Dari Alhuwail

Diabetes care in the age of informatics: Kuwait-Scotland health innovation network

In this paper, we describe the initial experience of implementing informatics support for the treatment of chronic conditions in Kuwait, including diabetes. We consider the broad requirements of service improvement and provision of clinical data. We describe work undertaken in the foundation and pilot phases of the Kuwait Scotland Health Innovation Network programme.

Nursing Informatics Research Priorities for the Future: Recommendations from an International Survey.

We present one part of the results of an international survey exploring current and future nursing informatics (NI) research trends. The study was conducted by the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA-NISIG) Student Working Group. Based on findings from this cross-sectional study, we identified future NI research priorities. We used snowball sampling technique to reach respondents from academia and practice. Data were collected between August and September 2015. Altogether, 373 responses from 44 countries were analyzed. The identified top ten NI trends were big data science, standardized terminologies (clinical evaluation/implementation), education and competencies, clinical decision support, mobile health, usability, patient safety, data exchange and interoperability, patient engagement, and clinical quality measures. Acknowledging these research priorities can enhance successful future development of NI to better support clinicians and promote health internationally.

Current Trends in Nursing Informatics: Results of an International Survey.

Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.

Leveraging Health Information Technology for Fall-Risk Management in Home Care A Qualitative Exploration of Clinicians’ Perspectives

Falls have a detrimental impact on home care outcomes. This study investigated home care clinicians’ perspectives on (1) how the currently adopted health information technology (IT) solutions supported fall-risk management activities, (2) various shortcomings of these solutions, and (3) ways to improve upon them. Within a case study design, qualitative data were collected through interviews and focus groups at one suburban home health agency in the United States. The clinicians mainly used the electronic health record but experienced substantial difficulties with documenting and accessing fall-related information. Improvement opportunities include providing better workflow support and usability, implementing medication alerts, facilitating fall-related information exchange, and leveraging the IT capabilities at patients’ homes. Additional IT solutions can improve the awareness, assessment, and intervention dimensions of fall-risk management.

Identifying the key performance improvement domains for home health agencies

Objective: The objective of this study was to support home health agencies (HHAs) in the United States (US) in their individualized quality assessment and performance improvement (QAPI) initiatives by identifying their key performance improvement domains (KPIDs). Methods: Qualitative research was conducted by following the Framework method. Rich contextual data were obtained through focus group meetings participated by domain experts. The analysis results were further refined in an online forum and validated at a final meeting. Results: Four focus groups involving a total of 20 participants resulted in useful discussions during which various perspectives were expressed by the expert participants. A well-defined set of 17 KPIDs emerged under four categories, namely, economical value, sociocultural sensitivity, interpersonal relationships, and clinical capabilities. Conclusions: The feedback we received from the focus groups indicates that performance improvement in HHAs is a lot more complicated than simply assessing whether certain clinical tasks are performed. The KPIDs identified in this study can help HHAs in their focused and individualized QAPI initiatives. Therefore, the results should be immediately relevant, interesting, and useful to the home care industry and policy makers in the US.

Technology Innovations for Better Fall Risk Management in Home Care

Achieving better fall risk management is an integral component of quality home care. The current qualitative study uncovers the challenges and opportunities of home health agencies (HHAs) in achieving better fall risk management. A secondary document analysis was adopted to learn from rich contextual information in fall incident reports recorded in a HHA. Poor engagement of patients and caregivers was a contributing factor in many fall incidents. Patients often fell as a result of not understanding or accepting their physical limitations. For better fall risk management, many incidents highlighted a need for providing complete and thorough care, better coordination of care, higher levels of sociocultural awareness, patient engagement, and caregiver involvement. The results provide evidence regarding the challenges and opportunities for improving fall risk management in home care along with insight about how information technology solutions can support improvement initiatives. [Journal of Gerontological Nursing, 44(7), 15-20.].

Facilitating Focused Process Improvement Efforts in Home Health Agencies to Improve Utilization Outcomes Effectively and Efficiently

The aim of this study was to identify a smaller set of clinical practices most associated with the utilization outcomes of the home health agencies. A secondary data analysis approach was adopted using the publicly accessible Home Health Compare repository as the main data source; the control variables such as rurality, agency size, and median income levels were obtained from other public data repositories. Checking for fall risks and starting care in a timely manner were most associated with hospital readmissions. These two practices and treating patients for pain are most associated with the emergency room visit rates. The results provide additional guidance to home health agencies in their prioritized and focused performance improvement initiatives to improve their utilization outcomes.

Evaluating hospital websites in Kuwait to improve consumer engagement and access to health information: a cross-sectional analytical study

BackgroundCurrent advances in information and communication technology have made accessing and obtaining health-related information easier than ever before. Today, many hospital websites use a patient-centric approach to promote engagement and encourage learning for better health-related decision making. However, little is known about the current state of hospital websites in the State of Kuwait. This study aims to evaluate hospital websites in Kuwait and offer recommendations to improve patient engagement and access to health information.MethodsThis study employs a cross-sectional analytical approach to evaluate hospital websites in Kuwait in 2017. The websites of hospitals that provide in-patient services were identified through a structured search. Only active websites that were available in either English or Arabic were considered. The evaluation of the websites involved a combination of automated and expert- based evaluation methods and was performed across four dimensions: Accessibility, Usability, Presence, and Content.ResultsNine hospitals met the inclusion criteria. Most of the websites fell short in all four dimensions. None of the websites passed the accessibility guidelines. The usability of websites varied between hospitals. Overall, the majority of hospitals in Kuwait have rudimentary online presence and their websites require careful reassessment with respect to design, content, and user experience. The websites focus primarily on promoting services provided by the hospital rather than engaging and communicating with patients or providing evidence-based information.ConclusionsHealthcare organization and website developers should follow best-practices to improve their websites taking into consideration the quality, readability, objectivity, coverage and currency of the information as well as the design of their websites. Hospitals should leverage social media to gain outreach and better engagement with consumers. The websites should be offered in additional languages commonly spoken by people living in Kuwait. Efforts should be made to ensure that health information on hospital websites are evidence-based and checked by healthcare professionals.

How Can Home Care Patients and Their Caregivers Better Manage Fall Risks by Leveraging Information Technology

Objectives: From the perspectives of home care patients and caregivers, this study aimed to (a) identify the challenges for better fall-risk management during home care episodes and (b) explore the opportunities for them to leverage health information technology (IT) solutions to improve fall-risk management during home care episodes. Methods: Twelve in-depth semistructured interviews with the patients and caregivers were conducted within a descriptive single case study design in 1 home health agency (HHA) in the mid-Atlantic region of the United States. Results: Patients and caregivers faced challenges to manage fall risks such as unmanaged expectations, deteriorating cognitive abilities, and poor care coordination between the HHA and physician practices. Opportunities to leverage health IT solutions included patient portals, telehealth, and medication reminder apps on smartphones. Conclusion: Effectively leveraging health IT could further empower patients and caregivers to reduce fall risks by acquiring the necessary information and following clinical advice and recommendations. The HHAs could improve the quality of care by adopting IT solutions that show more promise of improving the experiences of patients and caregivers in fall-risk management.

Supporting the information domains of fall-risk management in home care via health information technology

ABSTRACT In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians’ fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.