Electronic Tools Research Articles

Understanding 'quality' in adult traumatic brain injury rehabilitation from the perspectives of different stakeholders: a participatory mixed methods study.

The purpose of this study was to explore how 'quality' is understood for traumatic brain injury (TBI) rehabilitation from the perspectives of the rehabilitation recipients, their families and the providing clinicians. A participatory study using a mixed-methods, triangulation design. The study involved 1. a systematic literature search; 2. Individual semi-structured interviews with people with TBI and/or their caregivers and TBI rehabilitation clinicians, and 3. an online consensus process. 22 participants (7 people with TBI, 8 caregivers, 7 clinicians) participated in individual interviews. Their transcribed data were coded into broad categories via in-depth reflexive, thematic analysis; these categories were then mapped to 13 quality domains extracted from the literature. The emergent themes were then presented to the individuals, via an electronic consensus tool in two rounds. This resulted in 12 prioritized domains of quality that encompass service features, staff qualities and effectiveness. These evidence-informed and consensus-agreed indicators for quality may help guide both the provision and evaluation of TBI rehabilitation, that is valued and meaningful.

COVID-19, school closures and (cyber)bullying in Germany

ABSTRACT We analyse the prevalence of bullying in Germany during COVID-19, both as in-person bullying (in our context: school bullying) and via social media and electronic communication tools (cyberbullying). Using Google Trends data from 2013 to 2022 and exploiting the COVID-19 pandemic as a natural experiment when schools switched to distance learning, we document stark changes in the prevalence of (cyber)bullying in Germany: Our results indicate that during school years affected by COVID-19, online searches for school bullying decreased by about 29 percent, while online searches for cyberbullying increased by about 40 percent during the same periods.

A Retrospective Analysis of Lessons Learned and Perspectives on Expansion of Verbal Autopsy Implementation in Zambia, 2023.

Accurate cause-of-death statistics are vital for public health policy, but less than one-third of deaths globally are assigned a cause. Verbal autopsy (VA) methods are crucial in low- and middle-income countries lacking complete civil registration and vital statistics (CRVS) systems. We explored VA implementation in Zambia by using a previously developed framework. The National Mortality Surveillance Subcommittee under the Monitoring and Evaluation Technical Working Group within the Ministry of Health coordinates mortality surveillance activities in Zambia. To date, passive, non-population-representative VA data collection mechanisms have been used, leading to underrepresentation of some communities. In spite of the use of electronic data collection tools, VA systems have not been electronically linked to public health surveillance or CRVS systems. Funding for VA has largely been donor driven. Increasing government funding may ensure sustainability, while the adoption of sample-based platforms while linking VA information technology systems may make VA data more useful, timely, and accessible.

Current Practices for Delivering New Diagnosis Education at Children's Oncology Group Institutions: A Report From the Children's Oncology Group.

The Children's Oncology Group (COG) Nursing Discipline developed expert consensus recommendations and resources to guide the delivery of new diagnosis education across its member institutions. Current new diagnosis education practices across COG member institutions are unknown. To understand current new diagnosis education practices across COG member institutions. We conducted a cross-sectional survey of COG nurses between July and October 2023 to elicit current practices to deliver new diagnosis education to families across COG institutions. Data were collected and managed using REDCap electronic data capture tools. Individual responses from single institutions were averaged as a single institution-level response. Respondents included 146/227 (64.3%) COG institutions across 5 countries. Advanced practice nurses and nurse educators have primary responsibility for new diagnosis education at 28.1% and 26.7% of institutions, respectively. Less than half (42.4%) of institutions have a clearly defined process for delivering new diagnosis patient/family education. Almost all (88.2%) institutions use the COG Family Handbook; 64.7% use the COG New Diagnosis Guide, and 41.9% use the COG KidsCare app to support the delivery of new diagnosis education. More than half (61.5%) of institutions use checklists to facilitate the delivery of new diagnosis education, with 81.6% of large institutions versus 44.1% of small institutions reporting the use of checklists ( P = .004). There is variability in current new diagnosis education practices across COG institutions. These findings highlight opportunities for implementing standardized approaches aligned with expert consensus recommendations for the delivery of new diagnosis education.

Kárpátalja egyházi fenntartású iskoláinak virtuális nyelvi tájképe

We live in an age where everywhere we look, thousands of pieces of information are streaming towards us. This fact in itself highlights the importance of the linguistic landscape in our everyday lives, as everything that surrounds us, everything we perceive influences our thinking and therefore our use of language. In the 21st century, we need to pay particular attention to the virtual world, as a large percentage of the younger and even older generations receive a significant proportion of their stimuli through some types of electronic communication tools or social platforms. Schools have a particularly important role in language development and formation, as young people, the future generation, are most shaped within their walls. In the present study, we analysed a sample of posts published in the last few years on the social platforms (official website and Facebook) of the ecclesiastical schools of Transcarpathia. We relied on statistical and comparative analysis of the textual content of these entries. In addition, we examined the meta-linguistic information of the entries. The overall visual appearance of the website was also taken into consideration, i.e., the types of images published were also investigated. In the research, it was assumed that all the official webpages of the schools under investigation contain entries in both Ukrainian and Hungarian. We also assessed whether a higher percentage of entries in Hungarian appeared on the schools’ online interfaces. Results showed that the number of interactions by people who followed the sites was higher for Hungarian language posts, advertisements and articles. We assumed that religious posts and symbols regularly appeared on the websites and Facebook pages, and that a higher percentage of these posts and symbols appeared in Hungarian. It was also hypothesized that the volume of texts in Ukrainian was smaller than the amount of texts in Hungarian. The research has confirmed that both Ukrainian and Hungarian entries are found on the websites, with a higher share of entries in Hungarian. It also confirmed our hypothesis that followers of the websites tend to respond more frequently to posts in Hungarian, due to the fact that the majority of followers use Hungarian as their mother tongue. Last but not least, the research revealed that religious posts and symbols regularly appear on the official websites and Facebook pages of the lyceums, and the language of these posts is mostly Hungarian.

A comprehensive outline towards conciliation in the contemporary world of E-commerce

Since the start of the millennial era, technical advancements have led to exponential growth in electronic commerce, or e-commerce. According to the United Nations Conference on Trade and Development (UNCTAD), e-commerce sales reached about US$25 trillion globally in 2021 [1] and are expected to grow at a compound annual growth rate of 9% through 2027, which is twice as fast as the 4% annual growth rate predicted for traditional in-person retail [2]. Online dispute resolution (ODR) techniques that aim to settle disagreements and lower the likelihood of expensive lawsuits are becoming more and more necessary as both individuals and corporations use online shopping platforms. Due of its legally binding nature, arbitration is the most formal method, as was briefly discussed [3]. Online arbitration is carried out using electronic methods, like email and digital tools designed to make the duties of arbitrators and parties to a dispute easier. It adheres to the same rules and processes as traditional arbitration. On the plus side of e-arbitration, advancements in technology allow for time and cost savings without sacrificing the ease of remote filing. The conclusion of e-arbitration agreements raises several negative issues, including privacy and data protection issues for the consumer signing the agreements and power imbalances between corporate entities and the consumer. The degree to which artificial intelligence (AI) is effectively and sufficiently analysing a dispute between parties is up for debate because it's unclear how new this adjudication process is.

Social Determinants of Health Curriculum for the Pediatric Clerkship.

Education on social determinants of health (SDH) aligns with national standards for medical education. However, there are minimal existing resources targeted to medical students specific to the care of the pediatric population. We designed a case-based curriculum on SDH for third-year medical students on their pediatric clerkship to address this deficit. Third-year medical students on their pediatric clerkship received a case-based flipped classroom educational series on SDH in four 10-minute segments. Students completed voluntary and anonymous surveys delivered via an electronic survey tool before and after completion of the curriculum. Surveys were a self-assessment of knowledge and skills related to SDH in pediatrics and analysis of a pediatric case. One hundred sixty-seven third-year medical students completed the curriculum during their pediatric clerkship. Pre- and postsurvey response rates were 50% and 39%, respectively, for the self-assessment and 51% and 38%, respectively, for the case analysis components of the survey. Students demonstrated statistically significant improvement in knowledge and skills regarding SDH. After completion of the curriculum, students were more likely to identify SDH as factors contributing to the patient's health status and to propose questions targeted at SDH they would ask the patient or family when presented with a pediatric case. A case-based curriculum on SDH using a multisession flipped classroom approach advanced student knowledge and skills regarding SDH in the pediatric context. The curriculum has the potential for expansion to other institutions and to serve as a model for other subspecialties.

Using Existing Clinical Data to Measure Older Adult Inpatients' Frailty at Admission and Discharge: Hospital Patient Register Study.

Frailty is a widespread geriatric syndrome among older adults, including hospitalized older inpatients. Some countries use electronic frailty measurement tools to identify frailty at the primary care level, but this method has rarely been investigated during hospitalization in acute care hospitals. An electronic frailty measurement instrument based on population-based hospital electronic health records could effectively detect frailty, frailty-related problems, and complications as well be a clinical alert. Identifying frailty among older adults using existing patient health data would greatly aid the management and support of frailty identification and could provide a valuable public health instrument without additional costs. We aim to explore a data-driven frailty measurement instrument for older adult inpatients using data routinely collected at hospital admission and discharge. A retrospective electronic patient register study included inpatients aged ≥65 years admitted to and discharged from a public hospital between 2015 and 2017. A dataset of 53,690 hospitalizations was used to customize this data-driven frailty measurement instrument inspired by the Edmonton Frailty Scale developed by Rolfson et al. A 2-step hierarchical cluster procedure was applied to compute e-Frail-CH (Switzerland) scores at hospital admission and discharge. Prevalence, central tendency, comparative, and validation statistics were computed. Mean patient age at admission was 78.4 (SD 7.9) years, with more women admitted (28,018/53,690, 52.18%) than men (25,672/53,690, 47.81%). Our 2-step hierarchical clustering approach computed 46,743 inputs of hospital admissions and 47,361 for discharges. Clustering solutions scored from 0.5 to 0.8 on a scale from 0 to 1. Patients considered frail comprised 42.02% (n=19,643) of admissions and 48.23% (n=22,845) of discharges. Within e-Frail-CH's 0-12 range, a score ≥6 indicated frailty. We found a statistically significant mean e-Frail-CH score change between hospital admission (5.3, SD 2.6) and discharge (5.75, SD 2.7; P<.001). Sensitivity and specificity cut point values were 0.82 and 0.88, respectively. The area under the receiver operating characteristic curve was 0.85. Comparing the e-Frail-CH instrument to the existing Functional Independence Measure (FIM) instrument, FIM scores indicating severe dependence equated to e-Frail-CH scores of ≥9, with a sensitivity and specificity of 0.97 and 0.88, respectively. The area under the receiver operating characteristic curve was 0.92. There was a strong negative association between e-Frail-CH scores at hospital discharge and FIM scores (rs=-0.844; P<.001). An electronic frailty measurement instrument was constructed and validated using patient data routinely collected during hospitalization, especially at admission and discharge. The mean e-Frail-CH score was higher at discharge than at admission. The routine calculation of e-Frail-CH scores during hospitalization could provide very useful clinical alerts on the health trajectories of older adults and help select interventions for preventing or mitigating frailty.

Impact of an Adult Congenital Heart Disease Order Set in a Pediatric Cardiac Intensive Care Unit.

Background: Patients with congenital heart disease (CHD) are increasingly surviving to adulthood. Given their age- and condition-specific needs, the optimal postoperative setting for these patients is not yet determined. This study aims to evaluate the utility of an adult-specific order set in improving clinical outcomes for these patients in a pediatric cardiovascular intensive care unit (ICU). Methods: Adults with CHD (ACHD) admitted to the cardiovascular ICU following cardiac surgery at a pediatric tertiary care center were identified for a retrospective cohort study. Health care delivery metrics and clinical outcomes of participants who received the adult-specific order set were compared with control patients admitted prior to the intervention. Categorical outcomes were compared using the χ2 test of independence or Fisher exact test, and continuous outcomes were assessed using the t test. Results: A total of 130 ACHD patients received the intervention, with no significant differences observed in clinical outcomes when compared with 89 controls. While there was additionally no reduction in hospital-related mortality (2.3% vs 7.8%, RR 0.3; P = .1), clinician ordering behaviors were better aligned with best-practices following the intervention. Among patients with moderate or greater anatomic complexity, a post hoc analysis demonstrated reduced in-hospital mortality from those who received the adult order set. Conclusions: The implementation of an adult-specific order set in a pediatric care setting did not improve clinical outcomes for all ACHD patients. Patients with moderate and greater anatomic complexity did see a mortality benefit, suggestive that targeted electronic tools may most benefit those who have the highest risk.

Reliability and validation of an electronic penicillin allergy risk-assessment tool in a pregnant population

BackgroundPenicillin allergy adversely impacts patient care, yet most cases do not have true allergies. Clinicians require efficient, reliable clinical tools to identify low risk patients who can be safely de-labeled. Our center implemented the FIRSTLINE electronic point-of-care decision support tool to help non-allergist practitioners risk stratify patients with penicillin allergy. We sought to explore the reliability and validity of this tool in relation to allergist assessment and actual patient outcomes. We additionally compared it with two other published stratification tools, JAMA and PENFAST, to assess ability to accurately identify low risk patients appropriate for direct oral challenge.MethodsIn this single-center, retrospective, observational study, 181 pregnant females with self-reported penicillin allergy between July 2019 to June 2021 at BC Women’s Hospital, Vancouver, Canada were used to assess the reliability and validity of all three tools. Physician-guided history of penicillin use and symptoms were used for scoring. Results and recommendations were compared to actual patient outcomes after clinician decision for direct oral challenge or intradermal tests. We compared the performance of JAMA, PENFAST and FIRSTLINE.Results181 patients were assessed. 176/181 (97.2%) patients were deemed not allergic. Each risk stratification tool labelled majority of patients as low risk with 88.4% of patients PENFAST 0–2, 60.2% of patients JAMA low risk, 86.7% of patients FIRSTLINE very low risk.ConclusionWe demonstrate that our point-of-care electronic algorithm is reliable in identifying low risk pregnant patients, as compared to an allergist assessment. To our knowledge, this is the first study to provide direct comparison between multiple decision support tools using the same population, minimizing participant bias. Providing clinical algorithms to risk stratify patients, can enable healthcare professionals to safely identify individuals who may be candidates for direct penicillin oral challenges versus needing referral to specialists. This increases the generalizability and efficiency of penicillin allergy de-labeling.

Pedagogical technologies for teaching environmental engineering in the online learning system of higher education institution

The article outlines the pedagogical technologies for teaching environmental engineering in the online learning system of higher education institutions. There are proposed ways of developing educational technologies for teaching environmental engineering: active and collaborative learning, individualisation of training, use of video and audio materials, using electronic tools for evaluation of educational results, development of digital literacy, implementation of interactive online courses and professional communication and mentoring. There are presented the use of these technologies in the different aspects of environmental engineering, such as analysing water quality parameters, soil quality assessment, studying waste management practices, and studying the integration of renewable energy into the practice through virtual labs, online tests, video lectures, and collaborative projects. The proposed pedagogical technologies for teaching environmental engineering in the online learning system of higher education institutions were tested in the educational process. The Student's t-test was used for statistical calculation of the obtained experimental data. At the end of the experiment, there is a statistically significant difference between the mean values of the experimental and control groups. It can be claimed that the use of pedagogical technologies for teaching environmental engineering in the online learning system of higher education institutions is perspective.

Potential for an Electronic Clinical Decision Support Tool to Support Appropriate Antibiotic Use for Pediatric Diarrhea Among Village Doctors in Bangladesh.

Potential for an Electronic Clinical Decision Support Tool to Support Appropriate Antibiotic Use for Pediatric Diarrhea Among Village Doctors in Bangladesh.

Blockchain as Electronic Evidence Against Crypto Crimes in Indonesia

In the context of digital security, the utilization of blockchain technology as a means of evidence against crypto crimes has become an exceedingly crucial topic. This research elucidates whether the admissible evidence tool stipulated in Article 184 paragraph (1) of the criminal procedural law encompasses proof relating to crypto crimes and how the decentralized structure and transparent nature of blockchain can aid in furnishing accurate and credible evidence pertaining to crypto crimes. This study offers profound insights into the potential of blockchain concerning evidence provision and prevention of crypto crimes. The author employs normative research, a process aimed at uncovering legal rules, principles, and doctrines to address legal issues encountered. Based on the discussion, it can be concluded that blockchain can serve as an electronic evidence tool in crypto crimes. Aligned with the decentralized and transparent nature of blockchain, it can provide precise and permanent data.

Pediatric High Blood Pressure Recognition Associated With Electronic Decision Support: A Cohort Analysis.

Pediatric high blood pressure (BP) predicts future cardiovascular disease events. High BP is improperly measured, underrecognized, and undermanaged especially in disadvantaged populations. In a large, diverse, academic pediatric practice, we detail the associations of a comprehensive initiative with high BP provider recognition. A comprehensive BP initiative was promulgated including (1) retraining providers and staff on BP management; (2) deploying equipment at 55+ sites; and (3) electronic decision support tool alerting staff and clinicians and suggesting management. During the 14-month preintervention and 14-month postintervention periods, data on BP and patient characteristics were collected. The outcome was incident BP recognition defined as any of the following: BP-specific International Classification of Diseases, Tenth Revision, diagnosis; problem list entry; specialty referral; diagnostic testing; repeat visit; or antihypertensives. Dichotomized as underpre versus at or over 13 years of age, analyses utilized interrupted time series and multivariable-adjusted logistic regression. From preintervention (children, n=105 674; adolescents, n=54 365) to postintervention (children, n=87 917; adolescents, n=56 470), the proportion measured with high BP declined in children and adolescents (30% versus 14% and 30% versus 15%, respectively, each P<0.001). Post-intervention, high BP provider recognition was 58% higher in children (4.6%-7.3%) and 43% higher in adolescents (7.9% versus 11.3%; P<0.001 for both). The improvement was not different in disadvantaged race, ethnicity, or zip codes. A comprehensive BP initiative was associated with more appropriate high BP measurement and recognition including in disadvantaged populations. Future work may address the low overall and nonsustained recognition and consideration of electronic decision support for pediatric BP management and mitigating disparities.

«ОПТИКА» БӨЛІМІ БОЙЫНША ЭЛЕКТРОНДЫҚ ОҚУЛЫҚТАРДЫҢ ЗАМАНУИ БІЛІМ БЕРУ ҚҰРАЛЫ РЕТІНДЕ РӨЛІ

The article examines the effectiveness and role of the use of electronic textbooks in the education system. And, including in the section «Optics», optical phenomena and patterns are taken as a basis. The creation of electronic textbooks is one of the most pressing problems of the educational process today. The expansion of the use of modern information technologies has led to the need to develop electronic learning tools that increase the effectiveness of self-learning and the quality of learning for students. The use of electronic means in the learning process is effective for both the teacher and the student. The use of electronic learning tools in the educational process does not contradict the traditional teaching method, but rather complements the use of its achievements. Comparison parameters are also considered: page and rotation; reader's movement through the book; plane and depth; book block; personal appearance of the book; text; illustration; tactile sensations; reliability of information storage and accessible information update; one can say about the pros and cons of this and other types of books. The advantages of an electronic textbook in terms of printing are accompanied only by sound effects associated with its large information capacity and ease of use. With all the convenience of the e-book format, the reader may want to see it directly on the site if he does not want to download it, or, as in a bookstore, first view the publication and then decide whether to download it or not. The main disadvantages of the electronic textbook are due to its loss of personal artistic appearance. Currently, there are many tools for creating electronic textbooks. For example, the possibilities of the program SunRav BookEditor, SunRav BookReader, TurboSite, Flipsnack, EdApp, Canva, etc. are considered. In the article, we will define the role of analyzing the digital literacy of students using an electronic textbook. Examples of electronic forms of a physics textbook for grades 7-9 can be given.

Electronic Clinical Decision Support Tools: Strategies to Improve the Management of Lower Respiratory Tract Infections in Low-Resource Settings.

Lower respiratory tract infection (LRTI) is a common reason for hospitalization and antibacterial use globally. There is considerable overlap in the clinical presentation of bacterial and viral LRTIs. Low- or middle-income countries (LMICs) face the dual challenge of appropriately targeting antibacterials for bacterial LRTI while reducing inappropriate antibacterials for viral LRTI. We propose a framework by which an electronic clinical decision support tool (eCDST) for diagnosing LRTI and reducing unnecessary antibacterial use may be developed, validated, and prospectively evaluated in an LMIC. The developed tool would be data driven, low-cost, feasible in the local setting, adaptable based on resource availability, and updated in real time, with prospective assessment to identify its clinical impact. We draw upon our team's recent experience developing an eCDST for LRTI management in Sri Lanka. Publicly sharing such processes and data is valuable, such that we can collectively improve clinical care in LMICs and other settings.

ICardioMonitor Digital Monitoring System for People with Heart Failure: Development and Evaluation of Its Accessibility and Usability

Background/Objectives: The use of eHealth as a monitoring system in people with heart failure (HF) has been shown to be effective in promoting self-care and reducing re-admissions and mortality. The present study develops and evaluates the accessibility and usability of the web app iCardioMonitor HF monitoring system. Methods: This study consisted of two stages. The first stage (co-design) comprised two phases: (1) analysis of the scientific literature and expert opinions and (2) co-design of the iCardioMonitor (web app plus a knowledge-base algorithm) and definition of alert criteria. The second stage (cross-sectional descriptive study) analyzed system accessibility (% of people using the iCardioMonitor and % of parameters recorded) and usability, employing the Spanish version of the System Usability Scale for the Assessment of Electronic Tools. Results: The iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically. A total of 45 patients with an average age of 55.8 years (standard deviation [SD] = 10.582) and an average time since diagnosis of 7.1 years (SD = 7.471) participated in the second stage. The percentage of iCardioMonitor use was 83.2%. The average usability score was 77.2 points (SD = 21.828), higher in women than men (89.2; SD = 1.443–76.0; SD = 1.443) (p = 0.004). The usability score was higher the shorter the time since diagnosis (r = 0.402; p = 0.025) and the higher the number of responses (r = 0.377; p = 0.031). Conclusions: The results obtained show that iCardioMonitor is a tool accepted by patients and has obtained a remarkable score on the usability scale. iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically.

Architectural Proposal for Low-Cost Portable Digital Oscilloscopes Based on Microcontrollers and Operational Amplifiers

Recently, an increasing number of people have employed do-it-yourself (DIY) and do-it-with-others (DIWO) techniques and processes to develop unique technology products. This trend is commonly called the maker movement and fosters the creation of own electronic and mechanical devices and tools. Oscilloscopes are really useful tools to diagnose problems and analyze electronic devices and electrical circuits, and thus they should not stay outside this trend. To contribute to this field, an architecture to make low-cost portable digital oscilloscopes is proposed. The proposal is mainly based on general-purpose microcontrollers and operational amplifiers. Following this approach, a portable oscilloscope with two input channels, a graphic display, a synchronism detector, internal and external triggers, and a digital signal analyzer function is designed. Furthermore, different options for the implementation are proposed and discussed.

Clinical Use of Mental Health Digital Therapeutics in a Large Health Care Delivery System: Retrospective Patient Cohort Study and Provider Survey.

While the number of digital therapeutics (DTx) has proliferated, there is little real-world research on the characteristics of providers recommending DTx, their recommendation behaviors, or the characteristics of patients receiving recommendations in the clinical setting. The aim of this study was to characterize the clinical and demographic characteristics of patients receiving DTx recommendations and describe provider characteristics and behaviors regarding DTx. This retrospective cohort study used electronic health record data from a large, integrated health care delivery system. Demographic and clinical characteristics of adult patients recommended versus not recommended DTx by a mental health provider between May 2020 and December 2021 were examined. A cross-sectional survey of mental health providers providing these recommendations was conducted in December 2022 to assess the characteristics of providers and recommendation behaviors related to DTx. Parametric and nonparametric tests were used to examine statistical significance between groups. Of 335,250 patients with a mental health appointment, 53,546 (16%) received a DTx recommendation. Patients recommended to DTx were younger, were of Asian or Hispanic race or ethnicity, were female, were without medical comorbidities, and had commercial insurance compared to those without a DTx recommendation (P<.001). More patients receiving a DTx recommendation had anxiety or adjustment disorder diagnoses, but less had depression, bipolar, or psychotic disorder diagnoses (P<.001) versus matched controls not recommended to DTx. Overall, depression and anxiety symptom scores were lower in patients recommended to DTx compared to matched controls not receiving a recommendation, although female patients had a higher proportion of severe depression and anxiety scores compared to male patients. Provider survey results indicated a higher proportion of nonprescribers recommended DTx to patients compared to prescribers (P=.008). Of all providers, 29.4% (45/153) reported using the suggested internal electronic health record-based tools (eg, smart text) to recommend DTx, and of providers recommending DTx resources to patients, 64.1% (98/153) reported they follow up with patients to inquire on DTx benefits. Only 38.4% (58/151) of respondents report recommending specific DTx modules, and of those, 58.6% (34/58) report following up on the impact of these specific modules. DTx use in mental health was modest and varied by patient and provider characteristics. Providers do not appear to actively engage with these tools and integrate them into treatment plans. Providers, while expressing interest in potential benefits from DTx, may view DTx as a passive strategy to augment traditional treatment for select patients.

Insights into missing populations: Exploring characteristics of unscreened patients with cancer in psychosocial distress and social drivers of health screening in an ambulatory setting.

174 Background: Psychosocial distress is common among patients with cancer and distress screening is required for American College of Surgeons Commission on Cancer accreditation. Screenings proactively identify needs, connect patients to services, reduce distress and improve cancer outcomes. We implemented a dynamic 17-question electronic screening tool that includes: assessment for psychosocial distress, social drivers of health (SDH) and spiritual care, and evaluated differences in patient characteristics among those who did and did not complete the survey. Methods: The survey was developed through an interdisciplinary review of evidence-based questions to proactively address supportive care needs for patients. It is available in English and Spanish and sent to patients via the patient portal 7 days before the second oncology appointment with a reminder 3 days before the appointment. It was implemented across 5 Mount Sinai Health System ambulatory facilities, spanning 3 New York City boroughs between June 2022 and February 2024. We used descriptive statistics to compare demographic and clinical characteristics of patients who did and did not complete the survey. Results: A total of 11,199 patients were assigned surveys; (42%) did not complete it. Patients who did not complete the survey were more likely to be Asian and Hispanic, older age, to speak a language other than English, reside in Queens or Brooklyn, and were less likely to have Commercial insurance compared to those who completed the survey (p&lt;0.001 for all). There was no difference in sex (p=0.93) among the groups. Conclusions: There are significant disparities in the completion rates of electronic psychosocial distress and SDH screenings among patients with cancer, revealing that certain groups are less likely to engage with the tool. Targeted strategies are needed to increase screening completion rates among these populations. Future efforts should focus on addressing language barriers, enhancing technological accessibility, and developing culturally sensitive approaches to ensure all patients benefit from these screenings so we can better identify and address the supportive care needs of all cancer patients. Characteristics of patients who did and did not complete the survey. Characteristic Did Not Complete4654 (42%) Completed6545 (58%) p-value Race &lt;0.001 Black 978 (21) 1538 (23) Asian 642 (14) 698 (11) Unknown 225 (5) 258 (4) Other/Patient Declined 1298 (28) 1461 (22) White 1511 (32) 2590 (40) Age (mean (SD)) 64 (14) 61 (15) &lt;0.001 Non English Language 1167 (25) 956 (15) &lt;0.001