BackgroundEffective management and care of diabetes is crucial to reducing associated risks such as heart disease and kidney failure. With increasing access and use of the Internet, online chronic disease management is being explored as a means of providing patients with support and the necessary tools to monitor and manage their disease.ObjectiveThe objective of our study was to evaluate the experience of patients and providers using an online diabetes management portal for patients.MethodsParticipants were recruited from a large sample population of 887 for a follow-up questionnaire to be completed after 6 months of using the patient portal. Participants were presented with the option to participate in an additional interview and, if the participant agreed, a time and date was scheduled for the interview. A 5-item, open-ended questionnaire was used to capture providers' opinions of the patient portal. Providers included general practitioners (GPs), nurses, nurse practitioners (NPs), dieticians, diabetes educators (DECs), and other clinical staff.ResultsA total of 854 patients were consented for the questionnaire. Seventeen (8 male, 9 female) patients agreed to participate in a telephone interview. Sixty-four health care providers completed the five open-ended questions; however, an average of 48.2 responses were recorded per question. Four major themes were identified and will be discussed in this paper. These themes have been classified as: facilitators of disease management, barriers to portal use, patient-provider communication and relationship, and recommendations for portal improvements.ConclusionsThis qualitative study shows that online chronic disease management portals increase patient access to information and engagement in their health care, but improvements in the portal itself may improve usability and reduce attrition. Furthermore, this study identifies a grey area that exists in the roles that GPs and AHPs should play in the facilitation of online disease management.

No gold-standard tool has been agreed upon in the literature, and none fully addresses all IPE learner outcomes. Objective measures of higher level outcomes are necessary to ensure comprehensive evaluation of IPE/IPP.

Context. Although the literature on transitions from hospital to the community is extensive, little is known about this experience within the context of palliative care (PC).Objective. We conducted a systematic review to investigate the impact of receiving palliative care in hospital on the transition from hospital to the community.Methods. We systematically searched MEDLINE, Embase, ProQuest, and CINAHL from 1995 until April 10, 2018, and extracted relevant references. Eligible articles were published in English, included adult patients receiving PC as inpatients, and explored transitions from hospital to the community.Results. A total of 1514 studies were identified and eight met inclusion criteria. Studies were published recently (>2012; n ¼ 7, 88%). Specialist PC interventions were delivered by multidisciplinary care teams as part of inpatient PC triggers, discharge planning programs, and transitional care programs. Common outcomes reported with significant findings consisted of length of stay (n ¼ 5), discharge support (n ¼ 5), and hospital readmissions (n ¼ 6) for those who received inpatient PC. Most studies were at high risk of bias.Conclusion. Heterogeneity of study designs, outcomes, findings, and poor methodological quality renders it challenging to draw conclusions regarding PC's impact on the transition from hospital to home. Further research should use standardized outcomes with randomized controlled trial and/or propensity matched cohort designs.