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Pesch MH, Levitt KJ, Danziger P, Orringer K. Pediatrician's Beliefs and Practices Around Rapid Infant Weight Gain: A Qualitative Study. Glob Pediatr Health 2021; 8:2333794X21992164. [PMID: 33614855 PMCID: PMC7874340 DOI: 10.1177/2333794x21992164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/29/2020] [Accepted: 01/14/2021] [Indexed: 01/11/2023] Open
Abstract
Rapid infant weight gain is a risk factor for later obesity. The objective of this study was to examine primary care pediatricians’ beliefs and practices around rapid infant weight gain. Primary care pediatricians (N = 16) participated in a semi-structured interview about infant growth. Interviews were transcribed, analyzed for themes using the grounded theory and the constant comparative method then reliably coded for the presence of each theme. Three themes were identified, pediatricians (1) are uncertain about the concept, definition, and implications of excessive or rapid infant weight gain (N = 16, 100%), (2) are more comfortable with management of inadequate versus excessive or rapid weight gain (N = 10, 62.5%), and (3) perceive the primary cause of excessive or rapid infant weight gain to be overfeeding (N = 10, 62.5%). In conclusion, pediatricians are uncertain about the concept, definition, management, and long-term risks of rapid infant weight gain. Interventions to increase awareness and pediatrician sense of competence in management of rapid infant weight gain are needed.
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Wong MC, Huang J, Chan PS, Lok V, Leung C, Wang J, Cheung CS, Wong WN, Cheung NT, Ho CP, Yeoh EK. The Perceptions of and Factors Associated With the Adoption of the Electronic Health Record Sharing System Among Patients and Physicians: Cross-Sectional Survey. JMIR Med Inform 2020; 8:e17452. [PMID: 32436855 PMCID: PMC7273237 DOI: 10.2196/17452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 11/13/2022] Open
Abstract
Background
The electronic health record sharing system (eHRSS) was implemented as a new health care delivery platform to facilitate two-way communication between the public and private sectors in Hong Kong.
Objective
This study aimed to investigate the perceptions of and factors associated with the adoption of eHRSS among patients, the general public, and private physicians.
Methods
Telephone interviews were conducted in 2018 by using a simple random sampling strategy from a list of patients who had enrolled in the eHRSS and a territory-wide telephone directory for nonenrolled residents. We completed 2000 surveys (1000 each for enrolled and nonenrolled individuals). Private physicians completed self-administered questionnaires, including 762 valid questionnaires from 454 enrolled physicians and 308 nonenrolled physicians.
Results
Most participants (707/1000, 70.70%) were satisfied with the overall performance of the eHRSS. Regarding registration status, most nonenrolled patients (647/1000, 64.70%) reported that “no recommendation from their physicians and family members” was the major barrier, whereas more than half of the physicians (536/1000, 53.60%) expressed concerns on “additional workload due to use of eHRSS.” A multivariate regression analysis showed that patients were more likely to register when they reported “other service providers could view the medical records” (adjusted odds ratio [aOR] 6.09, 95% CI 4.87-7.63; P<.001) and “friends’ or family’s recommendation or assistance in registration” (aOR 3.51, 95% CI 2.04-6.03; P=.001). Physicians were more likely to register when they believed that the eHRSS could improve the quality of health care service (aOR 4.70, 95% CI 1.77-12.51; P=.002) and were aware that the eHRSS could reduce duplicated tests and treatments (aOR 4.16, 95% CI 1.73-9.97; P=.001).
Conclusions
Increasing the possibility of viewing patients' personal medical record, expanding the sharable data scope for patients, and highlighting the benefits of the system for physicians could be effective to enhance the adoption of the eHRSS.
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Affiliation(s)
- Martin Cs Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Junjie Huang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Paul Sf Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Veeleah Lok
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Colette Leung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Jingxuan Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Clement Sk Cheung
- Information Technology and Health Informatics Division, Hospital Authority, Hong Kong
| | - Wing Nam Wong
- Information Technology and Health Informatics Division, Hospital Authority, Hong Kong
| | - Ngai Tseung Cheung
- Information Technology and Health Informatics Division, Hospital Authority, Hong Kong
| | - Chung Ping Ho
- Information Technology Committee, Hong Kong Medical Association, Hong Kong
| | - Eng Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Tanda R, Beverly EA, Hughes K. Factors associated with Ohio nurse practitioners’ childhood obesity preventive practice patterns. J Am Assoc Nurse Pract 2017; 29:763-772. [DOI: 10.1002/2327-6924.12522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 08/06/2017] [Accepted: 08/15/2017] [Indexed: 11/11/2022]
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Grossman Z, Del Torso S, van Esso D, Ehrich JHH, Altorjai P, Mazur A, Wyder C, Neves AM, Dornbusch HJ, Jaeger Roman E, Santucci A, Hadjipanayis A. Use of electronic health records by child primary healthcare providers in Europe. Child Care Health Dev 2016; 42:928-933. [PMID: 27396507 DOI: 10.1111/cch.12374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/25/2016] [Accepted: 06/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is limited data on the use and functionality level of electronic health records (EHRs) supporting primary child health care in Europe. Our objective was to determine European primary child healthcare providers' use of EHRs, and functionality level of the systems used. METHODS European primary care paediatricians, paediatric subspecialists and family doctors were invited by European Academy of Paediatrics Research in Ambulatory Setting Network (EAPRASnet) country coordinators to complete a web-based survey on the use of EHRs and the systems' functionalities. Binomial logistic analysis has been used to evaluate the effect of specialty and type of practice on the use of EHRs. RESULTS The survey was completed by 679 child primary healthcare providers (response rate 53%). Five hundred and fifty four responses coming from 10 predominant countries were taken for further analysis. EHR use by respondents varied widely between countries, all electronic type use ranging between 7% and 97%. There was no significant difference in EHR use between group practice and solo practitioners, or between family doctors and primary care paediatricians. History and physical examination can be properly recorded by respondents in most countries. However, growth chart plotting capacity in some countries ranges between 22% and 50%. Vaccination recording capacity varies between 50% and 100%, and data exchange capacity with immunization databases is mostly limited, ranging between 0% and 54%. CONCLUSIONS There is marked heterogeneity in the use and functionalities of EHRs used among child primary child healthcare providers in Europe. More importantly, lack of critical paediatric supportive functionalities like growth tracking and vaccination status has been documented in some countries. There is a need to explore the reasons for these findings, and to develop a cross European paediatric EHR standards.
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Affiliation(s)
- Z Grossman
- Maccabi Health Services, Tel Aviv, Israel.
| | | | - D van Esso
- Primary Care Health Centre 'Pare Claret', Catalan Institute of Health, Barcelona, Spain
| | - J H H Ehrich
- Children's Hospital, Hannover Medical School, Hannover, Germany
| | - P Altorjai
- Tóth Ilona Healthcare Center H-1212 Budapest, Budapest, Hungary
| | - A Mazur
- Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - C Wyder
- Kinderaerzte KurWerk, Burgdorf, Switzerland
| | - A M Neves
- Department of Paediatrics, Santa Maria Hospital, Lisbon, Portugal
| | | | | | - A Santucci
- Pediatra di Famiglia USLUMBRIA 1, Perugia, Italy
| | - A Hadjipanayis
- Faculty of Medicine, Larnaca General Hospital, European University Cyprus, Engomi, Cyprus
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Kruse CS, Kothman K, Anerobi K, Abanaka L. Adoption Factors of the Electronic Health Record: A Systematic Review. JMIR Med Inform 2016; 4:e19. [PMID: 27251559 PMCID: PMC4909978 DOI: 10.2196/medinform.5525] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/03/2016] [Accepted: 03/21/2016] [Indexed: 11/19/2022] Open
Abstract
Background The Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures. Objective The purpose of this review is to compile a current and comprehensive list of facilitators and barriers to the adoption of the EHR in the United States. Methods Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE, 01/01/2012–09/01/2015, core clinical/academic journals, MEDLINE full text, and evaluated only articles germane to our research objective. Team members selected a final list of articles through consensus meetings (n=31). Multiple research team members thoroughly read each article to confirm applicability and study conclusions, thereby increasing validity. Results Group members identified common facilitators and barriers associated with the EHR adoption process. In total, 25 adoption facilitators were identified in the literature occurring 109 times; the majority of which were efficiency, hospital size, quality, access to data, perceived value, and ability to transfer information. A total of 23 barriers to adoption were identified in the literature, appearing 95 times; the majority of which were cost, time consuming, perception of uselessness, transition of data, facility location, and implementation issues. Conclusions The 25 facilitators and 23 barriers to the adoption of the EHR continue to reveal a preoccupation on cost, despite incentives in the HITECH Act. Limited financial backing and outdated technology were also common barriers frequently mentioned during data review. Future public policy should include incentives commensurate with those in the HITECH Act to maintain strong adoption rates.
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Affiliation(s)
- Clemens Scott Kruse
- Texas State University, School of Health Administration, San Marcos, TX, United States.
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Lehmann CU, Haux R. From bench to bed: bridging from informatics theory to practice. An exploratory analysis. Methods Inf Med 2014; 53:511-5. [PMID: 25377761 DOI: 10.3414/me14-01-0098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND In 2009, the journal Applied Clinical Informatics (ACI) commenced publication. Focused on applications in clinical informatics, ACI was intended to be a companion journal to METHODS of Information in Medicine (MIM). Both journals are official journals of IMIA, the International Medical Informatics Association. OBJECTIVES To explore, after five years, which congruencies and interdependencies exist in publications of these journals and to determine if gaps exist. To achieve this goal, major topics discussed in ACI and in MIM had to be analysed. Finally, we wanted to explore, whether the intention of publishing these companion journals to provide an information bridge from informatics theory to informatics practice and from practice to theory could be supported by this model. In this manuscript we will report on congruencies and interdependencies from practise to theory and on major topis in ACI. Further results will be reported in a second paper. METHODS Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 from these journals were indexed and analysed. RESULTS Hundred and ninety-six publications have been analysed (87 ACI, 109 MIM). In ACI publications addressed care coordination, shared decision support, and provider communication in its importance for complex patient care and safety and quality. Other major themes included improving clinical documentation quality and efficiency, effectiveness of clinical decision support and alerts, implementation of health information technology systems including discussion of failures and succeses. An emerging topic in the years analyzed was a focus on health information technology to predict and prevent hospital admissions and managing population health including the application of mobile health technology. Congruencies between journals could be found in themes, but with different focus in its contents. Interdependencies from practise to theory found in these publications, were only limited. CONCLUSIONS Bridging from informatics theory to practise and vice versa remains a major component of successful research and practise as well as a major challenge.
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Affiliation(s)
- C U Lehmann
- Prof. Dr. Christoph U. Lehmann, Pediatrics and Biomedical Informatics, Vanderbilt University, 2200 Children's Way, 11111 Doctors' Office Tower, Nashville, TN 37232-9544, USA, E-mail:
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Emani S, Ting DY, Healey M, Lipsitz SR, Karson AS, Einbinder JS, Leinen L, Suric V, Bates DW. Physician beliefs about the impact of meaningful use of the EHR: a cross-sectional study. Appl Clin Inform 2014; 5:789-801. [PMID: 25298817 DOI: 10.4338/aci-2014-05-ra-0050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 07/18/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND As adoption and use of electronic health records (EHRs) grows in the United States, there is a growing need in the field of applied clinical informatics to evaluate physician perceptions and beliefs about the impact of EHRs. The meaningful use of EHR incentive program provides a suitable context to examine physician beliefs about the impact of EHRs. OBJECTIVE Contribute to the sparse literature on physician beliefs about the impact of EHRs in areas such as quality of care, effectiveness of care, and delivery of care. METHODS A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who were preparing to qualify for the meaningful use of EHR incentive program. RESULTS Of the 1,797 physicians at both AMCs who were preparing to qualify for the incentive program, 967 completed the survey for an overall response rate of 54%. Only 23% and 27% of physicians agreed or strongly agreed that meaningful use of the EHR will help them improve the care they personally deliver and improve quality of care respectively. Physician specialty was significantly associated with beliefs; e.g., 35% of primary care physicians agreed or strongly agreed that meaningful use will improve quality of care compared to 26% of medical specialists and 21% of surgical specialists (p=0.009). Satisfaction with outpatient EHR was also significantly related to all belief items. CONCLUSIONS Only about a quarter of physicians in our study responded positively that meaningful use of the EHR will improve quality of care and the care they personally provide. These findings are similar to and extend findings from qualitative studies about negative perceptions that physicians hold about the impact of EHRs. Factors outside of the regulatory context, such as physician beliefs, need to be considered in the implementation of the meaningful use of the EHR incentive program.
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Affiliation(s)
- S Emani
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - D Y Ting
- Massachusetts General Physicians Organization, Massachusetts General Hospital , Boston, MA, USA
| | - M Healey
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ; Brigham and Women's Physicians Organization, Brigham and Women's Hospital , Boston, MA, USA
| | - S R Lipsitz
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - A S Karson
- Decision Support Unit, Massachusetts General Hospital, Harvard Medical School , Boston, MA, USA
| | - J S Einbinder
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - L Leinen
- Information Services, Partners HealthCare , Boston, MA, USA
| | - V Suric
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - D W Bates
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ; Department of Healthcare Policy and Management, Harvard School of Public Health , Boston, MA, USA
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