Patient-centered Health Care Delivery Research Articles

The role of AI and mobile apps in patient-centric healthcare delivery

Patient-centric healthcare is an approach to healthcare that prioritizes the needs, preferences, and values of patients in the delivery of medical services. As part of a patient-centric model, patients take active part in decision-making regarding their own care, while healthcare providers tailor treatments and services to each patient's needs. The rise of artificial intelligence (AI) and mobile applications (apps) has now opened new avenues for enhancing patient engagement and improving healthcare outcomes, so by leveraging AI's sophisticated data analytics and predictive capabilities, healthcare providers are able to gain unprecedented insights into patient health patterns, thereby enabling personalized, and proactive care plans tailored to the patient’s individual needs. Furthermore, mobile apps have become potent tools, giving patients smooth access to healthcare resources, virtual medical consultations, and real-time health tracking, boosting patient independence and enabling them to manage their health with greater ease. The integration of AI and mobile apps into healthcare delivery is revolutionizing patient-centric care by enhancing patient engagement, empowerment, and self-management capabilities. However, addressing concerns around data privacy, security, and digital literacy is crucial for successful implementation. This study outlines a framework for harnessing these technologies to enhance patient outcomes and overall healthcare experiences. It explores the roles AI and mobile apps play in facilitating patient-centric healthcare and examines how the use of these technologies can promote personalized care, boost patient education and self-management, and improve communication between patients and healthcare providers.

The impact of digital health technologies on pharmacy services and patient care

This comprehensive review delves into the profound impact of digital health technologies on the landscape of pharmacy services and patient care. The integration of electronic prescribing medication adherence apps, and tele-pharmacy services has revolutionized medication management in pharmacies. This amalgamation has not only streamlined processes but has also significantly minimized errors, leading to enhanced operational efficiency. Pharmacists, equipped with wearable devices, now engage in remote patient monitoring, allowing for personalized interventions and proactive healthcare strategies. The incorporation of genomic data, data analytics, and clinical decision support systems marks a transformative shift towards precision medicine within pharmacies. These technologies empower pharmacists to design tailored treatment plans based on individual genetic profiles, thereby optimizing therapeutic outcomes. As pharmacies increasingly embrace these digital tools, they metamorphose into dynamic healthcare hubs. Beyond traditional roles, pharmacies now offer virtual consultations and actively participate in patient education initiatives. This paradigm shift underscores a commitment to patient-centered care, exemplified by improved medication safety and a more interconnected healthcare ecosystem. The ongoing integration of digital health technologies holds promise for continued advancements in pharmacy services. This trajectory signifies a significant departure towards a more proactive, personalized, and technologically driven approach to patient care. The review underscores the transformative potential of digital health technologies in redefining the role of pharmacies and elevating the standards of patient-centered healthcare delivery.

A Survey Paper on Integrated Hospital Management System

Hospital Management Systems (HMS) are essential tools in modern healthcare, focusing on efficiency and streamlined operations. Key functionalities include patient registration, appointment scheduling, and doctor availability search. Accessible to administrators, doctors, and patients, HMS offers a customizable, user-friendly interface while emphasizing data protection and fast processing. Ongoing advancements promise to enhance the patient experience and diagnostic procedures, solidifying HMS's role in patient centric healthcare delivery.

Navigating the Future: The Transformative Impact of Artificial Intelligence on Hospital Management- A Comprehensive Review.

This comprehensive review explores the transformative impact of artificial intelligence (AI) on hospital management, delving into its applications, challenges, and future trends. Integrating AI in administrative functions, clinical operations, and patient engagement holds significant promise for enhancing efficiency, optimizing resource allocation, and revolutionizing patient care. However, this evolution is accompanied by ethical, legal, and operational considerations that necessitate careful navigation. The review underscores key findings, emphasizing the implications for the future of hospital management. It calls for a proactive approach, urging stakeholders to invest in education, prioritize ethical guidelines, foster collaboration, advocate for thoughtful regulation, and embrace a culture of innovation. The healthcare industry can successfully navigate this transformative era through collective action, ensuring that AI contributes to more effective, accessible, and patient-centered healthcare delivery.

“I am not just a place for implementation. I should be a partner”: a qualitative study of patient-centered care from the perspective of diabetic patients in Saudi Arabia

IntroductionPatient involvement in care is a major component of high quality of care and is becoming recognized worldwide with many beneficial for improving patient outcomes. However, a little is known about patient involvement in the Middle East region and Saudi Arabia in particular.ObjectivesTo evaluate patients’ perceptions of their involvement during their interactions with healthcare providers in Saudi Arabia.MethodsA qualitative exploratory study using semi structured interview was conducted from February 2022 to March 2022. Responses were transcribed and analyzed using a thematic analysis approach.ResultsWe conducted seven interviews with patients with diabetes ranging in age from 19 to 69 years old. We identified the following themes:1) patients’ perceptions of their involvement in care, 2) barriers to patient involvement, 3) effective communication, 4) empathy, and 5) culture. We found that patients had minimal knowledge of patient involvement in care.ConclusionThere is a clear need to improve education and awareness of patient involvement in Saudi Arabia. By educating patients about the possibilities of patient involvement and explaining their role it will make it easier for patients to understand appropriate levels of involvement. In addition, there is a need to understand the patient-centred care culture in Saudi Arabia through establishing frameworks with the focus on culture and patient-centred healthcare delivery.

Piloting patient-reported outcome measures for evaluation of the Irish Chronic Disease Programme

Abstract Background The Irish National Integrated Care Programme for Chronic Disease (ICPCD) aims to deliver end-to-end, patient-centred care across three clinical programmes; Heart, Respiratory and Diabetes. Patient-reported outcome measures (PROMs) are a means of objectively measuring changes in patients’ subjectively-perceived health status over time in response to services. As such, PROMs facilitate service monitoring and evaluation and are an important tool for the ICPCD to ensure optimal, patient-centred, value-based healthcare delivery. Methods To select the most appropriate PROMs instrument for use across ICPCD, comprehensive literature review was undertaken followed by key stakeholder consultation in winter 2022. Following consideration against a set of pre-determined criteria the EQ-5D-5L, a well-validated, reliable PROMs instrument, was selected as the most appropriate PROMs instrument for use. Study design involved pilot implementation of EQ-5D-5L in one ICPCD ambulatory care hub service followed by mixed methods evaluation of staff experience of the pilot. Results The pilot was conducted from April to June 2023 among a socio-demographically diverse sample of patients attending their first and last episode of care with the ICPCD diabetic patient education service in Galway. Following service attendance there was a significant aggregate improvement in self-reported overall health rating but no significant change in self-reported mobility, self-care, usual activities, pain/discomfort or anxiety/depression. Predominant staff concerns included staff and patient burden and the need for adequate staff resourcing and information technology support. Conclusions In conjunction with key national stakeholders findings from the pilot will be used to support the development of a PROMs implementation plan at scale for adoption across all ICPCD services. Ultimately national implementation will support the ongoing delivery of high quality patient-centred care within ICPCD services. Key messages • PROMs facilitate service evaluation and are an important tool for the Irish National Integrated Care Programme for Chronic Disease (ICPCD) to ensure optimal patient-centred healthcare delivery. • This pilot will support PROMs implementation at scale across ICPCD services and ultimately reinforce the ongoing delivery of high-quality, value-based, integrated healthcare.

Consensus recommendations on how to assess the quality of surgical interventions.

Postoperative complications represent a major public health burden worldwide. Without standardized, clinically relevant and universally applied endpoints, the evaluation of surgical interventions remains ill-defined and inconsistent, opening the door for biased interpretations and hampering patient-centered health care delivery. We conducted a Jury-based consensus conference incorporating the perspectives of different stakeholders, who based their recommendations on the work of nine panels of experts. The recommendations cover the selection of postoperative outcomes from the perspective of patients and other stakeholders, comparison and interpretation of outcomes, consideration of cultural and demographic factors, and strategies to deal with unwarranted outcomes. With the recommendations developed exclusively by the Jury, we provide a framework for surgical outcome assessment and quality improvement after medical interventions, that integrates the main stakeholders' perspectives.

Awareness, knowledge, attitude, and skills of telemedicine among mental healthcare providers

BackgroundTelemedicine plays a vital role in patient-centered healthcare delivery in the diagnosis, management, and development of future treatment plans for chronic diseases.ResultsThis study revealed that attitude toward telemedicine was high among the studied mental healthcare providers, while it was average among the other studied variables (awareness, knowledge, and skills). Psychiatrists had a high percentage in the studied variables (awareness, attitude, knowledge, and skills). There were statistically significant differences in the dimensions of the telemedicine questionnaire according to age, profession, and academic degree. There was a statistically significant relation between the levels of awareness, knowledge, and attitude toward telemedicine.ConclusionsThis study concluded that the studied mental healthcare providers had high attitudes while the other studied variables (awareness, knowledge, and skills) were average. Psychiatrists had a high percentage in the studied variables (awareness, attitude, knowledge, and skills), followed by psychologists, while nurses had the lowest level in all studied variables.

Validation of the Foot and Ankle Outcome Score for Use in Infracalcaneal Heel Pain

There is growing interest in adopting validated and reliable patient-reported outcome measures following surgery. While the Foot and Ankle Outcome Score (FAOS) has previously been validated for use in multiple foot/ankle conditions, it has not yet been validated in patients with infracalcaneal heel pain. In this study we aimed to validate the FAOS by looking at 4 psychometric properties of the survey: construct validity, content validity, reliability, and responsiveness, using patients in our practice with a clinical diagnosis of plantar fasciitis. A total of 150 patients (mean age 49.7 ± 12.1 years [36 men and 114 women]) were included in one or more of the 4 components of this study. All FAOS subscales demonstrated adequate construct validity when compared with the physical health component of the 12-Item Short Form Health Survey (SF-12), and 2 out of 5 subscales demonstrated moderate correlation with the mental health component of SF-12 (all Spearman rho >0.3, and p values <0.05). Most FAOS subscales demonstrated content validity and were found to contain relevant questions from the patient's perspective. All 5 subscales demonstrated good test-retest reliability with intraclass correlation coefficients ≥ 0.827. Finally, 4 out of the 5 subscales (all but other symptoms) were responsive to change at a mean follow up of 12.2 months after surgery (p < .05). We conclude that the FAOS is a responsive, reliable, and valid instrument for use in infracalcaneal heel pain. We believe that due to its ease of use and broad applicability, the FAOS could be more widely adopted in foot/ankle practices as patient-centered healthcare delivery and research becomes increasingly prioritized in the US and abroad.

“PRAGMATIC MODEL OF PATIENT SATISFACTION RELATE TO SERVICE QUALITY”

BACKGROUND: To measure the quality of the intangible aspects of services has become a great challenge for healthcare personnel. Quality of services has been a constant issue and associated with the growth of healthcare in the ambit of market share and profit. To do an improvement in the services quality service providers need to focus on patient satisfaction. OBJECTIVES: To find out the influencing factors of patient satisfaction from the perception of patients relate to service quality and to propose a model of patient satisfaction from the pragmatic approach. MATERIALS AND METHODS: Cross-sectional study was followed. Study was conducted in Gujarat and 1491 healthcare beneficiaries were included in this. A pre-designed and semi-structured questionnaire was used to assess the objectives of the study. RESULTS: The ratio of patient retention and clinical outcomes is impacted by the satisfaction level of patient satisfaction. Efficient, time-bound, and patient-centered health care delivery plays a significant role. Procedures of treatment, staff manners, accessibility &amp; cleanliness, staff expertise, staff communication&amp; care, financial affordability, hospital infrastructure, timing, and punctuality have shown a positive impact on patient satisfaction except for the financial aspect. And hence, all the stated factors land closer to 0.600, apart from the awareness aspect. An in-depth study found that unethical practices and financial affordability are counted as factors responsible for dissatisfaction. CONCLUSION: A higher level of patient satisfaction leads to loyalty to the organization. Availability of excellent quality of services, ethical approach, treatment transparency, procedure, and overlapping check-ups are noteworthy predictors of patient satisfaction. Appropriate action plans need to be suggested to enhance care, security, time treatment, and basic facilities in healthcare settings.

Does interprofessional education support integration of care services? A systematic review

The increase in and complexity of health challenges has necessitated the need for multi-professional approaches to healthcare and the integration of care services. This study aims to gain an understanding of the role of interprofessional education (IPE) in the integration of care services. A systematic review was conducted using the Discover platform to search databases including MEDLINE, CINAHL, Education Research Complete, Psychology & Behavioural Service Collection to identify publications on interprofessional education in health care services. Evidence supports IPE as a useful tool to enhance collaborative efforts in disease management and improve patient-centred healthcare delivery. IPE also leads to an overall improvement in diagnosis, treatment and quality of care. We found that IPE enhances collaboration, cohesion and communication in pursuit of optimal patient-centred results, and reduced rigid professional perspectives that can lead to poorer outcomes for patients.

Digital Patient Experience: Umbrella Systematic Review.

BackgroundThe adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx).ObjectiveThis study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health.MethodsWe performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories.ResultsThe search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx–related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations.ConclusionsWe propose the following definition for digital PEx: “Digital patient experience is the sum of all interactions affected by a patient’s behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health.” In this study, we constructed a design and evaluation framework that contains 4 phases—define design, define evaluation, design ideation, and design evaluation—and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx–related research.

Protocol for the Flinders Kidney Health Registry: patient outcomes of kidney cancers and nephrectomies

BackgroundKidney cancer accounts for 2% of new cancers diagnosed in Australia annually. Partial and radical nephrectomy are the treatment of choice for kidney cancer. Nephrectomy is also performed for living donor kidney transplantation. Nephrectomy is a risk factor for new-onset chronic kidney disease (CKD) or deterioration of pre-existing CKD. Understanding the risk factors for new-onset or deterioration of existing CKD after nephrectomy is important in developing preventive measures to provide better care for these patients. There is also a need to understand the incidence, natural history, management trends, and sequelae of radiofrequency ablation as well as surveillance of small renal cancers or small renal masses (SRMs). Clinical registries are critical in providing excellent patient-centre care and clinical research as well as basic science research. Registries evaluate current practice and guide future practice. The Flinders Kidney Health Registry will provide the key information needed to assess various treatment outcomes of patients with kidney cancer and patients who underwent nephrectomy for other reasons. The registry aims to provide clinical decision makers with longitudinal data on patient outcomes, health systems performance, and the effect of evolving clinical practice. The registry will also provide a platform for large-scale prospective clinical studies and research.MethodsPatients above the age of 18 undergoing nephrectomy or radiofrequency ablation for any indication and patients with SRMs will be included in the registry. Demographic, clinical and quality of life data will be collected from hospital information systems and directly from the patient and/or caregiver.DiscussionThe Registry will report a summary of patient characteristics including indication for treatment, clinical risk profiles, surgical and oncological outcomes, the proportion of patients who progress to CKD and end stage kidney disease, quality of life post treatment as well as other relevant outcomes for all patients who have undergone nephrectomy for any indication, ablation or surveillance for SRMs. The registry will record the follow-up practice after nephrectomy and patient on active surveillance, which will help to develop and enhance a best practice protocol. The collected prospective data will provide a platform for ongoing patient-orientated research and improve patient-centred healthcare delivery.

Re-engineering the Cypriot General Healthcare System for Syndemics.

To date in Cyprus, there is no dedicated “Quality Improvement” body or Public Health authority. The long-awaited general healthcare system (known as GeSy or GHS) has been completed, mid-stream of the COVID-19 pandemic. A recently proposed resilience plan in response to the lessons learnt from the pandemic was put forward by the Government of the Republic of Cyprus to strengthen the capacity of the GHS and support public health defense. The negotiator of GeSy and Health Minister 2015–2018 also provided his view that the health system needs a holistic transformation of service provision. Recognizing failures and thinking from a syndemogenesis perspective how the envisioned patient-centric healthcare delivery can be achieved, we propose that the public health response could also be linked to a politico-economic one in shielding GeSy. We make such case for a syndemic strategy (simultaneous management of COVID-19 and pre-existing epidemics on the island) and the development of the five-district model where each main district hospital is to complement the activities of the GHS through developing: 1. A training Center for training and sharing of best practices for COVID-19 and other public emergencies. 2. A public health body. 3. A quality improvement institute. 4. A commissioning center on planning and streamlining healthcare services. 5. A clinical trial platform. The rationale is based on the management literature and use of existing resources and capabilities for transforming the GeSy and generating value.

Innovations and Practices that Influence Patient-Centered Health Care Delivery Special Series

Innovations and Practices that Influence Patient-Centered Health Care Delivery Special Series

Value-based focused global population health management.

In 2018, approximately 18 million people worldwide were diagnosed with cancer and are predicted to double by 2040. The global quality chasm in improving health care worldwide requires "systems thinking" as the key to success. Aligning the goal around person-centered care captures the total needs of care of a population and not just disease categories. The integration of the Institute of Medicine's (IOM) six aims of quality termed "value-based focused" and population health management (PHM) provides all health care leaders grappling with improving the health care of the populations a framework for the communities they serve. In this context, the question becomes finding solutions to providing high quality, compassionate and patient-centered health care delivery. Over the last two decades, three paradigms have emerged; the six aims of quality, outcome-focused population health, and the "Quadruple Aim". We have termed the intersection of these concepts as Value-based focused Population Health Management (VBPHM). This review applies VBPHM across the geographic county and community levels in the United States. Specifically, we examine VBPHM at the county or county-equivalents and community levels within the United States. Lastly, the potential role of Community-based Participatory Research and it is applicability to our framework is discussed. VBPHM can comparably be applied globally to improve population health, especially in preventing and treating cancer better.

What do patients expect? Assessing patient-centredness from the patients’ perspective: an interview study

ObjectiveAlthough there has been much conceptual work on patient-centredness (PC), patients‘ perspectives on PC were neglected. In a previous study, participating patients rated the relevance of 16 dimensions of an...

Wearable technology to track activity and distress in breast cancer patients: case series

: Breast cancer is the most common cancer among women with a 5-year survival rate of up to 99% when detected early. This survival rate presents challenges to healthcare systems and providers in terms of ensuring patients receive adequate and timely support during the lengthy and often difficult journey of treatment and survivorship. The primary aim of this quality improvement project piloted the use of the Fitbit Alta HR fitness trackers in a large academic medical center in the south, where 19 breast cancer patients wore and synchronized a Fitbit Alta HR for 28 days. Participants were patients diagnosed with breast cancer (stages 0, I, II, III) who were actively receiving, or who had recently received, breast cancer treatment and care, and who had not previously used any type of health tracking device. The purpose was to understand how self-reported data could enhance patient-centered breast cancer care. Patients provided information on their physical activity and distress status, that enabled certified exercise physiologists to promote healthy lifestyle choices, identify potential treatment complications, and improve the patient’s overall quality of life. Although the sample size was small, a positive correlation between minutes asleep and number of awakenings (r=0.6852), and a negative correlation between distress levels and minutes fairly active (r=−0.3346), stood out as potential indications of the impact of distress on breast cancer patients. This project illuminated the potential value of understanding the ability to, and effectiveness of, capturing relevant patient reported outcomes as a valuable contribution to patient-centered healthcare delivery for patients undergoing treatment for breast cancer. Important findings suggest that building in the daily distress indicators to wearable devices may provide increased utility and expanded insight when such devices are used for patient reported monitoring and outcomes.

The COVID-19 pandemic as a catalyst for differentiated care models to end the HIV epidemic in the United States: applying lessons from high-burden settings.

The COVID-19 pandemic as a catalyst for differentiated care models to end the HIV epidemic in the United States: applying lessons from high-burden settings.

An evaluation of Alberta retina health service delivery in an office setting: a cross-sectional survey of patient experience

BackgroundRetina sub-specialists provide much of the retina related eye care across Canada. In the province of Alberta, 18 retina sub-specialists work across six different offices. The purpose of this study was to assess the quality of care provided by Alberta retina sub-specialists in an office setting by administering a patient satisfaction survey. The results of this survey were provided to the same retina specialists to promote improvements in patient-centered health care delivery.MethodsA cross sectional patient satisfaction survey was performed using a thirty-part questionnaire developed in collaboration with the Physician Learning Program at the University of Alberta. The survey was modelled after other similar patient satisfaction surveys used in other areas of medicine. Patients from ten of the eighteen retina practices in Alberta participated in this survey. Topics of the survey included pre-appointment experience, physician-patient interactions and quality, comments/ feedback and patient demographics.Results214 randomly sampled patients completed the survey from three geographically separate office locations in Calgary and Edmonton. 90% of patients responded that their retina sub-specialist listened adequately and provided quality care in a timely manner. Patients felt that there could be improvements to accessibility to the clinic and reduced wait times, as well as in the pre-operative consent process. Including a more complete explanation of the procedure as well as the potential risks and benefits. Only 51% of patients felt that the risks of a potential surgery had been adequately explained to them. There was a statistically significant association found between overall satisfaction and lower wait times, understanding of procedural risks and time with, listening to and involving the patient in care. There were no correlations found with other demographics such as ethnicity, sex, distance traveled or age.ConclusionsThis patient satisfaction survey provided valuable patient care feedback to the retina sub-specialists of Alberta. The survey results will assist this group to improve the consent process and thereby improve patient centered health care delivery. We would recommend the distribution of this survey or other similar patient satisfaction questionnaire by retina sub-specialists to their patients to improve patient centered care in their clinics.