Evaluation of computer-based medical histories taken by patients at home

Slack, Warner V.; Kowaloff, Hollis B.; Davis, Roger B.; Delbanco, Thomas L.; Locke, Steven E.; Safran, Charles; Bleich, Howard L.

doi:10.1136/amiajnl-2011-000580

Cited by 27 publications

(25 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, these were mainly reported before the timeframe of our review, suggesting a loss of research interest for unclear reasons 35. Several recent studies have examined automated patient interviewing in specialised settings including home,36 emergency department waiting rooms37 38 and online visits in primary care 39. One study found that physician-acquired history and computer-based systems each elicited important information that the other missed,40 reaffirming the role of technology in complementing rather than replacing the physician-acquired history.…”

Section: Resultsmentioning

confidence: 97%

Use of health information technology to reduce diagnostic errors

2013

View full text Add to dashboard Cite

BackgroundHealth information technology (HIT) systems have the potential to reduce delayed, missed or incorrect diagnoses. We describe and classify the current state of diagnostic HIT and identify future research directions.Methods A multi-pronged literature search was conducted using PubMed, Web of Science, backwards and forwards reference searches and contributions from domain experts. We included HIT systems evaluated in clinical and experimental settings as well as previous reviews, and excluded radiology computer-aided diagnosis, monitor alerts and alarms, and studies focused on disease staging and prognosis. Articles were organised within a conceptual framework of the diagnostic process and areas requiring further investigation were identified.ResultsHIT approaches, tools and algorithms were identified and organised into 10 categories related to those assisting: (1) information gathering; (2) information organisation and display; (3) differential diagnosis generation; (4) weighing of diagnoses; (5) generation of diagnostic plan; (6) access to diagnostic reference information; (7) facilitating follow-up; (8) screening for early detection in asymptomatic patients; (9) collaborative diagnosis; and (10) facilitating diagnostic feedback to clinicians. We found many studies characterising potential interventions, but relatively few evaluating the interventions in actual clinical settings and even fewer demonstrating clinical impact.ConclusionsDiagnostic HIT research is still in its early stages with few demonstrations of measurable clinical impact. Future efforts need to focus on: (1) improving methods and criteria for measurement of the diagnostic process using electronic data; (2) better usability and interfaces in electronic health records; (3) more meaningful incorporation of evidence-based diagnostic protocols within clinical workflows; and (4) systematic feedback of diagnostic performance.

show abstract

Section: Resultsmentioning

confidence: 97%

Use of health information technology to reduce diagnostic errors

2013

View full text Add to dashboard Cite

show abstract

“…25 26 Secure electronic patient portals offer the opportunity to improve patient education, 27 28 the management of chronic conditions 29 30 and efficiency of care 31 by shifting care from a prime focus in the doctor's office towards more integrated perspectives that include patients' daily lives, homes, caregivers and families. [32][33][34][35] Transparent hospital records may promote more information sharing in clinician-patient communication. 36 37 Overall, information gaps may be narrowed, thereby facilitating better continuity and integration of care.…”

Section: Introductionmentioning

confidence: 99%

Engaging patients through open notes: an evaluation using mixed methods

et al. 2016

Self Cite

View full text Add to dashboard Cite

Objectives(A) To gain insights into the experiences of patients invited to view their doctors’ visit notes, with a focus on those who review multiple notes; (B) to examine the relationships among fully transparent electronic medical records and quality of care, the patient-doctor relationship, patient engagement, self-care, self-management skills and clinical outcomes.DesignMixed methods qualitative study: analyses of survey data, including content analysis of free-text answers, and quantitative-descriptive measures combined with semistructured individual interviews, patient activation measures, and member checks.SettingGreater Boston, USA.ParticipantsPatients cared for by primary care physicians (PCPs) at the Beth Israel Deaconess Medical Center who had electronic access to their PCP visit notes. Among those submitting surveys, 576 free-text answers were identified and analysed (414 from female patients, 162 from male patients; 23–88 years). In addition, 13 patients (9 female, 4 male; 58–87 years) were interviewed.ResultsPatient experiences indicate improved understanding (of health information), better relationships (with doctors), better quality (adherence and compliance; keeping track) and improved self-care (patient-centredness, empowerment). Patients want more doctors to offer access to their notes, and some wish to contribute to their generation. Those patients with repeated experience reviewing notes express fewer concerns and more perceived benefits.ConclusionsAs the use of fully transparent medical records spreads, it is important to gain a deeper understanding of possible benefits or harms, and to characterise target populations that may require varying modes of delivery. Patient desires for expansion of this practice extend to specialty care and settings beyond the physician's office. Patients are also interested in becoming involved actively in the generation of their medical records. The OpenNotes movement may increase patient activation and engagement in important ways.

show abstract

“…These initiatives could also draw from emerging work on patient portals (e.g. PatientSite) linked to EMR systems [ 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

Computer-assisted client assessment survey for mental health: patient and health provider perspectives

Ferrari

Ahmad

Shakya

et al. 2016

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThe worldwide rise in common mental disorders (CMDs) is posing challenges in the provision of and access to care, particularly for immigrant, refugee and racialized groups from low-income backgrounds. eHealth tools, such as the Interactive Computer-Assisted Client Assessment Survey (iCCAS) may reduce some barriers to access. iCCAS is a tablet-based, touch-screen self-assessment completed by clients while waiting to see their family physician (FP) or nurse practitioner (NP). In an academic-community initiative, iCCAS was made available in English and Spanish at a Community Health Centre in Toronto through a mixed-method trial.MethodsThis paper reports the perspectives of clients in the iCCAS group (n = 74) collected through an exit survey, and the perspectives of 9 providers (four FP and five NP) gathered through qualitative interviews. Client acceptance of the tool was assessed for cognitive and technical dimensions of their experience. They rated twelve items for perceived Benefits and Barriers and four questions for the technical quality.ResultsMost clients reported that the iCCAS completion time was acceptable (94.5 %), the touch-screen was easy to use (97.3 %), and the instructions (93.2 %) and questions (94.6 %) were clear. Clients endorsed the tool’s Benefits, but were unsure about Barriers to information privacy and provider interaction (mean 4.1, 2.6 and 2.8, respectively on a five-point scale). Qualitative analysis of the provider interviews identified five themes: challenges in Assessing Mental Health Services, such as case complexity, time, language and stigma; the Tool’s Benefits, including non-intrusive prompting of clients to discuss mental health, and facilitation of providers’ assessment and care plans; the Tool’s Integration into everyday practice; Challenges for Use (e.g. time); and Promoting Integration Effectively, centered on the timing of screening, setting readiness, language diversity, and technological advances.ConclusionsParticipant clients and providers perceived iCCAS as an easy and useful tool for mental health assessments at the Community Health Centre and similar settings. The findings are anticipated to inform further work in this area.Trial registrationClinicalTrials.gov; NCT02023957; Registered retrospectively 12 Dec. 2013

show abstract

Evaluation of computer-based medical histories taken by patients at home

Cited by 27 publications

References 21 publications

Use of health information technology to reduce diagnostic errors

Use of health information technology to reduce diagnostic errors

Engaging patients through open notes: an evaluation using mixed methods

Computer-assisted client assessment survey for mental health: patient and health provider perspectives

Contact Info

Product

Resources

About