Objectives: To understand the interpersonal and communication behaviors that are perceived positively by patients in a video encounter and whether patient-centered relationships can be established virtually. Patients and Methods: A qualitative analysis of patient visit feedback was performed to build consensus around exemplary interpersonal and communication practices during a virtual urgent care visit. Voluntarily submitted patient comments associated with a 5-star review after a visit were randomly selected from more than 49,000 comments in an 11-month period, from January 1, 2016, through November 30, 2016. Researchers used a consensus-based, widely used health care communications framework as a sensitizing scaffold to develop a preliminary set of codes. Results: More than 30% of the comments coded were classified as Building Rapport. The next most frequently assigned code was Shares Information/Provides Guidance. Among codable comments, the third most frequently assigned code was Elicits Information. Provided Treatment accounted for only 2% of comments. Conclusion: These results suggest that patients who are satisfied with telemedicine encounters appreciate their relational experiences with the clinician and overall user experience, including access and convenience. Highly satisfied patients who interacted with providers on this platform commented on key aspects of medical communication, particularly skills that demonstrate patient-centered relationship building. This supports the notion that clinician-patient relationships can be established in a video-first model, without a previous in-person encounter, and that positive ratings do not seem to be focused solely on prescription receipt.
The Hospitaller Order of St John of God is involved in providing health, educational and social services to people with mental health problems and learning difficulties in the Republic of Ireland. As part of its development plan the Order is engaging in the development of a comprehensive Mental Health Information System encompassing both community and hospital-based services. This system is being developed by local practitioners with the assistance of an external facilitator. The Order is also extensively involved in developing legal and ethical protocols to ensure the system meets all requirements of data protection legislation both nationally and at European levels. Within the overall system, the nursing component is the first part to have been operationalized and some initial evaluation of its efficacy has been conducted. The purpose of this paper is to present the work of the nursing department at St John of God Hospital, Dublin, in the development, implementation and initial evaluation of a computerized patient information system.
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