Implementing a digital communication assistance tool to collect the medical history of refugee patients: DICTUM Friedland - an action-oriented mixed methods study protocol

Furaijat, Ghefar; Kleinert, Evelyn; Simmenroth, Anne; Müller, Frank

doi:10.1186/s12913-019-3928-1

Cited by 29 publications

(25 citation statements)

References 31 publications

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“…After preliminary testing with foreign-language colleagues, a three-week testing phase was supported by intensive field observation and technical backup in an initial reception facility for refugees. More details about the implementation process and test field are available in the Furaijat [16]. This study received approval from the Medical Ethics Committee of the University Medical Center Göttingen (Ethics Approval No.…”

Section: Methodsmentioning

confidence: 99%

“…This can foster miscommunication between the physician and patient and contribute to an incomplete list of symptoms, ultimately leading to poor quality of care [12]. Although there are several tools to address this problem, including multilingual symptom reporting questionnaires, limited efforts have been made to develop digital tools for multilingual or intercultural settings [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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A Digital Communication Assistance Tool (DCAT) to Obtain Medical History from Foreign-Language Patients: Development and Pilot Testing in a Primary Health Care Center for Refugees

Müller

Chandra

Furaijat

et al. 2020

IJERPH

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Background: Language barriers play a critical role in the treatment of migrant and refugee patients. In Germany, primary care interpreters are often not available especially in rural areas or if patients demand spontaneous or urgent consultations. Methods: In order to enable patients and their physicians to communicate effectively about the current illness history, we developed a digital communication assistance tool (DCAT) for 19 different languages and dialects. This paper reports the multidisciplinary process of the conceptual design and the iterative development of this cross-cultural user-centered application in an action-oriented approach. Results: We piloted our app with 36 refugee patients prior to a clinical study and used the results for further development. The acceptance and usability of the app by patients was high. Conclusion: Using digital tools for overcoming language barriers can be a feasible approach when providing health care to foreign-language patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Digital Communication Assistance Tool (DCAT) to Obtain Medical History from Foreign-Language Patients: Development and Pilot Testing in a Primary Health Care Center for Refugees

Müller

Chandra

Furaijat

et al. 2020

IJERPH

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“…Design: overall study approach and study type Phase I followed an action-oriented approach 10 which involved close collaboration between researchers and HCPs. Modifications suggested by users that could be implemented within the project timeframe were then used to develop a V2 prototype, and at a switch-over point, the V1 tool was replaced by the V2 tool, which was then fixed and remained unchanged during Phase II.…”

Section: Methodsmentioning

confidence: 99%

“…Our hypothesis was that some of the rapport, communication, documentation and time pressures in the crowded ED could be alleviated by the use by patients of a modified digital symptom assessment tool in the waiting room with transfer (handover) of a symptom assessment report to the HCPs in the ED. This pilot study was based on the approach of Furaijat et al 10 , in which the quality improvement delivered by a prototype patient facing system was assessed in two study stages. Phase I, the action-oriented phase, included the initial implementation of the patient- and HCP-tools (version V1), and their evaluation by all users.…”

Section: Introductionmentioning

confidence: 99%

Improving emergency department patient-doctor conversation through an artificial intelligence symptom taking tool: an action-oriented design pilot study

Scheder-Bieschin

Bluemke²,

Buijzer³

et al. 2020

Preprint

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IMPORTANCECommunication between patients and healthcare professionals is frequently challenging in the crowded emergency department (ED), with few opportunities to develop rapport or empathy. Digital tools for patients and physicians have been proposed as helpful but their utility is not established.OBJECTIVETo evaluate a patient-facing digital symptom and history taking, as well as handover tool in the waiting room.DESIGNA two-phase, questionnaire-based quality improvement study. Phase I observations guided iterative improvement, which was then further evaluated in Phase II.SETTINGED of a German tertiary referral and major trauma hospital providing interdisciplinary treatment for an average of 120 patients daily.PARTICIPANTSAll patients who were willing/able to provide consent, excluding patients: (i) with severe injury/illness requiring immediate treatment; (ii) with traumatic injury; (iii) incapable of completing a health assessment; or, (iv) under 18 years old. Of 1699 patients presenting to the ED, 815 were eligible based on triage level. With available recruitment staff, 135 were approached, of whom 81 were included in the study.INTERVENTION/OBSERVATIONPatients entered information into the tool, which generated a handover report to be accessed via a clinician dashboard. All users completed evaluation questionnaires. Clinicians were trained to observationally assess the tool as a prototype, without relying upon it for clinical care.MAIN OUTCOMES AND MEASURESPatient and clinician Likert scale ratings of tool performance.RESULTSRespondents were strongly positive in endorsing the tool’s usefulness in facilitating conversation (75% of patients, 73% physicians, 100% nurses). Nurses judged the tool as potentially time saving, whilst physicians assessed it as time saving only in some ED medical specialisms (e.g. Surgery). Patients understood the tool questions and reported high usability. The proportion of patients, physicians and nurses who would recommend the tool was 78%, 53% and 76%.CONCLUSIONS AND RELEVANCEThe system has clear potential to improve patient-HCP interaction and make efficiency savings in the ED. Future research and development will extend the range of patients for which the history collection has clinical utility.Key PointsQuestionCan a patient-facing digital symptom and clinical history taking tool provide conversational support, aid in symptom taking, facilitate record keeping, and lead to improved rapport between patients, physicians and nurses in the emergency department (ED)?FindingsAcceptability was high, with improved rapport experienced 90% of the time for patients, 73% for physicians and 100% for nurses. Nurses assessed the tool as having workflow benefit through potential time saving. Physicians assessed the current tool design as providing time saving in certain ED medical specialisms including Surgery.MeaningThe patient-facing tool for symptom and history taking provided meaningful conversation support and showed potential for efficiency savings, however, further research and testing is required before time savings can be consistently delivered to ED clinicians across the range of relevant ED medical specialisms.

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“…Advancements in electronic Health (eHealth) services to promote health, participation, and communication have been made in recent years [ 1 - 4 ]. These are in the form of mobile health technology (mobile devices) [ 5 ], and the majority are aimed at adults and adolescents [ 6 , 7 ], while the range of eHealth advancements for younger children is limited [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study

Gilljam¹,

Nygren²,

Svedberg³

et al. 2020

J Med Internet Res

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Background For children 6-12 years old, there is a shortage of electronic Health (eHealth) services that promote their participation in health care. Therefore, a digital communication tool, called Sisom, was developed to give children a voice in their health care. Children with long-term diseases want to be more involved in their health care and have the right to receive information, be listened to, express their opinions, and participate in decision making in health care. However, the outcomes of using Sisom in practice at pediatric oncology clinics have not been investigated. Objective The aim of this study was to investigate children’s participation during appointments with pediatricians at pediatric oncology clinics, with or without the use of the eHealth service Sisom. Methods A quasiexperimental design with mixed methods was used. We analyzed 27 filmed appointments with pediatricians for 14 children (8 girls and 6 boys) aged 6-12 years (mean 8.3 years) with a cancer diagnosis. The intervention group consisted of children who used Sisom prior to their appointments with pediatricians at a pediatric oncology clinic, and the control group consisted of children who had appointments with pediatricians at 4 pediatric oncology clinics. Data from observations from the videos were quantitatively and qualitatively analyzed. The quantitative analysis included manual calculations of how many times the pediatricians spoke directly to the children, the proportion of the appointment time that the children were talking, and levels of participation by the children. For the qualitative analysis, we used directed content analysis to analyze the children’s levels of participation guided by a framework based on Shier’s model of participation. Results Pediatricians directed a greater proportion of their discussion toward the child in the intervention group (731 occasions) than in the control group (624 occasions), but the proportion of the appointment time the children talked was almost the same for both the intervention and control groups (mean 17.0 minutes vs 17.6 minutes). The levels of participation corresponded to the first three levels of Shier’s participation model: children were listened to, children were supported to express their views, and children’s views were taken into account. The results showed an increased level of participation by the children in the intervention group. Several codes that were found did not fit into any of the existing categories, and a new category was thus formed: children received information. Conclusions This study shows that the eHealth service Sisom can increase children’s participation during appointments with health care professionals. Further studies employing a randomized control design focusing on the effects of eHealth services on children’s health outcomes, perceived participation, and cost-effectiveness could make a significant contribution to guiding the implementation of eHealth services in pediatric care.

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Implementing a digital communication assistance tool to collect the medical history of refugee patients: DICTUM Friedland - an action-oriented mixed methods study protocol

Cited by 29 publications

References 31 publications

A Digital Communication Assistance Tool (DCAT) to Obtain Medical History from Foreign-Language Patients: Development and Pilot Testing in a Primary Health Care Center for Refugees

A Digital Communication Assistance Tool (DCAT) to Obtain Medical History from Foreign-Language Patients: Development and Pilot Testing in a Primary Health Care Center for Refugees

Improving emergency department patient-doctor conversation through an artificial intelligence symptom taking tool: an action-oriented design pilot study

Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study

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