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G. Paré



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    OS06 - Partnership in Care and Outcomes (ID 2)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS06.03 - Improving Emergency Care Physicians' Performance Through Laboratory Information Exchange (ID 31)

      G. Paré, Research Chair in Digital Health, HEC Montreal; Montreal/CA

      • Abstract
      • Slides

      Purpose/Objectives: For hospitals, laboratory test results’ reliability, turnaround time and predictive ability are critical to the performance of hospital emergency departments (ED), and to the safety and quality of care provided by emergency care physicians (ECPs) to patients. As these results are now most often obtained by ECPs through their use of IT-enabled laboratory information exchange (LIE), the purpose of this study is to answer the following research questions: What is the actual nature of ECPs’ use of LIE, and what combination of health systems (LIS, CIS, EDIS, EHR and/or other) are actually accessed by these physicians for this purpose? What is the extensiveness of this use and most importantly, what is its effectiveness, that is, what are the clinical performance outcomes of LIE use in the ED?

      Methodology/Approach: In order to answer the research questions, a survey study was made of 163 ECPs practicing in hospitals in the province of Quebec, Canada, and having access to the province-wide EHR system (called DSQ) for LIE purposes. The majority of the sampled respondents were general practitioners (80%), the rest being specialists. The data were obtained through a web-based survey platform, and analyzed through descriptive and bivariate statistics as well as cluster analysis, using the SPSS statistical package.

      Finding/Results: The main findings of this study are threefold. First, the majority of sampled ECPs (70 %) simultaneously access two or more health systems for LIE purposes: a) their hospital’s laboratory information “viewer” (LIV) which interfaces a CIS (clinical information system), a LIS (laboratory information system) and/or a RHIR (regional health information repository), and b) Quebec’s province-wide EHR, the Quebec Health Record (QHR). Second, three LIE user profiles emerge: i) ECPs who rely extensively on both a LIV and the QHR (n = 100), ii) ECPs who rely extensively on a LIV only (n = 40), and iii) ECPs who rely extensively on the QHR only and to a lower extent on their EDIS (n=23). Third, the clinicians reporting higher performance outcomes from their LIE usage are those within the first group, that is, the LIV/QHR-reliant ECPs whose use of their hospital’s LIV is more extensive.

      Conclusion/Implications/Recommendations: The main implications of the study’s findings are threefold. First, the “laboratory” component of emergency care must be further studied in light of the growing reliance of ECPs upon information technology to enable their consultation and management of patients’ test results, that is, by explicitly incorporating effective use of LIE into ED performance models. Second, ECPS must be encouraged to make more extensive use of LIE, that is, to use their hospital-wide LIV and the province-wide EHR in combination, and to use more of the laboratory medicine functionalities available in these health systems. Third, given that the interoperability of a nation-/state-/province-wide EHR system with hospital information systems such as CIS and EDIS constitutes a necessary condition of extensive and effective laboratory information exchange in the ED, the ECPs’ requirements in this regard must be taken into account by those who design and implement these systems.

      140 Character Summary: A survey of 163 emergency care physicians in Canada allowed us to study the nature, extensiveness and effectiveness of their use of laboratory information exchange.

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    OS25 - Understanding Patient-Centred Care Amidst Digital Health Era (ID 49)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS25.05 - Self-Tracking and Adoption of Connected Health Technologies in Canada (ID 32)

      G. Paré, Research Chair in Digital Health, HEC Montreal; Montreal/CA

      • Abstract
      • Slides

      Purpose/Objectives: The present study examines Canadians’ use of mobile apps and smart devices to monitor aspects of their health and well-being. It is the first national survey of its kind in Canada, and the largest ever, world-wide.

      Methodology/Approach: We conducted an online survey with a sample of 4,109 Canadian adults. The questionnaire was developed based on a review of the scientific literature on the subject and pre-tested on 50 respondents. The survey was available from January 11 to February 2, 2017. To ensure a representative sample, the quota method was used (sex, age) following stratification by province. The maximum margin of error associated with our sample size is estimated at 1.6%, 19 times out of 20. The results were weighted based on the following variables: province, age and gender.

      Finding/Results: Our findings reveal that a majority of Canadian adults (66%) regularly track one or more aspects of their health or well-being. We defined two specific groups, namely, traditional trackers (39%) and e-trackers (61%). While traditional trackers monitor their health using mostly paper-based tools such as a notebook or a journal, e-trackers do so with the help of mobile apps and/or smart connected devices. About one third (32%) of Canadian adults use one or more mobile apps while 24% owns at least one smart connected device to monitor aspects of their health. Canadian e-trackers are typically younger adults (41%), employed (59%), university educated (55%) with an annual family income of over $80,000 (46%); and generally healthy - only a small segment (28%) of those who use mobile apps or smart devices reported living with a specific chronic illness or condition or self-rate their health status as ‘fair/poor’. The most popular smart device is by far the bracelet or watch, which is owned by 88% of respondents with at least one smart connected device. Mobile apps and smart devices are mainly used to monitor aspects of well-being such as physical activity, nutrition, weight, sleep, sports performance and, to a much lesser extent, medical or clinical data such as chronic disease condition indicators. The level of satisfaction with digital devices is reflected in respondents’ intentions to continue using such tools (88% for smart connected devices and 72% for mobile apps). About half of Canadian adults who do not currently own a smart connected device for health do not see the interest in owning one. Comparisons with other international survey findings will be presented.

      Conclusion/Implications/Recommendations: The present study shows an opportunity to advance the health of Canadians through mobile apps and smart devices; and highlight important nuances to better understand key market segments and opportunities. Our results can also be used to set the national baseline for future studies on the diffusion of connected health technologies. Importantly, findings are useful for IT developers as well as clinicians and administrators across all health settings to better understand the current digital market, the profiles of e-trackers, traditional trackers and non-trackers, the value proposition these tools provide to users, and health system transformation.

      140 Character Summary: A survey of 4,109 Canadian adults allowed us to study the current use of mobile apps and smart connected devices to monitor aspects of their health and well-being.

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