scholarly journals Perceived Value of Electronic Medical Records in Community Health Services: A National Cross-Sectional Survey of Primary Care Workers in Mainland China

2020 ◽  
Vol 17 (22) ◽  
pp. 8510
Author(s):  
Zining Xia ◽  
WenJuan Gao ◽  
Xuejuan Wei ◽  
Yingchun Peng ◽  
Hongjun Ran ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Chronic Conditions ◽  
Mainland China ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Community Health Centres ◽  
Care Workers

Objective: To evaluate the degree to which electronic medical records (EMRs) were used in primary care and the value of EMRs as perceived by primary care workers in China. Methods: A cross-sectional survey was conducted on 2719 physicians (n = 2213) and nurses (n = 506) selected from 462 community health centres across all regions of mainland China except for Tibet. Regional differences in the responses regarding the functionality of existing EMR systems and the perceived value of EMRs were examined using Chi-square tests and ordinal regression analyses. Results: Less than 59% of the community health centres had adopted EMRs. More than 89% of the respondents believed that it was necessary to adopt EMRs in primary care. Of the existing EMR systems, 50% had access to telehealth support for laboratory, imaging or patient consultation services. Only 38.4% captured data that met all task needs and 35.4% supported referral arrangements. “Management of chronic conditions” was voted (66%) as the top preferred feature of EMRs. Higher levels of recognition of the value of EMRs were found in the relatively more developed eastern region compared with their counterparts in other regions. Conclusions: Rapid EMR adoption in primary care is evident in mainland China. The low level of functionality in data acquisition and referral arrangements runs counter to the requirements for “management of chronic conditions”, the most preferred feature of EMRs in primary care. Regional disparities in the realised value of EMRs in primary care deserve policy attention.

scholarly journals Opportunities and barriers for providing HIV testing through community health centers in mainland China: a nationwide cross-sectional survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jason J. Ong ◽  
Ming Hui Peng ◽  
William W. Wong ◽  
Ying-Ru Lo ◽  
Michael R. Kidd ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Hiv Testing ◽  
Community Health ◽  
Community Health Centers ◽  
Mainland China ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier ◽  
High Risk Populations

Abstract Background Primary care may be an avenue to increase coverage of HIV testing but it is unclear what challenges primary healthcare professionals in low- and middle-income countries face. We describe the HIV testing practices in community health centres (CHCs) and explore the staff’s attitude towards further development of HIV testing services at the primary care level in China. Methods We conducted a national, cross-sectional survey using a stratified random sample of CHCs in 20 cities in 2015. Questionnaires were completed by primary care doctors and nurses in CHCs, and included questions regarding their demographics, clinical experience and their views on the facilitators and barriers to offering HIV testing in their CHC. Multivariate logistic regression was conducted to examine the association between staff who would offer HIV testing and their sociodemographic characteristics. Results A total of 3580 staff from 158 CHCs participated. Despite the majority (81%) agreeing that HIV testing was an important part of healthcare, only 25% would provide HIV testing when requested by a patient. The majority (71%) were concerned about reimbursement, and half (47%) cited lack of training as a major barrier. Almost half (44%) believed that treating people belonging to high-risk populations would scare other patients away, and 6% openly expressed their dislike of people belonging to high-risk populations. Staff who would offer HIV testing were younger (adjusted odds ratio (aOR) 0.97 per year increase in age, 95% confidence interval (CI):0.97–0.98); trained as a doctor compared to a nurse (aOR 1.79, 95%CI:1.46–2.15); held a bachelor degree or above (aOR 1.34, 95%CI:1.11–1.62); and had previous HIV training (aOR 1.55, 95%CI:1.27–1.89). Conclusions Improving HIV training of CHC staff, including addressing stigmatizing attitudes, and improving financial reimbursement may help increase HIV testing coverage in China.

scholarly journals Attributes of primary care in community health centres in China and implications for equitable care: a cross-sectional measurement of patients' experiences

QJM ◽  
2014 ◽  
Vol 108 (7) ◽  
pp. 549-560 ◽  
Author(s):  
H. H. X. Wang ◽  
S. Y. S. Wong ◽  
M. C. S. Wong ◽  
J. J. Wang ◽  
X. L. Wei ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Cross Sectional ◽  
Community Health Centres ◽  
Health Centres ◽  
Sectional Measurement

scholarly journals The extent to which family physicians record their patients’ exercise in medical records: a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034542 ◽  
Author(s):  
Cliff Lindeman ◽  
Ashley McCurdy ◽  
Carminda G Lamboglia ◽  
Brendan Wohlers ◽  
Anh N Q Pham ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Promotion ◽  
Electronic Medical Records ◽  
Family Physician ◽  
Scoping Review ◽  
Medical Records ◽  
Chronic Conditions ◽  
Geographic Origin ◽  
Family Physicians

ObjectiveExercise is an effective modality for the prevention and treatment of chronic conditions and family physicians are the healthcare providers tasked to manage patients’ chronic disease status. However, little is known about the exercise documentation in family-physician records. Therefore, a scoping review was conducted to describe family-physician-recorded exercise-related advice to patients in electronic medical records.DesignScoping review.SettingPrimary care clinics.Search strategyPubMed, Medline, SPORTDiscus, Google, Dissertations & Theses Global, OCLC PapersFirst (via First Search) and included references were searched between 1 January 1990 and 10 June 2018. Extracted information included year, geographic origin, data input structure, input frequency and content of exercise inputs in family physicians’ electronic medical records. The primary outcomes are the structure, purpose and frequency of inputs.ResultsOf a possible 1758 documents, 83 remained after a title and abstract scan and 22 after a full-text review. These documents included 32 findings of physical activity/exercise medical record documentation: counselling/advising patients (50.0%), status (12.5%), embedded questionnaires (12.5%), status as a risk factor (12.5%), health promotion documentation (6.3%), inactivity status (3.1%) and grading (3.1%). The frequency of exercise inputs in primary care records vary from as low as 0.4% of patients with documentation of physical activity health promotion inputs to as high as 87.8% of patients with exercise or physical activity status recorded. The majority of included documents (63.6%) were focused on patients with identified chronic conditions.ConclusionThe findings suggest that the structure and purpose of exercise documentation is often unclear or unspecified. Studies that present exercise information from family-physician medical records tend to focus on patients with specific chronic conditions and present little detail about the field from which information was extracted. The review found that the proportion of patients with physical activity or exercise information is often less than half.

scholarly journals How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

2020 ◽  
Author(s):  
Sai Zhen - Sim ◽  
Hui Li Koh ◽  
Sabrina Poay Sian Lee ◽  
Doris Yee Ling Young ◽  
Eng Sing Lee
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Healthcare Setting ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Health State ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore.Methods: A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses.Results: The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort.Conclusion: Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

scholarly journals The value of a Patient Access Portal in primary care: a cross-sectional survey of 62,486 registered users in the UK

2019 ◽  
Vol 19 (4) ◽  
pp. 855-872 ◽  
Author(s):  
Mohammed A. Mohammed ◽  
Jane Montague ◽  
Muhammad Faisal ◽  
Laura Lamming
Keyword(s):  
Primary Care ◽  
Medical Records ◽  
Positive Impact ◽  
Patient Access ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Monetary Value ◽  
Online Access

Abstract In England, primary care patients have access to Patient Access Portals (PAPs), enabling them to book appointments, request repeat medication prescriptions, send/receive messages and review their medical records. Few studies have elicited user views and value of PAPs, especially in a publicly funded primary care setting. This study aimed to elicit the value users of PAPs place on online access to medical records and linked services. Secondary data analysis of the completed electronic survey (available 2 May 2015–27 June 2015) distributed via the EMIS PAP to all its registered users. EMIS designed the survey; responses were voluntary. There were 62,486 responders (95.7% self-completed). The PAP was mainly used for medication requests (86.3%) and online appointment bookings (78.4%), and, to a lesser extent, medical record viewing (18.3%) and messaging (9.5%). The majority (70%) reported a positive impact from using it. One in five rated it as their favourite online service second only to online banking. Almost three out of four responders stated that availability of online access would influence their move to another practice. Nonetheless, responders were reluctant to award a high monetary value to it. These findings correlated with the number of long-term conditions. The majority of users place a relatively high value, but not monetary value, on the PAP and report a positive impact from using it. The potential for PAPs to enhance patient experience, especially for those with long-term conditions, appears to be largely untapped. Research exploring the reasons for non-use is also required.

scholarly journals Intimate partner violence management and referral practices of primary care workers in a selected population in Turkey

2019 ◽  
Vol 20 ◽  
Author(s):  
Aysegul Catak Taskiran ◽  
Aysun Ozsahin ◽  
Tamer Edirne
Keyword(s):  
Primary Care ◽  
Intimate Partner Violence ◽  
Violence Against Women ◽  
Partner Violence ◽  
Public Health Problem ◽  
Intimate Partner ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Workers ◽  
Lack Of Knowledge

Abstract Background: Violence against women is a significant public health problem and primary care workers (PCWs) have a crucial role in managing violence against women. However, though intimate partner violence (IPV) is frequently seen in primary care, most cases remain unreported. Aims: This study aims to investigate family physicians’ (FPs’) and co-working midwifes/nurses’ (M/Ns’) explanations about their responses to women disclosing IPV and the reasons for their actions. Methods: We conducted a cross-sectional survey via a face-to-face administered questionnaire interview involving 266 PCWs in a selected area in Turkey. We questioned the reasoning behind inappropriate responses such as not examining the patient and document findings, not recording a code of violence, and not notifying the police in the case of a disclosure of IPV. Results: We surveyed 129 FPs and 137 M/Ns. We found that the disclosure of IPV in primary care is very high, but more than one-third of physicians and half of M/Ns respond inappropriately. Reasons for inappropriate response varied. The majority believed that the victim would continue to live with her batterer, making any report ineffective. Some expressed concern for the women’s and their own personal safety, citing an increase in assault cases by perpetrators in the last few years. Many indicated a lack of knowledge about management of violence cases. Conclusion: Multiple barriers challenge PCWs in helping abused women. Common behaviours, safety concerns, and a lack of knowledge seem to be the major barriers to responding appropriately to IPV. To address this issue appropriately, protective measures for both parties – PCWs and violence victims – need to be enacted and a supportive constitutional and societal organization is required. Screening and identification should lead to interventions that benefit the victims rather than harming them.

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