BMJ HCI launches partnership programme for patients and carers as authors and peer reviewers

BMJ Health & Care Informatics (BMJHCI) is launching a partnership programme, where patients write articles and serve as peer reviewers on both patient-written and researcher-written articles. This article outlines the programme and describes the importance of public involvement in research and implementation in digital health. We think patients and carers should be funded to participate at this stage of research as well as other stages of research. The quality of peer review can be greatly improved by recruiting patients to peer review and improve readability and understanding of scientific literature and to ensure that research and other articles appropriately include what matters most to patients. Just as real-time communication is two-way communication, both healthcare providers and patients should have a voice in the literature, and involving patients in journals is an important step toward amplifying and supporting the balance of perspectives. Patients are the whole purpose of research and practice in health and care, so this rightly includes their role in the publication and review of health informatics literature as well as the publication of their own perspectives regarding access and delivery of healthcare. Patients and carers can provide valuable insights into research articles, and they can also serve as effective peer reviewers. The BMJHCI is excited to kick off the new partnership programme and encourages all interested patients and carers to apply to participate as authors and/or reviewers.

Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

Objective: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned. Methods: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives. Results: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID related informatics projects, all against a background of non-standardized digital development and disparate territory or state regulations and guidance. Common barriers in these four and in less-resourced countries included disparities in internet access and availability including bandwidth limitations when internet access was available, initial lack of coding standards, and fears of primary care clinicians that patients were delaying care despite the availability of televisits. Conclusions: Primary care clinicians were able to respond to the COVID crisis through telehealth and electronic record enabled change. However, the lack of coordinated national strategies and regulation, assurance of financial viability, and working in silos remained limitations. The potential for primary care informatics to transform current practice was highlighted. More research is needed to confirm preliminary observations and trends noted.

Ethical Use of Electronic Health Record Data and Artificial Intelligence: Recommendations of the Primary Care Informatics Working Group of the International Medical Informatics Association

Summary Objective: To create practical recommendations for the curation of routinely collected health data and artificial intelligence (AI) in primary care with a focus on ensuring their ethical use. Methods: We defined data curation as the process of management of data throughout its lifecycle to ensure it can be used into the future. We used a literature review and Delphi exercises to capture insights from the Primary Care Informatics Working Group (PCIWG) of the International Medical Informatics Association (IMIA). Results: We created six recommendations: (1) Ensure consent and formal process to govern access and sharing throughout the data life cycle; (2) Sustainable data creation/collection requires trust and permission; (3) Pay attention to Extract-Transform-Load (ETL) processes as they may have unrecognised risks; (4) Integrate data governance and data quality management to support clinical practice in integrated care systems; (5) Recognise the need for new processes to address the ethical issues arising from AI in primary care; (6) Apply an ethical framework mapped to the data life cycle, including an assessment of data quality to achieve effective data curation. Conclusions: The ethical use of data needs to be integrated within the curation process, hence running throughout the data lifecycle. Current information systems may not fully detect the risks associated with ETL and AI; they need careful scrutiny. With distributed integrated care systems where data are often used remote from documentation, harmonised data quality assessment, management, and governance is important. These recommendations should help maintain trust and connectedness in contemporary information systems and planned developments.

Effect of Procedure Type on Core Competency Implementation by Athletic Training Students

Context Core competencies (CCs) are now a required component of educational content in all types of Commission on Accreditation of Athletic Training Education-accredited athletic training programs. There is limited evidence demonstrating which procedures included during patient encounters (PEs) occurring in clinical education allow for implementation of CCs. Objective To determine the relationship between procedures performed by athletic training students during PEs on CC implementation. Design Panel design. Setting Undergraduate, professional athletic training program, National Collegiate Athletic Association Division I institution. Patients or Other Participants We purposefully recruited 1 athletic training program that used E*Value (Medhub) software; 40 participants (31 female, 9 male) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. Interventions Participants viewed a 20 minute recorded CC education module followed by educational handouts, which were available online for reference throughout the semester. E*Value was used to track procedures (prevention, evaluation, manual therapy, rehabilitation, treatment, diagnostic, surgical, or other) performed during PEs and an added block of questions indicating which, if any, of the CCs were implemented during the PE. Main Outcome Measure(s) Independent variables included procedures performed during PEs and whether any of the 6 CCs were implemented (yes/no). Binary logistic regression models determined how the type of procedure performed related to the implementation of each CC. Results Regression models were significant for 5 of the 6 CCs: patient-centered care (PCC; {\rm{\chi }}_7^2 = 62.949, P < .001), interprofessional education and collaborative practice (IPECP; {\rm{\chi }}_6^2 = 41.172, P < .001), health care informatics ({\rm{\chi }}_7^2 = 186.487, P < .001), evidence-based practice (EBP) ({\rm{\chi }}_8^2 = 54.712, P < .001), and quality improvement ({\rm{\chi }}_7^2 = 67.967, P < .001). Participants including evaluation procedures during PE were 3.6 and 1.3 times more likely to implement PCC and IPECP, respectively. Participants including a diagnostic procedure were 4.2 and 2.9 times more likely to implement EBP and IPECP, respectively, and 0.2 times less likely to implement health care informatics. Participants incorporating a manual therapy procedure were 2.6, 1.7, and 2.1 times more likely to implement PCC, EBP, and quality improvement, respectively. Conclusions Athletic training program administrators should identify clinical sites that allow for PEs and procedural opportunities that align with priorities for greater CC implementation.