scholarly journals Evolution or Revolution in Telehealth Regulation

2021 ◽  
Vol 9 (4) ◽  
pp. 12-24
Author(s):  
George Horvath
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ad Hoc ◽  
Integrative Approach ◽  
Care Providers ◽  
Current Crisis ◽  
Wide Range ◽  
The Future ◽  
History Of ◽  
The Moment

A frequently repeated adage, attributed to a wide range of authors and orators, holds that a serious crisis should never be allowed to go to waste. The moment in which we find ourselves renders this adage particularly timely. Responses to one of the defining crises of our age—the COVID–19 pandemic—have mostly been reactive. This includes the responses of multiple actors involved with telehealth. Congress, federal regulators, state legislatures, state regulators, private insurers, and health care providers, confronting the challenges of the pandemic, have responded by making ad hoc adjustments to the regulation and use of telehealth. Moving the conversation beyond this reactive posture, Professor Deborah Farringer’s article, A Telehealth Explosion: Using Lessons from the Pandemic to Shape the Future of Telehealth Regulation, surveys the history of telehealth regulation, the pandemic-era adjustments, and recent proposals for the future finds an opportunity instead. The article seeks to put a crisis to good use—taking “advantage of the momentum that the COVID–19 public health emergency has created”—to inform the creation of “a comprehensive and integrative approach” to telehealth regulation. I find it possible to read A Telehealth Explosion in two ways: as an article with narrow aims and as an article with much broader aims. Parts I and II present these two readings. In Part III, I situate the broader reading within the context of earlier expansions of federal regulation of the health care enterprise to pose the question of how likely it is that the current crisis can be put to the good use that Professor Farringer seeks.

The Registered Dietitian in Primary Care: The Hamilton Experience

2007 ◽  
Vol 68 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Wendy Gamblen ◽  
Sherri Schamehorn ◽  
Anne Marie Crustolo ◽  
Tracy Hussey ◽  
Nick Kates ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Interdisciplinary Collaboration ◽  
Community Services ◽  
Care Providers ◽  
Clinical Role ◽  
Nutrition Services ◽  
Wide Range ◽  
Canadian Health ◽  
Shared Care Model

The Hamilton Health Service Organization Nutrition Program integrates nine registered dietitians (RDs) into the offices of 80 family physicians (FPs) at 50 sites in Hamilton, Ontario. The program is based on a shared care model, in which FPs and RDs work collaboratively to provide nutrition services aimed at prevention, treatment, and management of nutrition-related problems. In addition to their clinical role, dietitians in the program are involved in health promotion, disease prevention and early intervention strategies, interdisciplinary collaboration, building links with community services, and research. The RDs’ specialized knowledge, skills, and experience allow them to provide a wide range of services that complement and augment those of the FP. This model is consistent with Canadian health care reform recommendations and offers significant benefits for both health care providers and consumers.

Guidelines for the Reporting of Nongynecologic Cytopathology Specimens

2009 ◽  
Vol 133 (11) ◽  
pp. 1743-1756
Author(s):  
Barbara A. Crothers ◽  
William D. Tench ◽  
Mary R. Schwartz ◽  
Joel S. Bentz ◽  
Ann T. Moriarty ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ad Hoc ◽  
Clinical Laboratory ◽  
Needle Aspiration ◽  
Health Care Team ◽  
Major Elements ◽  
Pathology Report ◽  
Care Providers ◽  
Healthcare Organizations

Abstract Context.—Gynecologic cytology terminology and report formatting have been nationally standardized since the implementation of The Bethesda System of 1988, but standard reporting for nongynecologic cytology has never been formally addressed on the same scale. Objectives.—To promote patient safety through uniform reporting in nongynecologic cytology (including fine-needle aspiration cytology) and to improve communication between laboratories and health care providers. Data Sources.—Sources include the College of American Pathologists Cytopathology Resource Committee; the College of American Pathologists Council on Scientific Affairs Ad Hoc Committee on Pathology Report Standardization; the College of American Pathologists Laboratory Accreditation Program inspection checklists; the Joint Commission for Accreditation of Healthcare Organizations; and the Clinical Laboratory Improvement Amendments of 1988. Conclusions.—We describe the major elements of quality nongynecologic cytology reporting and discuss areas of controversy in cytology reporting. Standardized nongynecologic specimen reporting will expand the concept of common report elements already widely implemented in gynecologic cytology reporting. The intent is to improve communication with the health care team while remaining in compliance with federal mandates and accreditation guidelines.

scholarly journals Factors Influencing Sustained Engagement with ECG Self-Monitoring: Perspectives from Patients and Health Care Providers

2018 ◽  
Vol 09 (04) ◽  
pp. 772-781 ◽  
Author(s):  
Meghan Reading ◽  
Dawon Baik ◽  
Melissa Beauchemin ◽  
Kathleen Hickey ◽  
Jacqueline Merrill
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Care Providers ◽  
Self Monitoring ◽  
Major Barrier ◽  
Utaut Model ◽  
History Of ◽  
Mhealth Technology

Background Patient-generated health data (PGHD) collected digitally with mobile health (mHealth) technology has garnered recent excitement for its potential to improve precision management of chronic conditions such as atrial fibrillation (AF), a common cardiac arrhythmia. However, sustained engagement is a major barrier to collection of PGHD. Little is known about barriers to sustained engagement or strategies to intervene upon engagement through application design. Objective This article investigates individual patient differences in sustained engagement among individuals with a history of AF who are self-monitoring using mHealth technology. Methods This qualitative study involved patients, health care providers, and research coordinators previously involved in a randomized, controlled trial involving electrocardiogram (ECG) self-monitoring of AF. Patients were adults with a history of AF randomized to the intervention arm of this trial who self-monitored using ECG mHealth technology for 6 months. Semistructured interviews and focus groups were conducted separately with health care providers and research coordinators, engaged patients, and unengaged patients. A validated model of sustained engagement, an adapted unified theory of acceptance and use of technology (UTAUT), guided data collection, and analysis through directed content analysis. Results We interviewed 13 patients (7 engaged, 6 unengaged), 6 providers, and 2 research coordinators. In addition to finding differences between engaged and unengaged patients within each predictor in the adapted UTAUT model (perceived ease of use, perceived usefulness, facilitating conditions), four additional factors were identified as being related to sustained engagement in this population. These are: (1) internal motivation to manage health, (2) relationship with health care provider, (3) supportive environments, and (4) feedback and guidance. Conclusion Although it required some modification, the adapted UTAUT model was useful in understanding of the parameters of sustained engagement. The findings of this study provide initial requirement specifications for the design of applications that engage patients in this unique population of adults with AF.

scholarly journals Awareness of Oral Cancer Among Dental Patients in Mecca, Saudi Arabia

2020 ◽  
Vol 14 (1) ◽  
pp. 369-374
Author(s):  
Mashael Alqahtani ◽  
Alla Nahhas ◽  
Lujain Malibari ◽  
Maryam Alghamdi ◽  
Sara Bazuhier ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Cancer ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Dental Patients ◽  
Adequate Knowledge ◽  
History Of ◽  
Demographical Data

Background: Oral Cancer (OC) is a serious health problem affecting the oral cavity, which may lead to death. Alcohol, tobacco, and chewing betel are the main risk factors. Early diagnosis and adequate knowledge of OC may improve the survival rate. Objective: This study aimed to assess the knowledge about oral cancer among dental patients in Mecca. Methods: A cross-sectional study was conducted in the dental clinics of Mecca. Interviewer-administered questionnaires were distributed to 416 respondents aged 18 or older, who spoke Arabic or English, had no history of OC, and participated voluntarily. The questionnaire consisted of three sections. The first regarded demographical data, the second measured knowledge about OC, and the third was concerned with education regarding OC provided by health-care providers. The interviewers also educated the participants by handing brochures with information about OC. Results: Knowledge about OC among dental patients in Mecca was found to be significantly low. Only 102 of the 416 participants (24.5%) had any knowledge. Only 3.4% of all participants had been educated about OC by their health-care providers. Conclusion: The results of this study show a considerable lack of general knowledge about OC among dental patients in Mecca. Health programs should be developed to raise the community’s awareness.

League Tables for Performance Improvement in Health Care

1998 ◽  
Vol 3 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Sandra Nutley ◽  
Peter C. Smith
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Analytical Techniques ◽  
Performance Data ◽  
Future Research ◽  
League Table ◽  
Care Providers ◽  
League Tables ◽  
Wide Range ◽  
The Impact

Objectives: Increasingly health care performance data are being disseminated in the form of ‘league tables' of health care providers, with the implication that such publication helps purchasers select the better providers, and spurs providers into improvements. This paper examines progress to date. Methods: Three stages of the league table process are considered: measurement, analysis and action. Results: A wide range of measurement schemes are now in place, although the emphasis has been on process variables and mortality as a measure of outcome. Several analytical techniques have been deployed to help users make sense of league tables, and to help determine the causes of variations in reported performance. The weakest aspect of current methods relates to the use to which such analysis is put. Conclusions: A haphazard approach to using league table data exists, with few reports on the impact of publication. A variety of directions for future research into the use of performance data are needed.

scholarly journals Plain Language Summary: Nosebleed (Epistaxis)

2020 ◽  
Vol 162 (1) ◽  
pp. 26-32
Author(s):  
David E. Tunkel ◽  
Sarah M. Holdsworth ◽  
Jacqueline D. Alikhaani ◽  
Taskin M. Monjur ◽  
Lisa Satterfield
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Practice Guideline ◽  
Medical Advice ◽  
Care Providers ◽  
Plain Language ◽  
Treatment And Prevention ◽  
History Of ◽  
Or History

This plain language summary explains nosebleeds, also known as epistaxis (pronounced ep-ih-stak-sis), to patients. The summary applies to any individual aged 3 years and older with a nosebleed or history of nosebleed who needs medical treatment or wants medical advice. It is based on the 2020 “Clinical Practice Guideline: Nosebleed (Epistaxis).” This guideline uses research to advise doctors and other health care providers on the diagnosis, treatment, and prevention of nosebleeds. The guideline includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to help patients ask questions and make decisions in their own care.

Trauma-Informed Care With Childhood Maltreatment Survivors: What Do Maternity Professionals Want to Learn?

2014 ◽  
Vol 4 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Kristen Choi ◽  
Julia S. Seng
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Childhood Maltreatment ◽  
Perinatal Care ◽  
Care Providers ◽  
History Of ◽  
Maternity Health ◽  
Maternity Health Care

BACKGROUND: Posttraumatic stress disorder (PTSD) affects 8% of pregnant women, and the biggest risk factor for pregnancy PTSD is childhood maltreatment. The care they receive can lead to positive outcomes or to retraumatization and increased morbidity. The purpose of this study is to gather information from a range of clinicians about their continuing education needs to provide perinatal care to women with a maltreatment history and PTSD.METHOD: Maternity health care professionals were interviewed by telephone. Network sampling and purposive sampling were used to include physicians, nurse practitioners, midwives, nurses, and doulas (n = 20), and results were derived from content analysis.RESULTS: Most providers received little or no training on the issue of caring for women with a history of childhood maltreatment or PTSD during their original education but find working with this type of patient rewarding and wish to learn how to provide better care. Providers identified a range of educational needs and recommend offering a range of formats and time options for learning.CONCLUSIONS: Maternity health care providers desire to work effectively with survivor moms and want to learn best practices for doing so. Thus, educational programming addressing provider needs and preferences should be developed and tested to improve care experiences and pregnancy outcomes for women with a history of trauma or PTSD.

scholarly journals Postpartum Depression Among Women With Previous Infertility in Health Care Centers of Hamadan in 2018

2020 ◽  
Vol 7 (2) ◽  
pp. 103-108
Author(s):  
Nasrin Matinnia ◽  
Saeid Yazdi-Ravandi
Keyword(s):  
Health Care ◽  
Marital Satisfaction ◽  
Postpartum Depression ◽  
Health Care Providers ◽  
Significant Relationship ◽  
Care Providers ◽  
The Family ◽  
History Of ◽  
Health Care Centers

Background: Childbirth is one of the essential goals of the family, so that infertility can cause many problems for the family. Therefore, the aims of the current study were the frequency of postpartum depression and evaluate the relationship between postpartum depression, socio-demographic factors, and quality of marital satisfaction in postpartum women with a history of infertility referring to health centers in Hamadan. Methods: This study was a cross-sectional study. The study population consisted of all primiparous women with a history of infertility referring to Hamadan health care centers in 2018, of which 240 randomly selected according to the inclusion criteria for one year. Subjects assessed by demographic and clinical information checklist, Edinburgh Postnatal Depression Scale (EPDS), and marital relationship quality scale (Revised Dyadic Adjustment Scale; RDAS). All statistical calculations performed by busing chi-square with SPSS-17. Results: 152 out of 240 participants (63.3%) had a degree of depression, of which 57 (23.7%) had mild depression, 63 (26.3%) had moderate depression, and 32 (13.3%) had severe depression. According to the result of the study, marital satisfaction in 23.3% (56), 37.1% (89), and 39.6% (95) were excellent, moderate, and low, respectively — the quality of marital relationships associated significantly with and postpartum depression (χ2=19.3, P<0.001). The results of the study showed that there was a significant relationship between age, occupation, educational level, duration of infertility, and depression (P<0.05), but there was no significant relationship between ethnicity, insurance, and depression (P<0.05). Conclusion: Regarding the results obtained in this study and comparison with existing studies, the infertility problem can cause mental and psychological disorders in women. It seems that marital satisfaction and its relationship with different factors and the proper interventions by health care providers are necessary to prevent postpartum depression in these women.

scholarly journals What Do Patients Complain About Online: A Systematic Review and Taxonomy Framework Based on Patient Centeredness (Preprint)

2019 ◽  
Author(s):  
Jing Liu ◽  
Shengchao Hou ◽  
Richard Evans ◽  
Chenxi Xia ◽  
Weidong Xia ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
A Priori ◽  
Patient Experiences ◽  
Study Patient ◽  
Significant Heterogeneity ◽  
Care Providers ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Wide Range

BACKGROUND Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. OBJECTIVE The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. METHODS First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. RESULTS In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. CONCLUSIONS Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.

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