A qualitative analysis of opportunities to strengthen pharmacy technician career pathways across practice settings.

Purpose: To identify pharmacy technician career pathways across pharmacy practice settings and opportunities to strengthen and expand these pathways.

Methods: Interviews were conducted with 17 participants from national pharmacy organizations, community pharmacies, health systems, and academia from March to May 2023. Interview questions were designed to elicit participants' perceptions of factors influencing entry into, recruitment and retention of, and advancement of the pharmacy technician workforce.

Routes to Rural Readiness: Enhancing Clinical Training Experiences for Physician Assistants.

Purpose: The purpose of this study was to describe practices and experiences of rurally oriented physician assistant (PA) training programs in providing rural clinical training to PA students.

Methods: A survey of PA program directors (PDs) included questions about program characteristics, student and clinical preceptor (CP) recruitment in rural areas, and barriers to, and facilitators of, rural clinical training. Programs that considered rural training "very important" to their goals were identified.

A Match Made in Rural: Interpreting Match Rates and Exploring Best Practices.

Background And Objectives: Although rural family medicine residency programs are effective in placing trainees into rural practice, many struggle to recruit students. Lacking other public measures, students may use residency match rates as a proxy for program quality and value. This study documents match rate trends and explores the relationship between match rates and program characteristics, including quality measures and recruitment strategies.

A Risk Prediction Model to Identify Newborns at Risk for Missing Early Childhood Vaccinations.

Background: Approximately 30% of US children aged 24 months have not received all recommended vaccines. This study aimed to develop a prediction model to identify newborns at high risk for missing early childhood vaccines.

Methods: A retrospective cohort included 9080 infants born weighing ≥2000 g at an academic medical center between 2008 and 2013.

Hepatitis B Vaccination of Low Birth Weight Infants in Washington State.

Objective: The U.S. Advisory Committee on Immunization Practices (ACIP) recommends that infants born weighing less than 2,000 g receive the hepatitis B (HepB) vaccine at hospital discharge or 30 days of age.

Terminology for melanocytic skin lesions and the MPATH-Dx classification schema: A survey of dermatopathologists.

Background: Diagnostic terms used in histopathology reports of cutaneous melanocytic lesions are not standardized. We describe dermatopathologists' views regarding diverse diagnostic terminology and the utility of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) for categorizing melanocytic lesions.

Methods: July 2018-2019 survey of board-certified and/or fellowship-trained dermatopathologists with experience interpreting melanocytic lesions.

Hepatitis B Birth Dose: First Shot at Timely Early Childhood Vaccination.

Introduction: Current U.S. recommendations state that newborns weighing ≥2,000 grams should receive a birth dose of hepatitis B vaccine, yet approximately one quarter do not receive this first dose as scheduled.

Sociodemographic, clinical and birth hospitalization characteristics and infant Hepatitis B vaccination in Washington State.

Objective: Hepatitis B (HepB) vaccine is recommended at birth; however, national coverage estimates fall far below target levels. Studies describing the factors associated with infant HepB vaccination are lacking. This study aimed to identify the sociodemographic, clinical and birth hospitalization factors associated with timely receipt of the first HepB vaccine dose.

Communicating with Vulnerable Patient Populations: A Randomized Intervention to Teach Inpatients to Use the Electronic Patient Portal.

Background: Patient portals are expanding as a means to engage patients and have evidence for benefit in the outpatient setting. However, few studies have evaluated their use in the inpatient setting, or with vulnerable patient populations.

Objective: This article assesses an intervention to teach hospitalized vulnerable patients to access their discharge summaries using electronic patient portals.

Will use of patient portals help to educate and communicate with patients with diabetes?

Objective: Chronic disease management can require daily attention, and increased levels of patient activation and engagement. We examined whether patients with diabetes perceive a greater benefit to having electronic access to their doctors' clinic notes compared to patients without diabetes. We hypothesized that easy electronic access to these notes may help patients with self-care by improving education and communication.

Patients' perceptions of their doctors' notes and after-visit summaries: A mixed methods study of patients at safety-net clinics.

Background: Patients are increasingly offered electronic access to their doctors' notes, and many consistently receive paper After-Visit Summaries. Specific feedback from patients about notes and summaries are lacking, particularly within safety-net settings.

Design: A mixed methods study SETTING AND PARTICIPANTS: Patients with poorly controlled diabetes attending two urban safety-net primary care clinics in Washington State.

The diagnostic challenge of low-grade ductal carcinoma in situ.

Background: Diagnostic agreement among pathologists is 84% for ductal carcinoma in situ (DCIS). Studies of interpretive variation according to grade are limited.

Methods: A national sample of 115 pathologists interpreted 240 breast pathology test set cases in the Breast Pathology Study and their interpretations were compared to expert consensus interpretations.

Ophthalmology patients' interest in online access to clinic notes at three US clinics.

Purpose: This study aimed to understand patients' perceptions about potential benefits and harms of accessing their own ophthalmology clinic notes via an electronic patient portal as part of the OpenNotes initiative.

Methods: The authors conducted a cross-sectional, in-person survey of ophthalmology patients at three US eye clinics. The paper survey was self-administered or administered with assistance from study staff before or after patients' clinical visits.

Patients Typing Their Own Visit Agendas Into an Electronic Medical Record: Pilot in a Safety-Net Clinic.

Collaborative visit agenda setting between patient and doctor is recommended. We assessed the feasibility, acceptability, and utility of patients attending a large primary care safety-net clinic typing their agendas into the electronic visit note before seeing their clinicians. One hundred and one patients and their 28 clinicians completed post-visit surveys.

Patient portals and personal health information online: perception, access, and use by US adults.

Background: Access to online patient portals is key to improving care, but we have limited understanding of patient perceptions of online portals and the characteristics of people who use them.

Methods: Using a national survey of 3677 respondents, we describe perceptions and utilization of online personal health information (PHI) portals.

Results: Most respondents (92%) considered online PHI access important, yet only 34% were offered access to online PHI by a health care provider, and just 28% accessed online PHI in the past year.

Identifying and processing the gap between perceived and actual agreement in breast pathology interpretation.

We examined how pathologists' process their perceptions of how their interpretations on diagnoses for breast pathology cases agree with a reference standard. To accomplish this, we created an individualized self-directed continuing medical education program that showed pathologists interpreting breast specimens how their interpretations on a test set compared with a reference diagnosis developed by a consensus panel of experienced breast pathologists. After interpreting a test set of 60 cases, 92 participating pathologists were asked to estimate how their interpretations compared with the standard for benign without atypia, atypia, ductal carcinoma in situ and invasive cancer.

Medical malpractice concerns and defensive medicine: a nationwide survey of breast pathologists.

Objectives: "Assurance behaviors" in medical practice involve providing additional services of marginal or no medical value to avoid adverse outcomes, deter patients from filing malpractice claims, or ensure that legal standards of care were met. The extent to which concerns about medical malpractice influence assurance behaviors of pathologists interpreting breast specimens is unknown.

Methods: Breast pathologists (n = 252) enrolled in a nationwide study completed an online survey of attitudes regarding malpractice and perceived alterations in interpretive behavior due to concerns of malpractice.

Characteristics of Patients Who Report Confusion After Reading Their Primary Care Clinic Notes Online.

Patient access to online electronic medical records (EMRs) is increasing and may offer benefits to patients. However, the inherent complexity of medicine may cause confusion. We elucidate characteristics and health behaviors of patients who report confusion after reading their doctors' notes online.

Demographic and practice characteristics of pathologists who enjoy breast tissue interpretation.

Physician attributes, job satisfaction and confidence in clinical skills are associated with enhanced performance and better patient outcomes. We surveyed 252 pathologists to evaluate associations between enjoyment of breast pathology, demographic/clinical characteristics and diagnostic performance. Diagnostic performance was determined by comparing pathologist assessments of a set of 60 cases with consensus assessments of the same cases made by a panel of experienced pathologists.

Patients who share transparent visit notes with others: characteristics, risks, and benefits.

Background: Inviting patients to read their primary care visit notes may improve communication and help them engage more actively in their health care. Little is known about how patients will use the opportunity to share their visit notes with family members or caregivers, or what the benefits might be.

Objective: Our goal was to evaluate the characteristics of patients who reported sharing their visit notes during the course of the study, including their views on associated benefits and risks.

Patient Access to Online Visit Notes: Perceptions of Doctors and Patients at an Urban HIV/AIDS Clinic.

Patients living with HIV/AIDS face large societal and medical challenges. Inviting patients to read their doctors' visit notes via secure electronic portals may empower patients and improve health. We investigated whether utilization and perceptions about access to doctors' notes differed among doctors and patients in an HIV/AIDS clinic versus primary care setting.

Digitized whole slides for breast pathology interpretation: current practices and perceptions.

Digital whole slide imaging (WSI) is an emerging technology for pathology interpretation; however, little is known about pathologists' practice patterns or perceptions regarding WSI. A national sample (N = 252) of pathologists from New Hampshire, Vermont, Washington, Oregon, Arizona, Alaska, Maine, and Minnesota were surveyed in this cross-sectional study (2011-2013). The survey included questions on pathologists' experience, WSI practice patterns, and perceptions using a six-point Likert scale.

Development of a diagnostic test set to assess agreement in breast pathology: practical application of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS).

Background: Diagnostic test sets are a valuable research tool that contributes importantly to the validity and reliability of studies that assess agreement in breast pathology. In order to fully understand the strengths and weaknesses of any agreement and reliability study, however, the methods should be fully reported. In this paper we provide a step-by-step description of the methods used to create four complex test sets for a study of diagnostic agreement among pathologists interpreting breast biopsy specimens.

The urban underserved: attitudes towards gaining full access to electronic medical records.

Background: As the use of electronic medical records (EMRs) spreads, health-care organizations are increasingly offering patients online access to their medical records. Studies evaluating patient attitudes towards viewing elements of their records through secure, electronic patient portals have generally not included medically underserved patients or those with HIV/AIDS. The goal of this study was to gain insight into such patients' attitudes towards online access to their medical records, including their doctors' visit notes.