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Shared Medical Visit

Sjoerd Broekman, Elisabeth Van Gils-Van Rooij, Berthold Meijboom, Dingenus De Bakker, Christoffel Yzermans
INTRODUCTION In the Netherlands, general practitioners (GPs) and emergency departments (EDs) collaborate increasingly in urgent care collaborations (UCCs) in which the two services share one combined entrance and joint triage. AIM The objective of this study is to determine if UCCs are cost-effective compared to the usual care setting where out-of-hours GP services and EDs work separately. METHODS This observational study compared UCCs with the usual care setting on costs by performing linear regression analyses...
September 2017: Journal of Primary Health Care
Jody C Gan
Service learning experiences abroad provide an excellent opportunity for seasoned health educators to share their skills with underresourced communities in other parts of the world while enriching their own professional development. Health educators have not traditionally participated in short-term medical service trips, which have become a popular humanitarian effort, yet their contributions can expand the scope of these efforts. With our responsibilities often focused on assessing needs, planning, implementing, and evaluation, seasoned health educators can provide guidance for new initiatives and share health promotion materials and other resources with communities in other parts of the world...
March 1, 2018: Health Promotion Practice
Rajeswari Swaminathan, Yungui Huang, Katherine Miller, Matthew Pastore, Sayaka Hashimoto, Theodora Jacobson, Danielle Mouhlas, Simon Lin
The adoption rate of genome sequencing for clinical diagnostics has been steadily increasing leading to the possibility of improvement in diagnostic yields. Although laboratories generate a summary clinical report, sharing raw genomic data with healthcare providers is equally important, both for secondary research studies as well as for a deeper analysis of the data itself, as seen by the efforts from organizations such as American College of Medical Genetics and Genomics and Global Alliance for Genomics and Health...
2018: Frontiers in Genetics
Hannah Chimowitz, Macda Gerard, Alan Fossa, Fabienne Bourgeois, Sigall K Bell
BACKGROUND: Enabling family/friend caregivers with access to visit notes may help avoid errors, delayed diagnoses, or other ambulatory safety risks. Patient, parent, and caregiver perceptions of how shared notes affect safety behaviors and attitudes were studied in an exploratory study. METHODS: To assess the impact of OpenNotes on safety, 24,722 patients with active portal accounts and ≥ 1 available visit notes during the prior year at an urban hospital were surveyed between June and September 2016...
March 2018: Joint Commission Journal on Quality and Patient Safety
Lenir Aparecida Chaves, Alzira de Oliveira Jorge, Mariangela Leal Cherchiglia, Ilka Afonso Reis, Marcos Antônio da Cunha Santos, Alaneir de Fátima Santos, Antônio Thomaz Gonzaga da Matta Machado, Eli Iola Gurgel Andrade
This cross-sectional study examined the integration of primary care in the healthcare network of the Brazilian Unified National Health System (SUS), using the Gradual Response Model of Item Response Theory. Based on data from 17,202 teams that participated in the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB, 2012), we measured gradients of integration to identify the teams' profile by level of integration. The results show that the items pertaining to matrix support measures (medical consultations, case discussions, shared clinical action, joint elaboration of therapeutic projects, permanent educational activities, work process discussions, interventions in the territory, and visits with primary care professionals) improved the performance of primary care teams...
February 19, 2018: Cadernos de Saúde Pública
Hisanao Akiyama, Yasuhiro Hasegawa
RATIONALE: Video-based treatment in telemedicine is a potential alternative to face-to-face treatment. We describe our trial use of telemedicine to treat a patient with primary headache. PATIENT CONCERNS: A 25-year-old woman visited our branch hospital with a chief complaint of recurrent headache. Our branch hospital had no headache specialist, so a headache specialist at our main hospital provided treatment remotely. DIAGNOSES: She was diagnosed with migraine without aura by the headache specialist using telemedicine...
March 2018: Medicine (Baltimore)
Sarah J Pugh, Ana M Ortega-Villa, William Grobman, Roger B Newman, John Owen, Deborah A Wing, Paul S Albert, Katherine L Grantz
OBJECTIVE: Accurate assessment of gestational age is critical to pediatric care, yet is limited in developing countries without access to ultrasound. Our objectives were to assess the accuracy of gestational age at birth (GA) prediction and preterm birth (PTB) classification using routinely collected anthropometry measures. DESIGN: Prospective cohort study. SETTING: United States. POPULATION OR SAMPLE: 2334 non-obese and 468 obese pregnant women...
February 23, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Jing Li, Preetham Talari, Andrew Kelly, Barbara Latham, Sherri Dotson, Kim Manning, Lisa Thornsberry, Colleen Swartz, Mark V Williams
BACKGROUND: Despite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM). METHODS: This quality improvement (QI) study was conducted at an academic medical centre...
February 14, 2018: BMJ Quality & Safety
Joanna-Grace M Manzano, Ming Yang, Hui Zhao, Linda S Elting, Marina C George, Ruili Luo, Maria E Suarez-Almazor
PURPOSE: Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions as well. It is important to describe the readmission profile of patients with cancer in the most clinically relevant approach to inform policy and health care delivery that can positively impact patient outcomes. PATIENTS AND METHODS: We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data...
February 13, 2018: Journal of Oncology Practice
Laura Siga Stephan, Eduardo Dytz Almeida, Raphael Boesche Guimarães, Antonio Gaudie Ley, Rodrigo Gonçalves Mathias, Maria Valéria Assis, Tiago Luiz Luz Leiria
BACKGROUND: Atrial fibrillation is responsible for one in four strokes, which may be prevented by oral anticoagulation, an underused therapy around the world. Considering the challenges imposed by this sort of treatment, mobile health support for shared decision-making may improve patients' knowledge and optimize the decisional process. OBJECTIVE: To develop and evaluate a mobile application to support shared decision about thromboembolic prophylaxis in atrial fibrillation...
February 1, 2018: Arquivos Brasileiros de Cardiologia
Neda Ratanawongsa, George Y Matta, Fuad B Bohsali, Margaret S Chisolm
BACKGROUND: Clinicians' use of electronic health record (EHR) systems while multitasking may increase the risk of making errors, but silent EHR system use may lower patient satisfaction. Delaying EHR system use until after patient visits may increase clinicians' EHR workload, stress, and burnout. OBJECTIVE: We aimed to describe the perspectives of clinicians, educators, administrators, and researchers about misses and near misses that they felt were related to clinician multitasking while using EHR systems...
February 6, 2018: JMIR Human Factors
Rajnish Mago, Andrea Fagiolini, Emmanuelle Weiller, Catherine Weiss
BACKGROUND: Evidence suggests that nearly half of patients with major depressive disorder (MDD) do not achieve an adequate response to antidepressant treatments (ADTs), which impacts patients' functioning, quality of life (QoL), and well-being. This patient survey aimed to better understand patient perspectives on the emotional impact of experiencing an inadequate response to ADTs. METHODS: An online survey was conducted in 6 countries with respondents diagnosed with MDD and experiencing an inadequate response to ADTs...
February 5, 2018: BMC Psychiatry
Maureen A Mavrinac
A physician and a patient find the missing element for healing in an alternative model of care: shared medical appointments.
February 2018: Health Affairs
Tasha M Hughes, Katiuscha Merath, Qinyu Chen, Steven Sun, Elizabeth Palmer, Jay J Idrees, Victor Okunrintemi, Malcolm Squires, Eliza W Beal, Timothy M Pawlik
BACKGROUND: Shared decision-making (SDM) is a process that respects the rights of patients to be fully involved in decisions about their care. By evaluating all available healthcare options and weighing patients' personal values and preferences against available unbiased evidence, patients and healthcare professionals can make health-related decisions together, as partners. We sought to evaluate the impact of perceived SDM on patient-reported outcomes, healthcare quality, and healthcare utilization...
January 31, 2018: American Journal of Surgery
James C Turner, Adrienne Keller, Hao Wu, Matthew Zimmerman, Jinghe Zhang, Laura E Barnes
OBJECTIVE: Our goal was to assess whether integration of behavioral and medical services in college settings is associated with decreased use of primary care by patients with mental health diagnoses (MHDs). METHOD: The cohort consisted of 80,219 patients with at least 1 MHD in 21 universities. Two levels of service integration were defined: "standard"-universities with separate electronic health records (EHR) systems and minimal clinical collaboration between services, and "enhanced"-universities with shared EHR and collaborative patient care...
January 29, 2018: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
Mufarriq Shah, Gail M Ormsby, Ayesha Noor, Rahul Chakrabarti, Manfred Mörchen, Fakir M Amirul Islam, C Alex Harper, Jill E Keeffe
AIM: To identify the current roles of eye and health care workers in eye care delivery and investigate their potential roles in screening and detection for management of diabetic retinopathy (DR) through task sharing. METHODS: Purposive sampling of 24 participants including health administrators, members from non-government organizations and all available eye care workers in Takeo province were recruited. This cross sectional mixed method study comprised a survey and in-depth interviews...
2018: International Journal of Ophthalmology
Dennis H Li, Brian Mustanski
PURPOSE: Sexual minority men (SMM) are at greater risk than heterosexual men for misusing prescription psychotropic medications. However, community prevalence estimates of prescription drug misuse among young SMM are lacking. The current study described lifetime and past-6-month stimulant, painkiller, and depressant/tranquilizer misuse in a large, racially diverse sample of 967 SMM aged 16-29 in Chicago, Illinois, and investigated demographic and other substance use associations. METHODS: Data came from the baseline visit of the RADAR longitudinal cohort study...
January 23, 2018: LGBT Health
Jose R Castillo-Mancilla, Mary Morrow, Yap Boum, Helen Byakwaga, Jessica E Haberer, Jeffrey N Martin, David Bangsberg, Samantha Mawhinney, Nicholas Musinguzi, Yong Huang, Russell P Tracy, Tricia H Burdo, Kenneth Williams, Conrad Muzzora, Peter W Hunt, Mark J Siedner
BACKGROUND: Residual systemic inflammation persists despite suppressive antiretroviral therapy (ART) and is associated with non-AIDS clinical outcomes. We aimed to evaluate the association between ART adherence and inflammation in Ugandans living with HIV who were predominantly receiving nevirapine-based ART with a thymidine analog backbone and were virologically suppressed by conventional assays. METHODS: Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble (s)CD14, sCD163, and the kynurenine/tryptophan ratio, in addition to CD8 T-cell activation, were measured at baseline and 6 months after ART initiation in treatment-naive adults who achieved an undetectable plasma HIV RNA (<400 copies/mL) at their 6-month visit...
April 15, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Daniel S Reuland, Laura Cubillos, Alison T Brenner, Russell P Harris, Bailey Minish, Michael P Pignone
BACKGROUND: The United States Preventive Services Task Force (USPSTF) issued recommendations for older, heavy lifetime smokers to complete annual low-dose computed tomography (LDCT) scans of the chest as screening for lung cancer. The USPSTF recommends and the Centers for Medicare and Medicaid Services require shared decision making using a decision aid for lung cancer screening with annual LDCT. Little is known about how decision aids affect screening knowledge, preferences, and behavior...
January 12, 2018: BMC Medical Informatics and Decision Making
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
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