Quality of medication information in discharge summaries from hospitals: an audit of electronic patient records.

Science.gov (United States)

Garcia, Beate Hennie; Djønne, Berit Svendsen; Skjold, Frode; Mellingen, Ellen Marie; Aag, Trine Iversen

2017-12-01

Background Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway. Method For each month in 2013, we randomly selected 60 discharge summaries from the Department of Medicine and Surgery (totally 720) and evaluated the medication information using eight Norwegian quality criteria. Main outcome measure Mean score per discharge summary ranging from 0 (lowest quality) to 16 (highest quality). Results Mean score per discharge summary was 7.4 (SD 2.8; range 0-14), significantly higher when evaluating medications used regularly compared to mediations used as needed (7.80 vs. 6.52; p < 0.001). Lowest score was achieved for quality criteria concerning generic names, indications for medication use, reasons why changes had been made and information about the source for information. Factors associated with increased quality scores are increasing numbers of medications and male patients. Increasing age seemed to be associated with a reduced score, while type of department was not associated with the quality. Conclusion In discharge summaries from 2013, we identified a low quality of medication information in accordance with the Norwegian quality criteria. Actions for improvement are necessary and follow-up studies to monitor quality are needed.

Patient information regarding medical radiation exposure is inadequate: Patients' experience in a university hospital

International Nuclear Information System (INIS)

Ukkola, L.; Oikarinen, H.; Henner, A.; Haapea, M.; Tervonen, O.

2017-01-01

Introduction: It is suspected that little or no information is provided to patients regarding radiological examinations. The purpose was to evaluate the coverage, content and source of this information in a university hospital. Methods: Altogether 147 patients (18–85 years) were interviewed after different examinations using a questionnaire. The patients had undergone 35 low (<1 mSv), 66 medium (1–10), and 46 high (>10) dose examinations. They were asked if they were informed about radiation use, the course or indication of the examination, the consequences of not having the examination, other options, the dose and risks of radiation, the source for the information and if any consent was enquired. Results: 52 (35%) patients did not receive any information while 95 (65%) obtained some information. Fifty-six (38%) patients received an information letter, and 75 (51%) obtained oral information, mainly from the referrer or the radiographer. The information was mostly about indication, course or radiation use, very seldom about radiation risks and the other areas. Those with a nuclear medicine examination received information more often than those with other medium- or high-dose examinations (p = 0.004). The patients scored the received information as 2.2 (mean, SD 1.3) on a Likert scale from 1 (poor) to 5 (good). Conclusion: Patients obtained inadequate information regarding radiological examinations in a university hospital. The information was provided non-systematically from various sources. The results help to set up practical guidelines for systematic information and to follow up their efficiency. The mode of operation might be helpful elsewhere in the future. - Highlights: • Patients obtained inadequate information regarding medical radiation exposure. • The information was provided non-systematically from various sources. • Patients with nuclear examinations were informed better than with other modalities. • In addition to general guidelines

Trained student pharmacists’ telephonic collection of patient medication information: Evaluation of a structured interview tool

Science.gov (United States)

Margolis, Amanda R.; Martin, Beth A.; Mott, David A.

2016-01-01

Objective To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Design Descriptive analysis of patient medication lists collected via telephone interviews. Participants 10 trained student pharmacists collected the medication lists. Intervention Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking community dwelling older adults using a structured interview tool to collect and document medication lists. Main outcome measures Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists’ adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio recorded interviews to the medication list information documented in an electronic medical record. Results On average it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high with an overall proportion of asked scripted probes of 83.75% (95%CI: 80.62–86.88%). Accuracy was also high for both prescription (95.1%, 95%CI: 94.3–95.8%) and non-prescription (90.5%, 95%CI: 89.4–91.4%) medications. Conclusion Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication

Trained student pharmacists' telephonic collection of patient medication information: Evaluation of a structured interview tool.

Science.gov (United States)

Margolis, Amanda R; Martin, Beth A; Mott, David A

2016-01-01

To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Descriptive analysis of patient medication lists collected with telephone interviews. Ten trained student pharmacists collected the medication lists. Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking, community-dwelling older adults using a structured interview tool to collect and document medication lists. Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists' adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio-recorded interviews to the medication list information documented in an electronic medical record. On average, it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high, with an overall proportion of asked scripted probes of 83.75% (95% confidence interval [CI], 80.62-86.88%). Accuracy was also high for both prescription (95.1%; 95% CI, 94.3-95.8%) and nonprescription (90.5%; 95% CI, 89.4-91.4%) medications. Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication lists to facilitate MTM sessions in the community pharmacy

Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

Science.gov (United States)

Herber, Oliver Rudolf; Gies, Verena; Schwappach, David; Thürmann, Petra; Wilm, Stefan

2014-10-02

The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany. We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework. Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions. Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

Nurses’ attitudes and behaviors on patient medication education

Directory of Open Access Journals (Sweden)

Bowen JF

2017-06-01

Full Text Available Background: Medication education is vital for positive patient outcomes. However, there is limited information about optimal medication education by nurses during hospitalization and care transitions. Objective: Examine nurses’ attitudes and behaviors regarding the provision of patient medication education. The secondary objectives were to determine if nurses’ medication education attitudes explain their behaviors, describe nurses’ confidence in patient medication knowledge and abilities, and identify challenges to and improvements for medication education. Methods: A cross sectional survey was administered to nurses servicing internal medicine, cardiology, or medical-surgical patients. Results: Twenty-four nurses completed the survey. Greater than 90% of nurses believed it is important to provide information on new medications and medical conditions, utilize resources, assess patient understanding and adherence, and use open ended question. Only 58% believed it is important to provide information on refill medications. Greater than 80% of nurses consistently provided information on new medications, assessed patient understanding, and utilized resources, but one-third or less used open-ended questions or provided information on refill medications. Most nurses spend 5-9 minutes per patient on medication education and their attitudes matched the following medication education behaviors: assessing adherence (0.57; p<0.01, providing information on new medications (0.52; p<0.05, using open-ended questions (0.51; p<0.01, and providing information on refill medications (0.39; p<0.05. Nurses had higher confidence that patients can understand and follow medication instructions, and identify names and purpose of their medications. Nurses had lower confidence that patients know what to expect from their medication or how to manage potential side effects. Communication, including language barriers and difficulty determining the patient�

Medical-Information-Management System

Science.gov (United States)

Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

1989-01-01

Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

A network system of medical and welfare information service for the patients, their families, hospitals, local governments, and commercial companies in a medical service area.

Science.gov (United States)

Matsumura, Kouji; Antoku, Yasuaki; Inoue, Reika; Kobayashi, Mariko; Hanada, Eisuke; Iwasaki, Yasutaka; Kumagai, Yasushi; Iwamoto, Haruya; Tsuchihashi, Saburo; Iwaki, Miho; Kira, Jun-ichi; Nose, Yoshiaki

2002-06-01

A service information system using the Internet, which connected the various people who are related to medical treatment and nursing welfare, was constructed. An intractable neurological disease patient who lives in the Onga district, Fukuoka, Japan, and the people who are related to the service were chosen as test users in an experimental model. The communicated service information was divided into open-use data (electronic bulletin board, welfare service, medical care service, and link to private company service home page) and closed-use data (the individual patient's hysterics). The open data server was installed in an Internet service provider The open data could be accessed not only by the patient, but also by the family, information center, companies, hospitals, and nursing commodity store related to patient's nursing and medical treatment. Closed data server was installed in an information center (public health center). Only patient and information center staff can access the closed data. Patients should search and collect the service information of various medical and welfare services by themselves. Therefore, services prepared for the patient are difficult to know, and they cannot be sufficiently utilized. With the use of this information system, all usable service information became accessible, and patients could easily use it. The electronic bulletin board system (BBS) was used by patients for knowing each other or each others' family, and was used as a device for exchange of wisdom. Also, the questions for the specialist, such as doctor, dentist, teacher, physical therapist, care manager, welfare office staff member, and public health nurse, and the answers were shown on the BBS. By arranging data file, a reference of various patients in question and answer, which appeared in this BBS, was made as "advisory hints" and was added to the open data. The advisory hints became the new service information for the patients and their family. This BBS discovered

Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

Science.gov (United States)

1991-01-01

automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

Assessment of the quality of medication information for patients in Spain.

Science.gov (United States)

Mira, José Joaquín; Lorenzo, Susana; Pérez-Jover, Virtudes; Navarro, Isabel; Martín de Rosales, Ana María; Lara, Catalina

2013-01-01

To analyze the extent to which Spanish leaflets and drug information on the Net met quality criteria. A descriptive study was conducted comparing readability (REA) and comprehensibility (COM) criteria of a random sample of 77 marketed products of the 12 active ingredients most frequently sold in 2010 in Spain. Leaflets were approved by the Spanish Agency for Medication (AEMPS). Flesch index, DISCERN, ELF, MIDAS and CIRF scales were used to evaluate quality criteria. COM assessment yielded between 63 and 77% of the maximum possible scores on the scales. None of the websites or leaflets met all the quality criteria of the DISCERN, CIRF or MIDAS scales. Four (3%) leaflets met all the 22 quality criteria of ELF. The leaflets showed shortcomings regarding: medication benefits (17 required substantial improvements, 31.5%), correct forms of storage (13, 24.1%), contraindications (12, 22.2%), side effects (11, 20.4%) and precautions to be taken (9, 16.7%). The quality of the information approved by the AEMPS is superior to that which can be found by surfing the Net. More specific information on precautions, complications and how to avoid common patient errors would allow patients the best chance to contribute to their own clinical safety.

Using video-taped examples of standardized patient to teach medical students taking informed consent

Directory of Open Access Journals (Sweden)

SHIRIN HABIBI KHORASANI

2015-04-01

Full Text Available Introduction: Medical student should be trained in medical ethics and one of the most essential issues in this field is taking informed consents. In this research, we compared the effect of effectiveness of teaching methods on students’ ability in taking informed consent from patients. Methods: This semi-experimental study was carried out on fifty eight subjects from the 4th-year students of Shiraz University of Medical Sciences who attended in medical ethics course before their ‘clinical clerkship’training.Method of sampling was census and students were randomly allocated into two groups of control group (n=28 was trained in traditional lecture-based class and the case groupnamed as A1 (n=22 were taught by video-taped examples of standardized patient.Then A1 group attended in traditional lecture-based classes named as A2. The groups were evaluated in terms the ability of recognition of ethical issues through the scenario based ethical examination before and after each training. Scenarios were related to the topics of informed consent. Data were analyzed by SPSS 14 software using descriptive statistics and anova test. P-value less than 0.05 was considered as significant. Results: The mean scores results of A2, A1 and B group were found to be 7.21, 5.91 and 5.73 out of 8, respectively. Comparison between the groups demonstrated that the ability of taking informed consent was significantly higher in A2 group (p<0.001, followed by A1 group (p<0.05, while was the least in the B group (p=0.875. Conclusion: According to this research, lecture-based teaching is still of great value in teaching medical ethics, but when combined with standardized patient, the outcome will be much better. It should be considered that mixed methods of teaching should be used together for better result.

Information in medical treatment courses

DEFF Research Database (Denmark)

Møller, Marianne; Hollnagel, Erik; Andersen, Stig Ejdrup

Background Unintended events and suboptimal treatment with medicines are major burdens for patients and health systems all over the world. Information processes have important roles for establishing safe and effective treatment courses. The platform for this Ph.d. study is learning from situations...... to the quality of medical treatment courses. Methods Systems theory, cybernetics (steering, timing and feedback) and a classic communication model are applied as theoretical frames. Two groups of patients and their information providers are studied using qualitative methods. The data analysis focuses...... that goes well (Safety-II) while having a broad understanding of quality. Objectives The overall purpose is to investigate how information is used as a steering tool for quality in medical treatment courses. In this first part of the study, the role of information on medicine is analyzed in relation...

Using video-taped examples of standardized patient to teach medical students taking informed consent.

Science.gov (United States)

Habibi Khorasani, Shirin; Ebrahimi, Sedigheh

2015-04-01

Medical student should be trained in medical ethics and one of the most essential issues in this field is taking informed consents. In this research, we compared the effect of effectiveness of teaching methods on students' ability intaking informed consent from patients. This semi-experimental study was carried out on fifty eight subjects from the 4th-year students  of Shiraz University of Medical Sciences who attended in medical ethics coursebefore their 'clinical clerkship'training.Method of sampling was census and students were randomly allocated into two groups of control group(n=28) was trained in traditional lecture-based class and the case groupnamed as A1(n=22) were taught by video-taped examples of standardized patient.Then A1 group attended in traditional lecture-based classes named as A2. The groups were evaluated in terms the ability of recognition of ethical issuesthrough the scenario based ethical examination before and after each training. Scenarios were related to the topics ofinformed consent. Data were analyzed by SPSS 14 software using descriptive statistics and anovatest.P-Value less than 0.05 was considered as significant. The mean scores results of A2, A1and B groupwere found to be7.21 , 5.91 and 5.73 out of 8,respectively. Comparison between the groups demonstrated that the ability of taking informed consent was significantly higher in A2 group (plecture-based teaching is still of great value in teaching medical ethics, but when combined with standardized patient, the outcome will be much better.it should be considered that mixed methodsof teaching should be used together for better result.

Health Information-Seeking Behavior Among Hypothyroid Patients at Saveetha Medical College and Hospital

OpenAIRE

Perumal, SS; Prasad, S; Surapaneni, KM; Joshi, A

2015-01-01

Background Hypothyroidism causes considerable morbidity. Low knowledge coupled with inadequate health literacy may lead to poor prevention and management. This study aimed to assess health information-seeking behavior and hypothyroid knowledge among South Indian hypothyroid patients. Methods This cross-sectional study was conducted in October 2013 in Saveetha Medical College, Chennai, India. Hundred clinically diagnosed hypothyroid patients ?18 years were interviewed in a hospital using a 57-...

Medical information therapy and medical malpractice litigation in ...

African Journals Online (AJOL)

2013-11-01

Nov 1, 2013 ... Instead, the study proposed the concept of medical information therapy – an .... practitioner's obligations, patient autonomy and self-determination ..... Handbook – Guidelines for Good and Ethical Practice in Medicine,.

Informed consent to medical treatment--the Israeli experience.

Science.gov (United States)

Weil, Z

1998-01-01

The ideological foundation of the doctrine of "informed consent" is rooted in the concept of personal freedom and freedom of choice. The concept of individual autonomy is represented by the "reasonable patient" standard which requires the disclosure of all information which a reasonable person in the position of the patient would need in order to make a rational decision regarding a proposed medical treatment. This attitude, however, conflicts with the traditional paternalism which is reflected in the "reasonable physician" standard, that is that a doctor must disclose that medical information which a rational doctor would relate to a patient in order to receive his consent. The enactment of the Patients' Rights Law in Israel in 1996 was an essential turning point in Israeli medical law. Section 13 of the new law explicitly establishes the requirement of informed consent and the details which a doctor must relate to a patient in order to reach the said agreement. Nevertheless, the law does not state the standard according to which it should be assessed whether the disclosure was proper. In a recent decision (C.A. 434/94 Shai Berman et al. v. Mor--the Institute for Medical Information, Ltd.) the Israeli Supreme Court took a step forward and determined that the duty to inform a patient will be judged by recognised criteria of negligence as they apply to the merits of each case.

Norwegian elderly patients' need for drug information and attitudes towards medication use reviews in community pharmacies.

Science.gov (United States)

Mamen, Anette Vik; Håkonsen, Helle; Kjome, Reidun L S; Gustavsen-Krabbesund, Bjørn; Toverud, Else-Lydia

2015-12-01

Medication use review (MUR) is a community pharmacy service in several countries. Knowledge about what patients want from such a service is limited. The aim of this study was therefore to investigate Norwegian elderly patients' need for drug information and their attitudes towards MURs. In Norway's two largest cities, 162 patients (72% women; mean age: 78.9 years) who used at least one prescription drug were recruited from 18 senior centres. They were interviewed personally with a structured questionnaire (29 closed and 4 open-ended questions). The average number of prescription drugs used was 4.4. Seventy per cent also used over-the-counter drugs. The main source of drug information was the general practitioner (GP) followed by package inserts and pharmacy staff. For drug-related problems, 62% would contact the GP compared with 24% who preferred the pharmacist. Fifty per cent remembered no information when collecting prescriptions. However, 56% wanted to know more about their medication and 55% were interested in a MUR. The main topics they wished to address were effect/side effects and interactions. Lack of privacy was reported to be a major obstacle in the current situation. This study shows that community pharmacies in Norway play a minor role regarding drug information to elderly polypharmacy patients. The GP is both their main information source and whom they contact for drug-related problems. However, half of the patients would like to know more about their medication. More than half were positive towards taking part in a MUR. © 2015 Royal Pharmaceutical Society.

Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

Science.gov (United States)

Behkami, Nima A.

2012-01-01

It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

Survey of patients' impressions of radiotherapy and their need for additional medical information. Japanese domestic survey of 1,529 patients in 2002

International Nuclear Information System (INIS)

Hirota, Saeko; Nagata, Yasushi

2005-01-01

We clarified the images, impressions, and information about radiotherapy in standard Japanese patients and, at the same time, investigated their need for information about radiotherapy, in order to identify what we, as radiation oncologists, should do to decrease patient anxiety and create good physician-patient relationships. We handed out 10 questionnaires to 1529 patients from April 2002 through July 2002 in 22 Japanese institutions that were equipped with radiotherapy machines. Questionnaires contained 10 items asking about patients' background, their impression of radiotherapy, frequency of exposure to information about radiotherapy, need to obtain information about radiotherapy, and ideal additional medical informational resources or their content. About 60% of patients had had the opportunity to obtain information about radiotherapy ''sometimes'' or ''often,'' but 80% of them were not satisfied with the availability of information and answered that it was inadequate. Ten percent responded that they had no idea about radiotherapy. Thirty percent felt unspecified anxiety concerning radiotherapy, and those who had less chance to be exposed to information about radiotherapy felt more anxiety than the others (33.2% vs. 25.2%, p=0.0008). The need for ''explanation and information about adverse effects'' was the top priority, followed by ''explanation of outcome''. Although they generally obtained information from their physician (radiation oncologist), they also wanted additional information via written media (662 patients, 43%). However, patients who were over 60 years old most wanted to obtain additional medical information directly from their own radiation oncologist (37.7%). Information about radiotherapy given to patients and the general public is still insufficient in Japan. To fully utilize radiotherapy, which is a very effective treatment option against cancer, and to reduce anxiety about radiotherapy among cancer patients, more information is necessary

Multimodal medical information retrieval with unsupervised rank fusion.

Science.gov (United States)

Mourão, André; Martins, Flávio; Magalhães, João

2015-01-01

Modern medical information retrieval systems are paramount to manage the insurmountable quantities of clinical data. These systems empower health care experts in the diagnosis of patients and play an important role in the clinical decision process. However, the ever-growing heterogeneous information generated in medical environments poses several challenges for retrieval systems. We propose a medical information retrieval system with support for multimodal medical case-based retrieval. The system supports medical information discovery by providing multimodal search, through a novel data fusion algorithm, and term suggestions from a medical thesaurus. Our search system compared favorably to other systems in 2013 ImageCLEFMedical. Copyright © 2014 Elsevier Ltd. All rights reserved.

Home delivery of medication - the role of a patient information leaflet on maximising service uptake.

Science.gov (United States)

Watson, L; Ahmed, N; Mccall, H; Minton, J; Benn, P; Edwards, S; Waters, L

2014-12-01

There are currently over 30,000 HIV-positive individuals in London and over 25,000 on anti-retroviral therapy. In 2009/2010, this equated to £170m spent by London's NHS on anti-retroviral drugs. Ways employed to reduce this cost include standardising the drugs patients are on and delivering medication to patients at home. Home delivery (HD) medication is exempt from value-added tax. The savings made from 10 patients using the home delivery service would free up resources to provide anti-retroviral therapy to one further patient. Studies have shown that concerns surrounding potential breaches of confidentiality are a potential barrier to some people using the home delivery service. In order to challenge these concerns, a leaflet was devised highlighting the major benefits to both the patient and the NHS of home delivery and addressing concerns over confidentiality. The leaflet was handed out to patients at the Mortimer Market Centre who were currently on anti-retroviral medication but not on home delivery. They were asked to complete a survey on their views of the service before and after reading the leaflet, whether they had been previously aware of the service and whether their concerns had been addressed. Some 79% felt that the patient information leaflet addressed all of their concerns, and it helped 11% decide whether to consider using home delivery. However, as more patients were opposed to the service after reading the patient information leaflet than those considering it, more work needs to be done to explore patients' concerns and other factors influencing home delivery service uptake. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Patients' view on medical students in dermatology practice

Directory of Open Access Journals (Sweden)

Seval Doğruk Kaçar

2014-12-01

Full Text Available Background and Design: Practical training of medical students, especially in specialties such as dermatology, is performed in outpatient clinics where mostly outpatients are encountered. The aim of this study was to compare patients’ perspectives on medical students in two university hospitals (X–Y situated in different regions of Turkey. Materials and Methods: A total of 250 patients, who visited outpatient clinics of X (group 1 and Y (group 2 university hospitals during practical training for fifth year medical students, were included in this study. A questionnaire composed of 16 items was filled by all patients. The first eight questions were about patients’ consent and preferences on the presence of medical students during their interview and the remaining eight questions inquired patients’ overall thoughts on medical students. Results: The patients in both groups were willing to be a part of the educational programme of medical students (39.8%, 53.5%, respectively. The patients were aware that they had the right to refuse the presence of medical students (61.0%, 62.3% and majority wanted to be informed on the presence of medical students during the interview (72.4%, 80.7%. While patients in group 1 evaluated being with medical students as pleasurable (43.1%, patients in group 2 did not agree (44.7%. In addition, both groups were not bothered to share personal information with medical students (50.4%, 44.7% and stated that they would recommend their friends and relatives to have a physical examination done by medical students (51.2%, 41.2%. Conclusion: The active role of medical students during dermatology training is positively viewed by patients in both western and eastern parts of our country. The patients’ request on being informed for the presence of medical students during clinical examination reveals the requirement of oral and written informed consent.

Managing medical and insurance information through a smart-card-based information system.

Science.gov (United States)

Lambrinoudakis, C; Gritzalis, S

2000-08-01

The continuously increased mobility of patients and doctors, in conjunction with the existence of medical groups consisting of private doctors, general practitioners, hospitals, medical centers, and insurance companies, pose significant difficulties on the management of patients' medical data. Inevitably this affects the quality of the health care services provided. The evolving smart card technology can be utilized for the implementation of a secure portable electronic medical record, carried by the patient herself/himself. In addition to the medical data, insurance information can be stored in the smart card thus facilitating the creation of an "intelligent system" supporting the efficient management of patient's data. In this paper we present the main architectural and functional characteristics of such a system. We also highlight how the security features offered by smart cards can be exploited in order to ensure confidentiality and integrity of the medical data stored in the patient cards.

Use of the medical information on the internet by pregnant patients with a prenatal diagnosis of neonatal disease requiring surgery.

Science.gov (United States)

Usui, Noriaki; Kamiyama, Masafumi; Tani, Gakuto; Kanagawa, Takeshi; Fukuzawa, Masahiro

2011-12-01

The purpose of this study was to clarify the current status and the problems associated with using medical information on the internet during pregnancy in patients prenatally diagnosed with fetal abnormalities at a single Japanese institution. A written, anonymous questionnaire survey was conducted in 155 pregnant patients who had been prenatally diagnosed as having neonatal surgical diseases between January 2000 and December 2009, and their families. Forty-three out of the 75 responding families (57.3%) had used medical information available on the internet during their pregnancy. The availability of information, assessed during 2 year-increments, has increased rapidly in the past 4 years. When the explanation of a physician was compared with the information provided by the internet, the knowledge or impression of the disease was different in 60% of cases and similar in 33% of cases. More importantly, 60% of the patients felt that the information obtained from the internet was more pessimistic than the physician's explanation. The number of pregnant patients who have used medical information on the internet has rapidly increased in the recent years. Subjects who used this information were more likely to experience a sense of anxiety and feelings regarding the seriousness of the disease.

Psychometric validation of a new measurement instrument for time-oriented patient information in electronic medical records: A questionnaire survey of physicians.

Science.gov (United States)

Shibuya, Akiko; Misawa, Jimpei; Maeda, Yukihiro; Ichikawa, Rie; Kamata, Michiyo; Inoue, Ryusuke; Morimoto, Tetsuji; Nakayama, Masaharu; Hishiki, Teruyoshi; Kondo, Yoshiaki

2017-12-01

Time is an important element in medical data. Physicians record and store information about patients' disease progress and treatment response in electronic medical records (EMRs). Because EMRs use timestamps, physicians can identify patterns over time regarding a patient's disease and treatment (eg, laboratory values and medications). However, analyses of physicians' use and satisfaction with EMRs have focused on functionality, storage, and system operation rather than the use of time-oriented information. This study aimed to understand physicians' needs regarding time-oriented patient information in EMRs in clinical practice. The reliability and validity of the items in the questionnaire were evaluated in 87 physicians at a national university hospital. Internal consistency was satisfactory (Cronbach alpha coefficient, 0.87). Four dimensions were identified in exploratory factor analysis. Correlations between the 4 dimensions supported the construct validity of the items. Scores of time-oriented patients' medical history in the 4 dimensions showed a significant association with physician age. Based on confirmatory factor analysis, associations were significant and positive (P information in EMRs, both time-oriented treatment results followed by time-oriented team information had significant positive associations. Our study suggests that 4 specific time-oriented patient information factors in EMRs are needed by physicians. Exploring physicians' needs regarding patient-specific time-oriented information may provide a better understanding of the barriers facing the adoption and use of EMRs (eg, decision-making and practice safety concerns) and lead to better acceptance of EMRs in physicians' clinical practices. © 2017 John Wiley & Sons, Ltd.

Asan medical information system for healthcare quality improvement.

Science.gov (United States)

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Medication errors: the role of the patient.

Science.gov (United States)

Britten, Nicky

2009-06-01

1. Patients and their carers will usually be the first to notice any observable problems resulting from medication errors. They will probably be unable to distinguish between medication errors, adverse drug reactions, or 'side effects'. 2. Little is known about how patients understand drug related problems or how they make attributions of adverse effects. Some research suggests that patients' cognitive models of adverse drug reactions bear a close relationship to models of illness perception. 3. Attributions of adverse drug reactions are related to people's previous experiences and to their level of education. The evidence suggests that on the whole patients' reports of adverse drug reactions are accurate. However, patients do not report all the problems they perceive and are more likely to report those that they do perceive as severe. Patients may not report problems attributed to their medications if they are fearful of doctors' reactions. Doctors may respond inappropriately to patients' concerns, for example by ignoring them. Some authors have proposed the use of a symptom checklist to elicit patients' reports of suspected adverse drug reactions. 4. Many patients want information about adverse drug effects, and the challenge for the professional is to judge how much information to provide and the best way of doing so. Professionals' inappropriate emphasis on adherence may be dangerous when a medication error has occurred. 5. Recent NICE guidelines recommend that professionals should ask patients if they have any concerns about their medicines, and this approach is likely to yield information conducive to the identification of medication errors.

Reliability of "Google" for obtaining medical information

Directory of Open Access Journals (Sweden)

Mihir Kothari

2015-01-01

Full Text Available Internet is used by many patients to obtain relevant medical information. We assessed the impact of "Google" search on the knowledge of the parents whose ward suffered from squint. In 21 consecutive patients, the "Google" search improved the mean score of the correct answers from 47% to 62%. We found that "Google" search was useful and reliable source of information for the patients with regards to the disease etiopathogenesis and the problems caused by the disease. The internet-based information, however, was incomplete and not reliable with regards to the disease treatment.

Incorporation of medical informatics and information technology as core components of undergraduate medical education - time for change!

Science.gov (United States)

Otto, Anthony; Kushniruk, Andre

2009-01-01

It is generally accepted that Information Technology (IT) is a highly desirable and a very necessary ingredient of modern health care. Review of available literature reveals a paucity of medical informatics and information technology courses in undergraduate medical curricula and a lack of research to assess the effectiveness of medical informatics in undergraduate medical education. The need for such initiatives is discussed and a pilot project is described that evaluated the effectiveness of education in the use of Electronic Medical Record (EMR) applications. Educational activities, for example, could be medical students conducting virtual medical encounters or interacting with EMR applications. An EMR application, which was used in several related projects, has been adapted to the educational environment: standardized patient records can be created and cloned so that individual students can interact with a "standard" patient and alter the patient's data.

"Do your homework…and then hope for the best": the challenges that medical tourism poses to Canadian family physicians' support of patients' informed decision-making.

Science.gov (United States)

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik

2013-09-22

Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism. Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Medical tourism is creating new challenges for

The emergency patient's participation in medical decision-making.

Science.gov (United States)

Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

2016-09-01

The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention.

Science.gov (United States)

Wang, Shan Huei

2017-08-02

Web-based medical service (WBMS), a cooperative relationship between medical service and Internet technology, has been called one of the most innovative services of the 21st century. However, its business promotion and implementation in the medical industry have neither been expected nor executed. Few studies have explored this phenomenon from the viewpoint of inexperienced patients. The primary goal of this study was to explore whether technology attractiveness, medical creditability, and diversified medical information sources could increase users' behavior intention. This study explored the effectiveness of web-based medical service by using three situations to manipulate sources of medical information. A total of 150 questionnaires were collected from people who had never used WBMS before. Hierarchical regression was used to examine the mediation and moderated-mediation effects. Perceived ease of use (P=.002) and perceived usefulness (P=.001) significantly enhance behavior intentions. Medical credibility is a mediator (P=.03), but the relationship does not significantly differ under diverse manipulative information channels (P=.39). Medical credibility could explain the extra variation between technology attractiveness and behavior intention, but not significant under different moderating effect of medical information sources. ©Shan Huei Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.08.2017.

Interventions to improve recall of medical information in cancer patients: a systematic review of the literature.

NARCIS (Netherlands)

Meulen, N. van der; Jansen, J.; Dulmen, S. van; Bensing, J.; Weert, J. van

2008-01-01

This systematic review investigates which interventions are effective to improve recall of medical information in cancer patients. A literature research was done in PubMed, PsychINFO, CINAHL and Cochrane Library, following the guidelines of the Cochrane Collaboration. The methodological quality of

Development of an integrated medical supply information system

Science.gov (United States)

Xu, Eric; Wermus, Marek; Blythe Bauman, Deborah

2011-08-01

The integrated medical supply inventory control system introduced in this study is a hybrid system that is shaped by the nature of medical supply, usage and storage capacity limitations of health care facilities. The system links demand, service provided at the clinic, health care service provider's information, inventory storage data and decision support tools into an integrated information system. ABC analysis method, economic order quantity model, two-bin method and safety stock concept are applied as decision support models to tackle inventory management issues at health care facilities. In the decision support module, each medical item and storage location has been scrutinised to determine the best-fit inventory control policy. The pilot case study demonstrates that the integrated medical supply information system holds several advantages for inventory managers, since it entails benefits of deploying enterprise information systems to manage medical supply and better patient services.

An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: The role of written and spoken communication.

Science.gov (United States)

Curtis, Laura M; Mullen, Rebecca J; Russell, Allison; Fata, Aimee; Bailey, Stacy C; Makoul, Gregory; Wolf, Michael S

2016-09-01

We tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. Patients (N=141) receiving a new prescription at one internal medicine clinic were recruited into a 2-arm physician-randomized study. We leveraged an EHR platform to automatically deliver 1-page educational 'MedSheets' to patients after medical encounters. We also assessed if physicians counseled patients via patient self-report immediately following visits. Patients' understanding was objectively measured via phone interview. 122 patients completed the trial. Most intervention patients (70%) reported receiving MedSheets. Patients reported physicians frequently counseled on indication and directions for use, but less often for risks. In multivariable analysis, written information (OR 2.78, 95% CI 1.10-7.04) and physician counseling (OR 2.95, 95% CI 1.26-6.91) were independently associated with patient understanding of risk information. Receiving both was most beneficial; 87% of those receiving counseling and MedSheets correctly recalled medication risks compared to 40% receiving neither. An EHR can be a reliable means to deliver tangible, print medication education to patients, but cannot replace the salience of physician-patient communication. Offering both written and spoken modalities produced a synergistic effect for informing patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

PASTE: patient-centered SMS text tagging in a medication management system.

Science.gov (United States)

Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

2012-01-01

To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

Science.gov (United States)

McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L

2013-09-01

We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

Medical record search engines, using pseudonymised patient identity: an alternative to centralised medical records.

Science.gov (United States)

Quantin, Catherine; Jaquet-Chiffelle, David-Olivier; Coatrieux, Gouenou; Benzenine, Eric; Allaert, François-André

2011-02-01

The purpose of our multidisciplinary study was to define a pragmatic and secure alternative to the creation of a national centralised medical record which could gather together the different parts of the medical record of a patient scattered in the different hospitals where he was hospitalised without any risk of breaching confidentiality. We first analyse the reasons for the failure and the dangers of centralisation (i.e. difficulty to define a European patients' identifier, to reach a common standard for the contents of the medical record, for data protection) and then propose an alternative that uses the existing available data on the basis that setting up a safe though imperfect system could be better than continuing a quest for a mythical perfect information system that we have still not found after a search that has lasted two decades. We describe the functioning of Medical Record Search Engines (MRSEs), using pseudonymisation of patients' identity. The MRSE will be able to retrieve and to provide upon an MD's request all the available information concerning a patient who has been hospitalised in different hospitals without ever having access to the patient's identity. The drawback of this system is that the medical practitioner then has to read all of the information and to create his own synthesis and eventually to reject extra data. Faced with the difficulties and the risks of setting up a centralised medical record system, a system that gathers all of the available information concerning a patient could be of great interest. This low-cost pragmatic alternative which could be developed quickly should be taken into consideration by health authorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Ontological Model-Based Transparent Access To Information In A Medical Multi-Agent System

Directory of Open Access Journals (Sweden)

Felicia GÎZĂ-BELCIUG

2012-01-01

Full Text Available Getting the full electronic medical record of a patient is an important step in providing a quality medical service. But the degree of heterogeneity of data from health unit informational systems is very high, because each unit can have a different model for storing patients’ medical data. In order to achieve the interoperability and integration of data from various medical units that store partial patient medical information, this paper proposes a multi-agent systems and ontology based approach. Therefore, we present an ontological model for describing the particular structure of the data integration process. The system is to be used for centralizing the information from a patient’s partial medical records. The main advantage of the proposed model is the low ratio between the complexity of the model and the amount of information that can be retrieved in order to generate the complete medical history of a patient.

Design and implementation of a web-based patient portal linked to an electronic health record designed to improve medication safety: the Patient Gateway medications module

Directory of Open Access Journals (Sweden)

Jeffrey Schnipper

2008-07-01

Full Text Available In this article we describe the background, design, and preliminary results of a medications module within Patient Gateway (PG, a patient portal linked to an electronic health record (EHR. The medications module is designed to improve the accuracy of medication lists within the EHR, reduce adverse drug events and improve patient_provider communication regarding medications and allergies in several primary care practices within a large integrated healthcare delivery network. This module allows patients to view and modify the list of medications and allergies from the EHR, report nonadherence, side effects and other medication-related problems and easily communicate this information to providers, who can verify the information and update the EHR as needed. Usage and satisfaction data indicate that patients found the module easy to use, felt that it led to their providers having more accurate information about them and enabled them to feel more prepared for their forthcoming visits. Further analyses will determine the effects of this module on important medication-related outcomes and identify further enhancements needed to improve on this approach.

[Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

Science.gov (United States)

Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

2009-10-01

The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

Health information technology and the medical school curriculum.

Science.gov (United States)

Triola, Marc M; Friedman, Erica; Cimino, Christopher; Geyer, Enid M; Wiederhorn, Jo; Mainiero, Crystal

2010-12-01

Medical schools must teach core biomedical informatics competencies that address health information technology (HIT), including explaining electronic medical record systems and computerized provider order entry systems and their role in patient safety; describing the research uses and limitations of a clinical data warehouse; understanding the concepts and importance of information system interoperability; explaining the difference between biomedical informatics and HIT; and explaining the ways clinical information systems can fail. Barriers to including these topics in the curricula include lack of teachers; the perception that informatics competencies are not applicable during preclinical courses and there is no place in the clerkships to teach them; and the legal and policy issues that conflict with students' need to develop skills. However, curricular reform efforts are creating opportunities to teach these topics with new emphasis on patient safety, team-based medical practice, and evidence-based care. Overarching HIT competencies empower our students to be lifelong technology learners.

Memorandum on the use of information technology to improve medication safety.

Science.gov (United States)

Ammenwerth, E; Aly, A-F; Bürkle, T; Christ, P; Dormann, H; Friesdorf, W; Haas, C; Haefeli, W E; Jeske, M; Kaltschmidt, J; Menges, K; Möller, H; Neubert, A; Rascher, W; Reichert, H; Schuler, J; Schreier, G; Schulz, S; Seidling, H M; Stühlinger, W; Criegee-Rieck, M

2014-01-01

Information technology in health care has a clear potential to improve the quality and efficiency of health care, especially in the area of medication processes. On the other hand, existing studies show possible adverse effects on patient safety when IT for medication-related processes is developed, introduced or used inappropriately. To summarize definitions and observations on IT usage in pharmacotherapy and to derive recommendations and future research priorities for decision makers and domain experts. This memorandum was developed in a consensus-based iterative process that included workshops and e-mail discussions among 21 experts coordinated by the Drug Information Systems Working Group of the German Society for Medical Informatics, Biometry and Epidemiology (GMDS). The recommendations address, among other things, a stepwise and comprehensive strategy for IT usage in medication processes, the integration of contextual information for alert generation, the involvement of patients, the semantic integration of information resources, usability and adaptability of IT solutions, and the need for their continuous evaluation. Information technology can help to improve medication safety. However, challenges remain regarding access to information, quality of information, and measurable benefits.

Information Governance: A Model for Security in Medical Practice

Directory of Open Access Journals (Sweden)

Patricia A.H. Williams

2007-03-01

Full Text Available Information governance is becoming an important aspect of organisational accountability. In consideration that information is an integral asset of most organisations, the protection of this asset will increasingly rely on organisational capabilities in security.  In the medical arena this information is primarily sensitive patient-based information. Previous research has shown that application of security measures is a low priority for primary care medical practice and that awareness of the risks are seriously underestimated. Consequently, information security governance will be a key issue for medical practice in the future. Information security governance is a relatively new term and there is little existing research into how to meet governance requirements. The limited research that exists describes information security governance frameworks at a strategic level. However, since medical practice is already lagging in the implementation of appropriate security, such definition may not be practical although it is obviously desirable. This paper describes an on-going action research project undertaken in the area of medical information security, and presents a tactical approach model aimed at addressing information security governance and the protection of medical data. 

The mediatory role of medication adherence in improving patients’ medication experience through patient–physician communication among older hypertensive patients

Directory of Open Access Journals (Sweden)

Lee W

2017-07-01

Full Text Available Woojung Lee, Youran Noh, Hyeonjin Kang, Song Hee Hong Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul, Korea Background: Understanding how patient–physician communication affects patients’ medication experience would help hypertensive patients maintain their regular long-term medication therapy. This study aimed to examine whether patient–physician communication (information and interpersonal treatment affects patients’ medication experience directly or indirectly through changing medication adherence for each of the two communication domains.Methods: A self-administered cross-sectional survey was conducted for older patients who had visited a community senior center as a member. Two communication domains were assessed using two subscales of the Primary Care Assessment Survey. Medication adherence and experience were measured using the Morisky Medication Adherence Scale and a five-point Likert scale, respectively. Mediatory effects were assessed via Baron and Kenny’s procedure and a Sobel test. Results: Patient–physician communication had a positive prediction on patients’ medication experience (β=0.25, P=0.03, and this was fully mediated by medication adherence (z=3.62, P<0.001. Of the two components of patient–physician communication, only informative communication showed a mediatory effect (z=2.21, P=0.03. Conclusion: Patient–physician communication, specifically informative communication, had the potential to improve patients’ medication experience via changes in medication adherence. This finding can inform health care stakeholders of the mediatory role of medication adherence in ensuring favorable medication experience for older hypertensive patients by fostering informative patient–physician communication. Keywords: patient medication experience, medication adherence, patient–physician communication, patient-centered practice, patient-reported outcome, mediation

Quantitative information in medical imaging

International Nuclear Information System (INIS)

Deconinck, F.

1985-01-01

When developing new imaging or image processing techniques, one constantly has in mind that the new technique should provide a better, or more optimal answer to medical tasks than existing techniques do 'Better' or 'more optimal' imply some kind of standard by which one can measure imaging or image processing performance. The choice of a particular imaging modality to answer a diagnostic task, such as the detection of coronary artery stenosis is also based on an implicit optimalisation of performance criteria. Performance is measured by the ability to provide information about an object (patient) to the person (referring doctor) who ordered a particular task. In medical imaging the task is generally to find quantitative information on bodily function (biochemistry, physiology) and structure (histology, anatomy). In medical imaging, a wide range of techniques is available. Each technique has it's own characteristics. The techniques discussed in this paper are: nuclear magnetic resonance, X-ray fluorescence, scintigraphy, positron emission tomography, applied potential tomography, computerized tomography, and compton tomography. This paper provides a framework for the comparison of imaging performance, based on the way the quantitative information flow is altered by the characteristics of the modality

Effect of antidepressant medication use on emotional information processing in major depression.

Science.gov (United States)

Wells, Tony T; Clerkin, Elise M; Ellis, Alissa J; Beevers, Christopher G

2014-02-01

Acute administration of antidepressant medication increases emotional information processing for positive information in both depressed and healthy persons. This effect is likely relevant to the therapeutic actions of these medications, but it has not been studied in patients with major depressive disorder taking antidepressants as typically prescribed in the community. The authors used eye tracking to examine the effects of antidepressant medication on selective attention for emotional stimuli in a sample of 47 patients with major depressive disorder (21 medicated and 26 unmedicated) and 47 matched comparison subjects without depression. Participants completed a passive-viewing eye-tracking task assessing selective attention for positive, dysphoric, threatening, and neutral stimuli in addition to providing medication information and self-report measures of depression and anxiety severity. Depressed participants currently taking antidepressants and nondepressed comparison subjects demonstrated greater total gaze duration and more fixations for positive stimuli compared with unmedicated depressed participants. Depressed participants on medication also had fewer fixations for dysphoric stimuli compared with depressed participants not on medication. Antidepressants, as prescribed in the community to patients with depression, appear to modify emotional information processing in the absence of differences in depression severity. These results are consistent with previous work and indicate a robust effect for antidepressants on positive information processing. They also provide further evidence for modification of information processing as a potential mechanism of action for antidepressant medication.

Visual representation of medical information: the importance of considering the end-user in the design of medical illustrations.

Science.gov (United States)

Scheltema, Emma; Reay, Stephen; Piper, Greg

2018-01-01

This practice led research project explored visual representation through illustrations designed to communicate often complex medical information for different users within Auckland City Hospital, New Zealand. Media and tools were manipulated to affect varying degrees of naturalism or abstraction from reality in the creation of illustrations for a variety of real-life clinical projects, and user feedback on illustration preference gathered from both medical professionals and patients. While all users preferred the most realistic representations of medical information from the illustrations presented, patients often favoured illustrations that depicted a greater amount of information than professionals suggested was necessary.

Why do patients engage in medical tourism?

Science.gov (United States)

Runnels, Vivien; Carrera, P M

2012-12-01

Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients' unmet need, the nature of services sought and the manner by which treatment is accessed. In order to beneficially employ the opportunities medical tourism offers, and address and contain possible threats and harms, an informed decision is crucial. This paper aims to enhance the current knowledge on medical tourism by isolating the focal content of the decisions that patients make. Based on the existing literature, it proposes a sequential decision-making process in opting for or against medical care abroad, and engaging in medical tourism, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care. Accordingly, it comments on the imperative of access to health information and the current regulatory environment which impact on this increasingly popular and complex form of accessing and providing medical care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Research on medical instrument information integration technology based on IHE PCD].

Science.gov (United States)

Zheng, Jianli; Liao, Yun; Yang, Yongyong

2014-06-01

Integrating medical instruments with medical information systems becomes more and more important in healthcare industry. To make medical instruments without standard communication interface possess the capability of interoperating and sharing information with medical information systems, we developed a medical instrument integration gateway based on Integrating the Healthcare Enterprise Patient Care Device (IHE PCD) integration profiles in this research. The core component is an integration engine which is implemented according to integration profiles and Health Level Seven (HL7) messages defined in IHE PCD. Working with instrument specific Javascripts, the engine transforms medical instrument data into HL7 ORU message. This research enables medical instruments to interoperate and exchange medical data with information systems in a standardized way, and is valuable for medical instrument integration, especially for traditional instruments.

Older Adults' Memory for Verbally Presented Medical Information

Science.gov (United States)

Bankoff, Sarah M.; Sandberg, Elisabeth Hollister

2012-01-01

Previous research demonstrates that patients typically have difficulty remembering information presented during healthcare consultations. This study examined how older adults learn and remember verbally presented medical information. Healthy older adults were tested for recall in experimental and field settings. Participants viewed a five-minute…

Effects of Information Access Cost and Accountability on Medical Residents' Information Retrieval Strategy and Performance During Prehandover Preparation: Evidence From Interview and Simulation Study.

Science.gov (United States)

Yang, X Jessie; Wickens, Christopher D; Park, Taezoon; Fong, Liesel; Siah, Kewin T H

2015-12-01

We aimed to examine the effects of information access cost and accountability on medical residents' information retrieval strategy and performance during prehandover preparation. Prior studies observing doctors' prehandover practices witnessed the use of memory-intensive strategies when retrieving patient information. These strategies impose potential threats to patient safety as human memory is prone to errors. Of interest in this work are the underlying determinants of information retrieval strategy and the potential impacts on medical residents' information preparation performance. A two-step research approach was adopted, consisting of semistructured interviews with 21 medical residents and a simulation-based experiment with 32 medical residents. The semistructured interviews revealed that a substantial portion of medical residents (38%) relied largely on memory for preparing handover information. The simulation-based experiment showed that higher information access cost reduced information access attempts and access duration on patient documents and harmed information preparation performance. Higher accountability led to marginally longer access to patient documents. It is important to understand the underlying determinants of medical residents' information retrieval strategy and performance during prehandover preparation. We noted the criticality of easy access to patient documents in prehandover preparation. In addition, accountability marginally influenced medical residents' information retrieval strategy. Findings from this research suggested that the cost of accessing information sources should be minimized in developing handover preparation tools. © 2015, Human Factors and Ergonomics Society.

[Information technology in medical education].

Science.gov (United States)

Ramić, A

1999-01-01

The role of information technology in educational models of under-graduate and post-graduate medical education is growing in 1980's influenced by PC's break-in in medical practice and creating relevant data basis, and, particularly, in 1990's by integration of information technology on international level, development of international network, Internet, Telemedicin, etc. The development of new educational information technology is evident, proving that information in transfer of medical knowledge, medical informatics and communication systems represent the base of medical practice, medical education and research in medical sciences. In relation to the traditional approaches in concept, contents and techniques of medical education, new models of education in training of health professionals, using new information technology, offer a number of benefits, such as: decentralization and access to relevant data sources, collecting and updating of data, multidisciplinary approach in solving problems and effective decision-making, and affirmation of team work within medical and non-medical disciplines. Without regard to the dynamics of change and progressive reform orientation within health sector, the development of modern medical education is inevitable for all systems a in which information technology and available data basis, as a base of effective and scientifically based medical education of health care providers, give guarantees for efficient health care and improvement of health of population.

Medical Information Security

OpenAIRE

William C. Figg, Ph.D.; Hwee Joo Kam, M.S.

2011-01-01

Modern medicine is facing a complex environment, not from medical technology but rather government regulations and information vulnerability. HIPPA is the government’s attempt to protect patient’s information yet this only addresses traditional record handling. The main threat is from the evolving security issues. Many medical offices and facilities have multiple areas of information security concerns. Physical security is often weak, office personnel are not always aware of security needs an...

Potentially inappropriate medication related to weakness in older acute medical patients

DEFF Research Database (Denmark)

Jensen, Line Due; Andersen, Ove; Hallin, Marianne

2014-01-01

: Patients aged ≥65 years admitted to the acute medical unit during the period October to December 2011 were included. Patients were interviewed at admission and at a follow-up visit 30 days after discharge. Data included information about medications, social status, functional status, cognitive status.......94), cognition (p = 0.10), pain (p = 0.46), or visual acuity (p = 0.55). CONCLUSIONS: Use of PIMs was very common among older people admitted to an acute medical unit. The use of PIMs is associated with low functional status, low handgrip strength, and reduced health-related quality of life.......: The prevalence of PIMs and the association with PIMs and functional status handgrip strength, HRQOL, comorbidities, social demographic data and vision. RESULTS: Seventy-one patients (55 % men) with a median age of 78.7 years participated. The median number of medications was eight per person. Eighty percent were...

Study on the standardization of hospital information system for medical image information sharing

International Nuclear Information System (INIS)

Kim, Seon Chil; Kwon, Su Ja

2001-01-01

As the adoption of PACS and hospital information system among university hospitals and hospital level institutions grows bigger, the need of sharing and transferring medical information among medical institutions is rising. For the medical information, which is saved in the hospital medical system, to be transferred within the same hospital, domestic, or foreign medical institutions, a standard protocol is necessary. But realistically, most of the domestic hospitals do not abide by H7L which is the HIS standard and so, information transferring is not possible as of present. As such, the purpose of this research is to implement the information between HIS and PACS to an international standard by constructing HL7 messages through HL7 Interface, which will eventually make possible information transferring between different hospitals. Our research team has developed a method which will make the PACS equip hospitals that do not follow HL7 standard which will make possible to transfer information between HIS and PACS through HL7 Message. By constructing message files, which follow the form of HL7 Message in the HL7 Interface, they can be transferred to PACS through the ftp protocol. The realization of the HIS/OCS Interface through HL7 enables data transferring between domestic and foreign medical institutions possible by implementing the international standard in the PACS and HIS data transferring process. The HL7 that our research team has developed made patient data transfer between medical institutions possible. The Interface is for a specific system model and in order for the data transfer between different systems to be realized, interfaces that are fit for each system must be needed. If the Interface is improvised and implemented to each hospital's information system, the data sharing among medical institutions can be broadened

Acceptance and perception of Nigerian patients to medical photography.

Science.gov (United States)

Adeyemo, W L; Mofikoya, B O; Akadiri, O A; James, O; Fashina, A A

2013-12-01

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of

A Multisite Survey Study of EMR Review Habits, Information Needs, and Display Preferences among Medical ICU Clinicians Evaluating New Patients.

Science.gov (United States)

Nolan, Matthew E; Cartin-Ceba, Rodrigo; Moreno-Franco, Pablo; Pickering, Brian; Herasevich, Vitaly

2017-10-01

The electronic chart review habits of intensive care unit (ICU) clinicians admitting new patients are largely unknown but necessary to inform the design of existing and future critical care information systems. We conducted a survey study to assess the electronic chart review practices, information needs, workflow, and data display preferences among medical ICU clinicians admitting new patients. We surveyed rotating residents, critical care fellows, advanced practice providers, and attending physicians at three Mayo Clinic sites (Minnesota, Florida, and Arizona) via email with a single follow-up reminder message. Of 234 clinicians invited, 156 completed the full survey (67% response rate). Ninety-two percent of medical ICU clinicians performed electronic chart review for the majority of new patients. Clinicians estimated spending a median (interquartile range (IQR)) of 15 (10-20) minutes for a typical case, and 25 (15-40) minutes for complex cases, with no difference across training levels. Chart review spans 3 or more years for two-thirds of clinicians, with the most relevant categories being imaging, laboratory studies, diagnostic studies, microbiology reports, and clinical notes, although most time is spent reviewing notes. Most clinicians (77%) worry about overlooking important information due to the volume of data (74%) and inadequate display/organization (63%). Potential solutions are chronologic ordering of disparate data types, color coding, and explicit data filtering techniques. The ability to dynamically customize information display for different users and varying clinical scenarios is paramount. Electronic chart review of historical data is an important, prevalent, and potentially time-consuming activity among medical ICU clinicians who would benefit from improved information display systems. Schattauer GmbH Stuttgart.

Intelligent medical information filtering.

Science.gov (United States)

Quintana, Y

1998-01-01

This paper describes an intelligent information filtering system to assist users to be notified of updates to new and relevant medical information. Among the major problems users face is the large volume of medical information that is generated each day, and the need to filter and retrieve relevant information. The Internet has dramatically increased the amount of electronically accessible medical information and reduced the cost and time needed to publish. The opportunity of the Internet for the medical profession and consumers is to have more information to make decisions and this could potentially lead to better medical decisions and outcomes. However, without the assistance from professional medical librarians, retrieving new and relevant information from databases and the Internet remains a challenge. Many physicians do not have access to the services of a medical librarian. Most physicians indicate on surveys that they do not prefer to retrieve the literature themselves, or visit libraries because of the lack of recent materials, poor organisation and indexing of materials, lack of appropriate and available material, and lack of time. The information filtering system described in this paper records the online web browsing behaviour of each user and creates a user profile of the index terms found on the web pages visited by the user. A relevance-ranking algorithm then matches the user profiles to the index terms of new health care web pages that are added each day. The system creates customised summaries of new information for each user. A user can then connect to the web site to read the new information. Relevance feedback buttons on each page ask the user to rate the usefulness of the page to their immediate information needs. Errors in relevance ranking are reduced in this system by having both the user profile and medical information represented in the same representation language using a controlled vocabulary. This system also updates the user profiles

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

Science.gov (United States)

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

Contesting asthma medication: patients' view of alternatives.

Science.gov (United States)

Kopnina, Helen

2010-08-01

There are few studies pertaining to asthma patients' views on complementary and alternative medicine (CAM). The driving question behind the study is why some asthma patients choose noncompliance to conventional western medicine and resort to other modalities, often deemed as being 'alternative,' 'complementary,' or 'integrated.' Does the patients' emancipation movement lead to greater awareness of the benefits of alternative medicine? Does the patients' identity as asthma sufferers play a role in their decision? Case studies based on semistructured interviews were conducted between June 2009 and January 2010 with 19 asthma patients in The Netherlands who have chosen complementary and alternative medicine (CAM). Patients were contacted through online forum of Dutch asthma patients' organization Astma Fonds. We have discovered that on the whole patients in the present study were well informed about risks and benefits of both prescribed and alternative medicines. We have argued that noncompliance to medical regime by some asthma patients can be explained by the rationality of their choice based on evidence of clinical trials of commonly assigned asthma medication as well as partial and anecdotal evidence of the benefits of CAM therapies. It is the patients themselves who, by invoking the same evidence-based dominant paradigm choose to address the conflict between protagonists of 'conventional,' western medicine and other modalities. The author argues that asthma patients' noncompliance with (Western) medical regime and choice for alternative medical treatment of asthma is a matter of rational choice informed by evidence-based awareness. This evidence-based rationality particularly refers here to the patients' awareness of the rather controversial results of clinical trials of commonly used asthma medicines, particularly those containing elements of budesonide (Pulmicort), an anti-inflammatory corticosteroid, and formoterol (Oxis, Foradil), a rapid-acting and long

Assault in medical law: revisiting the boundaries of informed consent to medical treatment in South Africa.

Science.gov (United States)

Wilson, Maria C I

2009-05-01

This article focuses on assault as a cause of action in medical law, with particular emphasis on the requirements for informed consent, both under common law and under the National Health Act 2003 (Sth Africa). In particular, the test for consent, adopted in Castell v De Greef 1994 (4) SA 408 (C), is analysed in detail. It is noted that the wording of this test for informed consent mirrors the wording of the test for negligence laid down in the Australian case of Rogers v Whitaker (1992) 175 CLR 479. Further, the relationship between the delictual elements of wrongfulness and fault in assault is discussed. It is argued that in South African law a valid consent to medical treatment requires knowledge not only of the general nature of medical treatment but also of the consequences of the treatment and, in determining which consequences should be disclosed to a patient, the constitutional rights to equality and self-determination support the application of a subjective patient-centred test for informed consent. However, it is also proposed that the broad right of a patient to information is reined in at the fault element of assault, so that a limited requirement of consciousness of wrongfulness on the part of the defendant negates liability for delictual assault.

Bat-Inspired Algorithm Based Query Expansion for Medical Web Information Retrieval.

Science.gov (United States)

Khennak, Ilyes; Drias, Habiba

2017-02-01

With the increasing amount of medical data available on the Web, looking for health information has become one of the most widely searched topics on the Internet. Patients and people of several backgrounds are now using Web search engines to acquire medical information, including information about a specific disease, medical treatment or professional advice. Nonetheless, due to a lack of medical knowledge, many laypeople have difficulties in forming appropriate queries to articulate their inquiries, which deem their search queries to be imprecise due the use of unclear keywords. The use of these ambiguous and vague queries to describe the patients' needs has resulted in a failure of Web search engines to retrieve accurate and relevant information. One of the most natural and promising method to overcome this drawback is Query Expansion. In this paper, an original approach based on Bat Algorithm is proposed to improve the retrieval effectiveness of query expansion in medical field. In contrast to the existing literature, the proposed approach uses Bat Algorithm to find the best expanded query among a set of expanded query candidates, while maintaining low computational complexity. Moreover, this new approach allows the determination of the length of the expanded query empirically. Numerical results on MEDLINE, the on-line medical information database, show that the proposed approach is more effective and efficient compared to the baseline.

Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety.

Science.gov (United States)

Kim, Julia M; Suarez-Cuervo, Catalina; Berger, Zackary; Lee, Joy; Gayleard, Jessica; Rosenberg, Carol; Nagy, Natalia; Weeks, Kristina; Dy, Sydney

2018-04-01

Patient and family engagement (PFE) is critical for patient safety. We systematically reviewed types of PFE strategies implemented and their impact on medication safety. We searched MEDLINE, EMBASE, reference lists and websites to August 2016. Two investigators independently reviewed all abstracts and articles, and articles were additionally reviewed by two senior investigators for selection. One investigator abstracted data and two investigators reviewed the data for accuracy. Study quality was determined by consensus. Investigators developed a framework for defining the level of patient engagement: informing patients about medications (Level 1), informing about engagement with health care providers (Level 2), empowering patients with communication tools and skills (Level 3), partnering with patients in their care (Level 4), and integrating patients as full care team members (Level 5). We included 19 studies that mostly targeted older adults taking multiple medications. The median level of engagement was 2, ranging from 2-4. We identified no level 5 studies. Key themes for patient engagement strategies impacting medication safety were patient education and medication reconciliation, with a subtheme of patient portals. Most studies (84%) reported implementation outcomes. The most commonly reported medication safety outcomes were medication errors, including near misses and discrepancies (47%), and medication safety knowledge (37%). Most studies (63%) were of medium to low quality, and risk of bias was generally moderate. Among the 11 studies with control groups, 55% (n = 6) reported statistically significant improvement on at least one medication safety outcome. Further synthesis of medication safety measures was limited due to intervention and outcome heterogeneity. Key strategies for engaging patients in medication safety are education and medication reconciliation. Patient engagement levels were generally low, as defined by a novel framework for determining

Development of digital dashboard system for medical practice: maximizing efficiency of medical information retrieval and communication.

Science.gov (United States)

Lee, Kee Hyuck; Yoo, Sooyoung; Shin, HoGyun; Baek, Rong-Min; Chung, Chin Youb; Hwang, Hee

2013-01-01

It is reported that digital dashboard systems in hospitals provide a user interface (UI) that can centrally manage and retrieve various information related to patients in a single screen, support the decision-making of medical professionals on a real time basis by integrating the scattered medical information systems and core work flows, enhance the competence and decision-making ability of medical professionals, and reduce the probability of misdiagnosis. However, the digital dashboard systems of hospitals reported to date have some limitations when medical professionals use them to generally treat inpatients, because those were limitedly used for the work process of certain departments or developed to improve specific disease-related indicators. Seoul National University Bundang Hospital developed a new concept of EMR system to overcome such limitations. The system allows medical professionals to easily access all information on inpatients and effectively retrieve important information from any part of the hospital by displaying inpatient information in the form of digital dashboard. In this study, we would like to introduce the structure, development methodology and the usage of our new concept.

Negligence in securing informed consent and medical malpractice.

Science.gov (United States)

Perry, C

1988-01-01

The doctrine of informed consent requires that the patient must act voluntarily and in the light of adequate information in order to give legally valid consent to medical care. Different models have been developed by various courts to determine whether the informational requirement, what the physician must disclose to the patient about the potential risks of the proposed treatment, has been met under the tort theory of negligence. To prevail, the patient plaintiff must show that a particular jurisdiction's disclosure standard has been breached, that harm has resulted, and that the defendant physician's negligent failure to discuss certain risks was causally responsible for the patient's failure to withhold consent. Perry discusses possible problems of redundancy or inconsistency concerning the relationship between different models for disclosure and causality, and notes that these problems may have serious implications for patient autonomy.

Information technology for medication administration: assessing bedside readiness among nurses in Lebanon

NARCIS (Netherlands)

Marini, Sana Daya; Hasman, Arie; Huijer, Huda Abu-Saad

2009-01-01

Medication errors continue to be of great concern to hospitals. The use of Information technology (IT) for medication administration was recommended to assist nurses to administer medications safely, decrease the chance of medication errors, and contribute to patient safety. Such IT will be

[The information about discharge medication: what do general practitioners need?].

Science.gov (United States)

Adam, Henning; Niebling, Wilhelm-Bernhard; Schott, Gisela

2015-04-01

The information about the patient's discharge medication (DM) in the discharge letter guarantees the subsequent pharmacotherapy at the interface between tertiary to primary care. International data however shows that general practitioners (GPs) receive discharge letters with a delay and relevant information about DM is lacking. The aim of this study was to assess the point of view of German GPs concerning the information about DM, since no recent data about this topic is available. In a postal survey 516 GPs in the city of Berlin were contacted and asked about the transit of discharge letters and the information about DM. Results | 117 GPs answered the questionnaire (23 %). Most frequently, the patient himself handed over the information about DM to the GP on the day of his first visit in the practice after discharge. However, more than two third of GPs wished to receive the information before the patient's first consultation (73 %). Therefore, the majority preferred the electronic communication via fax (46 %) or email (9 %). Almost half of the GPs stated that discharge letters were lacking information about changes in medication and reasons for these changes. At the same time, nearly all GPs thought that these informational aspects were important. GPs wish an early and electronic transit of the DM with information concerning changes in medication and reasons. If these wishes were considered, a continuous and thus safer pharmacotherapy at the interface could be guaranteed. © Georg Thieme Verlag KG Stuttgart · New York.

Remote patient monitoring: Information reliability challenges

NARCIS (Netherlands)

Petkovic, M.

2009-01-01

An increasing number of extramural applications in the personal healthcare domain pose new challenges regarding the security of medical data. In this paper, we focus on remote patient monitoring systems and the issues around information reliability. In these systems medical data is not collected by

Robust anonymous authentication scheme for telecare medical information systems.

Science.gov (United States)

Xie, Qi; Zhang, Jun; Dong, Na

2013-04-01

Patient can obtain sorts of health-care delivery services via Telecare Medical Information Systems (TMIS). Authentication, security, patient's privacy protection and data confidentiality are important for patient or doctor accessing to Electronic Medical Records (EMR). In 2012, Chen et al. showed that Khan et al.'s dynamic ID-based authentication scheme has some weaknesses and proposed an improved scheme, and they claimed that their scheme is more suitable for TMIS. However, we show that Chen et al.'s scheme also has some weaknesses. In particular, Chen et al.'s scheme does not provide user's privacy protection and perfect forward secrecy, is vulnerable to off-line password guessing attack and impersonation attack once user's smart card is compromised. Further, we propose a secure anonymity authentication scheme to overcome their weaknesses even an adversary can know all information stored in smart card.

Design and Analysis of an Enhanced Patient-Server Mutual Authentication Protocol for Telecare Medical Information System.

Science.gov (United States)

Amin, Ruhul; Islam, S K Hafizul; Biswas, G P; Khan, Muhammad Khurram; Obaidat, Mohammad S

2015-11-01

In order to access remote medical server, generally the patients utilize smart card to login to the server. It has been observed that most of the user (patient) authentication protocols suffer from smart card stolen attack that means the attacker can mount several common attacks after extracting smart card information. Recently, Lu et al.'s proposes a session key agreement protocol between the patient and remote medical server and claims that the same protocol is secure against relevant security attacks. However, this paper presents several security attacks on Lu et al.'s protocol such as identity trace attack, new smart card issue attack, patient impersonation attack and medical server impersonation attack. In order to fix the mentioned security pitfalls including smart card stolen attack, this paper proposes an efficient remote mutual authentication protocol using smart card. We have then simulated the proposed protocol using widely-accepted AVISPA simulation tool whose results make certain that the same protocol is secure against active and passive attacks including replay and man-in-the-middle attacks. Moreover, the rigorous security analysis proves that the proposed protocol provides strong security protection on the relevant security attacks including smart card stolen attack. We compare the proposed scheme with several related schemes in terms of computation cost and communication cost as well as security functionalities. It has been observed that the proposed scheme is comparatively better than related existing schemes.

Medication Review and Patient Outcomes in an Orthopedic Department

DEFF Research Database (Denmark)

Lisby, Marianne; Bonnerup, Dorthe Krogsgaard; Brock, Birgitte

2015-01-01

OBJECTIVE: We investigated the health-related effect of systematic medication review performed by a clinical pharmacist and a clinical pharmacologist on nonelective elderly orthopedic patients. METHODS: This is a nonblinded randomized controlled study of 108 patients 65 years or older treated...... with at least 4 drugs. For the intervention, the clinical pharmacist reviewed the participants' medication after completion of the usual medication routine. Information was collected from medical charts, interviews with participants, and database registrations of drug purchase. Results were conferred...

Consumerism: forcing medical practices toward patient-centered care.

Science.gov (United States)

Ozmon, Jeff

2007-01-01

Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

An Item Bank for Abuse of Prescription Pain Medication from the Patient-Reported Outcomes Measurement Information System (PROMIS®).

Science.gov (United States)

Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Hilton, Thomas F; Daley, Dennis C; Patkar, Ashwin A; McCarty, Dennis

2017-08-01

There is a need to monitor patients receiving prescription opioids to detect possible signs of abuse. To address this need, we developed and calibrated an item bank for severity of abuse of prescription pain medication as part of the Patient-Reported Outcomes Measurement Information System (PROMIS ® ). Comprehensive literature searches yielded an initial bank of 5,310 items relevant to substance use and abuse, including abuse of prescription pain medication, from over 80 unique instruments. After qualitative item analysis (i.e., focus groups, cognitive interviewing, expert review, and item revision), 25 items for abuse of prescribed pain medication were included in field testing. Items were written in a first-person, past-tense format, with a three-month time frame and five response options reflecting frequency or severity. The calibration sample included 448 respondents, 367 from the general population (ascertained through an internet panel) and 81 from community treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network. A final bank of 22 items was calibrated using the two-parameter graded response model from item response theory. A seven-item static short form was also developed. The test information curve showed that the PROMIS ® item bank for abuse of prescription pain medication provided substantial information in a broad range of severity. The initial psychometric characteristics of the item bank support its use as a computerized adaptive test or short form, with either version providing a brief, precise, and efficient measure relevant to both clinical and community samples. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Patient-provider communication about medication use at the community pharmacy counter.

Science.gov (United States)

van Dijk, Marloes; Blom, Lyda; Koopman, Laura; Philbert, Daphne; Koster, Ellen; Bouvy, Marcel; van Dijk, Liset

2016-02-01

The objectives of this study were to, first, describe the information exchanged between pharmacy staff and patients about prescribed medication at the community pharmacy counter, and second, to investigate to what extent this met professional medication counselling guidelines. Pharmaceutical encounters were videotaped in four community pharmacies in the Netherlands. Patients were included if they collected a prescription for their own use. An observation protocol, including the MEDICODE checklist, was used to analyse the video recordings. A distinction was made between first and repeat prescriptions. One hundred fifty-three encounters were videotaped. When dispensing first prescriptions, pharmacy staff provided most information on instructions how to use the medication (83.3%), form of the medication (71.4%) and treatment duration (42.9%). Topics for repeat prescriptions (such as the effects of the medication and the incidence of observed adverse effects) were rarely discussed. Pharmacy staff rarely encouraged patients to ask questions. Pharmacy staff members provided little medication-related information at the counter, especially for repeat prescriptions, did not encourage active patient participation, and thereby did not adhere to the guidelines of their professional organisation. Further research is needed to understand the reasons for this. © 2015 Royal Pharmaceutical Society.

Second medical opinions: the views of oncology patients and their physicians.

Science.gov (United States)

Philip, Jennifer; Gold, Michelle; Schwarz, Max; Komesaroff, Paul

2010-09-01

Second medical opinions (SMOs) are common in oncology practice, but the nature of these consultations has received relatively little attention. This study examines the views of patients with advanced cancer and their physicians of SMOs. Parallel, concurrent surveys were developed for patients and physicians. The first was distributed to outpatients with advanced cancer-attending specialist clinics in an Australian quaternary hospital. The second survey, developed on the basis of results of exploratory interviews with medical oncologists, was distributed to medical oncologists in Australia. Seventeen of fifty two (33%) patients had sought a SMO, most commonly prompted by concerns around communication with their first doctor, the extreme and desperate nature of their medical condition and the need for reassurance. Most (94%) patients found the SMO helpful, with satisfaction related to improved communication and reassurance. Patients were concerned that seeking a second medical opinion may affect their relationship with their primary doctor. Most physicians (82%) reported seeing between one and five SMO per month, with patients being motivated by the need for additional information and reassurance. Physicians regarded SMO patients as having greater information needs (84%), greater psychosocial needs (58%) and requiring more of the physician's time and energy (77%) than other patients. SMOs are common in cancer care with most patients motivated by the need for improved communication, additional information and reassurance. Physicians identify patients who seek SMOs as having additional psychosocial needs compared with other oncology patients.

Informational needs of gastrointestinal oncology patients.

Science.gov (United States)

Papadakos, Janet; Urowitz, Sara; Olmstead, Craig; Jusko Friedman, Audrey; Zhu, Jason; Catton, Pamela

2015-12-01

In response to the dearth of consumer health information for patients with gastrointestinal cancers, this study examined the informational needs of these patients to build a plan for future resource development. Although studies have examined informational needs of some such cancers, no published literature has investigated the comprehensive informational needs across all sites of gastrointestinal cancer. A cross-sectional needs assessment comprising a self-administered questionnaire was conducted at an ambulatory gastrointestinal oncology clinic in Toronto, Canada. Patient informational needs were measured, including importance of information, amount desired and preferred mode of delivery. Informational needs were grouped into six domains: medical, practical, physical, emotional, social and spiritual. Eighty-two surveys were analysed. The majority of the respondents were male (53.8%), over the age of 50 (77.8%), and born outside of Canada (51.9%). While many did not speak English as a child (46.3%), and do not speak English at home (22.2%), nearly all indicated comfort with receiving health information in English (97.5%). The majority of respondents were college educated (79.3%) and married (73%). Multiple cancer types were reported; the most common being colorectal (39%), followed by pancreatic (12%) and cancers of the gallbladder or bile duct (12%). Overall, respondents placed highest importance on medical information (P < 0.001). Preferred education modalities were pamphlets, websites and one-on-one discussions with health-care professionals. This study highlights the principal informational needs of patients with gastrointestinal malignancies, along with preferred modality for information delivery. This information will guide the development of educational resources for future patients. © 2014 John Wiley & Sons Ltd.

 Nutritional care of Danish medical in-patients - patients' perspectives

DEFF Research Database (Denmark)

Lassen, Karin Østergaard; Kruse, Filip; Bjerrum, Merete

2005-01-01

with the nutritional care.The patients includeed a total of 91 medical inpatients at two internal medical wards, aarhus University Hospital, Denmark. Their average age was 72 (+/-) 11 yerars. They were individually interviewed about the fodd service ad the nutritinal care upon discharge.Patients satifaction...... with the meals was overall high (90%). About 80% found the meals to be very important, but they lacked information about the food service, and the patient-staff communication about the food service was poor. The reults indicate that the nursing staff was exercising a 'knowledge monopoly' in relation to the food...... service. In conclusion, a majority of the patients dis not perceive the nutritional care as part of the therapy and nursing care during their hospitalization....

The quality and scope of information provided by medical laboratories to patients before laboratory testing: Survey of the Working Group for Patient Preparation of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

Science.gov (United States)

Nikolac, Nora; Simundic, Ana-Maria; Kackov, Sanja; Serdar, Tihana; Dorotic, Adrijana; Fumic, Ksenija; Gudasic-Vrdoljak, Jelena; Klenkar, Kornelija; Sambunjak, Jadranka; Vidranski, Valentina

2015-10-23

The aim of this work was to evaluate to what extent the scope and content of information provided to patients is standardized across medical biochemistry laboratories in Croatia. Two on-line self-report surveys were sent out: Survey A regarding attitudes on importance of patient preparation and Survey B on the contents of patient preparation instructions. 13/118 laboratories (11%) do not provide written instructions to patients on how to prepare for laboratory testing, and 36 (40%) do not include information about water intake in their instructions. Only half of laboratories provide instructions for prostate-specific antigen (53.8%), female sex hormones (53.7%) and therapeutic drug monitoring (TDM) (52.5%). Inadequate information about fasting status (55.0%) and 24 hour urine collection (77.9%) were frequent errors with high severity and were associated with the greatest potential to cause patient harm. Laboratory professionals in Croatia have a positive attitude towards the importance of patient preparation for laboratory testing. However, the information for laboratory testing is not standardized and frequently lacks guidance for tests related to TDM, coagulation and endocrinology. This study highlights the need for standardized, updated and evidence-based recommendations for patient preparation in order to minimize the risk for patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

Science.gov (United States)

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients

On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

Science.gov (United States)

Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

2013-01-01

We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Deficits in retention for verbally presented medical information.

Science.gov (United States)

Sandberg, Elisabeth H; Sharma, Ritu; Sandberg, Warren S

2012-10-01

Anesthesiologists deliver large quantities of verbal information to patients during preoperative teaching. Basic principles of cognitive psychology dictate that much of this information is likely to be forgotten. Exactly how much and what type of information can be retained and recalled remains an open question. With Institutional Review Board approval, 98 healthy, educated volunteers viewed a brief video containing a preoperative explanation of anesthetic options and instructions. Subjects were then asked to engage in free and cued recall of information from the video, and to complete a recognition task. We developed a coding scheme to objectively score the free and cued recall tasks for the quantity of information recalled relative to the quantity presented in the video. Data are presented as descriptive statistics. Subjects spontaneously recalled less than 25% of the information presented. Providing retrieval cues greatly enhanced recall: Subjects recalled 67%, on average, of the material queried in the cued recall task. Performance was even stronger on the multiple-choice test (83% of items correctly answered), indicating that the information was initially encoded. The category of information that was consistently least-remembered was presurgical medication instructions. Under realistic conditions for recall, most medical instruction given to patients will not be recalled, even if it is initially encoded. Given the limits of short-term memory, clinicians should carefully consider their patterns of information giving. Improvement of memory performance with cues for retrieval indicates that providing printed instructions for later review may be beneficial.

How patients can improve the accuracy of their medical records.

Science.gov (United States)

Dullabh, Prashila M; Sondheimer, Norman K; Katsh, Ethan; Evans, Michael A

2014-01-01

Assess (1) if patients can improve their medical records' accuracy if effectively engaged using a networked Personal Health Record; (2) workflow efficiency and reliability for receiving and processing patient feedback; and (3) patient feedback's impact on medical record accuracy. Improving medical record' accuracy and associated challenges have been documented extensively. Providing patients with useful access to their records through information technology gives them new opportunities to improve their records' accuracy and completeness. A new approach supporting online contributions to their medication lists by patients of Geisinger Health Systems, an online patient-engagement advocate, revealed this can be done successfully. In late 2011, Geisinger launched an online process for patients to provide electronic feedback on their medication lists' accuracy before a doctor visit. Patient feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the patient before changing the medication list shared by the patient and the clinicians. The evaluation employed mixed methods and consisted of patient focus groups (users, nonusers, and partial users of the feedback form), semi structured interviews with providers and pharmacists, user observations with patients, and quantitative analysis of patient feedback data and pharmacists' medication reconciliation logs. (1) Patients were eager to provide feedback on their medications and saw numerous advantages. Thirty percent of patient feedback forms (457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to the shared medication lists in 89 percent of cases (369 of 414 forms). These included frequency-or dosage changes to existing prescriptions and requests for new medications (prescriptions and over-the counter). (2) Patients provided useful and accurate online feedback. In a subsample of 107 forms, pharmacists responded positively to 68 percent of patient requests for

MIMS - MEDICAL INFORMATION MANAGEMENT SYSTEM

Science.gov (United States)

Frankowski, J. W.

1994-01-01

MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.

Medical Comics as Tools to Aid in Obtaining Informed Consent for Stroke Care.

Science.gov (United States)

Furuno, Yuichi; Sasajima, Hiroyasu

2015-07-01

Informed consent has now become common in medical practice. However, a gap still exists between doctors and patients in the understanding of clinical conditions. We designed medical comics about "subarachnoid hemorrhage" and "intracerebral hemorrhage" to help doctors obtain informed consent intuitively, quickly, and comprehensively.Between September 2010 and September 2012, we carried out a questionnaire survey about medical comics with the families of patients who had suffered an intracerebral or subarachnoid hemorrhage. The questionnaire consisted of 6 questions inquiring about their mental condition, reading time, usefulness of the comics in understanding brain function and anatomy, pathogenesis, doctor's explanation, and applicability of these comics.The results showed that 93.8% responders would prefer or strongly prefer the use of comics in other medical situations. When considering the level of understanding of brain function and anatomy, pathology of disease, and doctor's explanation, 81.3%, 75.0%, and 68.8% of responders, respectively, rated these comics as very useful or useful.We think that the visual and narrative illustrations in medical comics would be more helpful for patients than a lengthy explanation by a doctor. Most of the responders hoped that medical comics would be applied to other medical cases. Thus, medical comics could work as a new communication tool between doctors and patients.

Informal patient payments in oncology practice

Directory of Open Access Journals (Sweden)

Fomenko, Tetiana

2012-07-01

Full Text Available BACKGROUND: In Europe, new cases of cancer are diagnosed in 4 million people yearly, of whom 837 000 die. In Ukraine of 160 000 new cases almost 100 000 die. With proper treatment, one third of cancer cases is curable, but informal payments (IPP in health care limit access to treatment. We aimed to explore the experience of people treated for cancer to identify obstacles in obtaining health care and the expert opinion about health care for cancer patients in Ukraine.METHODS: The study is exploratory. Semi-structured in-depth interviews were conducted with 15 convenience sample patients or their relatives as well as with three experts between October 2011 – April 2012. RESULTS. Solicitation or receipt of IPP depends on the organizational culture. Respondents do not mind about IPP, but want this to be their own decision. IPP are often considered a “thank” to the medical staff for the service. The significant percentage of expenditures while in treatment for patients is due to purchases of medicines at their own expense. The problem of a long process of diagnostics and incomplete information by the medical staff about the stage of cancer and possible prognoses are essential for the respondents. According to experts not sufficient number of specialists and equipment for proper diagnosis and treatment is another problem. The attitude of medical staff to the patient with cancer largely depends on the personal features of the staff.CONCLUSIONS: Significant problems perceived by cancer patients are related to purchase of medicines at their own expense, structural and organizational features of hospitals, where they are staying for the treatment. Informal payments largely depend on the personal qualities of medical staff. The government must ensure fairness and equal access in getting care in oncology practice because it mainly affects the health of the nation.

How health information is received by diabetic patients?

Directory of Open Access Journals (Sweden)

Firoozeh Zare-Farashbandi

2015-01-01

Full Text Available Background: Knowledge of correct information-seeking behavior by the patients can provide health specialists and health information specialists with valuable information in improving health care. This study aimed to investigate the passive receipt and active seeking of health information by diabetic patients. Materials and Methods: A survey method was used in this research on 6426 diabetic patients of whom 362 patients were selected by a no percentage stratified random sampling. The Longo information-seeking behavior questionnaire was used to collect data and they were analyzed by SPSS 20 software. Results: The most common information source by diabetic patients was practitioners (3.12. The minimum usage among the information sources were from charity organizations and emergency phone lines with a usage of close to zero. The amount of health information gained passively from each source has the lowest average of 4.18 and usage of this information in making health decision has the highest average score of 5.83. Analysis of the data related to active seeking of information showed that knowledge of available medical information from each source has the lowest average score of 3.95 and ability in using the acquired information for making medical decisions has the highest average score of 5.28. The paired t-test showed that differences between passive information receipt (41.68 and active information seeking (39.20 considered as statistically significant (P < 0.001. Conclusion: Because diabetic patients are more passive information receivers than active information seekers, the health information must be distributed by passive means to these patients. In addition, information-seeking behavior during different time periods should be investigated; to identify more effective distribution of health information.

Does direct-to-consumer advertising affect patients' choice of pain medications?

Science.gov (United States)

Liu, Yifei; Doucette, William R

2008-04-01

In the United States, direct-to-consumer advertising (DTCA) has grown rapidly to promote prescription medications, including analgesics. Few studies in the literature directly examine the association between DTCA and patients' choice of pain medications. This article discusses how DTCA affects such choice from a behavioral perspective, because DTCA-prompted behaviors are important indicators of DTCA's influence. After DTCA exposure, patients may request prescriptions, seek further medication information, and ask about advertised conditions. Patients who suffer from pain may seek more communication with their health care providers because they are cautious about the information quality of DTCA, mainly because of the recall of rofecoxib (Vioxx; Merck, Whitehouse Station, NJ). However, the availability and DTCA of over-the-counter analgesics complicate their treatment choice. Patients could use DTCA as a tool to launch health communication and make an informed treatment choice with the guidance of their health care providers.

[Medication reconciliation in patients over 75 years].

Science.gov (United States)

Rubio-Cebrián, B; Santaolalla-García, I; Martín-Casasempere, I; Segura-Bedmar, M

2016-06-01

To continue with the implementation of the medication reconciliation process on admission, and to analyse potentially inappropriate prescriptions according to the STOPP-START -Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right (indicated) Treatment- criteria, and drug interactions. To extend the process of reconciliation at hospital discharge from the Cardiology and Chest Diseases departments. Retrospective observational study that included patients over 75 years old. The "Consensus Document on Terminology and Classification in Medication Reconciliation" was used for the classification of the discrepancies found. Potentially inappropriate prescriptions and drug interactions were reviewed. For reconciliation at discharge, a "Drug information program at discharge" leaflet and a "Patient information sheet" was developed. The number of reconciled patients was 818, with a level of coverage of 42.3% (target patients: 1,932). Reconciliation errors by patient were 23.4% (191) on admission and 22.5% (9) at discharge. All patients who were reconciled at discharge were given the "Drug information program at discharge" leaflet. Potentially inappropriate prescriptions, according to STOPP/START criteria, affected 6.0% (49) of reconciled patients. The number of clinically relevant interactions affected 11.7% (96) of patients. The implementation of a reconciliation process has detected the existence of errors between chronic and prescribed treatment in the hospital. The STOPP/START criteria applied to this group of patients have helped to find out the most common potentially inappropriate prescriptions. The analysis of drug interactions shows drug combinations that should be avoided in these patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

What do the patients with medication overuse headache expect from treatment and what are the preferred sources of information?

DEFF Research Database (Denmark)

Munksgaard, S B; Allena, M; Tassorelli, C

2011-01-01

Lack of knowledge on patients' expectations to treatment may lead to misunderstandings and prevent successful outcome. Presently, treatment of medication overuse headache (MOH) leads to improvement in up to 75% of patients, but the relapse rate may exceed 40%. This study aimed to evaluate......% requested effective prevention and fast relief of the headache episodes. 80 and 75%, respectively expected reduction in frequency and intensity. A total of 64% expected information about self-management and 52% expected to receive education on their headaches. The study demonstrates that patients...

Concordance of self-reported and medical chart information on cancer diagnosis and treatment

Directory of Open Access Journals (Sweden)

Shu Xiao Ou

2011-05-01

Full Text Available Abstract Background Self-reported information is an important tool for collecting clinical information for epidemiologic studies and in clinical settings where electronic medical records are not employed and shared. Methods Using data collected from the Shanghai Breast Cancer Survival Study (SBCSS, a population-based, prospective cohort study of 5,042 women diagnosed with breast cancer in Shanghai, China, we compared the concordance of patient questionnaire responses to a survey administered approximately 6 months after cancer diagnosis with medical chart information obtained from the diagnostic hospitals for several disease and treatment-related variables. Results Of 5,042 SBCSS participants, medical chart information was available for 4,948 women (98.1%. Concordance between patient self-reported and medical chart information was high for the majority of disease-related variables, including: diagnosing hospital (agreement: 98.7%, kappa: 0.99, type of surgery conducted (94.0%, 0.53, ER/PR status (94.5%, 0.91, and tumor position (98.2%, 0.97, as well as for important calendar dates, such as date of diagnosis, surgery, and first chemotherapy treatment. The 10 most commonly used chemotherapeutic drugs were all reported with agreement rates of at least 82%, with associated kappa values that ranged from 0.41 for calcium folinate to 0.76 for vinorelbine. Conclusions Our study found high validity for patient self-reported information for a variety of disease and treatment-related variables, suggesting the utility of self-reports as an important source of clinical information for both epidemiological research and patient care.

An improved biometrics-based authentication scheme for telecare medical information systems.

Science.gov (United States)

Guo, Dianli; Wen, Qiaoyan; Li, Wenmin; Zhang, Hua; Jin, Zhengping

2015-03-01

Telecare medical information system (TMIS) offers healthcare delivery services and patients can acquire their desired medical services conveniently through public networks. The protection of patients' privacy and data confidentiality are significant. Very recently, Mishra et al. proposed a biometrics-based authentication scheme for telecare medical information system. Their scheme can protect user privacy and is believed to resist a range of network attacks. In this paper, we analyze Mishra et al.'s scheme and identify that their scheme is insecure to against known session key attack and impersonation attack. Thereby, we present a modified biometrics-based authentication scheme for TMIS to eliminate the aforementioned faults. Besides, we demonstrate the completeness of the proposed scheme through BAN-logic. Compared to the related schemes, our protocol can provide stronger security and it is more practical.

Respect for patient autonomy as a medical virtue.

Science.gov (United States)

Cook, Thomas; Mavroudis, Constantine D; Jacobs, Jeffrey P; Mavroudis, Constantine

2015-12-01

Respect for patient autonomy is an important and indispensable principle in the ethical practice of clinical medicine. Legal tenets recognise the centrality of this principle and the inherent right of patients of sound mind - properly informed - to make their own personal medical decisions. In the course of everyday medical practice, however, challenging cases may result in ethical dilemmas for the patient, the physician, and society. Resolution of these dilemmas requires a thorough understanding of the underlying principles that allow the clinician to make informed decisions and to offer considered therapeutic options to the patient. We argue in this paper that there is also need for a transition of moral competency from understanding principles to attaining virtue in the classic Aristotelian tradition. Achieving moral virtue is based on a lifetime of learning, practising, and watching how others, who have achieved virtue, act and perform their duties. We further claim that learning moral virtue in medical practice is best realised by incorporating the lessons learnt during daily rounds where frank discussions and considered resolutions can occur under the leadership of senior practitioners who have achieved a semblance of moral excellence.

THE DEVELOPMENT OF INFORMATION COMPETENCES FOR MEDICAL STUDENTS

Directory of Open Access Journals (Sweden)

S. I. Karas

2014-01-01

Full Text Available The goal of this paper is the analysis of information communication technologies using for professional competencies development for medical students. There are described two informational learning technologies: standard and developed in Tomsk.Virtual learning environment Moodle is open source software which is developed for on-line education and installed in more than a dozen thousands educational institutions around the world including Russia. The Moodle provides students with rapid access to professional-oriented learning information via Internet any time and through any gadget. Using the Moodle a teacher can present different types of digital information, organize learning course, student’s knowledge and skills evaluation after structuring teacher’s knowledge. Rating approach is implemented in the Moodle very easy. Developed and develo­ping resources for the Moodle are located at the server http://simcenter.ssmu.ru.Learning electronic health record (LEHR is developing by Tomsk professional team and it is the integration of an electronic health record and a program for clinical subject. There are additional functions besides usual for paper medical record, for example: learning about specialized software, electronic re­ference books, and medical standard documents. Information and clinical competences are forming in LEHR at the same time what is the undoubted advantage for students. Now LEHR on pediatrics and neurology are testing before trial exploitation in the learning. Software for LEHR and information about virtual patients are located at the server http://students.umssoft.com.The analysis and our experience have shown the possibilities of effective using the information communication technologies for development of informational and professional competencies of medical students in different subjects of educational program.

Analysis of medical litigation among patients with medical disputes in cosmetic surgery in Taiwan.

Science.gov (United States)

Lyu, Shu-Yu; Liao, Chuh-Kai; Chang, Kao-Ping; Tsai, Shang-Ta; Lee, Ming-Been; Tsai, Feng-Chou

2011-10-01

This study aimed to investigate the key factors in medical disputes (arguments) among female patients after cosmetic surgery in Taiwan and to explore the correlates of medical litigation. A total of 6,888 patients (3,210 patients from two hospitals and 3,678 patients from two clinics) received cosmetic surgery from January 2001 to December 2009. The inclusion criteria specified female patients with a medical dispute. Chi-square testing and multiple logistic regression analysis were used to analyze the data. Of the 43 patients who had a medical dispute (hospitals, 0.53%; clinics, 0.73%), 9 plaintiffs eventually filed suit against their plastic surgeons. Such an outcome exhibited a decreasing annual trend. The hospitals and clinics did not differ significantly in terms of patient profiles. The Chi-square test showed that most patients with a medical dispute (p stress, had a history of medical litigation, and eventually did not sue the surgeons. The test results also showed that the surgeon's seniority and experience significantly influenced the possibility of medical dispute and nonlitigation. Multiple logistical regression analysis further showed that the patients who did decide to enter into litigation had two main related factors: marital stress (odds ratio [OR], 10.67; 95% confidence interval [CI], 1.20-94.73) and an education level below junior college (OR, 9.33; 95% CI, 1.01-86.36). The study findings suggest that the key characteristics of patients and surgeons should be taken into consideration not only in the search for ways to enhance pre- and postoperative communication but also as useful information for expert testimony in the inquisitorial law system.

Information and shared decision-making are top patients' priorities

Directory of Open Access Journals (Sweden)

Bronstein Alexander

2006-02-01

Full Text Available Abstract Background The profound changes in medical care and the recent stress on a patient-centered approach mandate evaluation of current patient priorities. Methods Hospitalized and ambulatory patients at an academic medical center in central Israel were investigated. Consecutive patients (n = 274 indicated their first and second priority for a change or improvement in their medical care out of a mixed shortlist of 6 issues, 3 related to patient-physician relationship (being better informed and taking part in decisions; being seen by the same doctor each time; a longer consultation time and 3 issues related to the organizational aspect of care (easier access to specialists/hospital; shorter queue for tests; less charges for drugs. Results Getting more information from the physician and taking part in decisions was the most desirable patient choice, selected by 27.4% as their first priority. The next choices – access and queue – also relate to more patient autonomy and control over that of managed care regulations. Patients studied were least interested in continuity of care, consultation time or cost of drugs. Demographic or clinical variables were not significantly related to patients' choices. Conclusion Beyond its many benefits, being informed by their doctor and shared decision making is a top patient priority.

Medical Service Information

CERN Multimedia

GS Department

2010-01-01

The Medical Service is pleased to inform you that a psychologist specialising in psychotherapy (member of the Swiss Federation of Psychologists- FSP), Mrs Sigrid Malandain, will be starting work at the CERN on 1 November 2010, in the premises of the Medical Service, Building 57-1-024. Members of CERN personnel can request individual consultations, by appointment, in French or in English, on Tuesdays and Thursdays by calling 78435 (Medical Service secretariat) or sending an e-mail to psychologist-me@cern.ch.

Information Needs of Hepato-Pancreato-Biliary Surgical Oncology Patients.

Science.gov (United States)

Gillespie, Jacqueline; Kacikanis, Anna; Nyhof-Young, Joyce; Gallinger, Steven; Ruthig, Elke

2017-09-01

A marked knowledge gap exists concerning the information needs of hepato-pancreato-biliary (HPB) surgical oncology patients. We investigated the comprehensive information needs of this patient population, including the type and amount of information desired, as well as the preferred method of receiving information. A questionnaire was administered to patients being treated surgically for cancers of the liver, pancreas, gallbladder, or bile ducts at Toronto General Hospital, part of the University Health Network, in Toronto, Canada. The questionnaire examined patients' information needs across six domains of information: medical, practical, physical, emotional, social, and spiritual. Among 36 respondents, the importance of information and amount of information desired differed significantly by domain (both p < 0.001). This group of patients rated information in the medical and physical domains as most important, though they also desired specific items of information from the emotional, practical, and social domains. Patients' overwhelming preference was to receive information via a one-on-one consultation with a healthcare provider. It is important for healthcare providers working with HPB surgical oncology patients to be comprehensive when providing information related to patients' cancer diagnosis, prognosis, associated symptoms, and side effects of treatment. Certain emotional, practical, and social issues (e.g., fears of cancer recurrence, drug coverage options, relationship changes) should be addressed as well. Face-to-face interactions should be the primary mode of delivering information to patients. Our findings are being used to guide the training of healthcare providers and the development of educational resources specific to HPB surgical oncology patients.

Guidelines for medical and health information sites on the internet: principles governing AMA web sites. American Medical Association.

Science.gov (United States)

Winker, M A; Flanagin, A; Chi-Lum, B; White, J; Andrews, K; Kennett, R L; DeAngelis, C D; Musacchio, R A

Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.

Medication apprehension and compliance among dialysis patients--a comprehensive guidance attitude.

Science.gov (United States)

Katzir, Ze'ev; Boaz, Mona; Backshi, Irena; Cernes, Relu; Barnea, Zvi; Biro, Alexander

2010-01-01

Compliance with treatment regimens is a continuing challenge for chronic dialysis patients and their medical caregivers. Poor patient adherence to prescribed medications can adversely affect treatment outcome. In this pre- versus post-intervention study, 89 chronic dialysis patients [75 hemodialysis (HD), 14 continuous ambulatory peritoneal dialysis (CAPD); mean age 62.7 +/- 12.39 years, 34 females] responded to a written questionnaire designed to assess knowledge about and compliance with 5 groups of prescribed medications: metabolic drugs, antihypertensives, cardiac-supporting agents, peptic disease therapy and hematological replacement therapy. Mode of intake, storage, means of supply and source of information for each class of drug were also assessed. Patients then received both oral and written instructions regarding their prescribed medications (intervention). This information was repeated 3 months later. Six months after the intervention, patients were re-administered the questionnaires. Response to the questionnaires and laboratory data were compared prior to and following the intervention. Overall, compliance with prescribed medications significantly improved following the intervention, from 89 to 95.7%, p = 0.0007. This relative improvement was greater in HD than CAPD patients (27 vs. 2%, p dialysis vintage. Compared to baseline values, post-intervention blood hemoglobin, hematocrit, mean corpuscular volume, ferritin and Ca levels were significantly improved. Dialysis patients appear to benefit from receiving comprehensive guidance about medications, in terms of compliance with medications and blood chemistry and hematology measures. (c) 2009 S. Karger AG, Basel.

Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.

Science.gov (United States)

Kennelty, Korey A; Chewning, Betty; Wise, Meg; Kind, Amy; Roberts, Tonya; Kreling, David

2015-01-01

Community pharmacists play a vital part in reconciling medications for patients transitioning from hospital to community care, yet their roles have not been fully examined in the extant literature. The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists' preferred content and modes of information transfer regarding updated medication information for recently discharged patients. Community pharmacists were purposively and conveniently sampled from the Wisconsin (U.S. state) pharmacist-based research network, Pharmacy Practice Enhancement and Action Research Link (PEARL Rx). Community pharmacists were interviewed face-to-face, and transcriptions from audio recordings were analyzed using directed content analysis. The Theory of Planned Behavior (TPB) guided the development of questions for the semi-structured interviews. Interviewed community pharmacists (N = 10) described the medication reconciliation process to be difficult and time-consuming for recently discharged patients. In the context of the TPB, more barriers than facilitators of reconciling medications were revealed. Themes were categorized as organizational and individual-level themes. Major organizational-level factors affecting the medication reconciliation process included: pharmacy resources, discharge communication, and hospital resources. Major individual-level factors affecting the medication reconciliation process included: pharmacists' perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics. Interviewed pharmacists consistently responded that several pieces of information items would be helpful when reconciling medications for recently discharged patients, including the hospital medication discharge list and stop-orders for discontinued medications. The TPB was useful for identifying barriers and facilitators of

Constructing Common Information Space across Distributed Emergency Medical Teams

DEFF Research Database (Denmark)

Zhang, Zhan; Sarcevic, Aleksandra; Bossen, Claus

2017-01-01

This paper examines coordination and real-time information sharing across four emergency medical teams in a high-risk and distributed setting as they provide care to critically injured patients within the first hour after injury. Through multiple field studies we explored how common understanding...... of critical patient data is established across these heterogeneous teams and what coordination mechanisms are being used to support information sharing and interpretation. To analyze the data, we drew on the concept of Common Information Spaces (CIS). Our results showed that teams faced many challenges...... in achieving efficient information sharing and coordination, including difficulties in locating and assembling team members, communicating and interpreting information from the field, and accommodating differences in team goals and information needs, all while having minimal technology support. We reflect...

Patients, privacy and trust: patients' willingness to allow researchers to access their medical records.

Science.gov (United States)

Damschroder, Laura J; Pritts, Joy L; Neblo, Michael A; Kalarickal, Rosemarie J; Creswell, John W; Hayward, Rodney A

2007-01-01

The federal Privacy Rule, implemented in the United States in 2003, as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), created new restrictions on the release of medical information for research. Many believe that its restrictions have fallen disproportionately on researchers prompting some to call for changes to the Rule. Here we ask what patients think about researchers' access to medical records, and what influences these opinions. A sample of 217 patients from 4 Veteran Affairs (VA) facilities deliberated in small groups at each location with the opportunity to question experts and inform themselves about privacy issues related to medical records research. After extensive deliberation, these patients were united in their inclination to share their medical records for research. Yet they were also united in their recommendations to institute procedures that would give them more control over whether and how their medical records are used for research. We integrated qualitative and quantitative results to derive a better understanding of this apparent paradox. Our findings can best be presented as answers to questions related to five dimensions of trust: Patients' trust in VA researchers was the most powerful determinant of the kind of control they want over their medical records. More specifically, those who had lower trust in VA researchers were more likely to recommend a more stringent process for obtaining individual consent. Insights on the critical role of trust suggest actions that researchers and others can take to more fully engage patients in research.

Informed use of patients' records on trusted health care services.

Science.gov (United States)

Sahama, Tony; Miller, Evonne

2011-01-01

Health care is an information-intensive business. Sharing information in health care processes is a smart use of data enabling informed decision-making whilst ensuring. the privacy and security of patient information. To achieve this, we propose data encryption techniques embedded Information Accountability Framework (IAF) that establishes transitions of the technological concept, thus enabling understanding of shared responsibility, accessibility, and efficient cost effective informed decisions between health care professionals and patients. The IAF results reveal possibilities of efficient informed medical decision making and minimisation of medical errors. Of achieving this will require significant cultural changes and research synergies to ensure the sustainability, acceptability and durability of the IAF.

Report for fiscal 2000 on electronic patient record network discussion committee. Survey on promotion of medical information use utilizing electronic patient record network; 2000 nendo denshi karute network kento iinkai hokokusho. Denshi karute network wo katsuyoshita iryo johoka no sokushin ni kansuru chosa

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

Based on the movements in the most advanced IT technologies and in social system reformation in the medical and health preservation fields, discussions were given on the assignments and measures to be solved to realize the medical information network, and the secondary utilization method of the medical information and the assignments and measures in the utilization thereof. A patient record is originally a document stating the secrets of a patient for his or her medical information, and has a nature that doctors may be sued from the patient if they disclose or exchange the document. There is a large number of company owners, politicians or salaried people who would not want their diseases which they had in the past, the name of the existing disease and medical treatment to be made public. The electronic patient record network has a conflicting proposition to elevate its values by means of data re-utilization, secondary utilization and information exchange. Preparation of the database requires multilateral analyses and classifications, as well as sufficient discussions and realistic execution including the consistency with the personal information protection law, as to whether it is information that the patient wants the exchange or disclosure, or whether it is information to be exchanged or disclosed even if the patient refuses it, not speak of attention to 5W1H. (NEDO)

Compliance to medication among hypertensive patients in Murtala ...

African Journals Online (AJOL)

%). Patients ... A major factor accounting for inadequate ... counting the remaining pills or pill counting systems). ... Information obtained included socio- .... medication compliance on the control of hypertension. ... Archives of Internal Medicine.

Information quality and dynamics of patients' interactions on tonsillectomy web resources

Directory of Open Access Journals (Sweden)

Marianne Arsenault

2016-05-01

Full Text Available Information technologies have drastically altered the way patients gather health-related information. By analysing web resources on tonsillectomy, we expose information quality and dynamics of patients' interactions in the online continuum. Readability was assessed using Flesch Reading Ease (FRE, Flesch Kincaid Grade Level (FKGL, Simple Measure of Gobbledygook (SMOG, and Gunning Fog Index (GFI. Comprehensibility and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT. Metrics of forums included author characteristics (level of disclosure, gender, age, avatar image, etc., posts' motive (community support vs. medical information and content (word count, emoticon use, number of replies, etc.. Analysis of 6 professional medical websites, of 10 health information portals, and of 3 discussion forums totalizing 1369 posts on 358 threads, from January 1, 2007 to December 31, 2014, reveals that online resources exceed understandability recommendations. Women were more present on online health forums (68.2% of authors disclosing their gender and invested themselves more in their avatar. Authors replying were significantly older than authors of original posts (39.7 ± 0.8 years vs. 29.2 ± 0.9 years, p < 0.001. The degree of self-disclosure was inversely proportional to the requests for medical information (p < 0.001. Men and women were equally seeking medical information (men: 74.0%, women: 77.0% and community support (men: 65.7%, women: 70.4%, however women responded more supportively (women 86.2%, men 59.1%, p < 0.001. The dynamics of patients' interactions used to overcome accessibility difficulties encountered is complex. This work outlines the necessity for comprehensible medical information to adequately answer patients' needs.

A systematic review of patient medication error on self-administering medication at home.

Science.gov (United States)

Mira, José Joaquín; Lorenzo, Susana; Guilabert, Mercedes; Navarro, Isabel; Pérez-Jover, Virtudes

2015-06-01

Medication errors have been analyzed as a health professionals' responsibility (due to mistakes in prescription, preparation or dispensing). However, sometimes, patients themselves (or their caregivers) make mistakes in the administration of the medication. The epidemiology of patient medication errors (PEs) has been scarcely reviewed in spite of its impact on people, on therapeutic effectiveness and on incremental cost for the health systems. This study reviews and describes the methodological approaches and results of published studies on the frequency, causes and consequences of medication errors committed by patients at home. A review of research articles published between 1990 and 2014 was carried out using MEDLINE, Web-of-Knowledge, Scopus, Tripdatabase and Index Medicus. The frequency of PE was situated between 19 and 59%. The elderly and the preschooler population constituted a higher number of mistakes than others. The most common were: incorrect dosage, forgetting, mixing up medications, failing to recall indications and taking out-of-date or inappropriately stored drugs. The majority of these mistakes have no negative consequences. Health literacy, information and communication and complexity of use of dispensing devices were identified as causes of PEs. Apps and other new technologies offer several opportunities for improving drug safety.

Securing the communication of medical information using local biometric authentication and commercial wireless links.

Science.gov (United States)

Ivanov, Vladimir I; Yu, Paul L; Baras, John S

2010-09-01

Medical information is extremely sensitive in nature - a compromise, such as eavesdropping or tampering by a malicious third party, may result in identity theft, incorrect diagnosis and treatment, and even death. Therefore, it is important to secure the transfer of medical information from the patient to the recording system. We consider a portable, wireless device transferring medical information to a remote server. We decompose this problem into two sub-problems and propose security solutions to each of them: (1) to secure the link between the patient and the portable device, and (2) to secure the link between the portable device and the network. Thus we push the limits of the network security to the edge by authenticating the user using their biometric information; authenticating the device to the network at the physical layer; and strengthening the security of the wireless link with a key exchange mechanism. The proposed authentication methods can be used for recording the readings of medical data in a central database and for accessing medical records in various settings.

Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

Directory of Open Access Journals (Sweden)

Abbasali Ebrahimian

2014-01-01

Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

[Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

Science.gov (United States)

Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

2010-04-01

To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

A qualitative evaluation of the crucial attributes of contextual information necessary in EHR design to support patient-centered medical home care.

Science.gov (United States)

Weir, Charlene R; Staggers, Nancy; Gibson, Bryan; Doing-Harris, Kristina; Barrus, Robyn; Dunlea, Robert

2015-04-16

Effective implementation of a Primary Care Medical Home model of care (PCMH) requires integration of patients' contextual information (physical, mental, social and financial status) into an easily retrievable information source for the healthcare team and clinical decision-making. This project explored clinicians' perceptions about important attributes of contextual information for clinical decision-making, how contextual information is expressed in CPRS clinical documentation as well as how clinicians in a highly computerized environment manage information flow related to these areas. A qualitative design using Cognitive Task Analyses and a modified Critical Incident Technique were used. The study was conducted in a large VA with a fully implemented EHR located in the western United States. Seventeen providers working in a PCMH model of care in Primary Care, Home Based Care and Geriatrics reported on a recent difficult transition requiring contextual information for decision-making. The transcribed interviews were qualitatively analyzed for thematic development related to contextual information using an iterative process and multiple reviewers with ATLAS@ti software. Six overarching themes emerged as attributes of contextual information: Informativeness, goal language, temporality, source attribution, retrieval effort, and information quality. These results indicate that specific attributes are needed to in order for contextual information to fully support clinical decision-making in a Medical Home care delivery environment. Improved EHR designs are needed for ease of contextual information access, displaying linkages across time and settings, and explicit linkages to both clinician and patient goals. Implications relevant to providers' information needs, team functioning and EHR design are discussed.

A unified framework for data modeling on medical information systems.

Science.gov (United States)

Neves, J; Cortez, P; Rocha, M; Abelha, A; Machado, J; Alves, V; Basto, S; Botelho, H; Neves, J

1999-01-01

Medical Information Systems (MIS) are seen as a way of optimizing the use of existing health-care infrastructure, without resorting to new and costly hospital (re)construction. The qualitative (re)design of such an environment requires a basic understanding of patient and doctors related characteristics and capabilities. Patient care, patient education, medical education, and clinical research need to be considered to meet the basic requirements on the level of services desirable, determined on the basis of the patient's length of stay; i.e., used for modeling the significant entities of such a world. The aim is to extract conclusions for the level of services provided to the users. One's concept will capture, as well as will integrate, the basic design principles under which MIS may be set.

Diagnostic information management system for the evaluation of medical images

Energy Technology Data Exchange (ETDEWEB)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina

1985-04-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions.

Diagnostic information management system for the evaluation of medical images

International Nuclear Information System (INIS)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina.

1985-01-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions. (author)

Accessing medication information by ethnic minorities: barriers and possible solutions.

Science.gov (United States)

Schaafsma, Evelyn S; Raynor, Theo D; de Jong-van den Berg, Lolkje T

2003-10-01

This review discusses two main questions: how suitable is current consumer medication information for minority ethnic groups, and what are effective strategies to overcome existing barriers. The focus is on minority groups whose first language is not the language of the healthcare system. We searched electronic databases and printed scientific journals focusing on (ethnic) minorities, health and/or (intercultural) communication. We also asked a discussion group for references. We found only a few articles on intercultural communication on medication or pharmacy information and one article on the improvement of intercultural communication in the pharmacy. Barriers to the access of medication information by ethnic minorities include second language issues and cultural differences due to different health beliefs, together with the low socio-economic status often seen among ethnic minorities. Cultural differences also exist among different socio-economic classes rather than only among ethnic groups. Most often, informal interpreters are used to improve intercultural communication. However, this may result in miscommunication due to a lack of medical knowledge or training on the part of the interpreter. To minimise miscommunication, bilingual health professionals or health interpreters/advocates can be used, although communication problems may still occur. The effectiveness of written information depends on the literacy skills of the target population. Cultural, medical and dialect biases should be avoided by testing the material. Multimedia systems may be alternatives to conventional written information. Barriers that ethnic minorities face in accessing medication information and possible solutions involving counselling and additional tools were identified for pharmacy practice. However, more research is needed to develop effective strategies for patient counselling in pharmacy to meet the needs of ethnic minorities.

A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial.

Science.gov (United States)

Mira, José Joaquín; Navarro, Isabel; Botella, Federico; Borrás, Fernando; Nuño-Solinís, Roberto; Orozco, Domingo; Iglesias-Alonso, Fuencisla; Pérez-Pérez, Pastora; Lorenzo, Susana; Toro, Nuria

2014-04-04

Nonadherence and medication errors are common among patients with complex drug regimens. Apps for smartphones and tablets are effective for improving adherence, but they have not been tested in elderly patients with complex chronic conditions and who typically have less experience with this type of technology. The objective of this study was to design, implement, and evaluate a medication self-management app (called ALICE) for elderly patients taking multiple medications with the intention of improving adherence and safe medication use. A single-blind randomized controlled trial was conducted with a control and an experimental group (N=99) in Spain in 2013. The characteristics of ALICE were specified based on the suggestions of 3 nominal groups with a total of 23 patients and a focus group with 7 professionals. ALICE was designed for Android and iOS to allow for the personalization of prescriptions and medical advice, showing images of each of the medications (the packaging and the medication itself) together with alerts and multiple reminders for each alert. The randomly assigned patients in the control group received oral and written information on the safe use of their medications and the patients in the experimental group used ALICE for 3 months. Pre and post measures included rate of missed doses and medication errors reported by patients, scores from the 4-item Morisky Medication Adherence Scale (MMAS-4), level of independence, self-perceived health status, and biochemical test results. In the experimental group, data were collected on their previous experience with information and communication technologies, their rating of ALICE, and their perception of the level of independence they had achieved. The intergroup intervention effects were calculated by univariate linear models and ANOVA, with the pre to post intervention differences as the dependent variables. Data were obtained from 99 patients (48 and 51 in the control and experimental groups, respectively

Augmented Reality: Real-Time Information Concerning Medication Consumed by a Patient.

Science.gov (United States)

Diodati, Gloria; Gómez, Adrián; Martínez, Marcela; Luna, Daniel; González Bernaldo de Quiros, Fernán

2015-01-01

This paper describes a mobile prototype capable of recognizing characters from a photograph of a medication package. The prototype was built to work on the iOS platform and was developed using Objective-C and C programming languages. The prototype, capable of recognizing text out of an image, included image processing algorithms, text processing algorithms, and techniques to search and handle information from a database. This prototype is presented as an option for capturing reliable and validated information by using new technologies available to the general population.

Something to think about: informing Canadians about ethical concerns in medical tourism

OpenAIRE

Adams, Krystyna Aleksandra

2013-01-01

Medical tourists, persons traveling across international borders with the intention of accessing medical care, are often unaware of safety and ethical concerns related to the practice of medical tourism. Accessing medical care as a medical tourist may result in risks to the health of the patient, as well as negative impacts to both destination and departure country health care systems and global health equity. These ethical considerations are not provided in sources of information commonly ac...

[Training in patient safety in medical and nursing schools].

Science.gov (United States)

Mira, J J; Guilabert, M; Vitaller, J; Ignacio, E

2016-01-01

To compare the information on patient safety received by students of medicine and nursing. Cross-sectional study was conducted using a convenience sample of medical and nursing students of 3 Universities. The Latin Patient Safety Student Information and a test of 5 questions with 5 options were used. A sample of 79 students in each group was enrolled to detect differences of .3 units (bilateral estimation), considering 80% statistical power and 95% confidence interval. A total of 144 students replied (74 nursing and 70 medicine students). Nursing students achieved higher scores in the communication with patients factor (3.8 vs 3.2, P<.001) and proactive attitude to identify risks for patient safety (4.3 vs 3.8, P<.001). Medical students were more aware of the inevitability of adverse events (2.3 vs 3.1, P<.001). Ten (7%) students had only one fault in the test, and only one (1%) answered all questions correctly. The training in patient safety should be improved both in nursing and medicine, although nursing students receive more information. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Patients’ views on electronic patient information leaflets

Directory of Open Access Journals (Sweden)

Hammar T

2016-06-01

Full Text Available Background: Information in society and in health care is currently undergoing a transition from paper to digital formats, and the main source of information will probably be electronic in the future. Objective: To explore patients’ use and perceptions of the patient information leaflet included in the medication package, and their attitude towards a transition to an electronic version. Methods: The data was collected during October to November 2014 among individuals in South-Eastern Sweden, using a questionnaire (n=406, response rate 78% and interviews (n=15. Results: The questionnaire showed that the majority of the respondents (52% occasionally read the patient information leaflet, 37% always read it, and 11% never read it. Almost half of the patients (41% were positive towards reading the patient information leaflet electronically while 32% were hesitant and 26% neutral. A majority of the patients would request to get the patient information leaflet printed at the pharmacy if it was not included in the package. There were differences in attitude related to age and gender. The interviews showed that patients had mixed views on a transition to an electronic patient information leaflet. The patients perceived several positive aspects with an electronic patient information leaflet but were concerned about elderly patients. Conclusion: Although many were positive towards reading the patient information leaflet electronically, the majority prefer the patient information leaflet in paper form. Providing appropriate and useful eHealth services for patients to access the patient information leaflet electronically, along with education, could prepare patients for a transition to electronic patient information leaflet.

Type 2 diabetes patients' and providers' differing perspectives on medication nonadherence: a qualitative meta-synthesis.

Science.gov (United States)

Brundisini, Francesca; Vanstone, Meredith; Hulan, Danielle; DeJean, Deirdre; Giacomini, Mita

2015-11-23

Poor adherence to medication regimens increases adverse outcomes for patients with Type 2 diabetes. Improving medication adherence is a growing priority for clinicians and health care systems. We examine the differences between patient and provider understandings of barriers to medication adherence for Type 2 diabetes patients. We searched systematically for empirical qualitative studies on the topic of barriers to medication adherence among Type 2 diabetes patients published between 2002-2013; 86 empirical qualitative studies qualified for inclusion. Following qualitative meta-synthesis methods, we coded and analyzed thematically the findings from studies, integrating and comparing findings across studies to yield a synthetic interpretation and new insights from this body of research. We identify 7 categories of barriers: (1) emotional experiences as positive and negative motivators to adherence, (2) intentional non-compliance, (3) patient-provider relationship and communication, (4) information and knowledge, (5) medication administration, (6) social and cultural beliefs, and (7) financial issues. Patients and providers express different understandings of what patients require to improve adherence. Health beliefs, life context and lay understandings all inform patients' accounts. They describe barriers in terms of difficulties adapting medication regimens to their lifestyles and daily routines. In contrast, providers' understandings of patients poor medication adherence behaviors focus on patients' presumed needs for more information about the physiological and biomedical aspect of diabetes. This study highlights key discrepancies between patients' and providers' understandings of barriers to medication adherence. These misunderstandings span the many cultural and care contexts represented by 86 qualitative studies. Counseling and interventions aimed at improving medication adherence among Type 2 diabetes might become more effective through better integration of

[Medication reconciliation at hospital admission: Results and identification of target patients].

Science.gov (United States)

San José Ruiz, B; Serrano De Lucas, L; López-Giménez, L R; Baza Martínez, B; Sautua Larreategi, S; Bustinza Txertudi, A; Sebastián Leza, Á; Chirivella Ramón, M T; Fonseca Legrand, J L; de Miguel Cascon, M

2016-06-01

To quantify and to classify the discrepancies between the admission treatment and the usual patient treatment. To determine the variables that predict those patients that will have more benefit from medication reconciliation. A prospective medication reconciliation study was conducted in the Vascular Surgery Unit from March 2014 to December 2014. When the patients were admitted to the Vascular Surgery Unit, they were informed about the study and asked to prepare information about their chronic treatment. The pharmacist then checked their clinical records, outpatient prescriptions, and also interviewed the patient, obtaining the best pharmacotherapeutic history available. The discrepancies with the admission treatment were written into the patient electronic clinical records. Finally, the physician classified the discrepancies, and changed the treatment, if needed. The statistical analysis included a comparison between patients with and without a non-justified discrepancy (NJD). The statistically different characteristics were used to plot Receiver Operating Characteristic curves, in order to determine the sensitivity and the specificity of these variables to select patients with discrepancies. A total of 380 patients were included. There were 845 non-justified, 600 justified non-documented, and 439 justified documented discrepancies. At least one NJD was identified in 293 patients (77%), with 65 patients (17%) having only justified discrepancies, and 22 patients (6%) having no discrepancies. NJD were: different dose, route or schedule (51%), omission (39%), wrong drug (8%) and commission (2%). The variables associated with discrepancies were number of chronic medications drugs and provider of information. In most studies, omission is the most frequent error. In contrast, in our study the most frequent error is different dose, route, or schedule. The variable that allows selecting patients at higher risk of discrepancies is the number of chronic drugs. This risk is

Involving Medical Students in Informed Consent: A Pilot Study.

Science.gov (United States)

Chiapponi, Costanza; Meyer, Frank; Jannasch, Olof; Arndt, Stephan; Stübs, Patrick; Bruns, Christiane J

2015-09-01

Studies have reported that patients often sign consent documents without understanding the content. Written paperwork, audio-visual materials, and decision aids have shown to consistently improve patients' knowledge. How informed consent should be taken is not properly taught at most universities in Germany. In this cross-sectional study, we investigated how much information about their procedure our patients retain. In particular, it should be elucidated whether an additional conversation between patients and properly prepared medical students shortly before surgery as an adjunct to informed consent can be introduced as a new teaching unit aimed to increase the understanding of surgery by patients and students. Informed consent of all patients had been previously obtained by three surgical residents 1-3 days in advance. All patients had received a copy of their consent form. The same residents developed assessment forms for thyroidectomy, laparoscopic cholecystectomy, umbilical hernia repair, and Lichtenstein procedure for inguinal hernia, respectively, containing 3-4 major common complications (e.g., bile duct injury, hepatic artery injury, stone spillage, and retained stones for laparoscopic cholecystectomy) and briefed the medical students before seeing the patients. Structured one-to-one interviews between students (n = 9) and patients (n = 55) based on four different assessment forms were performed and recorded by students. Both patients and students were asked to assess the new teaching unit using a short structured questionnaire. Although 100% of patients said at the beginning of their interview to have understood and memorized the risks of their imminent procedure, 5.8% (3/55) were not even able to indicate the correct part of the body where the incision would take place. Only 18.2% (10/55) of the patients were able to mention 2 or more complications, and 45.3% (25/55) could not even recall a single one. 96.4% (53/55) of the patients and 100% (9/9) of the

Modeling and Development of Medical Information System Based on Support Vector Machine in Web Network

Directory of Open Access Journals (Sweden)

Chuanfu Hu

2017-12-01

Full Text Available This paper aims at improving and utilizing the ontology information in ontology design of FOAF and vCard in real time, and the application of open relational data technology, SPARQL query information results and sending RDF/JSON data format. In addition, improve the effectiveness and efficiency of patient information extraction from the medical information website. This article includes two web search engines that are used to inform patients about medical care information. The experiment uses Drupal as the main software tool, and the Drupal RDF extension module provides some meaningful mapping. In the evaluation part, the structure of the experimental test platform is established and the system function test is carried out. The evaluation results include consumers or patients retrieving the latest doctor information and comparing search capabilities and techniques, between our system and existing systems.

Communicating with older cancer patients: impact on information recall

NARCIS (Netherlands)

Jansen, J.

2009-01-01

The central aim of this thesis was to unravel the relationship between patient characteristics, communication between patient and clinician, and subsequent patient information recall in the context of medical consultations with older cancer patients. Chapter 2 reviewed the literature to explore age

Ethical reflection on multi-disciplinarity and confidentiality of information in medical imaging through new information and communication technologies

International Nuclear Information System (INIS)

Beranger, J.; Le Coz, P.

2012-01-01

Technological advances in medical imaging has resulted in the exponential increase of the number of images per examination, caused the irreversible decline of the silver film and imposed digital imaging. This digitization is a concept whose levels of development are multiple, reflecting the complexity of this process of technological change. Under these conditions, the use of medical information via new information and communication technologies is at the crossroads of several scientific approaches and several disciplines (medicine, ethics, law, economics, psychology, etc.) surrounding the information systems in health, doctor-patient relationship and concepts that are associated. Each day, these new information and communication technologies open up new horizons and the space of possibilities, spectacularly developing access to information and knowledge. In this perspective of digital technology emergence impacting the multidisciplinary use of health information systems, the ethical questions are numerous, especially on the preservation of privacy, confidentiality and security of medical data, and their accessibility and integrity. (authors)

Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis.

LENUS (Irish Health Repository)

Grimes, T

2013-01-27

WHAT IS KNOWN AND OBJECTIVE: The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. METHODS: For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database. RESULTS: Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. WHAT IS NEW AND CONCLUSION: The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation.

Prescribing error at hospital discharge: a retrospective review of medication information in an Irish hospital.

Science.gov (United States)

Michaelson, M; Walsh, E; Bradley, C P; McCague, P; Owens, R; Sahm, L J

2017-08-01

Prescribing error may result in adverse clinical outcomes leading to increased patient morbidity, mortality and increased economic burden. Many errors occur during transitional care as patients move between different stages and settings of care. To conduct a review of medication information and identify prescribing error among an adult population in an urban hospital. Retrospective review of medication information was conducted. Part 1: an audit of discharge prescriptions which assessed: legibility, compliance with legal requirements, therapeutic errors (strength, dose and frequency) and drug interactions. Part 2: A review of all sources of medication information (namely pre-admission medication list, drug Kardex, discharge prescription, discharge letter) for 15 inpatients to identify unintentional prescription discrepancies, defined as: "undocumented and/or unjustified medication alteration" throughout the hospital stay. Part 1: of the 5910 prescribed items; 53 (0.9%) were deemed illegible. Of the controlled drug prescriptions 11.1% (n = 167) met all the legal requirements. Therapeutic errors occurred in 41% of prescriptions (n = 479) More than 1 in 5 patients (21.9%) received a prescription containing a drug interaction. Part 2: 175 discrepancies were identified across all sources of medication information; of which 78 were deemed unintentional. Of these: 10.2% (n = 8) occurred at the point of admission, whereby 76.9% (n = 60) occurred at the point of discharge. The study identified the time of discharge as a point at which prescribing errors are likely to occur. This has implications for patient safety and provider work load in both primary and secondary care.

[Ethical reflection on multidisciplinarity and confidentiality of information in medical imaging through new information and communication technologies].

Science.gov (United States)

Béranger, J; Le Coz, P

2012-05-01

Technological advances in medical imaging has resulted in the exponential increase of the number of images per examination, caused the irreversible decline of the silver film and imposed digital imaging. This digitization is a concept whose levels of development are multiple, reflecting the complexity of this process of technological change. Under these conditions, the use of medical information via new information and communication technologies is at the crossroads of several scientific approaches and several disciplines (medicine, ethics, law, economics, psychology, etc.) surrounding the information systems in health, doctor-patient relationship and concepts that are associated. Each day, these new information and communication technologies open up new horizons and the space of possibilities, spectacularly developing access to information and knowledge. In this perspective of digital technology emergence impacting the multidisciplinary use of health information systems, the ethical questions are numerous, especially on the preservation of privacy, confidentiality and security of medical data, and their accessibility and integrity. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

A needs assessment of health information technology for improving care coordination in three leading patient-centered medical homes.

Science.gov (United States)

Richardson, Joshua E; Vest, Joshua R; Green, Cori M; Kern, Lisa M; Kaushal, Rainu

2015-07-01

We investigated ways that patient-centered medical homes (PCMHs) are currently using health information technology (IT) for care coordination and what types of health IT are needed to improve care coordination. A multi-disciplinary team of researchers conducted semi-structured telephone interviews with 28 participants from 3 PCMHs in the United States. Participants included administrators and clinicians from PCMHs, electronic health record (EHR) and health information exchange (HIE) representatives, and policy makers. Participants identified multiple barriers to care coordination using current health IT tools. We identified five areas in which health IT can improve care coordination in PCMHs: 1) monitoring patient populations, 2) notifying clinicians and other staff when specific patients move across care settings, 3) collaborating around patients, 4) reporting activities, and 5) interoperability. To accomplish these tasks, many participants described using homegrown care coordination systems separate from EHRs. The participants in this study have resources, experience, and expertise with using health IT for care coordination, yet they still identified multiple areas for improvement. We hypothesize that focusing health IT development in the five areas we identified can enable more effective care coordination. Key findings from this work are that homegrown systems apart from EHRs are currently used to support care coordination and, also, that reporting tools are key components of care coordination. New health IT that enables monitoring, notifying, collaborating, reporting, and interoperability would enhance care coordination within PCMHs beyond what current health IT enables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The PHARMS (Patient Held Active Record of Medication Status) feasibility study: a research proposal.

LENUS (Irish Health Repository)

Walsh, Elaine

2018-01-08

Medication errors are a major source of preventable morbidity, mortality and cost and many occur at the times of hospital admission and discharge. Novel interventions (such as new methods of recording medication information and conducting medication reconciliation) are required to facilitate accurate transfer of medication information. With existing evidence supporting the use of information technology and the patient representing the one constant in the care process, an electronic patient held medication record may provide a solution. This study will assess the feasibility of introducing a patient held electronic medication record in primary and secondary care using the Consolidated Framework for Implementation Research (CFIR).This feasibility study is a mixed method study of community dwelling older adult patients admitted to an urban secondary care facility comprising a non-randomised intervention and qualitative interviews with key stakeholders. Outcomes of interest include clinical outcomes and process evaluation.This study will yield insights pertaining to feasibility, acceptability and participation for a more definitive evaluation of the intervention. The study also has the potential to contribute to knowledge of implementation of technology in a healthcare context and to the broader area of implementation science.

Seeking Medical Information Using Mobile Apps and the Internet: Are Family Caregivers Different from the General Public?

Science.gov (United States)

Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip

2017-03-01

Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.

Medical radiography and information societies: Challenges and opportunities

International Nuclear Information System (INIS)

Kalra, H.P.S.

2006-01-01

This paper presents the perspective from a less developed country for broadening the horizon of medical imaging as an integral part of medical records and biomedical information. From the industrial to the information society, the number as well as the diversity of stakeholders in the medical records and medical information has grown. this call for a fresh outlook on medical radiography and medical imaging

Improved glycemic control without hypoglycemia in elderly diabetic patients using the ubiquitous healthcare service, a new medical information system.

Science.gov (United States)

Lim, Soo; Kang, Seon Mee; Shin, Hayley; Lee, Hak Jong; Won Yoon, Ji; Yu, Sung Hoon; Kim, So-Youn; Yoo, Soo Young; Jung, Hye Seung; Park, Kyong Soo; Ryu, Jun Oh; Jang, Hak C

2011-02-01

To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C healthcare system refers to an individualized medical service in which medical instructions are given through the patient's mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone. After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients.

Indigenous Traditional Medical Practitioners’ Lack of Formal Medical Education Impacts their Choices of Information Resources for the Treatment of Sickle Cell Anemia. A Review of: Olatokun, W. M., & Ajagbe, E. (2010. Analyzing traditional medical practitioners’ information-seeking behavior using Taylor’s information-use environment model. Journal of Librarianship and Information Science, 42, 122-135.

Directory of Open Access Journals (Sweden)

Maria C. Melssen

2011-06-01

Full Text Available Objective – To determine the information seeking behaviours of traditional medical practitioners who treat sickle cell anemia patients.Design – Qualitative, interviewer-administered, structured questionnaire.Setting – City and surrounding rural area of Ibadan, Nigeria.Subjects – The researchers selected for this study 160 indigenous traditional medical practitioners who specialize in the treatment of sickle cell anemia. The majority of the subjects were male, with 96 male and 64 female. The practitioners were selected from four traditional medical practitioner associations in Ibadan, Nigeria. The researchers met with the leaders of the four organizations and identified which of the 420 members specialize in the treatment of sickle cell anemia.Methods – The subjects were asked survey questions orally during face-to-face interviews. The decision to conduct interviews and ask the survey questions orally (rather than having the subjects complete the survey questions on their own was based on the perceived low literacy level of the traditional medical practitioners. Survey questions were written using the analytical framework of Taylor’s information use environment model. According to the authors, the premise of Taylor’s information use environment model is that individuals can be grouped according to their “professional and/or social characteristics” (p. 124. The group is then characterized by the members’ approach to problem solving: the type of problems they encounter, the setting they find themselves in during the problem, and how the group as a whole determines what course of action needs to be taken in order to solve the problem. The problem solving strategy of the group impacts its need for information and how that information is located and used.The questions asked by the researchers fell into one of five research areas:• the environment of the group• the diagnosis and treatment methods of traditional medical

[Patient-centered medicine for tuberculosis medical services].

Science.gov (United States)

Fujita, Akira; Narita, Tomoyo

2012-12-01

necessary patient information among the relevant parties. The regional care pathway was developed by the Tobu Public Health Center. It is currently being used by several other public health centers in Hiroshima. Utilization of these two pathways has resulted in improved adherence, treatment being offered at local clinics, shorter hospitalization and better treatment outcomes. 2. Patient-centered DOTS in Funabashi-city: Akiko UOZUMI (Funabashi-city Public Health Center) In Funabashi-city, all TB patients, including those with LTBI, are treated under DOTS which recognizes and tries to accommodate the various different needs of each individual patient. For example, various types of DOTS are offered, such as pharmacy-based DOTS and DOTS supported by caregivers of nursing homes. This enables public health nurses to take into consideration both the results of risk assessment and convenience for the patient, and choose DOTS which most effectively support the patient. Furthermore, DOTS in principle is offered face-to-face, so that DOTS providers may not only build relationship of trust with the patient, but also to collect and analyze the necessary information regarding the patient and respond timely when problems arise. Such effort has directly contributed to improved default and treatment rate. 3. Hospital DOTS and clinical path for the treatment of tuberculosis: Kentaro SAKASHITA, Akira FUJITA (Tokyo Metropolitan Tama Medical Center) We introduced a version of hospital DOTS at Tama Medical Center (formerly Fuchu Hospital) in 2004. As part of this three-stage version, patients are allowed to progress to the next stage if they meet the step-up criteria. Following the introduction of this hospital DOTS, the occurrence of drug administration-related incidents decreased and support for patient adherence became easier for health care workers than before. In 2006, we developed a clinical path based on this hospital DOTS with consistent eligibility criteria for patients. This clinical

Evacuation support system for improved medical documentation and information flow in the field.

Science.gov (United States)

Walderhaug, Ståle; Meland, Per Håkon; Mikalsen, Marius; Sagen, Terje; Brevik, John Ivar

2008-02-01

Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care

Information Needs and Information Gathering Behavior of Medical Doctors in Maiduguri, Nigeria

Directory of Open Access Journals (Sweden)

Jonathan A. Ocheibi

2003-06-01

Full Text Available Survey data describes the results of an investigation on the information needs and information gathering behaviour of Medical doctors in Maiduguri, Nigeria. A total of 158 Medical doctors (128 males and 30 (females were used for the study. The overall response rate was around 70.2 percent. Medical doctors need specific medical information to enhance their knowledge on a day-to-day basis, particularly with the information explosion such as e-mail and internet facilities. Medical doctors prefer the use of publishers catalogues as the most important source for new developments in their relevant fields. Many do not have access to local data bases that are supposed to have remarkable impact on their information gathering behaviour.

Impact of patients' access to medical records in occupational medicine.

Science.gov (United States)

Krakov, A; Kabaha, N; Azuri, J; Moshe, S

2018-04-14

Information technologies offer new ways to engage with patients regarding their health, but no studies have been done in occupational health services (OHS). To examine the advantages and disadvantages of providing written and oral medical information to patients in OHS. In this cross-sectional study, data were retrieved from patients visiting four different OHS during 2014-15 for a fitness for work evaluation. We built a semi-quantitative satisfaction questionnaire, with responses ranging on a Likert scale of 1-5 from very dissatisfied (1) to very satisfied (5). There were 287 questionnaires available for analysis. The number of patients who received detailed oral and written information, which included an explanation of their health condition and of the occupational physician's (OP's) decision, was higher in clinics 1 and 3 compared to clinics 2 and 4 (48 and 38% compared to 21 and 31% respectively, P < 0.05). When patients were provided with detailed oral and written information, they declared having a better understanding (4.3 and 4.4 compared to 3.8 respectively, P < 0.001), a higher level of confidence in their OP (4.4 and 4.3 compared to 3.7 and 4 respectively, P < 0.001), a higher level of satisfaction (4.3 and 4.4 compared to 3.8 respectively, P < 0.001) and a higher sense of control and ability to correct the record (1.8 compared to 1.4 respectively, P < 0.01), compared to patients who received partial information. We recommend sharing detailed oral and written medical information with patients in OHS.

Perceptions of pharmacists and patients on information provision and their influence on patient satisfaction in Japanese community pharmacies.

Science.gov (United States)

Takaki, Hiroko; Abe, Takeru; Hagihara, Akihito

2015-12-01

The provision of information is now considered a major area in pharmacist-patient interactions. However, few reports have simultaneously evaluated patient and pharmacist perceptions with regard to the pharmacist's information provision. The aims were to clarify the perceptions of pharmacists and patients regarding information provision and the level of influence of those perceptions on patient satisfaction. A cross-sectional survey with respect to information provision was conducted for patients and pharmacists in community pharmacies in Fukuoka Prefecture, Japan. In total, 407 patient-pharmacist pairs were included in a t-test and multilevel analysis. The levels of patient perception regarding information provision were significantly higher than the levels of pharmacist perception in all variables. The pharmacists' perceived level of information provision concerning medication effects had a negative and significant association with patient satisfaction, while the patients' perceived level of information provision by the pharmacist had a positive and significant association with patient satisfaction. Higher patient expectations regarding the level of information provision concerning medication side effects and older age of the pharmacist were adversely related to patient satisfaction. Both pharmacist and patient perceptions of the information provision by pharmacists personalized to the patient had positive associations with patient satisfaction. Pharmacist perceptions related to the information provision were not associated with patient satisfaction. The present study highlights accurate information provision, building good patient-pharmacist relationships, and improving pharmaceutical care in community pharmacy settings. © 2015 John Wiley & Sons, Ltd.

Nip, tuck and click: medical tourism and the emergence of web-based health information.

Science.gov (United States)

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-02-12

An emerging trend is what has become commonly known as 'Medical Tourism' where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions.This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making.This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework.

Nip, Tuck and Click: Medical Tourism and the Emergence of Web-Based Health Information

Science.gov (United States)

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-01-01

An emerging trend is what has become commonly known as ‘Medical Tourism’ where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions. This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making. This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework. PMID:20517465

From patient talk to physician notes-Comparing the content of medical interviews with medical records in a sample of outpatients in Internal Medicine.

Science.gov (United States)

Langewitz, Wolf A; Loeb, Yael; Nübling, Matthias; Hunziker, Sabina

2009-09-01

An increasing number of consultations are delivered in group practices, where a stable 1:1 relationship between patient and physician cannot be guaranteed. Therefore, correct documentation of the content of a consultation is crucial to hand over information from one health care professional to the next. We randomly selected 20 interviews from a series of 56 videotaped consultations with patients requesting a general check-up exam in the outpatient department of Internal Medicine at the University Hospital Basel. All patients actively denied having any symptoms or specific health concerns at the time they made their appointment. Videotapes were analysed with the Roter Interaction Analysis System (RIAS). Corresponding physician notes were analysed with a category check-list that contained the information related items from RIAS. Interviews contained a total of 9.002 utterances and lasted between 15 and 53min (mean duration: 37min). Patient-centred communication (Waiting, Echoing, Mirroring, Summarising) in the videos significantly correlated with the amount of information presented by patients: medical information (r=.57; p=.009), therapeutic information (r=.50; p=.03), psychosocial information (r=.41; p=.07), life style information (r=.52; p=.02), and with the sum of patient information (r=.64; p=.003). Even though there was a significant correlation between the amount of information from the video and information in physician's notes in some categories (patient gives medical information; Pearson's r=.45; p=.05, patient gives psychosocial information; Pearson's r=.49; p=.03), an inspection of the regression lines shows that a large extent of patient information is omitted from the charts. Physicians never discussed with patients whether information should be documented in the charts or omitted. The use of typical patient-centred techniques increases information gathered from patients. Physicians document only a small percentage of patient information in the charts

Classification of medication incidents associated with information technology.

Science.gov (United States)

Cheung, Ka-Chun; van der Veen, Willem; Bouvy, Marcel L; Wensing, Michel; van den Bemt, Patricia M L A; de Smet, Peter A G M

2014-02-01

Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents submitted to the Dutch central medication incidents registration (CMR) reporting system were analyzed from the perspective of the healthcare professional with the Magrabi classification. During classification new terms were added, if necessary. The principal source of the IT-related problem, nature of error. Additional measures: consequences of incidents, IT systems, phases of the medication process. From March 2010 to February 2011 the CMR received 4161 incidents: 1643 (39.5%) from community pharmacies and 2518 (60.5%) from hospitals. Eventually one of six incidents (16.1%, n=668) were related to IT; in community pharmacies more incidents (21.5%, n=351) were related to IT than in hospitals (12.6%, n=317). In community pharmacies 41.0% (n=150) of the incidents were about choosing the wrong medicine. Most of the erroneous exchanges were associated with confusion of medicine names and poor design of screens. In hospitals 55.3% (n=187) of incidents concerned human-machine interaction-related input during the use of computerized prescriber order entry. These use problems were also a major problem in pharmacy information systems outside the hospital. A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.

Information Reception and Expectations Among Hospitalized Elderly Patients in Taiwan: A Pilot Study.

Science.gov (United States)

Chen, Kai-Li; Chang, Chia-Ming; Chen, Ching-Huey; Huang, Mei-Chih

2018-06-01

Communicating with patients, especially geriatric patients, is a challenge for medical professionals. Medical message receiving and expectations among hospitalized elderly patients have not been studied. The aim of this study was to explore medical message receiving and expectations concerning medical information among hospitalized elderly patients in Taiwan. A descriptive study design was used. Convenience sampling was applied, and the research was conducted in a geriatric ward in a medical center in southern Taiwan. Patients were recruited who were 65 years or older and capable of verbal communication. Data were collected using a self-developed semistructured questionnaire. For each participant, data were collected in one regular ward round. The messages of the physician were recorded. During the first and fourth hours after the ward round, the researcher collected the medical messages that were conveyed by the physician in the ward round and that could be repeated by the patients. Open-ended questions were used to collect data about patient expectations of medical messages during the first hour after the ward round. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using content analysis. Thirty patients participated in this study. All of the participants remembered the visit of the physician. Seventeen participants (56.6%), however, could not repeat the messages, and the total message repetition rate was 17.8% at the first hour after the ward round. By the fourth hour, the message repetition rate fell to 8.9%. Furthermore, three participants (10%) reported messages incorrectly. Participants reported the importance and necessity of physicians conveying medical messages. "Desire to know the reasons for discomfort" and "discharge date" were the messages most expected by the participants. This study suggests that most hospitalized elderly patients cannot repeat medical messages that are conveyed by their physicians

Patient-provider communication about medication use at the community pharmacy counter.

NARCIS (Netherlands)

Dijk, M. van; Blom, L.; Koopman, L.; Philbert, D.; Koster, E.; Bouvy, M.; Dijk, L. van

2016-01-01

Objective: The objectives of this study were to, first, describe the information exchanged between pharmacy staff and patients about prescribed medication at the community pharmacy counter, and second, to investigate to what extent this met professional medication counselling guidelines. Methods:

Quality and readability of online patient information regarding sclerotherapy for venous malformations.

Science.gov (United States)

Pass, Jonathan H; Patel, Amani H; Stuart, Sam; Barnacle, Alex M; Patel, Premal A

2018-05-01

Patients often use the internet as a source of information about their condition and treatments. However, this information is unregulated and varies in quality. To evaluate the readability and quality of online information for pediatric and adult patients and caregivers regarding sclerotherapy for venous malformations. "Venous malformation sclerotherapy" was entered into Google, and results were reviewed until 20 sites that satisfied predefined inclusion criteria were identified. Scientific and non-patient-focused web pages were excluded. Readability was assessed using the Flesch Reading Ease Score and American Medical Association reading difficulty recommendations and quality was assessed using Journal of the American Medical Association standards and assessing if the site displayed HONcode (Health on the Net Code) certification. Assessment of the breadth of relevant information was made using a predefined checklist. Forty-nine search engine results were reviewed before 20 sites were identified for analysis. Average Flesch Reading Ease Score was 44 (range: 24.2-70.1), representing a "fairly difficult" reading level. None of the sites had a Flesch Reading Ease Score meeting the American Medical Association recommendation of 80-90. Only one site met all four Journal of the American Medical Association quality criteria (average: 2.1). None of the sites displayed a HONcode seal. The information most frequently found was: sclerotherapy is performed by radiologists, multiple treatments may be needed and surgery is an alternative treatment. Online information regarding sclerotherapy for venous malformations is heterogeneous in quality and breadth of information, and does not meet readability recommendations for patient information. Radiologists should be aware of and account for this when meeting patients.

Developing a Shared Patient-Centered, Web-Based Medication Platform for Type 2 Diabetes Patients and Their Health Care Providers: Qualitative Study on User Requirements.

Science.gov (United States)

Bernhard, Gerda; Mahler, Cornelia; Seidling, Hanna Marita; Stützle, Marion; Ose, Dominik; Baudendistel, Ines; Wensing, Michel; Szecsenyi, Joachim

2018-03-27

Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients' knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user' adoption is optimal. The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients' ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align

Patient satisfaction with ambulatory care in Germany: effects of patient- and medical practice-related factors.

Science.gov (United States)

Auras, Silke; Ostermann, Thomas; de Cruppé, Werner; Bitzer, Eva-Maria; Diel, Franziska; Geraedts, Max

2016-12-01

The study aimed to illustrate the effect of the patients' sex, age, self-rated health and medical practice specialization on patient satisfaction. Secondary analysis of patient survey data using multilevel analysis (generalized linear mixed model, medical practice as random effect) using a sequential modelling strategy. We examined the effects of the patients' sex, age, self-rated health and medical practice specialization on four patient satisfaction dimensions: medical practice organization, information, interaction, professional competence. The study was performed in 92 German medical practices providing ambulatory care in general medicine, internal medicine or gynaecology. In total, 9888 adult patients participated in a patient survey using the validated 'questionnaire on satisfaction with ambulatory care-quality from the patient perspective [ZAP]'. We calculated four models for each satisfaction dimension, revealing regression coefficients with 95% confidence intervals (CIs) for all independent variables, and using Wald Chi-Square statistic for each modelling step (model validity) and LR-Tests to compare the models of each step with the previous model. The patients' sex and age had a weak effect (maximum regression coefficient 1.09, CI 0.39; 1.80), and the patients' self-rated health had the strongest positive effect (maximum regression coefficient 7.66, CI 6.69; 8.63) on satisfaction ratings. The effect of medical practice specialization was heterogeneous. All factors studied, specifically the patients' self-rated health, affected patient satisfaction. Adjustment should always be considered because it improves the comparability of patient satisfaction in medical practices with atypically varying patient populations and increases the acceptance of comparisons. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Security analysis and improvement of a privacy authentication scheme for telecare medical information systems.

Science.gov (United States)

Wu, Fan; Xu, Lili

2013-08-01

Nowadays, patients can gain many kinds of medical service on line via Telecare Medical Information Systems(TMIS) due to the fast development of computer technology. So security of communication through network between the users and the server is very significant. Authentication plays an important part to protect information from being attacked by malicious attackers. Recently, Jiang et al. proposed a privacy enhanced scheme for TMIS using smart cards and claimed their scheme was better than Chen et al.'s. However, we have showed that Jiang et al.'s scheme has the weakness of ID uselessness and is vulnerable to off-line password guessing attack and user impersonation attack if an attacker compromises the legal user's smart card. Also, it can't resist DoS attack in two cases: after a successful impersonation attack and wrong password input in Password change phase. Then we propose an improved mutual authentication scheme used for a telecare medical information system. Remote monitoring, checking patients' past medical history record and medical consultant can be applied in the system where information transmits via Internet. Finally, our analysis indicates that the suggested scheme overcomes the disadvantages of Jiang et al.'s scheme and is practical for TMIS.

The Application of Use Case Modeling in Designing Medical Imaging Information Systems

International Nuclear Information System (INIS)

Safdari, Reza; Farzi, Jebraeil; Ghazisaeidi, Marjan; Mirzaee, Mahboobeh; Goodini, Azadeh

2013-01-01

Introduction. The essay at hand is aimed at examining the application of use case modeling in analyzing and designing information systems to support Medical Imaging services. Methods. The application of use case modeling in analyzing and designing health information systems was examined using electronic databases (Pubmed, Google scholar) resources and the characteristics of the modeling system and its effect on the development and design of the health information systems were analyzed. Results. Analyzing the subject indicated that Provident modeling of health information systems should provide for quick access to many health data resources in a way that patients' data can be used in order to expand distant services and comprehensive Medical Imaging advices. Also these experiences show that progress in the infrastructure development stages through gradual and repeated evolution process of user requirements is stronger and this can lead to a decline in the cycle of requirements engineering process in the design of Medical Imaging information systems. Conclusion. Use case modeling approach can be effective in directing the problems of health and Medical Imaging information systems towards understanding, focusing on the start and analysis, better planning, repetition, and control

Patient needs and medication styles in COPD

Directory of Open Access Journals (Sweden)

L. M. Osman

2005-12-01

Full Text Available Patient self-care in illnesses such as chronic obstructive pulmonary disease (COPD is influenced by "trade-offs" that patients make between their social and psychological needs, and the "best practice" clinical management of their illness. Patients weigh the benefits of taking medication against the costs, such as symptoms. Personal styles of medication use and decision-making also affect how well COPD patients respond to treatment plans and their acceptance of particular treatments, including inhalers. The large amount of information now available may have made patients more autonomous than before, but the actual locus of control varies widely between patients. Patients seem to take a pragmatic approach when assessing inhaler devices, basing preference on how effective they perceive the device to be. Patients with COPD show loyalty to devices and, in the main, try to comply with instructions given by the healthcare provider. The health path for chronic obstructive pulmonary disease, which describes the course the disease typically takes, is a progressive deterioration. Patients therefore adopt a conservative attitude to their health goals and what they expect to gain from treatment and management plans. An understanding of these influences will help healthcare providers support the patient better and give the appropriate advice at each phase of a patient's health path.

Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS. A Randomized, Controlled Trial.

Directory of Open Access Journals (Sweden)

Anne Weiland

Full Text Available Patients with medically unexplained physical symptoms (MUPS are prevalent 25-50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don't feel understood. We developed an evidence-based communication training, aimed to improve specialists' interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness.The intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment that reinforced a patient's symptoms. They were taught to explain MUPS understandably, reassure patients effectively and avoid unnecessary diagnostic testing. Before and after the intervention training, specialists videotaped a total of six consultations with different MUPS patients. These were evaluated to assess doctors' MUPS-focused communicating skills using an adapted version of the Four Habit Coding Scheme on five-point Likert scales. Participants evaluated the training by self-report on three-point Likert scales. Doctors in the control group received training after completion of the study.123 doctors (40% specialists, 60% residents and 478 MUPS patients from 11 specialties were included; 98 doctors completed the study (80% and 449 videotaped consultations were assessed. Trained doctors interviewed patients more effectively than untrained ones (p < 0.001, summarized information in a more patient-centered way (p = 0.001, and better explained MUPS and the role of perpetuating factors (p < 0.05. No effects on planning skills were found. On a 3-point scale the training was evaluated with 2.79.MUPS-focused communication training increases the interviewing and

Effects of a Patient-Provider, Collaborative, Medication-Planning Tool: A Randomized, Controlled Trial

Directory of Open Access Journals (Sweden)

James F. Graumlich

2016-01-01

Full Text Available Among patients with various levels of health literacy, the effects of collaborative, patient-provider, medication-planning tools on outcomes relevant to self-management are uncertain. Objective. Among adult patients with type II diabetes mellitus, we tested the effectiveness of a medication-planning tool (Medtable™ implemented via an electronic medical record to improve patients’ medication knowledge, adherence, and glycemic control compared to usual care. Design. A multicenter, randomized controlled trial in outpatient primary care clinics. 674 patients received either the Medtable tool or usual care and were followed up for up to 12 months. Results. Patients who received Medtable had greater knowledge about indications for medications in their regimens and were more satisfied with the information about their medications. Patients’ knowledge of drug indication improved with Medtable regardless of their literacy status. However, Medtable did not improve patients’ demonstrated medication use, regimen adherence, or glycemic control (HbA1c. Conclusion. The Medtable tool supported provider/patient collaboration related to medication use, as reflected in patient satisfaction with communication, but had limited impact on patient medication knowledge, adherence, and HbA1c outcomes. This trial is registered with ClinicalTrials.gov NCT01296633.

Stigma among California's Medical Marijuana Patients.

Science.gov (United States)

Satterlund, Travis D; Lee, Juliet P; Moore, Roland S

2015-01-01

The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This article examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends, and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all.

Closed medical negligence claims can drive patient safety and reduce litigation.

Science.gov (United States)

Pegalis, Steven E; Bal, B Sonny

2012-05-01

Medical liability reform is viewed by many physician groups as a means of reducing medical malpractice litigation and lowering healthcare costs. However, alternative approaches such as closed medical negligence claims data may also achieve these goals. We asked whether information gleaned from closed claims related to medical negligence could promote patient safety and reduce costs related to medical liability. Specifically, we investigated whether physician groups have examined such data to identify error patterns and to then institute specific patient treatment protocols. We searched for medical societies that have systematically examined closed medical negligence claims in their specialty to develop specific standards of physician conduct. We then searched the medical literature for published evidence of the efficacy, if any, related to the patient safety measures thus developed. Anesthesia and obstetric physician societies have successfully targeted costs and related concerns arising from medical malpractice lawsuits by using data from closed claims to develop patient safety and treatment guidelines. In both specialties, after institution of safety measures derived from closed medical negligence claims, the incidence and costs related to medical malpractice decreased and physician satisfaction improved. Tort reform, in the form of legislatively prescribed limits on damages arising from lawsuits, is not the only means of addressing the incidence and costs related to medical malpractice litigation. As the experience of anesthesia and obstetric physicians has demonstrated, safety guidelines derived from analyzing past medical malpractice litigation can achieve the same goals while also promoting patient safety.

How complete is the information on preadmission psychotropic medications in inpatients with dementia? A comparison of hospital medical records with dispensing data.

Science.gov (United States)

Pisa, Federica Edith; Palese, Francesca; Romanese, Federico; Barbone, Fabio; Logroscino, Giancarlo; Riedel, Oliver

2018-06-05

Reliable information on preadmission medications is essential for inpatients with dementia, but its quality has hardly been evaluated. We assessed the completeness of information and factors associated with incomplete recording. We compared preadmission medications recorded in hospital electronic medical records (EMRs) with community-pharmacy dispensations in hospitalizations with discharge code for dementia at the University Hospital of Udine, Italy, 2012-2014. We calculated: (a) prevalence of omissions (dispensed medication not recorded in EMRs), additions (medication recorded in EMRs not dispensed), and discrepancies (any omission or addition); (b) multivariable logistic regression odds ratio, with 95% confidence interval (95% CI), of ≥1 omission. Among 2,777 hospitalizations, 86.1% had ≥1 discrepancy for any medication (Kappa 0.10) and 33.4% for psychotropics. When psychotropics were recorded in EMR, antipsychotics were added in 71.9% (antidepressants: 29.2%, antidementia agents: 48.2%); when dispensed, antipsychotics were omitted in 54.4% (antidepressants: 52.7%, antidementia agents: 41.5%). Omissions were 92% and twice more likely in patients taking 5 to 9 and ≥10 medications (vs. 0 to 4), 17% in patients with psychiatric disturbances (vs. none), and 41% with emergency admission (vs. planned). Psychotropics, commonly used in dementia, were often incompletely recorded. To enhance information completeness, both EMRs and dispensations should be used. Copyright © 2018 John Wiley & Sons, Ltd.

Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

Directory of Open Access Journals (Sweden)

Karen W. Geletko

2016-11-01

Full Text Available Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes. We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61 and practicing physicians (n = 53 completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ 2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Results: Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes ( P = .0003. Medical residents were more likely to receive information about e-cigarettes from colleagues ( P = .0001. No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Conclusions: Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services

Directory of Open Access Journals (Sweden)

Yardlee Kauffman

2014-01-01

Full Text Available Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available. Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services. Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted. Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory. Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists. Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for

Informing patients: the influence of numeracy, framing, and format of side effect information on risk perceptions.

Science.gov (United States)

Peters, Ellen; Hart, P Sol; Fraenkel, Liana

2011-01-01

Given the importance of effective patient communication, findings about influences on risk perception in nonmedical domains need replication in medical domains. To examine whether numeracy influences risk perceptions when different information frames and number formats are used to present medication risks. The authors manipulated the frame and number format of risk information in a 3 (frame: positive, negative, combined) × 2 (number format: frequency, percentage) design. Participants from an Internet sample (N = 298), randomly assigned to condition, responded to a single, hypothetical scenario. The main effects and interactions of numeracy, framing, and number format on risk perception were measured. Participants given the positive frame perceived the medication as less risky than those given the negative frame. Mean risk perceptions for the combined frame fell between the positive and negative frames. Numeracy did not moderate these framing effects. Risk perceptions also varied by number format and numeracy, with less-numerate participants given risk information in a percentage format perceiving the medication as less risky than when given risk information in a frequency format; highly numerate participants perceived similar risks in both formats. The generalizability of the findings is limited due to the use of non-patients, presented a hypothetical scenario. Given the design, one cannot know whether observed differences would translate into clinically significant differences in patient behaviors. Frequency formats appear to increase risk perceptions over percentage formats for less-numerate respondents. Health communicators need to be aware that different formats generate different risk perceptions among patients varying in numeracy.

Research on patient safety: falls and medications.

Science.gov (United States)

Boddice, Sandra Dawn; Kogan, Polina

2009-10-01

Below you will find summaries of published research describing investigations into patient safety issues related to falls and medications. The first summary provides details on the incidence of falls associated with the use of walkers and canes. This is followed by a summary of a fall-prevention intervention study that evaluated the effectiveness of widespread dissemination of evidence-based strategies in a community in Connecticut. The third write up provides information on three classes of medications that are associated with a significant number of emergency room visits. The last summary describes a pharmacist-managed medication reconciliation intervention pilot program. For additional details about the study findings and interventions, we encourage readers to review the original articles.

Dental management of medically compromised patients

Directory of Open Access Journals (Sweden)

Sherly Horax

2016-06-01

Full Text Available These days, treatment in dentistry is no longer for patient without complication, but also for patient with bad medical record. With correct treatment management in handling medical condition of patient, not only for dental treatment but also their systematic disease, all the dental staff also can improve for the better quality of life of the patient. Patient with medical compromised start to realize that  keeping good oral hygiene is so important for their lives, therefore dental staff need to improve their science and technology and also for facing patient with medical compromised. This article will discuss and suggest various treatment consideration and protocol for the patient of with medical compromised.

Strategy of health information seeking among physicians, medical residents, and students after introducing digital library and information technology in teaching hospitals of Iran.

Science.gov (United States)

kahouei, Mehdi; Alaei, Safollah; Shariat Panahi, Sohaila Sadat Ghazavi; Zadeh, Jamileh Mahdi

2015-05-01

It is important for physicians, medical students and health care organizations of developing countries to use reliable clinical information in order to deliver the best practice. Therefore, health sector of Iran endeavored to encourage physicians and medical students to integrate research findings into practice since 2005. Several educational interventions in the areas of information technology and databases were performed. Digital library was introduced in the teaching hospitals. The purpose of this study was to investigate whether these interventions increased the use of evidence-based health information resources among physicians, medical residents and students. This descriptive study involved 315 physicians, assistants and medical students in affiliated hospitals of Semnan University of medical sciences in 2013. A total 52.9% of physicians and 79.5% of medical residents and students always used patient data. 81.3% of physicians and 67.1% of medical residents and students reported using their own experiences, 26.5% of physicians and 16.9% of medical residents and students always used databases such as PubMed and MEDLINE for patient care. Our results revealed that in spite of providing educational and technical infrastructures for accomplishment of research utilization in medical education, the study subjects often identified and used what they regarded as reliable and relevant information from sources that do not truly represent the best evidence that is available. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

[Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

Science.gov (United States)

Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

2015-06-01

A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital.

Barriers to retrieving patient information from electronic health record data: failure analysis from the TREC Medical Records Track.

Science.gov (United States)

Edinger, Tracy; Cohen, Aaron M; Bedrick, Steven; Ambert, Kyle; Hersh, William

2012-01-01

Secondary use of electronic health record (EHR) data relies on the ability to retrieve accurate and complete information about desired patient populations. The Text Retrieval Conference (TREC) 2011 Medical Records Track was a challenge evaluation allowing comparison of systems and algorithms to retrieve patients eligible for clinical studies from a corpus of de-identified medical records, grouped by patient visit. Participants retrieved cohorts of patients relevant to 35 different clinical topics, and visits were judged for relevance to each topic. This study identified the most common barriers to identifying specific clinic populations in the test collection. Using the runs from track participants and judged visits, we analyzed the five non-relevant visits most often retrieved and the five relevant visits most often overlooked. Categories were developed iteratively to group the reasons for incorrect retrieval for each of the 35 topics. Reasons fell into nine categories for non-relevant visits and five categories for relevant visits. Non-relevant visits were most often retrieved because they contained a non-relevant reference to the topic terms. Relevant visits were most often infrequently retrieved because they used a synonym for a topic term. This failure analysis provides insight into areas for future improvement in EHR-based retrieval with techniques such as more widespread and complete use of standardized terminology in retrieval and data entry systems.

"You don't want to lose that trust that you've built with this patient...": (dis)trust, medical tourism, and the Canadian family physician-patient relationship.

Science.gov (United States)

Crooks, Valorie A; Li, Neville; Snyder, Jeremy; Dharamsi, Shafik; Benjaminy, Shelly; Jacob, Karen J; Illes, Judy

2015-02-25

Recent trends document growth in medical tourism, the private pursuit of medical interventions abroad. Medical tourism introduces challenges to decision-making that impact and are impacted by the physician-patient trust relationship-a relationship on which the foundation of beneficent health care lies. The objective of the study is to examine the views of Canadian family physicians about the roles that trust plays in decision-making about medical tourism, and the impact of medical tourism on the therapeutic relationship. We conducted six focus groups with 22 family physicians in the Canadian province of British Columbia. Data were analyzed thematically using deductive and inductive codes that captured key concepts across the narratives of participants. Family physicians indicated that they trust their patients to act as the lead decision-makers about medical tourism, but are conflicted when the information they are managing contradicts the best interests of the patients. They reported that patients distrust local health care systems when they experience insufficiencies in access to care and that this can prompt patients to consider going abroad for care. Trust fractures in the physician-patient relationship can arise from shame, fear and secrecy about medical tourism. Family physicians face diverse tensions about medical tourism as they must balance their roles in: (1) providing information about medical tourism within a context of information deficits; (2) supporting decision-making while distancing themselves from patients' decisions to engage in medical tourism; and (3) acting both as agents of the patient and of the domestic health care system. These tensions highlight the ongoing need for reliable third-party informational resources about medical tourism and the development of responsive policy.

Relationship of depression and anxiety to cancer patients' medical decision-making.

Science.gov (United States)

Petersen, Suni; Schwartz, Robert C; Sherman-Slate, Elisabeth; Frost, Hanna; Straub, Jamie L; Damjanov, Nevena

2003-10-01

The purpose of this study was to examine the relation of depression and anxiety to cancer patients' medical decision-making. Participants were 79 rural and urban cancer patients undergoing chemotherapy. The four decisional styles of the Decisional Processing Model were the independent variables. Dependent variables were anxiety and depression, measured by Spielberger's State-Trait Anxiety and the Center for Disease Control Depression Scale, respectively. Consistent with the Decisional Processing Model, analysis suggested that patients make medical decisions by information seeking, information processing, advice following, or ruminating. Decisional style did not vary according to type or stage of cancer, prognosis, time elapsed since initial diagnosis, or whether cancer was initial or recurrent. Decisional style did not systematically vary with depression and anxiety suggesting how a person makes decisions is a stable personality trait. Thus, decision-making may follow a cognitive schema. It is likely that patients' decisional styles help to manage anxiety and depression when confronted with life-threatening illness. Implications for informed consent and patients' involvement in decision-making are discussed.

Medication adherence in patients with rheumatoid arthritis: the effect of patient education, health literacy, and musculoskeletal ultrasound.

Science.gov (United States)

Joplin, Samantha; van der Zwan, Rick; Joshua, Fredrick; Wong, Peter K K

2015-01-01

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease affecting educational levels and limited health literacy are contributory factors. Psychological models may assist in explaining medication nonadherence. Increasing patient knowledge of their disease seems sensible. Existing educational interventions appear ineffective at improving medication adherence, probably due to an overemphasis on provision of biomedical information. A novel approach to patient education using musculoskeletal ultrasound is proposed.

Web-based Distributed Medical Information System for Chronic Viral Hepatitis

Science.gov (United States)

Yang, Ying; Qin, Tuan-fa; Jiang, Jian-ning; Lu, Hui; Ma, Zong-e.; Meng, Hong-chang

2008-11-01

To make a long-term dynamic monitoring to the chronically ill, especially patients of HBV A, we build a distributed Medical Information System for Chronic Viral Hepatitis (MISCHV). The Web-based system architecture and its function are described, and the extensive application and important role are also presented.

Information-seeking Behavior and Information Needs in Patients With Amyotrophic Lateral Sclerosis: Analyzing an Online Patient Community.

Science.gov (United States)

Oh, Juyeon; Kim, Jung A

2017-07-01

A few studies have examined the specific informational needs of the population with amyotrophic lateral sclerosis. The aims of this study were to describe the information-seeking behavior and information needs of patients with amyotrophic lateral sclerosis and their families in Korea by analyzing messages from an online patient community. A total of 1047 messages from the question and answer forum of the "Lou Gehrig's Disease Network" (http://cafe.daum.net/alsfree) from January 2010 to September 2015 were collected. The word frequency, main questions, and asker of the messages were analyzed and coded. Terms such as "hospital," "mother," "father," "gastrostomy," and "ALS" were most frequently identified. The most commonly mentioned main topic was about disease-specific information, while the most frequent subcategory was symptoms or management of symptoms. Other prominent categories concerned information about treatment, rehabilitation, and the medical system. The people who wrote the questions were mostly the son/daughter of patients with amyotrophic lateral sclerosis. Patients with amyotrophic lateral sclerosis and their family members commonly obtained information by posting their inquiries online and have a variety of questions regarding amyotrophic lateral sclerosis in this study. The findings of this study can be used as a base of information for developing educational programs and resources for patients with amyotrophic lateral sclerosis and their families.

Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

Science.gov (United States)

Weiland, Anne; Blankenstein, Annette H.; Van Saase, Jan L. C. M.; Van der Molen, Henk T.; Jacobs, Mariël E.; Abels, Dineke C.; Köse, Nedim; Van Dulmen, Sandra; Vernhout, René M.; Arends, Lidia R.

2015-01-01

Background Patients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an evidence-based communication training, aimed to improve specialists’ interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness. Methods The intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment) that reinforced a patient’s symptoms. They were taught to explain MUPS understandably, reassure patients effectively and avoid unnecessary diagnostic testing. Before and after the intervention training, specialists videotaped a total of six consultations with different MUPS patients. These were evaluated to assess doctors’ MUPS-focused communicating skills using an adapted version of the Four Habit Coding Scheme on five-point Likert scales. Participants evaluated the training by self-report on three-point Likert scales. Doctors in the control group received training after completion of the study. Results 123 doctors (40% specialists, 60% residents) and 478 MUPS patients from 11 specialties were included; 98 doctors completed the study (80%) and 449 videotaped consultations were assessed. Trained doctors interviewed patients more effectively than untrained ones (p < 0.001), summarized information in a more patient-centered way (p = 0.001), and better explained MUPS and the role of perpetuating factors (p < 0.05). No effects on planning skills were found. On a 3-point scale the training was evaluated with 2.79. Conclusion MUPS-focused communication

Lay-friendliness in translated Patient Information Leaflets

DEFF Research Database (Denmark)

Jensen, Matilde Nisbeth; Zethsen, Karen Korning

This paper seeks to empirically explore the claim that translated Danish Patient Information Leaflets (PILs) are less lay-friendly than their English source texts. The last two decades have seen an increased focus on providing patients with lay-friendly, easily understood information, enabling them...... to make informed decisions concerning their health. For this purpose, many new genres have been created, one such genre being the PIL, a mandatory text which in an EU context has to accompany all medication informing patients about dosage, side effects etc. Legally, the PIL genre is required to ensure lay......-friendly information as it must be “written and designed to be clear and understandable, enabling the users to act appropriately” (Article 63(2) of EU Directive 2001/83/EC). Despite the legal requirements and the intensified focus on lay-friendly health communication, many studies have shown that PILs are often...

Planning for chronic disease medications in disaster: perspectives from patients, physicians, pharmacists, and insurers.

Science.gov (United States)

Carameli, Kelley A; Eisenman, David P; Blevins, Joy; d'Angona, Brian; Glik, Deborah C

2013-06-01

Recent US disasters highlight the current imbalance between the high proportion of chronically ill Americans who depend on prescription medications and their lack of medication reserves for disaster preparedness. We examined barriers that Los Angeles County residents with chronic illness experience within the prescription drug procurement system to achieve recommended medication reserves. A mixed methods design included evaluation of insurance pharmacy benefits, focus group interviews with patients, and key informant interviews with physicians, pharmacists, and insurers. Most prescriptions are dispensed as 30-day units through retail pharmacies with refills available after 75% of use, leaving a monthly medication reserve of 7 days. For patients to acquire 14- to 30-day disaster medication reserves, health professionals interviewed supported 60- to 100-day dispensing units. Barriers included restrictive insurance benefits, patients' resistance to mail order, and higher copay-ments. Physicians, pharmacists, and insurers also varied widely in their preparedness planning and collective mutual-aid plans, and most believed pharmacists had the primary responsibility for patients' medication continuity during a disaster. To strengthen prescription drug continuity in disasters, recommendations include the following: (1) creating flexible drug-dispensing policies to help patients build reserves, (2) training professionals to inform patients about disaster planning, and (3) building collaborative partnerships among system stakeholders.

Using the computer to optimize human performance in health care delivery. The pathologist as medical information specialist.

Science.gov (United States)

Korpman, R A

1987-07-01

The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.

Guidelines for patient information in nuclear medicine;Guide pour l'information des patients en medecine nucleaire

Energy Technology Data Exchange (ETDEWEB)

Anon.

2010-02-15

This guide for patients information in nuclear medicine is organised in the following manner: what is a medical examination in nuclear medicine, the preparation and the duration of the examination, the possible risks and the radiation doses, pregnancy, delayed menstruation and nursing and what to do after the examination. (N.C.)

Stigma Among California's Medical Marijuana Patients

OpenAIRE

Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.

2015-01-01

The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This paper examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structure...

Health and medication information resources on the World Wide Web.

Science.gov (United States)

Grossman, Sara; Zerilli, Tina

2013-04-01

Health care practitioners have increasingly used the Internet to obtain health and medication information. The vast number of Internet Web sites providing such information and concerns with their reliability makes it essential for users to carefully select and evaluate Web sites prior to use. To this end, this article reviews the general principles to consider in this process. Moreover, as cost may limit access to subscription-based health and medication information resources with established reputability, freely accessible online resources that may serve as an invaluable addition to one's reference collection are highlighted. These include government- and organization-sponsored resources (eg, US Food and Drug Administration Web site and the American Society of Health-System Pharmacists' Drug Shortage Resource Center Web site, respectively) as well as commercial Web sites (eg, Medscape, Google Scholar). Familiarity with such online resources can assist health care professionals in their ability to efficiently navigate the Web and may potentially expedite the information gathering and decision-making process, thereby improving patient care.

Quality assessment of medical education and use of information technology.

Science.gov (United States)

Masic, Izet; Ciric, Damir; Pulja, Artan; Kulasin, Igor; Pandza, Haris

2009-01-01

Extensive and fast advancements in biomedical sciences created a significant delay in receiving relevant and updated information in medical practice - physicians use old techniques and treat patients incorrectly. Bosnia and Herzegovina signed the Bologna Declaration on 18 September 2003, and in the light of this new approach to university education, and the process of joining The European Union, the authors set the following aims: to determine the current level of knowledge among medical students at the Medical Faculty of the University of Sarajevo, to determine the level of knowledge among medical students before their enrolment at the faculty, and to find out students opinion on their needs for further education. Students also left their suggestions on what should be changed in the curriculum. 203 students were included in the survey and results show that they demand more practical work, direct contact with patients and presentation of interesting clinical cases. Many of them use the internet as professional education means. Professional papers are rarely used. At present, the availability of learning material is insufficient at the faculty library.

Development of an informative system on aspects of radiological protection in the medical practices

International Nuclear Information System (INIS)

Lopez B, G.M.; Martinez G, A.; Gonzalez R, N.; Hernandez A, R.; Valdes R, M.; Cardenas H, J.; Zaldivar H, W.; Diaz B, M.; Machado T, A.

2006-01-01

Today in day is difficult to imagine the development of the medical practices in the diagnosis and treatment of diverse illnesses without the use of the ionizing radiations. In spite of the diffusion and application of these practices, the patients and the public in general don't have full conscience of like the procedures are carried out and the risks that these involve. For it diverse international and national organizations in the last years recommend to include in the programs of radiological protection, all the information that should be given to the patients and the one public that attend as users to the medical institutions to undergo to procedures that imply the use of the ionizing radiations. In Cuba a growing and quick tendency exists to the introduction of nuclear techniques for medical ends, however paradoxically the relative aspects to the communication to the patients and the public in general about the risks of the procedures to that they will be subjected and in consequence on the measures to minimize them is not adequate. Keeping in mind the above-mentioned, specialists of national centers linked to the control and consultant ship in the topics of radiological protection in the medical practices that use ionizing radiations, they worked in the country in the design of an information system that should contribute to elevate the population's culture before the mentioned aspects. The present work describes the structure of this system in function of the different medical attention levels of our national health system. Additionally it exposes the development of a package of varied informative and training tools among those that are folding, posters, guides, instructions, CD Show that its approach general and specific aspects of the uses and risks of medical practices in nuclear medicine, radiodiagnostic and radiotherapy directed so much to health professionals, patients as public in general. (Author)

Communicating risks and benefits of medical exposures to patients

International Nuclear Information System (INIS)

Wall, B.F.

2001-01-01

An information leaflet for concerned patients is in preparation, which attempts to explain the risks and benefits of diagnostic medical exposures in terms suitable for the layman. In view of the wide variability in patient doses for the same examination and the considerable uncertainties in radiation risk coefficients, x-ray examinations have been divided into just four broad categories each spanning a factor of 10 in risk. The doses are put into perspective by comparison with those from natural background radiation. Sufficient quantitative information on the approximate level of the risks for some common diagnostic procedures is provided to allow patients to make an informed decision on whether the benefits, as described by the referring clinician, outweigh the radiation risks. (author)

[A survey of medical information education in radiological technology schools].

Science.gov (United States)

Ohba, Hisateru; Ogasawara, Katsuhiko; Hoshino, Shuhei; Hosoba, Minoru; Okuda, Yasuo; Konishi, Yasuhiko; Ikeda, Ryuji

2010-08-20

The purpose of this study was to clarify actual conditions and problems in medical information education and to propose the educational concept to be adopted in medical information. A questionnaire survey was carried out by the anonymous method in June 2008. The survey was intended for 40 radiological technology schools. The questionnaire items were as follows: (1) educational environment in medical information education, (2) content of a lecture in medical information, (3) problems in medical information education. The response rate was 55.0% (22 schools). Half of the responding schools had a laboratory on medical information. Seventeen schools had a medical information education facility, and out of them, approximately 50% had an educational medical information system. The main problems of the medical information education were as follows: (a) motivation of the students is low, (b) the educational coverage and level for medical information are uncertain, (c) there are not an appropriate textbook and educational guidance. In conclusion, these findings suggest that it is necessary to have a vision of medical information education in the education of radiological technologists.

A survey of medical information education in radiological technology schools

International Nuclear Information System (INIS)

Ohba, Hisateru; Ogasawara, Katsuhiko; Hoshino, Shuhei; Hosoba, Minoru; Okuda, Yasuo; Konishi, Yasuhiko; Ikeda, Ryuji

2010-01-01

The purpose of this study was to clarify actual conditions and problems in medical information education and to propose the educational concept to be adopted in medical information. A questionnaire survey was carried out by the anonymous method in June 2008. The survey was intended for 40 radiological technology schools. The questionnaire items were as follows: educational environment in medical information education, content of a lecture in medical information, problems in medical information education. The response rate was 55.0% (22 schools). Half of the responding schools had a laboratory on medical information. Seventeen schools had a medical information education facility, and out of them, approximately 50% had an educational medical information system. The main problems of the medical information education were as follows: motivation of the students is low, the educational coverage and level for medical information are uncertain, there are not an appropriate textbook and educational guidance. In conclusion, these findings suggest that it is necessary to have a vision of medical information education in the education of radiological technologists. (author)

Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative

Science.gov (United States)

2007-06-01

AD_________________ Award Number: W81XWH-06-2-0045 TITLE: Mass Medication Clinic (MMC) Patient ...SUBTITLE 5a. CONTRACT NUMBER Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative 5b. GRANT NUMBER W81XWH-06-2...sections will describe the events, results, and accomplishments of this study. With validation through this project the Patient Medical Assistant

38 CFR 17.241 - Sharing medical information services.

Science.gov (United States)

2010-07-01

..., research centers, and individual members of the medical profession, under which medical information and techniques will be freely exchanged and the medical information services of all parties to the agreement will... highly trained and qualified members of the medical profession. (c) Use of electronic equipment. Recent...

Personnel training and patient education in medical marijuana dispensaries in Oregon.

Science.gov (United States)

Linares, Roberto; Choi-Nurvitadhi, Jo; Cooper, Svetlana; Ham, YoungYoon; Ishmael, Jane E; Zweber, Ann

2016-01-01

To determine the knowledge and training of Oregon Medical Marijuana Dispensary (OMMD) personnel and describe the information and type of advice provided to patients who use Oregon dispensaries. Statewide cross-sectional email survey of OMMD personnel. Of the 141 surveys, 47 were initiated. The most frequently referenced types of training were on-the-job training and the Internet. Dispensary personnel most commonly used patients' preferences and symptoms as well as personal experiences to determine appropriate strains for patients. The majority of respondents advised patients about precautions and expected effects. Respondents were least likely to advise on drug interactions, or recommend a patient talk to a pharmacist or prescriber. Dispensary personnel in Oregon use a variety of resources to learn about medical marijuana. Although formal health or medical training was not indicated, personnel advise on marijuana's effects, use, and product selection. Further study is needed to assess the current training and advising on patients' ability to use medical marijuana safely and effectively. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Medical Crowdfunding for Patients Undergoing Orthopedic Surgery.

Science.gov (United States)

Durand, Wesley M; Johnson, Joseph R; Eltorai, Adam E M; Daniels, Alan H

2018-01-01

Crowdfunding for medical expenses is growing in popularity. Through several websites, patients create public campaign profiles to which donors can contribute. Research on medical crowdfunding is limited, and there have been no studies of crowdfunding in orthopedics. Active medical crowdfunding campaigns for orthopedic trauma, total joint arthroplasty, and spine surgery were queried from a crowdfunding website. The characteristics and outcomes of crowdfunding campaigns were abstracted and analyzed. For this study, 444 campaigns were analyzed, raising a total of $1,443,528. Among the campaigns that received a donation, mean amount raised was $4414 (SE, $611). Multivariate analysis showed that campaigns with unspecified location (odds ratio, 0.26; P=.0008 vs West) and those for total joint arthroplasty (odds ratio, 0.35; P=.0003 vs trauma) had significantly lower odds of receipt of any donation. Description length was associated with higher odds of donation receipt (odds ratio, 1.13 per +100 characters; Pcrowdfunding may be disproportionately available to patients with specific diagnoses, those from specific regions, those who are able to craft a lengthy descriptive narrative, and those with access to robust digital social networks. Clinicians are likely to see a greater proportion of patients turning to crowdfunding as it grows in popularity. Patients may ask physicians for information about crowdfunding or request testimonials to support campaigns. Surgeons should consider their response to such requests individually. These findings shed light on the dynamics of medical crowdfunding and support robust personal and professional deliberation. [Orthopedics. 2018; 41(1):e58-e63.]. Copyright 2017, SLACK Incorporated.

Predictive medical information and underwriting.

Science.gov (United States)

Dodge, John H

2007-01-01

Medical underwriting involves the application of actuarial science by analyzing medical information to predict the future risk of a claim. The objective is that individuals with like risk are treated in a like manner so that the premium paid is proportional to the risk of future claim.

Do Patients Feel Well Informed in a Radiation Oncology Service?

Science.gov (United States)

Jimenez-Jimenez, Esther; Mateos, Pedro; Ortiz, Irene; Aymar, Neus; Vidal, Meritxell; Roncero, Raquel; Pardo, Jose; Soto, Carmen; Fuentes, Concepción; Sabater, Sebastià

2018-04-01

Information received by cancer patients has gained importance in recent decades. The aim of this study was to evaluate the perception of information received by oncological patients in a radiotherapy department and to measure the importance of the other information sources. A cross-sectional study was conducted, evaluating patients who received radiotherapy. All the patients were asked two questionnaires: the EORTC QLQ-INFO26 module evaluating their satisfaction with received information, and a questionnaire analyzing other sources of information search. One hundred patients between 27 and 84 years were enrolled. Breast cancer (26 %) was the commonest cancer. Patients felt better informed about the medical tests and secondly about the performed treatment. The younger patients were those who were more satisfied with the information received and patients with no formal education felt less satisfied, with statistically significant differences. Patients did not seek external information; at the most, they asked relatives and other people with cancer. Patients were satisfied with the received information, although a high percentage would like more information. In general, patients did not search for external information sources. Age and educational level seem to influence in the satisfaction with the received information.

Perceived need for information of patients with haematological malignancies: a literature review.

Science.gov (United States)

Rood, Janneke A J; Eeltink, Corien M; van Zuuren, Florence J; Verdonck-de Leeuw, Irma M; Huijgens, Peter C

2015-02-01

To provide insight into the perceived need for information of patients with haematological malignancies. Providing timely and accurate information to patients diagnosed with a haematological malignancy is a challenge in clinical practice; treatment often has to start promptly, with little time to inform patients. Literature review. A comprehensive literature search was conducted from all available literature to May 2013 in the databases: Cumulative Index to Nursing and Allied Health Literature, PsycINFO and PubMed (Medline). Relevant studies were reviewed regarding the perceived need for information on various topics, sources of information and satisfaction with information provided. The initial search revealed 215 articles, fourteen of which were relevant. Patients need basic information on the disease (diagnosis and diagnostics), treatment (various treatment options, side effects and duration), prognosis (curability and prolonging life) and all other topics (recovery, self-care and psychosocial functioning). Need for detailed information varied between studies. Patients expressed a higher need for medical than for psychosocial information. Patients preferred to receive information from their doctors the most, followed by nurses. Most studies described patients' satisfaction with the information provided. Based on the limited number of data available, medical information is for patients of higher priority compared to psychosocial information. Patients need basic information on diagnosis, treatment, prognosis and all other topics. Need for detailed information varied between studies. Patients were satisfied with the provided information, preferably offered by doctors and nurses. The perceived need for information and satisfaction with the information provided differs strongly between patients. In clinical practice, more attention is needed for information tailored to the patient, taking into account important moderating factors such as age, type of cancer, time

The impact of health information technology on patient safety.

Science.gov (United States)

Alotaibi, Yasser K; Federico, Frank

2017-12-01

Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety.  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient's safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

THE INFORMATION CONFIDENTIALITY AND CYBER SECURITY IN MEDICAL INSTITUTIONS

Directory of Open Access Journals (Sweden)

SABAU-POPA CLAUDIA DIANA

2015-07-01

Full Text Available The information confidentiality and cyber security risk affects the right to confidentiality and privacy of the patient, as regulated in Romania by the Law 46/2002. The manifestation of the cyber security risk event affects the reputation of the healthcare institution and is becoming more and more complex and often due to the: development of network technology, the medical equipment connected to wifi and the electronic databases. The databases containing medical records were implemented due to automation. Thus, transforming data into medical knowledge contribute to a better understanding of the disease. Due to these factors, the measures taken by the hospital management for this type of risk are adapted to the cyber changes. The hospital objectives aim: the implementation of a robust information system, the early threats identifications and the incident reporting. Neglecting this type of risk can generate financial loss, inability to continue providing health care services for a certain period of time, providing an erroneous diagnosis, medical equipment errors etc. Thus, in a digital age the appropriate risk management for the information security and cyber risk represent a necessity. The main concern of hospitals worldwide is to align with international requirements and obtain credentials in terms of data security from the International Organisation for Standardization, which regulates the management of this type of risk. Romania is at the beginning in terms of concerns regarding the management, avoidance and mitigation of information security, the health system being most highly exposed to its manifestation. The present paper examines the concerns of the health system to the confidentiality of information and cyber security risk and its management arrangements. Thus, a set of key risk indicators is implemented and monitored for 2011-2013, using a user interface, a Dashboard, which acts as an early warning system of the manifestation of the

Towards a new kind of patient information leaflet?

DEFF Research Database (Denmark)

Fage-Butler, Antoinette Mary

There is general consensus amongst patients, academics and regulatory agencies that mandatory PILs, which accompany all medication in the EU, do not communicate effectively with patients. This is problematic as patients have stated that they want to receive information on their medication; they are...... with the interactive situation (Holmström & Röing, 2010), for the medium of print. I performed such a translation by considering the affordances of print as opposed to live interaction, developing the evaluative optic of patient centeredness for texts. The dissertation takes a discursive approach, employing.......g. treatments for rheumatoid arthritis and depression) than for minor, acute, physical conditions (e.g. indigestion and bacterial eye infections). The main practical implication of this finding is that the appropriateness of including greater patient centeredness in PILs seems contingent on the nature...

Medication Adherence in Patients with Rheumatoid Arthritis: The Effect of Patient Education, Health Literacy, and Musculoskeletal Ultrasound

Directory of Open Access Journals (Sweden)

Samantha Joplin

2015-01-01

Full Text Available Background. Rheumatoid arthritis (RA is a chronic systemic inflammatory disease affecting <1% of the population. Incompletely controlled RA results in fatigue, joint and soft tissue pain, progressive joint damage, reduced quality of life, and increased cardiovascular mortality. Despite an increasing range of disease modifying agents which halt disease progression, poor patient adherence with medication is a significant barrier to management. Objective. The goal of this review was to examine the effectiveness of measures to improve patient medication adherence. Methods. Studies addressing treatment adherence in patients with RA were identified by trawling PsycINFO, Medline, Cochrane, Pubmed, and ProQuest for studies published between January 2000 and October 2014. Articles were independently reviewed to identify relevant studies. Results. Current strategies were of limited efficacy in improving patient adherence with medications used to treat RA. Conclusion. Poor medication adherence is a complex issue. Low educational levels and limited health literacy are contributory factors. Psychological models may assist in explaining medication nonadherence. Increasing patient knowledge of their disease seems sensible. Existing educational interventions appear ineffective at improving medication adherence, probably due to an overemphasis on provision of biomedical information. A novel approach to patient education using musculoskeletal ultrasound is proposed.

The patient-centered medical home neighbor: A primary care physician's view.

Science.gov (United States)

Sinsky, Christine A

2011-01-04

The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

Providing Hemostatic and Blood Conservation Options for Jehovah's Witness Patients in a Large Medical System.

Science.gov (United States)

Bai, Yu; Castillo, Brian S; Tchakarov, Amanda; Escobar, Miguel A; Cotton, Bryan A; Holcomb, John B; Brown, Robert E

2016-12-01

People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products. Included in the medical protocol is an informative handout on related details to help treating physicians and patients make informed decisions about transfusion alternatives. Together, we have entered the medical protocol into the entire Memorial Hermann Hospital's electronic system. We report the detailed development and implementation process in order to share our experience and encourage others to develop their own management plan for this patient population. © 2016 by the Association of Clinical Scientists, Inc.

Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

DEFF Research Database (Denmark)

Houben, Steven; Frost, Mads; Bardram, Jakob E

2015-01-01

explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed......The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy...

Medical and Dental Patient Issues

Science.gov (United States)

... A RadiationAnswers.org Ask the Experts Medical and Dental Patient Issues What's My Risk? The risks of ... developed by our topic editors for this category: Dental-Patient Issues Medical CT Reference Books and Articles ...

An Experimental Comparison of a Co-Design Visualizing Personal Drug Information and Patient Information Leaflets: Usability Aspects.

Science.gov (United States)

Khodambashi, Soudabeh; Haugland, Dagrun; Ellingsberg, Anette; Kottum, Hanne; Sund, Janne Kutschera; Nytrø, Øystein

2017-01-01

Providing patients with specific information about their own drugs can reduce unintentional misuse and improve compliance. Searching for information is time-consuming when information is not personalized and is written using medical vocabulary that is difficult for patients to understand. In this study we explored patient information needs regarding visualizing of drug information and interrelationships by conducting a total of four co-design workshops with patients, other users and pharmacists. We developed a prototype and drug ontology to support reasoning about drug interactions. We evaluated individual performance in finding information, understanding the drug interactions, and learning from the provided information in the prototype compared to using patient information leaflets (PILs). We concluded that interactive visualization of drug information helps individuals find information about drugs, their side effects and interactions more quickly and correctly compared to using PILs. Our study is limited to co-morbid patients with transient ischaemic attack with several chronic diseases.

Media hype: Patient and scientific perspectives on misleading medical news.

Science.gov (United States)

Robledo, Israel; Jankovic, Joseph

2017-09-01

In this age of digital technology, Internet, and social media we are increasingly subjected to an information and disinformation overload. This includes not only political and economic information but also medical news, which is often presented as a "new discovery", "miracle cure" or some other press hyperbole. In this viewpoint article we present patient and scientific perspectives some recent episodes of medical hype related to Parkinson's disease research, including proposed therapies such as nilotinib, marijuana, stem cells and other controversial therapies that have attracted the mainstream and social media. We conclude by emphasizing the importance of vigilance on the part of patients and physicians when interpreting these often exaggerated and/or unfounded health claims. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

The utilization of nonprescription medications in Saudi patients with cardiovascular diseases

Directory of Open Access Journals (Sweden)

Eman M. Shorog

2018-01-01

Full Text Available Background: Cardiovascular diseases (CVDs are the most common cause of disease-related death in Saudi Arabia. The incidence of CVDs continues to increase, presenting a major health care problem. Nonprescription medications are widely used by patients with CVD and may cause adverse drug events, either by worsening the disease or by harmfully interacting with prescribed medications. We investigated the patterns of nonprescription medication utilization and the factors associated with their use in patients with CVD. Methods: This was a cross-sectional study conducted at the Cardiology Clinics of an academic tertiary health care center. Participants were asked about their sociodemographic characteristics, medical history and frequency of using nonprescription medications including over-the-counter (OTC products, dietary supplements, and herbal products. Moreover, we investigated the participants’ sources of information about nonprescription medications. Multivariate logistic regression analysis was conducted to examine the predictors of nonprescription medication use. Results: A total of 209 participants were interviewed. The mean age of the participants was 56 ± 15 years, and 110 (52.6% were female. Of the 209 participants, 116 (55% reported routine use of nonprescription medications. Black seeds and garlic were the most frequently used herbal products. Acetaminophen, cold/cough remedies, and ibuprofen were the most commonly reported OTC drugs. Of the surveyed patients, 54 (46.5% used nonprescription medications to manage cardiovascular conditions specifically. Compared with other comorbidities, diabetes mellitus was associated with a higher use of nonprescription medications. Conclusion: In patients with CVD, the routine use of nonprescription medications was common for a number of reasons. Health care providers should proactively discuss nonprescription use with their CVD patients to avoid potential harmful outcomes. Keywords

No Third Parties. The Medical Profession Reclaims Authority in Doctor-Patient Relationships

Directory of Open Access Journals (Sweden)

Lars Thorup Larsen

2016-09-01

Full Text Available A key aspect of the classic doctor-patient relationship is the idea that doctors exert a professional authority through medical expertise while also taking care of the patient. Some professional organizations have held that “no third parties” should come between doctor and patient, be it governments or corporations. The sanctity of medical authority has also met resistance, and doctors are often said to face more demanding patients today with their own information about diagnoses. This article concerns how the medical profession reacts faced with challenged authority. Do they seek to reestablish a classic authority position or develop an alternative relationship with citizens? The analysis compares approximately 1.000 editorials in American, British and Danish medical journals from 1950 to the present. The analysis shows that all medical professions see their authority challenged by third parties, but some react defensively while others try to rethink the authority relation between professionals and citizens.

[Internet as a source of information about infertility among infertile patients].

Science.gov (United States)

Talarczyk, Joanna; Hauke, Jan; Poniewaz, Marta; Serdyńska-Szuster, Monika; Pawelczyk, Leszek; Jedrzejczak, Piotr

2012-04-01

Around one million couples in Poland suffer from infertility People in reproductive age are most active Internet users. The aim of the study was to assess Internet habits of infertile patients. We checked to what extent infertile patients seek information about infertility on-line and what is their approach to the information found. 85 female patients treated for infertility for at least one year were surveyed. The anonymous questionnaire was designed by the authors of the publication. It consisted of questions related to medical history of the patients and sources of information about infertility they used. It also checked Internet activity of the patients and contained Beck's Depression Inventory (BDI). Chi-square test and Spearman's correlation test were used to evaluate the results. The majority of patients used Internet to find information about infertility (93%); 46% of the respondent declared Internet forums to be their main source of information about it. Patients used on-line sources of information more often than stricte medical sources. Internet influenced their relation with the physician. 64% of patients verified on-line information and treatment proposed by their doctor before using them. One third of the surveyed women claimed their knowledge about infertility comes more from the Internet than the specialist who treated them. There was a positive correlation between patients who checked diagnostic or therapeutic methods proposed by their physician with depression in BDI. Considering the great impact of Internet forums and web pages on patient approach to diagnostics and treatment of infertility there seems to be a need to create a professional Polish website and forum to provide the patients with reliable information about the disease.

Patient-Reported Safety Information: A Renaissance of Pharmacovigilance?

Science.gov (United States)

Härmark, Linda; Raine, June; Leufkens, Hubert; Edwards, I Ralph; Moretti, Ugo; Sarinic, Viola Macolic; Kant, Agnes

2016-10-01

The role of patients as key contributors in pharmacovigilance was acknowledged in the new EU pharmacovigilance legislation. This contains several efforts to increase the involvement of the general public, including making patient adverse drug reaction (ADR) reporting systems mandatory. Three years have passed since the legislation was introduced and the key question is: does pharmacovigilance yet make optimal use of patient-reported safety information? Independent research has shown beyond doubt that patients make an important contribution to pharmacovigilance signal detection. Patient reports provide first-hand information about the suspected ADR and the circumstances under which it occurred, including medication errors, quality failures, and 'near misses'. Patient-reported safety information leads to a better understanding of the patient's experiences of the ADR. Patients are better at explaining the nature, personal significance and consequences of ADRs than healthcare professionals' reports on similar associations and they give more detailed information regarding quality of life including psychological effects and effects on everyday tasks. Current methods used in pharmacovigilance need to optimise use of the information reported from patients. To make the most of information from patients, the systems we use for collecting, coding and recording patient-reported information and the methodologies applied for signal detection and assessment need to be further developed, such as a patient-specific form, development of a severity grading and evolution of the database structure and the signal detection methods applied. It is time for a renaissance of pharmacovigilance.

Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study.

Science.gov (United States)

Nejašmić, Danijel; Miošić, Ivana; Vrdoljak, Davorka; Permozer Hajdarović, Snježana; Tomičić, Marion; Gmajnić, Rudika; Diminić Lisica, Ines; Sironić Hreljanović, Jelena; Pleh, Vlatka; Cerovečki, Venija; Tomljenović, Anita; Bekić, Sanja; Jerčić, Minka; Tuđa, Karla; Puljak, Livia

2017-08-31

To determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia. A cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n=496) and rural (n=482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics. Half of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician's opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P<0.001 for both). Our finding that patients consider a physician's opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary.

Evaluating the Impact of Sample Medication on Subsequent Patient Adherence.

Science.gov (United States)

Pringle, Janice L; Aldridge, Arnie; Kearney, Shannon M; Grasso, Kim; Radack, John; Hogue, Susan; Manolis, Chronis

2016-11-01

Medication nonadherence is problematic throughout health care practice. Patient nonadherence is a result of several factors, such as financial issues, confusion about the medication, or concerns about possible side effects. Efforts to improve adherence have been implemented, but new strategies are needed to ensure that patients fill their medication prescriptions and adhere to their prescribed use. To investigate whether providing patients with a free 30-day supply of medication at the point of care via a dispensing kiosk-a secure, computerized cabinet placed in the prescriber's office-that provides sample medication and educational materials had a measurable impact on adherence and health care cost. The study sample consisted of patients drawn from the electronic health records of a large health care provider who were prescribed medications to treat diabetes, hypertension, and dyslipidemia. The comparison groups included a treatment group of patients who each received a 30-day generic sample of medication and a control group of patients who did not receive a sample. The study outcome was primary medication non-adherence (PMN), defined as whether a patient filled a prescription within 90, 180, or 365 days of prescribing. Only patients receiving a prescription for the first time were considered; patients on a medication before receipt of the sample were dropped. Postprescription medication adherence (PPMA), measured as proportion of days covered (PDC) and proportion of days covered ≥ 80% (PDC80), was also examined. Propensity score methods and multivariate regression models were used to examine the outcomes and group differences. Costs to the patient before and after the prescription were also analyzed. Key informant interviews were conducted with physicians, and qualitative analyses were performed. Patients who received a 30-day generic medication sample had a higher probability of filling a first prescription within 90 days (72.2% for treatment patients vs. 37

Air medical transport of cardiac patients.

Science.gov (United States)

Essebag, Vidal; Halabi, Abdul R; Churchill-Smith, Michael; Lutchmedial, Sohrab

2003-11-01

The air medical transport of cardiac patients is a rapidly expanding practice. For various medical, social, and economic indications, patients are being flown longer distances at commercial altitudes, including international and intercontinental flights. There are data supporting the use of short-distance helicopter flights early in the course of a cardiac event for patients needing emergent transfer for percutaneous coronary intervention or aortocoronary bypass. When considering elective long-distance air medical transport of cardiac patients for social or economic reasons, it is necessary to weigh the benefits against the potential risks of flight. A few recent studies suggest that long-distance air medical transport is safe under certain circumstances. Current guidelines for air travel after myocardial infarction do not address the use of medical escorts or air ambulances equipped with intensive care facilities. Further research using larger prospective studies is needed to better define criteria for safe long-distance air medical transport of cardiac patients.

Using digital technologies to engage with medical research: views of myotonic dystrophy patients in Japan.

Science.gov (United States)

Coathup, Victoria; Teare, Harriet J A; Minari, Jusaku; Yoshizawa, Go; Kaye, Jane; Takahashi, Masanori P; Kato, Kazuto

2016-08-24

As in other countries, the traditional doctor-patient relationship in the Japanese healthcare system has often been characterised as being of a paternalistic nature. However, in recent years there has been a gradual shift towards a more participatory-patient model in Japan. With advances in technology, the possibility to use digital technologies to improve patient interactions is growing and is in line with changing attitudes in the medical profession and society within Japan and elsewhere. The implementation of an online patient engagement platform is being considered by the Myotonic Dystrophy Registry of Japan. The aim of this exploratory study was to understand patients' views and attitudes to using digital tools in patient registries and engagement with medical research in Japan, prior to implementation of the digital platform. We conducted an exploratory, cross-sectional, self-completed questionnaire with a sample of myotonic dystrophy (MD) patients attending an Open Day at Osaka University, Japan. Patients were eligible for inclusion if they were 18 years or older, and were diagnosed with MD. A total of 68 patients and family members attended the Open Day and were invited to participate in the survey. Of those, 59 % submitted a completed questionnaire (n = 40). The survey showed that the majority of patients felt that they were not receiving the information they wanted from their clinicians, which included recent medical research findings and opportunities to participate in clinical trials, and 88 % of patients indicated they would be willing to engage with digital technologies to receive relevant medical information. Patients also expressed an interest in having control over when and how they received this information, as well as being informed of how their data is used and shared with other researchers. Overall, the findings from this study suggest that there is scope to develop a digital platform to engage with patients so that they can receive

Medical terminology in online patient-patient communication: evidence of high health literacy?

Science.gov (United States)

Fage-Butler, Antoinette M; Nisbeth Jensen, Matilde

2016-06-01

Health communication research and guidelines often recommend that medical terminology be avoided when communicating with patients due to their limited understanding of medical terms. However, growing numbers of e-patients use the Internet to equip themselves with specialized biomedical knowledge that is couched in medical terms, which they then share on participatory media, such as online patient forums. Given possible discrepancies between preconceptions about the kind of language that patients can understand and the terms they may actually know and use, the purpose of this paper was to investigate medical terminology used by patients in online patient forums. Using data from online patient-patient communication where patients communicate with each other without expert moderation or intervention, we coded two data samples from two online patient forums dedicated to thyroid issues. Previous definitions of medical terms (dichotomized into technical and semi-technical) proved too rudimentary to encapsulate the types of medical terms the patients used. Therefore, using an inductive approach, we developed an analytical framework consisting of five categories of medical terms: dictionary-defined medical terms, co-text-defined medical terms, medical initialisms, medication brand names and colloquial technical terms. The patients in our data set used many medical terms from all of these categories. Our findings suggest the value of a situated, condition-specific approach to health literacy that recognizes the vertical kind of knowledge that patients with chronic diseases may have. We make cautious recommendations for clinical practice, arguing for an adaptive approach to medical terminology use with patients. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Health Information Technology: Meaningful Use and Next Steps to Improving Electronic Facilitation of Medication Adherence.

Science.gov (United States)

Bosworth, Hayden B; Zullig, Leah L; Mendys, Phil; Ho, Michael; Trygstad, Troy; Granger, Christopher; Oakes, Megan M; Granger, Bradi B

2016-03-15

The use of health information technology (HIT) may improve medication adherence, but challenges for implementation remain. The aim of this paper is to review the current state of HIT as it relates to medication adherence programs, acknowledge the potential barriers in light of current legislation, and provide recommendations to improve ongoing medication adherence strategies through the use of HIT. We describe four potential HIT barriers that may impact interoperability and subsequent medication adherence. Legislation in the United States has incentivized the use of HIT to facilitate and enhance medication adherence. The Health Information Technology for Economic and Clinical Health (HITECH) was recently adopted and establishes federal standards for the so-called "meaningful use" of certified electronic health record (EHR) technology that can directly impact medication adherence. The four persistent HIT barriers to medication adherence include (1) underdevelopment of data reciprocity across clinical, community, and home settings, limiting the capture of data necessary for clinical care; (2) inconsistent data definitions and lack of harmonization of patient-focused data standards, making existing data difficult to use for patient-centered outcomes research; (3) inability to effectively use the national drug code information from the various electronic health record and claims datasets for adherence purposes; and (4) lack of data capture for medication management interventions, such as medication management therapy (MTM) in the EHR. Potential recommendations to address these issues are discussed. To make meaningful, high quality data accessible, and subsequently improve medication adherence, these challenges will need to be addressed to fully reach the potential of HIT in impacting one of our largest public health issues.

Medical Individualism or Medical Familism? A Critical Analysis of China's New Guidelines for Informed Consent: The Basic Norms of the Documentation of the Medical Record.

Science.gov (United States)

Bian, Lin

2015-08-01

Modern Western medical individualism has had a significant impact on health care in China. This essay demonstrates the ways in which such Western-style individualism has been explicitly endorsed in China's 2010 directive: The Basic Norms of the Documentation of the Medical Record. The Norms require that the patient himself, rather than a member of his family, sign each informed consent form. This change in clinical practice indicates a shift toward medical individualism in Chinese healthcare legislation. Such individualism, however, is incompatible with the character of Chinese familism that is deeply rooted in the Chinese ethical tradition. It also contradicts family-based patterns of health care in China. Moreover, the requirement for individual informed consent is incompatible with numerous medical regulations promulgated in the past two decades. This essay argues that while Chinese medical legislation should learn from relevant Western ideas, it should not simply copy such practices by importing medical individualism into Chinese health care. Chinese healthcare policy is properly based on Chinese medical familist resources. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The 'patient's physician one-step removed': the evolving roles of medical tourism facilitators.

Science.gov (United States)

Snyder, Jeremy; Crooks, Valorie A; Adams, Krystyna; Kingsbury, Paul; Johnston, Rory

2011-09-01

Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with medical tourism, but their roles are poorly understood. 12 facilitators were interviewed from 10 Canadian medical tourism companies. Three themes were identified: facilitators' roles towards the patient, health system and medical tourism industry. Facilitators' roles towards the patient were typically described in terms of advocacy and the provision of information, but limited by facilitators' legal liability. Facilitators felt they played a positive role in the lives of their patients and the Canadian health system and served as catalysts for reform, although they noted an adversarial relationship with some Canadian physicians. Many facilitators described personally visiting medical tourism sites and forming personal relationships with surgeons abroad, but noted the need for greater regulation of their industry. Facilitators play a substantial and evolving role in the practice of medical tourism and may be entering a period of professionalisation. Because of the key role of facilitators in determining the effects of medical tourism on patients and public health, this paper recommends a planned conversation between medical tourism stakeholders to define and shape facilitators' roles.

Study of the Status of Physicians-Patient Communication among Medical Interns

Directory of Open Access Journals (Sweden)

Sa’eedeh Farajzadeh

2009-02-01

Full Text Available Background and purpose: Proper communication between a physician and a patient is the key to diagnosis and management of diseases.Communication skills are essential for gathering information from patients, enhancing patients trust on physicians, relaxing them and managing them .The main purpose of this study was to determine the states of communication skills of medical interns to communicate with patients.Method: In this cross sectional study, communication skills of 72 medical interns of Kerman Medical University was assessed based on a checklist completed with direct observation and a questionnaire completed through interview with patients.The checklist included two parts: the first part for individual characteristics and the second part for 24 specifications related to initiation of an interview, conducting an interview and completion of aninterview.Another questionnaire with a similar structure was developed to gather patients’ comments about communication of medical interns with them.Results: Communication skills of medical interns were weak in 29.3%, moderate in 85.4% and good in 15.9% of interns. An agreement between observed communication skills and patients’ survey results about greeting, asking patients’ names and calling them by their names, acceptable physicians’ appearance, listening to patients’ words, friendly doctor- patient encounter, empathizing with patients (0.37, 0.26, 0.22.0.41and 0.44 respectively was seen. Results of individual variables show that relationship between age of patient and his or her opinion about communication was significant.Based on patient’s survey, the communication score given to the student increases with age of the patient.Conclusion: The study shows deficits in doctor-patient communication of medical interns in history taking. Given the importance of communication skills, the necessity to teach them in clinical skill centers before real contact with patients is obvious

Information needs among adolescent bariatric surgery patients and their caregivers.

Science.gov (United States)

Schneider, Nicole M; Tully, Carrie B; Washington, Gia A; Price, Karin L

2016-05-01

Bariatric surgery is an invasive medical treatment for morbid obesity that requires behavioral maintenance for physical success. Patient knowledge, motivation, and adherence are important factors in optimizing results. The purpose of the present study was to identify perceived informational gaps of adolescent and young adult bariatric surgery patients with morbid obesity (body mass index≥40 kg/m(2)). This study took place in a pediatric tertiary care academic medical center. Thirty-one adolescents/young adults who had undergone Roux-en-Y gastric bypass surgery at the authors' institution were recruited to complete questionnaires at their postsurgical visits (≥3 months postsurgery). Seventeen caregivers also participated in this study. The questionnaire used in the present study prompted patients and caregivers to reflect on information they wish they had known before surgery; questionnaire items included multiple choice and open-ended questions. Participants indicated that their informational needs were generally well met before surgery, although there were more needs noted by patients than by caregivers. Adolescent/young adult participants expressed a desire to have had more information about the necessity of taking vitamins daily and about having more gas. An association between informational needs and satisfaction was also found. Qualitative data revealed the importance of conveying cognitive-behavioral aspects of surgery to families (e.g., adherence, motivation). Despite most patients and caregivers being satisfied with the adolescent bariatric surgery program at the authors' institution, informational gaps exist. Teen-friendly ways to disseminate information would be helpful in influencing patients' satisfaction. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Medication Adherence Among Elderly Patients with High Blood Pressure in Gweru, Zimbabwe.

Science.gov (United States)

Wariva, Elizabeth; January, James; Maradzika, Julita

2014-02-04

High blood pressure is a global health concern which is mainly managed by taking anti-hypertensive medications. Although medication is available to control high blood pressure, adhering to treatment is a major problem among hypertensive patients. The purpose of the study was to assess the predisposing, enabling and reinforcing factors to medication adherence among hypertensive patients in Gweru urban aged 40-70 years. A descriptive cross sectional study was used with a sample size of 110 conveniently sampled hypertensive patients. We used an interviewer administered questionnaire designed using phase 4 of the PRECEDE model. The modal age was 70 years and mean age was 58 years (SD=10.29). There were 61.8% females and 38.2% males. Variables associated with medication adherence were: age (P=0.0059), marital status (P=0.015), average monthly income (P=0.0002), support group (P=0.027) and knowledge (P=0.0058). Providing information to patients with high blood pressure and having a good patient-provider relationship improves medication adherence. There is need to focus on the predisposing, enabling and reinforcing factors of medication adherence since demographic and socio-economic factors may be more difficult to change.

Personal and social factors regarding medical non-compliance in cardiac failure patients

International Nuclear Information System (INIS)

Mujtaba, S.F.; Masood, T.; Khalid, D.

2011-01-01

Objective: To determine the frequency and association of various personal and social factors with medical non-compliance in cardiac failure patients. Study Design: Cross-sectional, observational study. Place and Duration of Study: National Institute of Cardiovascular Diseases (NICVD), Karachi from January to August 2010. Methodology: Patients admitted in the medical wards of NICVD, who were being treated for cardiac failure, were included. Information regarding basic demographics, education level, self engagement in therapy and status of compliance was obtained by questionnaire. Statistical analysis was carried out by using Fisher's exact test and chi-square. Level of significance was < 0.05. Data was analyzed using SPSS V-15. Out of 267 patients, 73 (27.3%) were compliant while 194 (72.7%) were non-compliant. Educated, self caring patient, and those who knew names of their medications were more compliant than the rest. Conclusion: Medical non-compliance is very common in heart failure patients. Illiteracy and no self engagement in therapy are associated with non-compliance. (author)

DEVELOPMENT OF CLINICAL SCENARIO’S INFORMATION MODEL IN THE MEDICAL SIMULATION CENTER

Directory of Open Access Journals (Sweden)

I. V. Tolmachyov

2014-01-01

Full Text Available There is the big issue in medical education which is students don’t have enough skills. Often even with theoretical knowledge graduate medical students need to improve their skills by working with patients. Obviously it can be a risk for patients and takes quite long time. This situation could be changed with applying simulation technologies in medical education. Medical education with virtual simulators allows reducing the time of skills development and improving the quality of training. The aims of this work are developing informational model and creating clinical scenarios of emergency states in the Medical Simulation Center.Objectives:– to analyze the process of scenario conducting;– to create clinical scenarios of emergency states (anaphylactic shock, hypovolemic shock, obstructive shock with specialist’s help.The scenarios consist of sections such as main aim, skills, required mannequins, preparation of the mannequins, preparation of medical equipment and instruments for the scenario, preparation of special materials, scenario description, guide for operator, information for trainees.By analyzing the process of scenario conducting the key participants were defined who are operator, assistant, trainer, trainees. Also the main scenario stages were defined. Based on the stages diagram of variants of scenario conducting was designed.As an example there are fragments of scenario “Obstructive shock – a pulmonary embolism” in this article. Learn skills are cognitive, technical, social ones.Results. This paper presents an analysis of the clinical scenario conducting. Information model was developed which based on object-oriented decomposition. The model is the diagram of variants of scenario conducting. Scenario’s structure for emergency states was formulated. The scenarios are anaphylactic shock, hypovolemic shock, obstructive shock (pulmonary embolism, tension pneumothorax, pulmonary edema, hypertensive crisis, respiratory

Undergraduate medical students' perceptions and intentions regarding patient safety during clinical clerkship.

Science.gov (United States)

Lee, Hoo-Yeon; Hahm, Myung-Il; Lee, Sang Gyu

2018-04-04

The purpose of this study was to examine undergraduate medical students' perceptions and intentions regarding patient safety during clinical clerkships. Cross-sectional study administered in face-to-face interviews using modified the Medical Student Safety Attitudes and Professionalism Survey (MSSAPS) from three colleges of medicine in Korea. We assessed medical students' perceptions of the cultures ('safety', 'teamwork', and 'error disclosure'), 'behavioural intentions' concerning patient safety issues and 'overall patient safety'. Confirmatory factor analysis and Spearman's correlation analyses was performed. In total, 194(91.9%) of the 211 third-year undergraduate students participated. 78% of medical students reported that the quality of care received by patients was impacted by teamwork during clinical rotations. Regarding error disclosure, positive scores ranged from 10% to 74%. Except for one question asking whether the disclosure of medical errors was an important component of patient safety (74%), the percentages of positive scores for all the other questions were below 20%. 41.2% of medical students have intention to disclose it when they saw a medical error committed by another team member. Many students had difficulty speaking up about medical errors. Error disclosure guidelines and educational efforts aimed at developing sophisticated communication skills are needed. This study may serve as a reference for other institutions planning patient safety education in their curricula. Assessing student perceptions of safety culture can provide clerkship directors and clinical service chiefs with information that enhances the educational environment and promotes patient safety.

[Optimization of information on the medication of polypharmacy patients in primary care].

Science.gov (United States)

Nicieza-García, María Luisa; Salgueiro-Vázquez, María Esther; Jimeno-Demuth, Francisco José; Manso, Gloria

2016-01-01

As part of the protocol of the Health Service of the Principality of Asturias (Spain), primary care physicians periodically receive listings of the treatments of patients of any age taking 10 or more drugs/day for 6 months. Currently, the Health Service of the Principality of Asturias is developing a project that aims to assess the medications of polypharmacy patients. The aim is to identify: 1) the consumption of medicines of low therapeutic usefulness, 2) the consumption of potentially nephrotoxic drugs in patients with a low glomerular filtration rate, and 3) potentially inappropriate prescribing in patients aged 65 years or older. The project was started in Health Area II and the aim is to extend it to the remaining health areas. In our opinion, its automation and general implementation could be useful to optimize drug prescription. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Resolving embarrassing medical conditions with online health information.

Science.gov (United States)

Redston, Sarah; de Botte, Sharon; Smith, Carl

2018-06-01

Reliance on online health information is proliferating and the Internet has the potential to revolutionize the provision of public health information. The anonymity of online health information may be particularly appealing to people seeking advice on 'embarrassing' health problems. The purpose of this study was to investigate (1) whether data generated by the embarrassingproblems.com health information site showed any temporal patterns in problem resolution, and (2) whether successful resolution of a medical problem using online information varied with the type of medical problem. We analyzed the responses of visitors to the embarrassingproblems.com website on the resolution of their problems. The dataset comprised 100,561 responses to information provided on 77 different embarrassing problems grouped into 9 classes of medical problem over an 82-month period. Data were analyzed with a Bernoulli Generalized Linear Model using Bayesian inference. We detected a statistically important interaction between embarrassing problem type and the time period in which data were collected, with an improvement in problem resolution over time for all of the classes of medical problem on the website but with a lower rate of increase in resolution for urinary health problems and medical problems associated with the mouth and face. As far as we are aware, this is the first analysis of data of this nature. Findings support the growing recognition that online health information can contribute to the resolution of embarrassing medical problems, but demonstrate that outcomes may vary with medical problem type. The results indicate that building data collection into online information provision can help to refine and focus health information for online users. Copyright © 2018 Elsevier B.V. All rights reserved.

[Informed consent process in clinical trials: Insights of researchers, patients and general practitioners].

Science.gov (United States)

Giménez, Nuria; Pedrazas, David; Redondo, Susana; Quintana, Salvador

2016-10-01

Adequate information for patients and respect for their autonomy are mandatory in research. This article examined insights of researchers, patients and general practitioners (GPs) on the informed consent process in clinical trials, and the role of the GP. A cross-sectional study using three questionnaires, informed consent reviews, medical records, and hospital discharge reports. GPs, researchers and patients involved in clinical trials. Included, 504 GPs, 108 researchers, and 71 patients. Consulting the GP was recommended in 50% of the informed consents. Participation in clinical trials was shown in 33% of the medical records and 3% of the hospital discharge reports. GPs scored 3.54 points (on a 1-10 scale) on the assessment of the information received by the principal investigator. The readability of the informed consent sheet was rated 8.03 points by researchers, and the understanding was rated 7.68 points by patients. Patient satisfaction was positively associated with more time for reflection. GPs were not satisfied with the information received on the participation of patients under their in clinical trials. Researchers were satisfied with the information they offered to patients, and were aware of the need to improve the information GPs received. Patients collaborated greatly towards biomedical research, expressed satisfaction with the overall process, and minimised the difficulties associated with participation. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Patient counseling practices in U.S. pharmacies: effects of having pharmacists hand the medication to the patient and state regulations on pharmacist counseling.

Science.gov (United States)

Kimberlin, Carole L; Jamison, Allison Newland; Linden, Stephan; Winterstein, Almut G

2011-01-01

To determine the amount and type of oral counseling given to shoppers posing as new patients with new prescriptions and to determine how state regulations, pharmacy and pharmacist characteristics, and environmental factors affect oral counseling practices. Cross-sectional, observational, correlational study. 41 states and the District of Columbia between January 28 and March 31, 2008. 365 community pharmacy staff members had interactions with shopper-patients. Shoppers presented new prescriptions in community pharmacies and recorded observations related to oral communication with pharmacy staff. Oral provision of medication information and risk information to shoppers by pharmacy staff, as well as questions asked of shoppers by pharmacy staff. Some form of oral communication related to a medication was reported in 68% of encounters. At least one informational item for either medication was provided for approximately 42% of encounters. At least one risk information item was provided in 22% of encounters. Logistic regression findings indicated that the strongest predictor of oral counseling, either providing information or asking questions, was the pharmacist being the pharmacy staff member who handed the medication to the patient, controlling for all other variables in the models. In addition, having strict state regulations specifying that pharmacists must counsel all patients receiving new prescriptions predicted whether patients received counseling. A more private area for prescription pick up also was a significant predictor. The importance of the direct encounter between the pharmacist and patient and strict state regulations mandating that pharmacists counsel patients with new prescriptions were highlighted by these findings.

A National Medical Information System for Senegal: Architecture and Services.

Science.gov (United States)

Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou

2016-01-01

In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.

Knowledge brokers, companions, and navigators: a qualitative examination of informal caregivers' roles in medical tourism.

Science.gov (United States)

Casey, Victoria; Crooks, Valorie A; Snyder, Jeremy; Turner, Leigh

2013-12-01

Many studies examining the phenomena of medical tourism have identified health equity issues associated with this global health services practice. However, there is a notable lack of attention in this existing research to the informal care provided by the friends and family members who typically accompany medical tourists abroad. To date, researchers have not examined the care roles filled by informal caregivers travelling with medical tourists. In this article, we fill this gap by examining these informal caregivers and the roles they take on towards supporting medical tourists' health and wellbeing. We conducted 21 interviews with International Patient Coordinators (IPCs) working at medical tourism hospitals across ten countries. IPCs work closely with informal caregivers as providers of non-medical personal assistance, and can therefore offer broad insight on caregiver roles. The interviews were coded and analyzed thematically. Three roles emerged: knowledge broker, companion, and navigator. As knowledge brokers, caregivers facilitate the transfer of information between the medical tourist and formal health care providers as well as other staff members at medical tourism facilities. The companion role involves providing medical tourists with physical and emotional care. Meanwhile, responsibilities associated with handling documents and coordinating often complex journeys are part of the navigation role. This is the first study to examine informal caregiving roles in medical tourism. Many of the roles identified are similar to those of conventional informal caregivers while others are specific to the transnational context. We conclude that these roles make informal caregivers an integral part of the larger phenomenon of medical tourism. We further contend that examining the roles taken on by a heretofore-unconsidered medical tourism stakeholder group sheds valuable insight into how this industry operates and that such knowledge is necessary in order to respond to

Digital multimedia books produced using iBooks Author for pre-operative surgical patient information.

Science.gov (United States)

Briggs, Matthew; Wilkinson, Caroline; Golash, Aprajay

2014-10-01

Presenting patients with medical information and ensuring informed consent can be difficult due to patients with varying levels of literacy, physical and mental disabilities and spoken languages. Patients obtaining information from external sources, such as the internet, can also be problematic as the information can be irrelevant, inaccurate or misleading. A patient satisfaction study was performed in order to assess the effectiveness of using ebooks in order to communicate pre and post surgical information to neurosurgical patients. 3 digital books were produced using iBooks Author (a free desktop publishing program designed by Apple) including ACDF (anterior cervical discectomy and fusion), lumbar laminectomy and lumbar discectomy. Each book contained written information organised into sections and chapters along with an array of multimedia elements including 3D animations, interactive diagrams, 3D models of anatomy and patient experience videos. 32 volunteer patients were then presented with the digital books via an iPad during their preoperative assessment and then asked to complete a questionnaire. The results demonstrated a demand for this type of digital presentation of medical information and also showed patients no longer felt the need to seek further information from external sources.

Patients' perceptions of their "most" and "least" important medications: a retrospective cohort study.

Science.gov (United States)

Linsky, Amy; Simon, Steven R

2012-11-02

Despite benefits of adherence, little is known about the degree to which patients will express their perceptions of medications as more or less important to take as prescribed. We determined the frequency with which Veteran patients would explicitly identify one of their medications as "most important" or "least important." We conducted a retrospective cohort study of patients from ambulatory clinics at VA Boston from April 2010-July 2011. Patients answered two questions: "Which one of your medicines, if any, do you think is the most important? (if none, please write 'none')" and "Which one of your medicines, if any, do you think is the least important? (if none, please write 'none')." We determined the prevalence of response categories for each question. Our cohort of 104 patients was predominantly male (95%), with a mean of 9 medications (SD 5.7). Regarding their most important medication, 41 patients (39%) identified one specific medication; 26 (25%) selected more than one; 21 (20%) wrote "none"; and 16 (15%) did not answer the question. For their least important medication, 31 Veterans (30%) chose one specific medication; two (2%) chose more than one; 51 (49%) wrote "none"; and 20 (19%) did not directly answer the question. Thirty-five percent of patients did not identify a most important medication, and 68% did not identify a least important medication. Better understanding of how patients prioritize medications and how best to elicit this information will improve patient-provider communication, which may in turn lead to better adherence.

Guidelines for patient information in nuclear medicine

International Nuclear Information System (INIS)

Anon.

2010-01-01

This guide for patients information in nuclear medicine is organised in the following manner: what is a medical examination in nuclear medicine, the preparation and the duration of the examination, the possible risks and the radiation doses, pregnancy, delayed menstruation and nursing and what to do after the examination. (N.C.)

[Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

Science.gov (United States)

Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

2015-06-01

The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

Health Information Exchange: What do patients want?

Science.gov (United States)

Medford-Davis, Laura N; Chang, Lawrence; Rhodes, Karin V

2017-12-01

To determine whether emergency department patients want to share their medical records across health systems through Health Information Exchange and if so, whether they prefer to sign consent or share their records automatically, 982 adult patients presenting to an emergency department participated in a questionnaire-based interview. The majority (N = 906; 92.3%) were willing to share their data in a Health Information Exchange. Half (N = 490; 49.9%) reported routinely getting healthcare outside the system and 78.6 percent reported having records in other systems. Of those who were willing to share their data in a Health Information Exchange, 54.3 percent wanted to sign consent but 90 percent of those would waive consent in the case of an emergency. Privacy and security were primary concerns of patients not willing to participate in Health Information Exchange and preferring to sign consent. Improved privacy and security protections could increase participation, and findings support consideration of "break-the-glass" provider access to Health Information Exchange records in an emergent situation.

Information, consent and treatment of patients with Morgellons disease: an ethical perspective.

Science.gov (United States)

Söderfeldt, Ylva; Groß, Dominik

2014-04-01

Morgellons is a medically contested diagnosis with foremost dermatological symptoms. Patients experience fibers emerging from the skin, together with a range of other somatic, psychiatric, and neurological complaints. Within the medical community, it is generally held to be a variation of delusional parasitosis/delusional infestation, which is usually treated with antipsychotics. Little attention has been paid in the literature to the ethical aspects of treating patients with Morgellons disease. The communicative strategies suggested in the literature display significant ethical issues, primarily the use of therapeutic privilege, i.e. withholding information from the patient. Since this limits patient autonomy, that approach is ethically problematic. Instead, the physician has an ethical obligation to respect the patient's autonomy, provide full information, and seek consent before initiating a psychiatric referral.

[Need for Information about Medical Rehabilitation of Persons with German Pension Insurance: a Written Survey].

Science.gov (United States)

Walther, Anna Lena; Falk, Johannes; Deck, Ruth

2017-07-26

Aim In order to acquire target group-specific information on rehabilitation for members of the German pension insurance, they were asked about their ideas about medical rehabilitation and desired information regarding subjects and kind of information transfer. Method The core of the project was a written survey of members of the German pension insurance. N=600 insured people were invited to participate in the study. The questionnaire was developed in a qualitative pre-study. Results N=196 questionnaires were evaluated. Recovery of working ability was mentioned by most persons as the aim of medical rehabilitation. The most common idea regarding indication for rehabilitation was a specific operation. Physiotherapy was most often considered as therapy during medical rehabilitation. Information about formal steps, realistic aims and rehabilitation clinics were important. A conversation with their physician, written information material and a website were the preferred information pathways. Two-thirds of participants thought that information about medical rehabilitation was important even though they had no rehabilitation indication at the time of survey. Conclusion The identified target-related information needs can be considered in a need-oriented development of information material. These can contribute to an informed decision for members of the German pension insurance for or against medical rehabilitation or an application for rehabilitation. Moreover, patient-oriented information can contribute to more successful rehabilitation participation, higher satisfaction with and a better rating of medical rehabilitation. © Georg Thieme Verlag KG Stuttgart · New York.

The impact of health information technology on patient safety

Directory of Open Access Journals (Sweden)

Yasser K. Alotaibi

2017-12-01

Full Text Available Since the original Institute of Medicine (IOM report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety. This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient’s safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

Science.gov (United States)

Schwei, Rebecca J; Jacobs, Elizabeth A; Wingert, Katherine; Montague, Enid

2015-07-01

Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality ( BostonMed and Hopkins ) television shows were assessed with chi-square tests. The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (ptelevision shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.

Depressed patients' preferences for education about medications by pharmacists in Kuwait.

Science.gov (United States)

Al-Saffar, Nabeel; Abdulkareem, Abdulraheem; Abdulhakeem, Alsughayer; Salah, Al-Qattan; Heba, Metwalli

2008-07-01

To assess patients' opinion toward receiving written or specialized verbal pharmacists' interventions and to determine the effect of these interventions on patients' medication knowledge. 150 newly diagnosed patients with unipolar depression and initiated with a single antidepressant were randomized into 3 groups: control, leaflet and counselling, and interviewed at initiation and after 6-8 weeks of treatment at the outpatient department of the Psychiatric Hospital in Kuwait. 50% of respondents asserted that clinicians did not give them sufficient information while 90% favoured the idea of receiving further information about therapy. Forty seven percent of participants failed to return for the second follow-up appointment. The drop-out rate was 66% in the control, 42% in the Leaflet and only 34% in the counselling groups (P=0.004). A broad support for receiving leaflets and drug counselling (97%) was found among attendees. Moreover, 94% of the counselling and 79% of the leaflets group affirmed that they received adequate information compared to 47% of the control (P=0.001). Counselling was found to be significantly associated with a much higher recall of medicine name (OR=9.6, P=0.01), how to manage missed doses (OR=8.9, P=0.007), and correct use of medication (OR=31.3, Peducational material. However, both interventions were more informative than the control in conveying elemental drug information to patients. In contrast with the lack of enthusiasm that some clinicians express, the affirmativeness that was expressed by patients towards receiving written or verbal specialized educational interventions by pharmacists may support the psychiatric hospital pharmacists' stands in providing them for all patients which may aid in improving patients compliance and probably treatment outcome.

Pharma Websites and "Professionals-Only" Information: The Implications for Patient Trust and Autonomy.

Science.gov (United States)

Graber, Mark Alan; Hershkop, Eliyakim; Graber, Rachel Ilana

2017-05-24

Access to information is critical to a patient's valid exercise of autonomy. One increasingly important source of medical information is the Internet. Individuals often turn to drug company ("pharma") websites to look for drug information. The objective of this study was to determine whether there is information on pharma websites that is embargoed: Is there information that is hidden from the patient unless she attests to being a health care provider? We discuss the implications of our findings for health care ethics. We reviewed a convenience sample of 40 pharma websites for "professionals-only" areas and determined whether access to those areas was restricted, requiring attestation that the user is a health care professional in the United States. Of the 40 websites reviewed, 38 had information that was labeled for health care professionals-only. Of these, 24 required the user to certify their status as a health care provider before they were able to access this "hidden" information. Many pharma websites include information in a "professionals-only" section. Of these, the majority require attestation that the user is a health care professional before they can access the information. This leaves patients with two bad choices: (1) not accessing the information or (2) lying about being a health care professional. Both of these outcomes are unacceptable. In the first instance, the patient's access to information is limited, potentially impairing their health and their ability to make reasonable and well-informed decisions. In the second instance, they may be induced to lie in a medical setting. "Teaching" patients to lie may have adverse consequences for the provider-patient relationship. ©Mark Alan Graber, Eliyakim Hershkop, Rachel Ilana Graber. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.05.2017.

Postoperative information needs and communication barriers of esophageal cancer patients.

Science.gov (United States)

Henselmans, Inge; Jacobs, Marc; van Berge Henegouwen, Mark I; de Haes, Hanneke C J M; Sprangers, Mirjam A G; Smets, Ellen M A

2012-07-01

Given the poor prognosis of esophageal cancer and the impact of surgery on health-related quality of life (HRQL), addressing patients' postoperative information needs is important. This study aimed to examine (1) the content and type of patients' information needs and (2) patient perceived facilitators and barriers to patient participation. Interviews were conducted with 20 purposefully selected esophageal cancer patients. Open and structured questions were alternated. The transcribed interviews were analysed inductively and deductively, using MAXqda. Patients' post-operative information needs concerned HRQL, medical care and prognosis, covering several sub-domains. Different types of needs were identified, e.g., requests for information about cause, course and self-management. Barriers to patient participation mostly reflected beliefs and skills, and could be categorized into agenda and communication barriers. Facilitators of patient participation reflected physician, patient and interaction characteristics, companion support and pre-visit preparation. Many patients saw merit in pre-visit preparation interventions; few endorsed skill-building interventions. This study listed the postoperative information needs of esophageal cancer patients. Moreover, it gained insight into patient-perceived barriers and facilitators of patient participation. The findings demonstrate what information physicians should have available and informs interventions to support patients in meeting their information needs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Medication adherence in type 2 diabetes patients: study of patients ...

African Journals Online (AJOL)

Medication adherence in type 2 diabetes patients: study of patients in ... impact of medication adherence on the clinical outcomes of type 2 diabetes patients at ... the review of case notes of one-hundred and fifty two randomly selected patients.

Information security requirements in patient-centred healthcare support systems.

Science.gov (United States)

Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

2013-01-01

Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

Information consumerism on the World Wide Web: implications for dermatologists and patients.

Science.gov (United States)

Travers, Robin L

2002-09-01

The World Wide Web (WWW) is continuing to grow exponentially both in terms of numbers of users and numbers of web pages. There is a trend toward the increasing use of the WWW for medical educational purposes, both among physicians and patients alike. The multimedia capabilities of this evolving medium are particularly relevant to visual medical specialties such as dermatology. The origins of information consumerism on the WWW are examined, and the public health issues surrounding dermatologic information and misinformation, and how consumers navigate through the WWW are reviewed. The economic realities of medical information as a "capital good," and the impact this has on dermatologic information sources on the WWW are also discussed.Finally, strategies for guiding consumers and ourselves toward credible medical information sources on the WWW are outlined.

Patient satisfaction with medical care

Directory of Open Access Journals (Sweden)

M. A. Sadovoy

2017-01-01

Full Text Available Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation 

What is known about the patient's experience of medical tourism? A scoping review

Science.gov (United States)

2010-01-01

Background Medical tourism is understood as travel abroad with the intention of obtaining non-emergency medical services. This practice is the subject of increasing interest, but little is known about its scope. Methods A comprehensive scoping review of published academic articles, media sources, and grey literature reports was performed to answer the question: what is known about the patient's experience of medical tourism? The review was accomplished in three steps: (1) identifying the question and relevant literature; (2) selecting the literature; (3) charting, collating, and summarizing the information. Overall themes were identified from this process. Results 291 sources were identified for review from the databases searched, the majority of which were media pieces (n = 176). A further 57 sources were included for review after hand searching reference lists. Of the 348 sources that were gathered, 216 were ultimately included in this scoping review. Only a small minority of sources reported on empirical studies that involved the collection of primary data (n = 5). The four themes identified via the review were: (1) decision-making (e.g., push and pull factors that operate to shape patients' decisions); (2) motivations (e.g., procedure-, cost-, and travel-based factors motivating patients to seek care abroad); (3) risks (e.g., health and travel risks); and (4) first-hand accounts (e.g., patients' experiential accounts of having gone abroad for medical care). These themes represent the most discussed issues about the patient's experience of medical tourism in the English-language academic, media, and grey literatures. Conclusions This review demonstrates the need for additional research on numerous issues, including: (1) understanding how multiple information sources are consulted and evaluated by patients before deciding upon medical tourism; (2) examining how patients understand the risks of care abroad; (3) gathering patients' prospective and retrospective

The effects of patients initiated aggression on Chinese medical students' career planning.

Science.gov (United States)

Xie, Zhonghui; Li, Jing; Chen, Yuhua; Cui, Kaijun

2017-12-28

Patient initiated aggression is common among Chinese health-care workers, reaching over 10,000 incidents annually (Jinyang web. http://6d.dxy.cn/article/55497 . 2013), and the tense doctor-patient relationship generates stress among medical students. Because of the paucity of data (few surveys pay attention to the effects of violence perpetrated by patients on medical students), this study aimed to characterize patient initiated aggression against medical students. In this cross-sectional survey conducted at a medical school in West China in 2015, 157 medical students completed a self-administered questionnaire and the Short Form-36, which assesses quality of life. The associations between patient initiated aggression exposure and medical students' career planning or quality of life were assessed using a chi-square test. Of the 157 medical students, 48 (30.6%) reported having suffered patient initiated aggression at least once during the previous year in the form of mental abuse (20.4%), offensive threat (14.6%), physical violence (8.3%), sexual harassment (verbal: 8.3% or physical: 1.6%), and extreme violence (physical violence leading to surgical treatment or hospitalization) (0.6%). Insufficient communication was the primary reason cited (27.2%). Emotional attack (mental abuse and offensive threat) occurrence differed among age groups (χ 2  = 9.786, P = 0.020) and was ubiquitous among those aged >30 years old. Women were more likely than men to suffer physical violence (χ 2  = 6.796, P = 0.009). Patient initiated aggression was not significantly associated with medical students' career planning or quality of life. In this study, patient initiated aggression, albeit common, as in the rest of China, did not appear to be associated with medical students' career planning or quality of life. However, the characteristics described can inform policymaking and the design of programs to minimize patient initiated aggression occurrence.

Evaluation of the quality of patient information to support informed shared decision-making.

Science.gov (United States)

Godolphin, W; Towle, A; McKendry, R

2001-12-01

(a) To find out how much patient information material on display in family physicians' offices refers to management choices, and hence may be useful to support informed and shared decision-making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. The source of the pamphlets and these categories: available in the physicians' offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence-based patient choice. The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with respect to the mention of choices, risks, effect of no treatment or uncertainty and reliability (source, evidence-base). Good quality

Study of Self Medication In Patients With Diabetes Using Path Analysis

Directory of Open Access Journals (Sweden)

M Rezaei

2015-01-01

Full Text Available Self-medication is a behavior in which one tries to solve his/her health condition or problem without professional help. With regard to mortality and severe complications of diabetes, inappropriate self- medication can have severe consequences but proper planning can control this behavior to improve the patient′s health. In this study, the effect of each factor on self-medication in patients with diabetes is determined using path analysis technique. This cross-sectional study was conducted in the Kermanshah diabetes center. The number of patients with diabetes interviewed were 500. Each patient′s score of self-medication were determined according to a questionnaire, with a higher score showing greater self-medication. Demographic information and scores of trust to doctors, medical expenses, others′ recommendations and busy work environment as predictor variables were measured and analyzed using SPSS 16.0. Based on the questionnaire scores, two patients (0.4% largely, 191 (38.7% moderately and 300 (60.9% slightly were on self-medication. The variable; mistrust of doctors only directly, variables; age, the duration of diabetes and family history of heart disease only indirectly and variables; busy work environment, medical expenses, others′ recommendations and family history of hypertension directly and indirectly were related to self-medication. The results of this study showed that more than 60% of patients with diabetes had low self-medication, which represents the success of education principles and methods. Extracting causal relationships among the complexity of factors influencing a disease requires powerful statistical tools such as path analysis.

Doctor-patient dialogue--basic aspect of medical consultation.

Science.gov (United States)

Murariu-Brujbu, Isabella Cristina; Macovei, Luana Andreea

2013-01-01

Family medicine is the specialty that provides ongoing primary medical care and improves the health status of the individual, of the family and of the community through preventive, educational, therapeutic and rehabilitation measures. The family doctor often makes the interdisciplinary synthesis, in a flexible manner, either alone or in most cases with interdisciplinary consultation. In the latter case, the family doctor initiates the team work and makes the final evaluation by using the longitudinal follow-up of the disease. The doctor-patient encounter represents the "confrontation" with the greatest moral weight, due to the complexity of the values involved, the status of the doctor in a society, and patient's involvement in decision making. The patient is a person who should be treated with respect, honesty, professionalism and loyalty, whatever the clinical status, severity of illness, mental competence or incompetence. A focus, on an international scale, is represented by the characteristics of a good doctor, family physician included, as the latter is the first link in the network of health services. Each model of consultation varies in a more or less subtle way in priorities assignment, and suggests slight differences regarding the role played by doctor and patient in their collaboration. The qualities of a good family physician include not only the strictly professional competences, that also apply to other medical specialties, but also duties, such as, clearly explaining to patients issues concerning their health, informing them about all the possible preventive measures of diseases, making a diagnosis, initiating and supervising a therapy. Medical responsibility lies at the crossroads between medical science and the conscience of the doctor.

Medication absorption for patients with an ileostomy.

Science.gov (United States)

Moore, Susan

The Association of Stoma Care Nurses UK (2013) has stressed that it is the role of the stoma care nurse to provide education to patients, carers, prescribers and other nurses. This includes the area of medication management. Ensuring patients with an ileostomy receive their medication in a form they can absorb is of importance to every stoma care nurse. Prescribing for patients with a stoma calls for special care. Each patient with an ileostomy requires assessment of their medication regimen for the purpose of identifying potential medical absorption issues. However, from an extensive literature search, it is evident that there is very little literature published on this subject. This article looks at the considerations to take into account when prescribing medication for ileostomy patients, and examines the results of a clinical audit on medication prescribers' knowledge of the impact of ileostomy formation on the absorption of medication.

Benefits and problems in implementation for integrated medical information system

International Nuclear Information System (INIS)

Park, Chang Seo; Kim, Kee Deog; Park, Hyok; Jeong, Ho Gul

2005-01-01

Once the decision has been made to adopt an integrated medical information system (IMIS), there are a number of tissues to overcome. Users need to be aware of the impact the change will make on end users and be prepared to address issues that arise before they become problems. The purpose of this study is to investigate the benefits and unexpected problems encountered in the implementation of IMIS and to determine a useful framework for IMIS. The Yonsei University Dental Hospital is steadily constructing an IMIS. The vendor's PACS software, Piview STAR, supports transactions between workstations that are approved to integrating the health care enterprise (IHE) with security function. It is necessary to develop an excellent framework that is good for the patient, health care provider and information system vendors, in an expert, efficient, and cost-effective manner. The problems encountered with IMIS implementation were high initial investments, delay of EMR enforcement, underdevelopment of digital radiographic appliances and software and insufficient educational training for users. The clinical environments of dental IMIS is some different from the medical situation. The best way to overcome these differences is to establish a gold standard of dental IMIS integration, which estimates the cost payback. The IHE and its technical framework are good for the patient, the health care provider and all information systems vendors.

Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain.

Science.gov (United States)

Boehnke, Kevin F; Litinas, Evangelos; Clauw, Daniel J

2016-06-01

Opioids are commonly used to treat patients with chronic pain (CP), though there is little evidence that they are effective for long term CP treatment. Previous studies reported strong associations between passage of medical cannabis laws and decrease in opioid overdose statewide. Our aim was to examine whether using medical cannabis for CP changed individual patterns of opioid use. Using an online questionnaire, we conducted a cross-sectional retrospective survey of 244 medical cannabis patients with CP who patronized a medical cannabis dispensary in Michigan between November 2013 and February 2015. Data collected included demographic information, changes in opioid use, quality of life, medication classes used, and medication side effects before and after initiation of cannabis usage. Among study participants, medical cannabis use was associated with a 64% decrease in opioid use (n = 118), decreased number and side effects of medications, and an improved quality of life (45%). This study suggests that many CP patients are essentially substituting medical cannabis for opioids and other medications for CP treatment, and finding the benefit and side effect profile of cannabis to be greater than these other classes of medications. More research is needed to validate this finding. This article suggests that using medical cannabis for CP treatment may benefit some CP patients. The reported improvement in quality of life, better side effect profile, and decreased opioid use should be confirmed by rigorous, longitudinal studies that also assess how CP patients use medical cannabis for pain management. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Adherence to drug treatment in association with how the patient perceives care and information on drugs.

Science.gov (United States)

Ulfvarson, Johanna; Bardage, Carola; Wredling, Regina A-M; von Bahr, Christer; Adami, Johanna

2007-01-01

This study was to explore concordance with drugs prescribed and the patient's self-reported drug consumption, in relation to the older patient's perceived care and information given. Lack of adherence to prescriptions may lead to therapeutic failure with risks for relapse, unnecessary suffering and increased costs. A cross-sectional study with structured interviews of 200 patients who had recently been treated in a medical ward. Patients' medical records were studied to obtain information on their current use of drugs. The data were analyzed by logistic regression, adherence being the dependent response variable. The mean age of the study group was 79 years. The number of drugs reported in the medical chart ranged from one to 17 with a mean of 6.9. The patients reported a drug consumption ranging from 0 to 24 with a mean of 7.3. When comparing the interview results with the information in the medical charts, 30% of the patients showed adherence. An association was found between adherence and self-reported health status. Patients in the non-adherent group reported a higher consumption of drugs. Patients felt that the opportunity to ask questions of either the responsible physicians or of the nurses was influential in decreasing risk. In this study, the patient's total drug consumption was considered. The study showed a large discrepancy between the drugs stated in the medical chart and patient's self-reported drug consumption. The study failed to show that perceived information or educational level had an impact on the results but implicate that the quality of information influences adherence. It is of importance to recognize patients at risk for non-adherence. Decreased health status and many drugs are the main risk factors for patients being non-adherent, and should be recognized as such.

Using the Electronic Medical Record to Enhance Physician-Nurse Communication Regarding Patients' Discharge Status.

Science.gov (United States)

Driscoll, Molly; Gurka, David

2015-01-01

The fast-paced environment of hospitals contributes to communication failures between health care providers while impacting patient care and patient flow. An effective mechanism for sharing patients' discharge information with health care team members is required to improve patient throughput. The communication of a patient's discharge plan was identified as crucial in alleviating patient flow delays at a tertiary care, academic medical center. By identifying the patients who were expected to be discharged the following day, the health care team could initiate discharge preparations in advance to improve patient care and patient flow. The patients' electronic medical record served to convey dynamic information regarding the patients' discharge status to the health care team via conditional discharge orders. Two neurosciences units piloted a conditional discharge order initiative. Conditional discharge orders were designed in the electronic medical record so that the conditions for discharge were listed in a dropdown menu. The health care team was trained on the conditional discharge order protocol, including when to write them, how to find them in the patients' electronic medical record, and what actions should be prompted by these orders. On average, 24% of the patients discharged had conditional discharge orders written the day before discharge. The average discharge time for patients with conditional discharge orders decreased by 83 minutes (0.06 day) from baseline. Qualitatively, the health care team reported improved workflows with conditional orders. The conditional discharge orders allowed physicians to communicate pending discharges electronically to the multidisciplinary team. The initiative positively impacted patient discharge times and workflows.

Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

OpenAIRE

Karen W. Geletko; Karen Myers; Naomi Brownstein; Breanna Jameson; Daniel Lopez; Alaine Sharpe; Gail R. Bellamy

2016-01-01

Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (...

REALIZATION OF INFORMED CONSENT AS ONE OF PATIENT'S RIGHTS: CURRENT SITUATION IN AZERBAIJAN.

Science.gov (United States)

Rustamova, F A; Mammadov, V G; Munir, K M

Azerbaijan is a country in which the law is based on democratic principles. The mentioned principles underlie the national health care law. Democratic values, such as respect for human rights and freedoms, human dignity, as well as universal bioethical principles that are widely implemented in the national law, create conditions for the implementation of the patient's rights. The basic law governing the doctor-patient relationship, Law on Protection of Health of Population in Azerbaijan, reflects the basic patients' rights and obligations of doctors and medical institutions. Informed consent, which is a key component of patient rights, is also reflected, however, to date, a significant drawback of the Azerbaijan medical legislation is described in the article in this field. For example, at the moment there is no single standardized informed consent form in the country's different medical institutions. Due to the absence of any legally approved standards for informed consent forms, public and private health care institutions individually develop such forms, which sometimes can differ significantly. At the moment, one of the important directions in the field of healthcare is its improvement in accordance with international standards. The research made it possible to make conclusions about the necessary measures to improve and unify the informed consent form. The authors also analyzed the main provisions of the medical law of Azerbaijan and identified the main trends of its further development.

Electronic medical records and communication with patients and other clinicians: are we talking less?

Science.gov (United States)

O'Malley, Ann S; Cohen, Genna R; Grossman, Joy M

2010-04-01

Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication--real-time, face-to-face or phone conversations--with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-work flow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.

Shared decision-making and providing information among newly diagnosed patients with hematological malignancies and their informal caregivers: Not "one-size-fits-all".

Science.gov (United States)

Rood, J A J; Nauta, I H; Witte, B I; Stam, F; van Zuuren, F J; Manenschijn, A; Huijgens, P C; Verdonck-de Leeuw, I M; Zweegman, S

2017-12-01

To optimize personalized medicine for patients with hematological malignancies (HM), we find that knowledge on patient preferences with regard to information provision and shared decision-making (SDM) is of the utmost importance. The aim of this study was to investigate the SDM preference and the satisfaction with and need for information among newly diagnosed HM patients and their informal caregivers, in relation to sociodemographic and clinical factors, cognitive coping style, and health related quality of life. Newly diagnosed patients and their caregivers were asked to complete the Hematology Information Needs Questionnaire, the Information Satisfaction Questionnaire, and the Threatening Medical Situations Inventory. Medical records were consulted to retrieve sociodemographic and clinical factors and comorbidity by means of the ACE-27. Questionnaires were completed by 138 patients and 95 caregivers. Shared decision-making was preferred by the majority of patients (75%) and caregivers (88%), especially patients treated with curative intent (OR = 2.7, P = .041), and patients (OR = 1.2, P information was related to MCCS (P = .012), and need for specific information was related to MCCS and several clinical factors. Importantly, dissatisfaction with the information they received was reported by a third of the patients and caregivers, especially patients who wanted SDM (χ 2  = 7.3, P = .007), and patients with a higher MCCS (OR = 0.94, P = .038). The majority of HM patients want to be involved in SDM, but the received information is not sufficient. Patient-tailored information is urgently needed, to improve SDM. Copyright © 2017 John Wiley & Sons, Ltd.

Introducing information technologies into medical education: activities of the AAMC.

Science.gov (United States)

Salas, A A; Anderson, M B

1997-03-01

Previous articles in this column have discussed how new information technologies are revolutionizing medical education. In this article, two staff members from the Association of American Medical College's Division of Medical Education discuss how the Association (the AAMC) is working both to support the introduction of new technologies into medical education and to facilitate dialogue on information technology and curriculum issues among AAMC constituents and staff. The authors describe six AAMC initiatives related to computing in medical education: the Medical School Objectives Project, the National Curriculum Database Project, the Information Technology and Medical Education Project, a professional development program for chief information officers, the AAMC ACCESS Data Collection and Dissemination System, and the internal Staff Interest Group on Medical Informatics and Medical Education.

Patient-centered medical homes for patients with disabilities.

Science.gov (United States)

Hernandez, Brigida; Damiani, Marco; Wang, T Arthur; Driscoll, Carolyn; Dellabella, Peter; LePera, Nicole; Mentari, Michael

2015-01-01

The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

Implications of Patient Portal Transparency in Oncology: Qualitative Interview Study on the Experiences of Patients, Oncologists, and Medical Informaticists.

Science.gov (United States)

Alpert, Jordan M; Morris, Bonny B; Thomson, Maria D; Matin, Khalid; Brown, Richard F

2018-03-26

Providing patients with unrestricted access to their electronic medical records through patient portals has impacted patient-provider communication and patients' personal health knowledge. However, little is known about how patient portals are used in oncology. The aim of this study was to understand attitudes of the portal's adoption for oncology and to identify the advantages and disadvantages of using the portal to communicate and view medical information. In-depth semistructured interviews were conducted with 60 participants: 35 patients, 13 oncologists, and 12 medical informaticists. Interviews were recorded, transcribed, and thematically analyzed to identify critical incidents and general attitudes encountered by participants. Two primary themes were discovered: (1) implementation practices influence attitudes, in which the decision-making and execution process of introducing portals throughout the hospital did not include the input of oncologists. Lack of oncologists' involvement led to a lack of knowledge about portal functionality, such as not knowing the time period when test results would be disclosed to patients; (2) perceptions of portals as communication tools varies by user type, meaning that each participant group (patients, oncologists, and medical informaticists) had varied opinions about how the portal should be used to transmit and receive information. Oncologists and medical informaticists had difficulty understanding one another's culture and communication processes in their fields, while patients had preferences for how they would like to receive communication, but it largely depended upon the type of test being disclosed. The majority of patients (54%, 19/35) who participated in this study viewed lab results or scan reports via the portal before being contacted by a clinician. Most were relatively comfortable with this manner of disclosure but still preferred face-to-face or telephone communication. Findings from this study indicate that

Risk communication and informed consent in the medical tourism industry: A thematic content analysis of canadian broker websites

Science.gov (United States)

2011-01-01

Background Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across

Risk communication and informed consent in the medical tourism industry: A thematic content analysis of canadian broker websites

Directory of Open Access Journals (Sweden)

Crooks Valorie A

2011-09-01

Full Text Available Abstract Background Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was

Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites.

Science.gov (United States)

Penney, Kali; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

2011-09-26

Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally

[P.A.I.S., a personal medical information system. A comprehensive medical knowledge base].

Science.gov (United States)

Münch, E

1994-06-01

The electronic medical knowledge data base DOPIS is a compliation of knowledge from various special fields of medicine. Using uniform nomenclature, the data are presented on demand as they would be in a book chapter. Concise updates can be performed at low cost. The primary structure of the concept is the division of medical knowledge into data banks on diagnosis, literature, medication and pharmacology, as well as so-called electronic textbooks. All data banks and electronic textbooks are connected associatively. Visual information is obtained via the image data bank connected to the diagnosis data bank and the electronic books. Moreover, DOPIS has an integrated patient findings system, as well as an image processing and archiving system with research values enabling research functions. The diagnosis and literature data banks can be modified by the user or author, or fed with their own data (a so-called Expert System Shell). For authors from special fields working on the project, an extra Medical Electronic Publishing System has been developed and made available for the electronic textbooks. The model for the knowledge data base has been developed in the field of ENT, the programme implemented and initially ENT data have been stored.

Meeting the health information needs of prostate cancer patients using personal health records.

Science.gov (United States)

Pai, H H; Lau, F; Barnett, J; Jones, S

2013-12-01

There is interest in the use of health information technology in the form of personal health record (phr) systems to support patient needs for health information, care, and decision-making, particularly for patients with distressing, chronic diseases such as prostate cancer (pca). We sought feedback from pca patients who used a phr. For 6 months, 22 pca patients in various phases of care at the BC Cancer Agency (bcca) were given access to a secure Web-based phr called provider, which they could use to view their medical records and use a set of support tools. Feedback was obtained using an end-of-study survey on usability, satisfaction, and concerns with provider. Site activity was recorded to assess usage patterns. Of the 17 patients who completed the study, 29% encountered some minor difficulties using provider. No security breaches were known to have occurred. The two most commonly accessed medical records were laboratory test results and transcribed doctor's notes. Of survey respondents, 94% were satisfied with the access to their medical records, 65% said that provider helped to answer their questions, 77% felt that their privacy and confidentiality were preserved, 65% felt that using provider helped them to communicate better with their physicians, 83% found new and useful information that they would not have received by talking to their health care providers, and 88% said that they would continue to use provider. Our results support the notion that phrs can provide cancer patients with timely access to their medical records and health information, and can assist in communication with health care providers, in knowledge generation, and in patient empowerment.

Psychodynamics in medically ill patients.

Science.gov (United States)

Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

2009-01-01

This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

Input of Psychosocial Information During Multidisciplinary Team Meetings at Medical Oncology Departments: Protocol for an Observational Study.

Science.gov (United States)

Horlait, Melissa; Van Belle, Simon; Leys, Mark

2018-02-26

Multidisciplinary team meetings (MDTMs) have become standard practice in oncology and gained the status of the key decision-making forum for cancer patient management. The current literature provides evidence that MDTMs are achieving their intended objectives but there are also indications to question the positive impact of MDTMs in oncology settings. For cancer management to be patient-centered, it is crucial that medical information as well as psychosocial aspects-such as the patients' living situation, possible family problems, patients' mental state, and patients' perceptions and values or preferences towards treatment or care-are considered and discussed during MDTMs. Previous studies demonstrate that failure to account for patients' psychosocial information has a negative impact on the implementation of the treatment recommendations formulated during MDTMs. Few empirical studies have demonstrated the predominant role of physicians during MDTMs, leading to the phenomenon that medical information is shared almost exclusively at the expense of psychosocial information. However, more in-depth insight on the underlying reasons why MDTMs fail to take into account psychosocial information of cancer patients is needed. This paper presents a research protocol for a cross-sectional observational study that will focus on exploring the barriers to considering psychosocial information during MDTMs at medical oncology departments. This protocol encompasses a cross-sectional comparative case study of MDTMs at medical oncology departments in Flanders, Belgium. MDTMs from various oncology subspecialties at inpatient medical oncology departments in multiple hospitals (academic as well as general hospitals) are compared. The observations focus on the "multidisciplinary oncology consultation" (MOC), a formally regulated and financed type of MDTM in Belgian oncology since 2003. Data are collected through nonparticipant observations of MOC-meetings. Observational data are

Information sources used by parents to learn about medications they are giving their children.

Science.gov (United States)

Holappa, Miina; Ahonen, Riitta; Vainio, Kirsti; Hämeen-Anttila, Katri

2012-01-01

Previous studies have indicated the use of medication by children to be dependent on the attitudes of knowledge of their parents; however, little is known about sources parents might use in driving medication use decisions. The aim of this study was to describe the information sources that parents use regarding their children's medication and their perceptions of the reliability of these information sources. This study is part of a cross-sectional population survey with a random sample of 6000 children younger than 12 years. The response rate of the questionnaire was 67%. Parents were asked about the use of information sources and their perception of reliability with a list of 16 information sources. The information sources that parents reported having used were physicians (72%), patient information leaflets (PILs) (67%), public or school health nurses (52%), and pharmacists (44%). Regardless of the child's age, physicians were the parents' most-used information source. Physicians were the most-used information source also when the child had at least 1 of the 4 most common long-term diseases among children in Finland (asthma, diabetes, epilepsy, and juvenile idiopathic arthritis). Parents considered physicians (50%), PILs (31%), pharmacists (27%), nurses (20%), and public or school health nurses (17%) very reliable information sources. Finnish parents seek information from health care professionals and PILs when looking for information concerning their children's medication. Furthermore, they find health care professionals and PILs to be reliable information sources. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals.

Science.gov (United States)

Meng, Runtang; Li, Jingjing; Zhang, Yunquan; Yu, Yong; Luo, Yi; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying; Yu, Chuanhua

2018-04-17

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals

Science.gov (United States)

Li, Jingjing; Yu, Yong; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying

2018-01-01

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation. PMID:29673134

User-driven health care - answering multidimensional information needs in individual patients utilizing post-EBM approaches: a conceptual model.

Science.gov (United States)

Biswas, Rakesh; Martin, Carmel M; Sturmberg, Joachim; Shanker, Ravi; Umakanth, Shashikiran; Shanker, Shiv; Kasturi, A S

2008-10-01

Evidence based on average patient data, which occupies most of our present day information databases, does not fulfil the needs of individual patient-centred health care. In spite of the unprecedented expansion in medical information we still do not have the types of information required to allow us to tailor optimal care for a given individual patient. As our current information is chiefly provided in disconnected silos, we need an information system that can seamlessly integrate different types of information to meet diverse user group needs. Groups of certain individual medical learners namely patients, medical students and health professionals share the patient's need to increasingly interact with and seek knowledge and solutions offered by others (individual medical learners) who have the lived experiences that they would benefit to access and learn from. A web-based user-driven learning solution may be a stepping-stone to address the present problem of information oversupply in medicine that mostly remains underutilized, as it doesn't meet the needs of the individual patient and health professional user. The key to its success would be to relax central control and make local trust and strategic health workers feel more engaged in the project such that it is truly user-driven.

Flexible patient information search and retrieval framework: pilot implementation

Science.gov (United States)

Erdal, Selnur; Catalyurek, Umit V.; Saltz, Joel; Kamal, Jyoti; Gurcan, Metin N.

2007-03-01

Medical centers collect and store significant amount of valuable data pertaining to patients' visit in the form of medical free-text. In addition, standardized diagnosis codes (International Classification of Diseases, Ninth Revision, Clinical Modification: ICD9-CM) related to those dictated reports are usually available. In this work, we have created a framework where image searches could be initiated through a combination of free-text reports as well as ICD9 codes. This framework enables more comprehensive search on existing large sets of patient data in a systematic way. The free text search is enriched by computer-aided inclusion of additional search terms enhanced by a thesaurus. This combination of enriched search allows users to access to a larger set of relevant results from a patient-centric PACS in a simpler way. Therefore, such framework is of particular use in tasks such as gathering images for desired patient populations, building disease models, and so on. As the motivating application of our framework, we implemented a search engine. This search engine processed two years of patient data from the OSU Medical Center's Information Warehouse and identified lung nodule location information using a combination of UMLS Meta-Thesaurus enhanced text report searches along with ICD9 code searches on patients that have been discharged. Five different queries with various ICD9 codes involving lung cancer were carried out on 172552 cases. Each search was completed under a minute on average per ICD9 code and the inclusion of UMLS thesaurus increased the number of relevant cases by 45% on average.

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities

OpenAIRE

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed u...

Medication coaching program for patients with minor stroke or TIA: a pilot study.

Science.gov (United States)

Sides, Elizabeth G; Zimmer, Louise O; Wilson, Leslie; Pan, Wenqin; Olson, Daiwai M; Peterson, Eric D; Bushnell, Cheryl

2012-07-25

Patients who are hospitalized with a first or recurrent stroke often are discharged with new medications or adjustment to the doses of pre-admission medications, which can be confusing and pose safety issues if misunderstood. The purpose of this pilot study was to assess the feasibility of medication coaching via telephone after discharge in patients with stroke. Two-arm pilot study of a medication coaching program with 30 patients (20 intervention, 10 control). Consecutive patients admitted with stroke or TIA with at least 2 medications changed between admission and discharge were included. The medication coach contacted intervention arm patients post-discharge via phone call to discuss risk factors, review medications and triage patients' questions to a stroke nurse and/or pharmacist. Intervention and control participants were contacted at 3 months for outcomes. The main outcomes were feasibility (appropriateness of script, ability to reach participants, and provide requested information) and participant evaluation of medication coaching. The median lengths of the coaching and follow-up calls with requested answers to these questions were 27 minutes and 12 minutes, respectively, and participant evaluations of the coaching were positive. The intervention participants were more likely to have seen their primary care provider than were control participants by 3 months post discharge. This medication coaching study executed early after discharge demonstrated feasibility of coaching and educating stroke patients with a trained coach. Results from our small pilot showed a possible trend towards improved appointment-keeping with primary care providers in those who received coaching.

Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.

Science.gov (United States)

Power, Tara E; Swartzman, Leora C; Robinson, John W

2011-05-01

Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Patient empowerment by increasing the understanding of medical language for lay users.

Science.gov (United States)

Topac, V; Stoicu-Tivadar, V

2013-01-01

Patient empowerment is important in order to increase the quality of medical care and the life quality of the patients. An important obstacle for empowering patients is the language barrier the lay patient encounter when accessing medical information. To design and develop a service that will help increase the understanding of medical language for lay persons. The service identifies and explains medical terminology from a given text by annotating the terms in the original text with the definition. It is based on an original terminology interpretation engine that uses a fuzzy matching dictionary. The service was implemented in two projects: a) into the server of a tele-care system (TELEASIS) with the purpose of adapting medical text assigned by medical personnel for the assisted patients. b) Into a dedicated web site that can adapt the medical language from raw text or from existing web pages. The output of the service was evaluated by a group of persons, and the results indicate that such a system can increase the understanding of medical texts. Several design decisions were driven from the evaluation, and are being considered for future development. Other tests measuring accuracy and time performance for the fuzzy terminology recognition have been performed. Test results revealed good performance for accuracy and excellent results regarding time performance. The current version of the service increases the accessibility of medical language by explaining terminology with a good accuracy, while allowing the user to easily identify errors, in order to reduce the risk of incorrect terminology recognition.

Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients.

Science.gov (United States)

Wang, Jong-Yi; Ho, Hsiao-Yun; Chen, Jen-De; Chai, Sinkuo; Tai, Chih-Jaan; Chen, Yung-Fu

2015-07-12

In this era of ubiquitous information, patient record exchange among hospitals still has technological and individual barriers including resistance to information sharing. Most research on user attitudes has been limited to one type of user or aspect. Because few analyses of attitudes toward electronic patient records (EPRs) have been conducted, understanding the attitudes among different users in multiple aspects is crucial to user acceptance. This proof-of-concept study investigated the attitudes of users toward the inter-hospital EPR exchange system implemented nationwide and focused on discrepant behavioral intentions among three user groups. The system was designed by combining a Health Level 7-based protocol, object-relational mapping, and other medical informatics techniques to ensure interoperability in realizing patient-centered practices. After implementation, three user-specific questionnaires for physicians, medical record staff, and patients were administered, with a 70 % response rate. The instrument showed favorable convergent construct validity and internal consistency reliability. Two dependent variables were applied: the attitudes toward privacy and support. Independent variables comprised personal characteristics, work characteristics, human aspects, and technology aspects. Major statistical methods included exploratory factor analysis and general linear model. The results from 379 respondents indicated that the patients highly agreed with privacy protection by their consent and support for EPRs, whereas the physicians remained conservative toward both. Medical record staff was ranked in the middle among the three groups. The three user groups demonstrated discrepant intentions toward privacy protection and support. Experience of computer use, level of concerns, usefulness of functions, and specifically, reason to use electronic medical records and number of outpatient visits were significantly associated with the perceptions. Overall, four

Danglers in Patient Information Leaflets and Technical Manuals