Abstract The US Department of Veterans Affairs (VA) is using an automated short message service application named “Annie” as part of its coronavirus disease 2019 (COVID-19) response with a protocol for coronavirus precautions, which can help the veteran monitor symptoms and can advise the veteran when to contact his or her VA care team or a nurse triage line. We surveyed 1134 veterans on their use of the Annie application and coronavirus precautions protocol. Survey results support what is likely a substantial resource savings for the VA, as well as non-VA community healthcare. Moreover, the majority of veterans reported at least 1 positive sentiment (felt more connected to VA, confident, or educated and/or felt less anxious) by receiving the protocol messages. The findings from this study have implications for other healthcare systems to help manage a patient population during the coronavirus pandemic.

Background The introduction of the electronic health record (EHR) has had a significant impact on provider–patient interactions, particularly revolving around patient-centeredness. More research is needed to understand the provider perspective of this interaction. Objectives Our objective was to obtain provider feedback on a new exam room design compared with the one already in use with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning. An additional objective was to understand elements of exam room design and computing that were highly valued. Methods Semistructured interviews were conducted with 28 providers from several health care organizations. Interviews were audio recorded and transcribed for analysis. We used an inductive coding approach to abstract recurrent themes from the data. Results Our analysis revealed several themes organized around exam room layout, exam room computing, and provider workflow. We report frequency of occurrence of the coded data for computer accessories, computing usefulness, computer mobility, documentation habits, form factor, layout preference, patient interaction, screen sharing, and work habits. Conclusion Providers in our study preferred exam room design to promote flexibility, mobility, and body orientation directed toward the patient. Providers also expressed the need for exam room design to support varying work habits and preferences, including whether to share the computer screen or not.

Provider burnout has reached epidemic levels, especially with primary care-oriented specialties such as Family Medicine. Guided by a sociotechnical systems perspective, we investigated contributing burnout factors that relate to the electronic health record (EHR) and clinical workflow in an academic healthcare institution. We conducted semi-structured interviews with 10 family medicine and geriatrics providers and administered EHR usability and workflow integration surveys. Findings are organized around recurrent, overarching themes: (1) Clinic Workflow, (2) Documentation, (3) EHR Workflow and Usability, (4) Patient Complexity, (5) Staffing, and (6) Technical Issues. The most consistent finding across all provider interviews was poor EHR usability as a contributing factor to burnout; especially the number of clicks needed to complete EHR tasks. This finding is supported by low usability and workflow integration survey ratings. Using a sociotechnical systems framework, we demonstrate social, technological, and environmental contributors to burnout and discuss potential interventions to mitigate these contributing factors.

Training can be expensive, dangerous, or impractical for certain situations. Virtual reality (VR) technology could be utilized to reduce the negative aspects of real-life training and the consequences incurred from inadequate training. However, for VR to be an effective training method, it must reflect reality to a certain extent. We measured task performance and situation awareness for parking situations with 15 participants in a real-world environment, and in a virtual environment using a VR headset and a flat screen computer monitor separately. Results revealed no significant difference in driver situation awareness between the reality, VR, and flat screen conditions. Performance in terms of task time was significantly less with the reality condition compared to the others. Therefore, the VR device was not equivalent to the real-world environment for training purposes. We discuss ways in which improvements to the VR training condition may increase the effectiveness of VR-based training.

While there is an extensive and established history of research that demonstrates the unfortunate capacity of exam room computing and electronic health records (EHRs) to negatively impact provider-patient communication and interaction, recent trends in exam room computing are promising in that there may be an opportunity for the EHR to improve patient engagement. The logical evolution of this research is to flip the narrative to understand strategies for using exam room computing as a mediator or facilitator of provider-patient communication and interaction, rather than simply establishing ways to mitigate the documented barriers. Panelists will present and discuss their latest research and experiences that may contribute to the evolution of using exam room computing as a tool to enhance provider-patient communication and interaction. We will also discuss how a thoughtful exam room design with patient-centered exam room computing technologies and practices may positively impact specific human factors, safety, and bias outcomes.