Prescribing an App? Oncology Providers’ Views on Mobile Health Apps for Cancer Care

2017 ◽  
pp. 1-7 ◽  
Author(s):  
Callie M. Berkowitz ◽  
Leah L. Zullig ◽  
Bridget F. Koontz ◽  
Sophia K. Smith
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Mobile Health ◽  
Cancer Care ◽  
Structured Interview ◽  
Mobile App ◽  
Care Providers ◽  
Supportive Services ◽  
Wide Range ◽  
Oncology Providers

Introduction Although there are over 500 mobile health (mHealth) applications (apps) available for download in the field of oncology, little research has addressed their acceptability among health care providers. In addition, the providers’ perspectives regarding patient app use has been largely unexamined. We conducted a qualitative study to explore opportunities and barriers for mHealth app use for oncology care. Methods We developed a structured interview guide focusing on acceptability, appropriateness, feasibility, and sustainability of the use of apps in cancer care. We interviewed 15 oncology providers about their attitudes and preferences. De-identified audio recordings were transcribed and coded for emerging themes. Results Providers interviewed included physicians (n = 8) and advanced practice (n = 3) and supportive services (n = 4) providers who care for a wide range of cancer types; ages ranged from 32 to 68 years. Interviews lasted approximately 30 minutes. Oncology providers reported limited exposure to mHealth apps in patient care, but were generally open to recommending or prescribing apps in the future. Key themes included opportunities for mobile app use (including general health promotion, tracking symptoms, and engaging patients) and barriers to implementation (including access to technology, responsibility, workflow, and the source of the app itself). Conclusion Our results show openness among oncology providers to using mHealth technology as part of patient care, but concerns regarding implementation. Designing acceptable apps may be challenging and require involvement of key stakeholders, partnering with trustworthy institutions, and outcome-based research.

scholarly journals Brazil’s Community Health Workers Practicing Narrative Medicine: Patients’ Perspectives

2021 ◽  
Author(s):  
Rogério Meireles Pinto ◽  
Rahbel Rahman ◽  
Margareth Santos Zanchetta ◽  
W. Galhego-Garcia
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Health Workers ◽  
Hybrid Approach ◽  
Narrative Medicine ◽  
Structured Interview ◽  
Patient Perspectives ◽  
Care Providers

Abstract Background Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. Objective To document how CHWs apply specific NM concepts in Brazil’s Family Health Strategy (FHS), the key component of Brazil’s Unified Health System. Design We used a semi-structured interview, grounded in Charon’s (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. Key Results Sample: 18 females; 13 White, 12 “Pardo” (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. Conclusion This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence their ability to apply NM.

The Registered Dietitian in Primary Care: The Hamilton Experience

2007 ◽  
Vol 68 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Wendy Gamblen ◽  
Sherri Schamehorn ◽  
Anne Marie Crustolo ◽  
Tracy Hussey ◽  
Nick Kates ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Interdisciplinary Collaboration ◽  
Community Services ◽  
Care Providers ◽  
Clinical Role ◽  
Nutrition Services ◽  
Wide Range ◽  
Canadian Health ◽  
Shared Care Model

The Hamilton Health Service Organization Nutrition Program integrates nine registered dietitians (RDs) into the offices of 80 family physicians (FPs) at 50 sites in Hamilton, Ontario. The program is based on a shared care model, in which FPs and RDs work collaboratively to provide nutrition services aimed at prevention, treatment, and management of nutrition-related problems. In addition to their clinical role, dietitians in the program are involved in health promotion, disease prevention and early intervention strategies, interdisciplinary collaboration, building links with community services, and research. The RDs’ specialized knowledge, skills, and experience allow them to provide a wide range of services that complement and augment those of the FP. This model is consistent with Canadian health care reform recommendations and offers significant benefits for both health care providers and consumers.

scholarly journals Mobile Apps for Drug–Drug Interaction Checks in Chinese App Stores: Systematic Review and Content Analysis (Preprint)

2020 ◽  
Author(s):  
Chunying Shen ◽  
Bin Jiang ◽  
Qilian Yang ◽  
Chengnan Wang ◽  
Kevin Z Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Arithmetic Mean ◽  
Mobile App ◽  
Average Score ◽  
Care Providers ◽  
Rating Score ◽  
Average Rating ◽  
Mhealth Apps

BACKGROUND As a computerized drug–drug interaction (DDI) alert system has not been widely implemented in China, health care providers are relying on mobile health (mHealth) apps as references for checking drug information, including DDIs. OBJECTIVE The main objective of this study was to evaluate the quality and content of mHealth apps supporting DDI checking in Chinese app stores. METHODS A systematic review was carried out in November 2020 to identify mHealth apps providing DDI checking in both Chinese iOS and Android platforms. We extracted the apps’ general information (including the developer, operating system, costs, release date, size, number of downloads, and average rating), scientific or clinical basis, and accountability, based on a multidimensional framework for evaluation of apps. The quality of mHealth apps was evaluated by using the Mobile App Rating Scale (MARS). Descriptive statistics, including numbers and percentages, were calculated to describe the characteristics of the apps. For each app selected for evaluation, the section-specific MARS scores were calculated by taking the arithmetic mean, while the overall MARS score was described as the arithmetic mean of the section scores. In addition, the Cohen kappa (κ) statistic was used to evaluate the interrater agreement. RESULTS A total of 7 apps met the selection criteria, and only 3 included citations. The average rating score for Android apps was 3.5, with a minimum of 1.0 and a maximum of 4.9, while the average rating score for iOS apps was 4.7, with a minimum of 4.2 and a maximum of 4.9. The mean MARS score was 3.69 out of 5 (95% CI 3.34-4.04), with the lowest score of 1.96 for Medication Guidelines and the highest score of 4.27 for MCDEX mobile. The greatest variation was observed in the information section, which ranged from 1.41 to 4.60. The functionality section showed the highest mean score of 4.05 (95% CI 3.71-4.40), whereas the engagement section resulted in the lowest average score of 3.16 (95% CI 2.81-3.51). For the information quality section, which was the focus of this analysis, the average score was 3.42, with the MCDEX mobile app having the highest score of 4.6 and the Medication Guidelines app having the lowest score of 1.9. For the overall MARS score, the Cohen interrater κ was 0.354 (95% CI 0.236-0.473), the Fleiss κ was 0.353 (95% CI, 0.234-0.472), and the Krippendorff α was 0.356 (95% CI 0.237-0.475). CONCLUSIONS This study systematically reviewed the mHealth apps in China with a DDI check feature. The majority of investigated apps demonstrated high quality with accurate and comprehensive information on DDIs. However, a few of the apps that had a massive number of downloads in the Chinese market provided incorrect information. Given these apps might be used by health care providers for checking potential DDIs, this creates a substantial threat to patient safety.

scholarly journals Examining the role of MEDLINE as a patient care information resource: an analysis of data from the Value of Libraries study

2017 ◽  
Vol 105 (4) ◽  
Author(s):  
Kathel Dunn ◽  
Joanne Gard Marshall ◽  
Amber L. Wells ◽  
Joyce E. B. Backus
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Patient Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Resources ◽  
Information Resource ◽  
Care Providers ◽  
Other Information

Objective: This study analyzed data from a study on the value of libraries to understand the specific role that the MEDLINE database plays in relation to other information resources that are available to health care providers and its role in positively impacting patient care.Methods: A previous study on the use of health information resources for patient care obtained 16,122 responses from health care providers in 56 hospitals about how providers make decisions affecting patient care and the role of information resources in that process. Respondents indicated resources used in answering a specific clinical question from a list of 19 possible resources, including MEDLINE. Study data were examined using descriptive statistics and regression analysis to determine the number of information resources used and how they were used in combination with one another.Results: Health care professionals used 3.5 resources, on average, to aid in patient care. The 2 most frequently used resources were journals (print and online) and the MEDLINE database. Using a higher number of information resources was significantly associated with a higher probability of making changes to patient care and avoiding adverse events. MEDLINE was the most likely to be among consulted resources compared to any other information resource other than journals.Conclusions: MEDLINE is a critical clinical care tool that health care professionals use to avoid adverse events, make changes to patient care, and answer clinical questions.

Breaking bad news in the oncologic population: Residents' perspective.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24113-e24113
Author(s):  
Vihitha Thota ◽  
Mahati Paravathaneni ◽  
Sudheer Konduru ◽  
Bohdan Baralo ◽  
Sana Mulla ◽  
...  
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Confidence Level ◽  
Statistical Significance ◽  
Further Education ◽  
Bad News ◽  
Care Providers ◽  
Prior Training ◽  
Oncologic Patients ◽  
Delivering Bad News

e24113 Background: Delivering bad news to patients is a delicate but required skill for doctors as part of patient care. There has been evidence that good communication from health care providers can improve patients' compliance to treatment as well as be beneficial emotionally. While many studies have been done in regards to patients' perceptions of receiving bad news, there are limited studies looking at a physicians' perspective, and even more so concerning residents' perceptions. In community hospitals, many patients are diagnosed with cancer, and resident physicians are often responsible for informing the patients and their families regarding the diagnosis. The manner in which the news is delivered is important, however it is unclear how much training is provided to residents before they are required to break bad news to patients. The lack of training can often result in improper delivery and poor patient care. Methods: We surveyed Internal Medicine and General Surgery residents at Mercy Catholic Medical Center, a conglomeration of two community teaching hospitals in Philadelphia, about prior training, confidence level, attitudes, and need for further education on delivering bad news to oncologic patients using a survey created after extensive research. The factors associated with confidence level were analyzed using paired T-test and ANOVA methods. Results: A total of 65 residents (72%) participated. No statistical significance was seen between American versus foreign medical graduates, MD vs. DO residents, or among those in different specialties when assessing their confidence in delivering bad news. Though only 62% of participants reported having had prior training in delivering bad news, residents with previous training (p1) or who have had to deliver bad news previously (p2) reported higher confidence when it came to delivering a new diagnosis of cancer (p1 0.03, p2 0.001), delivering news regarding the progression of cancer (p1 0.03, p2 0.02), delivering news regarding the recurrence of cancer (p1 0.04, p2 0.002), and delivering news regarding end-stage cancer with little to no treatment options left (p1 0.04, p2 0.003). 100% of participants thought communicating bad news is an important skill for a physician, and 92% of participants thought further education would help prepare them for similar scenarios in the future. Simulated patient scenarios (64%), grand rounds lectures/presentations (59%), and feedback from faculty after actual patient scenarios (57%) were the most requested whereas pamphlets/brochures (17%) and online training courses (20%) were less popular. Conclusions: Our study highlights the importance of prior training or exposure among residents in being able to deliver bad news to patients effectively. We propose that implementing further training in the form of simulated scenarios and lectures can improve residents' confidence at delivering bad news and result in a better physician-patient relationship.

scholarly journals Building an oncology community of practice to improve cancer care

2018 ◽  
Vol 25 (6) ◽  
Author(s):  
W. Fingrut ◽  
L. A. Beck ◽  
D. Lo
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cancer Care ◽  
Care Providers ◽  
Care Services ◽  
Standards Of Practice ◽  
Barriers To Access ◽  
Multidisciplinary Meetings ◽  
Knowledge Of Cancer ◽  
Effective Models

Background Communities of practice (cops) have been shown to be effective models for achieving quality outcomes in health care.Objective Here, we describe the application of the cop model to the Canadian oncology context.Methods We established an oncology cop at our urban community hospital and its networks. Goals were to decrease barriers to access, foster collaboration, and improve knowledge of guidelines in cancer care. We hosted 6 in-person multidisciplinary meetings, focusing on screening, diagnosis, and management of common solid tumours. Health care providers affiliated with our hospital were invited to attend and to complete post-meeting surveys. Likert scales assessed whether cop goals were realized.Results Meetings attracted a mean of 57 attendees (range: 48–65 attendees), with a mean of 84% completing the surveys and consenting to the analysis. Attendees included family physicians (mean: 41%), specialist physicians (mean: 24%), nurses (mean: 10%), and allied health care providers (mean: 22%). Repeat attendance increased during the series, with 85% of attendees at the final meeting having attended 1 or more prior meetings. Across the series, most participants agreed or strongly agreed that the cop reduced barriers (mean: 76.0% ± 7.9%) and improved access to cancer care services (mean: 82.4% ± 8.1%) and subject matter experts (mean: 91.7% ± 4.2%); fostered teamwork (mean: 84.5% ± 6.8%) and a culture of collaboration (mean: 94.8% ± 4.2%); improved knowledge of cancer care services (mean: 93.3% ± 4.8%), standards of practice (mean: 92.3% ± 3.1%), and quality indicators (mean: 77.5% ± 6.3%); and improved cancer-related practice (mean: 88.8% ± 4.6%) and satisfaction in caring for cancer patients (mean: 82.9% ± 6.8%). Participant feedback carried a potential for bias.Conclusions We demonstrated the feasibility of oncology cops and found that participants perceived their value in reducing barriers to access, fostering collaboration, and improving knowledge of guidelines in cancer care.

Supporting Pediatric Patients and Their Families at the End of Life: Perspectives From Bereaved Parents

2020 ◽  
Vol 37 (12) ◽  
pp. 1009-1015
Author(s):  
Laura K. Sedig ◽  
Jessica L. Spruit ◽  
Trisha K. Paul ◽  
Melissa K. Cousino ◽  
Harlan McCaffery ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Health Care Providers ◽  
Life Experiences ◽  
The United States ◽  
Parental Perception ◽  
Care Providers ◽  
Supportive Services ◽  
Bereaved Parents ◽  
Actual Decision

Background: Cancer remains the leading cause of death by disease for children in the United States. It is imperative to optimize measures to support patients and families facing the end of a child’s life. This study asked bereaved parents to reflect on their child’s end-of-life care to identify which components of decision-making, supportive services, and communication were helpful, not helpful, or lacking. Methods: An anonymous survey about end-of-life experiences was sent to families of children treated at a single institution who died of a malignancy between 2010 and 2017. Results: Twenty-eight surveys were returned for a 30.8% response rate. Most of the bereaved parents (61%) reported a desire for shared decision-making; this was described by 52% of families at the end of their child’s life. There was a statistically significant association between how well death went and whether the parental perception of actual decision-making aligned with desired decision-making ( P = .002). Families did not utilize many of the supportive services that are available including psychology and psychiatry (only 22% used). Respondents felt that additional services would have been helpful. Conclusions: Health care providers should strive to participate in decision-making models that align with the preferences of the patient and family and provide excellent communication. Additional resources to support families following the death of a child should be identified for families or developed and funded if a gap in available services is identified.

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