scholarly journals Impact of Web-Based Self-Scheduling on Finalization of Well-Child Appointments in a Primary Care Setting: Retrospective Comparison Study

10.2196/23450 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e23450
Author(s):  
Frederick North ◽  
Elissa M Nelson ◽  
Rebecca J Majerus ◽  
Rebecca J Buss ◽  
Matthew C Thompson ◽  
...  
Keyword(s):  
Primary Care ◽  
Mayo Clinic ◽  
Care Setting ◽  
Primary Care Setting ◽  
Single Step ◽  
Appointment Scheduling ◽  
The Self ◽  
Staff Scheduling ◽  
Web Based ◽  
Sports Events

Background Web-booking of flights, hotels, and sports events has become commonplace in the travel and entertainment industry, but self-scheduling of health care appointments on the web is not yet widely used. An electronic health record that integrates appointment scheduling and patient web-based access to medical records creates an opportunity for patient self-scheduling. The Mayo Clinic developed and implemented a feature in its Patient Online Services (POS) web and mobile platform that allows software-managed self-scheduling of well-child visits. Objective This study aims to examine the use of a new self-scheduling appointment feature within POS in both web and mobile formats and determine the use characteristics, outcomes, and efficiency of self-scheduling compared with staff scheduling. Methods Within a primary care setting, we collected 13 months of all appointment activity for the well-child visit for children aged 2-12 years. As these specific appointment types are for minors, self-scheduling is performed by parents or other proxies. We compared the appointment actions of scheduling and cancelling for both self-scheduled and staff-scheduled appointments. The frequency in which patients were using self-scheduling outside of normal business hours was quantified, and we compared no-show outcomes of finalized appointments. Results Of the 1099 patients who performed any self-scheduling actions, 73.1% (803/1099) exclusively used self-scheduling and self-cancelling software. For those with access to self-scheduling (patients registered with the Mayo Clinic POS), 4.92% (1201/24,417) of all well-child appointment-scheduling actions were self-scheduled. Staff scheduling required more than a single appointment step (eg, schedule, cancel, reschedule) in 28.32% (3729/13,168) compared with only 6.93% (53/765) of self-scheduled appointments (P<.001). Self-scheduling appointment actions took place outside of regular business hours 29.5% (354/1201) of the time. No-shows accounted for 3.07% (28/912) of the self-scheduled finalized appointments compared with 4.12% (693/16,828) of staff-scheduled appointments, which is a nonsignificant difference (P=.12). Staff-scheduled finalized appointments (that allowed for scheduling appointments for more than 12 weeks in the future) revealed a potential demand of 11.15% (1876/16,828) for appointments with longer lead times. Conclusions Self-scheduling can generate a significant number of finalized appointments, decreasing the need for staff scheduler time. We found that 29.5% (354/1201) of the self-scheduling activity took place outside of the usual staff scheduler hours, adding convenience value to the scheduling process. For exclusive self-schedulers, 93.1% (712/765) finalized the appointment in a single step. The no-show rates were not adversely affected by the self-scheduling.

scholarly journals A Retrospective Comparison of Self-Scheduled to Staff-Scheduled Well-Child Appointments: Differences in Appointment Outcomes, After-Hours Access to Scheduling, and Appointment Requests (Preprint)

2020 ◽  
Author(s):  
Frederick North ◽  
Elissa M Nelson ◽  
Rebecca J Majerus ◽  
Rebecca J Buss ◽  
Matthew C Thompson ◽  
...  
Keyword(s):  
Mayo Clinic ◽  
Appointment Scheduling ◽  
The Self ◽  
Lead Times ◽  
Staff Scheduling ◽  
Sports Events ◽  
Retrospective Comparison ◽  
Significant Difference ◽  
Potential Demand ◽  
Well Child Visit

BACKGROUND Online booking of flights, hotels, and sports events has become commonplace in the travel and entertainment industry, but online self-scheduling of healthcare appointments is not yet widely used. An electronic health record (EHR) that integrates appointment scheduling and patient online access to medical records creates an opportunity for patient self-scheduling. Mayo Clinic developed and implemented a feature in its Patient Online Services (POS) web and mobile platform that allows software managed self-scheduling of well-child visits. OBJECTIVE We examined the use of a new self-scheduling appointment feature within POS in both web and mobile formats and determined use characteristics, outcomes, and efficiency of self-scheduling compared to staff-scheduling. METHODS Within a primary care setting, we collected 13 months of all appointment activity for the well-child visit for children ages 2 through 12. As these specific appointment types are for minors, self-scheduling is performed by parents or other proxies. We compared the appointment actions of scheduling and canceling for both the self-scheduled and staff-scheduled appointments. The frequency that patients were using self-scheduling outside of normal business hours was quantified and we compared ‘no-show’ outcomes of finalized appointments. RESULTS Of 1099 patients who performed any self-scheduling actions, 73.1% (803/1099) exclusively used the self-scheduling and self-canceling software. For those with access to self-scheduling (patients registered to Mayo Clinic POS), 4.92% (1201/24,417) of all well-child appointment scheduling actions were self-scheduled. Staff-scheduling required more than a single appointment step (e.g., schedule, cancel, reschedule) in 28.32% (3729/13,168) compared with only 7.01% (53/712) of self-scheduled appointments (P < .0001). Self-scheduling appointment actions took place outside of regular business hours 29.5% of the time (354/1201). No-shows accounted for 3.07% (28/912) of the self-scheduled finalized appointments compared to 4.12% (693/16,828) of staff-scheduled, a non-significant difference at P =.112. Staff-scheduled finalized appointments (that allowed for appointments greater than 12 weeks in the future) revealed a potential demand of 11.15% (1876/16,828) for appointments with longer lead times. CONCLUSIONS Self-scheduling can generate a significant number of finalized appointments, decreasing the need for staff scheduler time. About 30% of self-scheduling activity took place outside of usual staff scheduler hours, adding convenience value to the scheduling process. Over 90% of exclusive self-schedulers created a finalized appointment with a single appointment scheduling step. No-show rates were not adversely impacted by self-scheduling.

scholarly journals Web-Based Patient Segmentation in Finnish Primary Care: Protocol for Clinical Validation of the Navigator Service in Patients With Diabetes (Preprint)

2020 ◽  
Author(s):  
Riikka Riihimies ◽  
Elise Kosunen ◽  
Tuomas Koskela
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Status ◽  
Data Collection ◽  
Chronic Conditions ◽  
Care Setting ◽  
Primary Care Setting ◽  
Web Based ◽  
Patients With Diabetes ◽  
Patient Segmentation

BACKGROUND An aging population and increasing multimorbidity challenge health care systems worldwide. Patient segmentation aims to recognize groups of patients with similar needs, offer targeted services to these groups, and reduce the burden of health care. In this study, the unique Finnish innovation Navigator, a web-based service for patient segmentation, is presented. Both patients and health care professionals complete the electronic questionnaire concerning patients’ coping in everyday life and health state. Thus, it considers the patient perspective on self-care. One of four customership-strategy (CS) groups (self-acting, community, cooperating, and network) is then proposed in response to the answers given. This resulting strategy helps both professionals to coordinate patient health care and patients to utilize appropriate health services. OBJECTIVE This study aims to determine the feasibility, validity, and reliability of the Navigator service in the segmentation of patients with diabetes into four CS groups in a primary care setting. Patient characteristics concerning demographic status, chronic conditions, disabilities, health-related quality of life, and well-being in different CS groups will be described. We hypothesize that patients in the network group will be older, have more illnesses, chronic conditions or disabilities, and require more health care services than patients in the self-acting group. METHODS In this mixed methods study, data collection was based on questionnaires (user experience of Navigator, demographic and health status, World Health Organization Disability Assessment Schedule 2.0, EuroQol 5D, Wellbeing Questionnaire 12, and the Diabetes Treatment Satisfaction Questionnaire) issued to 300 patients with diabetes and on user-experience questionnaires for and semistructured focus-group interviews with 12 nurses. Navigator-database reports and diabetes-care values (blood pressure, BMI, HbA1c, low-density lipoprotein, albumin-creatinine, smoking status) were collected. Qualitative and descriptive analyses were used to study the feasibility, content, concurrent, and face validity of Navigator. While criterion and concurrent validity were examined with correlations, reliability was examined by calculating Cohen kappa and Cronbach alpha. Construct validity is studied by performing exploratory-factor analysis on Navigator data reports and by hypothesis testing. The values, demographics, and health status of patients in different groups were described, and differences between groups were studied by comparing means. Linear regression analysis was performed to assess which variables affect CS group variation. RESULTS Data collection was completed in September 2019, and the first feasibility results are expected by the end of 2020. Further results and publications are expected in 2021 and 2022. CONCLUSIONS This is the first scientific study concerning Navigator’s psychometric properties. The study will examine the segregation of patients with diabetes into four CS groups in a primary care setting and the differences between patients in groups. This study will assist in Navigator’s further development as a patient segmentation method considering patients’ perspectives on self-care. This study will not prove the effectiveness or efficacy of Navigator; therefore, it is essential to study these outcomes of separate care pathways. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/20570

scholarly journals Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Marwan S. Haddad ◽  
Lauren Bifulco ◽  
Jeannie McIntosh ◽  
Meghan Mc Clain Garcia
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Health Center ◽  
Feasibility Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Community Health Center ◽  
The Self ◽  
Implementation Study ◽  
Cross Sectional

Abstract Background Men who have sex with men (MSM) are at increased risk for extra-genital sexually transmitted infections (STIs). Without extra-genital screening, many chlamydia and gonorrhea infections would be missed among MSM. Yet, many barriers exist to extra-genital testing, and, in particular, to rectal collection. Self-collection increases screening and detection of asymptomatic chlamydia and gonorrhea among at-risk MSM and transgender women. This feasibility study assessed use of rectal self-collection and its acceptance among patients and primary care providers (PCPs) at a large, general practice community health center. The primary objective of this project was to assess the feasibility of including rectal self-collection as part of an implementation study looking to embed an STI care program in a safety-net primary care setting that would shift routine screening tasks to non-provider clinical team members such as medical assistants and nurses. Methods Three PCPs identified and offered rectal self-collection to their MSM and transgender female patients who were due for routine or risk-based STI screening. For those patients who elected to participate in the study, the PCP’s medical assistant (MA) reviewed the self-collection instructions with them as part of their routine preventive care duties, and patients collected their own sample. Patients and PCPs completed brief cross-sectional surveys assessing the self-collection process. Results Of 1191 patients with sexual orientation and gender identity (SOGI) data on file who were seen for a medical visit by one of the three PCPs, 87 (7.3%) identified as MSM or transgender female. Seventy-five were due for rectal screening, of whom 33 (44%) were offered and completed rectal self-collection. Survey results indicated that self-collection was acceptable to and preferred over clinician-collection by both PCPs and patients. Conclusions This study demonstrated that rectal self-collection is feasible as part of STI screening in a high-volume primary care setting, and can be administered as part of the clinical tasks that MAs routinely conduct. The overall acceptance by both PCPs and patients will allow the inclusion of rectal self-collection in an implementation study looking to increase STI screening at a large community health center by facilitating MA-led collection during medical provider visits and by establishing standalone nurse-led STI visits.

scholarly journals Web-Based Patient Segmentation in Finnish Primary Care: Protocol for Clinical Validation of the Navigator Service in Patients With Diabetes

10.2196/20570 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e20570
Author(s):  
Riikka Riihimies ◽  
Elise Kosunen ◽  
Tuomas Koskela
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Status ◽  
Data Collection ◽  
Chronic Conditions ◽  
Care Setting ◽  
Primary Care Setting ◽  
Web Based ◽  
Patients With Diabetes ◽  
Patient Segmentation

Background An aging population and increasing multimorbidity challenge health care systems worldwide. Patient segmentation aims to recognize groups of patients with similar needs, offer targeted services to these groups, and reduce the burden of health care. In this study, the unique Finnish innovation Navigator, a web-based service for patient segmentation, is presented. Both patients and health care professionals complete the electronic questionnaire concerning patients’ coping in everyday life and health state. Thus, it considers the patient perspective on self-care. One of four customership-strategy (CS) groups (self-acting, community, cooperating, and network) is then proposed in response to the answers given. This resulting strategy helps both professionals to coordinate patient health care and patients to utilize appropriate health services. Objective This study aims to determine the feasibility, validity, and reliability of the Navigator service in the segmentation of patients with diabetes into four CS groups in a primary care setting. Patient characteristics concerning demographic status, chronic conditions, disabilities, health-related quality of life, and well-being in different CS groups will be described. We hypothesize that patients in the network group will be older, have more illnesses, chronic conditions or disabilities, and require more health care services than patients in the self-acting group. Methods In this mixed methods study, data collection was based on questionnaires (user experience of Navigator, demographic and health status, World Health Organization Disability Assessment Schedule 2.0, EuroQol 5D, Wellbeing Questionnaire 12, and the Diabetes Treatment Satisfaction Questionnaire) issued to 300 patients with diabetes and on user-experience questionnaires for and semistructured focus-group interviews with 12 nurses. Navigator-database reports and diabetes-care values (blood pressure, BMI, HbA1c, low-density lipoprotein, albumin-creatinine, smoking status) were collected. Qualitative and descriptive analyses were used to study the feasibility, content, concurrent, and face validity of Navigator. While criterion and concurrent validity were examined with correlations, reliability was examined by calculating Cohen kappa and Cronbach alpha. Construct validity is studied by performing exploratory-factor analysis on Navigator data reports and by hypothesis testing. The values, demographics, and health status of patients in different groups were described, and differences between groups were studied by comparing means. Linear regression analysis was performed to assess which variables affect CS group variation. Results Data collection was completed in September 2019, and the first feasibility results are expected by the end of 2020. Further results and publications are expected in 2021 and 2022. Conclusions This is the first scientific study concerning Navigator’s psychometric properties. The study will examine the segregation of patients with diabetes into four CS groups in a primary care setting and the differences between patients in groups. This study will assist in Navigator’s further development as a patient segmentation method considering patients’ perspectives on self-care. This study will not prove the effectiveness or efficacy of Navigator; therefore, it is essential to study these outcomes of separate care pathways. International Registered Report Identifier (IRRID) DERR1-10.2196/20570

1499: The Prevalence of LUTS and Prostate Enlargement in the Primary Care Setting

2007 ◽  
Vol 177 (4S) ◽  
pp. 494-495 ◽  
Author(s):  
Michael Naslund ◽  
Alicia Gilsenan ◽  
Kirk Midkiff ◽  
Eric Wolford ◽  
Aileen Bown ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Prostate Enlargement

Recognizing and Treating PTSD in the Primary Care Setting

2008 ◽  
Author(s):  
Ruth Elaine Graves ◽  
Tanya N. Alim ◽  
Notalelomwan Aigbogun ◽  
Thomas A. Mellman ◽  
William B. Lawson
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting
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