Browsing by Author "Dempsey, Erika"

Now showing 1 - 3 of 3
  • Thumbnail Image
    ItemOpen Access
    “How Are You?” Perspectives of Patients and Healthcare Providers on Using Text-Messaging to Support Care for Patients with Rheumatoid Arthritis
    (2023-09-14) Zafar, Saania Nawab; Barber, Claire Ellen Hawkins; Hazlewood, Glen; Dempsey, Erika; Then, Karen
    Objective: Patients with rheumatoid arthritis may need to access rheumatology care between scheduled visits. WelTel is a virtual care platform that supports two-way text-based messaging between patients and their healthcare team. The objective of the present study was to explore perspectives and experiences of healthcare providers (HCPs) and patients regarding the use of text-messaging via WelTel as an adjunct to routine care. Methods: The 6-month WelTel pilot launched in September 2021 with 70 patients enrolled. Patients received monthly “How are you?” text-message check-ins and could message their healthcare team during clinic hours to request health advice. Thirty-nine patients and 21 HCPs were invited to participate in semi-structured interviews. A thematic analysis of transcripts was conducted using a deductive approach leveraging the Institute of Medicine Quality framework. Results: Thirteen patients (61.5% female, mean age 62, 10 white) completed interviews. Patients’ views suggested that text-messaging with the rheumatology team supported high quality care across multiple quality domains including patient-centeredness, timeliness, efficiency, safety, effectiveness, equity, and appropriateness. Seven HCPs (57% female) completed interviews. HCP perspectives varied dependent on whether they were adopters, partial adopters, or non-adopters of the WelTel platform, with more favorable views reported by adopters. Additional themes reported by HCPs included changes in workload and burnout. Conclusions: This foundational work suggests that patients perceive that adjunct text-messaging based care aids in the provision of high-quality care. Future studies should evaluate the impact on HCP workload and burnout and investigate the effect of texting on patient outcomes.
  • Thumbnail Image
    ItemOpen Access
  • Thumbnail Image
    ItemOpen Access
    The metabolic demands of internal medicine residency
    (2019-05-06) Sy, Sarah; Sall, Karanvir; Dempsey, Erika; Tedder, Gale; Madden, Kenneth M
    Abstract Background North American and European accreditation bodies have legislated progressively more strict work hour restrictions for residents in light of evidence that sleep deprivation leads to increased medical errors and decreased wellbeing. The purpose of the study is to determine the physiologic demands of internal medicine training during residency as well as document average sleep (on- and off-call) and physical activity performed using accelerometers. Methods A total of 40 internal medicine residents working on the clinical teaching unit at a single center were enrolled in the study from November 2011 to March 2016. There were 22 subjects that completed the study and were included in the analysis. SenseWear PRO 2 armband monitors were worn for 5 consecutive days including one call day. The primary outcomes of the study were to quantify and compare the calories per day, steps per day, METs per hour, hours of activity, hours of sleep, and sleep efficiency for on call versus post-call and non-call days. Results The average activity per day, calories per day, steps per day and METs per hour for the call day were 7.6 ± 7.6 h, 2647.0 ± 541.1, 11,261.1 ± 2355.9, and 1.7 ± 0.2 respectively. Each of these parameters had a statistically significant F statistic compared to post-call and non-call days. The subjects had a mean of 1.8 ± 2.0 h of sleep per day with a sleep efficiency of 77.3 ± 23.8% for the call day. The F statistic for sleep per day was significant with a p value < 0.001. Conclusion This study shows that overnight call has a substantial impact on multiple metabolic parameters. These findings have potentially important implications on future resident working hour restrictions.