The Feasibility of using Web-Based Methods to Capture Quality of Recovery in the Perioperative Period: Comparing Email, SMS Text, and Concurrent Mixed Modes Approaches (Preprint)

2020 ◽  
Author(s):  
Jamie L. Romeiser ◽  
James Cavalcante ◽  
Deborah C. Richman ◽  
Sunitha M. Singh ◽  
Xiaohui Liang ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Text Messaging ◽  
Response Rates ◽  
Web Based ◽  
Quality Of Recovery ◽  
Mixed Modes ◽  
The Web ◽  
Sms Text Messaging

BACKGROUND As patients are being discharged from the hospital earlier, the ability to monitor patient recovery between hospital discharge and the first follow-up clinic visit is becoming increasingly important. Despite substantial increases in both internet use and smartphone ownership over the past 5 years, clinicians have been slow to embrace the use of these devices to capture patient recovery information in the period between hospital discharge and the first clinical follow-up appointment. OBJECTIVE To investigate the generalizability of using a web-based platform to capture patient recovery in a broad surgical patient population, and compare response rates for three different web-based strategies for delivering recovery surveys over the perioperative time-period: email, short message service (SMS) text messaging, and a concurrent mixed approach of using both email and SMS text messaging. METHODS Patients undergoing surgeries managed with an Enhanced Recovery After Surgery (ERAS) pathway program were asked to participate in the web-based quality assurance monitoring program at the time of their pre-operative surgery appointment. Different follow-up methods were implemented over three sequential phases. Patients received HIPAA compliant web-based survey links by either email (phase 1), SMS text (phase 2), or concurrently using both email and SMS text (phase 3) using RedCap® and Twillio® software. Recovery assessments using the established Quality of Recovery-9 (QOR-9) tool were measured 4 days prior to surgery, and at 7 and 30 days postoperatively. Generalizability of the web-based system was examined by comparing demographic and clinical characteristics of those who participated vs. those that did not. Differences in response rates by web-based collection method were analyzed in adjusted models. RESULTS A total of 615 patients asked to participate, with 526 (85.53%) opting in to the follow-up program. Those who opted in were younger, slightly healthier, and more likely to be in a partnership. The concurrent mixed modes (CMM) was the most successful method for obtaining responses at every time point compared to text or email alone (pre: 74% vs. 67% vs 43%, P <.001; 7 day: 67% vs. 50% vs. 47%, P = .001; 30 day: 65% vs. 50% vs. 43%, P = .001, respectively). In the adjusted model, the CMM method of contact significantly predicted response compared to using email alone (Odds Ratio (OR) =3.4, P <.0001), and SMS text alone (OR=1.9, P =.0003). Additional significant predictors of response were race, partnership and time. CONCLUSIONS For internet users and smartphone owners, electronic capture of recovery surveys appears to be possible through this HIPAA compliant resource friendly mechanism. Discrepancies in both inclusion and response rates still exist among certain subgroups of patients, but the concurrent approach of using both email and text messages was the most effective approach to reach the largest number of patients across all subgroups.

scholarly journals A Suite of Mobile Conversational Agents for Daily Stress Management (Popbots): Mixed Methods Exploratory Study (Preprint)

2020 ◽  
Author(s):  
Matthew Louis Mauriello ◽  
Nantanick Tantivasadakarn ◽  
Marco Antonio Mora-Mendoza ◽  
Emmanuel Thierry Lincoln ◽  
Grace Hon ◽  
...  
Keyword(s):  
Stress Management ◽  
Design Guidelines ◽  
Coping Resources ◽  
Rank Test ◽  
Depression Symptoms ◽  
Conversational Agents ◽  
Daily Stress ◽  
Web Based ◽  
The Web

BACKGROUND Approximately 60%-80% of the primary care visits have a psychological stress component, but only 3% of patients receive stress management advice during these visits. Given recent advances in natural language processing, there is renewed interest in mental health chatbots. Conversational agents that can understand a user’s problems and deliver advice that mitigates the effects of daily stress could be an effective public health tool. However, such systems are complex to build and costly to develop. OBJECTIVE To address these challenges, our aim is to develop and evaluate a fully automated mobile suite of shallow chatbots—we call them Popbots—that may serve as a new species of chatbots and further complement human assistance in an ecosystem of stress management support. METHODS After conducting an exploratory Wizard of Oz study (N=14) to evaluate the feasibility of a suite of multiple chatbots, we conducted a web-based study (N=47) to evaluate the implementation of our prototype. Each participant was randomly assigned to a different chatbot designed on the basis of a proven cognitive or behavioral intervention method. To measure the effectiveness of the chatbots, the participants’ stress levels were determined using self-reported psychometric evaluations (eg, web-based daily surveys and Patient Health Questionnaire-4). The participants in these studies were recruited through email and enrolled on the web, and some of them participated in follow-up interviews that were conducted in person or on the web (as necessary). RESULTS Of the 47 participants, 31 (66%) completed the main study. The findings suggest that the users viewed the conversations with our chatbots as helpful or at least neutral and came away with increasingly positive sentiment toward the use of chatbots for proactive stress management. Moreover, those users who used the system more often (ie, they had more than or equal to the median number of conversations) noted a decrease in depression symptoms compared with those who used the system less often based on a Wilcoxon signed-rank test (W=91.50; Z=−2.54; <i>P</i>=.01; <i>r</i>=0.47). The follow-up interviews with a subset of the participants indicated that half of the common daily stressors could be discussed with chatbots, potentially reducing the burden on human coping resources. CONCLUSIONS Our work suggests that suites of shallow chatbots may offer benefits for both users and designers. As a result, this study’s contributions include the design and evaluation of a novel suite of shallow chatbots for daily stress management, a summary of benefits and challenges associated with random delivery of multiple conversational interventions, and design guidelines and directions for future research into similar systems, including authoring chatbot systems and artificial intelligence–enabled recommendation algorithms.

Web-Based Multimedia Tools for Monitoring and E-Learning

2010 ◽  
pp. 1-21 ◽  
Author(s):  
F. Bellas ◽  
O. Fontenla-Romero ◽  
N. Sánchez-Maroño ◽  
J. A. Becerra
Keyword(s):  
Teaching Methodology ◽  
Resource Monitoring ◽  
Web Based ◽  
Basic Point ◽  
Multimedia Tools ◽  
Degree Of Satisfaction ◽  
E Learning ◽  
Interactive Videos ◽  
The Web

This chapter is devoted to the application of Web-based multimedia tools as a complement to traditional e-learning resources to improve the quality of teaching in two senses: adapting lesson contents to improving the understanding and increasing the motivation of the students. The authors present a set of practical tools that have achieved successful results in their courses and that, together, provide a more proactive teaching methodology based on interactive and mobile learning materials. These tools can be divided into two main groups: simulations and interactive videos, directly related to the process of studying, and quizzes and questionnaires, useful to adapt the teaching to the objective comprehension level. In addition, the authors point out the advantages of providing the students with more familiar multimedia materials suitable for being transported and consulted in mobile devices. A basic point of this methodology is that all these resources are available through a Web-based interface, so that the interaction does not depend on the physical presence of the students. Finally, the authors must point out that with their methodology they are focused on monitoring learning, which is achieved directly with online questionnaires, but they have also performed resource monitoring, in terms of degree of satisfaction and practical use. This is achieved, in this case, through the use of surveys and from the analysis of the statistics provided by the Web-based application.

scholarly journals Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021249 ◽  
Author(s):  
Ilse van Beusekom ◽  
Ferishta Bakhshi-Raiez ◽  
Nicolette F de Keizer ◽  
Dave A Dongelmans ◽  
Marike van der Schaaf
Keyword(s):  
Intensive Care ◽  
Health Professionals ◽  
Web Based ◽  
Quality Registry ◽  
Email Address ◽  
National Quality ◽  
The Web ◽  
Screening Software ◽  
National Quality Registry

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.

Specification of the Context of Use for the Development of Web-Based Applications

2011 ◽  
pp. 146-162
Author(s):  
Marta Fernández de Arriba ◽  
Eugenia Díaz ◽  
Jesús Rodríguez Pérez
Keyword(s):  
Web Applications ◽  
Assistive Technologies ◽  
Web Content ◽  
Disabled People ◽  
Technological Environment ◽  
Web Based ◽  
Development Team ◽  
Context Of Use ◽  
The Web

This chapter presents the structure of an index which serves as support so allowing the development team to create the specification of the context of use document for the development of Web applications, bearing in mind characteristics of usability and accessibility, each point of the index being explained in detail. A correct preparation of this document ensures the quality of the developed Web applications. The international rules and standards related to the identification of the context of use have been taken into account. Also, the functionality limitations (sensorial, physical, or cognitive) which affect access to the Web are described, as well as the technological environment used by disabled people (assistive technologies or alternative browsers) to facilitate their access to the Web content. Therefore, following the developed specification of the context of use, usable and accessible Web applications with their corresponding benefits can be created.

Physicians’ Choice in Using Internet and Fax for Patient Recruitment and Follow-up in a Randomized Controlled Trial

2004 ◽  
Vol 43 (03) ◽  
pp. 268-272 ◽  
Author(s):  
S. Morita ◽  
T. Fukui ◽  
J. Sakamoto ◽  
M. Rahman
Keyword(s):  
Randomized Controlled Trial ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Data Entry ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Web Based ◽  
Randomized Controlled ◽  
The Web

Summary Objective: To examine the physicians’ preference between Web and fax-based remote data entry (RDE) system for an ongoing randomized controlled trial (RCT) in Japan. Methods: We conducted a survey among all the collaborating physicians (n = 512) of the CASE-J (Candesartan Antihypertensive Survival Evaluation in Japan) trial, who have been recruiting patients and sending follow-up data using the Web or a fax-based RDE system. The survey instrument assessed physicians’ choice between Web and fax-based RDE systems, their practice pattern, and attitudes towards these two modalities. Results: A total of 448 (87.5%) responses were received. The proportions of physicians who used Web, fax, and the combination of these two were 45.9%, 33.3% and 20.8%, respectively. Multivariate logistic regression analyses revealed that physicians 55 years or younger [odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1-3.3] and regular users of computers (OR = 4.2, 95% CI = 2.1-8.2) were more likely to use the Web-based RDE system. Conclusions: This information would be useful in designing an RCT with a Web-based RDE system in Japan and abroad.

scholarly journals A Structured Workshop to Improve the Quality of Resident Discharge Summaries

2012 ◽  
Vol 4 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Jaideep S. Talwalkar ◽  
Jason R. Ouellette ◽  
Shawnette Alston ◽  
Gregory K. Buller ◽  
Daniel Cottrell ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Discharge Summary ◽  
Faculty Members ◽  
Evaluation Tool ◽  
Outpatient Physician ◽  
Hospital Discharge Summary ◽  
Structured Program ◽  
Discharge Summaries

Abstract Background Poor communication at hospital discharge can increase the risk of adverse events. The hospital discharge summary is the most common tool for detailing events related to hospitalization in preparation for postdischarge follow-up, yet deficiencies in discharge summaries have been widely reported. Resident physicians are expected to dictate discharge summaries but receive little formal training in this arena. We hypothesized that implementation of an educational program on chart documentation skills would result in improvements in the quality of hospital discharge summaries in a community hospital internal medicine residency program. Methods A monthly, 1-hour workshop was launched in August 2007 to provide consistent and ongoing instruction on chart documentation. Guided by a faculty moderator, residents reviewed 2 randomly selected peer chart notes per session using instruments developed for that purpose. After the workshop had been in place for 2 years, 4 faculty members reviewed 63 randomly selected discharge summaries from spring 2007, spring 2008, and spring 2009 using a 14-item evaluation tool. Results Mean scores for 10 of the 14 individual items improved in a stepwise manner during the 3 years of the study. Items related to overall quality of the discharge summary showed statistically significant improvement, as did the portion of the summaries “carbon copied” to the responsible outpatient physician. Conclusions The quality of hospital discharge summaries improved following the implementation of a novel, structured program to teach chart documentation skills. Ongoing improvement was seen 1 and 2 years into the program, suggesting that continuing instruction in those skills was beneficial.

scholarly journals One-Way and Two-Way Mobile Phone Text Messages for Treatment Adherence Among Patients With HIV: Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Dickson Shey Nsagha ◽  
Vincent Verla Siysi ◽  
Same Ekobo ◽  
Thomas Obinchemti Egbe ◽  
Odette Dzemo Kibu
Keyword(s):  
Quality Of Life ◽  
Data Collection ◽  
Text Messaging ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Randomized Controlled ◽  
The Impact ◽  
Sms Text Messaging

BACKGROUND Incomplete adherence to antiretroviral therapy (ART) is one of the factors that contribute to HIV drug resistance, and it is a major problem for the public health system in controlling the HIV pandemic. There is emerging evidence that SMS can play an important role in health care delivery among patients with HIV on ART, especially in resource-limited settings. OBJECTIVE This paper aims to assess the impact of two-way and one-way SMS text messaging on adherence to HIV treatment. We hypothesized that sending weekly text messages through the one-way and two-way SMS text messaging approach will improve adherence to ART among patients with HIV and improve associated clinical outcomes (quality of life). METHODS A randomized controlled trial is being carried out among participants with HIV who have been on ART for at least one month from an accredited treatment center, namely the Buea Regional Hospital and Kumba District Hospital of South West Region, Cameroon. Participants with HIV, both male and female, aged 21 years and older make up a sample size of 207. The interventions involved the use of mobile phone text messages. Before commencing the intervention, a focus group discussion was carried out among the participants to understand their perception about the use of SMS-based interventions to improve adherence. A total of 246 participants were randomized to receive either a one-way text message (SMS sent to a recipient without recipient sending a reply) or two-way text message (SMS sent to a recipient and recipient sends a reply) or the control (no SMS, only standard care). Data on adherence and quality of life were collected at baseline and after 6 months and will be analyzed using SPSS version 21, while qualitative data will be analyzed using Atlas.ti 7.5. RESULTS Data collection began in September 2019 with focus group discussions and baseline data collection. After 1 month of baseline data collection, the intervention began in October 2019, and postintervention data were collected after 6 months (March 2020). At the end of the study, we will be able to understand the perception of patients toward SMS text messaging–based interventions and also assess the impact of one-way and two-way SMS text messages on treatment adherence among patients with HIV and on associated clinical outcomes (quality of life). CONCLUSIONS The impact of SMS text messaging varies across different settings. The results from this study will determine the perception of patients toward an SMS text messaging–based intervention and its impact on adherence to ART. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16127

scholarly journals Efficacy of Text Messaging and Personal Consultation by Pharmacy Students Among Adults With Hypertension: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Panpan Zhai ◽  
Khezar Hayat ◽  
Wenjing Ji ◽  
Qian Li ◽  
Li Shi ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Text Messaging ◽  
Controlled Trial ◽  
Intervention Group ◽  
Text Messages ◽  
Chinese Patients ◽  
Control Group ◽  
To Receive ◽  
Sms Text Messaging

BACKGROUND Hypertension is one of the leading risk factors for ischemic heart diseases, and high rates of hypertension prevalence have either remained the same or increased in developing countries in recent years. Unfortunately, about 20% to 50% of patients with chronic diseases have been nonadherent to their drug therapy. SMS text messaging and pharmacy student–led consultations have the potential to help patients manage their blood pressure (BP). OBJECTIVE The aim of this study was to assess the effectiveness, feasibility, and acceptability of SMS text messaging and consultation to manage the BP of Chinese patients with hypertension. METHODS We conducted a two-arm cluster randomized controlled trial among patients with hypertension in Xi’an City, Shaanxi Province, China, and recruited 384 patients from 8 community health care centers. Patients were randomized into an intervention group to receive SMS text messages and consultations or into a control group to receive usual care for 3 months. We sent SMS text messages at 3-day intervals and collected data at baseline (including demographics, clinical outcomes, medication complexity, side effects, patient behavior, knowledge about hypertension, BP, and medication adherence) and the 3-month follow-up (including BP, medication adherence, and knowledge about hypertension). RESULTS We assessed 445 patients with hypertension and excluded 61 patients who were not eligible or who had not filled out their questionnaires. The mean age of the patients was 68.5 (SD 7.9) years in the intervention group and 69.4 (SD 9.7) years in the control group, and the sample was primarily female (265/384, 69.0%). Patients in the intervention group showed significant improvements in systolic BP (SBP; mean 134.5 mm Hg, SD 15.5 mm Hg vs mean 140.7 mm Hg, SD 15.2 mm Hg; <i>P</i>=.001), medication adherence (mean 7.4, SD 1.2 vs mean 7.0, SD 1.3; <i>P</i>=.04), and knowledge about hypertension (mean 6.3, SD 0.9 vs mean 5.9, SD 1.2; <i>P</i>=.004) compared with those in the control group. In measures of diastolic BP (DBP), the two arms showed nonsignificant improvements (mean 78.2 mm Hg, SD 9.0 mm Hg vs mean 77.2 mm Hg, SD 10.3 mm Hg; <i>P</i>=.06). In total, 176 patients had controlled BP at the 3-month follow-up (98 patients in the intervention group vs 78 patients in the control group), but it was nonsignificant (<i>P</i>=.08). CONCLUSIONS The use of SMS text messaging and consultation to manage SBP and improve medication adherence is effective, feasible, and acceptable among Chinese patients with hypertension, although a significant difference was not observed with regard to DBP. It is important to maximize the potential of SMS text messaging and consultation by increasing the feasibility and acceptance of mobile interventions and conduct a cost-effectiveness analysis on this method. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900026862; http://www.chictr.org.cn/showproj.aspx?proj=42717.

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