scholarly journals Tensions Ahead: How Do We Build Feasible Digital Health Systems That Are Person-Centred and Usable?

2021 ◽  
Author(s):  
Helen Almond ◽  
Karrie Long ◽  
Guillaume Leroux

Globally, the term person-centred care has become all-pervasive across healthcare delivery. It has been suggested that it has become synonymous with good quality care. The term is used frequently in the aims and objectives for healthcare service and provision, although what lies behind the rhetoric in terms of practice may be questionable. Further, in an environment which is becoming increasingly dependent on technology, the interaction needs the user experience of both consumer and healthcare provider. There is a challenge as national surveys of health professionals continue to criticize the usability of digital health interfaces. This panel discussion aims to highlight the factors, which should be considered when designing health information interfaces as person-centred for all users. Drawing on our panel’s expertise, we suggest interfaces need to consider two main factors: personalization and user acceptance.

2021 ◽  
Author(s):  
Anna Janssen ◽  
Stella Talic ◽  
Dragan Gasevic ◽  
Tim Shaw

BACKGROUND There is an increasing quantity of electronic data sitting within the health system. This data has untapped potential to improve clinical practice if extracted efficiently and harnessed to change the behavior of health professionals. Furthermore, there is an in-creasing expectation by government and peak bodies that both individual health pro-fessionals and healthcare organisations will be utilising electronic data for licensing and accreditation. OBJECTIVE The objective of this study is to understand how digital technology for harnessing elec-tronic health data can be used effectively by health professionals to support practice reflection. METHODS A multidisciplinary approach was used to connect academic experts from core disci-plines of Health and Medicine, Education and Learning Sciences, and Engineering and Information Communication Technology (ICT) with government and health services partners to identify key problems preventing the healthcare industry from using elec-tronic data to support health professional learning. The approach was used to design a large-scale research program to solve this problem. The program will be delivered by doctoral candidates undertaking research projects with discrete aims that run in paral-lel to achieve the program’s overarching objectives. RESULTS The research program commenced in March 2020. Since this time four PhD Candidates have commenced their research projects. Preliminary findings are expected from indi-vidual projects in late 2021. CONCLUSIONS The approach used in this research program has potential to successfully unpack elec-tronic data siloed within clinical sites and enable health professionals to use it to reflect on their practice and deliver high quality care. Key outputs of the program will include fostering stronger connections between industry and academia, interlinking doctoral research projects to solve complex problems, the creation of new knowledge for clinical sites on how data can be used to understand performance and strengthening profes-sional development programs to align them with clinical practice. Key contributions of this paper include presenting a description of Practice Analytics, and describing the foundational academic disciplines that contribute to it. It will also present a method for designing a Practice Analytics research program.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Dratva ◽  
S Juvalta ◽  
M Gemperle ◽  
D Händler-Schuster ◽  
M Scheermesser ◽  
...  

Abstract Background Digital transformation in health and health systems is a chance and a challenge for health professionals irrespective of their field. To maximize the benefit for patients high digital health literacy is required. A requirement not represented in health professions’ curricula in Switzerland. Little is known on the digital health competencies of students, on their utilization and views of digital media in the context of health, thus a cross-sectional survey was performed at a School of Health Professsions in Switzerland. Methods All BSc. students (N = 1200; nursing, midwifery, occupational health, physiotherapy and health promotion) received an online questionnaire covering utilization of various information resources, views on digital health & media and the German eHealth Literacy Scale (eHEALS, score 0 - 40). Descriptive and group analyses were performed, further adjusted analyses will be run. Results 453 students responded (female N = 368, male N = 26). Participation was 38% and highest in 1st students. Personal health information resources used most were: internet 82%, familiy&friends 70%, health professionals 66%, textbooks 40%. A majority rated digital media as important (66%) or rather important (30%) for their future professional activities. The overall eHeals-score was 28.6 (sd 4.93); critical evaluation and confidence in applying information scored lowest. Preliminary group analyses show significant increase by study year (1st 28.0, 2nd 28.9, 3rd 29.7, p = 0.01), while scores by gender or health profession were non-significantly different. Conclusions Almost all students in health professions use digital media for their own health information needs and consider digital media as highly relevant for their future career. Critical evaluation skills need to be strenghtend. Digital Health Literacy is only slightly higher in 3rd year students. Longitudinal data are needed to differentiate cohort from learning effects. Key messages Digital media are increasingly important in health systems, a view shared by future health professionals. Data indicate only a small increase of digital health literacy across three years of study. Curricula should include digital health competencies to ensure a highly digitally skilled health work force.


2011 ◽  
Vol 5 (2) ◽  
pp. 321
Author(s):  
Ermelinda Do Carmo Valente Caldeira Batanete ◽  
Maria Vitória Glórias Almeida Casas-Nova

ABSTRACTObjective: to ascertain the perception regarding humanizing healthcare among the National Healthcare Service (NHS) patients in the area of Évora - Portugal. Method: this is a descriptive study, exploratory, with a quantitative approach using a random sampling starting from the guiding question: What is the NHS patients’ perception on humanizing the care provided by the healthcare services? Data were collected with an informed consent questionnaire, administered between September and October 2010 to 62 individuals who were patients in the NHS, according to the approval of the Ethic Committee on Research Involving Human Beings, with the 203/2008 legal opinion. Results: concerning humanizing health care, the respondents of this study outlined as particularly important aspects the following: being attended by gracious professionals who facilitate the dialogue and provide quality care in a short period of time. The value placed on being able to select one’s doctor and nurse is explained by aspects that patients find important such as availability, confidentiality, competence as well as the continuity of care and trust for the health professionals. Conclusion: the results highlight the following aspects: communication; attitudes and competence of the health professionals; accessibility and exercise of autonomy. Descriptores: humanizing; health care; health systems; consumer satisfaction; perceptionRESUMOObjetivo: conhecer a percepção dos usuários do Serviço Nacional de Saúde (SNS) do conselho de Évora - Portugal acerca da humanização dos cuidados. Método: estudo descritivo, exploratório, de abordagem quantitativa com uma amostra acidental, a partir da questão norteadora: Como é que os usuários do SNS percepcionam a humanização dos cuidados prestados nos serviços de saúde? A colheita de dados foi realizada através de um questionário com consentimento livre e esclarecido, aplicado entre setembro e outubro de 2010 a 62 sujeitos usuários do SNS, conforme aprovação do Comité de Ética em Pesquisa Envolvendo Seres  Humanos. Resultados: acerca da humanização dos cuidados de saúde os informantes deste estudo evidenciaram como aspectos particularmente importantes, um atendimento por profissionais simpáticos, que facilitem o diálogo e prestem cuidados de qualidade num curto espaço de tempo. A importância da escolha do médico e do enfermeiro de familia, pelos usuários do SNS, é justificada pela disponibilidade, a confidencialidade, a competência, assim como a continuidade de cuidados e a confiança nos profissionais de saúde. Conclusão: os resultados remetem-nos para um acentuado destaque dos seguintes aspectos: a comunicação; atitudes e competência dos profisionais de saúde;  acessibilidade e exercício da autonomia. Descritores: humanização; cuidados; sistemas de saúde; satisfação dos consumidores; percepção.RESUMENObjetivo: conocer la opinión de los usuarios del servicio nacional de Saúde (SNS) del consejo de Évora- Portugal sobre la humanizácion de los cuidados. Método: estudio descriptivo, exploratório, de abordage cuantitativa con una muestra aleatoria, basando-se en la pregunta norteadora: ¿Cómo los usuarios del SNS percepcionan la humanizácion de los cuidados prestados por  los servicios de salud? La cosecha de datos fue hecha utilizando un cuestionario con consentimiento libre y clarificado, aplicado entre septiembre y octubre de 2010 a 62 usuarios del SNS, con aprobación del Comité de Ética en la Investigación en Seres Humanos, con el dictamen legal 203/2008. Resultados: referente a la humanizácion de los cuidados de salud, los informadores de este estudio habían evidenciado particularmente como aspectos importantes, la atención de profesionales agradables que facilitan el diálogo y dan cuidados de calidad en poco tiempo. La seleccion del doctor y de la enfermera es justificada por la importancia que asume para los usuarios la disponibilidad, la confidencialidad, la competencia, así como la continuidad de cuidados y la confianza en los profesionales de salud. Conclusión: los resultados nos apuntan para la importancia de los aspectos siguientes: la comunicación; actitudes y capacidad de los profisionales de la salud;  accesibilidad y ejercicio de la autonomía. Descriptores: humanizácion; cuidados; sistemas de salud; satisfacción de los consumidores; percepción.


2018 ◽  
Vol 104 (5) ◽  
pp. 231-234 ◽  
Author(s):  
Sofia Sarfraz ◽  
Ian D Wacogne

The use of interpreters is essential in our multicultural society. The families and patients we treat come from differing backgrounds, cultures and spoken language. Many are not proficient in, or may even entirely lack, the ability to communicate effectively in English. As health professionals, we must meet their needs and manage the risks to provision of good quality care that language barriers may introduce. Use of an interpreter or interpreting service is an important skill, which is rarely formally taught in undergraduate or postgraduate curricula. Here, we present some of the pitfalls of using an interpreter, and offer some tips on getting the best out of their use.


2020 ◽  
Vol 26 (3) ◽  
pp. 2067-2082 ◽  
Author(s):  
Adela Grando ◽  
Julia Ivanova ◽  
Megan Hiestand ◽  
Hiral Soni ◽  
Anita Murcko ◽  
...  

This study explores behavioral health professionals’ perceptions of granular data. Semi-structured in-person interviews of 20 health professionals were conducted at two different sites. Qualitative and quantitative analysis was performed. While most health professionals agreed that patients should control who accesses their personal medical record (70%), there are certain types of health information that should never be restricted (65%). Emergent themes, including perceived reasons that patients might share or withhold certain types of health information (65%), care coordination (12%), patient comprehension (11%), stigma (5%), trust (3%), sociocultural understanding (3%), and dissatisfaction with consent processes (1%), are explored. The impact of care role (prescriber or non-prescriber) on data-sharing perception is explored as well. This study informs the discussion on developing technology that helps balance provider and patient data-sharing and access needs.


2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rubinelli

Abstract The paternalistic approach to health professional-patient communication is often no longer successful. The main reasons for this include the fact that trust in medicine and health professionals is no longer taken for granted. In many domains, the concepts of 'expert' and 'science' are in shadow. Moreover, patients can access all sorts of health information, including information that is or seems inconsistent with the advice given by their health professionals. This talk aims to illustrate some basic approaches to communication that can enhance health professional-patient interaction. First, health professionals should consider their communication with patients as a form of persuasion. Persuasion, that does not equal manipulation, is a way to communicate that takes into consideration the knowledge, beliefs, and attitudes of interlocutors. By adopting a person-centered style, health professionals should present their advice by contextualizing it into the emotional and cognitive setting of the patients. Second, communication should consider the lived experience of patients, that is the impact that a health condition or a preventive behavior has on their quality of life and their experience of pleasure. Indeed, managing health conditions is not just applying health advice: it often demands a change in lifestyles that can negatively impact how patients live their lives. Third, health professionals should develop clear strategies to engage with information that patients find from other sources. Health professionals must ask patients if they disagree with them, and to clarify any eventual difference of opinion. The information age has positively favored a democratization of health information. Yet, it imposes that health systems care for their communication. This talk concludes by presenting main evidence from on how to reinforce hospitals, public health institutions, and health services in communication so that patients want to listen.


Author(s):  
Tarek Numair ◽  
Daniel Toshio Harrell ◽  
Nguyen Tien Huy ◽  
Futoshi Nishimoto ◽  
Yvonne Muthiani ◽  
...  

Digitalization of health information can assist patient information management and improve health services even in low middle-income countries. We have implemented a mother and child health registration system in the study areas of Kenya and Lao PDR to evaluate barriers to digitalization. We conducted in-depth interviews with 20 healthcare workers (HCWs) who used the system and analyzed it qualitatively with thematic framework analysis. Quantitatively, we analyzed the quality of recorded data according to missing information by the logistic regression analysis. The qualitative analysis identified six themes related to digitalization: satisfaction with the system, mothers’ resistance, need for training, double work, working environment, and other resources. The quantitative analysis showed that data entry errors improved around 10% to 80% based on odds ratios in subsequent quarters compared to first quarter periods. The number of registration numbers was not significantly related to the data quality, but the motivation, including financial incentives among HCWs, was related to the registration behavior. Considering both analysis results, workload and motivation to maintain high performance were significant obstacles to implementing a digital health system. We recommend enhancing the scope and focus on human needs and satisfaction as a significant factor for digital system durability and sustainability.


2021 ◽  
Vol 28 (1) ◽  
pp. e100241
Author(s):  
Job Nyangena ◽  
Rohini Rajgopal ◽  
Elizabeth Adhiambo Ombech ◽  
Enock Oloo ◽  
Humphrey Luchetu ◽  
...  

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).ObjectiveTo determine the maturity readiness of the interoperability capacity of Kenya’s HIS.MethodsWe used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.ResultsMost domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.ConclusionNone of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.


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