Purpose
Despite recognizing the importance of eReferral in shaping tourists’ behavioral intentions, researchers have rarely explored its dynamics. In the recent years, interest in the superiority of ...interactive eReferral over eWOM has burgeoned, thus increasing theoretical and empirical quest, which has generated many inconsistencies. Drawing on social identity, trust transfer and social tie theories, the purpose of this paper is to explore an integrative model that investigates the impact of interactive eReferral on tourists’ engagement, eReferral sharing behavior and intention to visit. Besides the direct influences of interactive eReferral on tourists’ engagement, eReferral sharing behavior and intention to visit, the authors assess the mediating role of tourist engagement on the relationship between these concepts.
Design/methodology/approach
Utilizing survey data, variance-based structural equation modeling (VB-SEM) was applied to diagnose the proposed model.
Findings
VB-SEM results suggest that interactive eReferral has a positive impact on tourist engagement, eReferral sharing behavior and intention to visit. Tourist engagement mediates the link between interactive eReferral and eReferral sharing behavior, and intention to visit.
Originality/value
By examining the relationship between interactive eReferral, tourists’ engagement, eReferral sharing behavior and intention to visit, the model departs from existing views to shed new light on the interactivity of eReferral. Implications for marketing practices and research are discussed.
The study sought to determine whether interoperable, electronic health record-based referral (eReferral) produces higher rates of referral and connection to a state tobacco quitline than does ...fax-based referral, thus addressing low rates of smoking treatment delivery in health care.
Twenty-three primary care clinics from 2 healthcare systems (A and B) in Wisconsin were randomized, unblinded, over 2016-2017, to 2 smoking treatment referral methods: paper-based fax-to-quit (system A =6, system B = 6) or electronic (eReferral; system A = 5, system B = 6). Both methods referred adult patients who smoked to the Wisconsin Tobacco Quitline. A total of 14 636 smokers were seen in the 2 systems (system A: 54.5% women, mean age 48.2 years; system B: 53.8% women, mean age 50.2 years).
Clinics with eReferral, vs fax-to-quit, referred a higher percentage of adult smokers to the quitline: system A clinic referral rate = 17.9% (95% confidence interval CI, 17.2%-18.5%) vs 3.8% (95% CI, 3.5%-4.2%) (P < .001); system B clinic referral rate = 18.9% (95% CI, 18.3%-19.6%) vs 5.2% (95% CI, 4.9%-5.6%) (P < .001). Average rates of quitline connection were higher in eReferral than F2Q clinics: system A = 5.4% (95% CI, 5.0%-5.8%) vs 1.3% (95% CI, 1.1%-1.5%) (P < .001); system B = 5.3% (95% CI, 5.0%-5.7%) vs 2.0% (95% CI, 1.8%-2.2%) (P < .001).
Electronic health record-based eReferral provided an effective, closed-loop, interoperable means of referring patients who smoke to telephone quitline services, producing referral rates 3-4 times higher than the current standard of care (fax referral), including especially high rates of referral of underserved individuals.
eReferral may help address the challenge of providing smokers with treatment for tobacco use during busy primary care visits.ClinicalTrials.gov; No. NCT02735382.
This paper reports on a multimethod cross-sectional study of the Ontario electronic consultation (eConsult) service. Utilization and closeout survey data from July 2018 through June 2020 were ...analyzed using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Requesting clinicians submitted 60,474 eConsults, and monthly cases increased from 1,487 in July 2018 to 4,179 in June 2020. The median specialist response time was 1 day. An originally contemplated referral was avoided in 51% of cases. Ontario eConsult showed successful uptake across Ontario, demonstrating continued spread and scale, and offering a template for trailblazers looking to implement digital health innovations in their own jurisdictions.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Purpose
– The purpose of this paper is to examine the influence of electronic referral (eReferral) marketing and electronic word-of-mouth (eWOM) on brand image and purchase intention, coupled with ...the moderating effect of gender in the relationship.
Design/methodology/approach
– Structural equation modeling was applied to examine the interplay between the proposed variables, using a random sample of 308 respondents in Cyprus.
Findings
– The empirical results suggest the following: eReferral does influence brand image, and the impact is significant with women only; eWOM influences brand image, and the impact is more significant with women than men; eWOM influences purchase intention, and the impact is the same for both genders; brand image influences purchase intention, and the impact is more significant with women than men.
Research limitations/implications
– Marketing managers can benefit from these competitive advantage tools. Brand image, awareness and sales volume can be increased by utilizing eWOM or eReferral, depending on the product and/or service functionality as well as gender.
Originality/value
– While there is a substantial research stream on eWOM, to the best of the authors’ knowledge no research has differentiated eReferral from eWOM. This paper provides useful insights regarding the two concepts.
Rational and objective
Requests for magnetic resonance imaging (MRI) exams have notably increased in Canada. However, many of these exams may not always be indicated. The Joint Department of Medical ...Imaging and the eReferral Program have worked collaboratively to embed an integrated clinical decision support (DS) tool within the eReferral process for diagnostic imaging requests. This retrospective chart review aimed to assess the necessity of MRI exams for knee pain patients at the point of referral in relation to the referral method (no DS tools within fax‐ vs. DS tools within eReferral).
Methods
Seven hundred and seventeen medical charts of routine MRI referral requests to an Ontario Hospital for patients with knee complaints were reviewed during the study period. The necessity of the MRI exams was evaluated using the supporting algorithm and knee pathway appropriateness guidelines. MRI exams were considered necessary if requested for symptoms or signs that align with best‐practice standards, complemented with sound clinical assessment or history of a radiography scan before ordering an MRI.
Results
In general, MRI requests made through eReferral were 13.289 times more likely to be necessary orders than those made through fax. The likelihood of referring patients for a necessary MRI exam was higher for eReferral than fax for the year 2018/2019 (53.0% vs. 26.8%, P < 0.001) and for the year 2019/2020 (58.5% vs. 16.3%, P < 0.001). In addition, the rate of ordering X‐ray as the proper initial imaging scan for patients presenting with knee pain has steadily increased by 10% over the year for users of the eReferral platform compared to a decrease of 7% for those using fax.
Conclusion
Our findings highlight the positive impact of integrating DS tools at the point of referral in supporting the ordering of necessary MRI scans, suggesting that service re‐design and implementation of automated assistive technology services would impact patient care.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Smokers who attend NHS Stop Smoking Services (SSS) are four times more likely to stop smoking; however, uptake has been in decline. We report the development of an intervention designed to increase ...uptake of SSS, from a more motivated self-selected sample of smokers. In Phase 1 we collected data to explore the barriers and facilitators to people using SSS. In Phase 2, data from extant literature and Phase 1 were subject to behavioural analysis, as outlined by the Behaviour Change Wheel (BCW) framework. Relevant Behaviour Change Techniques (BCTs) were identified in order to address these, informing the content of the StopApp intervention. In Phase 3 we assessed the acceptability of the StopApp. Smokers and ex-smokers identified a number of barriers to attending SSS, including a lack of knowledge about what happens at SSS (Capability); the belief that SSS is not easy to access (Opportunity); that there would be 'scare tactics' or 'nagging'; and not knowing anyone who had been and successfully quit (Motivation). The 'StopApp' is in development and will link in with the commissioned SSS booking system. Examples of the content and functionality of the app are outlined. The next phase will involve a full trial to test effectiveness.
Background Accessing timely specialist physician advice and guidance is of critical importance to both Australian GP specialists (GPs) and their patients. The traditional method of referral, triage ...and subsequent face-to-face (FTF) consultation is facing challenges from an ever increasing volume of referrals and the needs of underserved populations. In response to such issues, electronic consults (eConsults) have been successfully used internationally to provide GPs with a means of asynchronously accessing specialist physician advice and guidance within 72 h. Few studies have addressed the potential impact of eConsults from the view of the non-GP specialist receiving the request, and none specifically related to specialist adult medicine physicians. The aim of this study was to determine the perceptions of current Royal Australasian College of Physicians (RACP) adult medicine Fellows towards establishing an eConsult model of care within their own clinical practice. Methods Semi-structured interviews were conducted with 14 RACP adult medicine Fellows between December 2019 and February 2020. Purposive and snowball sampling strategies were used to recruit physicians of differing ages and gender from diverse specialties and healthcare settings. The data were subjected to a descriptive thematic analysis. Results We describe five key themes of relevance to study participants: (1) improved access to non-GP specialist care; (2) the business model in relation to remuneration and time; (3) enhanced GP–Physician relationships; (4) impact on physician work–life balance; and (5) the need for a structured model of care. There was broad consensus that a significant number of outpatient referrals to adult medicine physicians would be more appropriately addressed in primary care with support via an asynchronous eConsult arrangement. RACP Fellows agreed this could improve access to timely specialist advice, place downward pressure on outpatient FTF clinic waiting times and reduce unnecessary patient travel. Conclusion These findings identify the drivers and barriers to the establishment of an Australian eConsultant model of care from the adult medicine physician’s perspective.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Rapid developments and implementation of digital technologies in public health domains throughout the last decades have changed the landscape of health delivery and disease prevention globally. A ...growing number of countries are introducing interventions such as online consultations, electronic health records, or telemedicine to their health systems to improve their populations' health and improve access to health care. Despite multiple definitions for digital public health and the development of different digital interventions, no study has analyzed whether the utilized technologies fit the definition or the core characteristics of digital public health interventions. A scoping review is therefore needed to explore the extent of the literature on this topic.
The main aim of this scoping review is to outline real-world digital public health interventions on all levels of health care, prevention, and health. The second objective will be the mapping of reported intervention characteristics. These will include nontechnical elements and the technical features of an intervention.
We searched for relevant literature in the following databases: PubMed, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), IEEE (Institute of Electrical and Electronics Engineers) Xplore, and the Association for Computing Machinery (ACM) Full-Text Collection. All original study types (observational studies, experimental trials, qualitative studies, and health-economic analyses), as well as governmental reports, books, book chapters, or peer-reviewed full-text conference papers were included when the evaluation and description of a digital health intervention was the primary intervention component. Two authors screened the articles independently in three stages (title, abstract, and full text). Two independent authors will also perform the data charting. We will report our results following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist.
An additional systematic search in IEEE Xplore and ACM, performed on December 1, 2021, identified another 491 titles. We identified a total of 13,869 papers after deduplication. As of March 2022, the abstract screening state is complete, and we are in the state of screening the 1417 selected full texts for final inclusion. We estimate completing the review in April 2022.
To our knowledge, this will be the first scoping review to fill the theoretical definitions of digital public health with concrete interventions and their characteristics. Our scoping review will display the landscape of worldwide existing digital public health interventions that use information and communication technologies. The results of this review will be published in a peer-reviewed journal in early 2022, which can serve as a blueprint for the development of future digital public health interventions.
DERR1-10.2196/33404.
Background:
Residents of rural areas of Alberta face significant barriers regarding access to specialist care, resulting in delays in provision of optimal care. Electronic referral and consultation ...systems are promising tools for facilitating timely access to specialist care, especially for people living in rural locations.
Objective:
To report our initial experience with the launch of an electronic advice request system for ambulatory kidney care in Alberta, Canada.
Methods:
We analyzed electronic advice requests for nephrology services in Alberta after the system’s pilot launch, from October 2016 to December 2017. Data for province-wide advice request utility by primary care providers (PCPs) were extracted from Alberta Netcare for analysis.
Results:
The total number of electronic advice requests directed to nephrology was 118 (mean number of requests: 2 per week). Only 31 (26.3%) of the cases required a face-to-face clinic visit with a nephrologist. Most (87; 73.7%) cases were managed by PCPs with ongoing nephrologist support via the advice request tool. Typical nephrologist response time was 5.7 ± 0.6 (mean ± SEM) days.
Conclusion:
These preliminary data suggest that the electronic advice request program has potential to enhance timely access to specialist kidney care and minimize unnecessary nephrologist visits while reducing response time. Broad implementation of this system may have a substantial positive impact on health outcomes and improve cost-effectiveness for nephrology care in the long term, particularly in rural communities of Alberta.
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