Informatics response to address the COVID-19 pandemic in a safety net healthcare system

Sadasivaiah, Shobha; Shaffer, Eric; Enanoria, Wayne; Su, George; Goldman, Seth K.; Scarafia, Jeff; Lee, Tina; Yu, Annie; Goldman, Lee; Ratanawongsa, Neda

doi:10.1093/jamiaopen/ooaa057

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…The network developed a standardized electronic health record (EHR) visit type and video visit workflow on June 15, 2020. Details of EHR implementation for telemedicine during the COVID-19 pandemic in this network are published elsewhere [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

System-Level Factors Associated With Telephone and Video Visit Use: Survey of Safety-Net Clinicians During the Early Phase of the COVID-19 Pandemic

Sharma¹,

Khoong²,

Sieera³

et al. 2022

JMIR Form Res

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Background The COVID-19 pandemic prompted safety-net health care systems to rapidly implement telemedicine services with little prior experience, causing disparities in access to virtual visits. While much attention has been given to patient barriers, less is known regarding system-level factors influencing telephone versus video-visit adoption. As telemedicine remains a preferred service for patients and providers, and reimbursement parity will not continue for audio visits, health systems must evaluate how to support higher-quality video visit access. Objective This study aimed to assess health system–level factors and their impact on telephone and video visit adoption to inform sustainability of telemedicine for ambulatory safety-net sites. Methods We conducted a cross-sectional survey among ambulatory care clinicians at a hospital-linked ambulatory clinic network serving a diverse, publicly insured patient population between May 28 and July 14, 2020. We conducted bivariate analyses assessing health care system–level factors associated with (1) high telephone adoption (4 or more visits on average per session); and (2) video visit adoption (at least 1 video visit on average per session). Results We collected 311 responses from 643 eligible clinicians, yielding a response rate of 48.4%. Clinician respondents (N=311) included 34.7% (n=108) primary or urgent care, 35.1% (n=109) medical, and 7.4% (n=23) surgical specialties. Our sample included 178 (57.2%) high telephone adopters and 81 (26.05%) video adopters. Among high telephone adopters, 72.2% utilized personal devices for telemedicine (vs 59.0% of low telephone adopters, P=.04). Video nonadopters requested more training in technical aspects than adopters (49.6% vs 27.2%, P<.001). Primary or urgent care had the highest proportion of high telephone adoption (84.3%, compared to 50.4% of medical and 37.5% of surgical specialties, P<.001). Medical specialties had the highest proportion of video adoption (39.1%, compared to 14.8% of primary care and 12.5% of surgical specialties, P<.001). Conclusions Personal device access and department specialty were major factors associated with high telephone and video visit adoption among safety-net clinicians. Desire for training was associated with lower video visit use. Secure device access, clinician technical trainings, and department-wide assessments are priorities for safety-net systems implementing telemedicine.

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Section: Methodsmentioning

confidence: 99%

System-Level Factors Associated With Telephone and Video Visit Use: Survey of Safety-Net Clinicians During the Early Phase of the COVID-19 Pandemic

Sharma¹,

Khoong²,

Sieera³

et al. 2022

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

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“…In particular, the ED is where the occurrence of disease burden and imbalances can be monitored, and targeted and culturally appropriate responses implemented [35]. Therefore, to increase the capacity of a healthcare safety net, support for physician practices, hospitals, and healthcare systems [39], expansion of treatment capabilities, and maintenance of the capacity of treating hospitals [40] must be ensured.…”

Section: Discussionmentioning

confidence: 99%

“…Good access to healthcare services can help expedite detection and treatment of COVID-19 patients [32,41] and reduce the mortality rate [43]. Accordingly, to increase the accessibility of a healthcare safety net, the accessibility of essential healthcare must be ensured [33], including COVID-19 testing [40], access to healthcare services [41], telemedicine services [33], and vaccinations [43].…”

Section: Discussionmentioning

confidence: 99%

“…Health equity implies the absence of unjust and preventable differences in health between groups of people [31]. However, a lack of personal protective equipment, limited staff to screen for COVID-19 [40], language barriers, insufficient data plans, and legal barriers in accessing technology or the Internet [44] have caused health inequalities. Moreover, health disparity is associated with an increased risk of serious diseases due to COVID-19 infection [45].…”

Section: Discussionmentioning

confidence: 99%

“…However, to prolong this effect, treatment and public health education are needed [32]. Additionally, education on the rapid utilization of health information technology to coordinate healthcare and public health responses to COVID-19 is needed [40]. Educational programs help nurses better care for their patients, increase their confidence, and ultimately improve the quality of patient care [47].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Healthcare Safety Nets during the COVID-19 Pandemic Based on Double Diamond Model: A Concept Analysis

Park

Lee

2021

Healthcare

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The purpose of this study was to analyze the concept of the “healthcare safety net” during the COVID-19 pandemic. Walker and Avant’s process of concept analysis was used in this systematic literature review. The attributes of the concept of a healthcare safety net during the COVID-19 pandemic were found to be: (a) capacity, (b) accessibility, (c) health equality, and (d) education. In consideration of these defining criteria, antecedents to the concept were identified as: (a) the COVID-19 pandemic, (b) health inequalities (internal factors and external factors), and (c) healthcare systems (health insurance, screening, protective equipment, medicine, and medical services). Consequences of the concept were: (a) meeting healthcare needs, (b) quality of life, and (c) a decrease in morbidity and mortality. A healthcare safety net is an important concept during the COVID-19 pandemic. In situations like COVID-19, healthcare safety nets are designed to meet safety needs, improve quality of life, and reduce patient turnover and mortality. Based on the results of this study, the development of standardized tools for measuring a healthcare safety net as well as that of policies and systems for resolving a healthcare safety net in the COVID-19 situation is recommended.

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Economic Efficiency of an Open-Source National Medical Lab Software in Canada

Peplinski

Pearce

2023

J Med Syst

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Although the Canada federal government has invested over $3.1 billion developing health information technology (HIT), all 10 provinces still have their own separate HIT systems, which are non-interoperable, expensive, and inconsistent. After first reviewing how these systems operate, this paper analyzes the costs and savings of integrating the common billing, lab results, and diagnostic imaging (BLD) functions of these separate systems using free and open-source software and proposes a system for this, HermesAPI. Currently, 8 provincial governments representing over 95% of Canada’s population allow private companies to create their own electronic medical records (EMR) system and integrate with provincial BLD systems. This study found the cost to develop and maintain HermesAPI would be between CAD$610,000 to CAD$740,000, but would prevent CAD$120,000 per company per province in development costs for a total savings of $6.4 million. HermesAPI would lower barriers to entry for the HIT industry to increase competition, improve the quality of HIT products, and ultimately patient care. The proposed open-source approach of the HermesAPI is one option towards building a more interoperable, less expensive, and more consistent HIT system for Canada. Supplementary Information The online version contains supplementary material available at 10.1007/s10916-023-01949-w.

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Informatics response to address the COVID-19 pandemic in a safety net healthcare system

Cited by 7 publications

References 5 publications

System-Level Factors Associated With Telephone and Video Visit Use: Survey of Safety-Net Clinicians During the Early Phase of the COVID-19 Pandemic

System-Level Factors Associated With Telephone and Video Visit Use: Survey of Safety-Net Clinicians During the Early Phase of the COVID-19 Pandemic

Healthcare Safety Nets during the COVID-19 Pandemic Based on Double Diamond Model: A Concept Analysis

Economic Efficiency of an Open-Source National Medical Lab Software in Canada

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