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Clinical laboratory quality improvement (QI) efforts can include population test utilization. The authors used a health care organization's Medical Data Warehouse (MDW) to characterize a gap in guideline-concordant laboratory testing recommended for safe use of antirheumatic agents, then tested the effectiveness of laboratory-led, technology-enabled outreach to patients at reducing this gap. Data linkages available through the Kaiser Permanente Colorado MDW and electronic health record were used to identify ambulatory adults taking antirheumatic agents who were due/overdue for alanine aminotransferase (ALT), aspartate aminotransferase (AST), complete blood count (CBC), or serum creatinine (SCr) testing. Outreach was implemented using an interactive voice response system to send patients text or phone call reminders. Interrupted time series analysis was used to estimate reminder effectiveness. Rates of guideline-concordant testing and testing timeliness in baseline vs. intervention periods were determined using generalized linear models for repeated measures. Results revealed a decrease in percentage of 3763 patients taking antirheumatic agents due/overdue for testing at any given time: baseline 24.3% vs. intervention 17.5% (P < 0.001). Among 3205 patients taking conventional antirheumatic agents, concordance for all ALT testing was baseline 52.8% vs. intervention 65.4% (P < 0.001) among patients chronically using these agents and baseline 20.6% vs. intervention 26.1% (P < 0.001) among patients newly starting these agents. The 95th percentiles for days to ALT testing were baseline 149 vs. intervention 117 among chronic users and baseline 134 vs. intervention 92 among new starts. AST, CBC, and SCr findings were similar. Technology-enabled outreach reminding patients to obtain laboratory testing improves health care system outcomes. [ABSTRACT FROM AUTHOR]

This study delivered a daily diary to 67 HIV-infected men who have sex with men (MSM) between 16 and 24 years old for 66 days to measure HIV-risk behaviors and other psychosocial variables via two diary modalities: internet (accessible via any web-enabled device) and voice (accessible via telephone). Participants were randomized to complete one diary modality for 33 days before switching to the second modality for 33 days. The study was implemented in three urban HIV health care centers in the United States where participants were receiving services. Through diary data and qualitative interview data, we examined the feasibility and acceptability of the dairies and identified barriers and facilitators of dairy compliance. Results show high participant retention in the daily diary (93.4 %) and high compliance for the number of dairies completed (72.4 %). Internet diaries were preferred by 92 % of participants and completed at a significantly higher rate (77.5 %) than voice diaries (67.7 %). Facilitators included opportunities for self-reflection and cathartic sharing, monetary compensation, relationships with study staff, and daily reminders. Barriers included being busy or not having privacy at the time of reminders, forgetting, and falling asleep. Participants also described barriers and facilitators unique to each modality. Overall, both modalities were feasible and acceptable for use with our sample of HIV-infected MSM. [ABSTRACT FROM AUTHOR]

The article offers insights on international and U.S. ergonomics standards related to software system designs. It describes two International Organization for Standardization (ISO) ergonomics standards and a Human Factors Ergonomics Society (HFES) standards relevant to the ergonomic design of systems and their usefulness to users. Since the standards contain useful recommendations, the article suggests that software designers be constantly updated with their new requirements.

Introduction: There is a paucity of research on modes of cannabis use (e.g., joint vs. blunt), and further, little consensus on how to accurately assess both modes of use and route of administration. This secondary analysis used a longitudinal design with data collected daily to characterize mode of cannabis use., Methods: 193 adult daily cannabis users who were considering quitting at some point enrolled in the study. No treatment was provided. Each day for 84 days, participants reported on mode of cannabis use (i.e., joints, blunts, pipes/vaporizer and food) using an interactive voice response system. We report on single and poly-use of modes across study days and weeks and examine characteristics associated with different modes of use., Results: White participants were most likely to use pipes/vaporizer, with use on 57% of study days, while Black participants were most likely to use blunts with use on 53% of days. Thus, joint use was less common in both groups. Poly-use of different modes within the same week was very common (i.e., 56% of weeks among White participants and 60% of weeks in Black participants). Age, gender, race, cannabis dependence, presence of others during cannabis use, and alcohol use were associated with different modes of use., Conclusions: The major limitation of this study was use of a convenience sample and lack of detailed data on vaporizer use. Joint use is no longer the most common mode of use in either White or Black participants and exclusive use of a single modality is uncommon., (Copyright © 2019 Elsevier Ltd. All rights reserved.)