''Giving the patients less work'': A thematic analysis of telehealth use and recommendations to improve usability for autistic adults / Daniel GILMORE in Autism, 27-4 (May 2023)  

Public ISBD [article]  inAutism > 27-4 (May 2023) . - p.1132-1141 Titre : ''Giving the patients less work'': A thematic analysis of telehealth use and recommendations to improve usability for autistic adults Type de document : Texte imprimé et/ou numérique Auteurs : Daniel GILMORE, Auteur ; Lauren HARRIS, Auteur ; Christopher HANKS, Auteur ; Daniel COURY, Auteur ; Susan MOFFATT-BRUCE, Auteur ; Jennifer H GARVIN, Auteur ; Brittany N HAND, Auteur Article en page(s) : p.1132-1141 Langues : Anglais (eng) Mots-clés : autism,primary care,telehealth,virtual visit Index. décimale : PER Périodiques Résumé : Virtual visits are a telehealth service where patients and providers communicate in real-time using audio and/or video technology. Setting up a virtual visit is complex and may pose challenges for some autistic adults. We conducted semi-structured interviews with autistic adults (n=7), family members of autistic adults (n=12), and clinic personnel (n=6) from one US-based clinic and used thematic analysis to identify factors affecting usability of virtual visits. We found virtual visit preparation involves multiple contacts between clinic personnel and patients or family members via a variety of channels and usability was affected by technology considerations, logistical considerations, and expectations for visits. Participants said technological experience and using the patient portal enhanced usability, but technological issues could increase anxiety. Clinic personnel reported time constraints created logistical barriers to virtual visits; streamlining the process before the visit via the patient portal may improve the usability of virtual visits for autistic adults, family members, and clinic personnel. Participants also reported unclear expectations for virtual visits reduced usability and recommended reminders, instructional videos, and estimated wait-times to clarify expectations. While our findings are based on a single clinic, they may help inform usability improvement efforts in other clinics offering virtual visits for autistic adults.Lay abstractReal-time telehealth visits, called ''virtual visits,'' are live video chats between patients and healthcare professionals. There are lots of steps involved in setting up a virtual visit, which may be difficult for some autistic adults. We interviewed 7 autistic adults, 12 family members of autistic adults, and 6 clinic staff from one clinic in the United States. Our goal was to understand their experiences with virtual visits and see how we can make virtual visits easier to use. We re-read text from the interviews to organize experiences and advice that was shared into topics. We found that autistic adults (or their family members) had to connect with clinic staff many times by phone or online over several days to set up a virtual visit. Participants said that having more experience with technology and using the online patient portal made virtual visits easier to use. But, having issues with technology before the visit could make autistic adults and family members anxious. Clinic staff said it was hard for them to meet the needs of people who were using virtual visits and those who were being seen in person at the clinic. Participants recommended reducing the number of calls between staff and autistic adults or family members using the online patient portal instead. Participants also recommended reminder messages, instruction videos, and approximate wait-times to help autistic adults and family members know what to expect for the virtual visit. Our results are based on peoples' experiences at one clinic, but could help other clinics make virtual visits easier to use for autistic adults and their family members. En ligne : https://doi.org/10.1177/13623613221132422 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499 [article] ''Giving the patients less work'': A thematic analysis of telehealth use and recommendations to improve usability for autistic adults [Texte imprimé et/ou numérique] / Daniel GILMORE, Auteur ; Lauren HARRIS, Auteur ; Christopher HANKS, Auteur ; Daniel COURY, Auteur ; Susan MOFFATT-BRUCE, Auteur ; Jennifer H GARVIN, Auteur ; Brittany N HAND, Auteur . - p.1132-1141. Langues : Anglais (eng) in Autism > 27-4 (May 2023) . - p.1132-1141 Mots-clés : autism,primary care,telehealth,virtual visit Index. décimale : PER Périodiques Résumé : Virtual visits are a telehealth service where patients and providers communicate in real-time using audio and/or video technology. Setting up a virtual visit is complex and may pose challenges for some autistic adults. We conducted semi-structured interviews with autistic adults (n=7), family members of autistic adults (n=12), and clinic personnel (n=6) from one US-based clinic and used thematic analysis to identify factors affecting usability of virtual visits. We found virtual visit preparation involves multiple contacts between clinic personnel and patients or family members via a variety of channels and usability was affected by technology considerations, logistical considerations, and expectations for visits. Participants said technological experience and using the patient portal enhanced usability, but technological issues could increase anxiety. Clinic personnel reported time constraints created logistical barriers to virtual visits; streamlining the process before the visit via the patient portal may improve the usability of virtual visits for autistic adults, family members, and clinic personnel. Participants also reported unclear expectations for virtual visits reduced usability and recommended reminders, instructional videos, and estimated wait-times to clarify expectations. While our findings are based on a single clinic, they may help inform usability improvement efforts in other clinics offering virtual visits for autistic adults.Lay abstractReal-time telehealth visits, called ''virtual visits,'' are live video chats between patients and healthcare professionals. There are lots of steps involved in setting up a virtual visit, which may be difficult for some autistic adults. We interviewed 7 autistic adults, 12 family members of autistic adults, and 6 clinic staff from one clinic in the United States. Our goal was to understand their experiences with virtual visits and see how we can make virtual visits easier to use. We re-read text from the interviews to organize experiences and advice that was shared into topics. We found that autistic adults (or their family members) had to connect with clinic staff many times by phone or online over several days to set up a virtual visit. Participants said that having more experience with technology and using the online patient portal made virtual visits easier to use. But, having issues with technology before the visit could make autistic adults and family members anxious. Clinic staff said it was hard for them to meet the needs of people who were using virtual visits and those who were being seen in person at the clinic. Participants recommended reducing the number of calls between staff and autistic adults or family members using the online patient portal instead. Participants also recommended reminder messages, instruction videos, and approximate wait-times to help autistic adults and family members know what to expect for the virtual visit. Our results are based on peoples' experiences at one clinic, but could help other clinics make virtual visits easier to use for autistic adults and their family members. En ligne : https://doi.org/10.1177/13623613221132422 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499

Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims / Daniel GILMORE in Autism, 25-1 (January 2021)  

Public ISBD [article]  inAutism > 25-1 (January 2021) . - p.266-274 Titre : Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims Type de document : Texte imprimé et/ou numérique Auteurs : Daniel GILMORE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Brittany N. HAND, Auteur Article en page(s) : p.266-274 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  health services  intellectual disability  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. Our study is the first, to our knowledge, to use US national data to compare physical and mental health conditions among autistic older adults with and without intellectual disability. The data analyzed in this study consisted of records from inpatient hospitalizations as well as "institutional outpatient" healthcare visits, which include visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers. Autistic older adults with intellectual disability were significantly more likely to have thyroid disorders, epilepsy, respiratory infections, gastrointestinal conditions, osteoporosis, cognitive disorders, and schizophrenia/psychotic disorders. In contrast, autistic older adults without intellectual disability were significantly more likely to have obesity, diabetes, high blood pressure, cerebrovascular disease, chronic obstructive pulmonary disease, arthritis, back conditions, attention deficit disorders, substance use disorders, and suicidal ideation or intentional self-injury. These findings highlight the importance of developing distinct, tailored health management strategies for the autistic older adults with and without intellectual disability. En ligne : http://dx.doi.org/10.1177/1362361320955109 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437 [article] Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims [Texte imprimé et/ou numérique] / Daniel GILMORE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Brittany N. HAND, Auteur . - p.266-274. Langues : Anglais (eng) in Autism > 25-1 (January 2021) . - p.266-274 Mots-clés : adults  autism spectrum disorders  health services  intellectual disability  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. Our study is the first, to our knowledge, to use US national data to compare physical and mental health conditions among autistic older adults with and without intellectual disability. The data analyzed in this study consisted of records from inpatient hospitalizations as well as "institutional outpatient" healthcare visits, which include visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers. Autistic older adults with intellectual disability were significantly more likely to have thyroid disorders, epilepsy, respiratory infections, gastrointestinal conditions, osteoporosis, cognitive disorders, and schizophrenia/psychotic disorders. In contrast, autistic older adults without intellectual disability were significantly more likely to have obesity, diabetes, high blood pressure, cerebrovascular disease, chronic obstructive pulmonary disease, arthritis, back conditions, attention deficit disorders, substance use disorders, and suicidal ideation or intentional self-injury. These findings highlight the importance of developing distinct, tailored health management strategies for the autistic older adults with and without intellectual disability. En ligne : http://dx.doi.org/10.1177/1362361320955109 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437

Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults / Brittany N. HAND in Autism, 24-3 (April 2020)  

Public ISBD [article]  inAutism > 24-3 (April 2020) . - p.755-764 Titre : Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults Type de document : Texte imprimé et/ou numérique Auteurs : Brittany N. HAND, Auteur ; Amber M. ANGELL, Auteur ; Lauren HARRIS, Auteur ; Laura A. CARPENTER, Auteur Article en page(s) : p.755-764 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  health services  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : While there is emerging evidence on the prevalence of physical and mental health conditions among autistic adults, less is known about this population's needs during older adulthood (aged 65+). We conducted a cross-sectional retrospective cohort study of 2016-2017 Medicare data to compare the prevalence of physical and mental health conditions in a national sample of autistic older adults (N = 4685) to a matched population comparison (N = 46,850) cohort. Autistic older adults had significantly greater odds of nearly all physical health conditions including epilepsy (odds ratio = 18.9; 95% confidence interval = 17.2-20.7), Parkinson's disease (odds ratio = 6.1; 95% confidence interval = 5.3-7.0), and gastrointestinal conditions (odds ratio = 5.2; 95% confidence interval = 4.9-5.5). Most mental health conditions were more common among autistic older adults, including schizophrenia and psychotic disorders (odds ratio = 25.3; 95% confidence interval = 22.4-28.7), attention deficit disorders (odds ratio = 24.4; 95% confidence interval = 16.2-31.0), personality disorders (odds ratio = 24.1; 95% confidence interval = 17.8-32.5), and suicidality or self-inflicted injury (odds ratio = 11.1; 95% confidence interval = 8.9-13.8). Health conditions commonly associated with advanced age in the general population (e.g. osteoporosis, cognitive disorders, heart disease, cancer, cerebrovascular disease, osteoarthritis) were also significantly more common among autistic older adults. By highlighting the significant physical and mental health needs for which autistic older adults require care, our findings can inform healthcare systems, healthcare providers, and public health initiatives seeking to promote well-being in this growing population. En ligne : http://dx.doi.org/10.1177/1362361319890793 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 [article] Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults [Texte imprimé et/ou numérique] / Brittany N. HAND, Auteur ; Amber M. ANGELL, Auteur ; Lauren HARRIS, Auteur ; Laura A. CARPENTER, Auteur . - p.755-764. Langues : Anglais (eng) in Autism > 24-3 (April 2020) . - p.755-764 Mots-clés : adults  autism spectrum disorders  health services  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : While there is emerging evidence on the prevalence of physical and mental health conditions among autistic adults, less is known about this population's needs during older adulthood (aged 65+). We conducted a cross-sectional retrospective cohort study of 2016-2017 Medicare data to compare the prevalence of physical and mental health conditions in a national sample of autistic older adults (N = 4685) to a matched population comparison (N = 46,850) cohort. Autistic older adults had significantly greater odds of nearly all physical health conditions including epilepsy (odds ratio = 18.9; 95% confidence interval = 17.2-20.7), Parkinson's disease (odds ratio = 6.1; 95% confidence interval = 5.3-7.0), and gastrointestinal conditions (odds ratio = 5.2; 95% confidence interval = 4.9-5.5). Most mental health conditions were more common among autistic older adults, including schizophrenia and psychotic disorders (odds ratio = 25.3; 95% confidence interval = 22.4-28.7), attention deficit disorders (odds ratio = 24.4; 95% confidence interval = 16.2-31.0), personality disorders (odds ratio = 24.1; 95% confidence interval = 17.8-32.5), and suicidality or self-inflicted injury (odds ratio = 11.1; 95% confidence interval = 8.9-13.8). Health conditions commonly associated with advanced age in the general population (e.g. osteoporosis, cognitive disorders, heart disease, cancer, cerebrovascular disease, osteoarthritis) were also significantly more common among autistic older adults. By highlighting the significant physical and mental health needs for which autistic older adults require care, our findings can inform healthcare systems, healthcare providers, and public health initiatives seeking to promote well-being in this growing population. En ligne : http://dx.doi.org/10.1177/1362361319890793 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422

Short report: Patterns of US federal autism research funding during 2017-2019 / Lauren HARRIS in Autism, 26-7 (October 2022)  

Public ISBD [article]  inAutism > 26-7 (October 2022) . - p.2135-2139 Titre : Short report: Patterns of US federal autism research funding during 2017-2019 Type de document : Texte imprimé et/ou numérique Auteurs : Lauren HARRIS, Auteur ; Daniel GILMORE, Auteur ; Anne LONGO, Auteur ; Brittany N. HAND, Auteur Article en page(s) : p.2135-2139 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/therapy  Autistic Disorder/therapy  Financial Management  Humans  United States  autism  funding  research priorities Index. décimale : PER Périodiques Résumé : In 2017, an advisory board consisting of autism researchers and community members recommended that funders of autism research prioritize research projects on: (1) treatments/interventions, (2) evidence-based services, and (3) lifespan issues. To describe funding in these areas since this recommendation was made, we searched the databases of the three largest federal funders of autism research in the United States. We found that the largest portion of federal funding during 2017-2019 was awarded to research on the biology of autism (32.59%) and treatments and interventions for autism (22.87%). Less funds were awarded to research areas that are high funding priorities by the Interagency Autism Coordinating Committee budget recommendation including services (5.02%) and lifespan issues (2.51%). Our findings emphasize that autism research funding is not consistent with the Interagency Autism Coordinating Committee budget recommendation to increase funding particularly to services and lifespan issues. We recommend that funding patterns should shift to better align with these priorities so that autism research may better serve the needs of the autism community. En ligne : http://dx.doi.org/10.1177/13623613211003430 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=484 [article] Short report: Patterns of US federal autism research funding during 2017-2019 [Texte imprimé et/ou numérique] / Lauren HARRIS, Auteur ; Daniel GILMORE, Auteur ; Anne LONGO, Auteur ; Brittany N. HAND, Auteur . - p.2135-2139. Langues : Anglais (eng) in Autism > 26-7 (October 2022) . - p.2135-2139 Mots-clés : Autism Spectrum Disorder/therapy  Autistic Disorder/therapy  Financial Management  Humans  United States  autism  funding  research priorities Index. décimale : PER Périodiques Résumé : In 2017, an advisory board consisting of autism researchers and community members recommended that funders of autism research prioritize research projects on: (1) treatments/interventions, (2) evidence-based services, and (3) lifespan issues. To describe funding in these areas since this recommendation was made, we searched the databases of the three largest federal funders of autism research in the United States. We found that the largest portion of federal funding during 2017-2019 was awarded to research on the biology of autism (32.59%) and treatments and interventions for autism (22.87%). Less funds were awarded to research areas that are high funding priorities by the Interagency Autism Coordinating Committee budget recommendation including services (5.02%) and lifespan issues (2.51%). Our findings emphasize that autism research funding is not consistent with the Interagency Autism Coordinating Committee budget recommendation to increase funding particularly to services and lifespan issues. We recommend that funding patterns should shift to better align with these priorities so that autism research may better serve the needs of the autism community. En ligne : http://dx.doi.org/10.1177/13623613211003430 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=484

Specialized primary care medical home: A positive impact on continuity of care among autistic adults / Brittany N. HAND in Autism, 25-1 (January 2021)  

Public ISBD [article]  inAutism > 25-1 (January 2021) . - p.258-265 Titre : Specialized primary care medical home: A positive impact on continuity of care among autistic adults Type de document : Texte imprimé et/ou numérique Auteurs : Brittany N. HAND, Auteur ; Daniel L. COURY, Auteur ; Susan W. WHITE, Auteur ; Amy R. DARRAGH, Auteur ; Susan MOFFATT-BRUCE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Jennifer H. GARVIN, Auteur Article en page(s) : p.258-265 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  continuity of care  health services  primary care Index. décimale : PER Périodiques Résumé : There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the "medical home". The medical home is not a residential home, but a system where a patient's healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults. En ligne : http://dx.doi.org/10.1177/1362361320953967 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437 [article] Specialized primary care medical home: A positive impact on continuity of care among autistic adults [Texte imprimé et/ou numérique] / Brittany N. HAND, Auteur ; Daniel L. COURY, Auteur ; Susan W. WHITE, Auteur ; Amy R. DARRAGH, Auteur ; Susan MOFFATT-BRUCE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Jennifer H. GARVIN, Auteur . - p.258-265. Langues : Anglais (eng) in Autism > 25-1 (January 2021) . - p.258-265 Mots-clés : adults  autism spectrum disorders  continuity of care  health services  primary care Index. décimale : PER Périodiques Résumé : There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the "medical home". The medical home is not a residential home, but a system where a patient's healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults. En ligne : http://dx.doi.org/10.1177/1362361320953967 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437

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