Please enable JavaScript.

Coggle requires JavaScript to display documents.

eHealth - Coggle Diagram

- - - - Use Health Literacy online, which is a Research-Based Guide with reccomandations of how to develop more accessible and intuitive digital health information tools for people with different literacy strengths and limitations (developed by ODPHP) [14]
    - - The health information should be accessible, understandable and comprehensible [15]
    - - Individuals
      - Government
      - Reserachers
      - HPOs
      - Practicioners
    - - Effective responsise to health literacy issues can improve quality of care
    - - ISHA-Q & HLQ (Identify common health literacy needs) - toolkit developed by Deakin University & WHO for developing countries
      - Ophelia Apporach [16]
        
        Questions
        
        ‘What are the health literacy strengths and weaknesses of clients of participating sites?’
        
        ‘How do sites interpret and respond to these in order to achieve positive health and equity outcomes for their clients?’
- - - - Reduces prescribing and medication errors and improve the safety of pharmacological treatment [23] [24] [26]
      - Increases efficiency of healthcare by improving the workflow .[23] [24]
      - Reduces the cost because of the reduced time spend with call-backs or requests from the pharmacy [23] [24] and an overall reduced administrative burden [27]
      - Iliminate illegible hand-written prescriptions on paper and reduce call-backs between the pharamacies and the other HPOs ; No workflow interruption; Clearance of what medication was prescribed in which doses[24]
      - Provide the ability to alerts for interactions between medications and drug-allergies [24] [27]
      - Access to medication history of the patient [24]
      - Promote meication safety; Reduction of error rates from 42,5 per 100 to 6,6 per 100 prescription one year after the implementation of ePrescribing system in an ambolatory setting in the US [26]
      - 53% reduction of calls from the pharmacy, 62% reduction of calls to the pharmacy [27]
      - Enhanced patient (reduces time of waiting in the pharmacy) and physician satisfaction [24] [27]
      - Raises awareness of the copayment system for the physicians; ePrescribing provides them with drug cost data by supporting in decision-making for prescribing --> It reduces the cost of medication for patients --> suggestion of preferred formulations [24] [27]
      - Improve patient adherence (no lost prescriptions) [24]
      - Eliminate or reduction of loss, abusion or fraud with prescriptions of controlled substances [24]
      - Doctor shopping: May help identify misuse of the controlled substances in EPCS [24]
    - - Security and technological issues [24] [27]
      - There are also studies which show that the electronic prescribing could threat medication safety by increasing medication errors
      - Financial issues [27]
      - Patient medication adherence
      - Patients may be treated by different providers, unable to track the recieved prescription
      - Meaningful use of the ePrescribing system, as the users do not routinely use the extended features such as obtain information of patient formulary [24]
      - Poor usability UX design, user (lack of knowledge) or environmental factors (lack of time) may lead to medication errors [24]
      - 1/3 of the participations reported that carrying a security authentication token at all times would be burdensome and would decelerate the adoption of the technology of EPCS [24]
      - Lack of efficient processes of ePrescribing [24]
      - Overdependance on technology, so downtown may lead to problems [36]
      - Alerting system; must have high specifity and sensitivity, not disrupt workflows unneccessary [37]
    - - 58.8% of prescribers rarely (once or less per week) responded to drug interaction alerts and clinical decision support (CDS)[24] In cases of unjustified overriding may threaten patient
      - However, justified overriding does not pose a problem when the benefits outweigh the disadvantages [37]
      - A need to optimize and minimize the frequency of the medication-related alerts [38]
    - - AI solutions to help patients take the medication
      - decision-support softwares for insuline treatments reccomandations - SINGAL; gives the physicians a recommandation for medication prescribing
    - - Successful implementation [39]
        
        Implementation
        
        Use
        
        Planning
        
        Understand existing work processes
        
        How could the actual processes be influences by ePrescribing
        
        Plan workflow and work changes
        
        standardize data entry processes; develop protocols
  - - - Increased efficiency
      - In Estonia the nr of patients grew with the implementation of online appointment tool with the same nr of doctors and the same nr of medical devices
  - - - Patients can manage their referrals in the app
      - Patients can book their appointments themselves
    - - Information transfer in a timely manner [40]
      - Knowledge sharing [40]
      - Efficient communication and knowledge sharing between practitioners[40] [41] [46]
        
        May help physicians in more specialised care to identify the reason (clinical question) for referral [46]
      - Enhance quality of referrals [40]
      - Optimize patient flow and improve efficiency [40] [41] [46]
      - Knowledge management - systematic handling of knowledge for greater organizational benefits
      - timely access to specialised care [46]
      - Reduction of waiting times [46]
      - Quanitiy of referrals increased [46]
      - GPs are satisfied with eRefs [46]
    - - Communication between primary and secondary healthcare by transfering information and appointment between two or more HPOs [41] [46]
      - Replaces the manuel process of paper-based referrals by automating the referral process and standardising the information and communciation [41] [46]
      - "The direction of a patient from GP to a medical specialist by transfering all or some of the responsibility which falls outside of a physician's competence [41]"
      - Health information vision for New Zealand is described as: "of e-Referrals as: “Patients are referred to the right practitioner with the right information and receive the right response”" [41]
    - - evidence on the cost-effectiveness of eRef is limited [46]
- - - - FAR [17]
        
        To identify trust and privacy attributes in eHealth
- - - - Racial bias
    - - Give the same appointment time to more than one patient
      - If patients from overbooked slots do show up some will experience waiting times
    - - A clinic should overbook patients with lowest show-ups
      - Overbook black patients, so they should wait longer
      - The show-up probability is calculated
        
        Sociodemographic information
        
        the patient's past no-shows
        
        the nr. of past appointments