Patients’ involvement in e-health services quality assessment: A system for the automatic interpretation of SMS-based patients’ feedback

AbstractPurposeEffective communication between patients and health services providers is a key aspect for optimizing and maintaining these services. This work describes a system for the automatic evaluation of users’ perception of the quality of SmsCup, a reminder system for outpatient visits based on short message service (SMS). The final purpose is the creation of a closed-loop control system for the outpatient service, where patients’ complaints and comments represent a feedback that can be used for a better implementation of the service itself.MethodsSmsCup was adopted since about eight years by an Italian healthcare organization, with very good results in reducing the no-show (missing visits) phenomenon. During these years, a number of citizens, even if not required, sent a message back, with comments about the service. The automatic interpretation of the content of those SMS may be useful for monitoring and improving service performances.Yet, due to the complex nature of SMS language, their interpretation represents an ongoing challenge. The proposed system uses conditional random fields as the information extraction method for classifying messages into several semantic categories. The categories refer to appreciation of the service or complaints of various types. Then, the system analyzes the extracted content and provides feedback to the service providers, making them learning and acting on this basis.ResultsAt each step, the content of the messages reveals the actual state of the service as well as the efficacy of corrective actions previously undertaken. Our evaluations showed that: (i) the SMS classification system has achieved good overall performance with an average F1-measure and an overall accuracy of about 92%; (ii) the notification of the patients’ feedbacks to service providers showed a positive impact on service functioning.ConclusionsOur study proposed an interactive patient-centered system for continuous monitoring of the service quality. It has demonstrated the feasibility of a tool for the analysis and notification of the patients’ feedback on their service experiences, which would support a more regular access to the service

Textwithsurgerypatients-A Research Hypothesis in Enhancing Education and Physical Assessment for Abdominal Surgical Patients

Medical surgical nurses may not have the time or resources to provide effective pre- and post-operative instructions for patients in today\u27s healthcare system. And, making timely physical assessments following discharge from the hospital is not always straightforward. Therefore, the risk for readmission associated with post-surgical complications is a concern. At present, mobile healthcare technologies and patient care are precipitously evolving and may serve as a resource to enhance communication between the healthcare provider and patient. A mobile telephone text message (short message service [SMS]) intervention for abdominal surgical patients may foster effective education (communication) and timely self-reported physical assessment in the home environment hence preventing deleterious outcomes. The aim of this research proposal is to identify the feasibility of using a SMS intervention via smart phones to improve health outcomes via timely communication, reach large numbers of at-risk surgical patients and, establish and sustain uniform protocols in a cost-efficient manner

Efficacy of Different Reminders to Reduce Missed Orthodontic Appointments

Objectives: Since forgetfulness is the major cause of missed appointments, reminder systems can be used prior to appointments. The present study aimed to evaluate the efficacy of different reminders [e-mails, social networks, telephone, and short message service (SMS)] in order to reduce missed appointments by orthodontic patients.Methods: Of a total of 751 active orthodontic patients, 379 were assigned to the reminder group and 372 to the control group. The former group was randomly divided into four subgroups who received a reminder 2 days before their appointments either by telephone, e-mail, SMS, or a message on Facebook. Patients allocated to the control group received no reminder. The percentage of missed appointments and the demographic characteristics of patients in each group were analyzed with the chi-squared test.Results: The percentage of missed appointments was significantly higher in the control group (41.39%) than the reminder group (11.08%) (P<0.001). There was no difference in the attendance rate of patients among telephone, SMS, and e-mail groups. Missed appointments were insignificantly higher in patients whose parents had the highest educational level (P=0.8). In patients with low family income, the percentage of missed appointments was the lowest, but this difference was not statistically significant (P=0.5).Conclusion: The study results indicated that sending reminders is an effective strategy to reduce missed appointments. E-mails and social networks can be employed to send reminders easily and cost-effectively and prevent missed appointments

Outpatient regulation system in health management: economic benefits of technological innovations

Purpose – The purpose of this paper is to evaluate the economic benefits of managing an outpatientappointments system with technological innovations.Design/methodology/approach – This study uses a quantitative methodological procedures aiming toevaluate the cost-benefit relation and also the payback of the management and operation of an outpatientappointments system with technological innovations.Findings – This study found a great benefit-cost relation of 30.6 showing the great economic value andsocial impact of managing an outpatient appointments regulation system with technologicalinnovations.Research limitations/implications – This study presents contribution to the literature discussionabout the economic evaluation of the benefits of managing and operating more effective outpatientappointments systems because of important technological innovations.Practical implications – This paper presents and discusses the most important and commonly usedstrategies and technological innovations to deal with and to manage an outpatient appointment regulationsystem aiming to reduce the patient no-show rates.Social implications – The findings of this study show a great benefit-cost relation of about 30.6 which isbeing reverted to the society.Originality/value – There not exist many similar studies in the pertinent literature, mostly with theBrazilian contexts

Evaluation of Mobile Telephone Text Message Reminders for People with Antipsychotic Medication

Nonadherence to treatment is a worldwide problem among people with severe mental disorders. Patient treatment adherence may be supported with simple reminding methods e.g. text message reminders. However, there is limited evidence of its benefits. Intervention evaluation is essential in mHealth research. Therefore, this evaluative study was conducted. This study aimed to evaluate text message reminder use in encouraging patients’treatment adherence among people with antipsychotic medication. The data were collected between September 2011 and December 2013. First, a systematic literature review revealed that text message reminders were widely used in healthcare. However, its impacts were conflicting. Second, a sub-sample (n = 562) analysis showed that patients preferred humorous text message reminders and preferred to receive them in the morning, at the beginning of the week. Age, gender and marital status seemed to have different effects on the preferred amount and timing of the selected reminders. Third, a cross-sectional survey revealed that people with antipsychotic medication (n = 408) expressed overall satisfaction towards the reminder system. Finally, the evaluative design showed that patient recruitment for a randomized controlled trial concerning people with antipsychotic medication was challenging due to low rates of eligible participants. Follow-up drop-out rates varied depending on the data collection method. Participants’ demographic characteristics were associated with the risk of dropping out from the trial. This study suggests that text messages are a potential reminder system in healthcare services among people with antipsychotic medication. More research is needed to gain a comprehensive picture of the impacts and effectiveness of text message reminders.Tekstiviestimuistutusten arviointi psykoosilääkitystä käyttävillä potilailla Huono hoitoon sitoutuminen on maailmanlaajuinen ongelma ihmisillä, joilla on vakava mielenterveyshäiriö. Hoitoon sitoutumista voidaan kuitenkin tukea yksinkertaisilla muistutusmenetelmillä, kuten tekstiviesteillä. Tekstiviestimuistutusten hyödyistä antipsykoosilääkitystä käyttävän potilaan hoitoon sitoutumisen tukemisessa tiedetään kuitenkin vain vähän. Interventioiden arviointi on olennainen osa mobiiliterveyden tutkimusta. Tästä syystä tämä arviointitutkimus toteutettiin. Tutkimuksen tarkoituksena oli arvioida tekstiviestimuistutusten käyttöä antipsykoosilääkitystä käyttävän potilaan hoitoon sitoutumisen tukemisessa. Aineisto kerättiin syyskuun 2011 ja joulukuun 2013 välillä. Ensiksi, systemaattinen kirjallisuuskatsaus osoitti, että tekstiviestimuistutuksia käytetään laajasti terveydenhuollossa. Tulokset tekstiviestimuistutusten hyödyistä olivat kuitenkin ristiriitaiset. Toiseksi, osajoukon (n = 562) analyysi osoitti, että osallistujat pitivät humoristisista tekstiviestimuistutuksista ja halusivat vastaanottaa ne aamuisin alkuviikosta. Osallistujien iällä, sukupuolella ja siviilisäädyllä näytti olevan yhteys potilaiden valitsemien tekstiviestien määrään ja siihen, mihin aikaan osallistujat halusivat vastaanottaa viestejä. Kolmanneksi, kyselytutkimus toi esille, että antipsykoosilääkitystä käyttävät potilaat (n = 408) olivat yleisesti tyytyväisiä saamaansa tekstiviestipalveluun. Lopuksi, arviointitutkimuksen mukaan antipsykoosilääkityksen omaavien potilaiden rekrytoiminen randomoituun kontrolloituun tutkimukseen oli haasteellista johtuen muun muassa sisäänottokriteerit täyttävien potilaiden vähäisestä määrästä. Tutkimuksen keskeyttäneiden osallistujien määrä vaihteli riippuen seuranta-aineiston keruuseen käytetystä menetelmästä. Osallistujien taustatekijät olivat yhteydessä riskiin keskeyttää tutkimus. Tutkimuksen mukaan tekstiviestit ovat mahdollinen muistutusjärjestelmä terveydenhuollossa antipsykoosilääkitystä käyttävien potilaiden keskuudessa. Lisää tutkimusta tarvitaan luomaan yhtenäinen käsitys tekstiviestimuistutusten hyödyistä ja vaikuttavuudesta.Siirretty Doriast

Youth Treatment Adherence at a Rural Community Mental-Health Clinic

This study examined the relationships between youth and adult psychopathology, and sociodemographic factors and treatment adherence for youth attending outpatient treatment at a rural community mental-health clinic. “Adherence” was defined as attending more than five sessions, while “non-adherence” was defined as attending fewer than or equal to five sessions. Results revealed no significant differences between youth adhering or not adhering to treatment depending on the relation of caregiver to youth or the mode of transportation taken to the clinic. Furthermore, caregiver and youth psychopathology and caregiver’s estimated travel time to the clinic did not predict treatment adherence. Incidentally, examination of sociodemographic variables revealed that caregivers and youth who spoke Spanish in the home were more likely to adhere to treatment. Additionally, supplemental analyses examining psychopathology and treatment adherence using a “total treatment” operational definition found that higher levels of youth anxiety predicted adherence to treatment. Implications of these results are discussed

Getting patients in the door: medical appointment reminder preferences

Between 23% and 34% of outpatient appointments are missed annually. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive health care services. Missed appointments result in unnecessary costs and organizational inefficiencies. Appointment reminders may help reduce missed appointments; particular types may be more effective than other types. We used a survey with a discrete choice experiment (DCE) to learn why individuals miss appointments and to assess appointment reminder preferences

The Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa: A Systematic Review and Recommendations for Future Research

Background: Previous studies have shown an unmet need in the treatment of eating disorders. In the last decade, interest in technology-based interventions (TBIs) (including computer-and Internet-based interventions [CBIs] or mobile interventions) for providing evidence-based therapies to individuals with different mental disorders has increased. Objective: The aim of this review was to systematically evaluate the potential of TBIs in the field of eating disorders, namely for anorexia nervosa (AN) and bulimia nervosa (BN),for both prevention and treatment, and also for carers of eating disorder patients. Methods: A systematic literature search was conducted using Medline and PsycINFO. Bibliographies of retrieved articles were also reviewed without date or study type restrictions. Results: Forty studies resulting in 45 publications reporting outcomes fulfilled the inclusion criteria: 22 randomized controlled trials, 2 controlled studies, and 16 uncontrolled studies. In total, 3646 patients were included. Overall, the studies provided evidence for the efficacy of guided CBIs, especially for BN patients and for compliant patients. Furthermore, videoconferencing also appeared to be a promising approach. Evaluation results of Internet-based prevention of eating disorders and Internet-based programs for carers of eating disorder patients were also encouraging. Finally, there was preliminary evidence for the efficacy of mobile interventions. Conclusions: TBIs may be an additional way of delivering evidence-based treatments to eating disorder patients and their use is likely to increase in the near future. TBIs may also be considered for the prevention of eating disorders and to support carers of eating disorder patients. Areas of future research and important issues such as guidance, therapeutic alliance, and dissemination are discussed

Targeting the use of reminders and notifications for uptake by populations (TURNUP): a systematic review and evidence synthesis.

Background: Missed appointments are an avoidable cost and a resource inefficiency that impact on the health of the patient and treatment outcomes. Health-care services are increasingly utilising reminder systems to counter these negative effects. Objectives: This project explores the differential effect of reminder systems for different segments of the population for improving attendance, cancellation and rescheduling of appointments. Design: Three inter-related reviews of quantitative and qualitative evidence relating to theoretical explanations for appointment behaviour (review 1), the effectiveness of different approaches to reminding patients to attend health service appointments (review 2) and factors likely to influence non-attendance (review 3). Data sources: Database searches were conducted on Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, The Cochrane Library, EMBASE (via NHS Evidence from 1 January 2000 to January/February 2012), Health Management Information Consortium database, Institute of Electrical and Electronics Engineers Xplore, The King’s Fund Library Catalogue, Maternity and Infant Care, MEDLINE, Physiotherapy Evidence Database, PsycINFO, SPORTDiscus and Web of Science from 1 January 2000 to January/February 2012. Supplementary screening of references of included studies was conducted to identify additional potentially relevant studies. Conceptual papers were identified for review 1, randomised controlled trials (RCTs) and systematic reviews for review 2 and a range of quantitative and qualitative research designs for review 3. Methods: We conducted three inter-related reviews of quantitative and qualitative evidence, involving a review of conceptual frameworks of reminder systems and adherence behaviours, a review of the reminder effectiveness literature and a review informed by realist principles to explain the contexts and mechanisms that explain reminder effectiveness. A preliminary conceptual framework was developed to show how reminder systems work, for whom they work and in which circumstances. Six themes emerged that potentially influence the effectiveness of the reminder or whether or not patients would attend their appointment, namely the reminder–patient interaction, reminder accessibility, health-care settings, wider social issues, cancellation and rebookings, and distal/proxy attributes. Standardised review methods were used to investigate the effectiveness of reminders to promote attendance, cancellation or rebooking across all outpatient settings. Finally, a review informed by realist principles was undertaken, using the conceptualframework to explain the context and mechanisms that influence how reminders support attendance, cancellation and rebooking. Results: A total of 466 papers relating to 463 studies were identified for reviews 2 and 3. Findings from 31 RCTs and 11 separate systematic reviews (review 2 only) revealed that reminder systems are consistently effective at reducing non-attendance at appointments, regardless of health-care setting or patient subgroups. Simple reminders that provide details of timing and location of appointments are effective for increasing attendance at appointments. Reminders that provide additional information over and above the date, time and location of the appointment (‘reminder plus’) may be more effective than simple reminders at reducing non-attendance and may be particularly useful for first appointments and screening appointments; simple reminders may be appropriate thereafter for most patients the majority of the time. There was strong evidence that the timing of reminders, between 1 and 7 days prior to the appointment, has no effect on attendance; substantial numbers of patients do not receive their reminder; reminders promote cancellation of appointments; inadequate structural factors prevent patients from cancelling appointments; and few studies investigated factors that influence the effectiveness of reminder systems for population subgroups. Limitations: Generally speaking, the systematic review method seeks to provide a precise answer to a tightly focused question, for which there is a high degree of homogeneity within the studies. A wide range of population types, intervention, comparison and outcomes is included within the RCTs we identified. However, use of this wider approach offers greater analytical capability in terms of understanding contextual and mechanistic factors that would not have been evident in a more narrowly focused review and increases confidence that the findings will have relevance in a wide range of service settings. Conclusions: Simple reminders or ‘reminder plus’ should be sent to all patients in the absence of any clear contraindication. Other reminder alternatives may be relevant for key groups of patients: those from a deprived background, ethnic minorities, substance abusers and those with comorbidities and/or illnesses. We are developing a practice guideline that may help managers to further tailor their reminder systems for their service and client groups. We recommend future research activities in three main areas. First, more studies should routinely consider the potential for differential effects of reminder systems between patient groups in order to identify any inequalities and remedies. Second, ‘reminder plus’ systems appear promising, but there is a need for further research to understand how they influence attendance behaviour. Third, further research is required to identify strategies to ‘optimise’ reminder systems and compare performance with current approaches