Technology-Enabled and Artificial Intelligence Support for Pre-Visit Planning in Ambulatory Care: Findings From an Environmental Scan

被引:11
作者
Holdsworth, Laura M. [1 ]
Park, Chance [2 ]
Asch, Steven M. [1 ,3 ]
Lin, Steven [1 ]
机构
[1] Stanford Sch Med, Div Primary Care & Populat Hlth, Stanford, CA 94305 USA
[2] Univ British Columbia, Vancouver, BC, Canada
[3] Vet Affairs, Ctr Innovat Implementat, Menlo Pk, CA USA
关键词
ambulatory care; artificial intelligence; qualitative methods; PATIENT; IMPLEMENTATION; DESIGN; IMPACT;
D O I
10.1370/afm.2716
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
PURPOSE Pre-visit planning (PVP) is believed to improve effectiveness, efficiency, and experience of care, yet numerous implementation barriers exist. There are opportunities for technology-enabled and artificial intelligence (AI) support to augment existing human-driven PVP processes-from appointment reminders and pre-visit questionnaires to pre-visit order sets and care gap closures. This study aimed to explore the current state of PVP, barriers to implementation, evidence of impact, and potential use of non-AI and AI tools to support PVP. METHODS We used an environmental scan approach involving: (1) literature review; (2) key informant interviews with PVP experts in ambulatory care; and (3) a search of the public domain for technology-enabled and AI solutions that support PVP. We then synthesized the findings using a qualitative matrix analysis. RESULTS We found 26 unique PVP implementations in the literature and conducted 16 key informant interviews. Demonstration of impact is typically limited to process outcomes, with improved patient outcomes remaining elusive. Our key informants reported that many PVP barriers are human effort-related and see potential for non-AI and AI technologies to support certain aspects of PVP. We identified 8 examples of commercially available technology-enabled tools that support PVP, some with AI capabilities; however, few of these have been independently evaluated. CONCLUSIONS As health systems transition toward value-based payment models in a world where the coronavirus disease 2019 pandemic has shifted patient care into the virtual space, PVP activities-driven by humans and supported by technology- may become more important and powerful and should be rigorously evaluated.
引用
收藏
页码:419 / 426
页数:8
相关论文
共 45 条
[1]   A Previsit Screening Checklist Improves Teamwork and Access to Preventive Services in a Medical Home Serving Low-Income Adolescent and Young Adult Patients [J].
Allende-Richter, Sophie H. ;
Johnson, Sydney T. ;
Maloyan, Mariam ;
Glidden, Patricia ;
Rice, Kerrilynn ;
Epee-Bounya, Alexandra .
CLINICAL PEDIATRICS, 2018, 57 (07) :835-843
[2]  
[Anonymous], 2015, 10 STEP PREV PLANN T
[3]   The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system [J].
Baker, David W. ;
Persell, Stephen D. ;
Kho, Abel N. ;
Thompson, Jason A. ;
Kaiser, Darren .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2011, 18 (06) :805-811
[4]   The Use of Internet-Based Technology to Tailor Well-Child Care Encounters [J].
Bergman, David Aaron ;
Beck, Arne ;
Rahm, Alanna Kulchak .
PEDIATRICS, 2009, 124 (01) :E37-E43
[5]   Validation of a Novel Electronic Health Record Patient Portal Advance Care Planning Delivery System [J].
Bose-Brill, Seuli ;
Feeney, Michelle ;
Prater, Laura ;
Miles, Laura ;
Corbett, Angela ;
Koesters, Stephen .
JOURNAL OF MEDICAL INTERNET RESEARCH, 2018, 20 (06)
[6]   The use of the environmental scan in health services delivery research: a scoping review protocol [J].
Charlton, Patricia ;
Doucet, Shelley ;
Azar, Rima ;
Nagel, Daniel A. ;
Boulos, Leah ;
Luke, Alison ;
Mears, Kim ;
Kelly, Katherine J. ;
Montelpare, William J. .
BMJ OPEN, 2019, 9 (09)
[7]   Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity [J].
Contratto, Erin ;
Romp, Katherine ;
Estrada, Carlos A. ;
Agne, April ;
Willett, Lisa L. .
SOUTHERN MEDICAL JOURNAL, 2017, 110 (05) :363-368
[8]   Improving the Safety of Teratogen Prescribing Practices in a Pediatric Rheumatology Clinic [J].
Cooper, Ashley M. ;
Horwitz, Mara ;
Becker, Mara L. .
PEDIATRICS, 2019, 143 (04)
[9]   Impact of Pharmacist Previsit Input to Providers on Chronic Opioid Prescribing Safety [J].
Cox, Nicholas ;
Tak, Casey R. ;
Cochella, Susan E. ;
Leishman, Eric ;
Gunning, Karen .
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE, 2018, 31 (01) :105-112
[10]   ImproveCareNow: The Development of a Pediatric Inflammatory Bowel Disease Improvement Network [J].
Crandall, Wallace ;
Kappelman, Michael D. ;
Colletti, Richard B. ;
Leibowitz, Ian ;
Grunow, John E. ;
Ali, Sabina ;
Baron, Howard I. ;
Berman, James H. ;
Boyle, Brendan ;
Cohen, Stanley ;
del Rosario, Fernando ;
Denson, Lee A. ;
Duffy, Lynn ;
Integlia, Mark J. ;
Kim, Sandra C. ;
Milov, David ;
Patel, Ashish S. ;
Schoen, Bess T. ;
Walkiewicz, Dorota ;
Margolis, Peter .
INFLAMMATORY BOWEL DISEASES, 2011, 17 (01) :450-457