Evaluating the quality of asynchronously versus synchronously delivered virtual care: Differences in rates of reported medication side effects by patients on a direct-to-consumer telehealth platform (Preprint)

2021 ◽  
Author(s):  
Lauren Broffman ◽  
Melynda Barnes ◽  
Kevin Stern ◽  
Amy Westergren
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Policy Makers ◽  
Direct To Consumer ◽  
Virtual Care ◽  
Patient Reported ◽  
Medication Side ◽  
Health Care Encounters ◽  
Established Relationship ◽  
End To End

BACKGROUND End-to-end asynchronous health care encounters are becoming an increasingly mainstream form of telehealth. Unlike synchronous telehealth, policy makers and other key health care stakeholders have been hesitant to fully embrace the fully asynchronous modality, especially in the context of direct-to-consumer (DTC) platforms where encounters are patient-initiated and there is no pre-established relationship with their provider. This hesitation is compounded by limited research comparing outcomes between asynchronous and synchronous care, especially in the DTC context. OBJECTIVE The purpose of this study is to explore whether entirely asynchronous care leads to different patient outcomes in the form of medication-related adverse events when compared to synchronous virtual care METHODS Using 10,000 randomly sampled patient records from a prominent, U.S. based DTC platform, we analyzed rates of patient-reported side effects from commonly prescribed medications and compared these rates across modalities of treatment RESULTS Fully end-to-end asynchronous care resulted in lower but nonsignificant rates of reported drug-related side effects compared to synchronous treatment. CONCLUSIONS In some circumstances, fully asynchronous care may not create unsafe prescribing conditions when compared to synchronous care. More research is needed to evaluate the safety of asynchronous care across a wider set of circumstances and measures.

scholarly journals Virtual care: Enhancing access or harming care?

2020 ◽  
Vol 33 (6) ◽  
pp. 288-292 ◽  
Author(s):  
Lorian Hardcastle ◽  
Ubaka Ogbogu
Keyword(s):  
Quality Care ◽  
Family Doctor ◽  
Healthcare Services ◽  
Policy Makers ◽  
Virtual Care ◽  
Established Relationship ◽  
Privacy Issues ◽  
Improve Access

COVID-19 has catalyzed the adoption of virtual medical care in Canada. Virtual care can improve access to healthcare services, particularly for those in remote locations or with health conditions that make seeing a doctor in person difficult or unsafe. However, virtual walk-in clinic models that do not connect patients with their own doctors can lead to fragmented, lower quality care. Although virtual walk-in clinics can be helpful for those who temporarily lack access to a family doctor, they should not be relied on as a long-term substitute to an established relationship with a primary care provider. Virtual care also raises significant privacy issues that policy-makers must address prior to implementing these models. Patients should be cautious of the artificial intelligence recommendations generated by some virtual care applications, which have been linked to quality of care concerns.

Recognizing the Role of Chaplaincy in Healthcare: Perspectives on the COVID-19 Pandemic

2021 ◽  
pp. 154230502110649
Author(s):  
Olamma C. Otisi
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Health Care Delivery ◽  
Spiritual Care ◽  
Care Delivery ◽  
Healthcare Systems ◽  
Policy Makers

The COVID-19 pandemic has been a difficult and trying time, but as most situations in life, it brought both good and bad side effects. Concerning chaplaincy, COVID-19 reveals that we have not arrived yet in the effort to incorporate spiritual care into essential health care delivery. Although chaplaincy is beginning to have a voice, we have been mostly speaking to ourselves. We need an advocacy voice that healthcare systems and policy makers can hear.

The ‘Modernisation’ of Scotland and its Impact on Glasgow, 1955–1979: ‘Unwanted Side Effects’ and Vulnerabilities

2016 ◽  
Vol 25 (3) ◽  
pp. 294-316 ◽  
Author(s):  
Chik Collins ◽  
Ian Levitt
Keyword(s):  
Side Effects ◽  
Government Policy ◽  
Regional Policy ◽  
Excess Mortality ◽  
Policy Agenda ◽  
Policy Makers ◽  
Uk Government ◽  
1960S And 1970S ◽  
The 1960S ◽  
The Impact

This article reports findings of research into the far-reaching plan to ‘modernise’ the Scottish economy, which emerged from the mid-late 1950s and was formally adopted by government in the early 1960s. It shows the growing awareness amongst policy-makers from the mid-1960s as to the profoundly deleterious effects the implementation of the plan was having on Glasgow. By 1971 these effects were understood to be substantial with likely severe consequences for the future. Nonetheless, there was no proportionate adjustment to the regional policy which was creating these understood ‘unwanted’ outcomes, even when such was proposed by the Secretary of State for Scotland. After presenting these findings, the paper offers some consideration as to their relevance to the task of accounting for Glasgow's ‘excess mortality’. It is suggested that regional policy can be seen to have contributed to the accumulation of ‘vulnerabilities’, particularly in Glasgow but also more widely in Scotland, during the 1960s and 1970s, and that the impact of the post-1979 UK government policy agenda on these vulnerabilities is likely to have been salient in the increase in ‘excess mortality’ evident in subsequent years.

scholarly journals From virtual to real healing: a critical overview of the therapeutic use of virtual reality to cope with mourning

2021 ◽  
Author(s):  
Silvia Francesca Maria Pizzoli ◽  
Dario Monzani ◽  
Laura Vergani ◽  
Virginia Sanchini ◽  
Ketti Mazzocco
Keyword(s):  
Health Care ◽  
Social Media ◽  
Virtual Reality ◽  
Side Effects ◽  
Virtual Environments ◽  
Therapeutic Use ◽  
Health Care Needs ◽  
Care Needs ◽  
South Korean ◽  
Critical Overview

AbstractIn recent years, virtual reality (VR) has been effectively employed in several settings, ranging from health care needs to leisure and gaming activities. A new application of virtual stimuli appeared in social media: in the documentary ‘I met you’ from the South-Korean Munhwa Broadcasting, a mother made the experience of interacting with the avatar of the seven-year-old daughter, who died four years before. We think that this new application of virtual stimuli should open a debate on its possible implications: it represents contents related to grief, a dramatic and yet natural experience, that can have deep psychological impacts on fragile subjects put in virtual environments. In the present work, possible side-effects, as well as hypothetical therapeutical application of VR for the treatment of mourning, are discussed.

scholarly journals Integrating data from multiple Finnish biobanks and national health-care registers for retrospective studies: Practical experiences

2021 ◽  
pp. 140349482110044
Author(s):  
Jaakko Lähteenmäki ◽  
Anna-Leena Vuorinen ◽  
Juha Pajula ◽  
Kari Harno ◽  
Mika Lehto ◽  
...  
Keyword(s):  
Health Care ◽  
Statistical Power ◽  
Data Exchange ◽  
Register Data ◽  
Genotype Data ◽  
Multiple Sources ◽  
Hospital Data ◽  
National Register ◽  
National Register Data ◽  
Health Care Encounters

Aim: This case study aimed to investigate the process of integrating resources of multiple biobanks and health-care registers, especially addressing data permit application, time schedules, co-operation of stakeholders, data exchange and data quality. Methods: We investigated the process in the context of a retrospective study: Pharmacogenomics of antithrombotic drugs (PreMed study). The study involved linking the genotype data of three Finnish biobanks (Auria Biobank, Helsinki Biobank and THL Biobank) with register data on medicine dispensations, health-care encounters and laboratory results. Results: We managed to collect a cohort of 7005 genotyped individuals, thereby achieving the statistical power requirements of the study. The data collection process took 16 months, exceeding our original estimate by seven months. The main delays were caused by the congested data permit approval service to access national register data on health-care encounters. Comparison of hospital data lakes and national registers revealed differences, especially concerning medication data. Genetic variant frequencies were in line with earlier data reported for the European population. The yearly number of international normalised ratio (INR) tests showed stable behaviour over time. Conclusions: A large cohort, consisting of versatile individual-level phenotype and genotype data, can be constructed by integrating data from several biobanks and health data registers in Finland. Co-operation with biobanks is straightforward. However, long time periods need to be reserved when biobank resources are linked with national register data. There is a need for efforts to define general, harmonised co-operation practices and data exchange methods for enabling efficient collection of data from multiple sources.

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