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Perspectives of family physicians on computer-assisted health-risk assessments

Perspectives of family physicians on computer-assisted health-risk assessments

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Title: Perspectives of family physicians on computer-assisted health-risk assessments
Author: Ahmad, F
Skinner, HA
Stewart, DE
Levinson, W
Abstract: Background: The firsthand experience of physicians using computer-assisted health-risk assessment is salient for designing practical eHealth solutions. Objective: The aim of this study was to enhance understanding about computer-assisted health-risk assessments from physicians’ perspectives after completion of a trial at a Canadian, urban, multi-doctor, hospital-affiliated family practice clinic. Methods: A qualitative approach of face-to-face, in-depth, semi-structured interviews was used. All interviews were audio recorded and field notes taken. Analytic induction and constant comparative techniques were used for coding and analyses. Interpretation was facilitated by peer audit and insights gained from the social exchange theoretical perspective. Results: Ten physicians (seven female and three male) participated in the interviews. Three overarching themes emerged in relation to computer-assisted health-risk assessments: (1) perceived benefits, (2) perceived concerns or challenges, and (3) feasibility. Physicians unanimously acknowledged the potential of computer-assisted health-risk assessments to open dialogue on psychosocial health risks. They also appreciated the general facilitative roles of the tool, such as improving time-efficiency by asking questions on health risks prior to the consultation and triggering patients’ self-reflections on the risks. However, in the context of ongoing physician-patient relationships, physicians expressed concerns about the impact of the computer-assisted health-risk assessment tool on visit time, patient readiness to talk about psychosocial issues when the purpose of the visit was different, and the suitability of such risk assessment for all visits to detect new risk information. In terms of feasibility, physicians displayed general acceptance of the risk assessment tool but considered it most feasible for periodic health exams and follow-up visits based on their perceived concerns or challenges and the resources needed to implement such programs. These included clinic level (staff training, space, confidentiality) and organizational level (time, commitment and finances) support. Conclusions: Participants perceived computer-assisted health-risk assessment as a useful tool in family practice, particularly for identifying psychosocial issues. Physicians displayed a general acceptance of the computer tool and indicated its greater feasibility for periodic health exams and follow-up visits than all visits. Future physician training on psychosocial issues should address physicians’ concerns by emphasizing the varying forms of “clinical success” for the management of chronic psychosocial issues. Future research is needed to examine the best ways to implement this program in diverse clinical settings and patient populations.
Sponsor: The study was funded by (1) the Canadian Institutes of Health Research (grants IGF 63976 and FOW 68219) through the Institute of Gender and Health/Ontario Women’s Health Council (now called ECHO: Improving Women’s Health in Ontario), and the Strategic Training on Health Care, Place & Technology Program and (2) the Social Sciences and Humanities Research Council of Canada (GRG Program). We thank Sheilah Hogg-Johnson and Richard H Glazier for their conceptual contributions. We greatly appreciate the contributions of our site collaborators, Maureen Kelly, Brenda McDowell, and Bill Wetzel. Support from the Centre for Research on Inner City Health, The Keenan Research Centre, in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, is also much appreciated.
Subject: Computer
Health
Risk assessment
Screening
Psychosocial
Primary care
Type: Article
Rights: "This work is licensed under the Creative Commons Attribution License CC-BY 2.0." Attribution 2.5 Canada
https://doi.org/10.2196/jmir.1260
http://creativecommons.org/licenses/by/2.5/ca/
URI: http://hdl.handle.net/10315/31631
Published: Journal of Medical Internet Research
Citation: Ahmad F, Skinner HA, Stewart DE & Levinson W. Perspectives of family physicians on computer-assisted health-risk assessments. Journal of Medical Internet Research 2010; 12(2):e12.
Date: 2010-05-07

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"This work is licensed under the Creative Commons Attribution License CC-BY 2.0." Except where otherwise noted, this item's license is described as "This work is licensed under the Creative Commons Attribution License CC-BY 2.0."