Tina Janamian

In a maternity shared-care environment, what do we know about the paper hand-held and electronic health record: a systematic literature review

BackgroundThe paper hand-held record (PHR) has been widely used as a tool to facilitate communication between health care providers and a pregnant woman. Since its inception in the 1950s, it has been described as a successful initiative, evolving to meet the needs of communities and their providers. Increasingly, the electronic health record (EHR) has dominated the healthcare arena and the maternity general practice shared-care arrangement seems to have adopted this initiative. A systematic review was conducted to determine perspectives of the PHR and the EHR with regards to data completeness; experiences of users and integration of care between women and health care providers.MethodA literature search was conducted that included papers from 1985 to 2012. Studies were chosen if they fulfilled the inclusion criteria, reporting on: data completeness; experiences of users and integration of care between women and health care providers. Papers were extracted by one reviewer in consultation with two reviewers with expertise in maternity e-health and independently assessed for quality.ResultsA total of 43 papers were identified for the review, from an initial 6,816 potentially relevant publications. No papers were found that reported on data completeness in a maternity PHR or a maternity EHR, in a shared-care setting. Women described the PHR as important to their antenatal care and had a generally positive perception of using an EHR. Hospital clinicians reported generally positive experiences using a PHR, while both positive and negative impressions were found using an EHR. The few papers describing the use of the PHR and EHR by community clinicians were also divergent and inconclusive with regards to their experiences. In a general practice shared-care model, the PHR is a valuable tool for integration between the woman and the health care provider. While the EHR is an ideal initiative in the maternity setting, facilitating referrals and communication, there are issues of fragmentation and continued paper use.ConclusionsThere was a surprising gap in knowledge surrounding data completeness on maternity PHRs or EHRs. There is also a paucity of available impressions from community clinicians using both forms of the records.

Key elements of high-quality practice organisation in primary health care: a systematic review.

Objectives: To identify elements that are integral to high‐quality practice and determine considerations relating to high‐quality practice organisation in primary care.

A systematic review of the challenges to implementation of the patient-centred medical home: lessons for Australia

Objective: To review the available literature to identify the major challenges and barriers to implementation and adoption of the patient‐centred medical home (PCMH) model, topical in current Australian primary care reforms.

Co-creating value in research: stakeholders' perspectives

In using these approaches, our CRE has partnered and worked closely with a variety of infl uential primary care organisations (Box). Collectively, they represent members delivering more than 100 million patient consultations per year or organisations responsible for setting the quality and safety benchmark for Australian primary care.From 2011, our CRE has had regular “linkage and ex-change”

On the road to value co-creation in health care: the role of consumers in defining the destination, planning the journey and sharing the drive

The role of consumers is now extending beyond being passive health care recipients and even active participants in their own care to involvement in innovation and value co‐creation in health care — from being “users and choosers” to becoming “makers and shapers” of services. For active dialogue to occur in co‐creation, consumers must become equal partners with health care organisations and providers, with the focus on areas of interest to all parties. The use of value co‐creation in health care involves embedding the approach across the whole health care system — from the microsystem level to the mesosystem and the entire macrosystem.

Development and pilot study of the Primary Care Practice Improvement Tool (PC-PIT): an innovative approach.

Objective: To assess the usability and validity of the Primary Care Practice Improvement Tool (PC‐PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co‐created with a range of partners and designed specifically for primary health care.

Creating health care value together: a means to an important end

ustralia’s outgoing Chief Scientist Ian Chubb issued a researcher “call to arms” in November A2015, when he identified Australia as the Organisation for Economic Co-operation and Development (OECD) country in which the research and business communities were least likely to engage with each other: “[given] the rhetorical tailwinds blowing over decades. you would have to conclude that we have a very big anchor (our culture) or no sails (our collective will)”. This Supplement supports the importance of this link and argues that the mismatch in a nation that does well in research but poorly on translation can be overcome— but only with our collective focus, new approaches to engagement, and a willingness to capitalise on a governmental direction now firmly rooted in innovation.

Primary care of women after gestational diabetes mellitus: mapping the evidence-practice gap

Objective: To determine the extent to which preventive activities, including the ordering of an oral glucose tolerance test (OGTT) between 6 and 12 weeks of birth, are integrated into womens primary care postpartum visits after a gestational diabetes mellitus (GDM)‐affected pregnancy.

Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

Objective: To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC‐PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility.

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

Objectives: To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC‐PIT).