Health Information Technology Commons^™

Emerging Trends In Healthcare Driven By The Covid-19 Pandemic: A Review From Health Informatics Perspective., Venugopal Mudgundi, Bhargav Desai, Farhad Nasar

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic is the first of its kind to hit the world in the modern information age. People working in healthcare across the globe have harnessed technological advances and modern digital tools in innovative new ways. This has brought specific, more recent trends in healthcare delivery to the forefront. In this review, we present a collection of articles that highlight some of the emerging trends in healthcare driven by the COVID-19 pandemic and that have the potential to transform healthcare in the coming decades. We provide a brief commentary on the opportunities and challenges for each trend.

Evaluating Driver Fatigue Measures, Mia Belovsky, Stanton B. Miller, Md

Physician Executive Leadership-Plus (PEL-Plus)

No abstract provided.

The Age Of Artificial Intelligence: Use Of Digital Technology In Clinical Nutrition, Berkeley K. Limketkai, Kasuen Mauldin, Natalie Manitius, Laleh Jalilian, Bradley R. Salonen

Faculty Research, Scholarly, and Creative Activity

Purpose of review

Computing advances over the decades have catalyzed the pervasive integration of digital technology in the medical industry, now followed by similar applications for clinical nutrition. This review discusses the implementation of such technologies for nutrition, ranging from the use of mobile apps and wearable technologies to the development of decision support tools for parenteral nutrition and use of telehealth for remote assessment of nutrition.

Recent findings

Mobile applications and wearable technologies have provided opportunities for real-time collection of granular nutrition-related data. Machine learning has allowed for more complex analyses of the increasing volume of data collected. The …

Engaging Patients In Atrial Fibrillation Management Via Digital Health Technology: The Impact Of Tailored Messaging., Tammy Toscos Phd, Amanda Coupe, Shauna Wagner, Ryan Ahmed, Amelia Roebuck, Mindy Flanagan, Michelle Drouin, Michael Mirro Md

Health Services and Informatics Research

Patients with atrial fibrillation (AF) demonstrate persistent knowledge gaps regarding their condition and a substandard adherence to oral anticoagulant (OAC) medication, which contribute to thromboembolic stroke and other clot-related complications. Tailored patient education and medication reminders may help reduce these negative health outcomes. We sought to improve disease knowledge and medication adherence among a sample of AF patients using tailored education and nudges. The intervention leveraged three digital health technologies: a patient portal, an electronic-prescribing data feed, and a smart pill bottle. The content of the educational messaging, nudges, and cadence were tailored according to findings from our user-centered design …

Involving Patients As Key Stakeholders In The Design Of Cardiovascular Implantable Electronic Device Data Dashboards: Implications For Patient Care, Carly Daley, Romisa Rohani Ghahari, Michelle Drouin, Ryan Ahmed, Shauna Wagner, Lauren Reining, Amanda Coupe, Tammy Toscos Phd, Michael Mirro Md

Health Services and Informatics Research

Background

Data from remote monitoring (RM) of cardiovascular implantable electronic devices (CIEDs) currently are not accessible to patients despite demand. The typical RM report contains multiple pages of data for trained technicians to read and interpret and requires a patient-centered approach to be curated to meet individual user needs.

Objective

The purpose of this study was to understand which RM data elements are important to patients and to gain design insights for displaying meaningful data in a digital dashboard.

Methods

Adults with implantable cardioverter–defibrillators (ICDs) and pacemakers (PMs) participated in this 2-phase, user-centered design study. Phase 1 included a card-sorting …

Understanding Subscription-Based Automated Electronic Notification Usage In Hospitals: A Qualitative Study, William J.K. Vervilles, Benjamin Slovis, Md, Ma, Jeffrey Riggio, Md

Phase 1

Introduction: The potential exists for patient harm when clinicians do not respond to clinical results in a timely manner. Much of the research on asynchronous electronic notifications (pager, cellphone or wearable devices) comes from home-grown electronic health records (EHR). Little is known about factors influencing notifications from vendor-based EHRs and the effect of subscription-based notifications, where providers select which results for notification. This study investigates what factors influence a clinician’s decision to order result notifications, the perceived role of these notifications in the clinical setting, and ways to improve notifications in a vendor-based EHR.

Methods: We queried the EHR to …

Evaluating The Impact Of Kardiamobile On Healthcare Expenditures, Christopher Gerace, Mph, Daniel Frisch, Md

Phase 1

Background: KardiaMobile is a mobile ECG device, with smartphone connectivity, that is able to detect atrial fibrillation (a-fib). The device captures a 30 second reading and an algorithm differentiates a-fib from sinus rhythm. The mobile application can alert the user to an a-fib reading and also send the ECG output to their personal physician. By monitoring a-fib without accessing traditional care, KardiaMobile has the potential to reduce healthcare costs for patients with a-fib. This study looked to evaluate the effect of KardiaMobile on healthcare utilization for patients with suspected or diagnosed a-fib and who see a clinical cardiac electrophysiologist.

Methods: …

Assessment Of A Wearable Device For Minute Ventilation In Detecting Different States Of Ventilation, Michael Morano, Yash Patel, Marc J. Torjman, Phd, Indupriya Eedara, Ms, Moeness Amin, Phd, Channy Loeum, Jeffrey Joseph, Do

Phase 1

Introduction: Minute ventilation (MV) and breathing status are valuable vital signs to measure in patients clinically such as in detecting opioid induced respiratory depression. However, there are few devices capable of continuously monitoring MV in an accurate fashion. RTM Vital Signs, LLC and TJU are developing a non-invasive wearable Tracheal Sound Sensor to determine if a device can accurately and continuously measure respiratory rate (RR), tidal volume (TV), MV, and changes in ventilation patterns based on sound recordings of breathing.

Methods: Tracheal breathing sounds were recorded in six researchers using a prototype sensor placed on the skin above the sternal …

Comparison Of Patient Satisfaction With Telehealth And In-Clinic Post-Operative Visits, Lillian Matthews, Bryan Renslo, Deborah T. Glassman, Md

Phase 1

Introduction: Telehealth has grown rapidly in the healthcare industry as a time efficient, affordable, and accessible means to provide care. Jefferson’s Department of Urology currently employs telehealth for post-operative visits but its efficacy in post-nephrectomy patients has not been well studied. We aim to demonstrate that patient satisfaction is the same for telehealth versus in-clinic post-operative visits in nephrectomy patients. Secondarily we will examine distance saved for telehealth patients.

Methods: We will administer an IRB approved questionnaire to all nephrectomy patients via the EPIC^® EMR platform after their post-operative visit. Each questionnaire will be specific to telehealth or …

Utilizing The Smart Rooms Device To Improve Patient Experience In Hospitals, Thomas Hurysz, Alison Romisher, Daniel Campbell, Maia Ottenstein

Phase 1

Introduction: Utilizing smart room assistants in a hospital setting has the capacity to improve both the patient and provider experience, as well as improve patient outcomes. Thomas Jefferson University Hospital created the Smart Rooms device, a HIPAA compliant voice assistant, specifically for hospital settings.

Methods: A prospective, cross-sectional study was conducted in 11 rooms on the Methodist Hospital postoperative floor between March 2019 and September 2019 to study the impact of the Smart Rooms device on patient experience. Patients were given a survey using a Likert scale which asked questions about their satisfaction with their stay. During this time, surveys …

Pilot Evaluation Of The Usability And Utility Of A Wearable Technology To Monitor And Evaluate Health Condition, Drew Nielsen, David Shipon, Md, Facc, Facp

Phase 1

Introduction: Cardiac rehabilitation programs have particularly poor attrition and rehospitalization from cardiac-related events is a large burden on the medical system, as 8.9% of patients who have acute MI are rehospitalized within one year. External barriers may exist that prevent patients from adequately completing in-house cardiac rehabilitation, which makes them strong candidates for a home-based rehab program (HBCR). Previous randomized trials have generated evidence that HBCR can achieve similar cardiac improvements in 3- 12-month clinical outcomes. With the large-scale adoption of wearable technologies, with an estimated 8.2 million devices owned by individuals over 55, we have an opportunity to incorporate …

Comparison Of Patient Satisfaction Between Telehealth And In-Clinic Post-Operative Visits, Bryan Renslo, Lillian Matthews, Deborah T. Glassman, Md

Phase 1

Introduction: Telehealth has the potential to be an efficient, affordable, and accessible means to give care. In the field of Urology, its use has large potential but has not been well studied. We hypothesize that the use of telehealth for post-op nephrectomy patients will maintain the same level of patient satisfaction. We also hypothesize that telehealth visits will take less time and save patients money by eliminating the need to travel.

Methods: From May through July 2019, post-nephrectomy patients who consented to the study were given either a telehealth or in-clinic post-operative visit. Outcome metrics and demographics information were obtained …

Smart Rooms Devices As A Modality Of Enhancing Patient Engagement, Daniel Campbell, Alison Romisher, Thomas Hurysz, Maia Ottenstein, Anna Marie Chang, Md

Phase 1

Introduction: Recent literature has demonstrated that increased patient engagement is linked to improved patient outcomes. As such, hospitals are currently attempting to increase patient engagement via use of digital tools. One potential digital tool is a Smart Rooms Device, a voiceassistant integrated into hospital rooms. The goal of this investigation is to identify modalities by which patients intend to engage with the Smart Rooms Device.

Methods: This is a prospective interview study conducted between 11/20/2019 and 12/17/2019, whereby patients from the TJU Observation Unit were asked pre-determined interview questions in order to ascertain potential device usages.

Results: 12 patients were …

Transforming The Patient Experience With Smart Room Technology, Alison Romisher, Thomas Hurysz, Daniel Campbell, Maia Ottenstein

Phase 1

Objective: Smart room technology is an innovative way to prioritize the patient experience by providing patients with an easily accessible hospital companion. This study introduced smart room devices into hospitals to determine whether their use would improve the patient experience as compared with those who did not use the device.

Methods: We conducted a prospective cross sectional study from March through September at Thomas Jefferson University Methodist Hospital. Smart room devices were placed in 11 rooms in the post-operative unit. Patients were surveyed by Jefferson medical students and DICE team members with regards to their overall experience using …

How Do Healthcare Staff Respond To Patient Experience Feedback Online? A Typology Of Responses Published On Care Opinion, Lauren Paige Ramsey, Laura Sheard Dr, Rebecca Lawton Professor, Jane O'Hara Dr

Patient Experience Journal

Patients are increasingly describing their healthcare experiences publicly online. This has been facilitated by digital technology, a growing focus on transparency in healthcare and the emergence of a feedback culture in many sectors. Due to this area being previously unexplored, the objective of this study was to identify a typology of responses that healthcare staff provide on Care Opinion (www.careopinion.org.uk), a not-for-profit online platform on which patients are able to provide narrative feedback about health and social care in the UK. Framework analysis was used to qualitatively analyse a purposive sample of 486 stories regarding hospital care, and their 475 …

Determining A Clinical Role For Digital Apps For Mental Health, Hephsibah Loeb, Md, Ann Chandy, Md

Department of Psychiatry and Human Behavior Posters

In 2017, the FDA approved the first app for treatment of alcohol, cocaine, marijuana and stimulant use disorders. In a preceding randomized controlled trial, mobile software Therapeutic Education System (TES) was found to reduce dropout from treatment and to increase patients’ rates of abstinence from substance abuse. Another study showed that PRIME-D, a mobile-based treatment for depression, positively affected symptoms of depression and disability. Many individuals seek out self-help apps for psychiatric complaints, although, in general, little evidence exists for evaluation of the most accessible mobile apps for self-help. What are the strengths and weaknesses of digital apps for treatment …

Toward A Discourse Community For Telemedicine: A Domain Analytic View Of Published Scholarship, Louiza Patsis

Selected Full Text Dissertations, 2011-

In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of …