scholarly journals Understanding the use of patient-reported data by health care insurers: A scoping review

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244546
Author(s):  
Anne Neubert ◽  
Óscar Brito Fernandes ◽  
Armin Lucevic ◽  
Milena Pavlova ◽  
László Gulácsi ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Scoping Review ◽  
Business Models ◽  
Grey Literature ◽  
Process Indicators ◽  
Patient Reported ◽  
Reported Data ◽  
And Function ◽  
Health Insurers

Background Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to explore how collected patient-reported data are utilized; and to elucidate the motives of why patient-reported data are collected by health insurers. Methods The study design is that of a scoping review. In total, 11 databases were searched on. Relevant grey literature was identified through online searches, reference mining and recommendations from experts. Forty-two documents were included. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-outcome approach; we also mapped the use and function of those data by a health insurer. Results Health insurers use patient-reported data for assurance and improvement of quality of care and value-based health care. The patient-reported data most often collected are those of outcomes, experiences and satisfaction measures; structure indicators are used to a lesser extent and often combined with process indicators. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people. Conclusions The breadth to which insurers use patient-reported data in their business models varies greatly. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insurer’s business. Health insurers are advised to be more explicit in regard to the role they want to play within the health system and society at large, and accommodate implications for the use of patient-reported data accordingly.

scholarly journals Pervasiveness of Communication Disorders and Fatigue in Stroke Patients: A Systematic Scoping Review

2021 ◽  
Author(s):  
Ellyn Riley ◽  
Emily Hart ◽  
Jonathan Preston ◽  
Ying Wu ◽  
Sameer Ashaie
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Communication Disorders ◽  
Communication Disorder ◽  
Real Patient ◽  
Eligibility Criteria ◽  
Post Stroke ◽  
Report Data ◽  
Reported Data ◽  
And Function

After a stroke, it is highly likely that an individual will experience substantial fatigue that can significantly affect recovery and function; stroke survivors also have more than a 50% chance of having at least one communication disorder. Current reviews of post-stroke fatigue have not provided evidence focused on communication disorders or the potential influence they may have on post-stroke fatigue and related recovery. The aim of this review was to determine how communication disorders are represented in post-stroke fatigue research and to catalogue methods used to identify communication disorders and measure fatigue. A systematic scoping review was conducted to identify studies measuring post-stroke fatigue. To identify these studies, a comprehensive literature search was conducted using relevant databases and grey literature sources, followed by several stages of review that adhered to PRISMA guidelines. We evaluated these studies using pre-established eligibility criteria and extracted data regarding the inclusion/exclusion of persons with communication disorders and the assessment methods used. The scoping review analysis was conducted on 161 studies. Of these, 41 (26%) excluded all communication disorders, 71 (44%) excluded severe communication disorders, and 49 (30%) included participants with communication disorders. Of the 120 studies that did not explicitly exclude all communication disorders, only 34 were confirmed to report data from at least one person with a communication disorder. Further, only 5 studies reported data that could be used to determine a relationship between these co-morbidities. Persons with communication disorders are underrepresented in post-stroke fatigue research and very few studies have examined the relationship between post-stroke fatigue and communication disorders, limiting conclusions that can be drawn. This is problematic because medical professionals relying on this evidence to guide clinical practice are likely to be treating individuals with co-occurring fatigue and communication disorders and the current research does not provide enough information about the potential impact of fatigue on communication disorders or vice versa. To bridge this gap, we suggest methods of assessment that could provide ways to more accurately 1) reflect the real patient population in post-stroke fatigue studies, and 2) measure and document fatigue in post-stroke communication disorder studies.

scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M. Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

Interventions for Improving Health Care Workers’ Retention in Epidemics – a Scoping Review

2021 ◽  
Author(s):  
Zahra Zarei Jelyani ◽  
Sadra Valiee ◽  
Mohammad Kia ◽  
Ali jajarmizadeh ◽  
Sajad Delavari
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Health System ◽  
Human Health ◽  
Scoping Review ◽  
Health Care Workers ◽  
Health Resources ◽  
The United States ◽  
Human Beings ◽  
Care Workers

Abstract Introduction: Generally, in Epidemics, such as COVID-19, health care workers (HCWs) faces many problems which lead to a shortage and weakening of human resources in the health system. Therefore, using effective strategies to retain human resources is one of the most important issues during outbreaks. This study aims to collect and classify the proposed interventions to strengthen human health resources and their sustainability during epidemics through scoping review.Methods: In this scoping review study, 2300 studies were retrieved through searching international databases –PubMed, Embase, Scopus and Web of Science. The retrieved studies were screened, and finally, 50 studies were included for analysis. The strategies were classified using inductive qualitative content analysis.Results: Most of the studies were conducted in the United States and the United Kingdom. The target population in 39 studies was all health workers; five studies were on physicians, five studies on nurses, and only one study on dentists. The proposed interventions were classified into five categories: preparation, protection, support, treatment, and feedback. Discussion: Most studies focused on providing interventions in one or two dimensions of human resources, but these interventions were summarized and categorized in this review. Therefore, this study has a holistic view of various dimensions of strengthening and maintaining human health resources during epidemics by providing a thematic map. Considering that human beings are multidimensional, policymakers and managers of the health system should use a set of interventions that simultaneously cover different aspects of their needs to strengthen and maintain HCWs.

scholarly journals Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Protocol for a Scoping Review

10.2196/19072 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e19072
Author(s):  
Susanne Grødem Johnson ◽  
Thomas Potrebny ◽  
Lillebeth Larun ◽  
Donna Ciliska ◽  
Nina Rydland Olsen
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Mobile Apps ◽  
Research Question ◽  
Grey Literature ◽  
Research Area ◽  
Research Field ◽  
Learning Technologies ◽  
Health Care Education ◽  
Care Education

Background E-learning technologies, including mobile apps, are used to a large extent in health care education. Mobile apps can provide extendable learning environments and motivate students for adaptive and collaborative learning outside the classroom context. Developers should design practical, effective, and easy-to-use mobile apps. Usability testing is an important part of app development in order to understand if apps meet the needs of users. Objective The aim of this study is to perform a scoping review of usability methods and attributes reported in usability studies of mobile apps for health care education. Methods The scoping review is guided by the methodological framework developed by Arksey & O’Malley and further developed by Levac et al and Kahlil et al. The stages we will follow are as follows: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; and (5) summarizing and reporting the results. We have developed two research questions to meet the aim of the study, which are as follows: (1) What usability methods are used to evaluate the usability of mobile apps for health care education? and (2) What usability attributes are reported in the usability studies of mobile apps for health care education? We will apply a comprehensive search of the literature, including 10 databases, a reference search, and a search for grey literature. Two review authors will independently screen articles for eligibility. Results The initial electronic database searches were completed in March 2019. The literature search identified 14,297 unique references. Following title and abstract screening, the full texts of 369 records were obtained. The scoping review is expected to be completed in spring 2021. Conclusions We expect the overview of usability methods and attributes reported in usability studies of mobile apps for health care education to contribute to the knowledge base for researchers and developers. It will give an overview of the research field and provide researchers and developers with relevant and important information on the usability research area, including highlighting possible research gaps. International Registered Report Identifier (IRRID) DERR1-10.2196/19072

scholarly journals An Analysis of the Learning Health System in Its First Decade in Practice: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Jodyn E Platt ◽  
Minakshi Raj ◽  
Matthias Wienroth
Keyword(s):  
Health Care ◽  
Health System ◽  
Thematic Analysis ◽  
Scoping Review ◽  
Rapid Learning ◽  
The Past ◽  
Learning From Data ◽  
Learning Health System ◽  
Over Time ◽  
Value Of Health

BACKGROUND In the past decade, Lynn Etheredge presented a vision for the Learning Health System (LHS) as an opportunity for increasing the value of health care via rapid learning from data and immediate translation to practice and policy. An LHS is defined in the literature as a system that seeks to continuously generate and apply evidence, innovation, quality, and value in health care. OBJECTIVE This review aimed to examine themes in the literature and rhetoric on the LHS in the past decade to understand efforts to realize the LHS in practice and to identify gaps and opportunities to continue to take the LHS forward. METHODS We conducted a thematic analysis in 2018 to analyze progress and opportunities over time as compared with the initial <i>Knowledge Gaps and Uncertainties</i> proposed in 2007. RESULTS We found that the literature on the LHS has increased over the past decade, with most articles focused on theory and implementation; articles have been increasingly concerned with policy. CONCLUSIONS There is a need for attention to understanding the ethical and social implications of the LHS and for exploring opportunities to ensure that these implications are salient in implementation, practice, and policy efforts.

scholarly journals Educational Resources and Curriculum on Lactation for Health Undergraduate Students: A Scoping Review

2020 ◽  
pp. 089033442098069
Author(s):  
Suzanne Hetzel Campbell ◽  
Nicole de Oliveira Bernardes ◽  
Thayanthini Tharmaratnam ◽  
Flaviana Vely Mendonça Vieira
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Scoping Review ◽  
Professional Education ◽  
Health Care Professionals ◽  
Grey Literature ◽  
Educational Resources ◽  
Inclusion Criteria ◽  
Breastfeeding Support ◽  
Support Skills

Background Breastfeeding is a fundamental component of health care, and health professionals need to be adequately prepared. As part of the system, health care professionals have the ability to influence the establishment and maintenance of breastfeeding. The global literature regarding the curricular approach or established best practices for health professional education in lactation is inconclusive and lacking in rigor. Research aim To explore the literature for the educational resources, methods, and curriculum used in the education of undergraduate health students related to lactation. Methods A scoping review examining the curricular programs of health professional students in lactation was undertaken exploring and summarizing evidence from peer reviewed and grey literature. A scoping review with a five-stage review process was followed. The database search between 1982–2018 generated 625 results, 79 full-text articles were reviewed, and 29 articles published in English met the inclusion criteria. Results In general, educational resources, methods, curricular approaches, and foundational topics were based on best practice standards. Some authors incorporated a variety of learning methods and provided experiential learning, with evidence of translation of knowledge into clinical practice. In the studies examined, researchers reported that students had improved their: knowledge and attitudes (59%); breastfeeding support skills (45%); and confidence (10%). However, even in programs that focused on developing students’ breastfeeding support skills, authors reported a lack of change in students’ confidence. Conclusions Although only English articles met the inclusion criteria, this review was unique in its search of multidisciplinary, multilingual, and international studies. Consistency in teaching across disciplines is key and not evident in the studies reviewed.

The Use of Palliative Sedation to Treat Existential Suffering: A Scoping Review on Practices, Ethical Considerations, and Guidelines

2019 ◽  
Vol 35 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Allysa L. Ciancio ◽  
Raza M. Mirza ◽  
Amy A. Ciancio ◽  
Christopher A. Klinger
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Research Policy ◽  
Grey Literature ◽  
Palliative Sedation ◽  
Ethical Considerations ◽  
Policy And Practice ◽  
Refractory Symptoms ◽  
Existential Suffering ◽  
The Impact

Context: Though palliative sedation has been recognized as an acceptable practice in Canada for many years now, there is a lack of clinical research and guidelines pertaining to its use as a treatment of existential refractory symptoms in the terminally ill. Objectives: This scoping review aimed to survey the literature surrounding palliative sedation and existential suffering and to inform research, policy, and practice. Methods: To address the main research question: Is palliative sedation an acceptable intervention to treat existential refractory symptoms in adults aged 65 and older? a scoping review following Arksey and O’Malley’s framework was performed, spanning electronic databases of the peer reviewed and grey literature. Articles were screened for inclusion, and a thematic content analysis allowed for a summary of key findings. Results: Out of 427 search results, 71 full text articles were obtained, 20 of which were included. Out of these articles, four themes were identified as key findings. These included: (1) Ethical considerations; (2) The role of the health care provider; looking specifically at the impact on nurses; (3) The need for multidisciplinary care teams; and (4) Existential suffering’s connection to religiosity and spirituality. Conclusion: Palliative sedation to treat existential refractory symptoms was labelled a controversial practice. A shortage of evidence-based resources limits the current literature’s ability to inform policy and clinical practice. There is a need for both qualitative and quantitative multi-center research so health care professionals and regional-level institutions have firm roots to establish proper policy and practice.

scholarly journals A review of the impact of financing mechanisms on maternal health care in Australia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Haylee Fox ◽  
Stephanie M. Topp ◽  
Emily Callander ◽  
Daniel Lindsay
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health System ◽  
Search Engine ◽  
Grey Literature ◽  
Maternal Health Care ◽  
World Health ◽  
Google Search ◽  
The Impact ◽  
Out Of Pocket Costs

Abstract Background The World Health Organization states there are three interrelated domains that are fundamental to achieving and maintaining universal access to care - raising sufficient funds for health care, reducing financial barriers to access by pooling funds in a way that prevents out-of-pocket costs, and allocating funds in a way that promotes quality, efficiency and equity. In Australia, a comprehensive account of the mechanisms for financing the health system have not been synthesised elsewhere. Therefore, to understand how the maternal health system is financed, this review aims to examine the mechanisms for funding, pooling and purchasing maternal health care and the influence these financing mechanisms have on the delivery of maternal health services in Australia. Methods We conducted a scoping review and interpretative synthesis of the financing mechanisms and their impact on Australia’s maternal health system. Due to the nature of the study question, the review had a major focus on grey literature. The search was undertaken in three stages including; searching (1) Google search engine (2) targeted websites and (3) academic databases. Executive summaries and table of contents were screened for grey literature documents and Titles and Abstracts were screened for journal articles. Screening of publications’ full-text followed. Data relating to either funding, pooling, or purchasing of maternal health care were extracted for synthesis. Results A total of 69 manuscripts were included in the synthesis, with 52 of those from the Google search engine and targeted website (grey literature) search. A total of 17 articles we included in the synthesis from the database search. Conclusion Our study provides a critical review of the mechanisms by which revenues are raised, funds are pooled and their impact on the way health care services are purchased for mothers and babies in Australia. Australia’s maternal health system is financed via both public and private sources, which consequentially creates a two-tiered system. Mothers who can afford private health insurance – typically wealthier, urban and non-First Nations women - therefore receive additional benefits of private care, which further exacerbates inequity between these groups of mothers and babies. The increasing out of pocket costs associated with obstetric care may create a financial burden for women to access necessary care or it may cause them to skip care altogether if the costs are too great.

scholarly journals Barriers to Creating Scalable Business Models for Digital Health Innovation in Public Systems: Qualitative Case Study (Preprint)

2020 ◽  
Author(s):  
Leah Taylor Kelley ◽  
Jamie Fujioka ◽  
Kyle Liang ◽  
Madeline Cooper ◽  
Trevor Jamieson ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Business Models ◽  
Digital Health ◽  
Digital Technologies ◽  
Economic Incentives ◽  
Barriers To Entry ◽  
Health Innovation ◽  
Health Technologies

BACKGROUND Health systems are increasingly looking toward the private sector to provide digital solutions to address health care demands. Innovation in digital health is largely driven by small- and medium-sized enterprises (SMEs), yet these companies experience significant barriers to entry, especially in public health systems. Complex and fragmented care models, alongside a myriad of relevant stakeholders (eg, purchasers, providers, and producers of health care products), make developing value propositions for digital solutions highly challenging. OBJECTIVE This study aims to identify areas for health system improvement to promote the integration of innovative digital health technologies developed by SMEs. METHODS This paper qualitatively analyzes a series of case studies to identify health system barriers faced by SMEs developing digital health technologies in Canada and proposed solutions to encourage a more innovative ecosystem. The Women’s College Hospital Institute for Health System Solutions and Virtual Care established a consultation program for SMEs to help them increase their innovation capacity and take their ideas to market. The consultation involved the SME filling out an onboarding form and review of this information by an expert advisory committee using guided considerations, leading to a recommendation report provided to the SME. This paper reports on the characteristics of 25 SMEs who completed the program and qualitatively analyzed their recommendation reports to identify common barriers to digital health innovation. RESULTS A total of 2 central themes were identified, each with 3 subthemes. First, a common barrier to system integration was the lack of formal evaluation, with SMEs having limited resources and opportunities to conduct such an evaluation. Second, the health system’s current structure does not create incentives for clinicians to use digital technologies, which threatens the sustainability of SMEs’ business models. SMEs faced significant challenges in engaging users and payers from the public system due to perverse economic incentives. Physicians are compensated by in-person visits, which actively works against the goals of many digital health solutions of keeping patients out of clinics and hospitals. CONCLUSIONS There is a significant disconnect between the economic incentives that drive clinical behaviors and the use of digital technologies that would benefit patients’ well-being. To encourage the use of digital health technologies, publicly funded health systems need to dedicate funding for the evaluation of digital solutions and streamlined pathways for clinical integration.

scholarly journals Advancing PROMs for health system use in Canada and beyond

2021 ◽  
Vol 5 (S2) ◽  
Author(s):  
Michael Terner ◽  
Krista Louie ◽  
Candy Chow ◽  
Greg Webster
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Health System ◽  
Knee Arthroplasty ◽  
Care Delivery ◽  
Patient Reported Outcome Measures ◽  
Data Standards ◽  
Data Set ◽  
Patient Reported ◽  
Hip And Knee Arthroplasty

AbstractPROMs are essential to delivering patient-centred health care, and when applied routinely they can enhance communication between patients and providers, inform decisions for value-based health system improvements and improve overall patient care experiences and outcomes. The use of patient-reported outcome measures (PROMs) across Canada varies across provinces and territories, partly because of differences in health care delivery models across these jurisdictions. A national program that coordinates uses of PROMs is needed to ensure that this information is comparable across jurisdictions. This commentary provides a summary look at the development of national PROMs data standards and reporting for hip and knee replacement surgery, including the selection of survey tools, building consensus, developing and promoting standards, and reporting on the results nationally and internationally as well as outlining recent learnings from regional implementation of data standards. In 2017, the Canadian Institute for Health Information published national PROMs data collection standards for hip and knee arthroplasty that included guidelines for survey time points, the minimum data set and PROMs instruments. This broad-scale PROMs collection initiative had stakeholder engagement and support from multiple levels within the health system, including administrators, clinic managers, patients, and health system decision-makers. Learnings from regional implementation of the standards demonstrated the importance of assessing existing infrastructure and information technology requirements, mapping clinical workflows, planning for human and information technology resources, navigating local legislation and hospital policies and ensuring data linkage capabilities. This initiative showed the need for a common regional approach for PROMs collection to be efficient and effective. The learnings from implementation of the national Canadian PROMs program for hip and knee arthroplasty can be used as an example for other jurisdictions and clinical areas such as renal care and mental health. Common data standards allow for secondary use of this data that is valuable for reporting and informing policy and guidelines as well as meeting care delivery goals to further the shift in health care systems becoming more patient-centred to improve the quality-of-life of patients.

Sign in / Sign up

Export Citation Format

Share Document