Enabling Guidelines for the Adoption of eHealth Solutions: Scoping Review

Støme, Linn Nathalie; Wilhelmsen, Christian Ringnes; Kværner, Kari J.

doi:10.2196/21357

Cited by 20 publications

(17 citation statements)

References 63 publications

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“…The increased use of e-logbooks in LICs requires both technical competence and availability of technology, which have been identified as important barriers to the implementation of eHealth innovations [ 8 ]. Study participants described both of these barriers during the semi-structured interviews, and addressing these challenges might be crucial for a successful implementation.…”

Section: Discussionmentioning

confidence: 99%

“…Although there are challenges in implementing an eHealth solution in a low-resource setting, this does not justify inaction. Digitalization is considered to be a driving force to improve access to surgical care and reduce health care inequality globally [ 8 , 18 ]. It has the potential to increase workforce capacity, as technology automates work that was previously required to be performed by people [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Evaluating the e-logbook system at an early stage can be seen as a strength of the study. The insight gained from the assessment of eHealth solutions still under development can contribute to promoting user-friendliness and secure data management, leading to a successful implementation of the innovation [ 8 ]. In addition, the combination of qualitative and quantitative data enabled a fuller picture to be formed based on the available data.…”

Section: Discussionmentioning

confidence: 99%

“…Electronic (e-) logbooks are an established practice in high-income countries [ 3 – 5 ] and are increasingly applied in low-income countries (LICs) [ 6 , 7 ]. However, there is limited documentation on the quality of surgical e-logbooks in LICs, especially in the early phase of implementation [ 8 ]. An early evaluation of eHealth solutions facilitates guidance and adjustment of further implementation and has been described as essential to increase the likelihood of successful adoption [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

et al. 2021

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Background Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. Methods Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. Results A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. Conclusions A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

et al. 2021

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“…These applications were primarily focused on diagnosis, prevention, and public health [ 3 ]. However, the COVID-19 pandemic prompted widespread emergency adoption of virtual care models that were haphazardly implemented, with the primary aim of reducing infection risk but also conserving resources including personal protective equipment [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Empowering Patients Through Virtual Care Delivery: Qualitative Study With Micropractice Clinic Patients and Health Care Providers

Burton¹,

Rush²,

Smith³

et al. 2022

JMIR Form Res

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Background Prior to the wider adoption of digital health technologies during the COVID-19 pandemic, applications of virtual care were largely limited to specialist visits and remote care using telehealth (phone or video) applications. Data sharing approaches using tethered patient portals were mostly built around hospitals and larger care systems. These portals offer opportunities for improved communication, but despite a belief that care has improved, they have so far shown few outcome improvements beyond medication adherence. Less is known about use of virtual care and related tools in the outpatient context and particularly in rural community contexts. Objective This study aims to reflect on the opportunities and barriers for sustainable virtual care through an example of a digitally enabled rural micropractice, which has provided 10%-15% virtual care since 2016 and 70% virtual care since March 2020. Methods Three focus groups, 1 with providers (physician and medical office manager) and 2 with a total of 8 patients from a rural micropractice in British Columbia, were conducted in November 2020 and December 2020. Virtual care delivery was explored through the topics of communication approach, mixing virtual and in-person care, the practice team’s journey in developing these approaches, and provider and patient satisfaction with the care model. Interviews were transcribed, checked for accuracy against recordings, and thematically analyzed. Results Both patients and providers reported ease of communication and high satisfaction. Either could initiate communication, and patients found the ability to share health information asynchronously through the portal allowed time to reflect and prepare their thoughts. Patients were highly engaged and reported feeling empowered and true partners in their health care, although they noted limited care coordination with specialists. The mix of virtual and in-person visits was highly regarded by patients and providers, and patients reported feeling safe and cared for 24/7, although both expressed concern about work spilling into the provider’s home life. The physician worried about missed diagnoses with virtual care. With respect to establishing the micropractice, solutions took about 5 years to optimize, with providers noting a learning curve requiring technical support for both themselves and their patients and a willingness to respond to patient feedback to identify the best solutions. Despite a mature virtual practice, patients reported deferred care due to COVID-19. Conclusions The micropractice’s hybrid care model encouraged patients to be true partners in their care and resulted in high patient engagement and satisfaction; yet, success may rely on the patient population being willing to engage and being comfortable with technology. Barriers lie in gaps in care coordination and provider fear that signs or symptoms more evident with an in-person exam could be missed. Even in this setting, deferral of care in light of COVID-19 was present, and opportunities to address care gaps should be sought.

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Surgical education in the post-COVID era: an EAES DELPHI-study

et al. 2022

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Backgrounds To date, it is unclear what the educational response to the restrictions on minimally invasive surgery imposed by the COVID-19 pandemic have been, and how MIS-surgeons see the post-pandemic future of surgical education. Using a modified Delphi-methodology, this study aims to assess the effects of COVID on MIS-training and to develop a consensus on the educational response to the pandemic. Methods A three-part Delphi study was performed among the membership of the European Association of Endoscopic Surgery (EAES). The first survey aimed to survey participants on the educational response in four educational components: training in the operating room (OR), wet lab and dry lab training, assessment and accreditation, and use of digital resources. The second and third survey aimed to formulate and achieve consensus on statements on, and resources in, response to the pandemic and in post-pandemic MIS surgery. Results Over 247 EAES members participated in the three rounds of this Delphi survey. MIS-training decreased by 35.6–55.6%, alternatives were introduced in 14.7–32.2% of respondents, and these alternatives compensated for 32.2–43.2% of missed training. OR-training and assessments were most often affected due to the cancellation of elective cases (80.7%, and 73.8% affected, respectively). Consensus was achieved on 13 statements. Although digital resources were deemed valuable alternatives for OR-training and skills assessments, face-to-face resources were preferred. Videos and hands-on training–wet labs, dry labs, and virtual reality (VR) simulation–were the best appreciated resources. Conclusions COVID-19 has severely affected surgical training opportunities for minimally invasive surgery. Face-to-face training remains the preferred training method, although digital and remote training resources are believed to be valuable additions to the training palette. Organizations such as the EAES are encouraged to support surgical educators in implementing these resources. Insights from this Delphi can guide (inter)national governing training bodies and hospitals in shaping surgical resident curricula in post pandemic times.

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Enabling Guidelines for the Adoption of eHealth Solutions: Scoping Review

Cited by 20 publications

References 63 publications

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

Empowering Patients Through Virtual Care Delivery: Qualitative Study With Micropractice Clinic Patients and Health Care Providers

Surgical education in the post-COVID era: an EAES DELPHI-study

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