Department of Neurology, NYU Langone Health, New York, New York, USA.
Barnard College of Columbia University, New York, New York, USA.
Headache. 2023 Jul-Aug;63(7):917-925. doi: 10.1111/head.14519. Epub 2023 Jun 14.
We assessed headache clinicians' viewpoints on potential remote access to patients' digital headache diary data and the practicalities of data utilization.
With the ubiquitous nature of electronic medical records and the existence of remote monitoring (RM) for many medical conditions, there is now the potential for remote symptom monitoring for patients with headache disorders. While patients are asked to utilize headache diaries, clinicians may or may not have access to the data before patient visits, and their perspectives regarding this emerging technology are currently unknown.
After recruiting participants from the National Institutes of Health Pain Consortium Network, the American Headache Society Special Interest Section listservs, and Twitter and Facebook social media platforms, we conducted 20 semi-structured qualitative interviews of headache providers across the United States from various types of institutions and asked them their perspectives on remote access to patient headache diary data. We transcribed the interviews, which were then coded by two independent coders. Themes and sub-themes were developed using inductive content analysis.
All clinicians felt the RM data needed to be integrated into the electronic medical record. Six themes emerged from the interviews: (i) Clinician perspectives on how RM could be beneficial but at other times could create obstacles/challenges, (ii) operationally, data integration could benefit headache care, (iii) there should be initial logistical considerations for bringing RM into clinical care, (iv) education may need to be provided to both patients and clinicians, (v) there are likely research benefits associated with RM, and (vi) additional suggestions for considering potential integration of RM into practice.
While headache clinicians had mixed opinions on the benefits/challenges that RM presents to patient care, patient satisfaction, and visit time, new ideas emerged that may help advance the field.
评估头痛临床医生对患者数字头痛日记数据远程访问的潜在看法,以及数据利用的实际情况。
随着电子病历的普及以及许多医疗条件下远程监测的存在,现在有可能对头痛障碍患者进行远程症状监测。虽然要求患者使用头痛日记,但在患者就诊之前,临床医生可能有也可能没有访问数据的权限,他们对这一新兴技术的看法目前尚不清楚。
在美国国家卫生研究院疼痛联合会网络、美国头痛学会特别利益组列表服务以及 Twitter 和 Facebook 社交媒体平台上招募参与者后,我们对来自美国各地不同类型机构的头痛提供者进行了 20 次半结构化定性访谈,询问他们对远程访问患者头痛日记数据的看法。我们对访谈进行了转录,然后由两位独立的编码员进行编码。使用归纳内容分析方法开发主题和子主题。
所有临床医生都认为 RM 数据需要整合到电子病历中。访谈中出现了六个主题:(i)临床医生对 RM 如何可能有益但有时会造成障碍/挑战的看法,(ii)从操作角度来看,数据集成可以使头痛护理受益,(iii)将 RM 引入临床护理需要考虑初始的后勤问题,(iv)可能需要向患者和临床医生提供教育,(v)RM 可能具有相关的研究益处,(vi)对考虑将 RM 纳入实践的其他建议。
尽管头痛临床医生对 RM 对患者护理、患者满意度和就诊时间带来的好处/挑战存在不同意见,但新的想法出现了,这可能有助于该领域的发展。