Effect of the COVID-19 Lockdown on Patients Valuation of Usability of Telemedicine.

The aim of this paper was to report patient valuation of usability with our telemedicine system and to explore the effect of pandemic in its behavior. We conducted a cross-sectional study based on the prospective recollection of the results of the Spanish abbreviated version of the Telehealth Usability Questionnaire (TUQ), from October 2019 to July 2020. We observed an inflection point of growth of answers during the pandemic era and a trend of decrease in usability valuations coinciding with the massive and forced implementation of the system after lockdown. This effect was transitory, evidencing an improvement over time. These results might be explained with a sociotechnical approach that includes considering the learning curve and suggest the importance of a telemedicine usability tool to guide decision-making. In conclusion, tools to assess telemedicine services may identify facilitators and barriers to its use in a highly changing social and technological context.

Exploring the Digital Divide as a Barrier to Use of a Personal Health Record in the Elderly.

The digital divide can hinder the ability of elderly patients to fully benefit from PHRs. They are "digital immigrants", not having the life-long exposure to technology as younger generations, as well as physical and cognitive disabilities. The aim of this study was to explore the digital divide as a barrier for the use of a PHR in older adults (> 69 years of age) and describe the use of a PHR in an elderly population in Argentina. We conducted a cross sectional study which included older adults who attended the Coronavirus vaccination campaign in 2021. Data were collected through a survey encompassing digital divide factors and use of the PHR. A total of 128 participants agreed to complete the survey, 60.15% reported using the PHR. We found a statistically significant correlation of education level, having a personal computer and internet access with PHR use. Concerning PHR users, 45.45% reported needing assistance to use it. Although the elderly population represents a large portion of patients, there is not enough research done on their use experience using eHealth solutions. There is pending work in the eHealth field to integrate these elders into current PHRs and help them enjoy their benefits.

Information Needs at the O.R. Waiting Room.

The objective of this study was to investigate the difficulties and information needs that both patients and their companions have in the context of a scheduled surgery. Observations in the operating room waiting zone and semi-structured interviews were conducted to patients with scheduled surgeries, their companions, administrative staff members and surgeons. We developed a journey map to explain the patient's experience through the perioperative process. The emerging categories were Fragmented communication, Understanding the surgical process and Waiting times. Knowing the information needs of patients and companions was important to identify problems and opportunities for improvement in our institution's Personal Health Records.

A Path Towards Inclusion: Transdisciplinary Experience for the Inclusion of Self-Perceived Gender in an Information System.

In Argentina, since 2012 the Gender Identity Law guarantees that people who identify as transgender must be called by their chosen name, among other things. Transgender patients are usually not represented in information systems, whether electronic or not. This can place them in situations of vulnerability and discrimination. With that in mind, an interdisciplinary team was formed to take address the problems of this population regarding to the information systems of Hospital Italiano de Buenos Aires. The aim of this study is to spread the experience of the transdisciplinary team on the Electronic Health Record's modification and other associated applications to achieve include the self-perceived gender identity and the chosen name of those people who modified their gender.

User-Centered Design of a Pediatric Vaccination Module for Patients.

Immunization information systems and registries are essential for vaccine programs to succeed. Personal Health Record should improve decision making of healthcare providers and consumer outcomes. This article aims to describe the software development of an immunization module using a user-centered design, starting from the analysis of potential users' needs. The design was made through cycles of iterations, adjustments were made validating real scenarios and taking into account the user needs. The main features identified through interviews were: vaccination schedule, further information on vaccines' usefulness, notification, downloadable patient vaccination status and other vaccines outside the official calendar. The final scope is to create a simple, efficient and safe platform for patient immunization management.

Physicians' Perceptions About PHR for Inpatients. Qualitative Study.

The aim of this article was to know physician perceptions about a PHR for inpatients and to examine ways to take advantage of possible functionalities that could help physicians in their daily workflow. This qualitative research, was conducted through: two focus groups and nine personal interviews performed with internal medicine physicians. Collection and analysis of obtained data was carried out by two professionals. It was made by the codification and categorization of data based on a process of constant comparison. The authors agreed upon three main dimensional themes: information, physician-patient/relatives communication, impact of PHR in physician workload. Physicians suggested functionalities and expressed concerns related to the management of sensitive information. As a conclusion we understand that it is crucial to involve physicians along PHR's development. This will help to overcome barriers and will improve adoption chances. Physicians will be directly affected by the implementation of a PHR for inpatients.

User-Centered Design Improves the Usability of Drug-Drug Interaction Alerts: A Validation Study in the Real Scenario.

Decision support systems can alert physicians to the existence of drug interactions. The Hospital Italiano de Buenos Aires, Argentina, has an in-house electronic health record with computerized physician order entry and clinical decision support. It includes a drug-drug interaction alert system, initially developed under traditional engineering techniques. As we detected a high alert override rate, we rebuilt the knowledge database and redesigned the alert interface with User-Centered Design techniques. A laboratory crossover study using clinical vignettes showed that new alerts were more usable than traditional ones.This paper aimed to validate these results through a controlled and randomized experimental study with two branches (old vs. new design) in a real setting. We analyzed, quantitatively, every fired alert between April 2015 and September 2016. Finally, we performed user surveys and qualitative interviews to inquire about their satisfaction and perceptions.In real scenarios, user-centered design alerts were more usable, being more effective and satisfactory, but less efficient than traditional alerts. "Safe omission", as a new concept, emerged from our stratified analyses and interviews.

Importancia de gestionar el cambio: experiencia con el proceso de identificación de pacientes / Importance of managing change: experience with patient identification process / Importância da gestão da mudança: uma experiência com o processo de identificação do paciente

A identificação correta e o cadastro único e inequívoco dos indivíduos que se relacionam à Instituição de Saúde é o primeiro desafio que enfrenta o desenvolvimento de um sistema de informação em saúde (SIS). Não só, em relação ao SIS, mas também às pessoas que levam adiante os processos dentro das organizações. Administrar a mudança é vital para as mesmas alcançarem seu objetivo e para a mudança se estabelecer e perdurar. Realizou-se uma investigação qualitativa para compreender os motivos pelos quais a porcentagem de tirada de foto e baixa dentro do processo de cadastro. Surgiram temas relacionados entre si: problemas técnicos, demoras no atendimento, e questões em relação ao paciente. Considera-se fundamental escutar os protagonistas desta tarefa, fazê-los parte da tomada de decisões, o que permitirá construir empoderamento e alcançar o objetivo de forma efetiva.

La identificación correcta y el registro único e inequívoco de los individuos que se relacionan con la Institución de Salud es el primer desafío que enfrenta el desarrollo de un sistema de información en salud (SIS). No sóloen relación a los SIS sino a las personas que llevan adelante los procesos dentro de las organizaciones. Gestionar elcambio es vital para que las mismas logren su objetivo y que el cambio se establezca y perdure. Se realizó una investigación cualitativa para comprender los motivos por los cuales es bajo el porcentaje de toma de foto dentro del proceso de identificación de personas. Surgieron temas relacionados entre sí: problemas técnicos, demora en la atención, y cuestiones en relación al paciente. Se considera fundamental escuchar a los protagonistas de esta tarea, hacerlos parte de la toma de decisiones, lo que permitirá construir empoderamiento y lograr el objetivo de manera efectiva.