Considering the Artifact Ecology when Supporting the Evolution of Practices - Analyzing the Parallel Journeys of Two Teleconsultation Software in a General Hospital

The growing use of teleconsultation, especially since the start of the Covid-19 pandemic, changes physicians' work at the hospital. In this paper, we set out to study how physicians have integrated teleconsultation into their healthcare practices. Moreover, we are interested in how teleconsultation software contributes to developing new medical practices and how the design of teleconsultation software can better support them. Based on 16 months of fieldwork in a general hospital that offers two different teleconsultation software, we have investigated teleconsultation practices through interviews and observations involving ten physicians doing teleconsultation and a telemedicine secretary. Unlike the existing informal remote care by phone, we observe that teleconsultation supports new formal healthcare practices, particularly for patient care management and inter-organizational cooperation. While analyzing the integration of teleconsultation in physicians' practices, we highlight that both pieces of software do not support those practices on equal terms according to their design. We argue that teleconsultation software design can limit the spread of these new healthcare practices and that the artifact ecology of physicians should be considered during the design process.

Workforce Demands of Rural Nurse Practitioners: A Descriptive Study

Purpose: Nurse practitioners (NPs) are rendering health care services in rural areas in increasing numbers, yet little is known about clinical skills and patient care management activities performed by these advanced practice nurses in the rural environment. The purpose of this descriptive study of rural NPs was to identify skills and patient care management activities that they have performed and considered critical to Kansas rural practice. Sample: A convenience sample of 208 nurse practitioners (NP) in rural and frontier Kansas were emailed a survey that asked about skills and activities they perform in their rural practice. Sixty-three responded for a response rate of 30%. Findings: The analysis produced a list of 26 skills and 37 patient care management activities critical to Kansas rural NP practice. Most of the skills/procedures were learned after graduation. Almost all the respondents reported additional training/certifications in advanced life support and trauma. The majority of respondents were family nurse practitioners who practiced in a variety of rural settings. “I grew up in a rural setting” and “Autonomy of practice” were the two top factors that influenced their decision to practice in a rural setting. Conclusion: The analysis produced a list of skills and patient care management activities critical to rural NP practice. Schools of nursing may find these lists useful as they prepare NPs for the rural workforce. Keywords: rural, nurse practitioner, training, education, skills, and patient care management activities DOI: https://doi.org/10.14574/ojrnhc.v21i1.656

Patient Care Management (Book Review)

As an author, it is my heartiest believe that the book will adjoin significant apprehension to future pharmacists in patient care as most of the portion created from recently published articles focusing pharmacists in patient care settings.

I-THS-1908 A Big Data Electronic Health Record for Patient Care Management and Analytics

The I-THS-1908, a big data electronic health record platform, is capable of establishing its capability as an electronic health record to tackle the large volume of data with high velocity and complex variety of patient data by providing the value to the patient care management and analytics. The further development of I-THS-1908 opens the opportunity to use the electronic health record for patient care management and analytics for all type of health conditions.

Resolving Disconnected Patient Records to Support Patient Care and Population Health

Population health relies on tracking patients through a continuum of care with patient records from disparate sources. An assumption is made that all patient records are connected. The reality is: they are not. Disconnected records negatively impact results: from individual patient care management through population health's predictive analytics. An enterprise master patient index (EMPI) system can be employed to connect all patient records, but it requires comprehensive tuning to maximize the number of connected records. This presentation describes how one large healthcare integrated delivery network tuned their EMPI system to maximize the number of connected patient records across all sources.