Behind-the-Scenes of Patient-Centered Care

Stiles, Renée A.; Deppen, Stephen A.; Figaro, M. Kathleen; Gregg, William M.; Jirjis, Jim; Rothman, Russell L.; Johnston, Philip E.; Miller, Randolph A.; Dittus, Robert S.; Speroff, Theodore

doi:10.1097/mlr.0b013e318148490c

Cited by 21 publications

(4 citation statements)

References 10 publications

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“…We identified a range of presentations by patients across the email consultations, with patients using email to consult about a wide range of issues, most commonly regarding medications and treatments. This matches the findings of other content analyses that looked at reasons for presentation using samples of email consultations [2,12,15,16,19]. Beyond content analyses, 2 studies set in the UK general practice have quantitatively examined the reasons that patients gave when leaving a web-based request for an appointment with a GP, known as an online consultation and acting as the first email in a consultation [24,25].…”

Section: Comparison With Prior Worksupporting

confidence: 64%

“…Studies have explored the content and nature of email consultations to understand whether concerns and benefits may be realized. Most previous content analyses of email consultations in primary care settings have been conducted in the United States and have found no evidence to support clinicians' worries about receiving inappropriate and excessive numbers of emails [11][12][13], patients tended to use email for clinical rather than administrative enquiries [12,14], and emails often contained one or more problems [15]; however, it should be noted that in the United States, patients pay per consultation. Emails were most likely to be requests from patients, most commonly for medications or treatments [12,16].…”

Section: Introductionmentioning

confidence: 98%

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Email Consultations Between Patients and Doctors in Primary Care: Content Analysis (Preprint)

Atherton¹,

Boylan²,

Eccles³

et al. 2020

Preprint

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BACKGROUND Increasingly, consultations in health care settings are conducted remotely using a range of communication technologies. Email allows for 2-way text-based communication, occurring asynchronously. Studies have explored the content and nature of email consultations to understand the use, structure, and function of email consultations. Most previous content analyses of email consultations in primary care settings have been conducted in North America, and these have shown that concerns and assumptions about how email consultations work have not been realized. There has not been a UK-based content analysis of email consultations. OBJECTIVE This study aims to explore and delineate the content of consultations conducted via email in English general practice by conducting a content analysis of email consultations between general practitioners (GPs) and patients. METHODS We conducted a content analysis of anonymized email consultations between GPs and patients in 2 general practices in the United Kingdom. We examined the descriptive elements of the correspondence to ascertain when the emails were sent, the number of emails in an email consultation, and the nature of the content. We used a normative approach to analyze the content of the email consultations to explore the use and function of email consultation. RESULTS We obtained 100 email consultations from 85 patients, which totaled 262 individual emails. Most email users were older than 40 years, and over half of the users were male. The email consultations were mostly short and completed in a few days. Emails were mostly sent and received during the day. The emails were mostly clinical in content rather than administrative and covered a wide range of clinical presentations. There were 3 key themes to the use and function of the email consultations: the role of the GP and email consultation, the transactional nature of an email consultation, and the operationalization of an email consultation. CONCLUSIONS Most cases where emails are used to have a consultation with a patient in general practice have a shorter consultation, are clinical in nature, and are resolved quickly. GPs approach email consultations using key elements similar to that of the face-to-face consultation; however, using email consultations has the potential to alter the role of the GP, leading them to engage in more administrative tasks than usual. Email consultations were not a replacement for face-to-face consultations.

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Section: Comparison With Prior Worksupporting

confidence: 64%

Section: Introductionmentioning

confidence: 98%

Email Consultations Between Patients and Doctors in Primary Care: Content Analysis (Preprint)

Atherton¹,

Boylan²,

Eccles³

et al. 2020

Preprint

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“…Email's use in urgent situations may compromise patient safety (Stiles 2007). If email is relied on for communication, then important issues and deadlines are easily overlooked as email messages may not be read immediately on receipt, or at all, and are easily deleted.…”

Section: Challenges: the Trouble With Emailmentioning

confidence: 99%

Email in healthcare: pros, cons and efficient use

Ginn

2024

BJPsych advances

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SUMMARY Email is a major means of communication in healthcare and it facilitates the fast delivery of messages and information. But email's ubiquity has brought challenges. It has changed the way we get things done, and working days can be dictated by the receipt and reply of multiple email messages, which drown out other priorities. This article examines email's advantages and disadvantages and, with a focus on healthcare professionals, examines what individuals and organisations can do to ensure email works for us, rather than – as can seem the case – the other way around.

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“…[13] Ideally, the EMR also should include and integrate not merely the data from face to face visits, but also patient concerns as expressed in electronic messages that may have been sent between visits. [14]…”

Section: Use Of the Electronic Medical Record To Target Health Screeningmentioning

confidence: 99%

The electronic medical record and patient-centered care

Nusbaum¹

2011

OJPHI

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Background:One goal in EMR development should be to facilitate a patient-centered clinical encounter. Much prior EMR development has focused on capturing objective data, such as laboratory values and medication lists. Less attention has been devoted to the more complex task of capturing and analyzing data that incorporates the patient’s concerns and preferences.Methods:A literature search supplemented the author’s own various experiences with one EMR (that used nationally by the Department of Veterans Affairs) from his various perspectives of a physician, an educator, and a Chief of Staff. This data was used to identify both opportunities and obstacles to promoting patient-centered care in an integrated care setting that relies heavily on an EMR. Qualitative analysis and suggestions are offered for how the EMR can individualize patient care, in support of a patient-centered approach.Result:Three promising target areas in efforts to develop a patient-centered EMR are: elicitation of the chief complaint, conduct of health screening activities, and evaluation of health literacy. A range of strategies were identified, some of which may require information technology development, such as to facilitate patient direct entry of data into their own EMR.Conclusion:EMR design can facilitate a more patient-centered clinical encounter. Beyond the benefits to the individual patient, patient-centric modifications to the EMR architecture may also facilitate quality improvement and research activities on patient centered care. In light of the widespread current discussions of a movement toward Accountable Care Organizations that use EMR, it will be especially important to ensure that the resulting care systems maintain a focus on the patient and not just on the system of care.

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Behind-the-Scenes of Patient-Centered Care

Abstract: Systematic content analysis of provider and staff electronic messages yields specific insight regarding clinical and administrative work carried out via electronic messaging.

Cited by 21 publications

References 10 publications

Email Consultations Between Patients and Doctors in Primary Care: Content Analysis (Preprint)

Email Consultations Between Patients and Doctors in Primary Care: Content Analysis (Preprint)

Email in healthcare: pros, cons and efficient use

The electronic medical record and patient-centered care

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