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This paper aims to explore the perceptions of facilitators and barriers to their using electronic medical records (EMRs) for these functions and contributes baseline data about the use of EMRs for chronic disease management. The sub‐study reported here is a baseline process evaluation of EMRs and their current use, preliminary to a larger, pragmatic, randomized controlled trial. Its purpose is to understand how EMRs are currently being used by primary care physicians to facilitate chronic disease prevention and screening in their practices.

This is a qualitative case study where the lead physician at each of eight primary care clinics (four in Alberta, four in Ontario) participated in semi‐structured interviews. Data were analyzed using thematic content analysis.

Although EMRs are being used in a limited fashion for chronic disease prevention and screening, clinicians identified few current benefits. Participants noted some instances in which paper charts were preferred and that the lack of human and financial resources is inhibiting the use of chronic disease applications already incorporated in EMRs.

To understand fully how EMRs can best be used in the logistical management of chronic disease prevention and screening requires research efforts towards improvement of the data structures they contain.

Data extraction needs to be easier so that screening of patients, at risk or living with chronic disease, can be facilitated.

Evaluation of the benefits, for the content of care and care relationships, conferred by this new method of communicating, needs to be complemented by a parallel exploration of the risks.

The paper illustrates that with the tremendous investments in EMRs it is important to learn how changes in their design could facilitate improvements in patient care in this important area.

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

Migrant and seasonal farmworkers (MSFWs) have many health challenges due to the nature of their work, low wages, living conditions, mobility, and lack of health insurance. The purpose of this paper is to assess the availability of health services, barriers to accessing health care, and the prevalence of chronic conditions among MSFWs in Indiana.

A site-based convenience sample of MSFWs aged 14 years and older completed a cross-sectional survey. A total of 97 participants who currently or previously identified as farmworkers completed the questionnaire.

Almost one-third of the respondents reported no access to a health care provider. Of those, 43 percent reported that cost prevented them from seeking care. Of those who reported chronic conditions ( n=22), over 50 percent did not have access to a health care provider. These findings highlight the need to further investigate the magnitude of the problem and begin exploring ways to improve affordable health care access among MSFWs in Northeastern Indiana.

The results from this study highlight the need for the development and implementation of community health education programs that target MSFWs in Indiana. The findings, although not generalized, offer important insights into health care challenges and barriers to access in Indiana. The authors recommend that assistance programs should be implemented for providing affordable health care services for Hispanic MSFWs.

Objective. To evaluate a health and fitness programme conducted within a New South Wales, Australia correctional facility for male inmates with a chronic illness. Design. A randomised control trial. Sample. Twenty male inmate participants with a chronic illness, two risk factors for developing a chronic illness or who were over the age of 40 years. Measurements. Pre and post programme health assessments that included resting blood pressure and heart rate, weight, body mass index, waist girth, peak flow measures, peripheral saturation of oxygen, blood glucose levels and 6 minute walk test. Intervention. A 12‐week structured exercise programme focusing on cardio respiratory endurance, strength and flexibility training. Results. Statistically significant improvements in resting heart rate and endurance were found. Conclusions. The health and fitness programme positively impacts on the health of inmates with a chronic illness. A further study with a larger sample size would be productive.

To assist in achieving cost effective health care allocations in a collective choice setting, the purpose of this paper is to illustrate the use of a tool not common in the public budgeting literature but is common in the health economics literature.

Through a meta-analysis of the health care spending literature that computed the value of quality-adjusted life years, the authors provide an alternative approach for budgeters and policymakers.

The authors provide an alternative approach for budgeters and policymakers for weighing the benefits of alternative health care spending allocations.

The authors introduce an alternative approach for weighing the benefits of alternative health care spending allocations. As a tool for budgeting professionals, cost per QALY allows for the opportunity to raise cost-effectiveness of public health expenditures as a tool for governments to allocate resources based on outcomes, rather than inputs.

The purpose of this paper is to conduct a statewide assessment of worksite health promotion (WHP) programs to identify the number of comprehensive programs and the health needs of worksites in Kentucky.

A random sample of 1,200 worksites in Kentucky was selected to receive the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard to collect cross-sectional information on their health promotion practices.

Few worksites in Kentucky have WHP programs and even fewer have comprehensive programs. More businesses rely on health insurance to treat chronic diseases than WHP programs to reduce chronic diseases. Small companies were less likely than larger companies to have WHP programs and less likely to have intentions of starting a program.

The response rate of 37 percent was a potential threat to external validity. Respondents had to recall activities conducted during the past 12 months, which could have led to recall bias. Response bias was a potential, as many of the respondents were human resources personnel who may not be as familiar with WHP programs in their worksites. Lastly, four sections of the survey had yet to be validated.

WHP programs, if accessible and comprehensive, have the potential to improve the working population’s health status.

Very little information on the availability and effectiveness of health promotion programs at worksites is available. A statewide assessment on WHP programs has never been conducted in Kentucky.

The COVID-19 pandemic has demonstrated the urgency of better chronic disease management and the importance of making it an integral part of the recovery agenda in Europe. This paper aims to explore the shift towards digital and integrated care systems in Europe.

In this viewpoint paper the Expert Group for Integrated Care and Digital Health Europe (EGIDE) group argues that an orchestrated shift towards integrated care holds the solution to the chronic disease pandemic.

The development of integrated care cannot happen without shifting towards a digitalised healthcare system via large-scale initiatives like the European Health Data Space (EHDS) and the involvement of all stakeholders.

The EGIDE group has identified some foundational principles, which can guide the way to realise the full potential of the EHDS for integrated care and can support the involved stakeholders’ thinking.

Community‐based participatory research (CBPR) has been shown to improve aspects of health promotion initiatives. This case study examines the effects of a CBPR intervention on intermediate outcomes (changes in the community) related to preventing health disparities and chronic disease. We describe how the Kansas City‐Chronic Disease Coalition used CBPR methods to help bring about community changes to reduce risk for cardiovascular diseases and diabetes among African Americans and Hispanics in Kansas City, Missouri. Using an empirical case study design, communities and scientific partners documented and analyzed the contribution of community changes (new or modified programs, policies or practices) facilitated by the coalition in two racial/ethnic communities: African American and Hispanic. Follow‐up interviews suggest that the coalition did a better job of implementing a CBPR intervention in the African American community than in the Hispanic community. Challenges to implementing CBPR interventions in multiple and diverse ethnic communities are discussed.

The purpose of this study is to examine knowledge and perceptions of risk surrounding chronic inflammatory diseases (CIDs) and intergenerational development, as well as practices used to acquire CID information among unaffected first- and second-generation South Asian immigrant parents and children in the Greater Toronto Area, Ontario.

Fifty-four in-depth interviews with parents and children (18 parents, 36 children) were conducted by trained facilitators, recorded, transcribed and analyzed qualitatively.

Findings reveal that although CIDs disproportionately affect South Asian immigrants, this group has low knowledge and awareness of CID symptoms, risk factors and conditions. Yet when equipped with some knowledge about CIDs, participants linked their increased risk of CIDs to perceived risks in their broader environments such as climate variations, pollution, unhealthy food environments and health system neglect, that although yearning to change these factors, felt unable to modify their risks as factors were beyond their control. Although information is critical to manage CIDs, the findings reveal important and divergent knowledge pathways and practices used among first- and second-generation parents and children, particularly related to health-care settings and academic resources, underscoring generational disparities in knowledge acquisition.

The findings suggest that a multi-sector, multi-tiered approach built around a series of structural interventions, programs and policy changes is needed to address CID knowledge and awareness gaps and entrenched culturally insensitive health care to create more equitable access to healthy, safe and responsive environments and care systems for CID management.