IT intervention to support medicine optimisation in primary care

Jeffries, M. et al. (2017) Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory. BMJ Open. 7:e014810

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Objectives: Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care.

Conclusions: Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation.

Read the full article here

Telehealthcare for patients suffering from chronic obstructive pulmonary disease

Lilholt, P.H. et al. (2017) BMJ Open. 7:e014587.

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Image source: Neil Webb – Wellcome Images // CC BY-NC-ND 4.0

Objective: To assess the effect of telehealthcare compared with usual practice in patients with chronic obstructive pulmonary disease (COPD).

Conclusions: The overall sample and all subgroups demonstrated no statistically significant differences in HRQoL between telehealthcare and usual practice.

Read the full article here

How big data is being mobilised in the fight against leukaemia

In a project funded by Bloodwise and the Scottish Cancer Foundation, we have created LEUKomics. This online data portal brings together a wealth of CML gene expression data from specialised laboratories across the globe | Lorna Jackson & Lisa Hopcroft for The Conversation

Leucemia mieloide cronica (LMC)

Image source: Paulo Henrique Orlandi Mourao – Wikimedia // CC BY-SA 3.0

Our intention is to eliminate the bottleneck surrounding big data analysis in CML. Each dataset is subjected to manual quality checks, and all the necessary computational processing to extract information on gene expression. This enables immediate access to and interpretation of data that previously would not have been easily accessible to academics or clinicians without training in specialised computational approaches.

Consolidating these data into a single resource also allows large-scale, computationally-intensive research efforts by bioinformaticians (specialists in the analysis of big data in biology). From a computational perspective, the fact that CML is caused by a single mutation makes it an attractive disease model for cancer stem cells. However, existing datasets tend to have small sample numbers, which can limit their potential.

Read the full blog post here

Transforming community care with digital technologies

Chris Gregory, head of clinical systems for LGSS Local Health and Care Shared Service explains how mobile solutions are transforming the work of community-based health teams | NHE

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As the IT provider to Northamptonshire Healthcare NHS FT, LGSS has been involved in delivering mobile working solutions to a number of community-based health teams, including health visitors and district nurses, and for providing similar solutions in local government.

The trend towards delivering care closer to home to meet both patient aspirations, and the need to deliver savings through the reduction of estate, means that increasing levels of flexible working are being demanded across the NHS. If done successfully, mobile working can help to deliver the type of service that patients tell us they would like from their health service.

As with many IT services we’ve had a few attempts at delivering practical mobile working solutions, each based on and constrained by the technology available at the time. Prior to our latest deployment, we asked staff what they needed from a mobile device. Overwhelmingly, those who responded wanted:

  • A small form factor: There is plenty of other equipment a district nurse needs to carry so devices need to be small, as light as possible and certainly no more awkward to carry than the files of paper notes previously used
  • Sufficient battery life to get through an entire working day
  • A fast start-up: Ensuring that as little of the precious contact time with the patient was spent waiting for the technology
  • Versatility: Multiple means of inputting data, suggesting the need for both touchscreen and keyboard input

Read the full article here

Smartphone text message service to foster hand hygiene compliance in health care workers

Kerbaj, J. et al. American Journal of Infection Control. Published online 9 December 2016

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Background: Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence.

Conclusions: Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance.

Read the full abstract here

Ethical Use of Telemedicine in Emergency Care

American College of Emergency Physicians(2016) Annals of Emergency Medicine68(6) p. 791

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  • The American College of Emergency Physicians (ACEP) believes that EDs using telemedicine should make this form of care accessible regardless of race, religion, sexual orientation, location, or ability to pay.

  • ACEP believes that EDs and hospitals should ensure that their telemedicine systems and practices provide patients with at least the privacy and confidentiality required under HIPAA. This includes ensuring that their equipment and technology are up-to-date and secure.

  • ACEP believes that telemedicine decisions relating to patient care, referrals, and transfers should be based on the patient’s health care needs.

  • ACEP supports the establishment of standards for telemedicine practitioners and development of related quality assurance and educational programs to develop the discipline.

  • ACEP supports legislative efforts that would allow single-state licensing to be sufficient for telemedical practice throughout the United States.

  • ACEP believes that all aspects of the telemedical consultations between advance medical practitioners (ie, physicians, nurse practitioners, and physician assistants) are subject to the same informed consent and refusal standards as face-to-face medical encounters.

Read the full abstract here

Using data to identify good-quality care for older people

Sherlaw-Johnson, C. et al. Nuffield Trust. Published online: 1 November 2016

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Image source: Nuffield Trust

This report describes the results of some pilot analysis to ascertain the usefulness of using this approach, using a few indicators that were mainly derived from acute emergency hospital use. The aims were to test out ways of using data to identify potential success; to understand the challenges of attributing data findings to real-world activity; to judge the feasibility of extending into wider work; and to inform what this wider work should look like.

This study shows that there is scope for using more sophisticated analytical methods for identifying improvements in care quality, and that they have advantages in improving specificity and as continuous monitoring tools. This may be particularly true at the local level, or even at a lower level, such as individual GP practices. While we applied these techniques retrospectively, there are likely to be advantages in using these methods for prospective monitoring and evaluation.

Read the full overview here

Read the full report here