Journal of Medical Internet Research

Primary care informatics (PCI) professionals address workflow and technology solutions in a wide spectrum of health, ranging from optimizing the experience of the individual patient in the clinic room to supporting the health of populations and augmenting the work of frontline primary care clinical teams. PCI overlaps uniquely with 2 disciplines with an impact on societal health—primary care and health informatics. Primary care is a gateway to health care access and aims to synthesize and coordinate numerous, complex elements of patients’ health and medical care in a holistic manner. However, over the past 25 years, primary care has become a specialty in crisis: in a post–COVID-19 world, workforce shortages, clinician burnout, and continuing challenges in health care access all contribute to difficulties in sustaining primary care. Informatics professionals are poised to change this trajectory. In this viewpoint, we aim to inform readers of the discipline of PCI and its importance in the design, support, and maintenance of essential primary care services. Although this work focuses on primary care in the United States, which includes general internal medicine, family medicine, and pediatrics (and depending on definition, includes specialties such as obstetrics and gynecology), many of the principles outlined can also be applied to comparable health care services and settings in other countries. We highlight (1) common global challenges in primary care, (2) recent trends in the evolution of PCI (personalized medicine, population health, social drivers of health, and team-based care), and (3) opportunities to move forward PCI with current and emerging technologies using the 4Cs of primary care framework. In summary, PCI offers important contributions to health care and the informatics field, and there are many opportunities for informatics professionals to enhance the primary care experience for patients, families, and their care teams.

Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain.

Although many people are supportive of their deidentified health care data being used for research, concerns about privacy, safety, and security of health care data remain. There is low awareness about how data are used for research and related governance. Transparency about how health data are used for research is crucial for building public trust. One proposed solution is to ensure that affected communities are notified, particularly marginalized communities where there has previously been a lack of engagement and mistrust.

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The co-design of health technology enables patient-centeredness and can help reduce barriers to technology use.

Searches for “pro-suicide” websites in the United States peaked during the week a high-profile news story was published and remained elevated for 6 months afterward, highlighting the need to avoid mentioning specific sources of explicit suicide instructions in media publications.

Studies have shown that patients have difficulty understanding medical jargon in electronic health record (EHR) notes, particularly patients with low health literacy. In creating the NoteAid dictionary of medical jargon for patients, a panel of medical experts selected terms they perceived as needing definitions for patients.

Obesity is a chronic, multifactorial, and relapsing disease, affecting people of all ages worldwide, and is directly related to multiple complications. Understanding public attitudes and perceptions toward obesity is essential for developing effective health policies, prevention strategies, and treatment approaches.

This paper presents a case study describing the use of social media, specifically Facebook and Instagram, as a valuable tool for recruiting participants in community-engaged health care studies. Drawing on the experiences of our team during a qualitative study aiming to understand the needs of Indigenous fathers and Two-Spirit parents as they transition to parenthood, we offer an in-depth exploration of our social media recruitment strategy. This strategy encompasses deliberate content creation and online engagement with local Indigenous community organizations and people. Through the implementation of this recruitment strategy, we successfully recruited 18 Indigenous fathers and 4 Two-Spirit parents to our community-engaged project. We learned that social media can be used to enhance recruitment by building community trust, engagement, tailored content for specific audiences, and adaptive strategies guided by data metrics provided by social media platforms. Our journey included several challenges, such as dealing with fraudulent participants, navigating budget and resource constraints, and facing recruitment limitations, which we also describe in detail. Our paper provides essential insights for researchers considering the use of social media as a recruitment tool but we are unsure of how to begin. Health care researchers may find our experience and recommendations helpful for developing and implementing their own effective social media recruitment strategy. Meanwhile, sharing our experience contributes to the broader understanding of the role of social media in participant recruitment.

Information and communications technology–based tailored management (TM) intervention is a novel automatic system in which a smartphone app for the management of patients with hypertension and diabetes, the provider web, and Bluetooth devices are linked. However, little evidence exists regarding the cost-effectiveness of the interventions using mobile apps.

The COVID-19 pandemic, patient preference, and economic opportunity are shifting acute care from the hospital to the home, supported by the transformation in remote monitoring technology. Monitoring patients with digital medical devices gives unprecedented insight into their physiology. However, this technology does not exist in a vacuum. Distinguishing pathology from physiological variability, user error, or device limitations is challenging. In a hospital, patients are monitored in a contrived environment. Monitoring at home instead captures activities of daily living alongside patients’ trajectory of disease and recovery. Both settings make for “noisy” data. However, we are familiar with hospital noise, accounting for it in our practice and perceptions of normal. Home monitoring as a diagnostic intervention introduces a new set of downstream consequences, dependent on device, cadence of collection, adherence, duration, alarm thresholds, and escalation criteria. We must accept greater ambiguity and contextualize vital signs. All devices balance accuracy with acceptability, so compromises are inevitable and perfect data should not be expected. Alarms must be specific as well as sensitive, balancing clinical risk with capacity for response. By setting expectations around data from the home, we can smooth the adoption of remote monitoring and accelerate the transition of acute care.

The Zindagi Mehfooz (safe life; ZM) electronic immunization registry (EIR) is a comprehensive suite of digital health interventions that aims to improve equitable access, timeliness, and coverage of child immunizations through a smartphone-based app for vaccinators, web-based dashboards for supervisors and managers, text message alerts and reminders for caregivers, and a call center. It has been implemented at scale in Sindh Province, Pakistan.