Online Appointment Research Articles

Digital divide in access and use of digital health technologies: what do we know from Germany?

Abstract Even though Germany is an industrialised country, health inequalities exist between individuals or population groups due to unequal access to scarce social resources such as money or knowledge. This case study illustrates the extent of the digital divide in access and use of digital health technologies. Data from the Liter@te study, in which 96 adults aged 18-64 years with low reading and writing skills living in Germany were asked about their digital health technology use and their digital health literacy, were compared with two parallel conducted population surveys in Germany (i.e., nationwide telephone survey on digitalisation and health with 1020 internet users aged 18 years and above, online survey on digitalisation in health care with 1839 adults aged 18-80 years insured at a statutory health insurance company). Adults with low reading and writing skills used digital devices in the health context such as computers (23% vs. 71%) or activity trackers (21% vs. 35%) less frequently than the general population, whereas no differences were reported in the use of smartphones (79% vs. 70%). In addition, 18% of adults with low reading and writing skills and 4% of the general population stated that they do not use digital health technologies. Other digital health technologies such as online appointment scheduling (25% vs. 81%) or health websites (32% vs. 45%) were also used less frequently by adults with low reading and writing skills compared to the general population. Participants in the Liter@te study who do not use digital health technologies reported more frequent access problems (e.g., no suitable device, technical problems, poor internet connection) than participants in the population survey. 35% of participants in the Liter@te study have a low digital health literacy (eHEALS score between 8-19/40 points), compared to only 8% in the population survey.

EHealth profile and care coordination of primary care physicians

Abstract Background Digital health or eHealth is a vast field encompassing mobile health (mHealth), health information technology, wearable devices, telehealth, and telemedicine, and is changing the practice of medicine. While it holds promise for enhancing care coordination, its adoption is hindered by various barriers, including at the healthcare professional level. We assessed the eHealth profile of primary care physicians and its relationship with care coordination. Methods As part of the Commonwealth Fund 2022 IHP survey of primary care physicians, 1114 physicians in Switzerland completed a questionnaire on their digital health use, and care coordination practices. Based on their responses, we built a digital health score, summarizing physicians’ use of digital health tools, and a care coordination score. Associations between both scores were assessed using stratified analyses and multiple linear regression. Results Among 1114 participants (46% women, mean age 52), 83% used electronic patient records, 96% used teleconsultations for less than 5% of consultations, and 63% never used connected health tools for the monitoring of patients with chronic diseases. A total of 16% allowed for online appointments, 20% for online medical prescriptions, 52% for communicating electronically lists of medications with other healthcare professionals, and 89% the possibility of e-mail or web communications with the patient. The eHealth score was positively associated with the number of weekly working hours, being an internal medicine specialist or practicing physician, the number of full-time equivalents in the practice, and with being in a group practice setting. The higher the eHealth profile score, the higher was the care coordination score. Conclusions Physicians’ use of digital health tools was positively associated with care coordination. This could underscore the potential benefits of digital health in enhancing collaborative and interprofessional care practices. Key messages • In a large survey of primary care physicians, the use of digital health tools and care coordination were correlated. • Digital health could enhance collaborative and interprofessional care practices.

Barriers and enablers that influence the uptake of HIV testing among heterosexual migrants in the Netherlands.

Heterosexual migrant men and women in the Netherlands often face barriers to accessing health services, including HIV testing, that may lead to late-stage HIV diagnoses. This study explored factors of influence in the usage of HIV testing among heterosexual migrants. Qualitative evaluation with semi-structured interviews at the Amsterdam-based AIDS Healthcare Foundation (AHF) Checkpoint and one focus group discussion (FGD) conducted during June-July 2023 with 19 participants: interviews with 12 heterosexual migrants from low- or middle-income countries (LMICs) and FGD (n = 5) and interviews (n = 2) with 7 key informants from the (public) health sector. Recorded interviews were transcribed and thematically analyzed, using the framework of Andersen's Expanded Behavioral Model of Health Services Use. In total, 55 themes emerged from the interviews and the FGD. Examples include insufficient availability of information on HIV and testing services, and difficulty in accessing these services (e.g. the barrier of the online appointment system of the Centre for Sexual Health (CSH)). HIV test participants expressed free, rapid testing, no appointment required, and a positive experience during their HIV test as enablers to test in the future. Results from key informants showed that poor health literacy and lack of clarity on the healthcare system's guidelines were barriers for heterosexual migrants in accessing information on HIV and testing services. It also revealed past initiatives and interventions that were successful in reaching at-risk groups such as the integration of HIV testing into sexually transmitted infection (STI) testing, but that were subsequently discontinued due to financial constraints. Factors contributing to a low HIV test uptake were participants' perception of limited accessibility of CSH facilities, insufficient available information on HIV (testing) services, and low perception of HIV risk. Unclear policies on accessing HIV/STI testing services at CSHs, and potential missed opportunities for HIV testing at general practitioners were contributing factors identified by key informants.

Emergency Knowledge Translation, COVID-19 and indoor air: evaluating a virtual ventilation and filtration consultation program for community spaces in Ontario

BackgroundAn October, 2021 review of Public Health Ontario's COVID-19 guidance for congregate settings such as shelters and long-term care homes demonstrated that this guidance did not include references to ventilation or filtration. In April 2022, an interdisciplinary team with expertise in indoor air quality (IAQ), engineering, epidemiology, community programming and knowledge translation launched a virtual ventilation and filtration consultation program for community spaces in Toronto, Ontario. The program gives people working in community spaces direct access to IAQ experts through 25-min online appointments. The program aims to help reduce the risk of COVID-19 transmission in community spaces, and was designed to help compensate for gaps in public health guidance and action.MethodsRepresentatives from participating organizations (n. 27) received a link to an online survey via email in April 2023. Survey questions explored the impacts of the program on topics such as: purchase and use of portable air filters; maintenance and use of bathroom fans; and, maintenance and modification of HVAC systems. Survey participation was anonymous, and no demographic information was collected from participants.ResultsRepresentatives from 11 organizations completed the survey (40%). Of those who responded, nine (82%) made changes as a result of the program, with eight (73%) making two or more changes such as purchasing portable air filters and increasing routine maintenance of HVAC systems.ConclusionsWhen presented with brief access to expert support and tailored plain language guidance, people working in community spaces increased their use of ventilation and filtration strategies for COVID-19 infection prevention and control.

Design characteristics and service experience with e-government services: A public value perspective

We propose a model that explains how e-government service design characteristics influence citizens’ service experience. Drawing on the public value perspective, we define four categories of e-government impacts and identify their corresponding design characteristics: (1) capability—accuracy and completeness; (2) interactions—accessibility and self-service capability; (3) orientation—user support and personalization capability; and (4) value distribution—privacy protection. We propose that citizens’ perceptions of the design characteristics affect four core technology beliefs—i.e., performance expectancy, effort expectancy, facilitating conditions, and trust—that in turn affect two service experience outcomes—i.e., perceived service quality and continuance intention. We tested our model in a two-stage survey of 2623 users of two e-government services—i.e., an e-government portal and an online appointment booking service. The results showed that citizens’ perceptions of the design characteristics predict the core technology beliefs that in turn predict perceived service quality and eventually continuance intention. Further mediation analyses showed that the core technology beliefs significantly mediate the effects of design characteristics on perceived service quality, but with different patterns of full and partial mediation across the two services. These findings contribute to understanding the underlying mechanisms through which service design characteristics influence service experience. We discuss the theoretical and practical implications on e-government service design and delivery.

Appointment Blitz: Optimizing Patient-Therapist Rehab Scheduling.

Taiwan has a well-structured healthcare insurance system that offers accessible medical resources to the public through nominal health insurance fees. Consequently, individuals in need of care willingly pay nominal charges for medical services, including rehabilitation treatment. This study delves into the rehabilitation department of a medical center in southern Taiwan. Despite offering comprehensive traditional rehabilitation services covering neurological, musculoskeletal, pediatric, cardiopulmonary, communication, and swallow disorders, the demand for appointments significantly surpasses the number of available therapists. Therefore, this paper proposes an efficiently method to optimize patient-therapist appointment. With a Complex Conditional Logic that we have designed in this paper, we aim to simplify the scheduling processing for patient seeking appointment either online or via phone calls. More than 50,000 cases have been treated since the system's launch within a year, facilitates hospital resource allocation and enhancing patient medical experiences.

Investigating Patient Use and Experience of Online Appointment Booking in Primary Care: Mixed Methods Study.

Online appointment booking is a commonly used tool in several industries. There is limited evidence about the benefits and challenges of using online appointment booking in health care settings. Potential benefits include convenience and the ability to track appointments, although some groups of patients may find it harder to engage with online appointment booking. We sought to understand how patients in England used and experienced online appointment booking. This study aims to describe and compare the characteristics of patients in relation to their use of online appointment booking in general practice and investigate patients' views regarding online appointment booking arrangements. This was a mixed methods study set in English general practice comprising a retrospective analysis of the General Practice Patient Survey (GPPS) and semistructured interviews with patients. Data used in the retrospective analysis comprised responses to the 2018 and 2019 GPPS analyzed using mixed-effects logistic regression. Semistructured interviews with purposively sampled patients from 11 general practices in England explored experiences of and views on online appointment booking. Framework analysis was used to allow for comparison with the findings of the retrospective analysis. The retrospective analysis included 1,327,693 GPPS responders (2018-2019 combined). We conducted 43 interviews with patients with a variety of experiences and awareness of online appointment booking; of these 43 patients, 6 (14%) were from ethnic minority groups. In the retrospective analysis, more patients were aware that online appointment booking was available (581,224/1,288,341, 45.11%) than had experience using it (203,184/1,301,694, 15.61%). There were deprivation gradients for awareness and use and a substantial decline in both awareness and use in patients aged >75 years. For interview participants, age and life stage were factors influencing experiences and perceptions, working patients valued convenience, and older patients preferred to use the telephone. Patients with long-term conditions were more aware of (odds ratio [OR] 1.43, 95% CI 1.41-1.44) and more likely to use (OR 1.65, 95% CI 1.63-1.67) online appointment booking. Interview participants with long-term conditions described online appointment booking as useful for routine nonurgent appointments. Patients in deprived areas were clustered in practices with low awareness and use of online appointment booking among GPPS respondents (OR for use 0.65, 95% CI 0.64-0.67). Other key findings included the influence of the availability of appointments online and differences in the registration process for accessing online booking. Whether and how patients engage with online appointment booking is influenced by the practice with which they are registered, whether they live with long-term conditions, and their deprivation status. These factors should be considered in designing and implementing online appointment booking and have implications for patient engagement with the wider range of online services offered in general practice.

Factors influencing patients’ intention to use the Health Clinic Online Appointment System app

Factors influencing patients’ intention to use the Health Clinic Online Appointment System app

Control of Online-Appointment Systems When the Booking Status Signals Quality of Service

We revisit a service provider’s problem to match supply and demand via an online appointment system such as a doctor in the health care sector. We identify in a survey that an extensive set of available appointments leads to significantly less demand because customers infer a lower quality of the service, as part of an observational learning process. We capture the quality inference effect in a multinomial logit framework and present a Markov decision process for solving the problem of releasing available slots of the appointment system to optimality aiming at maximizing the expected profits. We further evaluate several simple decision rules and provide management insights on which rule to apply under different generic scenarios. Different from current literature, offering all available appointments may lead to suboptimal results when accounting for the quality inference effect. The profit-maximizing strategy then is to offer a subset of the available appointments.

Artificial Intelligence in Healthcare: Implications, Challenges, and Future Prospects

Artificial intelligence is a technology that enables machines, especially computer systems, to mimic human intelligence and problem-solving abilities. This technology is being used nowadays in many areas of the healthcare industry, from scheduling online appointments to robot-assisted, safer surgeries with better patient outcomes. Just like a physician, AI can record a patient's history, signs and symptoms, and lab results, leading to an accurate diagnosis and a proper treatment plan, but in no time. This is just a small example of the implications of AI in the sector. Other areas of medicine are also being benefited by this innovation, like gastroentology, radiology, surgery, and preventive medicine. The development of advanced algorithms has reduced the burden on radiologists by helping them identify abnormal images and pick up malignant lesions with minimal diagnostic errors. Similarly, AI-assisted colonoscopy can help identify malignant and benign polyps. AI-powered systems, like Google's DeepMind Health, may identify malignant growth in mammograms and diabetic retinopathy, which can aid in early detection and treatment.

Malaysian Hospitals on the web: A multi-criteria assessment of official websites

This study thoroughly examines and assesses hospital websites in Malaysia according to a predefined list of indicators and sub-indicators, based on four criteria: Technology Features, Content, Services, and Community Interaction, as defined in the Health Sector Website Assessment Index (HSWAI). A total of 107 Malaysia hospitals were assessed. Private and university hospitals outperform public ones, especially in online appointment management and patient care automation areas. Most hospital websites perform well in the technology features criterion and satisfactorily on content, but show shortcomings in accessibility, reliability, research and teaching, participation, and community interaction elements, and most of them fall short in quality metrics data. Malaysian hospitals should adopt best practices to improve their websites concerning accessibility, reliability, services, and community interaction. The website design should endeavour to include multiple stakeholders, considering people with disabilities, in line with the sustainable development goals of leaving no one behind. Additionally, websites should ensure the dissemination of evidence-based information while taking advantage of social media to reach a wider audience.

DOCTOR APPOINTMENT SYSTEM

ABSTRACT— Doctor Appointment System is a web based application which provides patients or any user and easy way of booking a doctor’s appointment online. This is a web based application that overcomes the issue of managing and booking appointments according to user’s choice or demands. The task sometime become very tedious for the compounder or doctor himself in manually allotting appointments for the users as per their availability. Hence this project offers an effective solution where user can view various booking slots available select the preferred date and time. The main objective of “Doctor Appointment Management System” project is to providing easier doctor appointment and gets appointment online which save lots of time. Index Terms – Deep Learning, Machine Learning, CNN, Image classification, Brain disease, MRI classification.

Innovation and Practice of "yae920.com" One-stop Service Mode from the Perspective of Digital Transformation

With the deepening of digital transformation, the medical service industry is facing huge innovation opportunities and challenges. This paper studies the "yae920.com" one-stop service model and discusses the impact of digital transformation on its service innovation and practice. The study first analyzed the overall impact of the digital transformation on the medical service industry, including the optimization of the service process, the improvement of the patient experience, and the improvement of the operational efficiency. Then, through the method of case study, it expounds how "yae920.com" innovates the one-stop service mode in the process of digital transformation, including the integration and optimization of functions such as online appointment registration, online consultation and consultation, electronic prescription circulation, online drug purchase and distribution and so on. The research also deeply explores the challenges and coping strategies encountered by "yae920.com" in the process of service model innovation, as well as the practical results achieved. The research results show that the digital transformation provides strong support for the innovation of the "yae920.com" one-stop service mode, and effectively improves the service efficiency and patient satisfaction. The research in this paper has certain reference value for promoting the digital transformation and service mode innovation of the medical service industry.

The relationship between patient experience and real-world digital health access in primary care: A population-based cross-sectional study.

Implementing digital health technologies in primary care is anticipated to improve patient experience. We examined the relationships between patient experience and digital health access in primary care settings in Ontario, Canada. We conducted a retrospective cross-sectional study using patient responses to the Health Care Experience Survey linked to health and administrative data between April 2019-February 2020. We measured patient experience by summarizing HCES questions. We used multivariable logistic regression stratified by the number of primary care visits to investigate associations between patient experience with digital health access and moderating variables. Our cohort included 2,692 Ontario adults, of which 63.0% accessed telehealth, 2.6% viewed medical records online, and 3.6% booked appointments online. Although patients reported overwhelmingly positive experiences, we found no consistent relationship with digital health access. Online appointment booking access was associated with lower odds of poor experience for patients with three or more primary care visits in the past 12 months (adjusted odds ratio 0.16, 95% CI 0.02-0.56). Younger age, tight financial circumstances, English as a second language, and knowing their primary care provider for fewer years had greater odds of poor patient experience. In 2019/2020, we found limited uptake of digital health in primary care and no clear association between real-world digital health adoption and patient experience in Ontario. Our findings provide an essential context for ensuing rapid shifts in digital health adoption during the COVID-19 pandemic, serving as a baseline to reexamine subsequent improvements in patient experience.

Optimizing Doctor Availability and Appointment Allocation in Hospitals through Digital Technology and AI Integration

Many patients miss their appointments all around the world and many of them don't even cancel at all or don't do so in time due to several reasons. In order to address the widespread issue of medical no-shows, this paper proposes a solution that involves building a machine learning model utilizing patient datasets that are already available. This model will identify patterns and links between various patient factors and the patients' propensity to miss appointments. As a result, based on their information, it is possible to anticipate the chance of a patient appearing. Based on the Support Vector Machines classification technique, the machine learning model created the solution predictive model. Effective healthcare services are vital in today's fast-paced environment. This strategy aims to reduce the distance between patients and medical professionals by offering a workable and friendly solution. For certain medical institutions, such as clinics and hospitals, this initiative makes it easier for patients and customers to schedule doctor appointments online. Using this technology, patients may easily browse a database of doctors' biographies, specializations, and availability. Even the day and time of their choosing can be chosen for appointments. Each patient's appointment request will be scheduled by this doctor's appointment system and forwarded to the physician. The system administrator will update the list of doctors, including their specialties, personal information, and system access credentials. Patients will look for a physician who specializes in their requirements by exploring the doctor's appointment system online. Before making their request, the patient can browse the doctor's weekly schedule to choose a day and time that works best for them. Following that, the physicians have access to all of their appointments as well as the patients' appointment requests, which are prioritized according to their availability. It gives medical professionals a strong tool for successfully managing the schedules, which reduces administrative strain and ensures a positive patient experience.

Examining Accessibility of Freestanding Abortion Clinics for People With Disabilities [ID 2683401

INTRODUCTION: People with disabilities face numerous barriers to equitable health care but have a fundamental right to safe abortion care. This study reviews the accessibility of freestanding abortion clinics in the United States for those with disabilities. METHODS: A quantitative data analysis was performed. All freestanding abortion clinics registered with the Abortion Care Network were included except those directly affiliated with a university or general gynecology clinic and those exclusively operating online. Two independent reviewers analyzed clinic websites after an interrater reliability test. Independent variables analyzed included Flesch Reading Ease score, presence of a statement affirming dignity for all persons, online appointment scheduling, transparent pricing, and financial assistance information. RESULTS: Seventy-two clinics were included. No clinic explicitly stated that their facilities were accessible to individuals with disabilities. Fifty-four percent had a statement affirming dignity for all persons, most of which were in the Northeast or West Coast. 6% had an accessibility widget, and 63% had online appointment scheduling. Mean Flesch Reading Ease score was 55.37 correlating to a 10th- to 12th-grade reading level. 33% had transparent pricing information, and 71% offered information on financial assistance. CONCLUSION: Several accessibility barriers were identified on these websites. Freestanding abortion clinics should focus on enhancing accessibility by explicitly affirming dignity for all patients, providing clear information on facility accessibility, and implementing an accessibility widget, online scheduling, and transparent pricing. Furthermore, these websites should be written at an easily comprehensible reading level. These simple changes would make these clinics more accessible for those with disabilities.

Design and Implementation of a Primary Healthcare Cloud Platform

This paper presents the design and implementation of a primary healthcare cloud platform that aims to optimize primary medical services through informatization. The cloud platform integrates multiple functional modules including patient information management, diagnostic and treatment processes, pharmaceutical inventory, online appointments, financial management, and data analysis to meet the daily operational needs of primary healthcare institutions. Starting with the project background and current situation analysis, the paper details user needs research and functional design, and gives key discussions on the selection of system architecture and critical technology modules. During system development, technologies such as Spring Boot, Spring Cloud, and MySQL were used to build an efficient, stable, and secure platform. The system's reliability was ensured through unit testing, integration testing, system testing, and user acceptance testing. The paper concludes with a look into the future development direction of the platform, including further optimization of user experience, introduction of natural language processing and artificial intelligence technologies, and expansion of collaborative functions between primary healthcare institutions.

«Digital Postcovid Syndrome» - possibilities and limits in digital communication with neurological patients

Background: This work deals with the question of which digital touchpoints in the course of a patient journey are desired by neurological patients, important for effective treatment and easy to implement. Methodology: 100 (44 men, 56 women) patients in a neurological practice at three different locations were examined using a written questionnaire with closed questions on topics of online booking, making appointments and reminders via SMS, video consultation with the doctor and chat with the doctor or the medical practice assistant. Results: It was shown that the older a person is, the less they prefer digital booking and consultation and that the more they work, the more they prefer digital booking and consultation and the longer they live in Switzerland, the less they prefer chat advice. Data protection plays a more important role in older patients. Regarding gender no significant differences can be shown. Discussion: The results are in line with a survey conducted by the Swiss Medical Association (Foederatio Medicorum Helveticorum) of 2020, which shows that the population wants to relieve the burden on doctors in administrative tasks through the use of digital solutions considered desirable. In this study, both younger and older patients are very interested in booking appointments online and to receive an appointment reminder via text message. Since older patients tend to prefer conservative booking, a «hybrid model» should be offered so that both options are available.

Digitalization of the right to medical assistance: a comparative aspect

The article examines how to reflect the impact of digitalization on obtaining personal rights to medical care in Ukraine and the countries of the European Union. In particular, a really comparative analysis of the implementation of this right in domestic and foreign legislation. The positive impact on the process of digitalization of services in the field of health care is substantiated.
 The need for further implementation of digitized services in the field of health care to ensure the right to medical care of a person has been proven, providing a historical analysis of the positive impact. A significant example of a positive impact was the possibility of realizing a certain right in the conditions of martial law, where Ukraine is a unique example, despite military aggression, through the public digitalization of management, in particular in the field of health care.
 The statistics of the impact of digitization of medical services on the level of public health support in the countries of the European Medical Union, as well as the attitude of Europeans to the digitization of services, were analyzed. It has been established that it is still a relevant problem for both citizens of Ukraine and citizens of European countries, to weaken the realization of this right, given the impossibility of making an online appointment with a doctor, conducting an online consultation, taking into account the issue of relevant devices or funds. Protest is predominant among global citizen engagement, after digitized health services, is a convenient tool in today's world.
 Special attention is paid to the unique experience of Ukraine in the development of the digitalization of the right to medical assistance of a person in the conditions of martial law, despite active military aggression, because in these conditions the positive and negative aspects of this legal and social phenomenon are particularly clearly reflected.

Research on the Hotspots and Development of “Internet+ Nursing Services” in China: A Bibliometric Analysis Based on CiteSpace

Objective: This study aims to explore the current research status, hotspots, and trends of the emerging nursing model of “Internet+ nursing service” in China, and to provide theoretical references for further research and development. Methods: The literature related to “Internet+ nursing service” was retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database, and SinoMed. Subsequently, visual analysis was performed using the CiteSpace scientific knowledge mapping software. Results: A total of 1223 articles were included. The number of papers published in this field has been increasing yearly, and a core group of authors has been formed. Research institutions are mainly comprised of universities and hospitals and a high percentage of projects were funded provincially and municipally, while the least percentage of projects were funded nationally. The main research hotspots include the nurse standardized management for online appointments, the current application situation for the nursing model, and factors influencing its application amongst the elderly and also in women and children’s groups. Conclusion: Although the “Internet+ nursing service” in China is still in its early stages, considerable progress has been made in relevant research. Future research should focus on identifying and omitting factors that hinder the industry’s growth, thereby establishing an effective long-term model of care.