Determining the impact of a clinic coordinator on patient access and clinic efficiency in a pediatric multidisciplinary spina bifida clinic using medical informatics

2021 ◽  
pp. 1-6
Author(s):  
Matthew J. McLaughlin ◽  
Ann C. Modrcin ◽  
Timothy P. Hickman ◽  
Mark Hoffman
Keyword(s):  
Medical Informatics ◽  
Median Number ◽  
Patient Access ◽  
Missed Appointments ◽  
Clinic Efficiency ◽  
Before And After ◽  
Business Objects ◽  
Cost Efficient ◽  
The Impact ◽  
Improve Patient

PURPOSE: The objective of this study was to analyze the effects on patient access by decreasing missed appointments after hiring a clinic coordinator using medical informatics. METHODS: A single-center retrospective analysis of the rates of missed appointments before and after hiring a clinic coordinator in a multidisciplinary spinal differences clinic were analyzed using a commercially available business software system (SAP® Business Objects). The total number of clinic visits was collected for each month to determine the access available for patients. RESULTS: The median number of missed appointments per clinic by month before employing the clinic coordinator was higher than in the two years following implementation (p <  0.0005). No differences were seen in the number of available appointment slots per month indicating no new clinics were needed to improve patient access (p = 0.551). Projected billing amounts prior to hiring the clinic coordinator indicated that $91,520 was lost in the 2 years prior to hiring this coordinator compared to $30,160 lost during the 2 years following the creation of this position (p = 0.0009). CONCLUSION: Hiring a clinic coordinator decreased the rate of missed appointments and was a cost-efficient intervention to improve patient access and provide effective patient care in a multidisciplinary setting.

scholarly journals Impact of the pan-Canadian Oncology Drug Review on provincial concordance with respect to cancer drug funding decisions and time to funding

2017 ◽  
Vol 24 (5) ◽  
pp. 295 ◽  
Author(s):  
A. Srikanthan ◽  
H. Mai ◽  
N. Penner ◽  
E. Amir ◽  
A. Laupacis ◽  
...  
Keyword(s):  
Linear Models ◽  
Drug Product ◽  
Median Number ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Oncology Drug ◽  
Before And After ◽  
Canadian Provinces ◽  
The Impact ◽  
Drug Review

Background The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding.Methods In a retrospective review, Health Canada’s Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics.Results Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr’s implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada’s noc date to the date of funding significantly declined (to 393 days from 522 days, p < 0.001). Exploratory analyses excluding provinces with incomplete data did not change the results.Conclusions After the implementation of the pcodr, greater concordance in cancer drug funding decisions between provinces and decreased time to funding decisions were observed.

scholarly journals mHealth App Prescription in Australian General Practice: Pre-Post Study

10.2196/16497 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16497 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Tammy Hoffmann ◽  
Paul Glasziou
Keyword(s):  
General Practice ◽  
Median Number ◽  
Implementation Intervention ◽  
Electronic Reporting ◽  
Before And After ◽  
Australian General Practice ◽  
Prescription Rates ◽  
Drug Interventions ◽  
The Impact ◽  
Mhealth Apps

Background Evidence of effectiveness of mobile health (mHealth) apps as well as their usability as non-drug interventions in primary care are emerging around the globe. Objective This study aimed to explore the feasibility of mHealth app prescription by general practitioners (GPs) and to evaluate the effectiveness of an implementation intervention to increase app prescription. Methods A single-group, before-and-after study was conducted in Australian general practice. GPs were given prescription pads for 6 mHealth apps and reported the number of prescriptions dispensed for 4 months. After the reporting of month 2, a 2-minute video of one of the apps was randomly selected and sent to each GP. Data were collected through a prestudy questionnaire, monthly electronic reporting, and end-of-study interviews. The primary outcome was the number of app prescriptions (total, monthly, per GP, and per GP per fortnight). Secondary outcomes included confidence in prescribing apps (0-5 scale), the impact of the intervention video on subsequent prescription numbers, and acceptability of the interventions. Results Of 40 GPs recruited, 39 commenced, and 36 completed the study. In total, 1324 app prescriptions were dispensed over 4 months. The median number of apps prescribed per GP was 30 (range 6-111 apps). The median number of apps prescribed per GP per fortnight increased from the pre-study level of 1.7 to 4.1. Confidence about prescribing apps doubled from a mean of 2 (not so confident) to 4 (very confident). App videos did not affect subsequent prescription rates substantially. Post-study interviews revealed that the intervention was highly acceptable. Conclusions mHealth app prescription in general practice is feasible, and our implementation intervention was effective in increasing app prescription. GPs need more tailored education and training on the value of mHealth apps and knowledge of prescribable apps to be able to successfully change their prescribing habits to include apps. The future of sustainable and scalable app prescription requires a trustworthy electronic app repository of prescribable mHealth apps for GPs.

scholarly journals Telehealth to support referral management in a universal health system: a before-and-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabrina Dalbosco Gadenz ◽  
Josué Basso ◽  
Patrícia Roberta Berithe Pedrosa de Oliviera ◽  
Stephan Sperling ◽  
Marcus Vinicius Dutra Zuanazzi ◽  
...  
Keyword(s):  
Linear Models ◽  
Patient Flow ◽  
Waiting Times ◽  
Median Number ◽  
Waiting Lists ◽  
Referral Management ◽  
Before And After ◽  
The Impact ◽  
Universal Health ◽  
Before And After Study

Abstract Background Management of patient flow within a healthcare network, allowing equitable and qualified access to healthcare, is a major challenge for universal health systems. Implementation of telehealth strategies to support referral management has been shown to increase primary care resolution and to promote coordination of care. The objective of this study was to assess the impact of telehealth strategies on waiting lists and waiting times for specialized care in Brazil. Methods Before-and-after study with measures obtained between January 2019 and February 2020. Baseline measurements of waiting lists were obtained immediately before the implementation of a remotely operated referral management system. Post-interventional measurements were obtained monthly, up to six months after the beginning of operation. Data was extracted from the database of the project. General linear models were applied to assess interaction of locality and time over number of cases on waiting lists and waiting times. Results At baseline, the median number of cases on waiting lists ranged from 2961 to 12,305 cases. Reductions of the number of cases on waiting lists after six months of operation were observed in all localities. The magnitude of the reduction ranged from 54.67 to 88.97 %. Interaction of time measurements was statistically significant from the second month onward. Median waiting times ranged from 159 to 241 days at baseline. After six months, there was a decrease of 100 and 114 waiting days in two localities, respectively, with reduction of waiting times only for high-risk cases in the third locality. Conclusions Adoption of telehealth strategies resulted in the reduction of number of cases on waiting lists. Results were consistent across localities, suggesting that telehealth interventions are viable in diverse settings.

scholarly journals PICU Passport: Pilot study of a handheld resident curriculum

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adrian D. Zurca ◽  
Conrad Krawiec ◽  
Daniel McKeone ◽  
Adil Z. Solaiman ◽  
Brandon M. Smith ◽  
...  
Keyword(s):  
Pediatric Intensive Care ◽  
Median Number ◽  
Educational Tool ◽  
Knowledge Gaps ◽  
Specific Knowledge ◽  
Pediatric Residents ◽  
Before And After ◽  
Satisfaction With Education ◽  
Resident Learning ◽  
The Impact

Abstract Background To explore the impact of an educational tool designed to streamline resident learning during their pediatric intensive care (PICU) rotations. Methods Topics and procedures were chosen for inclusion based on national requirements for pediatric residents. Residents received a PICU Passport at the beginning of their rotations. PICU faculty were provided learning objectives for each topic. Residents and faculty were surveyed before and after starting use of the Passport. Results Twenty-two residents pre-Passport and 38 residents post-Passport were compared. Residents were more satisfied with their educational experiences (27 % vs. 79 %; P < 0.001), more likely to report faculty targeted teaching towards knowledge gaps (5 % vs. 63 %; P < 0.001) and felt more empowered to ask faculty to discuss specific topics (27 % vs. 76 %; P = 0.002). The median number of teaching sessions increased from 3 to 10 (Z = 4.2; P < 0.001). Most residents (73 %) felt the Passport helped them keep track of their learning and identify gaps in their knowledge. Conclusions The PICU Passport helps residents keep track of their learning and identify gaps in their knowledge. Passport use increases resident satisfaction with education during their PICU rotation and empowers residents to ask PICU faculty to address specific knowledge gaps.

scholarly journals mHealth App Prescription in Australian General Practice: Pre-Post Study (Preprint)

2019 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Tammy Hoffmann ◽  
Paul Glasziou
Keyword(s):  
General Practice ◽  
Median Number ◽  
Implementation Intervention ◽  
Electronic Reporting ◽  
Before And After ◽  
Australian General Practice ◽  
Prescription Rates ◽  
Drug Interventions ◽  
The Impact ◽  
Mhealth Apps

BACKGROUND Evidence of effectiveness of mobile health (mHealth) apps as well as their usability as non-drug interventions in primary care are emerging around the globe. OBJECTIVE This study aimed to explore the feasibility of mHealth app prescription by general practitioners (GPs) and to evaluate the effectiveness of an implementation intervention to increase app prescription. METHODS A single-group, before-and-after study was conducted in Australian general practice. GPs were given prescription pads for 6 mHealth apps and reported the number of prescriptions dispensed for 4 months. After the reporting of month 2, a 2-minute video of one of the apps was randomly selected and sent to each GP. Data were collected through a prestudy questionnaire, monthly electronic reporting, and end-of-study interviews. The primary outcome was the number of app prescriptions (total, monthly, per GP, and per GP per fortnight). Secondary outcomes included confidence in prescribing apps (0-5 scale), the impact of the intervention video on subsequent prescription numbers, and acceptability of the interventions. RESULTS Of 40 GPs recruited, 39 commenced, and 36 completed the study. In total, 1324 app prescriptions were dispensed over 4 months. The median number of apps prescribed per GP was 30 (range 6-111 apps). The median number of apps prescribed per GP per fortnight increased from the pre-study level of 1.7 to 4.1. Confidence about prescribing apps doubled from a mean of 2 (not so confident) to 4 (very confident). App videos did not affect subsequent prescription rates substantially. Post-study interviews revealed that the intervention was highly acceptable. CONCLUSIONS mHealth app prescription in general practice is feasible, and our implementation intervention was effective in increasing app prescription. GPs need more tailored education and training on the value of mHealth apps and knowledge of prescribable apps to be able to successfully change their prescribing habits to include apps. The future of sustainable and scalable app prescription requires a trustworthy electronic app repository of prescribable mHealth apps for GPs.

scholarly journals Evaluating the Impact of Interruptive Alerts within a Health System: Use, Response Time, and Cumulative Time Burden

2019 ◽  
Vol 10 (05) ◽  
pp. 909-917 ◽  
Author(s):  
Pierre Elias ◽  
Eric Peterson ◽  
Bob Wachter ◽  
Cary Ward ◽  
Eric Poon ◽  
...  
Keyword(s):  
Dwell Time ◽  
Improve Patient Care ◽  
Median Number ◽  
Related Factors ◽  
Alert Fatigue ◽  
Time Burden ◽  
System Use ◽  
Outpatient Settings ◽  
The Impact ◽  
Improve Patient

Abstract Background Health systems often employ interruptive alerts through the electronic health record to improve patient care. However, concerns of “alert fatigue” have been raised, highlighting the importance of understanding the time burden and impact of these alerts on providers. Objectives Our main objective was to determine the total time providers spent on interruptive alerts in both inpatient and outpatient settings. Our secondary objectives were to analyze dwell time for individual alerts and examine both provider and alert-related factors associated with dwell time variance. Methods We retrospectively evaluated use and response to the 75 most common interruptive (“popup”) alerts between June 1st, 2015 and November 1st, 2016 in a large academic health care system. Alert “dwell time” was calculated as the time between the alert appearing on a provider's screen until it was closed. The total number of alerts and dwell times per provider per month was calculated for inpatient and outpatient alerts and compared across alert type. Results The median number of alerts seen by a provider was 12 per month (IQR 4–34). Overall, 67% of inpatient and 39% of outpatient alerts were closed in under 3 seconds. Alerts related to patient safety and those requiring more than a single click to proceed had significantly longer median dwell times of 5.2 and 6.7 seconds, respectively. The median total monthly time spent by providers viewing alerts was 49 seconds on inpatient alerts and 28 seconds on outpatient alerts. Conclusion Most alerts were closed in under 3 seconds and a provider's total time spent on alerts was less than 1 min/mo. Alert fatigue may lie in their interruptive and noncritical nature rather than time burden. Monitoring alert interaction time can function as a valuable metric to assess the impact of alerts on workflow and potentially identify routinely ignored alerts.

scholarly journals Strategic Operational Redesign for Successfully Navigating Prior Authorization Barriers at a Large-Volume Proton Therapy Center

2020 ◽  
pp. JOP.19.00533
Author(s):  
Eric D. Brooks ◽  
Matthew S. Ning ◽  
Matthew B. Palmer ◽  
G. Brandon Gunn ◽  
Steven J. Frank ◽  
...  
Keyword(s):  
Proton Therapy ◽  
Cost Effective ◽  
Full Time ◽  
Prior Authorization ◽  
Patient Access ◽  
Administrative Burden ◽  
Effective Manner ◽  
Before And After ◽  
Therapy Center ◽  
Improve Patient

PURPOSE: Prior authorization (PA) can be a resource-intensive barrier to oncologic care. To improve patient access and reduce delays at our large, academic proton therapy center, we implemented a novel payor-focused strategy to efficiently navigate the PA process while eliminating physician burden and reducing inappropriate denials. METHODS: In 2017, business operations were redesigned to better reflect the insurance process: (1) certified medical dosimetrists (CMDs), with their unique treatment expertise, replaced our historical PA team to function as an effective interface among physicians, patients, and payors; (2) a structured, tiered timeline was implemented to hold payors accountable to PA deadlines; and (3) our PA team provided administrative leadership with requisite insurance knowledge. PA outcomes were compared 6 months before and after the intervention. RESULTS: After implementation of this multifaceted strategy, the median time to successful appeal (after initial denial of coverage) decreased from 30 to 18 days ( P < .001), and the total number of overturned denials increased by 56%. Because of the efficiency of the CMDs, full-time equivalents on the PA team actually decreased by 44%, translating to a 34% reduction in team personnel expenses. Internal referrals increased by 29%, attributable to optimized communication and diminished administrative burden for providers. New treatment starts also increased, resulting in a 37% larger patient census on treatment. CONCLUSION: Incorporating payor-focused strategies can improve patient access in a cost-effective manner while decreasing time and administrative burden associated with the PA process. These operational concepts can be adapted for other oncologic practice settings facing analogous PA-related obstacles.

An advertising campaign’s impact on public awareness of vitiligo: a Google-Trends® analysis (Preprint)

2020 ◽  
Author(s):  
Frédéric Lapostolle ◽  
Charles Durand ◽  
Lisa Weisslinger ◽  
Chloe Baker ◽  
Frédéric Adnet
Keyword(s):  
Public Awareness ◽  
Median Number ◽  
Google Trends ◽  
Public Understanding ◽  
Median Frequency ◽  
The Public ◽  
Fashion Brand ◽  
Before And After ◽  
Internet Searches ◽  
The Impact

BACKGROUND The internet has changed the world. Meanwhile, internet searches themselves are now also being used a scientific tool. Recently, a famous European fashion brand (Desigual®) published as publicity, the photograph of a young model with vitiligo. OBJECTIVE To study the impact of the public display of such a rare disease on related internet searches. METHODS To do this, we investigated the Google Trends according to previously recommended methods. We compared the number of internet searches using the word ‘’vitiligo’’ and the model’s name, before and after the publication of this picture. Google Trends gives the frequency of such requests on a scale from 0 to 100, 100 corresponding to the maximum number of requests during the period of interest. A six year period was studied; three years before and three years after the campaign (i.e. 2013 September 1st). RESULTS The median frequency of searches for ‘’vitiligo’’ according to Google Trends, worldwide, was 52 (46-61) during the reference period. After the campaign, the median number of internet requests significantly increased to 70 (59-79) (p<0.0001). Seasonal variability was observed in both periods. During the same periods, the median number of internet searches based on the name of the model significantly increased, from 0 (0-0) to 24 (15-31) (p<0,0001). CONCLUSIONS This advertising campaign featuring a model with vitiligo seems to have been associated with a significant increase in internet searches for this condition. Such campaigns could indeed help to incidentally ‘’popularize’’ such skin disorders, with better public understanding contributing to an improvement in patients’ quality of life. CLINICALTRIAL Not applicable

Preparing tomorrow's doctors: the impact of a special study module in medical informatics

2001 ◽  
Vol 35 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Kieran J McGlade ◽  
Catherine J McKeveney ◽  
Vivienne L S Crawford ◽  
Patrick Brannigan
Keyword(s):  
Medical Informatics ◽  
Special Study ◽  
The Impact
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