General Practice and Primary Care - Research Publications

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    Process Mining-Driven Analysis of the COVID19 Impact on the Vaccinations of Victorian Patients
    Augusto, A ; Deitz, T ; Faux, N ; Manski-Nankervis, J-A ; Capurro, D ( 2021-12-08)
    Process mining is a discipline sitting between data mining and process science, whose goal is to provide theoretical methods and software tools to analyse process execution data, known as event logs. Although process mining was originally conceived to facilitate business process management activities, research studies have shown the benefit of leveraging process mining tools in different contexts, including healthcare. However, applying process mining tools to analyse healthcare process execution data is not straightforward. In this paper, we report the analysis of an event log recording more than 30 million events capturing the general practice healthcare processes of more than one million patients in Victoria–Australia–over five years. Our analysis allowed us to understand benefits and limitations of the state-of-the-art process mining techniques when dealing with highly variable processes and large data-sets. While we provide solutions to the identified limitations, the overarching goal of this study was to detect differences between the patients‘ health services utilization pattern observed in 2020– during the COVID-19 pandemic and mandatory lock-downs –and the one observed in the prior four years, 2016 to 2019. By using a combination of process mining techniques and traditional data mining, we were able to demonstrate that vaccinations in Victoria did not drop drastically–as other interactions did. On the contrary, we observed a surge of influenza and pneumococcus vaccinations in 2020, contradicting research findings of similar studies conducted in different geographical areas.
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    A Conceptual Re-evaluation of Reproductive Coercion: Centring Intent, Fear and Control
    Tarzia, L ; Hegarty, K ( 2020-09-13)
    Background: Reproductive coercion and abuse (RCA) is a hidden form of violence against women. It includes behaviours intended to control or dictate a woman’s reproductive autonomy, for the purpose of either preventing or promoting pregnancy. Main text: In this commentary, we argue that there is a lack of conceptual clarity around RCA that is a barrier to developing a robust evidence base. Furthermore, we suggest that there is a poor understanding of the way that RCA intersects with other types of violence (intimate partner violence; sexual violence) and – as a result – inconsistent definition and measurement in research and practice. To address this, we propose a new way of understanding RCA that centres perpetrator intent and the presence of fear and control. Recommendations for future research are also discussed. Conclusion: We suggest that IPV and SV are the mechanisms through which RCA is perpetrated. In other words, RCA cannot exist without some other form of co-occurring violence in a relationship. This has important implications for research, policy and practice including for screening and identification of women in reproductive healthcare settings.
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    Rapid Design and Delivery of an Experience-Based Co-designed Mobile App to Support the Mental Health Needs of Health Care Workers Affected by the COVID-19 Pandemic: Impact Evaluation Protocol (Preprint)
    Lewis, M ; Palmer, VJ ; Kotevski, A ; Densley, K ; O'Donnell, ML ; Johnson, C ; Wohlgezogen, F ; Gray, K ; Robins-Browne, K ; Burchill, L (JMIR Publications, 2020-12-02)
    BACKGROUND

    The COVID-19 pandemic has highlighted the importance of health care workers’ mental health and well-being for the successful function of the health care system. Few targeted digital tools exist to support the mental health of hospital-based health care workers, and none of them appear to have been led and co-designed by health care workers.

    OBJECTIVE

    RMHive is being led and developed by health care workers using experience-based co-design (EBCD) processes as a mobile app to support the mental health challenges posed by the COVID-19 pandemic to health care workers. We present a protocol for the impact evaluation for the rapid design and delivery of the RMHive mobile app.

    METHODS

    The impact evaluation will adopt a mixed methods design. Qualitative data from photo interviews undertaken with up to 30 health care workers and semistructured interviews conducted with up to 30 governance stakeholders will be integrated with qualitative and quantitative user analytics data and user-generated demographic and mental health data entered into the app. Analyses will address three evaluation questions related to engagement with the mobile app, implementation and integration of the app, and the impact of the app on individual mental health outcomes. The design and development will be described using the Mobile Health Evidence Reporting and Assessment guidelines. Implementation of the app will be evaluated using normalization process theory to analyze qualitative data from interviews combined with text and video analysis from the semistructured interviews. Mental health impacts will be assessed using the total score of the 4-item Patient Health Questionnaire (PHQ4) and subscale scores for the 2-item Patient Health Questionnaire for depression and the 2-item Generalized Anxiety Scale for anxiety. The PHQ4 will be completed at baseline and at 14 and 28 days.

    RESULTS

    The anticipated average use period of the app is 30 days. The rapid design will occur over four months using EBCD to collect qualitative data and develop app content. The impact evaluation will monitor outcome data for up to 12 weeks following hospital-wide release of the minimal viable product release. The study received funding and ethics approvals in June 2020. Outcome data is expected to be available in March 2021, and the impact evaluation is expected to be published mid-2021.

    CONCLUSIONS

    The impact evaluation will examine the rapid design, development, and implementation of the RMHive app and its impact on mental health outcomes for health care workers. Findings from the impact evaluation will provide guidance for the integration of EBCD in rapid design and implementation processes. The evaluation will also inform future development and rollout of the app to support the mental health needs of hospital-based health care workers more widely.

    INTERNATIONAL REGISTERED REPORT

    DERR1-10.2196/26168

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    Health information work - a scoping review protocol
    Gray, K ; Gilbert, C (PeerJ Preprints, 2019-02-15)
    Background: The work of managing health data, health information or health knowledge is a vital, yet unacknowledged, function in our current health system. This protocol is for a literature review which explores the evolution and development of the concept of health information work. Methodology: A scoping review of published literature in the domains of health sciences, information technology and information sciences has been carried out. A thematic and bibliometric analysis of the resulting set of publications is currently being undertaken. Results: The review results will shed light on the responsibilities and the contribution of the health information workforce, with a synthesis of themes identified in the literature, and analysis of publication year spans, prominent authors, institutions and source journals.