An Empirical Examination of Factors Influencing the Intention to Use Physician Rating Websites

Physician rating websites (PRWs) are social media platforms that enable patients to submit ratings and reviews of physicians. While numerous PRWs are available on the Internet and millions of physician reviews are posted on those websites, many people still do not use them when making clinical decisions. This study seeks to understand what factors impact intention to use PRWs. A sample of 109 students was employed. Each subject was randomly assigned to either RateMDs, Vitals, or Brigham and Women’s Hospital’s website. The subjects were asked to choose a primary care doctor based on the reviews posted on the assigned website and complete a survey accordingly. The regression analysis revealed that perceived credibility of reviewers and general use of online reviews influenced intention to use PRWs, whereas perceived integrity of website providers only moderated the relation between perceived credibility of reviewers and intention to use PRWs

Best Strategies to Address Burnout Among Healthcare Professionals: An Integrative Review

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy work environments. The ILR was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Additionally, Melnyk’s level of evidence pyramid hierarchy and Whittemore and Knafl’s (2005) constant comparison method was used. A total of 16 studies published from 2017 to 2022 were suitable for analysis. The studies in this review evaluated a wide range of interventions to reduce burnout among healthcare professionals. The information gathered as a result of the literature review may be used by healthcare leaders and executives to make recommended practice changes related to implementing best practices to address burnout within hospitals

TripAdvisor of healthcare: Opportunities for value creation through patient feedback platforms

The objective of this study is to explore new opportunities for hospitals to use patient feedback platforms (i.e., digital platforms on which patients express their opinions on their care journeys). Patient feedback platforms generate an ever-expanding amount of data on patient experience of care that is currently unused by most hospital or their business intelligence unit. We used the methodological approach of netnography on the negative feedback received by one hospital combined with interviews to identify the potential value of the data generated by the patient feedback platform. The main findings are that a digital feedback platform serves as a source of data to indicate: (1)Where to act (by localizing the negative comments), (2) On what to act (what thematic provides satisfaction and therefore is to be kept; or causes dissatisfaction and thus is to be improved), and (3) How to innovate (ideas about new practices to implement). It becomes evident that the platforms are developing a service to help hospitals make sense of this raw data and that a hospital can use patient feedback from other hospitals to improve their own practices. The first implication of our results is that patient feedback platforms generate a complementary type of feedback (i.e. based on patient perception and not empirical fact), as well as a source of data (i.e., patients’ external spontaneous feedback and not internally controlled survey feedback) for the Business Intelligence unit engaged in the transformation of the hospital towards patient-centered care. The second implication is that these platforms create a feedback network effect (i.e. A patient’s feedback can be used by hospitals other than the focal hospital concerned by that feedback, therefore increasing the overall value of the platform). The third implication is that digital transformation is enabled not only by data generation on the platform but also by data analysis services provided by the third party that runs the platform

Commit to Be Fit: Antecedents and Consequences of Goal-Directed Health and Fitness Technology Use

This three-essay dissertation explores the antecedents and consequences of goal-directed health and fitness technology use. My first essay is an interdisciplinary review of consumer health IT research in the IS field and health informatics field. To explore the nature of consumer health IT research, I conducted a thematic analysis using Orlikowski and Iacono's (2001) IT artifact framework. I found that the nominal, proxy, and tool views of IT artifact are the most widely used perspectives when scholars frame how consumer health IT as an IT artifact is designed, deployed, and used. This study summarizes current consumer health IT research trends and suggests promising directions for future work.Inspired by my first essay, my second and third essays focus on extending current knowledge of fitness technologies, a subtype of consumer health IT. In my second essay, I look at fitness technology use behavior from a goal-directed behavior perspective, to ask how fitness technologies help users achieve their fitness goals. Drawing on the concepts of IT affordance and engagement, I propose that actualized fitness technology affordances influence users' cognitive and emotional exercise engagement, leading to fitness goal attainment. The results show that only emotional exercise engagement exerts significant influences on fitness goal attainment and that only actualized self-appraisal affordance and actualized social appraisal affordance significantly impact users' emotional exercise engagement.My third essay focuses on understanding individuals' discontinuance and habitual use of fitness trackers from the perspectives of fitness tracker identity and exercise identity. Drawing on Carter and Grover's (2015) theoretical model of IT identity, this research investigates how the technological, personal, and social aspects of users' fitness technology use experiences shape their fitness tracker identity to influence their fitness tracker use behaviors. My results show that individuals who positively identify with a fitness tracker are less likely to discontinue and more likely to develop habitual use. Further, for the same fitness tracker identity, employees with stronger exercise identity have lower discontinuance intention. Also, for the same fitness tracker identity, employees with more monetary rewards from their organizations have lower discontinuance intention. Moreover, I found various significant antecedents of fitness tracker identity

Information Technology's Role in Global Healthcare Systems

Over the past few decades, modern information technology has made a significant impact on people’s daily lives worldwide. In the field of health care and prevention, there has been a progressing penetration of assistive health services such as personal health records, supporting apps for chronic diseases, or preventive cardiological monitoring. In 2020, the range of personal health services appeared to be almost unmanageable, accompanied by a multitude of different data formats and technical interfaces. The exchange of health-related data between different healthcare providers or platforms may therefore be difficult or even impossible. In addition, health professionals are increasingly confronted with medical data that were not acquired by themselves, but by an algorithmic “black box”. Even further, externally recorded data tend to be incompatible with the data models of classical healthcare information systems.From the individual’s perspective, digital services allow for the monitoring of their own health status. However, such services can also overwhelm their users, especially elderly people, with too many features or barely comprehensible information. It therefore seems highly relevant to examine whether such “always at hand” services exceed the digital literacy levels of average citizens.In this context, this reprint presents innovative, health-related applications or services emphasizing the role of user-centered information technology, with a special focus on one of the aforementioned aspects

A framework for conceptualizing how narratives from health-care consumers might improve or impede the use of information about provider quality

Consumers choosing a health-care provider have access to diverse information including narratives by patients about their prior experiences. However, little research has examined how narratives might improve or impede the use of information about the quality of providers’ performance. This paper describes a conceptual framework for examining mechanisms by which narrative information might influence consumer judgments and decisions about providers. We conducted a conceptual review of risk communication and behavioral decision research. We synthesized the literature to form the foundation of a conceptual framework for assessing how narrative information about provider quality impacts consumer decisions about providers. We identified four key characteristics of narratives (convey emotion; explain logic; provide relational information; and capture naturalistic experience) that may address four consumer needs (avoid surprise and regret; recognize dominant options; motivate to act or not act; and make multi-attribute tradeoff decisions). We also identified three main functions of narratives (provide a simple, powerful cue; imbue quality information with meaning; and stimulate cognition and behavior) in four decision contexts (short-term treatments; external disruptions; chronic illness; problematic experiences). A rigorous research program can be derived from the conceptual framework to generate evidence-based recommendations about whether and how patient narratives might encourage: (1) more reasoned decisions; (2) consistency with a patient’s own values/preferences; and (3) engagement with provider quality information. Research results can be used then to develop robust guidance for health communicators reporting diverse and often incommensurate performance metrics

THE DIRECT PRIMARY CARE MODEL: PRACTICE CHARACTERISTICS AND PATIENT EXPERIENCE

The Direct Primary Care practice model has been growing in both number of practices and public awareness. However, there has been little academic research about this emerging practice model. This research is aimed to describe the current state of the DPC practice model by examining the services provided, geographic distribution of practices, statistical distribution of membership fees, demographic characteristics of physicians using the model and to determine whether regional pricing variation existed. In addition, differences were analyzed between the patient satisfaction levels in DPC and fee-for-service practices. A dataset was created by visiting the website of all known, non-corporate, DPC practices and gathering data points about the services, pricing structure, and medical providers in the practice. A second dataset was created using the Healthgrades.com patient satisfaction ratings for each DPC physician with seven or more reviews and matching each physician with two fee-for-service physicians, based on medical specialty, gender, age and location. The ratings for each of the eight Healthgrades patient satisfaction questions were classified as high, medium and low and then aggregated by region, physician gender, physician age and urban vs rural practice location. vi Average monthly fees in DPC practices were found to range from $36.00 to$87, depending on patient age. DPC practices were found to offer their patients discounted labs, discounted radiology, direct physician access through personal email, and direct physician cell phone access. More than half of DPC practices offered visits to the patients’ homes and just less than half dispensed discounted prescription medications from their office in states where it was legally permitted. The majority of DPC physicians were board certified in Family Medicine, with the minority certified in Internal Medicine and Pediatrics. A majority of DPC physicians were female, which is quite different from the percentage practicing in fee-for-service practices. This study found that regional variation in DPC monthly fees did exist, with the West and North Eastern regions of the US being more expensive than practices in the South and Midwest. Finally, based on Healthgrades ratings, DPC physicians had higher levels of patient satisfaction than fee-for-service physicians but neither group contained much intragroup variation in ratings

Anti-obesity Medications Prescribing Measures Utilized by Primary Care Practitioners: Scoping Review

Background Obesity is a chronic, complex and multifactorial disease with the prevalence increasing in North American adults. Novel AOMs are demonstrating weight loss results comparable to bariatric surgery when used effectively. As the gatekeepers to AOMs, primary care providers can play a key role in obesity management through exploring safe prescribing measures employed in primary care. Objectives This review will systematically map the existing literature on prescribing measures for AOMs to determine the extent, range, and nature of literature available on the measures utilized by PCPs when prescribing AOMs in North America. Methods One independent reviewer conducted a review using the PRISMA-SCR and JBI methodology. Pubmed, CINAHL, Cochrane, OVID databases were searched between October 9 and December 1. A 10 year date restriction was applied to reflect current practice. Results There were 11 sources included in this review of which ten were quantitative studies. These sources identified barriers and facilitators with safe prescribing measures, counselling and uptake of clinical guidelines pertaining to use of AOMs. Conclusions This review identified that lack of knowledge and time were common barriers for the safe prescribing, counsel and follow, and utilization of clinical guidelines when using AOMs by PCPs

Users’ search mechanisms and risks of inappropriateness in healthcare innovations : the role of literacy and trust in professional contexts

In the context of professional service organizations, user engagement with knowledge search might generate significant risks of inappropriateness to innovation processes. Previous research suggests that professionals would then keep users at arms' length, controlling the design and implementation of innovations internally. This study overcomes this view investigating how professional service organizations can enable users' knowledge search while controlling for the risks of inappropriateness. Combining a qualitative research on 5 innovation processes in healthcare organizations with quantitative research on 110 service users, our findings highlight that professional providers, such as senior clinicians, shaped their tactics according to the ‘threats’ of laggards, i.e. users searching knowledge outside of professional logics of appropriateness; more than to the opportunities of lead-user communities. Professional providers sought to “activate” users' engagement with knowledge search by investing on their literacy, i.e. showing the basics of the logic of appropriateness informing their decision; and on trust relationships, i.e. becoming transparent on the criteria of knowledge selection during the innovation processes

Trust and motivation in the health sector : a systematic review

Supporting improved performance of health workers is vital in health system strengthening. There are several factors that have been identified as playing key roles in influencing health worker performance. Motivation of HWs is one of the areas for improving delivery of health care services, yet it is under investigated. Moreover, the mechanisms underlying the interactions between motivation and other variables such as workplace trust relations are largely unknown. This dissertation is organised into three parts. Part A is the review protocol which outlines the background and the review methodology. A qualitative systematic review approach is adopted and literature search of the five chosen databases is conducted using keywords and phrases derived from the review question. Defined inclusion and exclusion criteria are used to identify and select suitable articles. An appropriate tool is then used to appraise selected articles which are then subjected to thematic analysis. Part B is a literature review of existing empirical and theoretical work on health worker motivation. It provides the background to the systematic review in Part C. It defines the word motivation as used in the health sector, and then explores empirical work on health worker motivation using an appropriate conceptual framework. The literature review further summarises and concludes on the possible link between trust and motivation in the health sector