Perceptions and Needs of Artificial Intelligence in Health Care to Increase Adoption: Scoping Review

Background Artificial intelligence (AI) has the potential to improve the efficiency and effectiveness of health care service delivery. However, the perceptions and needs of such systems remain elusive, hindering efforts to promote AI adoption in health care. Objective This study aims to provide an overview of the perceptions and needs of AI to increase its adoption in health care. Methods A systematic scoping review was conducted according to the 5-stage framework by Arksey and O’Malley. Articles that described the perceptions and needs of AI in health care were searched across nine databases: ACM Library, CINAHL, Cochrane Central, Embase, IEEE Xplore, PsycINFO, PubMed, Scopus, and Web of Science for studies that were published from inception until June 21, 2021. Articles that were not specific to AI, not research studies, and not written in English were omitted. Results Of the 3666 articles retrieved, 26 (0.71%) were eligible and included in this review. The mean age of the participants ranged from 30 to 72.6 years, the proportion of men ranged from 0% to 73.4%, and the sample sizes for primary studies ranged from 11 to 2780. The perceptions and needs of various populations in the use of AI were identified for general, primary, and community health care; chronic diseases self-management and self-diagnosis; mental health; and diagnostic procedures. The use of AI was perceived to be positive because of its availability, ease of use, and potential to improve efficiency and reduce the cost of health care service delivery. However, concerns were raised regarding the lack of trust in data privacy, patient safety, technological maturity, and the possibility of full automation. Suggestions for improving the adoption of AI in health care were highlighted: enhancing personalization and customizability; enhancing empathy and personification of AI-enabled chatbots and avatars; enhancing user experience, design, and interconnectedness with other devices; and educating the public on AI capabilities. Several corresponding mitigation strategies were also identified in this study. Conclusions The perceptions and needs of AI in its use in health care are crucial in improving its adoption by various stakeholders. Future studies and implementations should consider the points highlighted in this study to enhance the acceptability and adoption of AI in health care. This would facilitate an increase in the effectiveness and efficiency of health care service delivery to improve patient outcomes and satisfaction.

Postacute-Stroke Management Problems in Home Care Service: A Qualitative Single-Centered Study in Yogyakarta, Indonesia

Objective This study explores the postacute-stroke management problems, particularly for patients with total dependency (Barthel Index <20), in home care service of Dr. Sardjito Hospital (SH) from the hospital personnel's and caregiver's points of view. Materials and Methods In-depth interviews with a semi-structured interview guide were conducted with hospital personnel and patients' caregivers based on the purposeful sampling. There were 10 hospital personnel that were interviewed: the director of medical service, head of home care unit, neurologists, general practitioners, nurses, and physiotherapist. There were eight caregivers who participated in the study. Statistical Analysis Data from the interviews were analyzed using systematic text condensation using Nvivo 12 plus. Results Our findings showed that all health personnel in SH agreed that home care service is a part of an integrated health care service for continuation of care. However, the preparedness by the hospital management is still lacking in infrastructures, such as standardized operational procedure, quality control, and financial system, as well as in terms of competent human resources and their welfare. In addition, the patient's family and caregiver are lacking in knowledge and independency to take care of the patients with the need of home care services' monitoring to deliver the expected home care for postacute-stroke's patient regularly. Conclusion Home care service is an act of implementing hospital obligation to fulfill the patients' rights. An established hospital policy to ensure a comprehensive home care service delivery is necessary. The capability and welfare of the health care personnel should be put into account for the standardized human resources.

Assessment of Pregnant Women’s Satisfaction with Model of Care Initiative: Antenatal Care Service at Primary Health Care in Cluster One in Riyadh, Saudi Arabia

The current study assessed pregnant women’s satisfaction with antenatal care (ANC) services at primary health care centers (PHCs) in Riyadh Cluster One. The study was conducted at 11 PHCs where the ANC initiative has been implemented. A total of 646 pregnant women were enrolled. A questionnaire was completed by participants to measure the level of satisfaction with the provided services, care, and consultation. Subsequently, the data were analyzed to determine the significant differences and conduct regression analysis. The overall satisfaction with initial triage assessment, provided services, consultation, and examination was 93.7%, 87.8%, 71.8%, and 53.9%, respectively. Regarding ANC services, education was the only statistically significant variable that influenced patient satisfaction (p < 0.05). In contrast, satisfaction with the provided care was significantly related to all the variables studied. For consultation, education (p < 0.001) and monthly income (p < 0.05) were the statistically significant role players. In the regression analysis, secondary education was statistically significantly related to the provided services, consultation, and examination. Despite the satisfactory level of ANC at the selected PHCs, higher patient satisfaction could be achieved in the future by improving the consultation and examination practices. Overall satisfaction with the health care workers at PHCs is high. Incorporating implied ameliorations would enhance the quality of services and patient satisfaction.

Expanded Pharmacy Practice Implementation: Lessons from Remote Practice

Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP—Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist’s perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research. Results: A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted. Discussion/Conclusion: Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.

Subsidy policy selection of elderly care service projects under uncertain actual demand: a real options analysis based on China’s experience

Background Elderly care service projects (ECSPs) aim to provide care services with the help of market forces on the supply side to satisfy the huge demand of the elderly. Subsidies play an important role in motivating the investors to invest in the ECSPs immediately. The optimal subsidy scheme should balance the policy costs and the investors’ interests. Methods Based on the policy background of China, this study applied the real options theory to compare the effects of construction subsidy and operating subsidy on achieving policy goals from the perspective of uncertain actual demand. It introduced numerical examples to identify the optimal subsidy scheme and embedded the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to verify the uncertainty of actual demand. Results The results showed that in the context of uncertain actual demand, operating subsidy has greater advantages in reducing investment thresholds, saving subsidy costs and increasing spillover values. Moreover, a sound quality supervision system, a differentiated operating subsidy scheme and a sustainable growth market demand environment are conducive to increasing the long-term interests of the government and the investors. Conclusions The study emphasized the importance of subsidy selection in the context of uncertain actual demand, and provided a practical reference for policy designers in China and other developing countries to choose the optimal subsidy scheme for the ECSPs.

Suicide as a medical education curricular topic: a documentary analysis of Brazilian federal medical schools

Purpose Physicians worldwide need to be able to identify and assess suicide risk or behavior in their consults. The proper training of medical staff is an important form of suicide prevention, especially because 80% of the patients who died by suicide were in contact with a health-care service in the year of their death. The purpose of this study is to verify if some of the most important Brazilian medical schools includes discussions regarding suicide in their curricula, and describe them. Design/methodology/approach The study performed a documentary analysis of all Brazilian federal higher education institutions. The analysis involved selecting the institutions that approached the topic of suicide in their curricula, and sorting it by keywords. The curricula that contained such keywords were then entirely read, analyzed and all components found were described regarding course period, workload and approach. Findings Within the 68 analyzed institutions, 19 (28%) included suicide in their curricula with a total of 31 components approaching suicide among them. Those components belonged to different stages of the course and had different workloads and approaches. A total of seven different approaches were identified: Clinical (54.8%); Emergency (16.1%); Medical Psychology (9.7%); Ethics (6.5%); Social (6.5%); Occupational (3.2%) and Forensic (3.2%). Originality/value To the best of the authors’ knowledge, the study is the first to address medical education regarding suicide in a large number of Brazilian institutions. It is also one of the few studies worldwide to quantify suicide discussion on a large number of institutions using documentary analysis.

Village health workers as health diplomats: negotiating health and study participation in a malaria elimination trial in The Gambia

Background Although many success stories exist of Village Health Workers (VHWs) improving primary health care, critiques remain about the medicalisation of their roles in disease-specific interventions. VHWs are placed at the bottom of the health system hierarchy as cheap and low-skilled volunteers, irrespective of their highly valued social and political status within communities. In this paper, we shed light on the political role VHWs play and investigate how this shapes their social and medical roles, including their influence on community participation. Method The study was carried out within the context of a malaria elimination trial implemented in rural villages in the North Bank of The Gambia between 2016 and 2018. The trial aimed to reduce malaria prevalence by treating malaria index cases and their potentially asymptomatic compound members, in which VHWs took an active role advocating their community and the intervention, mobilising the population, and distributing antimalarial drugs. Mixed-methods research was used to collect and analyse data through qualitative interviews, group discussions, observations, and quantitative surveys. Results and discussion We explored the emic logic of participation in a malaria elimination trial and found that VHWs played a pivotal role in representing their community and negotiating with the Medical Research Council to bring benefits (e.g. biomedical care service) to the community. We highlight this representative role of VHWs as ‘health diplomats’, valued and appreciated by community members, and potentially increasing community participation in the trial. We argue that VHWs aspire to be politically present and be part of the key decision-makers in the community through their health diplomat role. Conclusion It is thus likely that in the context of rural Gambia, supporting VHWs beyond medical roles, in their social and political roles, would contribute to the improved performance of VHWs and to enhanced community participation in activities the community perceive as beneficial.

What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

Background Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. Methods We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. Results Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. Conclusions It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. Trial registration ACTRN 12619000251123.