{"id":{"repo_id":"toronto-retro","oai_identifier":"oai:utoronto.scholaris.ca:1807/93251"},"canonical_url":"https://search.dev.ndltd.org/etd/toronto-retro/oai:utoronto.scholaris.ca:1807/93251","repository":{"repo_id":"toronto-retro","name":"University of Toronto","base_url":"https://utoronto.scholaris.ca/server/oai/request"},"display":{"title":"Team-based electronic communication in the care of patients with complex conditions","abstract":"Background: The management of patients with complex care needs often involves specialized care from multiple providers in different settings. Care coordination is often inadequate, leading to poor continuity of care. Digital health tools can connect patients and their team of providers to facilitate communication across institutions, disciplines and health events. This dissertation examines digital health tools for patient-provider team-based communication, their feasibility in practice and role in improving continuity of care. Methods: Three studies were conducted. The first study was a scoping review of web-based tools for text-based communication between patients and providers, including those for team-based communication. The second study was a cluster randomized controlled feasibility trial evaluating the feasibility of implementation and preliminary effectiveness of a web-based tool for asynchronous, patient-provider team-based communication on continuity of care relative to usual care. Finally, a qualitative descriptive study was conducted with participants from the trial to understand their perceptions on the value of the tool. Results: The first study identified tools for a variety of chronic conditions, the majority of which targeted diabetes, chronic respiratory diseases and mental illness for purposes of providing symptom updates or to facilitate lifestyle/behavior change. Few tools were found specifically for team-based communication. In the second study, it was shown that implementation of a tool for patient-centered, team-based communication was feasible. Numerically-higher continuity of care scores were observed in the intervention arm relative to the control arm. In the third study, participants felt that web-based communication tools provided more opportunity to seek clarification between appointments. Patients, however, viewed such communication as supplemental to clinical appointments, highlighting traditional face-to-face interaction with their providers as an integral aspect of the therapeutic relationship. Conclusions: Patient-provider team-based communication tools are promising. It is suggested that patient-centered and team-specific implementation approaches are needed to optimize uptake of tools for team-based communication in the complex care population. Further study is needed to establish the effectiveness of improving continuity of care.","abstract_html":"Background: The management of patients with complex care needs often involves specialized care from multiple providers in different settings. Care coordination is often inadequate, leading to poor continuity of care. Digital health tools can connect patients and their team of providers to facilitate communication across institutions, disciplines and health events. This dissertation examines digital health tools for patient-provider team-based communication, their feasibility in practice and role in improving continuity of care. Methods: Three studies were conducted. The first study was a scoping review of web-based tools for text-based communication between patients and providers, including those for team-based communication. The second study was a cluster randomized controlled feasibility trial evaluating the feasibility of implementation and preliminary effectiveness of a web-based tool for asynchronous, patient-provider team-based communication on continuity of care relative to usual care. Finally, a qualitative descriptive study was conducted with participants from the trial to understand their perceptions on the value of the tool. Results: The first study identified tools for a variety of chronic conditions, the majority of which targeted diabetes, chronic respiratory diseases and mental illness for purposes of providing symptom updates or to facilitate lifestyle/behavior change. Few tools were found specifically for team-based communication. In the second study, it was shown that implementation of a tool for patient-centered, team-based communication was feasible. Numerically-higher continuity of care scores were observed in the intervention arm relative to the control arm. In the third study, participants felt that web-based communication tools provided more opportunity to seek clarification between appointments. Patients, however, viewed such communication as supplemental to clinical appointments, highlighting traditional face-to-face interaction with their providers as an integral aspect of the therapeutic relationship. Conclusions: Patient-provider team-based communication tools are promising. It is suggested that patient-centered and team-specific implementation approaches are needed to optimize uptake of tools for team-based communication in the complex care population. Further study is needed to establish the effectiveness of improving continuity of care.","abstract_has_math":false,"creators":["Voruganti, Rishi T."],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":"Health Policy, Management and Evaluation","school":null,"contributors":[],"advisors":["Grunfeld, Eva"],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017-11","date_published":"2017-11","updated_at":"2026-07-27T21:28:13Z","subjects":[],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/1807/93251","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Grunfeld, Eva"]},{"key":"dc:contributor.department","label":"Department","values":["Health Policy, Management and Evaluation"]},{"key":"dc:creator","label":"Author","values":["Voruganti, Rishi T."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2017-11"]},{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2019-01-11T05:00:13Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2019-01-11T05:00:13Z"]},{"key":"dc:date.issued","label":"Date","values":["2017-11"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/1807/93251"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: The management of patients with complex care needs often involves specialized care from multiple providers in different settings. Care coordination is often inadequate, leading to poor continuity of care. Digital health tools can connect patients and their team of providers to facilitate communication across institutions, disciplines and health events. This dissertation examines digital health tools for patient-provider team-based communication, their feasibility in practice and role in improving continuity of care. Methods: Three studies were conducted. The first study was a scoping review of web-based tools for text-based communication between patients and providers, including those for team-based communication. The second study was a cluster randomized controlled feasibility trial evaluating the feasibility of implementation and preliminary effectiveness of a web-based tool for asynchronous, patient-provider team-based communication on continuity of care relative to usual care. Finally, a qualitative descriptive study was conducted with participants from the trial to understand their perceptions on the value of the tool. Results: The first study identified tools for a variety of chronic conditions, the majority of which targeted diabetes, chronic respiratory diseases and mental illness for purposes of providing symptom updates or to facilitate lifestyle/behavior change. Few tools were found specifically for team-based communication. In the second study, it was shown that implementation of a tool for patient-centered, team-based communication was feasible. Numerically-higher continuity of care scores were observed in the intervention arm relative to the control arm. In the third study, participants felt that web-based communication tools provided more opportunity to seek clarification between appointments. Patients, however, viewed such communication as supplemental to clinical appointments, highlighting traditional face-to-face interaction with their providers as an integral aspect of the therapeutic relationship. Conclusions: Patient-provider team-based communication tools are promising. It is suggested that patient-centered and team-specific implementation approaches are needed to optimize uptake of tools for team-based communication in the complex care population. Further study is needed to establish the effectiveness of improving continuity of care."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["Ph.D."]},{"key":"dc:title","label":"Title","values":["Team-based electronic communication in the care of patients with complex conditions"]}]}],"canonical_facts":{"dc:contributor.advisor":["Grunfeld, Eva"],"dc:contributor.department":["Health Policy, Management and Evaluation"],"dc:creator":["Voruganti, Rishi T."],"dc:date":["2017-11"],"dc:date.accessioned":["2019-01-11T05:00:13Z"],"dc:date.available":["2019-01-11T05:00:13Z"],"dc:date.issued":["2017-11"],"dc:description.abstract":["Background: The management of patients with complex care needs often involves specialized care from multiple providers in different settings. Care coordination is often inadequate, leading to poor continuity of care. Digital health tools can connect patients and their team of providers to facilitate communication across institutions, disciplines and health events. This dissertation examines digital health tools for patient-provider team-based communication, their feasibility in practice and role in improving continuity of care. Methods: Three studies were conducted. The first study was a scoping review of web-based tools for text-based communication between patients and providers, including those for team-based communication. The second study was a cluster randomized controlled feasibility trial evaluating the feasibility of implementation and preliminary effectiveness of a web-based tool for asynchronous, patient-provider team-based communication on continuity of care relative to usual care. Finally, a qualitative descriptive study was conducted with participants from the trial to understand their perceptions on the value of the tool. Results: The first study identified tools for a variety of chronic conditions, the majority of which targeted diabetes, chronic respiratory diseases and mental illness for purposes of providing symptom updates or to facilitate lifestyle/behavior change. Few tools were found specifically for team-based communication. In the second study, it was shown that implementation of a tool for patient-centered, team-based communication was feasible. Numerically-higher continuity of care scores were observed in the intervention arm relative to the control arm. In the third study, participants felt that web-based communication tools provided more opportunity to seek clarification between appointments. Patients, however, viewed such communication as supplemental to clinical appointments, highlighting traditional face-to-face interaction with their providers as an integral aspect of the therapeutic relationship. Conclusions: Patient-provider team-based communication tools are promising. It is suggested that patient-centered and team-specific implementation approaches are needed to optimize uptake of tools for team-based communication in the complex care population. Further study is needed to establish the effectiveness of improving continuity of care."],"dc:description.degree":["Ph.D."],"dc:identifier.uri":["http://hdl.handle.net/1807/93251"],"dc:title":["Team-based electronic communication in the care of patients with complex conditions"],"dc:type":["Thesis"]},"updated_at":"2026-07-27T21:28:13Z"}