Oncology and Primary Care Involvement in Breast Cancer Survivorship Care More Than 5 Years After Initial Treatment.

Purpose: Very little is known about primary care involvement in the care of cancer survivors beyond the initial 5 years post-treatment when transitioning to primary care is guideline-recommended for many survivors.

Methods: The ICanCare study is a longitudinal survey of women diagnosed with breast cancer in 2014-2015 identified in the Georgia and Los Angeles SEER registries. Women were surveyed during initial treatment and again approximately 6 years later in survivorship (2021-2022; n = 1,412, 60% response rate).

Accuracy, thoroughness, and quality of outpatient primary care documentation in the U.S. Department of Veterans Affairs.

Background: Electronic health records (EHRs) can accelerate documentation and may enhance details of notes, or complicate documentation and introduce errors. Comprehensive assessment of documentation quality requires comparing documentation to what transpires during the clinical encounter itself. We assessed outpatient primary care notes and corresponding recorded encounters to determine accuracy, thoroughness, and several additional key measures of documentation quality.

Asynchronous Conferencing Through a Secure Messaging Application Increases Reporting of Medical Errors in a Mature Trauma Center.

Background: Medical errors occur frequently, yet they are often under-reported and strategies to increase the reporting of medical errors are lacking. In this work, we detail how a level 1 trauma center used a secure messaging application to track medical errors and enhance its quality improvement initiatives.

Methods: We describe the formulation, implementation, evolution, and evaluation of a chatroom integrated into a secure texting system to identify performance improvement and patient safety (PIPS) concerns.

Texting is caring: a content analysis of clinical text messages by hospitalists.

Background: Clinical texting systems (CTS) are widely used in hospitals for team communication about patients. With more institutions adopting such systems, there is a need to understand how texting is being used in clinical practice.

Methods: We conducted content analysis of 809 randomly selected message threads sent to and from hospitalists in a 9-month window.

Content Analysis of Emoji and Emoticon Use in Clinical Texting Systems.

Importance: Emoji and emoticons are quickly becoming an omnipresent feature of virtual communication. As health care systems increasingly adopt clinical texting applications, it is critical to understand how clinicians use these ideograms with colleagues and how it may affect their interactions.

Objective: To evaluate the functions that emoji and emoticons serve in clinical text messages.

Continuous Glucose Monitoring and Other Wearable Devices to Assess Hypoglycemia among Older Adult Outpatients with Diabetes Mellitus.

Background: Hypoglycemia (HG) causes symptoms that can be fatal, and confers risk of dementia. Wearable devices can improve measurement and feedback to patients and clinicians about HG events and risk.

Objectives: The aim of the study is to determine whether vulnerable older adults could use wearables, and explore HG frequency over 2 weeks.

Retention, Fasting Patterns, and Weight Loss With an Intermittent Fasting App: Large-Scale, 52-Week Observational Study.

Background: Intermittent fasting (IF) is an increasingly popular approach to dietary control that focuses on the timing of eating rather than the quantity and content of caloric intake. IF practitioners typically seek to improve their weight and other health factors. Millions of practitioners have turned to purpose-built mobile apps to help them track and adhere to their fasts and monitor changes in their weight and other biometrics.

Qualitative Analysis of Team Communication with a Clinical Texting System at a Midwestern Academic Hospital.

Background: Hospitals are increasingly replacing pagers with clinical texting systems that allow users to use smartphones to send messages while maintaining compliance for privacy and security. As more institutions adopt such systems, the need to understand the impact of such transitions on team communication becomes ever more significant.

Methods: We conducted focus groups with hospitalists and individual interviews with nurses at one academic medical center in the Midwest.

"I Don't Want to Spend the Rest of my Life Only Going to a Gender Wellness Clinic": Healthcare Experiences of Patients of a Comprehensive Transgender Clinic.

Background: Transgender individuals are less likely to have had a primary care visit in the last year than cisgender individuals. While the importance of multidisciplinary clinics for transgender care has been established, little is known about the healthcare experiences of transgender patients with these clinics.

Objective: To describe how patients experience transgender clinics and how these experiences compare to those experiences in other settings.

Financial hardship is associated with lower uptake of colorectal, breast, and cervical cancer screenings.

Purpose: Cancer screening uptake differs between groups in ways that cannot be explained by socioeconomic status alone. This study examined associations between material, psychosocial, and behavioral aspects of financial hardship and cancer screening behaviors.

Methods: Surveys were mailed to 7,979 people ages 18-75 who were seen in the statewide health system in Indiana.

Insecure messaging: how clinicians approach potentially problematic messages from patients.

Objective: Secure messaging has become an integrated function of patient portals, but misuse of secure messaging by both patients and clinicians can lead to miscommunication and errors, such as overlooked urgent messages. We sought to uncover variations in clinician approaches and responses to messaging with patients.

Methods: In this two-part study, 20 primary care clinicians (1) composed message responses to five hypothetical patient vignettes and messages and (2) were subsequently interviewed for their perspectives on appropriate circumstances for secure messaging.

Communication About Health Information Technology Use Between Patients and Providers.

Background: Although growing, the prevalence of the use of health information technology (HIT) by patients to communicate with their providers is not well understood on the population level, nor whether patients are communicating with their providers about their use of HIT.

Objective: To understand whether patients are communicating with their providers about HIT use and the patient characteristics associated with the communication.

Design: Cross-sectional, self-administered survey of a sample of patients across the state of Indiana.

Too Many Don'ts and Not Enough Do's? A Survey of Hospitals About Their Portal Instructions for Patients.

Background: Patient portals present the opportunity to expand patients' access to their clinicians and health information. Yet patients and clinicians have expressed the need for more guidance on portal and secure messaging procedures to avoid misuse. Little information is currently available concerning whether and how expectations of portal and messaging usage are communicated to patients.

The Impact of Physician Social Media Behavior on Patient Trust.

Institutions have developed professionalism policies to help guide physician social media behavior in light of professionalism lapses that have resulted in serious consequences. Prior research has gathered perspectives on online professionalism; however, the public's views remain poorly understood. Importantly, the impact of physician social media behavior on patient trust is unknown.

Rural and Urban Differences in the Adoption of New Health Information and Medical Technologies.

Background: This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations.

Methods: A random sample of 7,979 people aged 18-75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed.

Results: Completed surveys were returned by 970 participants.

Racial and Socioeconomic Disparities in Cancer-Related Knowledge, Beliefs, and Behaviors in Indiana.

Background: This statewide survey examined differences in cancer-related knowledge, beliefs, and behaviors between racial and socioeconomic groups in select counties in Indiana.

Methods: A stratified random sample of 7,979 people aged 18-75 who lived in one of 34 Indiana counties with higher cancer mortality rates than the state average, and were seen at least once in the past year in a statewide health system were mailed surveys.

Results: Completed surveys were returned by 970 participants, yielding a 12% response rate.

A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations.

Background: Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area.

Objective: To understand how existing guidelines align with current practice, evidence, and technology.

Does personality affect health-related quality of life? A systematic review.

Background: Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear.

Seeing is Engaging: Vlogs as a Tool for Patient Engagement.

Video blogs (‘vlogs’ – pronounced as one syllable) are a popular platform for conveying know-how online and can be used as a tool for patient engagement. It can be challenging to engage patients in their own care, and the unique attributes of vlogs overcome some of the barriers to engagement such as high treatment burden and a lack of the sense of community. While some clinicians may distrust social media and question its place in patient care, we present The Frey Life, one example of a patient vlog, to show how the platform models and fosters engagement, and provides the patient perspective.

A qualitative exploration of favorite patients in primary care.

Objective: To ascertain whether physicians have favorite patients, their experiences with such patients, and how such relationships may influence patients and physicians.

Methods: Semi-structured key informant interviews with 25 primary care internists practicing in several clinic settings at a large academic medical center.

Results: The term 'favorite patient' raised concerns regarding boundaries and favoritism.

Patient Use of Email, Facebook, and Physician Websites to Communicate with Physicians: A National Online Survey of Retail Pharmacy Users.

Background: Patient-physician communication often occurs outside the clinic setting; many institutions discourage electronic communication outside of established electronic health record systems. Little empirical data are available on patient interest in electronic communication and Web-based health tools that are technically feasible but not widely available.

Research Objective: To explore patient behavior and interest in using the Internet to contact physicians.

What are health-related users tweeting? A qualitative content analysis of health-related users and their messages on twitter.

Background: Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals' behavior on Twitter.

Objective: Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health.

Untangling the relationship between medication adherence and post-myocardial infarction outcomes: medication adherence and clinical outcomes.

Background: Patients who adhere to medications experience better outcomes than their nonadherent counterparts. However, these observations may be confounded by patient behaviors. The level of adherence necessary for patients to derive benefit and whether adherence to all agents is important for diseases that require multiple drugs remain unclear.