Hospitals' internal accountability.

This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting.

A conceptual framework for analyzing how Canadian physicians are using electronic medical records in clinical care.

Our electronic medical record (EMR) case study research pursued a set of questions to provide Canadian physicians with practical information on best practices and lessons learned regarding implementation and use of EMRs in ambulatory clinical care. The study's conceptual framework included an EMR System and Use Assessment Survey, interview guide, transcription codes, observation guide and case study report template. The common message that emerged was that no clinic would return to paper-based charts after experiencing the benefits of EMR.

Telehealth as gatekeeper: policy implications for geography and scope of services.

Why, despite enthusiasm, is telehealth still a relatively minor part of healthcare delivery in many health systems? We examined two less-considered policy issues: (1) the scope of services being offered by telehealth and how this matches existing arrangements for insured services; and (2) how the ability of telehealth services to minimize barriers associated with geography is dealt with in a system organized and financed on geographical boundaries. Fifty-three semistructured interviews with key stakeholders involved in the management of 43 Canadian telehealth programs were conducted. In addition, quantitative activity data were analyzed from 33 telehealth programs.

Findings from evaluations of the benefits of diagnostic imaging systems.

Canada Health Infoway and its partners in the provinces and territories have made significant investments in diagnostic imaging (DI) systems across Canada. Infoway's DI Investment Program is to implement storage for diagnostic digital images so that clinicians can view images regardless of where they are stored. Specifically, Infoway is investing in Picture Archiving and Communications Systems (PACS), which are those systems with the modern digital archiving capabilities used by DI systems.

Do people want to be autonomous patients? Preferred roles in treatment decision-making in several patient populations.

Background: What role do people want to play in treatment decision-making (DM)?

Objective: Examine the role patients indicate they would prefer in making treatment decisions across multiple clinical settings in Ontario, Canada.

Design: Secondary analysis of a series of survey/interview-based studies measuring preferred role, conducted in 12 different populations.

Setting And Participants: Respondents were outpatients, largely but not entirely attending outpatient clinics in large teaching hospitals in urban settings in the Province of Ontario, Canada.

Patient, consumer, client, or customer: what do people want to be called?

Objective: To clarify preferred labels for people receiving health care.

Background: The proper label to describe people receiving care has evoked considerable debate among providers and bio-ethicists, but there is little evidence as to the preferences of the people involved.

Design: We analysed dictionary definitions as to the derivation and connotations of such potential labels as: patient, client, customer, consumer, partner and survivor.

How does trust affect patient preferences for participation in decision-making?

Objective: Does trust in physicians aid or hinder patient autonomy? We examine the relationship between trust in the recipient's doctor, and desire for a participative role in decisions about medical treatment.

Design: We conducted a cross-sectional survey in an urban Canadian teaching hospital.

Setting And Participants: A total of 606 respondents in three clinics (breast cancer, prostate cancer, fracture) completed questionnaires.