scholarly journals Electronic Health Record Portal Use by Family Caregivers of patients undergoing Hematopoietic Cell Transplantation: A National Survey Study (Preprint)

JMIR Cancer ◽  
10.2196/26509 ◽  
2020 ◽  
Author(s):  
Vibhuti Gupta ◽  
Minakshi Raj ◽  
Flora Hoodin ◽  
Lilian Yahng ◽  
Thomas Braun ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Family Caregivers ◽  
Cell Transplantation ◽  
National Survey ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Survey Study ◽  
Health Record ◽  
Electronic Health

scholarly journals Electronic Health Record Portal Use by Family Caregivers of patients undergoing Hematopoietic Cell Transplantation: A National Survey Study (Preprint)

2020 ◽  
Author(s):  
Vibhuti Gupta ◽  
Minakshi Raj ◽  
Flora Hoodin ◽  
Lilian Yahng ◽  
Thomas Braun ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Family Caregivers ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Care Recipient ◽  
Health Record ◽  
Patient Portal ◽  
Brief Cope ◽  
Electronic Health

BACKGROUND As family caregivers of hematopoietic cell transplantation (HCT) patients have multifaceted caregiving responsibilities of long duration (medical, household, financial), they also have multiple needs, physical, social, psychological, and informational. OBJECTIVE This study explored prevalence of electronic health record (EHR) patient portal use by family caregivers for managing both their own and their HCT care recipient’s health, as well as potential factors associated with portal use. METHODS A national electronic caregiver health survey, first developed via cognitive interviewing methods of HCT caregivers, was distributed nationally by patient advocacy organizations to family caregivers of HCT patients. It assessed self-reported caregiver demographics, caregiving characteristics, depression and anxiety assessed by the Patient Health Questionnaire-4, coping assessed by the Brief COPE, and caregiver portal use to manage of their care recipient’s and their own health. RESULTS We found 77% of respondents (n=948) accessed EHR patient portals for their care-recipient, themselves or both. Multivariate models indicated caregiver use of care recipient EHR portals was more likely with younger, white, married, lower income caregivers caring for a parent, residing with the care recipient and experiencing more caregiver depression. Caregiver use of their own EHR portal was more likely with younger, white, higher income caregivers caring for a parent, and experiencing chronic medical conditions of their own. Partially due to multi-collinearity, anxiety and coping did not contribute independently to this model. CONCLUSIONS Findings from the survey could open avenues for future research into caregiver use of technology for informational support or intervention, including wearables and mHealth applications. INTERNATIONAL REGISTERED REPORT RR2-10.2196/17077

scholarly journals Use of Electronic Health Record Tools to Facilitate and Audit Infliximab Prescribing

2018 ◽  
Vol 23 (1) ◽  
pp. 18-25
Author(s):  
Bethany R. Sharpless ◽  
Fernando del Rosario ◽  
Zarela Molle-Rios ◽  
Elora Hilmas
Keyword(s):  
Literature Review ◽  
Electronic Health Record ◽  
National Survey ◽  
Free Text ◽  
Health Record ◽  
Order Information ◽  
Text Data ◽  
Review Analysis ◽  
Electronic Health ◽  
Implementation Data

OBJECTIVES The objective of this project was to assess a pediatric institution's use of infliximab and develop and evaluate electronic health record tools to improve safety and efficiency of infliximab ordering through auditing and improved communication. METHODS Best use of infliximab was defined through a literature review, analysis of baseline use of infliximab at our institution, and distribution and analysis of a national survey. Auditing and order communication were optimized through implementation of mandatory indications in the infliximab orderable and creation of an interactive flowsheet that collects discrete and free-text data. The value of the implemented electronic health record tools was assessed at the conclusion of the project. RESULTS Baseline analysis determined that 93.8% of orders were dosed appropriately according to the findings of a literature review. After implementation of the flowsheet and indications, the time to perform an audit of use was reduced from 60 minutes to 5 minutes per month. Four months post implementation, data were entered by 60% of the pediatric gastroenterologists at our institution on 15.3% of all encounters for infliximab. Users were surveyed on the value of the tools, with 100% planning to continue using the workflow, and 82% stating the tools frequently improve the efficiency and safety of infliximab prescribing. CONCLUSIONS Creation of a standard workflow by using an interactive flowsheet has improved auditing ability and facilitated the communication of important order information surrounding infliximab. Providers and pharmacists feel these tools improve the safety and efficiency of infliximab ordering, and auditing data reveal that the tools are being used.

A standardized process in the electronic health record to identify and recruit family and other unpaid caregivers of Veterans for a caregiver survey study (Preprint)

2021 ◽  
Author(s):  
Jessica E. Ma ◽  
Janet Grubber ◽  
Cynthia J. Coffman ◽  
Virginia Wang ◽  
S. Nicole Hastings ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Survey Study ◽  
Health Record ◽  
Logistic Regression Models ◽  
Home And Community Care ◽  
Electronic Health ◽  
Unpaid Caregiver ◽  
Family Based ◽  
Adult Day Health Care ◽  
Systematic Identification

BACKGROUND Most efforts to identify caregivers for research use passive approaches like self-nomination. We describe an approach where the EHR can help identify, recruit, and increase diverse representation of caregivers. OBJECTIVE Few health systems have implemented systematic processes to identify caregivers. We aimed to evaluate an electronic health record (EHR) algorithm for identifying Veterans with caregivers. METHODS We identified initial cohorts of Veterans likely to need supportive care from friends or family based with pre-defined EHR referrals for home and community care. Veterans were contacted assess whether the Veteran had an unpaid caregivers; unpaid caregivers were then contacted and offered enrollment in a caregiver survey. We compared Veteran characteristics from the EHR across these referral, screening, and recruitment groups using descriptive statistics and logistic regression models. RESULTS Of 12,212 Veterans identified through EHR referrals, 2,134 (17.4%) were selected for screening and 1,367 (11.2%) answered phone screening; 813 (60%) of those screened had a caregiver, and 435 (53%) caregivers participated in a survey. Married veterans had increased odds of having a caregiver (adjusted OR 2.63 [95%CI 1.65-4.24]) or had an adult day health care referral (adjusted OR 3.06 [95%CI 1.38 – 7.76]) or a respite care referral (adjusted OR 2.21 [95%CI 1.45-3.44].) Caregivers of Veterans with dementia had increased odds of participating in the survey (adjusted OR 1.78 [95%CI 1.20-2.65]). CONCLUSIONS The EHR algorithm process is systematic, resource intensive, and imperfect. Sixty percent of successfully screened Veterans had an unpaid caregiver. Implementing discrete caregiver fields in the EHR would support more efficient systematic identification of caregivers. CLINICALTRIAL ClincalTrials.gov Identifier: NCT03474380.

scholarly journals User Evaluation of the Swedish Patient Accessible Electronic Health Record: System Usability Scale (Preprint)

2020 ◽  
Author(s):  
Maria Hägglund ◽  
Isabella Scandurra
Keyword(s):  
Electronic Health Record ◽  
Ease Of Use ◽  
Survey Study ◽  
Health Record ◽  
Patient Portal ◽  
Data Set ◽  
System Usability Scale ◽  
System Usability ◽  
National Patient ◽  
Electronic Health

BACKGROUND Transparency is increasingly called for in health care, especially, when it comes to patients’ access to their electronic health records. In Sweden, the e-service Journalen is a national patient accessible electronic health record (PAEHR), accessible online via the national patient portal. User characteristics and perceived benefits of using a PAEHR influence behavioral intention for use and adoption, but poor usability that increases the effort expectancy can have a negative impact. It is, therefore, of interest to explore how users of the PAEHR Journalen perceive its usability and usefulness. OBJECTIVE The aim of this study was to explore how the users of the Swedish PAEHR experience the usability of the system and to identify differences in these experiences based on the level of transparency of the region. METHODS A survey study was conducted to elicit opinions and experiences of patients using Journalen. The data were collected from June to October 2016. The questionnaire included questions regarding the usability of the system from the System Usability Scale (SUS). The SUS analysis was the focus of this paper. Analysis was performed on different levels: nationally looking at the whole data set and breaking it down by focusing on 2 different regions to explore differences in experienced usability based on the level of transparency. RESULTS During the survey period, 423,141 users logged into Journalen, of which 2587 unique users completed the survey (response rate 0.61%). The total mean score for all respondents to the SUS items was 79.81 (SD 14.25), which corresponds to a system with good usability. To further explore whether the level of transparency in a region would affect the user’s experience of the usability of the system, we analyzed the 2 regions with the most respondents: Region Uppsala (the first to launch, with a high level of transparency), and Region Skåne (an early implementer, with a low level of transparency at the time of the survey). Of the participants who responded to at least 1 SUS statement, 520 stated that they had received care in Region Skåne, whereas 331 participants had received care in Region Uppsala. Uppsala’s mean SUS score was 80.71 (SD 13.41), compared with Skåne’s mean of 79.37 (SD 13.78). CONCLUSIONS The Swedish national PAEHR Journalen has a reasonably good usability (mean SUS score 79.81, SD 14.25); however, further research into more specific usability areas are needed to ensure usefulness and ease of use in the future. A somewhat higher SUS score for the region with high transparency compared with the region with low transparency could indicate a relationship between the perceived usability of a PAEHR and the level of transparency offered, but further research on the relationship between transparency and usability is required.

scholarly journals Exploring the potential of online self-reported and routinely collected electronic healthcare record data in self-harm research

2020 ◽  
Author(s):  
◽  
Amanda Marchant
Keyword(s):  
Cohort Study ◽  
Electronic Health Record ◽  
National Survey ◽  
Health Data ◽  
Data Sources ◽  
Health Record ◽  
Healthcare Data ◽  
Research Register ◽  
Self Harm ◽  
Electronic Health

Background:Self-harm is a major public health concern and is a leading cause of death from injury. Reaching participants for self-harm research raises a number of challenges, however an opportunity exists in the use of both the internet for data collection and in the use of routinely collected healthcare data.Aims and objectives:The aim of this project was to explore the potential of both online and routinely collected healthcare data for self-harm research and the way in which these data sources can be brought together.Methods:This thesis represents a series of projects exploring the use of various data sources for self-harm research. The first was the development and piloting of an online platform (SHARE UK) for self-harm research. This website incorporated multiple functions: hosting questionnaires; sign-up for a research register; sign-up for linkage with routinely collected data and uploads to a media databank. Next a national survey was conducted to explore young people’s perspectives on the use of both online and healthcare data for self-harm research. Lastly a population level electronic health record cohort study analysing trends over time and contacts across healthcare services was conducted.Results:Participants engaged well with research online: 498 participants signed up to the SHARE UK platform; of whom 85% signed up for the research register. Sixty-two participants uploaded 95 items to the media databank. Alternative formats are discussed. Only 15% of participants consented for linkage with healthcare data. A total of 2,733 young people aged 10-24 who self-harm completed the national survey. Results demonstrated that the necessity for participants to give their address for linkage poses a significant barrier. Opinions around the use of Big Data, encompassing social media, marketing and health data are explored.A total of 937,697 individuals aged 10-24 provided 5,269,794 person years of data from 01.01.2003 to 20.09.2015 to the electronic health record cohort study. Self-harm incidence was highest in primary care. Males preferentially present to emergency departments. Male are less likely than females to be admitted following attendance. This difference persists in the youngest age groups and for self-poisoning. Analysis supports the importance of non-specialist services.Conclusions:This thesis has explored both online and routinely collected healthcare data and their utility for self-harm research, exploring participant views and issues via a national survey. An online platform for self-harm research was successfully piloted and issues identified. This series of projects explores possibilities for future self-harm research. The use of multiple data sources allows research to represent both those in the community and those presenting to healthcare settings, lowering many of the barriers to participating in self-harm research. The future utility of the SHARE UK platform through its collaboration with the Adolescent Mental Health Data Platform (ADP) is discussed. Results of this series of projects will be used to inform the development of this platform with lessons learnt from the pilot addressed and findings from both the national survey and the electronic health record cohort study informing and shaping future research.

scholarly journals National Survey of Hematopoietic Cell Transplantation Center Personnel, Infrastructure, and Models of Care Delivery

2015 ◽  
Vol 21 (7) ◽  
pp. 1308-1314 ◽  
Author(s):  
Navneet S. Majhail ◽  
Lih-Wen Mau ◽  
Pintip Chitphakdithai ◽  
Tammy Payton ◽  
Michael Eckrich ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
National Survey ◽  
Hematopoietic Cell Transplantation ◽  
Care Delivery ◽  
Models Of Care ◽  
Hematopoietic Cell ◽  
Transplantation Center
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