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Tang C, Lorenzi N, Harle CA, Zhou X, Chen Y. Interactive systems for patient-centered care to enhance patient engagement. J Am Med Inform Assoc 2016; 23:2-4. [PMID: 26912537 DOI: 10.1093/jamia/ocv198] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Charlotte Tang
- Department of Computer Science, Engineering and Physics, University of Michigan-Flint, Flint, MI, USA
| | - Nancy Lorenzi
- Department of Biomedical Informatics, School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Christopher A Harle
- Department of Health Policy and Management, Indiana University, Indianapolis, IN, USA
| | - Xiaomu Zhou
- School of Communication and Information, Rutgers University, New Brunswick, NJ, USA
| | - Yunan Chen
- Department of informatics, Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA, USA
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Maher M, Hanauer DA, Kaziunas E, Ackerman MS, Derry H, Forringer R, Miller K, O'Reilly D, An L, Tewari M, Choi SW. A Novel Health Information Technology Communication System to Increase Caregiver Activation in the Context of Hospital-Based Pediatric Hematopoietic Cell Transplantation: A Pilot Study. JMIR Res Protoc 2015; 4:e119. [PMID: 26508379 PMCID: PMC4704973 DOI: 10.2196/resprot.4918] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Pediatric hematopoietic cell transplantation (HCT), commonly referred to as blood and marrow transplantation (BMT), is an intense treatment modality that requires the involvement of engaged caregivers during the patient's (child's) prolonged hospitalization. The ubiquity of electronic health records (EHRs) and a trend toward patient-centered care could allow a novel health information technology (IT) system to increase parental engagement. The paucity of research on acute care, hospital-based (inpatient) health IT applications for patients or caregivers provides an opportunity for testing the feasibility of such applications. The pediatric BMT population represents an ideal patient group to conduct an evaluation due to the lengthy inpatient stays and a heightened need for patient activation. OBJECTIVE The primary objective of this study is to assess the feasibility of implementing the BMT Roadmap in caregivers as an intervention during their child's inpatient hospitalization. The BMT Roadmap is an inpatient portal prototype optimized for tablet with a user-centered design. It integrates patient-specific laboratory and medication data from the EHR in real-time and provides support in terms of discharge goals, home care education, and other components. Feasibility will be proven if (1) the BMT Roadmap functions and can be managed by the study team without unexpected effort, (2) the system is accessed by users at a defined minimum threshold, and (3) the qualitative and quantitative research conducted provides quality data that address the perceived usefulness of the BMT Roadmap and could inform a study in a larger sample size. METHODS This will be a single-arm, nonrandomized feasibility study. We aim to enroll 10 adult caregivers (age ≥ 18 years) of pediatric patients (aged 0-25 years) undergoing autologous (self-donor) or allogeneic (alternative donor) BMT. Assenting minors (aged 10-18) will also be invited to participate. Recruitment of study participants will take place in the outpatient pediatric BMT clinic. After signing an informed consent, the research study team will provide participants with the BMT Roadmap, available on an Apple iPad, which will used throughout the inpatient hospitalization. To measure the study outcomes, approximately 6-8 semistructured qualitative interviews will be conducted periodically from pre-BMT to 100 days post-BMT and an additional 15-20 semistructured interviews will be conducted among BMT health care providers to assess perceived usefulness and usability of the system, as well as any associated workflow impacts. Quantitative survey instruments will only be administered to adult participants (age ≥ 18 years). RESULTS Recruitment will begin in September 2015, and preliminary findings are expected in 2016. CONCLUSIONS This protocol offers a framework for the design and analysis of a personalized health IT system that has the potential to increase patient and caregiver engagement in acute care, hospital-based contexts.
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Affiliation(s)
- Molly Maher
- School of Information, University of Michigan, Ann Arbor, MI, United States
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Maher M, Kaziunas E, Ackerman M, Derry H, Forringer R, Miller K, O'Reilly D, An LC, Tewari M, Hanauer DA, Choi SW. User-Centered Design Groups to Engage Patients and Caregivers with a Personalized Health Information Technology Tool. Biol Blood Marrow Transplant 2015; 22:349-358. [PMID: 26343948 DOI: 10.1016/j.bbmt.2015.08.032] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/25/2015] [Indexed: 12/30/2022]
Abstract
Health information technology (IT) has opened exciting avenues for capturing, delivering and sharing data, and offers the potential to develop cost-effective, patient-focused applications. In recent years, there has been a proliferation of health IT applications such as outpatient portals. Rigorous evaluation is fundamental to ensure effectiveness and sustainability, as resistance to more widespread adoption of outpatient portals may be due to lack of user friendliness. Health IT applications that integrate with the existing electronic health record and present information in a condensed, user-friendly format could improve coordination of care and communication. Importantly, these applications should be developed systematically with appropriate methodological design and testing to ensure usefulness, adoption, and sustainability. Based on our prior work that identified numerous information needs and challenges of HCT, we developed an experimental prototype of a health IT tool, the BMT Roadmap. Our goal was to develop a tool that could be used in the real-world, daily practice of HCT patients and caregivers (users) in the inpatient setting. Herein, we examined the views, needs, and wants of users in the design and development process of the BMT Roadmap through user-centered Design Groups. Three important themes emerged: 1) perception of core features as beneficial (views), 2) alerting the design team to potential issues with the user interface (needs); and 3) providing a deeper understanding of the user experience in terms of wider psychosocial requirements (wants). These findings resulted in changes that led to an improved, functional BMT Roadmap product, which will be tested as an intervention in the pediatric HCT population in the fall of 2015 (ClinicalTrials.govNCT02409121).
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Affiliation(s)
- Molly Maher
- School of Information, University of Michigan, Ann Arbor, Michigan; School of Public Health, University of Michigan, Ann Arbor, Michigan
| | | | - Mark Ackerman
- School of Information, University of Michigan, Ann Arbor, Michigan; Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan
| | - Holly Derry
- Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan
| | - Rachel Forringer
- Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan
| | - Kristen Miller
- Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan
| | - Dennis O'Reilly
- Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan
| | - Larry C An
- Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan
| | - Muneesh Tewari
- Department of Internal Medicine, Hematology/Oncology Division and Molecular Medicine and Genetics Division, University of Michigan, Ann Arbor, Michigan; Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan; Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan; Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan; Comprehensive Cancer Center, Bioinformatics Core, University of Michigan, Ann Arbor, Michigan
| | - David A Hanauer
- School of Information, University of Michigan, Ann Arbor, Michigan; Comprehensive Cancer Center, Bioinformatics Core, University of Michigan, Ann Arbor, Michigan; Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Sung Won Choi
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan; Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan.
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