Mobile Health in Emergency Care

Author(s):  
Waddaa Redha ◽  
Kirsten Hartwick ◽  
Neal Sikka

With the passage of the Affordable Care Act (ACA) in 2010, significant changes are occurring within the healthcare system. It is imperative that ways to both reduce cost and improve health are found. Since emergency medicine is often considered the gateway to the healthcare system, healthcare providers need to determine the best way to provide high quality care in the emergency department while also curbing costs. Mobile health, or mHealth, utilizes technology to increase the mobility of patients and their providers and provides a medium to transfer data and information efficiently. In emergency medicine, this technology can be applied in various treatments including wound care, stroke care, and prehospital care. In this article, the authors discuss the current uses of mHealth within emergency care and potential areas for future growth.

2020 ◽  
Vol 37 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Kim Hansen ◽  
Adrian Boyle ◽  
Brian Holroyd ◽  
Georgina Phillips ◽  
Jonathan Benger ◽  
...  

ObjectivesQuality and safety of emergency care is critical. Patients rely on emergency medicine (EM) for accessible, timely and high-quality care in addition to providing a ‘safety-net’ function. Demand is increasing, creating resource challenges in all settings. Where EM is well established, this is recognised through the implementation of quality standards and staff training for patient safety. In settings where EM is developing, immense system and patient pressures exist, thereby necessitating the availability of tiered standards appropriate to the local context.MethodsThe original quality framework arose from expert consensus at the International Federation of Emergency Medicine (IFEM) Symposium for Quality and Safety in Emergency Care (UK, 2011). The IFEM Quality and Safety Special Interest Group members have subsequently refined it to achieve a consensus in 2018.ResultsPatients should expect EDs to provide effective acute care. To do this, trained emergency personnel should make patient-centred, timely and expert decisions to provide care, supported by systems, processes, diagnostics, appropriate equipment and facilities. Enablers to high-quality care include appropriate staff, access to care (including financial), coordinated emergency care through the whole patient journey and monitoring of outcomes. Crowding directly impacts on patient quality of care, morbidity and mortality. Quality indicators should be pragmatic, measurable and prioritised as components of an improvement strategy which should be developed, tailored and implemented in each setting.ConclusionEDs globally have a remit to deliver the best care possible. IFEM has defined and updated an international consensus framework for quality and safety.


2019 ◽  
Author(s):  
Corey B. Bills ◽  
Peter Acker ◽  
Tina McGovern ◽  
Rebecca Walker ◽  
Htoo Ohn ◽  
...  

Abstract Background Currently, Myanmar does not have a nationalized emergency care or emergency medical services (EMS) system. The provision of emergency medicine (EM) education to physicians without such training is essential to address this unmet need for high quality emergency care. We queried a group of healthcare providers in Myanmar about their experience, understanding and perceptions regarding the current and future needs for EM training in their country. Methods A 34-question survey was administered to a convenience sample of healthcare workers from two primary metropolitan areas in Myanmar to assess exposure to and understanding of emergency and pre-hospital care in the country. Results 236 of 290 (81% response rate) individuals attending one of two full-day symposia on emergency medicine completed the survey. The majority of respondents were female (n=138, 59%), physicians (n=171, 74%), and working in private practice (n=148, 64%). A majority of respondents (n=133, 57%) spent some to all of their clinical time providing acute and emergency care however 83.5% (n=192) of all surveyed reported little or no past training in emergency care; and those who have received prior emergency medicine training were more likely to care for emergencies (>2 weeks training; p=.052). 81% (n= 184) thought the development of emergency and acute care services should be a public health priority. Conclusions Although this subset of surveyed health practitioners commonly provides acute care, providers in Myanmar may not have adequate training in emergency medicine. Continued efforts to train Myanmar’s existing healthcare workforce in emergency and acute care should be emphasized.


2021 ◽  
Vol 27 (4) ◽  
pp. 267-278
Author(s):  
Somayyeh Zakerabasali ◽  
Seyed Mohammad Ayyoubzadeh ◽  
Tayebeh Baniasadi ◽  
Azita Yazdani ◽  
Shahabeddin Abhari

Objectives: Despite the growing use of mobile health (mHealth), certain barriers seem to be hindering the use of mHealth applications in healthcare. This article presents a systematic review of the literature on barriers associated with mHealth reported by healthcare professionals.Methods: This systematic review was carried out to identify studies published from January 2015 to December 2019 by searching four electronic databases (PubMed/MEDLINE, Web of Science, Embase, and Google Scholar). Studies were included if they reported perceived barriers to the adoption of mHealth from healthcare providers’ perspectives. Content analysis and categorization of barriers were performed based on a focus group discussion that explored researchers’ knowledge and experiences.Results: Among the 273 papers retrieved through the search strategy, 18 works were selected and 18 barriers were identified. The relevant barriers were categorized into three main groups: technical, individual, and healthcare system. Security and privacy concerns from the category of technical barriers, knowledge and limited literacy from the category of individual barriers, and economic and financial factors from the category of healthcare system barriers were chosen as three of the most important challenges related to the adoption of mHealth described in the included publications.Conclusions: mHealth adoption is a complex and multi-dimensional process that is widely implemented to increase access to healthcare services. However, it is influenced by various factors and barriers. Understanding the barriers to adoption of mHealth applications among providers, and engaging them in the adoption process will be important for the successful deployment of these applications.


2020 ◽  
Author(s):  
Emna CHERIF ◽  
Elisabeth MARTIN VERDIER ◽  
Corinne ROCHETTE

Abstract Background: Healthcare systems are facing many changes. Particularly, patients are more engaged in the care process. The medical perspective of the process is insufficient to provide patients with high quality care and service personalisation. This research presents an attempt to complete this medical perspective through an experiential perspective, especially for chronic diseases such as cancer. We investigated patients’ experiences and profiles to reach a deeper understanding of their needs and expectations when they confront the disease. The objectives of this research were to model the key stages underling the patient pathway and to identify the challenging touch points of the interactions between patients and healthcare providers. Bringing together findings of patient experience, pathway, and profiles would help all the stakeholders involved to develop better practices for the healthcare process. Methods: A qualitative observational nethnography on a French specialized forum for breast cancer patients “ les Impatientes” was conducted. A total of 967 reviews were collected over a complete year period from all over France. Thematic and lexicometric content analysis were performed according to the experience dimensions, the pathway stages and touch points, as well as the patients’ profiles. Results: Data analysis shows that the healthcare pathway experienced by the patients is built around three stages. The discovery stage is closely related to the emotional dimension regarding the patient and physician relationship. The examination stage is characterized by a more technical and informational needs for the types of treatments. The follow-up and survivorship stage illustrates the patients’ need to assess the treatments’ effectiveness and the quality of the follow-up. Moreover, three profiles of patients were identified. The newcomers, the altruists and the autonomous are characterized by different attitudes depending on the stage of the healthcare pathway they were living. Conclusions: Our research presents an original modelling of the patient pathway and profiles beyond the medical process. It gives practical tracks to improve the healthcare pathway. Patients expect healthcare providers to integrate and strengthen several challenging touch points in order to create satisfactory patient experiences and high quality service.


2019 ◽  
Vol 9 (2) ◽  
pp. 11-14 ◽  
Author(s):  
John Mikhaeil ◽  
Bryan Ng ◽  
Michael-Roy Durr ◽  
Sparsh Shah ◽  
Edmond Chiu

The Student-Run Clinic Association (SRCA) is a pan-Canadian effort to develop new student-run clinics and scale the operation of existing clinics. Student-run clinics utilize a multidisciplinary team of health professional students to provide accessible primary care services to vulnerable and marginalized populations under the supervision of qualified and licensed healthcare providers. The SRCA plays an integral role in building the infrastructure necessary for student-run clinics to be sustainable and scalable across the country. The outcome of our initiative is to enhance equitable, high-quality care to underserved populations in Canada, while simultaneously providing future healthcare providers with experience serving this population.


2019 ◽  
Vol 8 (3) ◽  
pp. 246-256
Author(s):  
B. L. Kurilin ◽  
V. Y. Kisselevskaya-Babinina ◽  
N. A. Karasyov ◽  
I. V. Kisselevskaya-Babinina ◽  
E. V. Kislukhkina ◽  
...  

Background The most important part of the state social and economic policy is optimization of the healthcare system, where the loss of public health leads to economic damage. Against this background, forecasting the work of medical institutions is the basis for the successful development of healthcare, despite the fact that the healthcare system, indicators and standards of medical and social welfare are still not stable, and a clear development strategy for the shortand long-term period has not been worked out. Aim of study Determining the most optimal method for predicting the work of a medical institution, based on identification of the main trends in the time series when constructing a model of the dependence of parameters or determining the behavior of data as a stochastic series (i.e. modeling random processes and random events with some random error).Material and methods To predict the main statistical indicators of N.V. Sklifosovsky Research Institute for Emergency Medicine based on a retrospective analysis, data were used that were submitted to the City Bureau of Medical Statistics and entered into official reporting forms (form № 30, approved by Goskomstat of the Russian Federation dated September 10, 2002, № 175): the number of hospitalized patients and mortality rates in inpatient and intensive care units. To select the optimal methodology for the experimental forecast model, data were used for the period from 1991 to 2016. Indicators for 2017 were taken as control values.Results As a result of the comparison of several methods (moving averages, least squares approach, Brown model, Holt–Winters method, autocorrelation model, Box–Jenkins method) as applied to the work of N.V. Sklifosovsky Research Institute for Emergency Medicine, the Holt–Winters model was chosen as the most appropriate one for the data characteristics.Findings 1. When using methods of moving averages, least squares, Box-Jenkins, as well as Brown model and autocorrelation, the forecast result is not always influenced by strictly straight-line indicators of the time series, due to the heterogeneity of the time series and the presence of outliers (often found in a medical institution providing emergency care), which lead to a significant decrease in the reliability of forecasting. 2. The application of the Holt–Winters model, which takes into account the exponential trend (the trend of time series indicators) and additive season (periodic fluctuations observed in the time series), is most suitable for processing statistical data and forecasting for long-term, medium-term and short-term periods taking the specifics of a hospital providing emergency care into account. 3. The choice of the optimal method for predicting the work of a medical institution, based on the identification of the main trends in the time series, taking most of the features in the modeling of random processes and events into account, allowed to reduce the relative forecast error.


CJEM ◽  
2002 ◽  
Vol 4 (05) ◽  
pp. 359-368 ◽  
Author(s):  

ABSTRACT: In April 2001, the Commission on the Future of Health Care in Canada was established. The Honorable Roy Romanow was given the mandate to “inquire into and undertake dialogue with Canadians on the future of Canada’s public health care system” and “to develop recommendations that will ensure the long-term sustainability of a high quality, universally accessible, publicly administered health care system, for all Canadians.” The Canadian Association of Emergency Physicians (CAEP) recognized an obligation to share in this public dialogue, to communicate the current state of emergency medicine, and to identify the components necessary to achieve excellence in emergency care. The CAEP Advocacy Committee was asked to develop a document that would educate and enlighten the Commissioner. Basic themes were identified, and authors from across the country were invited to write brief, factual essays with achievable recommendations. The resulting series of essays was presented on April 30, 2002, at the Health Care Commission’s open public hearing in Calgary, Alberta. This article, part 1 of a 2-part series, includes discussions of Urban Emergency Care Delivery, Rural Emergency Care, Emergency Care for Children, Prehospital Care and Emergency Medical Services, and National Standards for Hospital Emergency Services.


2020 ◽  
pp. 707-715

OBJECTIVE. The aim of this paper is is to present the assumptions of the Value Based Healthcare concept, the related benefits and examples of countries in which the concept is implemented. The article also proposes solutions based on the VBHC model that could be implemented in the Polish healthcare system. MATERIALS AND METHODS. A literature search was conducted using the PubMed via Ovid database using the following keywords: Gray literature items were also analyzed using the Google Scholar tool and other documents, eg of the European Commission. Then the work was divided into the following thematic areas: definitions and principles of VBHC, benefits and challenges related to the implementation of the model, VBHC in Europe, recommendations for solutions in Poland based on VBHC. Value Based Healthcare (VBHC) is a healthcare financing model developed by M. Porter and E. Teisberg. It is based on the assumptions of financing healthcare providers based on treatment outcomes, that is, values. This concept was created in connection with the constantly growing costs in the American healthcare system, which, however, did not translate into health indicators in the population. The aim of VBHC is to minimize the cost of the system while achieving the best result for the patient. In this model of healthcare organization, it is assumed that those healthcare providers who provide the best quality care should be best financed, thus contributing to cure or significantly improving the quality of life of patients. CONCLUSIONS. Value Based Healthcare is the recommended method of financing due to the optimization of healthcare expenses while maintaining the appropriate quality of services provided to patients. Currently, many countries in Europe and around the world have started implementing this system solution. However, the transition from a service charge to value for money model is a complex process. In the authors’ opinion, the longterm benefits of such a financing model bring a significant improvement in the quality of services and patient satisfaction.


Author(s):  
Isolde Martina Busch ◽  
Michela Rimondini

A large body of research suggests that establishing and strengthening patient–provider relationships, characterized by transparency, respect, trust, and empathy, is highly beneficial for patients, their caregivers, and healthcare providers [...]


2020 ◽  
Author(s):  
Emna CHERIF ◽  
Elisabeth MARTIN VERDIER ◽  
Corinne ROCHETTE

Abstract Background Healthcare systems are facing many changes. Particularly, patients are more engaged in the care process. The medical perspective of the process is insufficient to provide patients with high quality care and service personalisation. This research presents an attempt to complete this medical perspective through an experiential perspective, especially for chronic diseases such as cancer. We investigated patients’ experiences and profiles to reach a deeper understanding of their needs and expectations when they confront the disease.The objectives of this research were to model the key stages underling the patient pathway and to identify the challenging touch points of the interactions between patients and healthcare providers. Bringing together findings of patient experience, pathway, and profiles would help all the stakeholders involved to develop better practices for the healthcare process.Methods A qualitative observational nethnography on a French specialized forum for breast cancer patients “les Impatientes” was conducted. A total of 967 reviews were collected over a complete year period from all over France. Thematic and lexicometric content analysis were performed according to the experience dimensions, the pathway stages and touch points, as well as the patients’ profiles.Results Data analysis shows that the healthcare pathway experienced by the patients is built around three stages. The discovery stage is closely related to the emotional dimension regarding the patient and physician relationship. The examination stage is characterized by a more technical and informational needs for the types of treatments. The follow-up and survivorship stage illustrates the patients’ need to assess the treatments’ effectiveness and the quality of the follow-up. Moreover, three profiles of patients were identified. The newcomers, the altruists and the autonomous are characterized by different attitudes depending on the stage of the healthcare pathway they were living.Conclusions Our research presents an original modelling of the patient pathway and profiles beyond the medical process. It gives practical tracks to improve the healthcare pathway. Patients expect healthcare providers to integrate and strengthen several challenging touch points in order to create satisfactory patient experiences and high quality service.


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