Radical Technological Innovation and Perception: A Non-Physician Practitioners’ Perspective

Radical technological innovations, such as chatbots, fundamentally alter many aspects of healthcare organizations. For example, they transform how clinicians care for their patients. Despite the potential benefits, they cannot be integrated into practice without the support of the clinicians whose jobs are affected. While previous research shed important light on physicians’ perceptions, little is known on nonphysician practitioners view said innovations. This paper reports on a qualitative study, involving 10 nonphysician clinicians from Ontario, Canada, conducted to determine the perceptions and cognitions of clinicians regarding radical innovation and their previous experiences with technological change. Results indicate that clinicians as semi-autonomous agents can interpret and act upon their environment with regard to determining how innovations such as chatbots are implemented

Marshfield Clinic: Health Information Technology Paves the Way for Population Health Management

Highlights Fund-defined attributes of an ideal care delivery system and best practices, including an internal electronic health record, primary care teams, physician quality metrics and mentors, and standardized care processes for chronic care management

Talking together : consumer communities in healthcare

Consumer involvement in computer mediated communities (CMCs) is increasing particularly in high involvement services such as healthcare. This paper examines the role of CMCs as providers of patient information and support and the subsequent effect on the relationship between 'informed' consumers and health care providers. The evolving dialogue between consumers in virtual communities provides one key axis along which professional service consumption will evolve. The challenge for service consumers is to develop frameworks that facilitate robust dialogue and exchange of information and emotional support to complement their rising authority. The parallel challenge is for the established medical profession to recognise the consequences of this evolving dialogue and develop approaches to service delivery that effectively engage with consumers on the basis of this increasing authority

The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: a qualitative study of Kaiser Permanente.

BackgroundPatient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However, despite growing research on patient portals and their effects, our understanding of the organizational dynamics that explain how effects come about is limited.MethodsThis paper uses qualitative methods to advance our understanding of the organizational dynamics that influence the impact of a patient portal on organizational performance and patient health. The study setting is Kaiser Permanente, the world's largest not-for-profit integrated delivery system, which has been using a portal for over ten years. We interviewed eighteen physician leaders and executives particularly knowledgeable about the portal to learn about how they believe the patient portal works and what organizational factors affect its workings. Our analytical framework centered on two research questions. (1) How does the patient portal impact care delivery to produce the documented effects?; and (2) What are the important organizational factors that influence the patient portal's development?ResultsWe identify five ways in which the patient portal may impact care delivery to produce reported effects. First, the portal's ability to ease access to services improves some patients' satisfaction as well as changes the way patients seek care. Second, the transparency and activation of information enable some patients to better manage their care. Third, care management may also be improved through augmented patient-physician interaction. This augmented interaction may also increase the 'stickiness' of some patients to their providers. Forth, a similar effect may be triggered by a closer connection between Kaiser Permanente and patients, which may reduce the likelihood that patients will switch health plans. Finally, the portal may induce efficiencies in physician workflow and administrative tasks, stimulating certain operational savings and deeper involvement of patients in medical decisions. Moreover, our analysis illuminated seven organizational factors of particular importance to the portal's development--and thereby ability to impact care delivery: alignment with financial incentives, synergy with existing IT infrastructure and operations, physician-led governance, inclusive decision making and knowledge sharing, regional flexibility to implementation, continuous innovation, and emphasis on patient-centered design.ConclusionsThese findings show how organizational dynamics enable the patient portal to affect care delivery by summoning organization-wide support for and use of a portal that meets patient needs

Art as Occupation: A Phenomenological Study of Art as a Means of Self-Expression for an Individual Recovering from Severe Physical, Sexual, and Ritual Abuse

This phenomenological study presents an in-depth exploration of one individual\u27s retrospective account of using art over approximately ten years in Occupational Therapy (OT) intervention while recovering from severe abuse with a diagnosis of Dissociative Identity Disorder (DID). After an extensive literature review, the qualitative data was gathered during thorough semi-structured interviews using conference calls and correspondence through e-mail with the participant. Data analysis involved horizontalization of narrative data resulting in the dissemination of meaning units. From these a textual and structural description of the participant\u27s individual experience emerged through self-reflection and discussion of meaning units with the participant and outside expert. Member checking and bracketing were utilized continually to increase trustworthiness and avoid bias. Through integration of both the textual and structural descriptions of the data, this phenomenological study illustrated the essence of the participant\u27s individual experience using art in multiple forms and its effectiveness during recovery in Occupational Therapy intervention

Virtual Reality applied to biomedical engineering

Actualment, la realitat virtual esta sent tendència i s'està expandint a l'àmbit mèdic, fent possible l'aparició de nombroses aplicacions dissenyades per entrenar metges i tractar pacients de forma més eficient, així com optimitzar els processos de planificació quirúrgica. La necessitat mèdica i objectiu d'aquest projecte és fer òptim el procés de planificació quirúrgica per a cardiopaties congènites, que compren la reconstrucció en 3D del cor del pacient i la seva integració en una aplicació de realitat virtual. Seguint aquesta línia s’ha combinat un procés de modelat 3D d’imatges de cors obtinguts gracies al Hospital Sant Joan de Déu i el disseny de l’aplicació mitjançant el software Unity 3D gracies a l’empresa VISYON. S'han aconseguit millores en quant al software emprat per a la segmentació i reconstrucció, i s’han assolit funcionalitats bàsiques a l’aplicació com importar, moure, rotar i fer captures de pantalla en 3D de l'òrgan cardíac i així, entendre millor la cardiopatia que s’ha de tractar. El resultat ha estat la creació d'un procés òptim, en el que la reconstrucció en 3D ha aconseguit ser ràpida i precisa, el mètode d’importació a l’app dissenyada molt senzill, i una aplicació que permet una interacció atractiva i intuïtiva, gracies a una experiència immersiva i realista per ajustar-se als requeriments d'eficiència i precisió exigits en el camp mèdic

Providing adaptive health updates across the personal social network

Peer reviewedPublisher PD

“You see yourself like in a mirror”: the effects of internet-mediated personal networks on body image and eating disorders

Body image issues associated with eating disorders consist of attitudinal and perceptual components: individuals’ dissatisfaction with body shape or weight, and inability to correctly assess body size. While prior research has mainly explored social pressure from media, fashion, and advertising, we aim to uncover how personal networks, also encompassing internet-mediated interactions, bear upon body image. We estimate these effects with data from a survey of users of websites on eating disorders, including indicators of their body size and body image, and maps of their networks of connections. A bivariate ordered probit accounts for the joint distribution of attitudinal and perceptual body image dimensions depending on network characteristics. Results, confirmed by in-depth interviews, provide evidence that personal networks affect body image concerns, and show that this influence varies significantly by body size. Personal networks, as may be formed also (but not only) online, can be conducive to positive body image development

The Impact of Contact Tracing on the Spread of COVID-19: An Egocentric Agent-Based Model

At its core, contact tracing is a form of egocentric network analysis (ENA). One of the biggest obstacles for ENA is informant accuracy (i.e., amount of true contacts identified), which is even more prominent for interaction-based network ties because they often represent episodic relational events, rather than enduring relational states. This research examines the effect of informant accuracy on the spread of COVID-19 through an egocentric, agent-based model. Overall when the average person transmits COVID-19 to 1.62 other people (i.e., the R0), they must be, on average, 75% accurate with naming their contacts. In higher transmission contexts (i.e., transmitting to at least two other people), the results show that multi-level tracing (i.e., contact tracing the contacts) is the only viable strategy. Finally, sensitivity analysis shows that the effectiveness of contact tracing is negatively impacted by the timing and overall percent of asymptomatic cases. Overall, the results suggest that if contact tracing is to be effective, it must be fast, accurate, and accompanied by other interventions like mask-wearing to drive down the average R0