Behavioral Health Professionals’ Perceptions on Outcomes of Patient-Controlled Granular Information Sharing Study: Focus Groups and Survey (Preprint)

2020 ◽  
Author(s):  
Julia Ivanova ◽  
Tianyu Tang ◽  
Nassim Idouraine ◽  
Anite Murcko ◽  
Adela Grando ◽  
...  
Keyword(s):  
Focus Groups ◽  
Information Sharing ◽  
Behavioral Health ◽  
Health Professionals ◽  
Medical Information ◽  
Health Data ◽  
Health Record ◽  
Team Members ◽  
Patient Study ◽  
Actual Patient

BACKGROUND Granular information sharing studies rarely use actual patient electronic health record (EHR) information. In a previous study, behavioral health patients categorized their own EHR data into sensitive categories (e.g. mental health) and chose which care team members (e.g. pharmacists) should have access to those records. In this study, behavioral health professionals are provided access to the outcomes of a previous patient study to better understand the perspectives of health professionals on patient-controlled granular information sharing. OBJECTIVE Assess behavioral health professionals’: (1) perspectives on understanding and opinions about granular information sharing; (2) accuracy in assessing redacted medical information; (3) reactions to patient rationale for health data categorization, assignment of sensitivity, and sharing choices; and (4) recommendations on how to improve the process of granular health information sharing. METHODS Four two-hour focus groups and a pre- and post-survey were conducted at two integrated health facilities. During the focus groups, outcomes from a previous study on patients’ medical record sharing choices were shared. Thematic analysis and descriptive statistical analyses were conducted. RESULTS Twenty-eight professionals were initially unaware of or provided incorrect definitions of granular information sharing (56.0%). After having access to outcomes from a previous patient study, professionals increased their mixed perspectives (21.4% to 37.1%) on granular information sharing. A majority (81.3%) identified that key medical data had been redacted from the study case. Many (66.1%) stated they did not understand patient rationale for categorization or medical sharing preferences. Finally, participants recommended that a variety of educational approaches be incorporated to inform patients about granular information and health record sharing processes. CONCLUSIONS This study provides detailed insights from behavioral health professionals on patient-controlled granular information sharing. Health professionals accurately identified information gaps resulting from patient-directed data redaction, improved in their overall concept comprehension, underscored the fine line between patient safety and patient rights, and expressed a commitment to help patients appreciate the risks and benefits associated with granular information sharing. Outcomes will inform the development, deployment and evaluation of an electronic consent tool for granular health data sharing.

scholarly journals Behavioral Health Professionals’ Perceptions on Patient-Controlled Granular Information Sharing: Focus Groups (Preprint)

10.2196/18792 ◽  
2020 ◽  
Author(s):  
Julia Ivanova ◽  
Tianyu Tang ◽  
Nassim Idouraine ◽  
Anita Murcko ◽  
Adela Grando ◽  
...  
Keyword(s):  
Focus Groups ◽  
Information Sharing ◽  
Behavioral Health ◽  
Health Professionals

Do bedside whiteboards enhance communication in hospitals? An exploratory multimethod study of patient and nurse perspectives

2019 ◽  
Vol 29 (10) ◽  
pp. 1.6-2 ◽  
Author(s):  
Anupama Goyal ◽  
Hanna Glanzman ◽  
Martha Quinn ◽  
Komalpreet Tur ◽  
Sweta Singh ◽  
...  
Keyword(s):  
Focus Groups ◽  
Information Sharing ◽  
Clinical Information ◽  
Frequent User ◽  
Team Members ◽  
The Past ◽  
Surgical Units ◽  
Educational Programmes ◽  
Physician Engagement ◽  
Inpatient Units

ObjectiveTo understand patient and nurse views on usability, design, content, barriers and facilitators of hospital whiteboard utilisation in patient rooms.DesignMultimethods study.SettingAdult medical-surgical units at a quaternary care academic centre.ParticipantsFour hundred and thirty-eight adult patients admitted to inpatient units participated in bedside surveys. Two focus groups with a total of 13 nurses responsible for updating and maintaining the whiteboards were conducted.ResultsMost survey respondents were male (55%), ≥51 years of age (69%) and admitted to the hospital ≤4 times in the past 12 months (90%). Over 95% of patients found the whiteboard helpful and 92% read the information on the whiteboard frequently. Patients stated that nurses, not doctors, were the most frequent user of whiteboards (93% vs 9.4%, p<0.001, respectively). Patients indicated that the name of the team members (95%), current date (87%), upcoming tests/procedures (80%) and goals of care (63%) were most useful. While 60% of patients were aware that they could use the whiteboard for questions/comments for providers, those with ≥5 admissions in the past 12 months were significantly more likely to be aware of this aspect (p<0.001). In focus groups, nurses reported they maintained the content on the boards and cited lack of access to clinical information and limited use by doctors as barriers. Nurses suggested creating a curriculum to orient patients to whiteboards on admission, and educational programmes for physicians to increase whiteboard utilisation.ConclusionBedside whiteboards are highly prevalent in hospitals. Orienting patients and their families to their purpose, encouraging daily use of the medium and nurse–physician engagement around this tool may help facilitate communication and information sharing.

Current Disaster Medicine in Japan and the Change Brought by Information Sharing

2019 ◽  
Vol 14 (2) ◽  
pp. 292-302
Author(s):  
Yuji Kondo ◽  
Manabu Ichikawa ◽  
Hisayoshi Kondo ◽  
Yuichi Koido ◽  
Yasuhiro Otomo ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Information Sharing ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Patient Information ◽  
Medical Information ◽  
Disaster Medicine ◽  
Cloud System ◽  
Health Record ◽  
Electronic Health

The biggest agenda in disaster medicine in Japan is considered as the collection and sharing of information. Sharing Information Platform for Disaster Management (SIP4D) is the platform that can connect the information system of each government agency in the event of a disaster. The purpose of the present study is to clarify the damage estimation in a Disaster Medical Assistance Team (DMAT) operation, information sharing within headquarters for disaster control, information for the level of damage in hospital, conditions for a DMAT dispatch request, safest route to reach the operation site, and improvements in patient medical information sharing and to assess the utility of introducing electronic health record by SIP Disaster Resilience: Theme 4. We used the information of SIP4D and Health Crisis and Risk Information Supporting Internet system (H-CRISIS) assistance to clarify the variables. We also examined the utility of using an electronic medical record system at the time of a disaster via creating a patient evacuation medical record cloud system in a 2016 Large-scale disaster drill. We requested Staging Care Unit (SCU) members to enter patient information by using a tablet. In SCUs that were outside the afflicted area, we browsed the electronic medical record on the cloud system and compared the time to send patient information using an electronic medical record in SCU to the time to send the same without using an electronic medical record and examined the superiority of the operation. In the statistical analysis, we used the Wilcoxon rank-sum test by MEPHAS. The significance level was set as P < 0.01. Based on the information for personnel damage estimation through SIP4D, the damage estimates are compiled for each prefecture, secondary medical zone, municipality, and school district. Additionally, it is possible to compile the number of predictive and serious patients per disaster hospital and to display it as a WEB service via the geographic information system (GIS). The information in the headquarters for disaster control is shared and visualized on the map, and thus, it is possible to use common information in each section. Furthermore, hospital damage situation, DMAT dispatch conditions, access route, and safety can also be visualized on the map. With respect to the usefulness of introducing an electronic health record at the time of a disaster, the median time to transfer medical information corresponded to 23.5 min in the group that used electronic health records (8 cases) and 41 min in the group that did not use electronic health records (8 cases). The results indicated a significantly shortened time in the group that used the electronic health record (P = 0.0073). It is ideal to estimate the number of patients and hospital damage from information that can grasp the scale of the disaster, such as intensity of an earthquake, set up appropriate headquarters, calculate the required number of DMATs, and instantaneously determine dispatch means and safety routes accordingly. Furthermore, patient information is digitalized from the point of triage, linked to the medical chart for disaster, managed collectively, and entered into the cloud. It is desirable to share patient information across the country. Based on the medical needs predicted from the information, it is also desirable to calculate the appropriate destination and means of transporting the patient in line with the actual damage situation such as infrastructure and road information. Another goal involves building a system that can calculate the aforementioned measures by using artificial intelligence. SIP4D is recognized as useful in terms of the integration and sharing of disaster information, damage situation, and hazard information gathering. It is assumed that SIP4D will lead to a major change in the existing DMAT operation regime. Additionally, the creation of an electronic medical record at the time of disaster and sharing it on the cloud system decreases the time of handover of a patient’s medical information when medical evacuation to a remote place occurs. It is expected that this can aid in improving the efficiency of the medical support team, and thereby, reduce preventable disaster deaths.

Māori Research(er) in Three Poems

2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd
Keyword(s):  
Palliative Care ◽  
Health Literacy ◽  
Cultural Identity ◽  
Focus Groups ◽  
Health Professionals ◽  
Bell Hooks ◽  
Face To Face ◽  
The Third ◽  
Ruth Behar ◽  
Seeking Help

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.

Improving Access to Integrated Behavioral Health in a Nurse-Led Federally Qualified Health Center

2021 ◽  
pp. 107839032199416
Author(s):  
Sarah Stalder ◽  
Aimee Techau ◽  
Jenny Hamilton ◽  
Carlo Caballero ◽  
Mary Weber ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Behavioral Health ◽  
Behavioral Health Care ◽  
Primary Care Providers ◽  
Care Team ◽  
Psychiatric Nurse ◽  
Care Providers ◽  
Team Members ◽  
Task Forces

BACKGROUND: The specific aims of this project were to create a fully integrated, nurse-led model of a psychiatric nurse practitioner and behavioral health care team within primary care to facilitate (1) patients receiving an appropriate level of care and (2) care team members performing at the top of their scope of practice. METHOD: The guiding model for process implementation was Rapid Cycle Quality Improvement. Three task forces were established to develop interventions in the areas of Roles and Responsibilities, Training and Implementation, and the electronic health record. INTERVENTION: The four interventions that emerged from these task forces were (1) the establishment of patient tiers based on diagnosis, medications, and risk assessment; (2) the creation of process maps to engage care team members; (3) just-in-time education regarding psychiatric medication management for primary care providers; and (4) use of a registry to track patients. RESULTS: The process measures of referrals to the psychiatric care team and psychiatric assessment intakes performed as expected. Both measures were higher at the onset of the project and lower 1 year later. The outcome indicator, number of case reviews, increased dramatically over time. CONCLUSIONS: For psychiatric nurse practitioners, this quality improvement effort provides evidence that a consultative role can be effective in supporting primary care providers. Through providing education, establishing patient tiers, and establishing an effective workflow, more patients may have access to psychiatric services.

scholarly journals Using NLP in openEHR archetypes retrieval to promote interoperability: a feasibility study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Sun ◽  
Fei Zhang ◽  
Jing Li ◽  
Yicheng Yang ◽  
Xiaolin Diao ◽  
...  
Keyword(s):  
Information Sharing ◽  
Language Processing ◽  
Medical Information ◽  
Medical Professional ◽  
Semantic Interoperability ◽  
Medical Information System ◽  
Search Term ◽  
Search Terms ◽  
Novel Approach ◽  
Test Sets

Abstract Background With the development and application of medical information system, semantic interoperability is essential for accurate and advanced health-related computing and electronic health record (EHR) information sharing. The openEHR approach can improve semantic interoperability. One key improvement of openEHR is that it allows for the use of existing archetypes. The crucial problem is how to improve the precision and resolve ambiguity in the archetype retrieval. Method Based on the query expansion technology and Word2Vec model in Nature Language Processing (NLP), we propose to find synonyms as substitutes for original search terms in archetype retrieval. Test sets in different medical professional level are used to verify the feasibility. Result Applying the approach to each original search term (n = 120) in test sets, a total of 69,348 substitutes were constructed. Precision at 5 (P@5) was improved by 0.767, on average. For the best result, the P@5 was up to 0.975. Conclusions We introduce a novel approach that using NLP technology and corpus to find synonyms as substitutes for original search terms. Compared to simply mapping the element contained in openEHR to an external dictionary, this approach could greatly improve precision and resolve ambiguity in retrieval tasks. This is helpful to promote the application of openEHR and advance EHR information sharing.

scholarly journals Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework

2021 ◽  
pp. bmjqs-2020-012479
Author(s):  
Alyssa M Pandolfo ◽  
Robert Horne ◽  
Yogini Jani ◽  
Tom W Reader ◽  
Natalie Bidad ◽  
...  
Keyword(s):  
Focus Groups ◽  
Antibiotic Prescribing ◽  
Negative Consequences ◽  
Out Of Hours ◽  
Team Members ◽  
Clinical Vignettes ◽  
Molecular Microbiology ◽  
Semistructured Interviews ◽  
Decision Making Processes ◽  
The Individual

BackgroundAntibiotics are extensively prescribed in intensive care units (ICUs), yet little is known about how antibiotic-related decisions are made in this setting. We explored how beliefs, perceptions and contextual factors influenced ICU clinicians’ antibiotic prescribing.MethodsWe conducted 4 focus groups and 34 semistructured interviews with clinicians involved in antibiotic prescribing in four English ICUs. Focus groups explored factors influencing prescribing, whereas interviews examined decision-making processes using two clinical vignettes. Data were analysed using thematic analysis, applying the Necessity Concerns Framework.ResultsClinicians’ antibiotic decisions were influenced by their judgement of the necessity for prescribing/not prescribing, relative to their concerns about potential adverse consequences. Antibiotic necessity perceptions were strongly influenced by beliefs that antibiotics would protect patients from deterioration and themselves from the ethical and legal consequences of undertreatment. Clinicians also reported concerns about prescribing antibiotics. These generally centred on antimicrobial resistance; however, protecting the individual patient was prioritised over these societal concerns. Few participants identified antibiotic toxicity concerns as a key influencer. Clinical uncertainty often complicated balancing antibiotic necessity against concerns. Decisions to start or continue antibiotics often represented ‘erring on the side of caution’ as a protective response in uncertainty. This approach was reinforced by previous experiences of negative consequences (‘being burnt’) which motivated prescribing ‘just in case’ of an infection. Prescribing decisions were also context-dependent, exemplified by a lower perceived threshold to prescribe antibiotics out-of-hours, input from external team members and local prescribing norms.ConclusionEfforts to improve antibiotic stewardship should consider clinicians’ desire to protect with a prescription. Rapid molecular microbiology, with appropriate communication, may diminish clinicians’ fears of not prescribing or of using narrower-spectrum antibiotics.

How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals

2021 ◽  
pp. 026921632110265
Author(s):  
Hannah Seipp ◽  
Jörg Haasenritter ◽  
Michaela Hach ◽  
Dorothée Becker ◽  
Lisa-R Ulrich ◽  
...  
Keyword(s):  
Home Care ◽  
Focus Groups ◽  
Health Professionals ◽  
Care Delivery ◽  
Death And Dying ◽  
Theory Approach ◽  
Palliative Home Care ◽  
Palliative Care Teams ◽  
Key Issues

Background: Specialised palliative home-care supports patients with life-limiting diseases in their familiar surroundings. The number of palliative care teams and patients being cared for is increasing worldwide. To assess and improve quality, it is needed to understand, how specialised palliative home-care can be provided successfully. For this purpose we examined the views of all involved stakeholders. Aim: To identify the issues that patients, their relatives and involved health professionals view as important in ensuring the success of specialised palliative home-care. Design: We used a qualitative design based on participant observations, interviews and focus groups following the principles of a Grounded Theory approach. Setting/participants: All specialised palliative home-care teams ( n = 22) caring for adults in Hesse, Germany, participated. We conducted participant observations ( n = 5), and interviewed patients ( n = 14), relatives ( n = 14) and health professionals working in or collaborating with specialised palliative home-care ( n = 30). We also conducted focus groups ( n = 4) with health professionals including a member check. Results: Successful specialised palliative home-care needs to treat complex symptoms, and provide comprehensive care including organisation of care, involving relatives and addressing issues of death and dying. Sense of security for patients and relatives is key to enable care at home. Care delivery preferences include a focus on the quality of relationships, respect for individuality and the facilitation of self-determination. Conclusions: Consideration of the identified key issues can help to ensure successful specialised palliative home-care. Knowledge of these should also be considered when researching and assessing quality of care. Trial registration: German Clinical Trials Register DRKS-ID: DRKS00012421; http://www.germanctr.de .

scholarly journals The concept of health in older age: views of older people and health professionals

2007 ◽  
Vol 31 (4) ◽  
pp. 642 ◽  
Author(s):  
Melita J Giummarra ◽  
Betty Haralambous ◽  
Kirsten Moore ◽  
Joan Nankervis
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Health Professionals ◽  
Social Connectedness ◽  
Older Age ◽  
Concept Of Health ◽  
Concepts Of Health ◽  
Health Promoting ◽  
Barriers And Motivators ◽  
Holistic Manner

This study aimed to explore how older people and health professionals conceptualise health in older age. Thirty-six older people and 41 health professionals participated in 10 focus groups (five with older people and five with health professionals) and discussed concepts of health, the modifiable aspects of health, and barriers and motivators to undertaking health-promoting behaviour change. Both older people and health professionals were found to conceptualise health in a holistic manner. While health professionals tended to place the source of poor health on failures of social connectedness and poor service delivery, older people stressed the importance of taking ownership of one?s own health and actively seeking out health promoting activities and services.

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