Journal of Maine Medical Center最新文献_第4页

Patient and Provider Experience with Artificial Intelligence Screening Technology for Diabetic Retinopathy in a Rural Primary Care Setting. 农村初级保健环境中糖尿病视网膜病变人工智能筛查技术的患者和提供者体验

Journal of Maine Medical Center Pub Date : 2023-01-01 Epub Date: 2023-04-20 DOI: 10.46804/2641-2225.1144

Brian Nolan, Emma R Daybranch, Kerri Barton, Neil Korsen

{"title":"Patient and Provider Experience with Artificial Intelligence Screening Technology for Diabetic Retinopathy in a Rural Primary Care Setting.","authors":"Brian Nolan, Emma R Daybranch, Kerri Barton, Neil Korsen","doi":"10.46804/2641-2225.1144","DOIUrl":"10.46804/2641-2225.1144","url":null,"abstract":"Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified initial challenges in incorporating the tool into the primary care visit (31%). Patients expressed a favorable view of the service, sharing an openness to being screened more regularly (75%) and a desire to have screenings performed at Western Maine Primary Care going forward (81%).Discussion: Patients were generally favorable about their experience with the new DR screening technology. Providers indicated challenges due to the limited availability of trained medical assistant photographers during the initial implementation of DR screening, as well as timing issues in coordinating screening with regular office appointments.Conclusions: This study supports further investigation of this technology in primary care, particularly in areas with challenges to care access. The potential benefits of this innovative tool in caring for people with diabetes includes improving access to retinopathy screenings and supporting wider detection of vision-threatening retinopathy.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45672537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing an Interprofessional Community Psychiatry Rotation Using an Assertive Community Treatment Team Model: A Preliminary Evaluation. 采用自信的社区治疗团队模式发展跨专业社区精神病学轮转:初步评估

Journal of Maine Medical Center Pub Date : 2023-01-01 Epub Date: 2023-07-12 DOI: 10.46804/2641-2225.1143

Ruth Frydman

{"title":"Developing an Interprofessional Community Psychiatry Rotation Using an Assertive Community Treatment Team Model: A Preliminary Evaluation.","authors":"Ruth Frydman","doi":"10.46804/2641-2225.1143","DOIUrl":"10.46804/2641-2225.1143","url":null,"abstract":"Introduction: There is a shortage of psychiatric providers trained to work in community settings with people with serious mental illness (SMI) and associated comorbidities. We designed an innovative psychiatry rotation and curriculum for psychiatry residents and other learners.Methods: The rotation incorporates working with our Assertive Community Treatment team and includes home visits, assertive outreach, and visits in other community settings. It was designed to improve learners' confidence in their understanding and skill set for working with and treating people with SMI in the community on an interprofessional (IP) team. This pilot quality improvement project evaluated psychiatry resident responses to the rotation using a standard evaluation form (residents) and post-rotation debriefing (all learners and IP staff).Results: Preliminary responses to the evaluation form indicated that the rotation improved residents' confidence in their knowledge of underlying approaches, social determinants of mental health, and community resources. The rotation also improved their skills in working collaboratively with people with SMI, IP teams, and people with serious substance use disorders. Debriefing sessions revealed that the rotation was rated highly by learners and IP staff.Discussion: Preliminary results suggest that the rotation (1) was well received by learners and IP staff and (2) increased residents' confidence in their understanding and skill set for working in community psychiatry on an IP team.Conclusions: Using an IP team model, this rotation provides an opportunity for improving learners' confidence in their expertise, skills, and understanding of how to work with patients with SMI and comorbidities who are marginalized and difficult to engage.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46872598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy of the drug dependency checkbox on the Maine birth certificate for Medicaid-covered births, 2016-2020 2016-2020年缅因州医疗补助出生出生证明上药物依赖复选框的准确性

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1139

J. Dudley, C. McGuire, A. Kumarage, C. Anumaka, K. Ahrens

{"title":"Accuracy of the drug dependency checkbox on the Maine birth certificate for Medicaid-covered births, 2016-2020","authors":"J. Dudley, C. McGuire, A. Kumarage, C. Anumaka, K. Ahrens","doi":"10.46804/2641-2225.1139","DOIUrl":"https://doi.org/10.46804/2641-2225.1139","url":null,"abstract":"Introduction: The accuracy of the drug dependency checkbox on the Maine birth certificate is unknown. Our objective was to compare the drug dependency checkbox with information on substance use disorders as documented in Medicaid claims data. Methods: Using rule-based deterministic matching, we linked Medicaid enrollment information to 2016-2020 Maine birth record data (N=58,584). Among the linked records (n=27,448), we identified maternal substance use disorder (SUD) diagnoses during the 280 days before through 7 days after delivery using ICD-CM-10 diagnosis codes. We used the following hierarchy to create mutually exclusive SUD categories: opioid use disorder (OUD), cannabis use disorder without cocaine use disorder, and other SUD disorders (alcohol, cocaine, nicotine, or other substance use diagnosis). Results: Among women enrolled in Medicaid at the time of delivery, 12% had drug dependency indicated on their birth record and 33% had at least one SUD diagnosis recorded in their Medicaid claims during pregnancy. Among the birth records with the drug dependency checkbox checked, 56% had an OUD, 25% cannabis use disorder without cocaine use disorder, 8% other SUD, and 10% had no SUD. Among those with the drug dependency checkbox unchecked, the corresponding percentages were 4%, 9%, 13%, and 75%. Discussion: Although diagnoses of OUD and cannabis use disorder were more common among birth records with the drug dependency checkbox checked, reporting of drug dependency on the birth record does not appear to accurately indicate SUD during pregnancy. Conclusions: Our findings suggest the drug dependency checkbox on the Maine birth certificate may be of limited value in identifying SUD during pregnancy.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42240011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Who and How: Telemedicine Eligibility and Participant Guidelines in the Ambulatory Setting 谁和如何：门诊环境中的远程医疗资格和参与者指南

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1123

Tracy Jalbuena, Rebecca Hemphill, Megan F. Selvitelli, Jasmine Bishop, Adam Ouellette, R. Alfiero

{"title":"Who and How: Telemedicine Eligibility and Participant Guidelines in the Ambulatory Setting","authors":"Tracy Jalbuena, Rebecca Hemphill, Megan F. Selvitelli, Jasmine Bishop, Adam Ouellette, R. Alfiero","doi":"10.46804/2641-2225.1123","DOIUrl":"https://doi.org/10.46804/2641-2225.1123","url":null,"abstract":"Introduction: Telehealth use has dramatically increased due to the COVID-19 pandemic. Yet there are significant gaps in evidence regarding the clinical appropriateness of synchronous visits for ambulatory telemedicine that are under the umbrella of telehealth and defined as video appointments between patients and providers. As a result, there are few sensible guidelines for day-to-day practice, resulting in a lack of standardization and risk of suboptimal care. Methods: We developed patient inclusion/exclusion guidelines for use in ambulatory telemedicine. Complementary tools included guides on patient preparation, telemedicine physical exam, and provider etiquette. We analyzed telemedicine use by practice type and surveyed a subset of MaineHealth ambulatory practices regarding the applicability of the guidelines. Results: Volume and specialty distribution data show that although telemedicine volume increased significantly, use varied by specialty. Behavioral health providers used telemedicine the most, followed by primary care, medical specialties, and, finally, surgical specialties. Stratification intensified as restrictions on in-person care declined. Discussion: We observed the expected pattern of use by specialty type, given our inclusion/exclusion criteria. Although these criteria may be conceptually straightforward, implementation is not. We operationalized these concepts to ensure individual practices can adapt and implement these insights in a reproducible and predictable way, leading to increased standardization across the health system. Conclusions: Clinical teams need help determining how to best use telemedicine tools. Here, we provide practice-level guidelines focused on practical implementation. We hope this communication advances the effort to develop standards of care for telemedicine indications.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45994218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Projected Utility of the Ready Set Return Application 现成退货应用程序的预计效用

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1129

Erin H. Hartigan, Cassidy Sirois, Jonathan Lindau, Taylor Lockwood, V. Nesom, Nan M. Solomons

{"title":"Projected Utility of the Ready Set Return Application","authors":"Erin H. Hartigan, Cassidy Sirois, Jonathan Lindau, Taylor Lockwood, V. Nesom, Nan M. Solomons","doi":"10.46804/2641-2225.1129","DOIUrl":"https://doi.org/10.46804/2641-2225.1129","url":null,"abstract":"Introduction: An application (app) that summarizes best practices may promote standardized care among clinicians treating patients during anterior cruciate ligament (ACL) rehabilitation. The purpose of this study was to test the prototype of the Ready Set Return (RSR) app to determine receptiveness for use in clinical practice. Methods: Two mock patient cases were used to familiarize 19 physical therapists and athletic trainers with the RSR app. Then these participants provided feedback about the user experience, features, and content using Likert ratings and free-text fields through an online survey. Results: Most participants (89%-95%) would recommend the RSR app to others and noted that the app would allow them to stay up to date with current practice. Thematic analysis of free-text responses indicated that the app was easy to navigate and that evidence-based progressions and clinical milestones were useful in clinical practice. Users suggested enhancements that included adding patient access and specific treatment options. Discussion: Generalizable findings suggest that clinicians appreciated the details and images of specific tests and measures; automatic test scoring; and standardized benchmarks to progress care. Specific findings suggest the RSR app’s summary of evidence-informed practice may help standardize care, specifically for patients undergoing rehabilitation after ACL reconstruction. Conclusion: This subset of clinicians reacted positively to the prototype and felt that the RSR app would benefit their practice and patients. This feedback will guide the next iteration, advancing from a low-fidelity to high-fidelity prototype.","PeriodicalId":93781,"journal":{"name":"Journal of Maine Medical Center","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49439395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Being There: Engaging in Conversations About a Child’s Future When They Are Facing Serious Illness 在那里：当孩子面临严重疾病时，参与关于他们未来的对话

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1131

Christine C Bennett

引用次数: 0

Trends in Cannabis-Related and Opioid-Related Hospitalization Rates in Maine, 2010-2020 2010-2020年缅因州大麻相关和阿片类药物相关住院率趋势

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1119

S. McMahon, Katherine Ahrens

引用次数: 0

Increasing Naloxone Co-Prescribing Among At-Risk Individuals: Evaluation of a Quality Improvement Project in a Large Health System 在高危人群中增加纳洛酮联合用药：大型卫生系统质量改进项目的评估

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1109

Sarah Hemphill, Kristen Silvia, Marc D. Kimball

引用次数: 0

A Qualitative Analysis of Postgraduate Training Programs for Family Nurse Practitioners 家庭护理研究生培养项目的定性分析

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1125

John R Massey

引用次数: 0

Association Between Primary Care Provider Status and Preventive Health Care Among People Who Inject Drugs 注射药物人群初级保健提供者状况与预防性医疗保健的关系

Journal of Maine Medical Center Pub Date : 2022-07-15 DOI: 10.46804/2641-2225.1133

E. K. Nenninger, Katherine Sharp, B. Bustamente, K. Murray, K. Thakarar

引用次数: 0