scholarly journals Consultative workshop proceedings of the Canadian Team to Improve Community-Based Cancer Care Along the Continuum

2017 ◽  
Vol 24 (2) ◽  
pp. 135 ◽  
Author(s):  
E. Grunfeld ◽  
B. Petrovic ◽  
For the CanIMPACT Investigators
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Community Based ◽  
Nurse Navigator ◽  
Cancer Specialists ◽  
The Continuum

The multidisciplinary pan-Canadian canimpact (Canadian Team to Improve Community-Based Cancer Care Along the Continuum) group is studying how to improve cancer care for patients in the primary care setting. A consultative workshop hosted by the team took place on 31 March and 1 April 2016 in Toronto, Ontario. The workshop included 74 participants from 9 provinces, with representation from primary care, cancer specialties, international liaisons, knowledge users, researchers, and patients. On the agenda were presentations from canimpact phase 1 projects includingqualitative studies on the perspectives of survivors and health care providers about continuity and coordination of care;an environmental scan and systematic review of existing initiatives designed to improve care integration;population-based administrative health database analyses related to breast cancer diagnosis, treatment, and survivorship; anda qualitative study on the experiences, desired roles, and needs of primary health care providers with respect to personalized medicine.In addition, there were presentations on two possible intervention approaches, including nurse navigation and the eConsult system. Based on the information presented, participants worked in small groups to develop recommendations for phase 2, which will involve development and evaluation of an intervention to improve the integration of care between primary care providers and cancer specialists. After a process of deliberation and voting, workshop participants recommended testing the implementation of eConsult in the oncology setting to determine whether it improves relationships, communication, knowledge sharing, and connections between family doctors and cancer specialists; and, to improve system navigation, evaluating eConsult in existing nurse navigator programs, if feasible.

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals (Preprint)

2020 ◽  
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

BACKGROUND Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. OBJECTIVE The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. METHODS Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. RESULTS The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. CONCLUSIONS The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals

10.2196/24157 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24157
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

Background Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. Objective The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. Methods Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. Results The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. Conclusions The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

Is the Far West Mental Health Integration Project Making a Difference? The General Practitioner Perspective

2005 ◽  
Vol 11 (3) ◽  
pp. 32 ◽  
Author(s):  
David Perkins ◽  
David Lyle
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Care Providers ◽  
Care Staff ◽  
Care Providers ◽  
Community Based ◽  
Mental Health Integration ◽  
Integration Project ◽  
The Impact

This paper reports on the evaluation of an Australian Government and NSW State funded Mental Health Integration Project in remote far western NSW. The project was part of the Mental Health Integration Program, developed from the Second National Mental Health Plan. The project implemented a model of community-based mental health services and used innovative financing arrangements to allow the provision of community-based specialist mental health teams to remote communities and to recruit visiting psychiatrists to support the local primary care providers. The evaluation strategy included a survey of general practitioners (GPs) in the Upper Western Sector and Broken Hill, designed to investigate their level and type of contact with psychiatrists and community-based specialist mental health care teams, their perceptions about the impact of the new services, and their interest in further professional development in mental health care.The project has shown that visiting specialists can be deployed in a primary care setting with a focus on meeting the needs of local GPs, primary health care staff and their patients.

scholarly journals Online Health Promotion to Reduce Cancer Risk: Lessons From Learning With Alaska’s Tribal Primary Care Providers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 16s-16s
Author(s):  
K. Cueva ◽  
M. Cueva ◽  
L. Revels ◽  
M. Hensel ◽  
M. Dignan
Keyword(s):  
Primary Care ◽  
Online Learning ◽  
Cancer Risk ◽  
Online Education ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Cancer Information ◽  
Advisory Group ◽  
Care Providers ◽  
Community Based

Background: Alaska's tribal primary care providers in rural Alaska - community health aides and practitioners (CHA/Ps) - requested online education about cancer for themselves and their communities. Aim: A research team at the Alaska Native Tribal Health Consortium engaged in community-based participatory action research to develop culturally respectful online cancer education to support CHA/Ps to increase their knowledge, reduce their own cancer risk, and share cancer information. Methods: This project created ten online learning modules, a semester-long online course that combined the modules with synchronous conversations, and a supplemental webinar series. All modules were community-based and collaboratively developed with input from a community advisory group of CHA/Ps, content experts, and interested partners. Learners completed an evaluation survey at the end of each module and webinar. Course participants completed a precourse assessment, and evaluations at the end of each module, at the end of the course, two-months postcourse, and six-months postcourse. Results: While evaluation is ongoing, as of March 2018, 194 unique individuals, including 27 course participants, had completed 1,288 module evaluation surveys. Learners reported an increase in cancer knowledge, and intentions to reduce their personal cancer risk and share cancer information as a result of the online learning. On 98% of completed surveys, learners shared that they planned to change their interactions with patients as a result of the learning, including talking more about cancer screening, cutting down/quitting tobacco, being more physically active, and eating healthy. A total of 88% of unique learners planned to reduce their personal cancer risk as a result of the learning, including by quitting tobacco, having recommended cancer screenings, exercising, and eating healthier. Comparison of pre and postcourse survey responses showed CHA/Ps’ had changed to eat more fruits and vegetables and exercise more, as well as felt more knowledgeable about cancer, and more comfortable both with finding medically-accurate cancer information online and talking to their patients, families, and communities about cancer. Conclusion: This culturally respectful education strategy may be adaptable to other populations to support primary care providers and their communities to reduce cancer risk. This intervention may be of particular interest to health care providers, public health professionals, and those interested in health systems in rural and remote regions and in areas with limited medical infrastructure.

scholarly journals An Epigenetics-Based, Lifestyle Medicine–Driven Approach to Stress Management for Primary Patient Care: Implications for Medical Education

2019 ◽  
Vol 14 (3) ◽  
pp. 294-303 ◽  
Author(s):  
Jenny Lee ◽  
Frank Papa ◽  
Paresh Atu Jaini ◽  
Sarah Alpini ◽  
Tim Kenny
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Care ◽  
Stress Management ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Therapeutic Interventions ◽  
Care Providers ◽  
Lifestyle Medicine ◽  
Lifestyle Choices

Over 75% of patients in the primary care setting present with stress-related complaints. Curiously, patients and health care providers all too often see stress as a relatively benign sequela of many common illnesses such as heart disease, cancer, lung disease, dementia, diabetes, and mental illness. Unfortunately, various day-to-day lifestyle choices and environmental factors, unrelated to the presence of any disease, can cause stress sufficient to contribute to the development of various diseases/disorders and suboptimal health. There is evidence suggesting that counseling in stress management–oriented therapeutic interventions (as offered by lifestyle medicine–oriented practitioners) may prevent or reduce the onset, severity, duration, and/or overall burden of stress-related illnesses. Such counseling often involves considerations such as the patient’s nutrition, physical activity, interest in/capacity to meditate, drug abuse/cessation, and so on. Unfortunately, lifestyle medicine–oriented approaches to stress management are rarely offered in primary care—the patient care arena wherein such counseling would likely be best received by patients. Would health care outcomes improve if primary care providers offered counseling in both stress management and positive lifestyle choices? The purpose of this article is to provide both primary care practitioners and educators in health care training programs with an introductory overview of epigenetics. An emerging field of science offering insights into how factors such as stress and lifestyle choices interact with our genes in ways that can both positively and negatively impact the various micro (eg, cellular) through macro (eg, physiologic, pathophysiologic) processes that determine our tendencies toward illness or wellness. A deeper understanding of epigenetics, as provided herein, should enable primary care providers and medical educators to more confidently advocate for the primary benefits associated with counseling in both stress reduction and the pursuit of healthy lifestyle choices.

scholarly journals A Systems-Wide Approach for Early Detection and Management of Dementia in Primary Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 346-346
Author(s):  
Annette Fitzpatrick ◽  
Basia Belza
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Signs And Symptoms ◽  
Primary Care Providers ◽  
Population Increase ◽  
Community Advisory Board ◽  
Care Practice ◽  
Care Providers ◽  
Cognitive Changes

Abstract Dementia is frequently unrecognized and under-reported by health care providers. The needs of an aging population increase the burden on an already over-worked primary care system that is often without the appropriate training, resources, and reimbursement to address the growing number of people with cognitive decline in the US. In this symposium we present a systems-wide approach within University of Washington (UW) Primary Care to increase awareness of early signs and symptoms, detection of cognitive impairment, and support of providers, patients and caregivers that will ultimately improve outcomes of care. This quality improvement (QI) program integrates stakeholder-selected components of the GSA KAER (Kickstart-Assess-Evaluate and Refer) Model and Toolkit (2020 Edition), developed by the Gerontological Society of America (GSA), into primary care practice. We describe content and logistics of a continuing education intervention for primary care providers and clinical staff to increase skills for evaluation and management of dementia. Working with UW clinic managers and information technology (IT), we have developed a pragmatic system for streamlining operations and documenting care utilizing newly developed interdisciplinary workflows and electronic health record order sets. Using input from our Community Advisory Board, we explain development of a web-based resource directory to be used in-clinic and at home to support providers, staff, patients, families, and caregivers across cognitive changes. Strategies presented here are aimed to help other health care systems initiate steps to integrate KAER and other tools into a practical QI program for improving detection and management of dementia through support of primary care.

The Trans Primary Care Guide: A Community-Based Approach to Developing a Web-based, Illustrated Resource for Primary Health Care Providers (Preprint)

2018 ◽  
Author(s):  
Kelly Katharina Speck ◽  
Shelley L Wall
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Care Providers ◽  
Successful Implementation ◽  
Care Providers ◽  
Design And Development ◽  
Community Based ◽  
Web Based ◽  
Basic Care ◽  
Training Resources

BACKGROUND There is a large gap in educational and training resources on trans-sensitive care in health professional curricula. In-person continuing medical education training sessions are often limited by time, place, and instructor availability. Web-based technologies offer the potential to easily reach primary care providers across the province. However, existing online training resources are lengthy in content, lack visual communication strategies, and do not encompass the multitude of different transition options sought by trans individuals. OBJECTIVE This article describes a community-based, participatory approach to the design and development of a web-based, illustrated resource guide with non-sequential access to medical and basic care protocols and guidelines to improve primary care providers' knowledge and confidence in caring for trans clients. METHODS The design and development of the Trans Primary Care Guide was informed by a participatory design research strategy focused on iterative improvement of the resource through iterative review by an advisory committee, formative evaluations with trans participants and primary care providers, and usability testing. RESULTS A web-based, illustrated resource (Trans Primary Care Guide) was developed to educate primary care providers on the health care needs of trans and gender-diverse people. CONCLUSIONS Successful implementation of the web-based resource was in part due to the utilization of design strategies to help primary care providers contextualize trans-competencies, the community-academic partnership and due to the early engagement of trans participants to ensure that information is gender affirming and culturally specific to regional community needs. CLINICALTRIAL Not applicable.

scholarly journals Knowledge, Attitudes, and PrEP Prescribing Practices of Health Care Providers in Philadelphia, PA

2019 ◽  
Vol 10 ◽  
pp. 215013271987852 ◽  
Author(s):  
Margaret R. Carter ◽  
Erika Aaron ◽  
Tanner Nassau ◽  
Kathleen A. Brady
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Women’S Health ◽  
Women's Health ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Hiv Care ◽  
Care Providers ◽  
Prescribing Practices ◽  
Biomedical Intervention

Introduction: Preexposure prophylaxis (PrEP) is an effective biomedical intervention that has the potential to dramatically decrease the incidence of HIV but remains an underutilized method of HIV prevention. The Philadelphia Department of Public Health administered an online survey to health care providers in the Philadelphia area with the aim of characterizing PrEP attitudes, knowledge, and prescribing practices. Methods: Online surveys were distributed to 1000 providers who were recruited through distribution lists of Philadelphia medical providers between September and December 2017. A Likert-type response scale was utilized to analyze participant self-reported responses. Participant practice settings included HIV/ID, family and internal medicine, women’s health, and pediatric/adolescent clinics. Results and Discussion: The response rate of the survey was 9%. Of 81 complete responses, 75% (N = 61) felt comfortable providing PrEP and 77% (N = 62) had ever written a PrEP prescription. Compared with primary care providers, HIV care providers were significantly more knowledgeable about required laboratory testing for prescribing PrEP ( P = .03) and were more likely to have prescribed PrEP to more than 10 patients ( P = .006). Women’s health and pediatric providers reported feeling less comfortable providing PrEP to their patients ( P = .0003). Conclusion: The majority of health care providers in the Philadelphia area who responded to the survey reported experience with providing PrEP to their patients. In the present study, HIV care providers were significantly more comfortable and knowledgeable about prescribing PrEP compared with providers in primary care, women’s health, and/or adolescent/pediatric medicine. Results were limited by sampling bias, as providers who responded to the survey may have prior experience with PrEP. Future Health Department educational trainings need to target primary and preventive care providers, providers who have never prescribed PrEP, and providers who see few patients living with HIV.

scholarly journals Outcomes of a tertiary-based innovative approach to engage primary care providers in provision of hepatitis C treatment in community settings

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Davoud Pourmarzi ◽  
Hayley Thompson ◽  
James A. Thomas ◽  
Lisa Hall ◽  
Andrew Smirnov ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Health Care Providers ◽  
Formative Evaluation ◽  
Primary Care Providers ◽  
Care Providers ◽  
Hcv Treatment ◽  
Community Based ◽  
Direct Acting Antiviral ◽  
Direct Acting

Abstract Background Australia is committed to eliminating the hepatitis C virus (HCV) by 2030. Despite regulations in Australia that enable the prescription of subsidised direct acting antiviral (DAA) by primary health care providers, the number of providers who treat patients for HCV remains low and this limits the prospect of HCV elimination. The Prince Charles Hospital, Brisbane, Australia, implemented an innovative program called Cure-It aimed at engaging primary care providers in community-based HCV treatment. This paper aims to describe initial experiences and short-term patient outcomes of this program. Methods A formative evaluation was conducted using program data for the period March 2016 to April 2018. Descriptive statistics were used to report the number of engaged primary care providers, patients’ baseline characteristics, treatment plans, and treatment outcomes. Results Thirty primary care providers from different settings were engaged in HCV treatment. Among 331 patients eligible for community-based treatment, 315 (95.2%) commenced treatment, the completion rate was 92.4 and 66.5% achieved sustained virological response at 12 weeks (SVR12). The SVR12 had not been documented for 26.8% of patients. Among patients whose SVR12 was documented, 98.2% achieved SVR12. Only 1.3% of patients experienced treatment failure. Conclusion A flexible tertiary-led model can improve primary care providers and patients’ engagement with provision of HCV treatment. Tertiary centres need to play their role to improve the accessibility of HCV treatment through providing training and on-going support for primary care providers while enabling those providers to become more confident in providing treatment independently.

“There Are so Many Nuances . . . ”: Health Care Providers’ Perspectives of Pain Communication With Hmong Patients in Primary Care Settings

2020 ◽  
pp. 104365962095943
Author(s):  
Maichou Lor ◽  
David Rabago ◽  
Miroslav Backonja
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Content Analysis ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Limited English Proficiency ◽  
Qualitative Content Analysis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Pain Communication

Introduction While researchers have studied Hmong patients with limited English proficiency in pain communication, no research has examined primary care providers’ (PCPs’) interpretation of Hmong pain communication. This study examines PCPs’ pain communication experience with Hmong patients. Method A qualitative content analysis was conducted with PCPs. Interviews were audio recorded, transcribed, and analyzed using conventional content analysis. Results Fifteen PCPs—including seven physicians, one osteopathic physician, four nurse practitioners, and three physician assistants—participated. PCPs’ interpretations of pain communication with Hmong patients were characterized by three themes: (a) the providers experienced pain communication problems related to language, (b) the providers perceived the Hmong to have different beliefs about pain, and (c) the providers used different strategies to improve communication. Discussion The findings suggest that challenges are present in achieving effective pain communication between Hmong patients and their PCPs. Ineffective pain communication hinders the delivery of culturally congruent health care for Hmong patients.

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