Collaborative Evaluation for the Utah All Payer Claims Database Capacity Enhancement

BackgroundPre-exposure prophylaxis (PrEP) in the form of daily tenofovir disoproxil fumarate (TDF/FTC) is a potentially transformative tool to prevent HIV infection. However, PrEP scale-up in the United States has been slow and difficult to evaluate comprehensively. All payer claims databases (APCDs) are large datasets that contain information on medical and pharmaceutical claims from most public and private payers in each state, and provide an unusual opportunity to evaluate statewide PrEP implementation efforts.MethodsWe used 2012–2017 data from Rhode Island’s APCD and developed an algorithm to identify individuals prescribed TDF/FTC for PrEP. We compared APCD PrEP data to electronic medical record (EMR) data at the largest dedicated PrEP program in the state, and to other comprehensive pharmaceutical claims data (AIDSVu.org). We calculated the PrEP-to-Need ratio (PnR) based on annual HIV incidence, and used multivariable logistic regression to predict ZIP code-level PrEP use, and specialty of prescribing provider (primary care vs. infectious disease).ResultsThe Rhode Island APCD included insurance claims for 917,633 individuals (87% of the Rhode Island population). PrEP use increased substantially in Rhode Island over the 5-year period, from 13 to 331 prescriptions between 2012 and 2017, with 546 total users during this time period. Users were predominantly male (89%) and privately insured (69.1%), and concentrated in Providence County (71.5%). The PnR ratio increased from 0.2 to 4.0 from 2012–2017. Compared with AIDSVu and EMR Data, the APCD underestimated the number of PrEP users in Rhode Island, but improved over time in documenting users. Infectious diseases specialists had 8.4 times the odds (95% CI: 5.4 to 12.9) of being a PrEP prescriber compared with primary care providers. A total of 2.6% of infectious disease specialists were PrEP prescribers compared with 0.33% of PCPs. The proportion of Black or Hispanic individuals in a ZIP-code was not a significant predictor of PrEP use.ConclusionAPCDs offer an innovative approach to evaluate statewide PrEP implementation comprehensively. Engaging PCPs in PrEP implementation is critical to improve overall uptake among populations most at-risk.DisclosuresAll authors: No reported disclosures.

Purpose: The purpose of this research was (a) to examine school-based speech-language pathologists' (SLPs') implicit attitudes toward immigrants and how these relate to prioritization and use of best practices when assessing multilingual children and (b) to determine if key demographic factors relate to the use and prioritization of these best practices. Method: Eighty-six certified SLPs ranked how they prioritize and use best practices in multilingual assessments and completed an online immigrant Implicit Association Test. Results: The majority of participants exhibited a strong implicit bias against immigrants (median D-score of 0.84, interquartile range: 0.49), but no significant relationship was found between increasing bias and lower prioritization or use of best practices. Increased years working as an SLP and increasingly distant personal relationships to immigration were related to lower prioritization and use of some best practices. An unexpected association included increased reported use of interpreters with increasing implicit bias against immigrants. Conclusions: This research found a strong implicit bias against immigrants among participating school-based SLPs, consistent with previous work detailing health professionals' preferences for ingroups over outgroups. It adds to the call for further research into the impact of implicit biases on clinical practice, and the methods and merits of addressing implicit biases in targeted populations such as SLPs. This study also identified demographic factors associated with decreased prioritization and use of certain best practices when assessing multilingual children. More work is needed to learn how to mitigate these factors to ensure culturally sensitive clinical practice. Supplemental Material: https://doi.org/10.23641/asha.16799638

Purpose: This paper describes undergraduate nursing students’ assessment of learning in a clinical teaching model that replaces 50% of the traditional clinical hours with high-fidelity simulation. We assessed students’ perceptions of the use of best practices in simulation teaching, and the importance assigned to each teaching practice to support learning.Methods: Longitudinal program evaluation design. We surveyed undergraduate nursing students with the Educational Practices Questionnaire (EPQ) at the mid-point (semester 2) and end of the program (semester 4). We used paired t-tests to assess changes in student EPQ scores between mid- and end-program.Results: Results showed that students’ reported greater exposure over time to clinical simulation activities that fostered active learning and high expectations; the degree to which they rated collaborative learning as important also increased.Conclusions: Students’ perceptions of the use of educational best practices and the importance of simulation in nursing education from program mid-point to end-point lends support for a clinical teaching model that uses a simulation to substitute for traditional clinical hours.

The goal of the newly funded Translating Evidence to Support Transitions (TEST) grant is to increase the use and adoption of research-based best practices in transition planning services for high school students with emotional and behavioral disturbances (EBD) receiving special education services. A Spanish translation of this publication is available for download.

Knowledge translation researchers in the last decade have seen a torrent of publications arguing for the central importance of organizational context in influencing implementation success. The Translating Research in Elder Care (TREC) program investigates the role of organizational context on the use of best practices, provider and resident outcomes in residential long-term care facilities (nursing homes) in three western Canadian provinces. The purpose of this presentation is to present findings from our study examining the influence of organizational context on the use of best practices by healthcare aides.

The teaching of listening comprehension in Swaziland is marred by unsystematic practices, largely characterized by individual teacher’s preferred instructional practice, leading to students’ compromised performance in English language, mainly in listening comprehension. This intrinsic case-study examined the use of best practices in teaching of listening comprehension at senior secondary schools in Swaziland. The main objective of the study was to unearth teachers’ prevalent instructional practices, currently impacting students’ performance in listening comprehension. Twenty participants from twenty schools were selected for this study. Simple random sampling (EPSEM) of schools and purposive sampling of participants was used. Data were collected using two methods: observation and standardized open-ended interviews. The constant comparative method and the Three-C model were used to analyse data. The study revealed inconsistencies in teaching of listening comprehension and lack of books and other supportive teaching materials. Creative synthesis and vignettes are used to present the results. The findings of this study have implications for improving teaching of listening comprehension in Swaziland, including improving students’ performance in listening comprehension.

User Interface Design Patterns (UIDPs) improve the interaction between the users and the applications through interfaces with a suitable navigability, intuitive and without restrictions in the size of the screen, to show the content. Nowadays UIDPs are very used in the development of new apps. For medical domain there are 2 types of apps: (1) apps focused on health professionals: control of appointments and files, medical encyclopedias, among others; and (2) apps focused on citizens in general: self-care of health, medical calculators, health service locators, among others. UIDPs are not considered and analyzed in the design and development process of medical apps. In this work, we carried out an analysis of UIDPS suitable for the development of medical apps, in order to identify the most used user graphical interfaces for this kind of applications. The aim of this work is to provide a guide that allows to developers incentive the use of best practices for future developments of medical apps. In conclusion, the use of best practices for the medical apps development will improve the interaction of users with the apps and it will increase the use of these apps since these are intended to make day-to-day easier of patients and their families.

Aim/Purpose: This article addresses the lack of research on BIPOC (Black, Indigenous, People of Color) PhD students’ experiences in collaborative learning processes. It aims to fill this gap by using collaborative autoethnography to analyze the experiences of four BIPOC doctoral students who participated as co-researchers in a year-long collaborative program evaluation self-study of their academic program. Background: The authors discuss their experience in a student leadership role in the collaborative program evaluation process of their doctoral program as a form of collaborative learning, how their identities influenced the processes they participated in, and the themes of what they learned during the evaluation process. The article ends with recommendations to improve the experience and impact of BIPOC doctoral students’ participation and better align the skills learned at the PhD level with the broader job market. Methodology: The study uses the qualitative method of collaborative autoethnography to analyze the perspectives and experiences of four BIPOC doctoral students within a broader cultural context. Contribution: This article provides insight on how to improve the experience of BIPOC doctoral students’ participation in the collaborative process and better align the skills learned at the PhD level with the broader job market. It provides four recommendations: first, align student training with job market realities; second, dismantle systemic and structural barriers; third, respond to the effects of social location; and last, negotiate power through consensus building. Findings: Five themes emerged from the reflections. First, consider how important planning and good communication are to the collaborative learning process in terms of preparation, group dynamics, and resource availability. Second, power disparities existed among faculty, student researchers, and committees. Third, consider how the researchers’ identities affected their interpretations and interactions at the individual, group, and organizational levels. Fourth, the importance of negotiating between diverse perspectives and interests; and finally, what they gained from participating in the collaborative review process. Recommendations for Practitioners: The authors provided four recommendations for improving the experience of BIPCO doctoral students’ participation in the collaborative process and better aligning the skills learned at the PhD level with the broader job market. First, align student training with job market realities. Second, dismantle systemic and structural barriers. Third, respond to the effects of social location. Last, negotiating power through consensus building. Recommendation for Researchers: Researchers should work toward creating an accepted framework for the collaborative program evaluation process to provide a road map of the journey instead of just providing the compass. Additionally, they should design and conduct a full-scale collaborative program evaluation to engage BIPOC students from the beginning. Finally, they should conduct a participatory-collaborative-inclusive academic program evaluation at different levels of higher education. Impact on Society: This article provides insight on how to improve the experience of BIPOC doctoral students’ participation in the collaborative process. It also demonstrates how collaborative learning assists in aligning the skills learned at the PhD level with the broader job market. Future Research: Future research should work toward creating an accepted framework for the collaborative program evaluation process to provide a road map of the journey instead of just providing the compass. Additionally, it should design and conduct a full-scale collaborative program evaluation to engage BIPOC students from the beginning. Finally, future research could conduct a participatory-collaborative-inclusive academic program evaluation at different levels of higher education.

Improving treatment outcomes for people with resonance problems (due to velopharyngeal disorders) is a priority for many speech-language pathologists (SLPs), but there exists a limited understanding of the practices SLPs are using to assess and monitor therapeutic effects in this population. The current study was designed to answer the following questions: (1) What are current clinical practices versus best practices for assessing resonance disorders, tracking therapeutic effects, and determining discharge criteria? (2) What assessment practices would SLPs prefer to use with clients who have resonance disorders? (3) What are barriers to SLPs' use of best practices? and (4) What effects do SLP demographics have on clinical practices? Thirty-eight SLPs, specializing in the treatment of resonance disorders, participated in the study. Responses were compared with best practice recommendations derived from the literature. Most clinicians were using low-tech assessment tools, often because they lacked access to high-tech tools. Demographics and training did not affect clinical assessment practices. There is a need to increase the availability of high-tech assessment tools to SLPs practicing in the area of resonance disorders, as consistent use of sophisticated assessment devices would exemplify contemporary thinking about the transfer of knowledge to practice in this area.

The use of best practices and lesson's learned has been instrumental in the early development of the Aeronomy of Ice in the Mesosphere (AIM) mission. From the development and use of the Concept of Operations Document as a tool in the requirements development process [1] to the use of the operational control system and the Flight Operations Team throughout the instrument, bus and observatory level Integration and Test phases, AIM has leveraged off of previous practices and low-cost operational concepts to minimize both the cost of mission operations and the risks inherent in such low-budget operations. The University of Colorado's Laboratory for Atmospheric and Space Physics (LASP) has been a leader in university-operated missions. LASP has had previous success in using students in the support of all facets of operations, going back to the Solar Mesosphere Explorer in the 1980's, and continuing on numerous missions today, including the completely student operated Student Nitric Oxide Experiment (SNOE) satellite, a project that ended in December of last year. AIM intends to capitalize on this past experience by involving students in the design, development and operation of the mission. AIM will be operated from the LASP Multi-mission Operations Center (MMOC), and is anticipated to share that facility with the QuikSCAT, ICESat and SORCE projects. The LASP MMOC has been developed around a host of different spacecraft buses, including the LASP built SNOE bus, the Ball Aerospace RS-2000 buses used for QuikSCAT and ICESat and the Orbital Sciences Corporation’s (OSC) LEOStar-2 Platform used for SORCE. AIM will also utilize the Orbital LEOStar-2 Platform and SORCE Lesson's Learned have been heavily factored into the AIM development. Besides the LASP internal Lesson's Learned, AIM has also leveraged the experience of other small satellites projects and other satellite operators from civil space, military space, industry and academia. A set of Best Practices [2] developed by the AIAA's Space Operations

The purpose of this study was to explore the relationship between superintendent leadership and the operational processes of school improvement. School district superintendents (N = 226) from six southeastern states were surveyed concerning their leadership authenticity and school improvement practices. Descriptive statistics, analyzes of variance, Pearson correlation coefficients, and structure equation modeling were used to analyze the data. A significant and positive relationship was found between superintendent levels of leadership authenticity and their districts’ use of best practices in the school improvement process. Implications for practice in academic professional preparation programs, for practicing administrators, and for governing boards are discussed.

The authors examined the effects of inquiry-based teaching by undergraduate preservice teachers in an elementary school composed of low-income Hispanic children for whom English was a second language. Initially, focus was an analysis of preservice teachers’ use of best practices for teaching social studies content to English Learners (ELs). The study explored the impact of a diverse field setting on interns’ willingness to adopt culturally relevant pedagogy techniques in social studies teaching. This study ultimately examined the impact of culturally responsive teaching among preservice teachers with limited exposure to multicultural ideals or critical pedagogies working with English Learners. Future direction in social studies methods courses to emphasize greater inclusion of global interconnectedness is also discussed.

Best practices seek to eliminate factors that create interruptions in processes and that occur at construction sites.The objective of this research was to develop a didactic game that helps managers to make practical the use of best practices in structural masonry construction process, to stimulate flow production continuity and to eliminate wastes.The methodology involves the procedures required to development and validation of proposed tool.For this, the following tasks were carried out: exploratory study, preparation of a best practices list, development, validation and application of a checklist; development of didactic game and its validation by the application in a group dynamics, primarily with professors and scientific initiation students, and later with managers of three of the six construction sites researched.As a result it was found that the neglect of most of these activities could result in the occurrence of making-do and consequently in rework; the managers use best practices in their daily and.1216

<b>MRC-NIHR Efficacy and Mechanism Evaluation (EME) Programme Logic Model</b><br /> <br /> Juliana Callaghan&sup1;, Robert Gray&sup1;, Louise Jones&sup2;, Adam Lockwood&sup1;, Danny McAuley&sup3;, John Norrie⁴, Danielle Preedy&sup1;, Sarah Thomas&sup1;, Insa Wemheuer&sup1;<br /> &sup1;National Institute for Health and Care Research (NIHR), School of Healthcare Enterprise and Innovation, University of Southampton, &sup2;UK Research and Innovation (UKRI) Medical Research Council (MRC), &sup3;Queen's University of Belfast, ⁴The University of Edinburgh<br /> February 2023<br /> <br /> The EME Programme is a partnership between the Medical Research Council (MRC) and the National Institute for Health and Care Research (NIHR). The aim of the programme is to improve the health and wealth of the nation by funding clinical efficacy studies that test if an intervention or technology which has shown early promise in patients works as expected in a well-defined group of patients. This may include using such studies to understand treatment mechanisms. The programme plays a key role in translational research by testing novel or repurposed interventions/technologies and determining whether their development should progress to later-phase clinical trials, or inform new earlier-stage research. <a href="https://www.nihr.ac.uk/explore-nihr/funding-programmes/efficacy-and-mechanism-evaluation.htm">More information can be found on the programme page on the NIHR website</a>.<br /> <br /> A logic model is a graphical way to show how an activity, programme or intervention is expected to work and bring about the benefits and changes it intends to achieve. By summarising the core elements, a logic model can then be used to support programme planning, implementation and evaluation. NIHR logic models represent in a linear flow diagram the key activities, outputs, outcomes and impacts of each funding programme as a series of logical steps.<br /> <br /> <br /> <br /> <b>Inputs</b><br /> The first step outlined in the logic model focuses on ‘inputs’, i.e., the resources needed to undertake programme activities. The inputs for the EME Programme are: <ul> <li>MRC and NIHR funding</li> <li>funding from the devolved nations</li> <li>NIHR coordinating centre resources</li> <li>stakeholder time</li> <li>the existing UK research infrastructure in terms of expertise, capacity and funding</li> </ul> <br /> <br /> <b>Activities&nbsp; </b><br /> Inputs feed into activities, the second stage of the logic model. Activities are the actions that NIHR and the funded research community undertake to help achieve the programme’s aims and objectives. Together, inputs and activities represent NIHR’s planned work.<br /> <br /> The initial focus for the programme is identification of key research questions, issues and programme priorities. A NIHR team develops targeted <a href="https://www.nihr.ac.uk/researchers/funding-opportunities/">funding opportunities</a> and activities through horizon scanning and collaboration with key stakeholders to stimulate activity or applications in an area of strategic priority. The programme also invites researcher-led proposals, which enables research into investigator-driven areas. All submitted project proposals are reviewed by harnessing detailed feedback from experts, including academics and other professional experts (for example, clinical staff and health care professionals) as well as patients, carers, service users, specific communities and/or members of the general public. A panel recommends high-quality research projects for funding according to set criteria.<br /> <br /> Funded projects are then actively monitored by a NIHR team that supports the project by providing advice and expertise regarding, for example, risks, appropriate methodologies, stakeholder management or patient and public involvement and engagement.<br /> <br /> NIHR support also includes guidance on the dissemination of research outputs. NIHR supports transparent research management and publication of knowledge, with information on and results of projects being openly accessible via the NIHR <a href="https://fundingawards.nihr.ac.uk/">website</a> and <a href="https://www.journalslibrary.nihr.ac.uk/#/">NIHR Journals Library</a> that hosts the <a href="https://www.journalslibrary.nihr.ac.uk/EME/#/">NIHR EME journal</a>.<br /> <br /> Further, the EME Programme’s application and funding process ensures that funded research projects test interventions/technologies independently and rigorously for efficacy, as well as mechanistic insight. The research process often includes collecting samples, for example in the form of biobanks. By funding projects that follow on from clinical studies supported by the NIHR or other funders, the programme also actively supports researchers in reusing data or samples.<br /> <br /> The EME Programme also builds research capacity through initiatives to broaden, strengthen and upskill the translational research community. &nbsp;For example, the programme provides tailored funding opportunities and activities to support the development of early-career clinical trialists and to stimulate cross-sector and international collaboration.<br /> <br /> <br /> <b>Outputs </b><br /> The next step of the flow diagram focuses on the range of ‘outputs’ that result directly from the undertaken activities. For the EME Programme, these include: <ul> <li>academic outputs such as articles in the <a href="https://www.journalslibrary.nihr.ac.uk/eme/#/">NIHR EME journal</a> and other peer-reviewed journals,</li> <li>communications tailored to key audiences (e.g. patient groups, industry, policy-makers and health-care professionals)</li> <li>study data from the testing of interventions/technologies</li> <li>samples collected as part of the research</li> <li>new intellectual property (IP) being registered as a result of the funded research</li> </ul> <br /> <br /> <br /> <b>Cross-cutting activities</b><br /> Some activities that enable the intended change cut across several steps of the logic model: <ul> <li>Stakeholder collaboration: the programme works closely with stakeholders such as other funders, industrial partners, patients, carers, service users, specific communities and the public to support translational research across the ecosystem</li> <li>Targeted knowledge exchange and dissemination takes place across the project lifecycle</li> <li>Activities, outputs and outcomes produced through research contribute to an increasing pool of knowledge which feeds into and influences both the identification of new questions and methods for answering those questions.</li> </ul> <br /> <br /> <b>Outcomes</b><br /> Outcomes are the changes or benefits the programme intends to produce through its activities and by funding a portfolio of research. Due to the programme’s position on the translational pathway and its role being to inform further research, outcomes are typically seen on a short- to medium-term.<br /> <br /> <b>Scientific advancements</b><br /> Research outputs document and disseminate the scientific advancements made by NIHR-funded projects. Scientific advancements include improved knowledge of the potential health benefits of interventions/ technologies and their mechanisms of action. They also include methodological advancements in the field of clinical trials and mechanistic studies. Improved knowledge can also stimulate further research. For research funded by the EME Programme, this can occur in both directions of the research and development pathway, with, for example, research teams continuing to study the tested interventions/ technologies in later-phase clinical trials or the results stimulating further earlier stage research. This all contributes to the UK’s world-leading reputation in delivering translational health research.<br /> <br /> <b>More efficient and effective health research</b><br /> Developing sample banks and establishing the effectiveness of interventions and technologies results in more efficient and effective health research. For example, trials showing ‘no effect’ of the tested intervention/ technology leads to researchers switching to other approaches, which reduces waste in UK scientific research and increases the efficiency of investments in Phase II and Phase III trials. Involving patients, carers, service users, specific communities and/or members of the general public in all steps of the research process results in increased relevance of research to patient and public need. Increased international and cross-sector collaboration in research enables aligned and complementary research aims to be addressed and optimises delivery of the translational research ecosystem.<br /> <br /> <b>De-risking future investment in research</b><br /> In the medium-term, research funded by the EME programme is expected to result in the de-risking of future investment in research by establishing which interventions and technologies are effective, how they work, and progressing those that are effective for practical use as measured on the Technology Readiness Level (TRL) scale. Increased knowledge around interventions/technologies and their mechanisms of action can also enable increased investment in associated development.<br /> <br /> <b>Enhanced research capacity </b><br /> Research projects funded by the EME Programme also contribute to enhancing research capacity in the form of training and skill-building of project team members through specialist skills and career progression, for example. Working on EME-funded projects is also expected to improve understanding of and interest in translational research for both researchers and trial sites. Collectively, this is expected to result in increased trial activity, capacity and networks, which in turn contributes to international recognition of the UK’s research capabilities.<br /> <br /> <br /> <b>Impacts</b><br /> Impacts, or long-term outcomes, are the anticipated broader (direct and indirect) changes or benefits for organisations, communities, systems and wider society expected to result from the programme's contribution via its activities and portfolio of funded research. These are expected to become apparent in approximately 10-25 years.&nbsp;<br /> For the EME Programme, the overarching long-term benefits are further research and the development of new and repurposed interventions and technologies. These contribute to health benefits through new or repurposed interventions and technologies; improved wealth of the nation through job creation; more effective and efficient use of healthcare resources through targeted investment into promising interventions and technologies; and ultimately, to improving the health and wealth of the nation.&nbsp;<br /> <br /> <br /> <b>Contributions and acknowledgements</b><br /> The NIHR supports the principles of open research, including full and appropriate recognition of the many varied contributions to the creation of knowledge. To support this, we use the<a href="https://credit.niso.org/"> CRediT taxonomy</a> to accurately reflect how each team member has brought their knowledge and skills to the development and delivery of this work. Those that have contributed to this work are listed alphabetically.&nbsp; <ul> <li>Juliana Callaghan:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Writing – review &amp; editing</li> <li>Robert Gray:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization, Writing – review &amp; editing&nbsp;</li> <li>Louise Jones:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization</li> <li>Adam Lockwood:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization, Project administration, Funding acquisition, Methodology, Supervision, Writing – review &amp; editing</li> <li>Danny McAuley:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization, Writing – review &amp; editing</li> <li>John Norrie:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization, Writing – review &amp; editing</li> <li>Danielle Preedy: &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization, Writing – review &amp; editing</li> <li>Sarah Thomas:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Conceptualization, Funding acquisition, Methodology, Supervision</li> <li>Insa Wemheuer:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Project administration, Visualization, Writing – original draft, Writing – review &amp; editing</li> </ul> <br /> In addition, we would specifically like to thank Rebecca Adler, Principal Consultant at NIRAS, and David Salisbury, Independent Consultant and NIRAS Associate, for facilitating the initial development of a Theory of Change for the EME Programme that formed the basis of developing the logic model presented in this document. We would also like to thank the Communications Team at the School of Healthcare Enterprise and Innovation, University of Southampton, for their advice and support in undertaking the visualisation of the model.&nbsp;<br /> <br /> The Logic Model presented in this document also builds on the following document:&nbsp;<br /> <br /> Rentel M C, Simpson K, Dav&eacute; A, Carter S, Blake M, Franke J, <i>et al.</i> A 10-year impact assessment of the Efficacy and Mechanism Evaluation (EME) programme: an independent mixed-method evaluation study. <i>Efficacy Mech Eval</i> 2021;8(20)<br /> <br /> <b>Competing interests&nbsp;</b><br /> This work has been undertaken as part of the delivery of the National Institute for Health and Care Research (NIHR), which is funded by the Department of Health and Social Care. The EME programme is a partnership between the Medical Research Council (MRC) and the NIHR. It is funded by the MRC and the NIHR, with contributions from the CSO in Scotland, Health and Care Research Wales and the HSC R&amp;D Division, Public Health Agency in Northern Ireland. All authors of this document have contributed to it as part of work paid for by the NIHR. No competing interests were disclosed.

Continuity in patient healthcare shows significant gaps and variations, due to reduced communication between healthcare services. The information transfer to all stages of health structures is often inadequate with many variations, especially at the critical stage after discharge from the hospital, in which patients are usually more vulnerable. The major problem of the lack of interconnection between healthcare services occurs mainly among the elderly, the chronically ill and those who take a lot medication. The main effects of this problem are medication side effects, treatment overlap, poor quality of healthcare and financial costs. Enhancing communication, through the electronic interface and the use of the Personal Electronic Health Folder (P.E.H.F.), which will include the individual details of each patient and information about his clinical status, is aiming at the use of best practices for patient recovery by healthcare providers. The thorough literature review, the strategic analysis PESTEL and the control process, pointed out the need to use the P.E.H.F., to achieve substantial improvements in the quality of patient healthcare. With the practical use of P.E.H.F., the healthcare of all patients will be unquestionably, safe, effective, patient-centered, immediate and fair.