Difference between revisions of "The Invisible Work of Personal Health Information Management Among People With Multiple Chronic Conditions: Qualitative Interview Study Among Patients and Providers"

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The following is a review of Ancker et al. 2015 regarding the value of patients information management within those suffering from multiple chronic diseases: <ref name = "Ancker et al. 2015"> Ancker, J. S., Witteman, H. O., Hafeez, B., Provencher, T., Van de Graaf, M., & Wei, E. (2015). The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers. Journal of medical Internet research, 17(6). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526906/ </ref>
 
The following is a review of Ancker et al. 2015 regarding the value of patients information management within those suffering from multiple chronic diseases: <ref name = "Ancker et al. 2015"> Ancker, J. S., Witteman, H. O., Hafeez, B., Provencher, T., Van de Graaf, M., & Wei, E. (2015). The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers. Journal of medical Internet research, 17(6). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526906/ </ref>
  
==Review 1==
 
 
=== Introduction/Background ===
 
=== Introduction/Background ===
Due to the rise in cost of health care delivery across the United States in patients suffering from chronic diseases, there has been an increasing trend towards the prevention of such diseases since each day the number of patients which can afford a treatment for their disease constantly increases. Zarkogianni et al. 2015, explore the utilization of these new technologies as means to prevent the pitfalls of treatments in the population by using the latest sensoring technologies and [[CDS]] in order to facilitate self-managing in patients and support decision making in physicians.
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Management of patient’s information across the various clinical settings represents a crucial role in the further improvement in the treatment for their condition, especially when they suffer from multiple chronic conditions (MCC). The issue of having an ineffective control in the retrieval of a patient history results in coordination issues within the clinical setting, poor quality of care, and redundant medical errors. However, the issue lies not only within the clinical management alone, but with how well the patient is able to manage its own information through his Personal Health Record (PHR). Given the following option for the patient to manage his/her own information a question arises. Where is the pitfall of the management of information? Is it due to clinical personal or the result of an inexperience user/patient? Ancker et al. 2015, explore the effectiveness of the use of “personal health information management” (PHIM) an activity viewed from a patient perspective, as the tasks involved in collecting and managing personal medical information; This study explored the use of PHIM across users suffering from MCC.  
  
 
=== Methods ===
 
=== Methods ===
The review evaluated the following technologies:
 
  
* Sensors for Glucose and lifestyle monitoring
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Participants were recruited from three different clinical settings:
* [[Clinical Decision Support]] Systems (CDSS) for diabetes management
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* Weill Cornell Physicians,
* [[Predictive analytics|Predictive modeling]] using molecular data to assess the onset or progression of DM (Diabetes Mellitus)
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* New York-Presbyterian Hospital
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* Institute for Family Health.
  
=== Results ===
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The process of recruitment involved distribution of flyers across different clinical settings, and those involved in the study were surveyed immediately or after clinical visit. 22 patients were enrolled and 7 health care providers with a slight association within them; Patient-Provider (13/22).  
* Sensoring technology is evolving from a traditional invasive procedure towards a non-invasive procedure. Although, this shift is taking place the reliability of such test conducted under non-invasive methods aren't as accurate as those in traditional invasive procedures thus total support can't be given to them, however their evolution is a fact and we are not far from experiencing such technologies.  
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* CDSS turns out to be the giant whose setting the path for the rest of this technologies. Backed-up with evidence-based medicine and support from a portion of the medical community, this tool can indeed increase the rate of un-diagnosed patients at risk of developing DM by physicians thus it is a must to maintain and optimize this technology so that its reliability and acceptance isn't lost by the medical community since its adoption is currently undergoing and hasn't ended to establish it as a permanent tool around the clinical setting.
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=== Results ===
  
* In regards to the use of molecular data, it is an new technology with solid scientific information used for the unveiling of correlations and patterns observed in the development of DM.
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Results from the study revealed that there is an association with complex and changing networks of clinical settings expressed by patients suffering from MCC. Although, many of the patients expected that their PHRs information management was conducted by those in the clinical setting, many of them in reality took an extreme active role managing their records. Yet, many of these activities were performed by the driven fear from their private information been erroneously used or shared across the different clinical settings. Also, many of their actions and decisions on how to manage their information were influenced/limited by their knowledge on how the health care system worked.  
  
=== Conclusion ===
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=== Conclusion/Comments ===
Zerkogianni et al. 2015, recognize the increase in the rate of the evolution of technologies and that their integration with other clinical systems in the health setting such as an [[ EMR| EHR]] can optimize even more the information gathered through them to provide a higher quality of prevention rates within the cluster of not only DM, but other chronic illnesses. However, they also established that although there is an ongoing current adoption this process hasn't been fully achieved across every single health care setting. There are several clinical settings in which this systems haven't been adopted despite the focus on achieving meaningful use around the US. Moreover, they also acknowledge that none of the explored technologies are close to be perfect and an ongoing update and maintenance is required to fulfill the needs of those ill.
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=== Comments ===
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I would criticize that there sample was limited to three urban facilities and to English speaking patients. Further inclusion criteria for the election of those three settings wasn’t provided been an issue for the understanding of the value of the study in that specific area. Aside, from these pitfalls the study yields some interesting insights. Mainly, the recurrent fear of patients for the security and privacy of their information. Although, it is indeed an issue which we aren’t completely immune to, it is not a reason to be a factor for the increase in the activity of patients. Diseased populations with MCC should understand and further discuss the management of their information with their different health providers in order to change this effective, but erroneous way to act and manage their PHRs information.
I would criticize that there wasn't any evaluation in regards to m-Health an ongoing and fairly new system been implemented as a medium to also support the tracking and self-managing in patients suffering from chronic illnesses. Also, although we still face a portion of the clinical population who restrains from using technologies such as the ones discussed there is more than enough evidence of the benefits financially for the physicians and in quality for the service delivered to the patients. Due to these reasons the shift and full or partial adoption of this technologies will eventually take place around the next decade being that evidence illustrates a better quality of health care in the different scopes of its delivery.  
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== References ==
 
== References ==

Revision as of 06:18, 23 November 2015

The following is a review of Ancker et al. 2015 regarding the value of patients information management within those suffering from multiple chronic diseases: [1]

Introduction/Background

Management of patient’s information across the various clinical settings represents a crucial role in the further improvement in the treatment for their condition, especially when they suffer from multiple chronic conditions (MCC). The issue of having an ineffective control in the retrieval of a patient history results in coordination issues within the clinical setting, poor quality of care, and redundant medical errors. However, the issue lies not only within the clinical management alone, but with how well the patient is able to manage its own information through his Personal Health Record (PHR). Given the following option for the patient to manage his/her own information a question arises. Where is the pitfall of the management of information? Is it due to clinical personal or the result of an inexperience user/patient? Ancker et al. 2015, explore the effectiveness of the use of “personal health information management” (PHIM) an activity viewed from a patient perspective, as the tasks involved in collecting and managing personal medical information; This study explored the use of PHIM across users suffering from MCC.

Methods

Participants were recruited from three different clinical settings:

  • Weill Cornell Physicians,
  • New York-Presbyterian Hospital
  • Institute for Family Health.

The process of recruitment involved distribution of flyers across different clinical settings, and those involved in the study were surveyed immediately or after clinical visit. 22 patients were enrolled and 7 health care providers with a slight association within them; Patient-Provider (13/22).

Results

Results from the study revealed that there is an association with complex and changing networks of clinical settings expressed by patients suffering from MCC. Although, many of the patients expected that their PHRs information management was conducted by those in the clinical setting, many of them in reality took an extreme active role managing their records. Yet, many of these activities were performed by the driven fear from their private information been erroneously used or shared across the different clinical settings. Also, many of their actions and decisions on how to manage their information were influenced/limited by their knowledge on how the health care system worked.

Conclusion/Comments

I would criticize that there sample was limited to three urban facilities and to English speaking patients. Further inclusion criteria for the election of those three settings wasn’t provided been an issue for the understanding of the value of the study in that specific area. Aside, from these pitfalls the study yields some interesting insights. Mainly, the recurrent fear of patients for the security and privacy of their information. Although, it is indeed an issue which we aren’t completely immune to, it is not a reason to be a factor for the increase in the activity of patients. Diseased populations with MCC should understand and further discuss the management of their information with their different health providers in order to change this effective, but erroneous way to act and manage their PHRs information.

References

  1. Ancker, J. S., Witteman, H. O., Hafeez, B., Provencher, T., Van de Graaf, M., & Wei, E. (2015). The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers. Journal of medical Internet research, 17(6). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526906/