Browsing by Author "Sicotte, Claude"
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- ItemClinicians' perceptions of organizational readiness for change in the context of clinical information system projects: insights from two cross-sectional surveys.(2011-03-15) Paré, Guy; Sicotte, Claude; Poba-Nzaou, Placide; Balouzakis, GeorgeBACKGROUND The adoption and diffusion of clinical information systems has become one of the critical benchmarks for achieving several healthcare organizational reform priorities including home care primary care and integrated care networks However these systems are often strongly resisted by the same community that is expected to benefit from their use Prior research has found that early perceptions and beliefs play a central role in shaping future attitudes and behaviors such as negative rumors lack of involvement and resistance to change In this line of research this paper builds on the change management and information systems literature and identifies variables associated with clinicians early perceptions of organizational readiness for change in the specific context of clinical information system projects METHODS Two cross sectional surveys were conducted to test our research model First a questionnaire was pretested and then distributed to the future users of a mobile computing technology in 11 home care organizations The second study took place in a large teaching hospital that had approved a budget for the acquisition of an electronic medical records system Data analysis was performed using partial least squares RESULTS Scale items used in this study showed adequate psychometric properties In Study 1 four of the hypothesized links in the research model were supported with change appropriateness organizational flexibility vision clarity and change efficacy explaining 75 of the variance in organizational readiness In Study 2 four hypotheses were also supported two of which differed from those supported in Study 1 the presence of an effective project champion and collective self efficacy In addition to these variables vision clarity and change appropriateness also helped explain 75 of the variance in the dependent variable Explanations for the similarities and differences observed in the two surveys are provided CONCLUSIONS Organizational readiness is arguably a key factor involved in clinicians initial support for clinical information system initiatives As healthcare organizations continue to invest in information technologies to improve quality and continuity of care and reduce costs understanding the factors that influence organizational readiness for change represents an important avenue for future research
- ItemA cost-effectiveness analysis of interactive paediatric telecardiology.(2004-04-07) Sicotte, Claude; Lehoux, Pascale; Van Doesburg, Nicolaas; Cardinal, Godefroy; Leblanc, YvesWe analysed the cost effectiveness of a teleconsultation service after five years of operation The service provides diagnostic consultation at a distance for children suffering from cardiac pathologies A retrospective study was performed with all 78 infants who had received a paediatric cardiology teleconsultation over a four year period from January 1998 The cost effectiveness of telecardiology was compared with that of the conventional means of providing services Teleconsultation proved to be an effective and reliable method of enhancing access to tertiary care The number of patient journeys both emergency transfers and semi urgent or elective visits to the tertiary care centre was reduced by 42 However the cost analysis demonstrated that teleconsultation did not result in overall cost savings the total cost of telecardiology was C dollars 272 327 and the total cost of conventional care would have been C dollars 157 212 There were direct savings for patients but not for the health care system because of the high cost of the equipment and telecommunication fees Telemedicine therefore represented a supplementary cost of C dollars 1500 per patient In summary telemedicine added to cost but increased effectiveness The incremental cost effectiveness ratio of teleconsultation was estimated to C dollars 3488 per patient journey avoided
- ItemCost-minimization analysis of a telehomecare program for patients with chronic obstructive pulmonary disease.(2006-04-19) Paré, Guy; Sicotte, Claude; St-Jules, Danielle; Gauthier, RichardA cost minimization analysis was performed on a telehomecare program for patients with a chronic obstructive pulmonary disease COPD The research was quasi experimental and included a control group We compared the effects and costs of care provided to a group of 19 patients under a telehomecare program to a comparable group of 10 patients receiving regular home care without telemonitoring Our results clearly indicate that there were fewer home visits by nurses and hospitalizations for patients in the experimental group However these patients made more telephone calls than patients in the control group although this difference was not statistically significant Of utmost importance the cost minimization analysis yielded positive results Indeed telemonitoring over a 6 month period generated 355 in savings per patient or a net gain of 15 compared to traditional home care Our study confirms the findings of previous studies that analyzed the efficacy of telemonitoring for patients with COPD Patients were found to easily accept the idea of using the technology and the telehomecare program demonstrated significant clinical benefits Financial advantages of the program could have been more pronounced had it not been for the cost of technology that effectively erased a good portion of the savings
- ItemCost-minimization analysis of a wide-area teleradiology network in a French region.(2006-07-31) Daucourt, Valentin; Sicotte, Claude; Pelletier-Fleury, Nathalie; Petitjean, Marie-Edith; Chateil, Jean-François; Michel, PhilippeThe objective of our study was to perform a cost minimization analysis of a wide area teleradiology network
- ItemEffects of home telemonitoring to support improved care for chronic obstructive pulmonary diseases.(2011-03-09) Sicotte, Claude; Paré, Guy; Morin, Sandra; Potvin, Jacques; Moreault, Marie-PierreTo assess the impact of a home telemonitoring technology on patients with chronic obstructive pulmonary disease in terms of care satisfaction patient empowerment improved quality of life and utilization of hospital and home care
- ItemFeasibility and outcome evaluation of a telemedicine application in speech-language pathology.(2003-11-05) Sicotte, Claude; Lehoux, Pascale; Fortier-Blanc, Julie; Leblanc, YvesThis evaluative study assessed the feasibility and outcome of delivering speech language services from a distance to children and adolescents who stutter All six patients who formed the first cohort seen in the telespeech programme were included in the study The results demonstrated that interactive videoconferencing can provide a feasible and effective care delivery model Patient attendance was maintained throughout the intervention All participants showed improved fluency Stuttering ranged from 13 to 36 before treatment and 2 to 26 after treatment All participants maintained at least part of their improved fluency during the six month follow up when stuttering ranged from 4 to 32 The study demonstrates that full assessment and treatment of stuttering in children and adolescents can be accomplished successfully via telemedicine
- ItemImpact of Synchronous Telemedicine Models on Clinical Outcomes in Pediatric Acute Care Settings: A Systematic Review.(0000-00-00) Nadar, Mahmoud; Jouvet, Philippe; Tucci, Marisa; Toledano, Baruch; Sicotte, ClaudeOBJECTIVES To evaluate the impact of synchronous telemedicine models on the clinical outcomes in pediatric acute care settings DATA SOURCES Citations from EBM Reviews MEDLINE EMBASE Global Health PubMed and CINAHL STUDY SELECTION We identified studies that evaluated the impact of synchronous telemedicine on clinical outcomes between January 2000 and April 2018 All studies involving acutely ill children in PICUs pediatric cardiac ICUs neonatal ICUs and pediatric emergency departments were included Publication inclusion criteria were study design participants characteristics technology type interventions settings outcome measures and languages DATA EXTRACTION Two authors independently screened each article for inclusion and extracted information including telecommunication method intervention characteristics sample characteristics and size outcomes and settings DATA SYNTHESIS Out of the 789 studies initially identified 24 were included The six main outcomes of interest published were quality of care hospital and standardized mortality rate transfer rate complications and illness severity change in medical management and length of stay The use of synchronous telemedicine results improved quality of care and resulted in a decrease in the transfer rate 31 87 5 four studies a shorter length of stay 8 2 vs 15 1 d six studies a change or reinforcement of the medical care plan a reduction in complications and illness severity and a low hospital and standardized mortality rate Overall the quality of the included studies was weak CONCLUSIONS Despite the broad recommendations found for using telemedicine in pediatric acute care settings high quality evidence of its impacts is still lacking Further robust studies are needed to better determine the clinical effectiveness and the associated impacts of telemedicine in pediatric acute care settings
- ItemSystematic review of home telemonitoring for chronic diseases: the evidence base.(2007-05-04) Paré, Guy; Jaana, Mirou; Sicotte, ClaudeHome telemonitoring represents a patient management approach combining various information technologies for monitoring patients at distance This study presents a systematic review of the nature and magnitude of outcomes associated with telemonitoring of four types of chronic illnesses pulmonary conditions diabetes hypertension and cardiovascular diseases
- ItemUse of telemedicine for haemodialysis in very remote areas: the Canadian First Nations.(2011-04-04) Sicotte, Claude; Moqadem, Khalil; Vasilevsky, Murray; Desrochers, Johanne; St-Gelais, MadeleineWe used a pre post design to compare the health and care utilization of patients receiving telehaemodialysis services in two James Bay Cree communities The Cree are an Amerindian First Nation living in the remote James Bay region The same group of dialysed patients n 19 was followed longitudinally over a two year period 12 months pre and 12 months post Analysis of variables measuring the patients health conditions showed that the quality of care provided was well within recognized good practice guidelines Repeated measures ANOVA on the variables measuring care utilization showed a significant decrease in the monthly number of medication changes over time P Under 0 01 Different telehaemodialysis models were used in the two communities virtual patient rounds and telecase reviews with multidisciplinary teams but they did not lead to differences in health condition or care utilization This suggests that there is no single prescriptive model for the delivery of tele expertise