4 results on '"Walker, Jan"'
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2. People with diabetes who read their clinicians' visit notes: Behaviors and attitudes.
- Author
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Dong, Zhiyong, Leveille, Suzanne, Lewis, Dana, and Walker, Jan
- Subjects
PATIENT portals ,DIABETES ,PATIENTS' attitudes ,SURVEYS ,PSYCHOSOCIAL factors ,RESEARCH funding ,ELECTRONIC health records ,READING ,PEOPLE with diabetes ,OUTPATIENT services in hospitals ,ADULTS - Abstract
Objectives: To understand behaviors and attitudes of adults with diabetes who read their clinicians' visit notes. Methods: By linking a large 2017 patient survey involving three institutions with administrative and portal use data, we identified patients with diabetes mellitus from outpatient records and examined reading behaviors related to eligible notes—initial, follow-up, history and physical, and progress notes. We analyzed patients' perceived benefits of reading notes. Results: 2104 respondents had diagnoses of diabetes mellitus and had read ≥1 note in the 12-month period. Patients had an average of 8.7 eligible notes available and read 59% of them. The strongest predictor of reading more notes was having more notes available; the specialties of the authoring clinicians were not correlated with note reading rates. Patients reported understanding notes by primary care clinicians and specialists equally well; more than 90% of patients reported understanding everything or almost everything in a self-selected note. Across visit types, 73–80% of patients reported that note reading was extremely important for taking care of their health. Discussion: People with diabetes want to read their clinicians' notes, are accessing them at high rates, and report understanding the notes and benefiting from reading them. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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3. Rapid access rehabilitation after exacerbations of chronic obstructive pulmonary disease: A Delphi study
- Author
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Quach, Shirley, Oliveira, Ana, Brooks, Dina, Walker, Jan, and Goldstein, Roger
- Abstract
AbstractBACKGROUNDPulmonary rehabilitation (PR) improves function and health-related quality of life following acute exacerbations of chronic obstructive pulmonary disease (AECOPD). There is increasing interest in initiating rapid access rehabilitation (RAR) within 48 h of AECOPD discharge, to facilitate transition to home and conventional PR. In this report, we identify the practical considerations for the design and implementation of a RAR program.METHODHealthcare professionals (HCP), policymakers (PM), and patients living with COPD were invited to participate in a 2-round e-Delphi process. They provided feedback on five RAR themes, identified from semi-structured interviews, using a 6-point Likert scale. The initial round 1 questionnaire included 196 statements for HCP and PM and 144 for patients.RESULTSA total of 38 participants were enrolled (17 HCP, 12 PM, and 9 patients). Participants agreed that RAR should be initiated within 1 to 3 weeks of discharge for motivated patients with frequent exacerbations and those with co-existing health conditions. The consensus was for a hybrid format, of 1 to 2-h sessions, several times a week for a total duration of 4 to 6 weeks, with the structure being modified by patients’ preferences. Factors to improve referral and uptake included educating patients and HCP about RAR benefits and having a patient ambassador to support patients.CONCLUSIONStakeholders reached consensus around characteristics for participant eligibility, program structure, treatment priorities, outcome measures, approaches to facilitate referral, uptake and implementation of RAR. Such information forms the basis of a testable RAR program for patients transitioning home from hospital or referred for PR following an AECOPD.
- Published
- 2024
- Full Text
- View/download PDF
4. Leveraging an Electronic Health Record Patient Portal to Help Patients Formulate Their Health Care Goals: Mixed Methods Evaluation of Pilot Interventions.
- Author
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Naimark J, Tinetti ME, Delbanco T, Dong Z, Harcourt K, Esterson J, Charpentier P, and Walker J
- Subjects
- Humans, Male, Female, Pilot Projects, Aged, Surveys and Questionnaires, Focus Groups, Aged, 80 and over, Patient Portals, Electronic Health Records
- Abstract
Background: Persons with multiple chronic conditions face complex medical regimens and clinicians may not focus on what matters most to these patients who vary widely in their health priorities. Patient Priorities Care is a facilitator-led process designed to identify patients' priorities and align decision-making and care, but the need for a facilitator has limited its widespread adoption., Objective: The aims of this study are to design and test mechanisms for patients to complete a self-directed process for identifying priorities and providing their priorities to clinicians., Methods: The study involved patients of at least 65 years of age at 2 family medicine practices with 5 physicians each. We first tested 2 versions of an interactive website and asked patients to bring their results to their visit. We then tested an Epic previsit questionnaire derived from the website's questions and included standard previsit materials. We completed postintervention phone interviews and an online survey with participating patients and collected informal feedback and conducted a focus group with participating physicians., Results: In the test of the first website version, 17.3% (35/202) of invited patients went to the website, 11.4% (23/202) completed all of the questions, 2.5% (5/202) brought results to their visits, and the median session time was 43.0 (IQR 28.0) minutes. Patients expressed confusion about bringing results to the visit. After clarifying that issue in the second version, 15.1% (32/212) of patients went to the website, 14.6% (31/212) completed the questions, 1.9% (4/212) brought results to the visit, and the median session time was 35.0 (IQR 35.0) minutes. In the test of the Epic questionnaire, 26.4% (198/750) of patients completed the questionnaire before at least 1 visit, and the median completion time was 14.0 (IQR 23.0) minutes. The 8 main questions were answered 62.9% (129/205) to 95.6% (196/205) of the time. Patients who completed questionnaires were younger than those who did not (72.3 vs 76.1 years) and were more likely to complete at least 1 of their other assigned questionnaires (99.5%, 197/198) than those who did not (10.3%, 57/552). A total of 140 of 198 (70.7%) patients responded to a survey, and 86 remembered completing the questionnaire; 78 (90.7%) did not remember having difficulty answering the questions and 57 (68.7%) agreed or somewhat agreed that it helped them and their clinicians to understand their priorities. Doctors noted that the sickest patients did not complete the questionnaire and that the discussion provided a good segue into end-of-life care., Conclusions: Embedding questionnaires assaying patient priorities into patient portals holds promise for expanding access to priorities-concordant care., (©Jody Naimark, Mary E Tinetti, Tom Delbanco, Zhiyong Dong, Kendall Harcourt, Jessica Esterson, Peter Charpentier, Jan Walker. Originally published in JMIR Formative Research (https://formative.jmir.org), 29.08.2024.)
- Published
- 2024
- Full Text
- View/download PDF
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