Health Technologies that Interface Patients and Providers

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    Investigating Ethical Design Requirements for Digitalized Healthcare Support: The Case of Ambulatory Physiotherapeutic Assistance Systems
    ( 2018-01-03) Mueller, Marius ; Heger, Oliver ; Niehaves, Bjoern
    Due to the advent of digitalized healthcare services and de-centralized structures, the tele-medical support of therapeutic treatments is increasingly in the focus of researchers and practitioners. Here, systems offering an interface between patients and physicians emerge as a fruitful way to reduce clinical visits and, thus, increase patient satisfaction and health. Yet, research on requirements for such systems has largely focused on patients who are not able to fully grasp the issues associated with such technologies due to their novelty and the changes they entail. With this study, inspired by the Responsible Innovation framework, we investigate the case of an ambulatory physiotherapeutic assistance system. We conducted four focus group workshops involving experts from different domains in order to integrate multiple stakeholder perspectives and thereby explore system design requirements. Our findings indicate that patient autonomy, security, privacy, competence and socio-cultural aspects contain relevant technological implications, each involving multiple design requirements.
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    Effect of Handoff Training on Resident Communication Quality: An Observational Study
    ( 2018-01-03) Abraham, Joanna ; Kannampallil, Thomas ; Ward, Charlotte ; Bogan, Christopher ; Hyderi, Abbas
    We evaluated the effect of handoff training conducted during resident orientation on communication quality using a non-randomized between-subjects study, where the training group received structured, in-person handoff training, and the control group received no training. Handoff conversations for both groups were audio-recorded. Communication quality was measured as the frequency of communication breakdowns. We found that training group had fewer breakdowns; however, after adjusting for patient acuity and patient days in the unit, communication quality between the two groups were similar (OR=0.3, 95% CI=0.08-1.07, p=0.06). However, there were significant differences in the clinical content exchanged during communication: compared to the control group, residents in the training group discussed significantly more clinical content related to identifying information, past medical history and contextual information; and less clinical content related to active problems and assessment of active problems. We discuss the implications of such handoff training program during resident orientations.
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    The Impact of Computing Device Design on Patient-Centered Communication: An Experimental Study
    ( 2018-01-03) Randell, Rebecca ; Tang, Charlotte ; Chen, Yunan
    Prior research has studied the impact of use of a single computing device, such as a desktop or a tablet computer, on patient-provider communication. While some studies have considered how contextual features such as room layout and software interface design affect computer use and patient-provider interaction in the exam room, it is not known how the choice of computing device impacts patient-provider communication. We conducted a within-participant experimental study. Three physicians participated in nine simulated consultations, using a desktop computer, a tablet computer, and a tabletop computer. Consultations were video-recorded and the video data were analyzed using framework analysis. Findings reveal the choice of device impacts the extent to which the consultation is patient-centered. To better support patient-centered communication, a large adjustable horizontal screen can facilitate eye contact and patient engagement. Findings also highlight the need for design of future systems to consider the characteristics of both openness and privacy.
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    Can a Hospital’s Analytics Capabilities Impact Patient Satisfaction? A Multi-Year Panel Study
    ( 2018-01-03) Adjerid, Idris ; Angst, Corey ; Devaraj, Sarv
    An empirical link between organizational performance and the IT necessary to enable data analytics capabilities has not yet been established. Drawing from organization information processing theory (OIPT), which argues that uncertainty and equivocality negatively impact organizational performance, we construct a model in which performance-”measured as hospitals’ patient satisfaction-”is a function of clinical analytics capabilities, complexity, and concentration. Our argument is that clinical analytics is an uncertainty-reducing mechanism that directly impacts satisfaction. However, we propose a nuanced moderating role of complexity of patient cases and concentration (the mix of procedures performed in a hospital). We show that analytics capabilities increased patient satisfaction, but we also find evidence for the moderating role of complexity on the effect of analytics on satisfaction. The result for the moderating impact of concentration was not significant; however, our post-hoc analysis indicated that the moderating effect was present in larger hospitals.
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