Clark K, Bardwell W A, Arsenault T, DeTeresa R, Loscalzo M
Sheri & Les Biller Patient and Family Resource Center, City of Hope, Duarte, CA, USA.
Psychooncology. 2009 Aug;18(8):822-30. doi: 10.1002/pon.1509.
The University of California, San Diego, Moores Cancer Center implemented a systematic approach for patients to communicate with their health-care team in real-time regarding psychosocial problem-related distress using touch-screen technology. The purpose of this report is to describe our experience in implementing touch-screen problem-related distress screening as the standard of care for all outpatients in a health-care setting. Although early identification of distress has recently gained wide attention, the practical issues of implementing psychosocial screening with and without the use of technology have not been fully addressed or investigated.
'The How Can We Help You and Your Family?' screening instrument was used to identify and address patient problem-related distress for clinical services, program development, research and education. Using a HIPPA-compliant approach, the touch-screen technology also helped to identify patients interested in clinical trials and additional support services.
We found that the biggest barrier to implementing this technology was the attitude of the front desk staff (i.e. schedulers, clerks, administrative staff) who felt that the touch-screen would be burdensome. Our experience suggested that it was essential to actively involve these personnel from the beginning of the planning process. As specifically acknowledged in the recent 2007 Institute of Medicine report (Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The National Academies Press: Washington, DC, 2007), use of this computerized version of the screening instrument was able to bridge the gap between the detection of problem-related distress and referrals for assessment or treatment.
We found that it is feasible to implement a computerized problem-related distress screening program in a comprehensive cancer center.
加利福尼亚大学圣地亚哥分校莫尔斯癌症中心实施了一种系统方法，让患者能够使用触摸屏技术就与心理社会问题相关的困扰与他们的医疗团队进行实时沟通。本报告的目的是描述我们在将触摸屏相关问题困扰筛查作为医疗机构所有门诊患者的护理标准方面的经验。尽管困扰的早期识别最近受到了广泛关注，但使用和不使用技术实施心理社会筛查的实际问题尚未得到充分解决或研究。
“我们如何帮助您和您的家人？”筛查工具用于识别和解决患者与临床服务、项目开发、研究和教育相关的困扰问题。采用符合健康保险流通与责任法案（HIPPA）的方法，触摸屏技术还有助于识别对临床试验和额外支持服务感兴趣的患者。
我们发现实施这项技术的最大障碍是前台工作人员（即调度员、办事员、行政人员）的态度，他们认为触摸屏会带来负担。我们的经验表明，从规划过程一开始就积极让这些人员参与至关重要。正如2007年医学研究所最近的报告（《为患者提供全面癌症护理：满足心理社会健康需求》。美国国家科学院出版社：华盛顿特区，2007年）中特别指出的那样，使用这种筛查工具的计算机化版本能够弥合与问题相关困扰的检测与评估或治疗转诊之间的差距。
我们发现，在综合癌症中心实施计算机化的与问题相关困扰筛查项目是可行的。
