The Digitisation of Healthcare in a Global Pandemic

The chapter discusses the rapid digitisation of healthcare during the COVID-19 global crisis and its implications for healthcare quality from patient, clinician, and provider perspectives. Using the example of patient portals, online interfaces that provide patients with real-time access to their health records, the chapter explores how this large-scale shift to digital healthcare has influenced key elements of healthcare quality. These elements include the safety, timeliness, effectiveness, efficiency, equity, eco-friendliness, and person-centeredness of care delivery, as well as patient and staff well-being. The discussion addresses health anxiety exacerbated by remote service delivery and potential associations with cyberchondria and online search behaviours. Additionally, concerns about digital health literacy, equality of access, patient data privacy, and cybersecurity are discussed in the context of increasing health system shocks. Recommendations are made about how the future adaptation of digital healthcare can support healthcare quality in a post-pandemic era.

Healthcare quality for Muslims: TCCM and TSR frameworks analyses

Purpose Transformative service research (TSR) has received considerable attention from researchers and marketers in recent years and becomes a research priority in health care. In response, this paper adapts the TSR entities and wellbeing framework to systematically review healthcare quality research on Muslim consumers. The purpose of this paper is to identify research gaps and provide directions for future research, aligning healthcare studies with the TSR framework. Design/methodology/approach The authors of this paper reviewed empirical papers in healthcare quality research on Muslim patients between the years 2000 and 2020. The recorded journal articles were synthesized using insights from the TSR framework. Several literature gaps were identified and future research directions were provided using the TCCM framework, in which T stands for theory, C for context, C for characteristics and M for methodology. Findings This paper finds studies that encompass several domains of the TSR framework including cultural and religious dimensions, service interaction and customer engagement dimensions and customer service wellbeing. Findings also reveal subject matters related to the TSR framework, which receive less attention in the healthcare literature. A number of potential avenues for theoretical extension in health care are also discussed. Social implications The implications of this paper are highly relevant to Muslim healthcare consumers, the healthcare system and society in general. The findings suggest inspiring changes in the healthcare ecosystem that yields a greater quality of life (health and wellbeing) for individuals and their respective communities. Originality/value This paper advances the current state of healthcare research by identifying and organizing components of TSR entities and wellbeing framework, using Muslim patients as the context. It enhances some pioneering approaches within the domain of TSR and quality dynamics and provides a holistic perspective as guidance and systematic thinking to further advancement in the field of services marketing and Islamic marketing.

Bridging health technology assessment and healthcare quality improvement using international consortium of health outcomes measurement standard sets

Objective Although health technology assessment (HTA) and healthcare quality improvement are distinct processes, a greater level of alignment in outcome measures used may increase the quality and efficiency of data collection. This study evaluates the agreement in outcome measures used in oncology for healthcare quality improvement and HTAs, and how these align to the International Consortium for Health Outcomes Measurement (ICHOM) standard sets. Methods We conducted a cross-sectional comparative analysis of ICHOM sets focusing on oncological indications and publicly available measures for healthcare quality and HTA reports published by the National Health Care Institute from the Netherlands and the National Institute for Health and Care Excellence from the United Kingdom. Results All ICHOM sets and HTAs used overall survival, whereas quality improvement used different survival estimates. Different progression estimates for cancer were used in HTAs, ICHOM sets, and quality improvement. Data on health-related quality of life (HRQoL) was recommended in all ICHOM sets and all HTAs, but selectively for quality improvement. In HTAs, generic HRQoL questionnaires were preferred, whereas, in quality improvement and ICHOM sets, disease-specific questionnaires were recommended. Unfavorable outcomes were included in all HTAs and all ICHOM sets, but not always for quality improvement. Conclusions Although HTA and quality improvement use outcome measures from the same domains, a greater level of alignment seems possible. ICHOM may provide input on standardized outcome measures to support this alignment. However, residual discrepancies will remain due to the different objectives of HTA and quality improvement.

Physician Rating Websites in the United States: A systematic review (Preprint)

BACKGROUND Physician rating websites are gaining popularity, however, data on their usability and influence on healthcare quality is limited. OBJECTIVE to provide an overview of physician rating websites in the US and find answers for the following questions: 1. What are the most commonly studied/rated physician rating websites in the US? 2. Which specialty of physicians/providers are most commonly studied/rated? 3. How many physicians were rated on the studied PRWs? 4. What is the average number of ratings on these websites and are they positive or negative? 5. How does the profile of providers influence their rating? 6. How are PRWs associated with healthcare quality? 7. How PRWs are associated with patient-physician relationship? METHODS A systematic literature search was conducted through Medline for peer-reviewed articles in the English language on studies conducted in the US. RESULTS 33 articles published in peer-reviewed journals were included in the final review. Most of the studies were conducted on surgeons. A significant number of studies observed no correlation of online ratings with gender, geographic location, and years of experience. Additionally, no significant correlation was found between PRWs and healthcare quality. CONCLUSIONS It has been observed that with the current structure of these websites, the reliability of information available on them is rather questionable, and hence more research is required to assess the credibility of these websites along with their cost-effectiveness, effect on the patient-physician relationship, and quality of healthcare delivery.

Pregnancy as a Risk Factor of Severe COVID-19

Since first being identified in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an etiological agent behind Coronavirus disease 19 (COVID-19), has caused three waves of a global pandemic, with a fourth in progress. Despite its high percentage of asymptomatic and low-symptomatic courses of illness, the SARS-CoV-2 pandemic has claimed a higher death toll than the SARS-CoV and MERS-CoV epidemics because of its high infectivity when compared to the other coronaviruses. High COVID-19 mortality is associated with age and other coexisting morbidities, as well as healthcare quality. According to several studies, pregnant women are at a higher risk of severe COVID-19 infection and adverse pregnancy outcomes (caesarean delivery, pre-term birth, low birth weight, preeclampsia, ICU admission, and need for mechanical ventilation). In our review of recent literature, we focused on the effects of COVID-19 in pregnant women, emphasizing the subcellular pathophysiology of SARS-CoV-2. In this paper, we concentrate on the pathophysiology of sub-cellular changes in COVID-19 and endeavor to highlight the aspects that manifest in physiological pregnancy and potentially create a higher risk of SARS-CoV-2 infection and acute COVID-19 symptoms. Understanding how pregnancy-associated changes can cause a synergistic effect with COVID-19 may point us in the right direction for future prophylaxis and treatment for women undergoing COVID-19 during pregnancy.

Applying Quality Improvement Approaches for the Control of Critical Medical Processes in a Healthcare Facility

Healthcare facilities face major challenges as patients require for the continuous improvement of the healthcare quality. We have used as research method the study of the scientific literature from the medical databases, and we have identified the categories of processes that ensure the quality in a healthcare facility. It is drawn a detailed map of the basic medical processes which highlights the sequence and interaction of medical processes that take place on requesting patients until they become resolved patients. The particularization of quality improvement methods for the improvement of critical medical processes is presented. By using the Pareto diagram it is analyzed the adverse events associated with healthcare and by employment of Ishikawa diagram it is analyzed the causes of associated infections highlighting the factors that contributed to the increase of confirmed healthcare associated infections, which are assigned to the hospital information system and the hospital monitoring system.

Physicians’ clinical experience and its association with healthcare quality: a systematised review

Background and purposeThere is conflicting evidence regarding whether physicians’ clinical experience affects healthcare quality. Knowing whether an association exists and which dimensions of quality might be affected can help healthcare services close quality gaps by tailoring improvement initiatives according to physicians’ clinical experience. Here, we present a systematised review that aims to assess the potential association between physicians’ clinical experience and different dimensions of healthcare quality.MethodsWe conducted a systematised literature review, including the databases MEDLINE, Embase, PsycINFO and PubMed. The search strategy involved combining predefined terms that describe physicians’ clinical experience with terms that describe different dimensions of healthcare quality (ie, safety, clinical effectiveness, patient-centredness, timeliness, efficiency and equity). We included relevant, original research published from June 2004 to November 2020.ResultsFifty-two studies reporting 63 evaluations of the association between physicians’ clinical experience and healthcare quality were included in the final analysis. Overall, 27 (43%) evaluations found a positive or partially positive association between physicians’ clinical experience and healthcare quality; 22 (35%) found no association; and 14 (22%) evaluations reported a negative or partially negative association. We found a proportional association between physicians’ clinical experience and quality regarding outcome measures that reflect safety, particularly in the surgical fields. For other dimensions of quality, no firm evidence was found.ConclusionWe found no clear evidence of an association between measures of physicians’ clinical experience and overall healthcare quality. For outcome measures related to safety, we found that physicians’ clinical experience was proportional with safer care, particularly in surgical fields. Our findings support efforts to secure adequate training and supervision for early-career physicians regarding safety outcomes. Further research is needed to reveal the potential subgroups in which gaps in quality due to physicians’ clinical experience might exist.