radhakrishnan ◽  
Arun Kumar Yadav
Keyword(s):  
Small Sample Size ◽  
Target Organ Damage ◽  
Group Discussion ◽  
Organ Damage ◽  
Small Sample ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Factors ◽  
Prohibitive Cost ◽  
The Cost

Background and Aims: Biologics are a relatively new class of highly effective drugs in the management of psoriasis. They act on specific immune processes, achieve rapid and sustained clearance and do not cause target organ damage unlike conventional systemic therapy. It appears that their use in our country is not as widespread as in developed nations despite these benefits ; their prohibitive cost may be a major factor for the limited usage. This survey aimed to find out the extent of use and factors hindering usage of biologics for the management of psoriasis by Indian dermatologists. Methods: It was a cross-sectional questionnaire based study. The questionnaire was designed after a focussed group discussion, followed by validation. The survey was sent in the form of a link to Indian dermatologists. The responses were recorded in excel-sheet and the data was analyzed by SPSS ver 25. Results: Of the 310 participants who took part, 287 completed the survey. Two hundred (70%) were users of biologics, while 87 (30%) had never used them. Cost was the major factor which prevented biologic use. Majority of the respondents used biologics in less than 2 cases per month. Secukinumab was the most common biologic used followed by etanercept. The factors which determined choice of biologics were convenience, cost, previous experience, co-morbid conditions and recommendations by an expert. Limitations: A small sample size was the limitation of the study. Dermatologists who do not use biologics may be under-represented in the study. Conclusions: Biologics are not used optimally by Indian dermatologists for management of psoriasis. The cost, fear of adverse effects, lack of awareness and inadequate felt need are major factors which prevent their regular use.

scholarly journals Brief report: social media as a tool for scientific updating at the time of COVID pandemic

2020 ◽  
Author(s):  
Rita Murri ◽  
Francesco Vladimiro Segala ◽  
Pierluigi Del Vecchio ◽  
Antonella Cingolani ◽  
Eleonora Taddei ◽  
...  
Keyword(s):  
Social Media ◽  
Medical Information ◽  
Rapid Evolution ◽  
Age Groups ◽  
Daily Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialties ◽  
The Face ◽  
Use Of Social Media

AbstractIn the face of the rapid evolution of the COVID-19 pandemic, healthcare professionals on the frontline are in urgent need of frequent updates in the accomplishment of their practice. Hence, clinicians started to search for prompt, valid information on sources parallel to academic journals publications. Aim of this work is to investigate the extent of this phenomenon.We administered an anonymous online cross-sectional survey to 645 Italian clinicians. 369 questionnaires were returned. 19,5% (n=72) of respondents were younger than 30 years-old; 49,3% (n=182) worked in Infectious Diseases, Internal Medicine or Respiratory Medicine departments, 11.5% (n=42) in Intensive Care Unit and 7.4% (n=27) were general practitioner. 70% (n=261) of respondents reported that their use of social media to seek medical information increased during the pandemic. 39.3% (n = 145) consistently consulted Facebook groups and 53.1% (n = 196) Whatsapp chats. 47% (n = 174) of respondents reported that information shared on social media had a consistent impact on their daily practice. In the present study, we found no difference in social media usage between age groups or medical specialties.Given the urgent need for scientific update in face of the present health emergency, these findings may help understanding how clinicians access new evidences and implement them in their daily practice.

scholarly journals Correlates of COVID-19 vaccine acceptance, hesitancy and refusal among employees of a safety net California county health system with an early and aggressive vaccination program: Results from a cross-sectional survey

2021 ◽  
Author(s):  
Nicole M. Gatto ◽  
Jerusha E Lee ◽  
Donatella Massai ◽  
Susanna Zamarripa ◽  
Bijan Sasaninia ◽  
...  
Keyword(s):  
Health System ◽  
Healthcare Workers ◽  
Model Building ◽  
Safety Net ◽  
Childhood Vaccination ◽  
Vaccine Hesitancy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Job Classification

Information on vaccine acceptance among healthcare workers is needed as health professionals provide front line care to COVID-19 patients. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbachs alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. Appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates in healthcare workers.

scholarly journals The detrimental impacts of smart technology device overuse among school students in Kuwait: a cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ali Jasem Buabbas ◽  
Madawi Anwar Al-Mass ◽  
Basma Awad Al-Tawari ◽  
Mohammad Abbas Buabbas
Keyword(s):  
High School ◽  
High School Students ◽  
Sleep Disturbances ◽  
Categorical Variables ◽  
Smart Technology ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Equal Distribution ◽  
Device Use

Abstract Background Children and adolescents are becoming the most prolific users of smart technology (ST) devices due to the numerous advantages presented by these devices. However, the overuse of ST devices can have detrimental impacts on health. Therefore, the aim of this study was to investigate the pattern of ST device use among school students in Kuwait and the possible associated health problems. Methods This cross-sectional survey used a pretested questionnaire to collect data from students of different educational levels within the governmental sector: primary, secondary and high school. Chi-square tests were applied to find associations or significant differences between the categorical variables, in which p < 0.05 was considered statistically significant. Results This study included 3015 students, of whom 53.6% were female. The sample had an equal distribution of primary (33.8%), secondary (32.4%) and high school students (33.8%). Almost all of the participants (99.7%) owned a ST device, chiefly smartphones (87.7%). Most of the students used ST devices for > 4 total hours per day on average, which is categorised as “overuse”. Among those overusing ST devices, the symptoms most commonly experienced included headaches (35.0%), sleep disturbances (36.6%) and neck/shoulder pain (37.7%). Students who used ST devices for < 1 h per session experienced eye-related problems. Moreover, students who played sports on a regular basis were more likely to spend less time per session on ST devices. The prolonged use of ST devices was associated with higher reporting of seizures, eye squints and transient vision loss. Conclusion The overuse of ST devices per day and per session by school-aged children has the potential to have a detrimental impact on their health, as has been noticed among students in Kuwait. Healthcare professionals, school authorities and parents could use these results to plan strategies to change ST device use behaviours among schoolchildren.

Examination of Internet Banking Customer Perception of Service Quality

2017 ◽  
pp. 253-263 ◽  
Author(s):  
Nilanjan Ray ◽  
Tilak Nath Ghosh ◽  
Krishnendu Sen
Keyword(s):  
Service Quality ◽  
Internet Banking ◽  
Primary Data ◽  
Personal Contact ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Customer Perception ◽  
Quality Dimensions ◽  
Major Factors ◽  
The Impact

The present study empirically examines the impact of internet banking service quality dimensions on Customer Satisfaction. This study is a cross-sectional survey that employed the use of pre-structured questionnaire to collect primary data from a sample of 120 respondents through personal contact, field survey and email. Collected data have been analyzed through SPSS 21 software by different statistical tools like Reliability test for judgment of internal consistency of collected data and paired t- test. It was also found that customers are satisfied with IS-QUAL dimensions. Service quality has become as one of the major factors of the client satisfaction.

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