Patient Digital Technologies to Support Primary Care across Disorders: Perspectives from Primary Care Providers, Behavioral Health Consultants, and Nurses (Preprint)

2021 ◽  
Author(s):  
Oleg Zaslavsky ◽  
Frances Chu ◽  
Brenna Renn
Keyword(s):  
Primary Care ◽  
Mobile Apps ◽  
Medication Management ◽  
Primary Care Providers ◽  
Health Conditions ◽  
Care Providers ◽  
Health Promoting Behaviors ◽  
Live Video ◽  
Health Promoting ◽  
Clinical Conditions

BACKGROUND Acceptance of digital health technologies among primary care providers and staff for various clinical conditions has not been explored. OBJECTIVE The purpose of this nationwide study was to determine differences between behavioral health consultants (BHCs), primary care providers (PCPs), and nurses in acceptance of mobile apps, wearables, live video, phone, email, instant chats, text messages, social media, and patient portals to support patient care across clinical conditions. METHODS We surveyed 51 BHCs, 52 PCPs, and 48 nurses embedded in primary care clinics across the United States. We asked respondents to mark technologies they consider appropriate to support patients in: acute and chronic disease, medication management, health-promoting behaviors, sleep, substance use, and common and serious mental health conditions. RESULTS Respondents were geographically dispersed across the nation, although most (82.9%) practiced in urban and suburban settings. Compared to other personnel, a higher proportion of BHCs endorsed live video. Similarly, a higher proportion of nurses endorsed all other technologies. PCPs had the lowest rates of endorsement across technologies. Within clinical contexts, the highest acceptance rates were 81% and 70% for BHCs and PCPs respectively in live video for common mental health conditions, and 75% for nurses in mobile apps for health-promoting behaviors. The lowest (9%) endorsement rate across providers was in social media for medication management. CONCLUSIONS The survey suggests subtle differences in the way clinicians envision using technologies to support patient care. Future work must attend to provider perceptions to ensure the sustainment of services across conditions and patient populations.

scholarly journals Primary Care Providers Believe That Comprehensive Medication Management Improves Their Work-Life

2019 ◽  
Vol 32 (4) ◽  
pp. 462-473 ◽  
Author(s):  
Kylee A. Funk ◽  
Deborah L. Pestka ◽  
Mary T. Roth McClurg ◽  
Jennifer K. Carroll ◽  
Todd D. Sorensen
Keyword(s):  
Primary Care ◽  
Medication Management ◽  
Primary Care Providers ◽  
Work Life ◽  
Care Providers

scholarly journals Primary Care Providers’ Acceptance of Pharmacists’ Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease

2019 ◽  
Vol 35 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Leah L. Zullig ◽  
Shelley A. Jazowski ◽  
Clemontina A. Davenport ◽  
Clarissa J. Diamantidis ◽  
Megan M. Oakes ◽  
...  
Keyword(s):  
Primary Care ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Medication Management ◽  
Primary Care Providers ◽  
Care Providers ◽  
Diabetic Kidney

scholarly journals Opportunities and Barriers to Medication Safety in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 611-612
Author(s):  
Fatoumata Jallow ◽  
Elisa Stehling ◽  
Zara Sajwani ◽  
Kathryn Daniel ◽  
Yan Xiao
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medication Safety ◽  
Medication Management ◽  
Primary Care Providers ◽  
Vulnerable Population ◽  
Community Dwelling ◽  
Care Providers ◽  
Essential Information ◽  
Barriers And Enablers

Abstract Community-dwelling multi-morbid older adults are a vulnerable population for medication safety-related threats. We interviewed a sample of these older adults recruited from local retirement communities and from primary care practices to learn their perceptions of barriers and enablers for their medication safety. The present study is part of the Partnership in Resilience for Medication Safety (PROMIS) study. One of the aims of this project is to identify barriers and opportunities to improve older adults' medication safety. These interviews were conducted during COVID-19 pandemic conditions. Results from this qualitative study suggest that trust between these older adults and their healthcare providers is an essential component of medication safety. Overarching themes include disruptions in medication management, caregivers caring for each other, patient safety practices or habits, and medication management literacy. Participants also shared strain due to lack of skills to navigate telemedicine visits, trust in Primary Care Providers (PCPs) and pharmacists to prescribe and dispense safely for them, reliance on PCPs and pharmacists to give essential information about medications without having to be asked. Our interviews illustrated large variations in older adults’ perceived role in medication safety, with some developing expertise in understanding how medications work for them and how long-term medications should be periodically reviewed. The types of information needs and supports from PCPs were likely different. Understanding these barriers and enablers for safe medication management can help us develop medication safety improvements for this vulnerable population.

Beyond Hospital Discharge Mechanics: Managing the Discharge Paradox and Bridging the Care Chasm

2016 ◽  
Vol 27 (8) ◽  
pp. 1225-1235 ◽  
Author(s):  
Heather E. Canary ◽  
Victoria Wilkins
Keyword(s):  
Primary Care ◽  
Hospital Discharge ◽  
Primary Care Providers ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Discharge Process ◽  
Care Providers ◽  
Pediatric Hospital ◽  
Process Improvements ◽  
Analyze Data

Hospital discharge processes are complex and confusing, and can detrimentally affect patients, families, and providers. This qualitative study investigated pediatric hospital discharge experiences from the perspectives of parents of children with acute and chronic health conditions, primary care providers, and hospitalists. Focus groups and interviews with parents, primary care providers, and hospitalists were used to explore discharge experiences and ideas for improvement offered by participants. Using an iterative approach to analyze data resulted in five major themes for discharge experiences: (a) discharge problems, (b) teamwork, (c) ideal discharge, (d) care chasm, and (e) discharge paradox. The first three themes concern practical issues, whereas the last two themes reflect negative emotional experiences as well as practical problems encountered in the discharge process. Improvements in communication were viewed as a primary strategy for improving the discharge process for better outcomes for patients, their families, and providers.

Integrated Health Care

2017 ◽  
Author(s):  
Jason Cheng ◽  
Jeanie Tse
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mental Illness ◽  
Physical Health ◽  
Behavioral Health ◽  
Primary Care Providers ◽  
Health Conditions ◽  
Health Staff ◽  
Care Providers ◽  
Care Experience

People with serious mental illness often receive inadequate care for physical health conditions. This chapter illustrates ways in which psychiatrists can play a key role in managing the physical health of an individual by communicating with primary care providers, educating behavioral health staff about disease management, and expanding the scope of practice to include screening for and managing metabolic conditions. This role is particularly important for the numerous individuals with mental illness who are not well engaged with primary care. For these people, therapeutic approaches such as motivational enhancement and trauma-informed care can support self-management of physical health conditions. Co-location and integration of primary care and behavioral health services can address barriers to accessing care. Although integration poses certain challenges, it has the potential to achieve the triple aim of improving the health care experience, improving population health, and reducing health care costs.

scholarly journals Development of a Telehealth-Coordinated Intervention to Improve Access to Community-Based Mental Health

2018 ◽  
Vol 28 (Supp) ◽  
pp. 457-466 ◽  
Author(s):  
Sandra Contreras ◽  
Lorena Porras-Javier ◽  
Bonnie T. Zima ◽  
Neelkamal Soares ◽  
Christine Park ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Los Angeles ◽  
Qualitative Interviews ◽  
Medication Management ◽  
Primary Care Providers ◽  
Care Process ◽  
Care Providers ◽  
Community Mental Health Clinics ◽  
Transition Points

Objective: To develop an intervention to improve the mental health referral and care process for children referred by primary care providers (PCPs) to community mental health clinics (MHCs) using a community partnered approach.Design: A Project Working Group (PWG) with representatives from each partner orga­nization met monthly for 6 months.Setting: Multi-site federally qualified health center (FQHC) and two community MHCs in Los Angeles county.Participants: 26 stakeholders (14 FQHC clinic providers/staff, 8 MHC providers/staff, 4 parents) comprised the PWG.Data Sources: Qualitative interviews, PWG meeting notes, intervention processes and workflow reports.Intervention: The PWG reviewed qualita­tive data from stakeholders (interviews of 7 parents and 13 providers/staff). The PWG met monthly to identify key transition points where access to and coordination of care were likely compromised and to develop solutions.Results: Three critical transition points and system solutions were identified: 1) Parents refuse initial referral to the MHC due to stigma regarding mental health services. Solution: During initial referral, parents watch a video introducing them to the MHC. 2) Parents don’t complete the MHC’s screening after referral. Solution: A live videoconference session connecting parents at the FQHC with MHC staff ensures completion of the screening and eligibility process. 3) PCPs reject transfer of patients back to primary care for ongoing psycho­tropic medication management. Solution: Regularly scheduled live videoconferences connect PCPs and MHC providers.Conclusions: A community partnered ap­proach to care design utilizing telehealth for care coordination between clinics can potentially be used to address key chal­lenges in MHC access for children.Ethn Dis. 2018;28(Suppl 2):457-466; doi:10.18865/ed.28.S2.457.

scholarly journals Role of club doctors in the mental health management of Australian rules football players: a Delphi study

2021 ◽  
pp. bjsports-2021-104388
Author(s):  
Ben Weber ◽  
Jason Bos ◽  
Elizabeth Mary Clancy ◽  
Ranjit Menon ◽  
Tom Cross ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Delphi Study ◽  
Mental Health Problems ◽  
Health Management ◽  
Primary Care Providers ◽  
Health Conditions ◽  
Limited Information ◽  
Care Providers ◽  
Mental Health Conditions

Professional team athletes experience a range of mental health problems, both sports and non-sports related. However, there is limited information available for those charged with responsibility for managing these mental health conditions, particularly within the context of professional sporting clubs. This paper reports on consensus findings from a study of club doctors, who are primary care providers for professional team athletes within a specific code, the Australian Football League (AFL). Drawing on findings from a systematic literature search, a two-round Delphi procedure was used to develop a consensus on best practice for managing mental health conditions for club doctors as primary care providers for professional team athletes. Participants in this study were current and former club doctors employed in professional AFL clubs across Australia, with 28 doctors participating across two survey rounds. Overall, 77 statements were presented, with 50 endorsed as essential or important by ≥ 80% of the participants across the two rounds. Primary themes across nine domains include: (1) Prevention and Mental Health Promotion Activities; (2) Screening; (3) Engaging External Specialists; (4) Duty of Care; (5) Treatment: Assessment, Treatment and Case Coordination; (6) Communication; (7) Confidentiality; (8) Sleep Management and (9) Substance Use Management. This study is the first to offer club doctors working in professional team settings consensus guidelines for the management of mental health conditions, and the opportunity for greater clarification and consistency in role delivery.

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