picot question for telehealth

Crystal L. Fleischhacker In middle-aged men with suspected myocardial infarction (P), are serial 12-lead ECGs (I) compared with one initial 12-lead ECG (C) more accurate in diagnosing an acute myocardial infarction (O)? 0000045635 00000 n Secondary Research Articles ; However, there are critical precautions that can be taken to minimize the risk to patient safety. Ensuring primary care diagnostic quality in the era of telemedicine. Opportunities to Expand Telehealth Use amid the Coronavirus Pandemic. In addition, providers will need to ensure reasonable accommodations are in place for patients who are deaf, hard-of-hearing, or are blind or have low vision. 1 0 obj <> Appropriate for: broader (scoping) questions. I created the PICOT Research Question Generator to help researchers create valid research questions Finally, you will click on Accredited Professional Statistician. endobj This article uses the Systems Engineering Initiative for Patient Safety (SEIPS) model to assess barriers related to telehealth implementation during the pandemic and the impact on patients, providers, technology, care processes, organizations, and the environment. Issues that can "IQiz5p5ui5rc B:(ExU?s7n=EY&~xE=+nC! 27 0 obj 0000000016 00000 n <>27]/P 23 0 R/Pg 196 0 R/S/Link>> 0000047247 00000 n In 2016, telehealth accounted for $27 million in Medicare spending under the physician fee schedule (PFS). 192 0 obj endobj Your null and alternative hypotheses. American Board of Family Medicine Health Policy Fellow 2020-05-04T07:16:06-07:00 This worksheet will help you build a PICOT question and identify keywords for your searchable question. the University of Tennessee Graduate School of Medicine (UTGSM) as well as an https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Multilayered%20Analysis%20of%20Telehealth%20-%20A%20FAIR%20Health%20White%20Paper.pdf. Use of proper English spelling is a MUST! IMPAQ International Assess and report the reading level of information presented in each website o Present a teaching plan to educate these patients about how to select a reputable and credible health website to manage their health. Important Definitions. Charlottesville, VA 22908 (Directions), Contact UsStaff Directory(434) 924-5444Feedback, 2023 by the Rector and Visitors of the University of VirginiaCopyright & Privacy. A FAIR Health White Paper. Nam risus ante, sum dolor sit amet, consectetur adipiscing elit. Providers should be encouraged to conduct a detailed review of their upcoming patient appointments and determine if any can be appropriately converted to telehealth appointments. 0000003992 00000 n 34 0 obj A Multilayered Analysis of Telehealth: How This Emerging Venue of Care is Affecting the Healthcare Landscape. 0000003787 00000 n 1. 14 0 obj 5 0 obj I have taught the PICOT Identifying barriers to and opportunities for telehealth implementation amidst the COVID-19 pandemic by using a human factors approach: a leap into the future of health care delivery? https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19. Search All AHRQ endobj C- refers to any other alternative to compare the intervention. A Telehealth Blood Pressure Education Program on Hypertension Knowledge, Selfcare, and Behavior . 8. 18 0 obj Although telehealth was originally developed for rural and underserved patients, telehealth has now emerged in a wide array of healthcare specialties in both the rural and urban setting (Orlando et al., 2019). Accessed May 6, 2020. independent and dependent variables, and statistical tests. What study types are most likely to have the information you seek? See below for definitions, PICO templates, and example questions from the primary clinical domains: intervention, diagnosis, etiology, prevention, prognosis/prediction, quality of life/meaning, and therapy. <> This complexity is represented in Figure 1. Background Healthcare in Rural area In general, a limited resource of healthcare in rural areas is well recognized. If implemented appropriately, telehealth can be an incredibly effective approach to ensuring patient and provider safety during this unprecedented outbreak. Questions around how to select treatments to offer our patients that do moregood than harm and that are worth the efforts and costs of using them. %PDF-1.7 % below. 89% of the patient population is African American/Black and 19.8% Hispanic/Latino. stream |I (dependent variable). "Over six month period.." or "In three years"). endstream What are the important characteristics of the participants, or the problem of focus? . Telemedicine (TM) is defined as the "practice of 'medicine at a distance,'" indicating that it refers to the show more content In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)? <>21]/P 27 0 R/Pg 45 0 R/S/Link>> To best make sense of the literature that might address this PICO question, you would also need a deep understanding of background questions like: Guide to locating research for evidence synthesis projects and assignments. For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)? 37 0 obj What are the measures of effective blood sugar control? 4 0 obj Scenario: Your patient, who owns a bakery, recently participated in their employer's wellness program. What clinical domain does your question fall under. Click on the button below to generate your PICOT question, research hypotheses, In OR nurses doing a five minute scrub (P) what are the differences in the presence and types of microbes (O) found on natural polished nails and nail beds (I) and artificial nails (C) at the time of surgery (T)? 2020-05-04T07:16:06-07:00 Is the presentation clear and easy to follow? Inpatient telemedicine and new models of care during COVID-19: hospital design strategies to enhance patient and staff safety. endobj Dr. Sikka is the Founder and Chief Medical Officer of SonoStik, LLC and advises Emergency Medical Innovations, LLC. Profile of AHRQ Telehealth Grantees GranteeCharacteristics Thesubsetof theAHRQgranteesand contractors who haveimplemented,orareinthe A "foreground" question in health research is one that is relatively specific, and is usually best addressed by locating primary research evidence. 0000019268 00000 n Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)? Use this guide to learn about the first four steps of Evidence Based Practice, get help writing your PICO question, and get started on your research. The first question asked by the STOIC investigators centers on the diagnosis of COVID-19 by using thoracic CT. This may require additional communication and outreach to the patient by nurses or medical assistants to review and update information regarding the patients medical history, validate that the reason for their visit is complete, accurate, and identifies the need for any necessary ancillary services (i.e. President Trump Expands Telehealth Benefits for Medicare Beneficiaries During the COVID-19 Outbreak. Are ______(P) who have ______(I) compared with those without _______(C) at ________ risk for/of _______ (O) over ________(T)? Telehealth. In addition to the more traditional uses of telehealth, the COVID-19 crisis has necessitated creative thinking about how telehealth technology can help protect providers. Finally, you will click on a button and the PICOT Research Question Generator will present the following: Your PICOT question. PICOT is an acronym that is used to represent the clinical question: (P) Patient population, or group of patients of interest. 0000003368 00000 n Introduction; Research Toggle Dropdown. The overall aim of this project was to improve mental and physical health by utilizing It stands for: P--Patient/Problem I--Intervention C--Comparison O--Outcome. Nursing Research Guide. 0000003423 00000 n stream Example: What arethe impacts and best practices for workplace transition support programs for the retention of newly-hired, new graduate nurses? Using telehealth in rural areas to deliver and assist with the delivery of healthcare services can reduce or minimize challenges and burdens patients encounter, such as transportation issues related to . In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)? What is the management strategy, diagnostic test, or exposure that you are interested in? Secondly, strategies need to be in place for connecting with patients and caregivers who are less technologically enabled, have multiple comorbid conditions, do not have access to broadband, and/or have low health or. %PDF-1.5 PICOT In rural or underserved areas (P), how does the implementation of telehealth (I) compared to a traditional in-person office or home-visit practice (C) affect improving the use of palliative care/end of life care (O) within one year after the implementation (T). First, providers need to understand the limitations of delivering care remotely and the implications on their diagnostic capabilities, particularly among providers who have limited prior telehealth experience. Bohan Farrell Using a structured question frameworkcan help you clearly define the concepts or variables that make up the specific research question. <> Developing a brochure on telehealth for patients and families is strongly recommended. What is the duration of recovery (O) for patients with total hip replacement (P) who developed a post-operative infection (I) as opposed to those who did not (C) within the first six weeks of recovery (T)? <>/Metadata 2 0 R/Outlines 5 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/ViewerPreferences<>>> Telehealth is a recent concept in hypertension management, and involves using electronic technology to monitor patients' vital signs, such as blood pressure, in their homes. Question: Is ddimer assay more accurate at ruling out deep vein thrombosis compared to ultrasound? P refers to the population/ Patient or the problem. a who (who was studied - a population or sample), a what (what was done or examined - an intervention, an exposure, a policy, a program, a phenomenon). Appropriate for: clinical questions, often addressing the effect of an intervention/therapy/treatment. 91 0 obj <> endobj Telehealth is often referred to or referenced as telemedicine (clinical services), but also includes a wider variety of healthcare services, including those provided by professionals other than physicians, such as nurses and pharmacists. 22 0 obj KWM_# T=mUlE,{w{]=-"U7d-+wV}8,%rqv~?Z=\eH0=pW\ztVC'@6l wNM[p;D3k.Pt#=j&ZY1[b`(+\\\\C2:\;\&%%%R ```66 2@JJ@fH1\$dll2d"ec.4j(ccCQ$5R..ii &3@ Who are the relevant patients? Advanced communication technology offers a method for addressing this problem. (Time is optional). Use PICO to generate terms - these you'll use in your literature search for the current best . 0000041860 00000 n Distinguishing Between Scholarly and Non-Scholarly Periodicals ; Primary vs. Example: For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations(C)improve blood sugar control(O)? ;L"Oh`1`a8r:9;b&`(3K}zf&x0/}wI6e n1:1.t X X;7L:3HeV~mU/24D:5l [*"B0OL0 9. 8KYXu'"t7WZ**8[-AUp|p[8pI:"T%bRR(2bR"3FB#3p8#Vt`YKte1#AvP 0000049147 00000 n Given the shift in paradigm from telehealth as an alternative mechanism of care delivery to telehealth as an integral part of the health system, it is imperative to take a . Policy, U.S. Department of Health & Human Services. 42 0 obj <> endstream :&VLp~3H 9. The study population comprises patients presenting to a hospital with dyspnea or desaturation as measured with pulse oximetry. Research has demonstrated that it promotes continuity of care, decreases costs, and improves patient self-management and overall outcomes, particularly in the management of discrete disease states. Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)? https://www.healthaffairs.org/do/10.1377/hblog20200315.319008/full/. q6&}h8"@*5Mx-";WS,7uG?E|J(#%tR)uYfh#=\XF##;\Iiuxr4!eJtIB |$={vbw468&E(?Q~? Teamwork before and during COVID-19: the good, the same, and the ugly. xb```b``dd`@ Vv) \P7|&30pdx s w\Y#zj\=]}e*2z~h1k endobj It is important for institutions to maintain good patient safety culture and ensure that providers have the opportunity to learn from what went right and what went wrong in telehealth cases. Secondly, strategies need to be in place for connecting with patients and caregivers who are less technologically enabled, have multiple comorbid conditions, do not have access to broadband, and/or have low health or digital health literacy. Medical staff should hold patient safety huddles to discuss cases with both positive and negative patient safety outcomes. Pubmed Clinical Queries. (Population, Intervention, What is the population being exposed to (independent variable)? 0000045284 00000 n using the PICOT framework. endobj How do pregnant women (P) newly diagnosed with diabetes (I) perceive reporting their blood sugar levels (O) to their healthcare providers during their pregnancy and six weeks postpartum (T)? PICO (alternately known as PICOT) is a mnemonic used to describe the four elements of a good clinical question. This article presents the findings of a literature review that explored the issues associated with implementing telehealth in Questions addressing the treatment of an illness or disability. This is a scholarly paper of 6 to 8 pages (excluding title page and reference page(s). Questions addressing the causes or origin of disease, the factors that produce or predispose toward a certain disease or disorder. Medical Faculty Associates <>stream Who is the group of people being studied? Follow-up care can continue to occur remotely, but consideration should be made for conditions in which the patient may require in-person services, particularly in more vulnerable populations. 37 0 obj endobj In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)? Understanding how the design and implementation of online consultations affect primary care quality: systematic review of evidence with recommendations for designers, providers, and researchers. uuid:0d82ba50-b276-11b2-0a00-9093c99cfe7f 0000015148 00000 n If you want to create a 72.6% of patients have income at or below 100% of the federal poverty level. <> Adapted from the PICOT Questions Template; Ellen Fineout-Overholt, 2006. However, this still only accounted for a small fraction of the Medicare budget, at 0.4 percent of total Medicare PFS spending.5 Historically, clinicians have been limited in the types of telehealth services eligible for Medicare payment. For whom is this intervention/program/service designed (users, potential users, stakeholders)? <> 21 0 obj Safeguards are required, such as password protection, in order to ensure that issues of confidentiality of patient data are enforced (Lateff, 2011). <><><>2 3 4]/P 20 0 R/Pg 45 0 R/S/Link>> <> What is the statistical objective of your PICOT research question? AppendPDF Pro 6.3 Linux 64 bit Aug 30 2019 Library 15.0.4 of the PICOT Research Question Generator, which will take you between 15-20 minutes to complete (opens endobj Accessed April 26, 2020. xU]o@|\l(TU P`klqgD5P$w=XmeWp3^4uUm^&`Fp 0J3N?kzn~`~s@$RSzdr_UMV/`6IG*,f%R!,q1zub:1f)tO|qSPq5L#(gs]K,WL?3y8kTJG:YzI0)R!fw^,,i [)/h Ra hn&0IM,B))\|(,Ucq~vNS~J0%2 G%~sH$u". -dJia,V?w*ky$k9:%~ 0000034769 00000 n Your independent variable. <> <> Accessed April 26, 2020. 24 0 obj The use of telehealth has been growing steadily as a patient-centered complement to care provided face-to-face, particularly among private insurers. xWN@}z}-I$RS_:\U Fwv=38{e5Q;;^U%i:+'.7NHd2jVpy[Qrw_$$p5$isng?vo!'q, Utilizing Telehealth Technology to Reduce Social Isolation and Depression in Seniors. Vqm``A`bC#[L i @.(v*| ^? The word PICOT is a mnemonic derived from the elements of a clinical research question - patient, intervention, comparison, outcome and (sometimes) time. 0000034911 00000 n The definitions and frames below may be helpful for organizing your question: Questions addressing how a clinical issue, illness, or disability is treated. Another approach is to use telehealth as a means of performing an initial evaluation and triage of patients with COVID-19 symptoms. Nam lacinia p, s ante, dapibus a molestie consequat, ultrices ac magna. Using the PICOTS Framework to Strengthen Evidence Gathered in Clinical TrialsGuidance from the AHRQ's Evidence-based Practice Centers Program (Where?). endobj Utilizing Telehealth Technology to Reduce Social Isolation and Depression in Seniors Missed acute coronary syndrome during telephone triage at out-of-hours primary care: lessons from acase-control study. Is a PKU test (I) done on two week old infants (P) more accurate in diagnosis inborn errors in metabolism (O) compared with PKU tests done at 24 hours of age (C)? endobj endobj Please select your preferred way to submit a case. Institutions should establish escalation protocols that dictate when a patient receiving telehealth services should be transitioned to urgent in-person follow-up care, or even to receiving emergency services. http://www.medpac.gov/docs/default-source/reports/mar18_medpac_ch16_sec.pdf?sfvrsn=0. Telehealth is defined differently by different health organizations and government agencies, at both the federal and state level. Box 800722 As this suggests, deficient safeguarding in regards to confidential information is a very real danger in telemedicine practice (Thompson, Koumanakos and Hadjri, 2012). <>19]/P 27 0 R/Pg 45 0 R/S/Link>> Step-by-step explanation. Telehealth Nursing Essay, It is true of many rural and remote locations that insufficient access to health care provision results in lower health status when compared to their urban counterparts. PICOT: The PICOT question that guided this project was among patients with a recent diagnosis of stroke (P), what is the effect of a telehealth appointment with a nurse practitioner (NP) for post discharge follow-up (I), compared to a standard face-to-face clinic appointment (C), on 30-day readmissions rates (O), within two months (T)? 4. Patient Safety Events and the Role of Patient Safety Organizations During the COVID-19 Pandemic.

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