Developing national level informatics competencies for undergraduate nurses : methodological approaches from Australia and Canada

Health information systems are being implemented in countries by governments and regional health authorities in an effort to modernize healthcare. With these changes, there has emerged a demand by healthcare organizations for nurses graduating from college and university programs to have acquired nursing informatics competencies that would allow them to work in clinical practice settings (e.g. hospitals, clinics, home care etc). In this paper we examine the methods employed by two different countries in developing national level nursing informatics competencies expected of undergraduate nurses prior to graduation (i.e. Australia, Canada). This work contributes to the literature by describing the science and methods of nursing informatics competency development at a national level

Digital health as an enabler for hospital@home: A rising trend or just a vision?

Background: Hospital@home is a model of healthcare, where healthcare professionals actively treat patients in their homes for conditions that may otherwise require hospitalization. Similar models of care have been implemented in jurisdictions around the world over the past few years. However, there are new developments in health informatics including digital health and participatory health informatics that may have an impact on hospital@home approaches. Objectives: This study aims to identify the current state of implementation of emerging concepts into the hospital@home research and models of care; to identify strengths and weaknesses, opportunities, and threats associated with the models of care; and to suggest a research agenda. Methods: We employed two research methodologies, namely, a literature review and a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The literature from the last 10 years was collected from PubMed using the search string “hospital at home” OR “care at home” OR “patient at home.” Relevant information was extracted from the included articles. Results: Title and abstract review were conducted on 1,371 articles. The full-text review was conducted on 82 articles. Data were extracted from 42 articles that met our review criteria. Most of the studies originated from the United States and Spain. Several medical conditions were considered. The use of digital tools and technologies was rarely reported. In particular, innovative approaches such as wearables or sensor technologies were rarely used. The current landscape of hospital@home models of care simply delivers hospital care in the patient's home. Tools or approaches from taking a participatory health informatics design approach involving a range of stakeholders (such as patients and their caregivers) were not reported in the literature reviewed. In addition, emerging technologies supporting mobile health applications, wearable technologies, and remote monitoring were rarely discussed. Conclusion: There are multiple benefits and opportunities associated with hospital@home implementations. There are also threats and weaknesses associated with the use of this model of care. Some weaknesses could be addressed by using digital health and wearable technologies to support patient monitoring and treatment at home. Employing a participatory health informatics approach to design and implementation could help to ensure the acceptance of such care models

What Can We Learn from Quality Requirements in ISO/TS 82304-2 for Evaluating Conversational Agents in Healthcare?

Evaluating conversational agents (CA) that are supposed to be applied in healthcare and ensuring their quality is essential to avoid patient harm. However, most researchers only study usability and use the CA in clinical trials before conducting such careful evaluation. In previous work, consensus on metrics for evaluating healthcare CA have been found. However, the metrics are still too generic to form an evaluation framework. In this work, we try to link the ISO technical specification ISO/TS 82304-2 Quality Requirements for Health and Wellness Apps to the set of metrics to come a step closer towards an evaluation framework. We identify three links between ISO requirements and the set of metrics, namely accessibility, usability, and security. Although the technical specification rather lists aspects to be considered during development instead of concrete metrics for studying the quality, we can link to some aspects that are also of interest for health CA evaluation. For example, measuring the readability for ensuring accessibility or implementing the Web Content Accessibility Guidelines are two aspects of relevance for health CA

Patient experiences through head and neck cancer: Information delivery combatting psychological distress

As part of a larger study investigating the utility of electronic decision support tools for patients with head and neck cancer (HNC), this article describes the patient experience of receiving cancer treatment in British Columbia, Canada. It aims to give voice to the patient experience and recommend a model of psychological adjustment for clinicians and clinical service management to consider to refine patient centric care pathways for HNC. Based in phenomenology, semi-structured interviews were conducted with 12 survivors of HNC, audio-video recorded, and thematically analyzed. Three themes were identified: (1) patients have high, though varying information needs; (2) an emotional experience; and (3) coping, strength, and resiliency. These themes arose from six concepts: (1) information needs; (2) fear of the unknown; (3) desire for personalized information; (4) varying degrees of information needs; (5) fear as a motivator versus stressor; and (6) high information needs on life after treatment. Conclusions: The patient experience must be considered through the full care trajectory and into survivorship to provide the right information to the correct patient at the optimal time. Patient journey mapping may be a novel approach to exploring the temporal relationship between information needs and the patient experience along the cancer continuum to uncover opportune moments, from the patient perspective, for knowledge and supportive care intervention. The model of psychological adjustment by Calver et al. (2019) can be considered to inform the delivery of cancer care information in a method recognizing the patient as the ultimate knowledge holder. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Evaluating the Content and Usability of an Experimental Text Summarization System and Three Web-Based Search Engines

This paper describes the evaluation of a new automated text summarization system, Centrifuser. This system provides information to patients and families relevant to their specific health questions. Centrifuser accepts queries about health conditions, and produces a summary of information from articles retrieved by a standard search engine that is tailored to the user's question. The evaluation involved audio- and video-recording of all subject interactions with the interfaces in situ at a hospital. Subjects, consisting of friends or family of hospitalized patients, were asked to “think aloud” as they interacted with Centrifuser and three commonly used search engines: Google, Yahoo, and About.com. Results of the evaluation show that subjects found Centrifuser's summarization capability useful and easy to understand. In comparing Centrifuser to the three search engines, subjects' ratings varied; however, specific interface features were deemed useful across interfaces. We conclude with a discussion of the implications for engineering Web-based retrieval systems