A Regional Web-Based Medical Center Patient Appointment System for Direct Support to Soldier Readiness Centers

2005 ◽  
Author(s):  
Ruixia Zhou
Keyword(s):  
Medical Center ◽  
Web Based ◽  
Direct Support ◽  
Patient Appointment ◽  
Appointment System

Development and Patient Usability Analysis of a Veteran Centric Web-based Decision Aid for Lung Cancer Screening (Preprint)

2021 ◽  
Author(s):  
Marilyn Schapira ◽  
Sumedha Chhatre ◽  
Jason Prigge ◽  
Jessica Meline ◽  
Dana Kaminstein ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Trial ◽  
Cancer Screening ◽  
Medical Center ◽  
Clinical Care ◽  
Lung Cancer Screening ◽  
Potential Range ◽  
Medical Terminology ◽  
Web Based ◽  
System Usability Scale

BACKGROUND Web based tools developed to facilitate a Shared Decision Making (SDM) process may facilitate implementation of lung cancer screening (LCS), an evidence based intervention to improve cancer outcomes. Veterans have specific risk factors and shared experiences that impact the benefit and potential harms of LCS, so may value a Veteran centric LCS SDM too OBJECTIVE To develop and conduct usability testing of a LCS Decision Tool (LCSDecTool) designed for Veterans receiving care at a Veteran Affairs Medical Center (VAMC). METHODS A user-centered design approach was undertaken to develop the LCSDecTool. Usability of a prototype was assessed among 18 Veterans from two VA sites. Usability of a high fidelity version was assessed among 43 Veterans as part of a clinical trial. Outcomes included the System Usability Scale (SUS), the End User Computer Satisfaction (EUCS), and the Patient Engagement (PE) scale. Qualitative data from observations and short interviews with users were analyzed and themes pertaining to usability identified. RESULTS The mean (SD) in the pilot clinical trial (n=43) for the SUS (potential range 0 [low] to 100 [high] was 65.76 [15.23]); EUCS (potential range 1 [low] to 5 [high] was 3.91 [0.95]); and PE (potential range 1[low) to 5 [high] was 4.62 [0.67]). Time to completion of the LCSDecTool in minutes (median, intra-quartile range) was (13, 10-16). Emerging themes included: 1) a baseline gap in awareness of LCS with knowledge gained from using the LCSDecTool, 2) an interest in details about the LCS process, 3) the LCSDecTool was easy to use overall but specific navigation challenges identified, and 4) difficulty in understanding medical terminology. CONCLUSIONS The LCSDecTool demonstrates a good level of usability among Veterans when testing in the context of clinical care. Study findings will inform further modifications of the tool, including shortening the length and simplifying language. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT02899754

HELEN, a Modular Framework for Representing and Implementing Clinical Practice Guidelines

2004 ◽  
Vol 43 (04) ◽  
pp. 413-426 ◽  
Author(s):  
H.-J. Gausepohl ◽  
M. Haak ◽  
S. Knaebel ◽  
O. Linderkamp ◽  
T. Wetter ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Medical Center ◽  
Web Based ◽  
Knowledge Representations ◽  
Medical Institutions ◽  
Set Up ◽  
Spiral Model ◽  
Modular Framework

Summary Objectives: In order to implement clinical practice guidelines for the Department of Neonatology of the Heidelberg University Medical Center we developed a modular framework consisting of tools for authoring, browsing and executing encoded clinical practice guidelines (CPGs). Methods: Based upon a comprehensive analysis of literature, we set up requirements for guideline representation systems. Additionally, we analyzed further aspects such as the critical appraisal and known bridges and barriers for implementing CPGs. Thereafter we went through an evolutionary spiral model to develop a comprehensive ontology. Within this model each cycle focuses on a certain topic of management and implementation of CPGs. Results: In order to bring the resulting ontology into practice we developed a framework consisting of a tool for authoring, a server for web-based browsing, and an engine for the execution of certain elements of CPGs. Based upon this framework we encoded and implemented several CPGs in varying medical domains. Conclusions: This paper shall present a practical framework for both authors and implementers of CPGs. We have shown the fruitful combination of different knowledge representations such as narrative text and algorithm for implementing CPGs. Finally, we introduced a possible approach for the explicit adaptation of CPGs in order to provide institution-specific recommendations and to support sharing with other medical institutions.

scholarly journals Correlation Between Self-Reported Resident Duty Hours and Time-Stamped Parking Data

2012 ◽  
Vol 4 (2) ◽  
pp. 254-256 ◽  
Author(s):  
Smitha R. Chadaga ◽  
Angela Keniston ◽  
Dan Casey ◽  
Richard K. Albert
Keyword(s):  
Medical Center ◽  
Daily Basis ◽  
Work Hours ◽  
Parking Garage ◽  
Monthly Basis ◽  
Web Based ◽  
Duty Hours ◽  
Resident Work ◽  
Significant Difference ◽  
Reported Data

Abstract Background Failure to comply with Accreditation Council for Graduate Medical Education-mandated resident work hour limitations can result in citations and shortened accreditation cycles. Many programs assess compliance by collecting self-reports of work hours from each resident. Objectives To examine residents' self-reported assessment of work hours recorded on a daily basis using a Web-based product with electronically recorded times collected as residents entered and exited the parking garage. Methods Study participants consisted of 62 University of Colorado Denver internal medicine residents rotating at Denver Health Medical Center on a monthly basis over a 4-month period. Self-reported data submitted by 60 residents were compared with the times these residents entered and exited from the parking garage at Denver Health Medical Center, as assessed by an electronic badge reader. Results A high level of agreement was found between these two data sets. No significant difference was found between the time-stamped parking data and self-reported Web-based data for resident work hours. Conclusions Residents accurately self-reported their work hours, using a daily Web-based duty hours log when compared to an independent, objective and blinded assessment of work hours.

scholarly journals Implementation of a Pediatric Pharmacy Education Program at a Community Regional Medical Center

2020 ◽  
Vol 25 (1) ◽  
pp. 25-30
Author(s):  
Chelsea L. Ferguson ◽  
Sarah Ferrell ◽  
Karen Kovey ◽  
Joanna Young ◽  
Sara Trovinger
Keyword(s):  
Health System ◽  
Education Program ◽  
Medical Center ◽  
Surrogate Marker ◽  
Pharmacy Education ◽  
Web Based ◽  
Before And After ◽  
Regional Medical Center ◽  
The One ◽  
Provider Survey

OBJECTIVES This study aimed to implement a web-based pediatric education program designed for pharmacists who participate in neonatal and pediatric order verification at a community-based health system and to evaluate the success through measuring outcomes related to both comfort and competence of pharmacists in pediatric and neonatal pharmacotherapy. METHODS This prospective quality improvement study assessed changes in confidence and competence from before to after education. Eight educational modules were designed to provide education based on the needs of this institution. All pharmacists who participate in neonatal and pediatric order verification were eligible for inclusion throughout the health system. Time in the verification queue for pediatric and neonatal medication orders was compared for before to after education as an objective surrogate marker for comfort and competence. A provider survey was conducted before and after education to assess the providers' perspective of the quality and necessity of pharmacist-provider interactions. RESULTS All confidence scores showed statistical improvement from before to after education (p < 0.001). Before to after education competency scores significantly improved (median 77% [IQR, 69%–85%] to 100% [IQR, 92%–100%]; p < 0.01). The module with the lowest mean score (87%) was module 4 (Antibiotics Part 1), and the one with highest number of retakes (24 retakes from 16 different pharmacists) was module 5 (Antibiotics Part 2). CONCLUSIONS Targeted web-based education effectively improved both confidence and competence among health-system pharmacists to provide pediatric and neonatal care in a community hospital.

scholarly journals The Use of Technology for Communicating With Clinicians or Seeking Health Information in a Multilingual Urban Cohort: Cross-Sectional Survey (Preprint)

2019 ◽  
Author(s):  
Elaine C Khoong ◽  
Natalie A Rivadeneira ◽  
Robert A Hiatt ◽  
Urmimala Sarkar
Keyword(s):  
Vulnerable Populations ◽  
Technology Use ◽  
Medical Center ◽  
Safety Net ◽  
Usual Source Of Care ◽  
Web Based ◽  
Lower Odds ◽  
Usual Source ◽  
Use Of Technology ◽  
Source Of Care

BACKGROUND Technology is being increasingly used to communicate health information, but there is limited knowledge on whether these strategies are effective for vulnerable populations, including non–English speaking or low-income individuals. OBJECTIVE This study assessed how language preferences (eg, English, Spanish, or Chinese), smartphone ownership, and the type of clinic for usual source of care (eg, no usual source of care, nonintegrated safety net, integrated safety net, private or community clinic, academic tertiary medical center, or integrated payer-provider) affect technology use for health-related communication. METHODS From May to September 2017, we administered a nonrandom, targeted survey to 1027 English-, Spanish-, and Chinese-speaking San Francisco residents and used weighted multivariable logistic regression analyses to assess predictors of five technology use outcomes. The three primary predictors of interest—language preference, smartphone ownership, and type of clinic for usual care—were adjusted for age, gender, race or ethnicity, limited English proficiency, educational attainment, health literacy, and health status. Three outcomes focused on use of email, SMS text message, or phone apps to communicate with clinicians. The two other outcomes were use of Web-based health videos or online health support groups. RESULTS Nearly one-third of participants watched Web-based health videos (367/1027, 35.74%) or used emails to communicate with their clinician (318/1027, 30.96%). In adjusted analyses, individuals without smartphones had significantly lower odds of texting their clinician (adjusted odds ratio [aOR] 0.27, 95% CI 0.13-0.56), using online health support groups (aOR 0.14, 95% CI 0.04-0.55), or watching Web-based health videos (aOR 0.31, 95% CI 0.15-0.64). Relative to English-speaking survey respondents, individuals who preferred Chinese had lower odds of texting their clinician (aOR 0.25, 95% CI 0.08-0.79), whereas Spanish-speaking survey respondents had lower odds of using apps to communicate with clinicians (aOR 0.34, 95% CI 0.16-0.75) or joining an online support group (aOR 0.30, 95% CI 0.10-0.92). Respondents who received care from a clinic affiliated with the integrated safety net, academic tertiary medical center, or integrated payer-provider systems had higher odds than individuals without a usual source of care at using emails, SMS text messages, or apps to communicate with clinicians. CONCLUSIONS In vulnerable populations, smartphone ownership increases the use of many forms of technology for health purposes, but device ownership itself is not sufficient to increase the use of all technologies for communicating with clinicians. Language preference impacts the use of technology for health purposes even after considering English proficiency. Health system factors impact patients’ use of technology-enabled approaches for communicating with clinicians. No single factor was associated with higher odds of using technology for all health purposes; therefore, existing disparities in the use of digital health tools among diverse and vulnerable populations can only be addressed using a multipronged approach.

scholarly journals A Web-Based Clinical System for Cohort Surveillance of Specific Clinical Effectiveness and Safety Outcomes: A Cohort Study of Non–Vitamin K Antagonist Oral Anticoagulants and Warfarin

10.2196/13329 ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. e13329 ◽  
Author(s):  
Fong-Ci Lin ◽  
Shih-Tsung Huang ◽  
Rung Ji Shang ◽  
Chi-Chuan Wang ◽  
Fei-Yuan Hsiao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Surveillance System ◽  
Adverse Drug Events ◽  
Medical Center ◽  
Oral Anticoagulants ◽  
Critical Role ◽  
Clinical Effectiveness ◽  
University Hospital ◽  
Drug Surveillance ◽  
Web Based

Background Conventional systems of drug surveillance lack a seamless workflow, which makes it crucial to have an active drug surveillance system that proactively assesses adverse drug events. Objective The aim of this study was to develop a seamless, Web-based workflow for comparing the safety and effectiveness of drugs in a database of electronic medical records. Methods We proposed a comprehensive integration process for cohort surveillance using the National Taiwan University Hospital Clinical Surveillance System (NCSS). We studied a practical application of the NCSS that evaluates the drug safety and effectiveness of novel oral anticoagulants (NOACs) and warfarin by cohort tree analysis in an efficient and interoperable platform. Results We demonstrated a practical example of investigating the differences in effectiveness and safety between NOACs and warfarin in patients with nonvalvular atrial fibrillation (AF) using the NCSS. We efficiently identified 2357 patients with nonvalvular AF with newly prescribed oral anticoagulants between 2010 and 2015 and further developed 1 main cohort and 2 subcohorts for separately measuring ischemic stroke as the clinical effectiveness outcome and intracranial hemorrhage (ICH) as the safety outcome. In the subcohort of ischemic stroke, NOAC users exhibited a significantly lower risk of ischemic stroke than warfarin users after adjusting for age, sex, comorbidity, and comedication in an intention-to-treat (ITT) analysis (P=.01) but did not exhibit a significantly distinct risk in an as-treated (AT) analysis (P=.12) after the 2-year follow-up. In the subcohort of ICH, NOAC users did not exhibit a different risk of ICH both in ITT (P=.68) and AT analyses (P=.15). Conclusions With a seamless and Web-based workflow, the NCSS can serve the critical role of forming associations between evidence and the real world at a medical center in Taiwan.

scholarly journals WAS-GN: Web-based Appointment System with GSM Network

2011 ◽  
Vol 3 (5) ◽  
pp. 315-333 ◽  
Author(s):  
Mohd Helmy Abd Wahab ◽  
Ooi Lee Lee ◽  
Herdawatie Abdul Kadir ◽  
Ayob Johari ◽  
Ariffin Abdul Mutalib ◽  
...  
Keyword(s):  
Web Based ◽  
Appointment System ◽  
Gsm Network

scholarly journals The Use of Technology for Communicating With Clinicians or Seeking Health Information in a Multilingual Urban Cohort: Cross-Sectional Survey

10.2196/16951 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e16951 ◽  
Author(s):  
Elaine C Khoong ◽  
Natalie A Rivadeneira ◽  
Robert A Hiatt ◽  
Urmimala Sarkar
Keyword(s):  
Vulnerable Populations ◽  
Technology Use ◽  
Medical Center ◽  
Safety Net ◽  
Usual Source Of Care ◽  
Web Based ◽  
Lower Odds ◽  
Usual Source ◽  
Use Of Technology ◽  
Source Of Care

Background Technology is being increasingly used to communicate health information, but there is limited knowledge on whether these strategies are effective for vulnerable populations, including non–English speaking or low-income individuals. Objective This study assessed how language preferences (eg, English, Spanish, or Chinese), smartphone ownership, and the type of clinic for usual source of care (eg, no usual source of care, nonintegrated safety net, integrated safety net, private or community clinic, academic tertiary medical center, or integrated payer-provider) affect technology use for health-related communication. Methods From May to September 2017, we administered a nonrandom, targeted survey to 1027 English-, Spanish-, and Chinese-speaking San Francisco residents and used weighted multivariable logistic regression analyses to assess predictors of five technology use outcomes. The three primary predictors of interest—language preference, smartphone ownership, and type of clinic for usual care—were adjusted for age, gender, race or ethnicity, limited English proficiency, educational attainment, health literacy, and health status. Three outcomes focused on use of email, SMS text message, or phone apps to communicate with clinicians. The two other outcomes were use of Web-based health videos or online health support groups. Results Nearly one-third of participants watched Web-based health videos (367/1027, 35.74%) or used emails to communicate with their clinician (318/1027, 30.96%). In adjusted analyses, individuals without smartphones had significantly lower odds of texting their clinician (adjusted odds ratio [aOR] 0.27, 95% CI 0.13-0.56), using online health support groups (aOR 0.14, 95% CI 0.04-0.55), or watching Web-based health videos (aOR 0.31, 95% CI 0.15-0.64). Relative to English-speaking survey respondents, individuals who preferred Chinese had lower odds of texting their clinician (aOR 0.25, 95% CI 0.08-0.79), whereas Spanish-speaking survey respondents had lower odds of using apps to communicate with clinicians (aOR 0.34, 95% CI 0.16-0.75) or joining an online support group (aOR 0.30, 95% CI 0.10-0.92). Respondents who received care from a clinic affiliated with the integrated safety net, academic tertiary medical center, or integrated payer-provider systems had higher odds than individuals without a usual source of care at using emails, SMS text messages, or apps to communicate with clinicians. Conclusions In vulnerable populations, smartphone ownership increases the use of many forms of technology for health purposes, but device ownership itself is not sufficient to increase the use of all technologies for communicating with clinicians. Language preference impacts the use of technology for health purposes even after considering English proficiency. Health system factors impact patients’ use of technology-enabled approaches for communicating with clinicians. No single factor was associated with higher odds of using technology for all health purposes; therefore, existing disparities in the use of digital health tools among diverse and vulnerable populations can only be addressed using a multipronged approach.

Impact of Changes in EHR Use during COVID-19 on Physician Trainee Mental Health

2021 ◽  
Vol 12 (03) ◽  
pp. 507-517
Author(s):  
Katherine J. Holzer ◽  
Sunny S. Lou ◽  
Charles W. Goss ◽  
Jaime Strickland ◽  
Bradley A. Evanoff ◽  
...  
Keyword(s):  
Stress Disorder ◽  
Medical Center ◽  
Academic Medical Center ◽  
Well Being ◽  
Health Record ◽  
Depression And Anxiety ◽  
Web Based ◽  
Academic Medical ◽  
Multivariable Models ◽  
Physician Trainee

Abstract Objectives This article investigates the association between changes in electronic health record (EHR) use during the coronavirus disease 2019 (COVID-19) pandemic on the rate of burnout, stress, posttraumatic stress disorder (PTSD), depression, and anxiety among physician trainees (residents and fellows). Methods A total of 222 (of 1,375, 16.2%) physician trainees from an academic medical center responded to a Web-based survey. We compared the physician trainees who reported that their EHR use increased versus those whose EHR use stayed the same or decreased on outcomes related to depression, anxiety, stress, PTSD, and burnout using univariable and multivariable models. We examined whether self-reported exposure to COVID-19 patients moderated these relationships. Results Physician trainees who reported increased use of EHR had higher burnout (adjusted mean, 1.48 [95% confidence interval [CI] 1.24, 1.71] vs. 1.05 [95% CI 0.93, 1.17]; p = 0.001) and were more likely to exhibit symptoms of PTSD (adjusted mean = 15.09 [95% CI 9.12, 21.05] vs. 9.36 [95% CI 7.38, 11.28]; p = 0.035). Physician trainees reporting increased EHR use outside of work were more likely to experience depression (adjusted mean, 8.37 [95% CI 5.68, 11.05] vs. 5.50 [95% CI 4.28, 6.72]; p = 0.035). Among physician trainees with increased EHR use, those exposed to COVID-19 patients had significantly higher burnout (2.04, p < 0.001) and depression scores (14.13, p = 0.003). Conclusion Increased EHR use was associated with higher burnout, depression, and PTSD outcomes among physician trainees. Although preliminary, these findings have implications for creating systemic changes to manage the wellness and well-being of trainees.

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