scholarly journals Delivering Personalized Care at a Distance: How Telemedicine Can Foster Getting to Know the Patient as a Person

2021 ◽  
Vol 11 (2) ◽  
pp. 137
Author(s):  
Janet Record ◽  
Roy Ziegelstein ◽  
Colleen Christmas ◽  
Cynthia Rand ◽  
Laura Hanyok
Keyword(s):  
New Technologies ◽  
Office Visit ◽  
Modern Technology ◽  
Office Visits ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Personalized Care ◽  
High Satisfaction

The promise of precision medicine is based on the use of new technologies to better characterize patients by defining individuals in the areas of genomics, proteomics, metabolomics and other aspects of biologic variability. Wise application of modern technology can similarly transform health visits with patients, allowing for better characterization of the patient’s individual life circumstances than possible in a traditional office visit. The use of, and experience with, telemedicine have increased significantly during the COVID-19 pandemic. Patients and clinicians report high satisfaction with telemedicine, and the quality of communication and patient-centeredness experienced in this setting are both rated highly. In this article, we explore the benefits offered by telemedicine in facilitating personalized care with particular focus on telemedicine delivered by video platforms. We propose strategies and skills specific to the effective implementation of personalized telemedicine, drawing on literature in patient-centered communication and home visits. While traditional in-person office visits continue to offer important opportunities such as thorough physical examination and the potential for enhanced non-verbal communication, telemedicine offers many important advantages that can facilitate the process of getting to know the patient as a person.

scholarly journals Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care

2021 ◽  
Author(s):  
Kari White ◽  
Subasri Narasimhan ◽  
Sophie A. Hartwig ◽  
Erin Carroll ◽  
Alexandra McBrayer ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Parental Involvement ◽  
Service Delivery ◽  
Quality Care ◽  
Health Service Delivery ◽  
Policy Implications ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Staff Members

Abstract Introduction Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent. Methods Between May 2018 and September 2019, in-depth interviews were conducted with 34 staff members involved in scheduling, counseling, and administration at abortion facilities in three Southeastern states. Interviews explored procedures for documenting parental involvement, minors’ and parents’ reactions to requirements, and challenges with implementation and compliance. Both inductive and deductive codes, informed by the Institute of Medicine’s healthcare quality framework, were used in the thematic analysis. Results Parental involvement laws adversely affected four quality care domains: efficiency, patient-centeredness, timeliness, and equity. Administrative inefficiencies stemmed from the extensive documentation needed to prove an adult’s relationship to a minor, increasing the time and effort needed to comply with state reporting requirements. If parents were not supportive of their minor’s decision, participants felt they had a duty to intervene to ensure the minor’s decision and needs remained centered. Staff further noted that delays to timely care accumulated as minors navigated parental involvement and other state mandates, pushing some beyond gestational age limits. Lower income families and those with complex familial arrangements had greater difficulty meeting state requirements. Conclusions Parental involvement mandates undermine health service delivery and quality for minors seeking abortion services in the Southeast. Policy Implications Removing parental involvement requirements would protect minors’ reproductive autonomy and support the provision of equitable, patient-centered healthcare.

scholarly journals Patient-centered approaches applied in inpatient and outpatient TB services in Armenia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Z Grigoryan ◽  
N Truzyan ◽  
V Petrosyan
Keyword(s):  
Healthcare Providers ◽  
International Standards ◽  
Family Education ◽  
Outpatient Services ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Group Discussions ◽  
Legal Documents ◽  
Source Data

Abstract Background Healthcare system performance indicators are common instruments measuring and facilitating quality improvement. The End-TB strategy urges provision of integrated patient-centered (PC) care for all forms of tuberculosis (TB). This study aimed to assess and compare quality of inpatient and outpatient TB services using international standards on specific PC indicators to identify potential targets for improvement. Methods Joint Commission International (JCI) accreditation standards, adapted to local needs and context, were used as a basic instrument for qualitative and quantitative data collection. We utilized Patient and Family Right (PFR) and Patient and Family Education (PFE) 15 standards with 49 measurable elements as PC indicators for the nationwide assessment of TB services. A scoring system and a scaling approach were used to convert all-source-data and present the overall performance of services. Results We reviewed and analyzed data from 10 legal documents, 34 medical records and 155 interviews and focus group discussions with TB healthcare providers, patients and family members from inpatient and outpatient TB services to define the degree of compliance of their practices and treatment experiences to JCI standards. Outpatient TB services met the PFR and PFE standards at the 51%-level receiving a grading of partially performed and requiring improvements. The inpatient services met the PFR and PFE standards at 39%- and 26%-level respectively, receiving a grading of minimally performed for the JCI standards, showing statistically significantly less patient centeredness compared to the outpatient services (p = 0.007, CI 0.234; 0.4234), and requiring major improvements. Conclusions Strengthening interventions towards patient-centeredness are essential in both inpatient and outpatient services, but Armenia needs to put more emphasis on inpatient care to bridge the gap between the existing and recommended practices.

Healthy ageing phenotypes and trajectories

2017 ◽  
pp. 1243-1250
Author(s):  
Sebastiano Collino ◽  
Blandine Comte ◽  
Estelle Pujos Guillot ◽  
Claudio Franceschi ◽  
Antonio Nuñez Galindo ◽  
...  
Keyword(s):  
New Technologies ◽  
Healthy Ageing ◽  
Phenotypic Characterization ◽  
Disease States ◽  
Age Related ◽  
Multiple Dimensions ◽  
Underlying Mechanisms ◽  
Further Development

The concept of healthy ageing today is linked to the efforts of maintaining physical and mental independence, and to prevent the decline of physiological functions that are mandatory to guarantee a good quality of life. Yet, an individual’s ageing trajectory and underlying mechanisms are multifaceted and still far from understood. Hence, there is an urgent need for the further development of ageing phenotypes that can be utilized in the identification of biomarkers to characterize and predict biological age, taking into account the multiple dimensions of ageing. New technologies, often termed ‘systems biology’ approaches, are being increasingly applied to research focused on ageing populations. These technologies should enable investigators, and eventually clinicians, to (a) understand ageing metabolism in a more detailed and specific way; (b) enable the phenotypic characterization of many age-related disorders including chronic disease states; and (c) stratify older adults and the multiple comorbid conditions that may impact them.

scholarly journals Telerehabilitation for Communication and Swallowing Disorders in Parkinson’s Disease

2021 ◽  
pp. 1-6
Author(s):  
Deborah Theodoros
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
New Technologies ◽  
Negative Impact ◽  
Swallowing Disorders ◽  
Future Research ◽  
Patient Centered ◽  
Language Pathology

Communication and swallowing disorders are highly prevalent in people with Parkinson’s disease (PD). The negative impact of these disorders on the quality of life of the person with PD and their families cannot be underestimated. Despite a demand for speech-language pathology services to support people with PD, many barriers to services exist. Telerehabilitation provides an alternate and complementary approach to in-person therapy that is patient-centered, enables timely assessment and intervention, and facilitates continuity of care throughout the course of the disease. This review explores the telerehabilitation applications designed for the management of the communication and swallowing disorders in PD, addresses the benefits and challenges of telerehabilitation, identifies future research directions, and highlights the potential of new technologies to enhance the management of communication and swallowing disorders and quality of life for people with PD.

Patient Centeredness and Engagement in Quality-of-Care Oncology Research

2015 ◽  
Vol 11 (3) ◽  
pp. 176-179 ◽  
Author(s):  
Steven B. Clauser ◽  
Christopher Gayer ◽  
Elizabeth Murphy ◽  
Navneet S. Majhail ◽  
K. Scott Baker
Keyword(s):  
Quality Of Care ◽  
Interdisciplinary Research ◽  
Care Delivery ◽  
Patient Centeredness ◽  
Patient Centered ◽  
High Quality ◽  
Research Teams ◽  
Quality Cancer Care ◽  
Oncology Research

The Patient-Centered Outcomes Research Institute seeks to partner with diverse interdisciplinary research teams who demonstrate a commitment to the inclusion and engagement of patients and stakeholders as they work to develop high-quality cancer care delivery systems.

scholarly journals Impact of Telemedicine on Patient Satisfaction and Perceptions of Care Quality in Radiation Oncology

2021 ◽  
pp. 1-7
Author(s):  
Narek Shaverdian ◽  
Erin F. Gillespie ◽  
Elaine Cha ◽  
Soo Young Kim ◽  
Stephanie Benvengo ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Patient Experience ◽  
Radiation Oncology ◽  
Treatment Plan ◽  
Office Visit ◽  
Comprehensive Cancer Center ◽  
Office Visits ◽  
Oncology Practice

Background: The COVID-19 pandemic has transformed cancer care with the rapid expansion of telemedicine, but given the limited use of telemedicine in oncology, concerns have been raised about the quality of care being delivered. We assessed the patient experience with telemedicine in routine radiation oncology practice to determine satisfaction, quality of care, and opportunities for optimization. Patients and Methods: Patients seen within a multistate comprehensive cancer center for prepandemic office visits and intrapandemic telemedicine visits in December 2019 through June 2020 who completed patient experience questionnaires were evaluated. Patient satisfaction between office and telemedicine consultations were compared, patient visit-type preferences were assessed, and factors associated with an office visit preference were determined. Results: In total, 1,077 patients were assessed (office visit, n=726; telemedicine, n=351). The telemedicine-consult survey response rate was 40%. No significant differences were seen in satisfaction scores between office and telemedicine consultations, including the appointment experience versus expectation, quality of physician’s explanation, and level of physician concern and friendliness. Among telemedicine survey respondents, 45% and 34% preferred telemedicine and office visits, respectively, and 21% had no preference for their visit type. Most respondents found their confidence in their physician (90%), understanding of the treatment plan (88%), and confidence in their treatment (87%) to be better or no different than with an office visit. Patients with better performance status and who were married/partnered were more likely to prefer in-person office visit consultations (odds ratio [OR], 1.04 [95% CI, 1.00–1.08]; P=.047, and 2.41 [95% CI, 1.14–5.47]; P=.009, respectively). Patients with telephone-only encounters were more likely to report better treatment plan understanding with an office visit (OR, 2.25; 95% CI, 1.00–4.77; P=.04). Conclusions: This study is the first to assess telemedicine in routine radiation oncology practice, and found high patient satisfaction and confidence in their care. Optimization of telemedicine in oncology should be a priority, specifically access to audiovisual capabilities that can improve patient–oncologist communication.

scholarly journals Patient-centered care, advance care planning, and treatment preferences among home medical care patients in Japan: The ZEVIOUS study

2021 ◽  
Author(s):  
Shinu Hayashi ◽  
Yutaka Shirahige ◽  
Yukio Tsugihashi ◽  
Hidekazu Iida ◽  
Misaki Hirose ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Treatment Preferences ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Quality Of Primary Care ◽  
Centered Care ◽  
Advance Care ◽  
Home Medical Care

AbstractBackgroundIt remains unclear how both the quality of patient-centered care and the patient’s illness affect advance care planning (ACP) in primary care settings. Identifying the facilitators and barriers to ACP in primary care settings has become a growing scientific and clinical challenge.ObjectiveTo examine the association between the quality of primary care and ACP preparedness among patients. Additionally, to investigate whether ACP preparedness and the patient’s illness are associated with the expression of future treatment preferences.DesignMulticenter cross-sectional study.ParticipantsAdult Japanese patients receiving home medical care.Main MeasuresA survey was run to assess consideration of ACP by patients and expression of future treatment preferences. The quality of primary care, which reflects patient centeredness, was assessed with the Japanese version of the Primary Care Assessment Tool– Short Form. Information on the clinical conditions that required home medical care was collected from physicians.Key ResultsOf 194 patients using 29 home medical services, 62 patients (32%) showed signs of ACP preparedness, and 153 patients (78%) expressed their treatment preferences. In a multivariable-adjusted generalized estimating equation, primary care quality was associated with ACP preparedness (per 10-point increase, adjusted OR: 1.96, 95% CI: 1.51–2.56). However, we found insufficient evidence to support that ACP preparedness was associated with a lower incidence of non-expression of treatment preferences (adjusted OR: 1.02, 95% CI 0.49–2.12). In contrast, having cancer was associated with a lower incidence of non-expression of treatment preferences (adjusted OR: 0.12, 95% CI: 0.01–0.995).ConclusionsAt a minimum, patient centeredness in home medical care facilitates must ensure the initiation of ACP preparedness. To understand the association between ACP preparedness and expression of treatment preferences, further efforts are warranted to clarify the quality and content of ACP preparedness simultaneously with the patient’s illness.

Evaluation of patient's versus hematologist/oncologist's office visit agenda.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 125-125
Author(s):  
Cory Patrick ◽  
Kaitlin McIntyre ◽  
Rakesh Singal ◽  
Damien Mikael Hansra
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Office Visit ◽  
P Value ◽  
Office Visits ◽  
Exact Test ◽  
Racial Profile ◽  
Asian Pacific Islander ◽  
Asian Pacific

125 Background: Few studies have been reported in oncology regarding elements of physician agenda. We aim to compare elements of a doctor office visit agenda between hem/onc physicians (MD) and patients (pts). Methods: Pts and MDs were enrolled to completed a five question survey. Pts were asked: “My doctor” Focuses more on quantity of life and less on quality of life, spends enough time with me, addresses symptoms, addresses chemo side effects, and addresses prognosis. MDs were asked the same questions but worded: "I” spend enough time with pts for example. Answers were recorded on a 5 point scale (1 = highly disagree, 2 = disagree, 3 = neutral, 4 = agree,5 = highly agree) and converted into 2 categories (1,2,3 = neutral/disagree vs 4,5 = agree). Fisher’s exact test with 2 sided p-value was used to compare significance between MD & pts. Results: 1008 pts and 55 MDs were enrolled between 06/2013 - 10/2015. Pt mean age 55 (18-88) with 45% male and 55% female. Racial profile: 16% white, 14% black, 2% Asian/Pacific Islander. Ethnicity: 62% of pts were Hispanic vs. 38% not Hispanic, & 6% other. A significant number of pts feel MDs focus more on quantity of life vs. quality of life (64% pt vs 26% MD p < 0.0001) and MD spend enough time (94% pt vs 82% MD p < 0.05). No differences were seen for symptoms (92% vs 87% p = 0.2), side effects (92% vs 94% p = 1.0), or prognosis (91% vs 96% p = 0.3) pt vs MD respesctively. Conclusions: Pts feel MDs focus more on quantity of life vs. the quality of life. MDs feel they focus more on quality of life vs. quantity of life. Perhaps bridging the gap in what constitutes “quality of life” may improve patient satisfaction. Furthermore MDs underestimate the time spent with their patients. Perhaps MD are spending too much time with some patients resulting in inefficient office visits.

scholarly journals MODELS OF SOCIAL RECOVERY WITHIN THE CONTEXT OF PERSONAL-ORIENTED PARADIGM

2019 ◽  
pp. 47-51
Author(s):  
A. Kuntsevska
Keyword(s):  
Quality Of Life ◽  
Personal Development ◽  
Care Delivery ◽  
Standard Of Care ◽  
Full Potential ◽  
Patient Centered ◽  
Personalized Care ◽  
Health And Social Care ◽  
Social Recovery

This paper analyzes main features of social recovery models, developed within the frameworks of Person-centered paradigm. Person- centeredness is an increasingly common public health and social care concept, that is used to describe a standard of care that ensures that the patient / client is at the center of care delivery. There is no single definition of person-centered care, rather we can find such terms as patient- centered, family-centered, user-centered, individualized. But irrespective of the terms used, a lot of research has looked at what matters to patients and how to provide personalized care to ensure that people have a good experience. Person-centered recovery depends on a number of aspects, in particular: the values of people and placing people at the center of care, taking into account the desires of people and the needs they have chosen, ensuring that people are emotionally comfortable and secure with family and friends, ensuring that people have access to the appropriate care they need, when and where they need to ensure that people receive all the care they need. Main principles of person-centered approach are: recognizing dignity, giving respect and compassion to service users and providers; collaboration with the individual, their family and staff in care planning and assessment; enabling systems and services to help people recognize and build on their own strengths, preferences and objectives in order to realize their full potential. One of the strongest and most methodologically grounded models built in the person-oriented framework is the Comprehensive Rehabilitation Approach (CARe), developed by Dirk den Hollander and Jean Pierre Wilken. The model is based on psychological rehabilitation, recovery and empowerment principles, and is intended to support individuals in their personal development. CARe works with the client in three domains: meeting quality of life wishes and objectives; overcoming insecurity and increasing strength; gaining access to ideal environments and optimizing the quality of life of living environments and social networks.

Economic Production Inventory model with the associated costs of internet advertising to acquire customers residing worldwide

2014 ◽  
Vol 12 (9) ◽  
pp. 3921-3926
Author(s):  
Ritha Prakash ◽  
Nivetha Martin
Keyword(s):  
Modern Technology ◽  
Inventory Model ◽  
Internet Advertising ◽  
Advertising Strategy ◽  
Technology Acquisition ◽  
Industrial Sectors ◽  
Economic Production ◽  
Production Inventory ◽  
Short Span

In recent times, we are witnessing the technological revolution which provides access to tremendous changes in all the fields including the industrial sectors. The notable benefit of the modern technology is quick accomplishment of complex tasks within a short span of time, which has motivated the manufacturers to imbibe novelty techniques in the production process to enhance the quality of the product so as to retain its market position amidst the competitors. As globalization has gained more concern, the manufacturers employ internet advertising strategy to elevate the product to international level and to propagate the attributes of the products to the customers residing worldwide. In this paper an EPQ inventory model is developed in which the associated costs of technology, acquisition of local and international customers via internet advertising costs are included, a numerical example is also presented to validate the model.

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