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Oh S, Sang E, Stawnychy MA, Garren P, You SB, O'Connor M, Hirschman KB, Hodgson N, Cranston T, Jablonski J, O'Brien K, Newcomb M, Spahr M, Bowles KH. Application of a Human Factors and Systems Engineering Approach to Explore Care Transitions of Sepsis Survivors From Hospital to Home Health Care. HUMAN FACTORS 2024:187208231222399. [PMID: 38171592 DOI: 10.1177/00187208231222399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
STUDY AIM This study aims to describe the transition-in-care work process for sepsis survivors going from hospitals to home health care (HHC) and identify facilitators and barriers to enable practice change and safe care transitions using a human factors and systems engineering approach. BACKGROUND Despite high readmission risk for sepsis survivors, the transition-in-care work process from hospitals to HHC has not been described. METHODS We analyzed semi-structured needs assessment interviews with 24 stakeholders involved in transitioning sepsis survivors from two hospitals and one affiliated HHC agency participating in the parent implementation science study, I-TRANSFER. The qualitative data analysis was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) framework to describe the work process and identify work system elements. RESULTS We identified 31 tasks characterized as decision making, patient education, communication, information, documentation, and scheduling tasks. Technological and organizational facilitators lacked in HHC compared to the hospitals. Person and organization elements in HHC had the most barriers but few facilitators. Additionally, we identified specific task barriers that could hinder sepsis information transfer from hospitals to HHC. CONCLUSION This study explored the complex transition-in-care work processes for sepsis survivors going from hospitals to HHC. We identified barriers, facilitators, and critical areas for improvement to enable implementation and ensure safe care transitions. A key finding was the sepsis information transfer deficit, highlighting a critical issue for future study. APPLICATION We recommend using the SEIPS framework to explore complex healthcare work processes before the implementation of evidence-based interventions.
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Ma J, Sun X, Wang X, Liu B, Shi K. Factors Affecting Patient Adherence to Inhalation Therapy: An Application of SEIPS Model 2.0. Patient Prefer Adherence 2023; 17:531-545. [PMID: 36896268 PMCID: PMC9990505 DOI: 10.2147/ppa.s395327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/18/2023] [Indexed: 03/06/2023] Open
Abstract
PURPOSE This study aims to explore factors that affect patient adherence to inhalation therapy by applying a patient-centered approach. PATIENTS AND METHODS We conducted a qualitative study to identify the factors that influence adherent behaviors among asthma/COPD patients. 35 semi-structured interviews with patients, and 15 semi-structured interviews with healthcare providers (HCPs) who manage asthma/COPD patients were conducted. The SEIPS 2.0 model was applied as a conceptual framework for guiding the interview content and analysis of the interview data. RESULTS Based on the findings of this study, a conceptual framework of patient adherence in asthma/COPD during inhalation therapy was constructed including five themes: person, task, tool, physical environment, and culture and society. Person-related factors include patient ability and emotional experience. Task-related factors refer to task type and frequency and flexibility. Tool-related factors are the type of inhalers and usability of inhalers. Physical environment-related factors include home environment and COVID-19 situation. Culture and social related factors consist of two aspects: cultural beliefs and social stigma. CONCLUSION The findings of the study identified 10 influential factors that impact on patient adherence to inhalation therapy. A SEIPS-based conceptual model was constructed based on the responses of patients and HCPs to explore the experiences of patients engaging in inhalation therapy and interacting with inhalation devices. In particular, new insight about factors of emotional experience, physical environment and traditional cultural beliefs were found crucial for patients with Asthma/COPD to conduct patients' adherent behaviors.
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Affiliation(s)
- Jing Ma
- Faculty of Science and Engineering, University of Nottingham, Ningbo, People’s Republic of China
| | - Xu Sun
- Faculty of Science and Engineering, University of Nottingham, Ningbo, People’s Republic of China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, People’s Republic of China
- Correspondence: Xu Sun, Department of Mechanical, Materials and Manufacturing, Faculty of Science and Engineering, University of Nottingham, Ningbo, People’s Republic of China, Tel/Fax +8657488186443, Email
| | - Xinwei Wang
- Faculty of Science and Engineering, University of Nottingham, Ningbo, People’s Republic of China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, People’s Republic of China
| | - Bingjian Liu
- Faculty of Science and Engineering, University of Nottingham, Ningbo, People’s Republic of China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, People’s Republic of China
| | - Kaiqi Shi
- Suzhou Inhal Pharma Co., Ltd., Suzhou, People’s Republic of China
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Gaughan AA, Walker DM, Sova LN, Vink S, Moffatt-Bruce SD, McAlearney AS. Improving Provisioning of an Inpatient Portal: Perspectives from Nursing Staff. Appl Clin Inform 2022; 13:355-362. [PMID: 35419788 PMCID: PMC9008224 DOI: 10.1055/s-0042-1743561] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Inpatient portals are recognized to provide benefits for both patients and providers, yet the process of provisioning tablets to patients by staff has been difficult for many hospitals. OBJECTIVE Our study aimed to identify and describe practices important for provisioning an inpatient portal from the perspectives of nursing staff and provide insight to enable hospitals to address challenges related to provisioning workflow for the inpatient portal accessible on a tablet. METHODS Qualitative interviews were conducted with 210 nursing staff members across 26 inpatient units in six hospitals within The Ohio State University Wexner Medical Center (OSUWMC) following the introduction of tablets providing access to an inpatient portal, MyChart Bedside (MCB). Interviews asked questions focused on nursing staffs' experiences relative to MCB tablet provisioning. Verbatim interview transcripts were coded using thematic analysis to identify factors associated with tablet provisioning. Unit provisioning performance was established using data stored in the OSUWMC electronic health record about provisioning status. Provisioning rates were divided into tertiles to create three levels of provisioning performance: (1) higher; (2) average; and (3) lower. RESULTS Three themes emerged as critical strategies contributing to MCB tablet provisioning success on higher-performing units: (1) establishing a feasible process for MCB provisioning; (2) having persistent unit-level MCB tablet champions; and (3) having unit managers actively promote MCB tablets. These strategies were described differently by staff from the higher-performing units when compared with characterizations of the provisioning process by staff from lower-performing units. CONCLUSION As inpatient portals are recognized as a powerful tool that can increase patients' access to information and enhance their care experience, implementing the strategies we identified may help hospitals' efforts to improve provisioning and increase their patients' engagement in their health care.
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Affiliation(s)
- Alice A Gaughan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Daniel M Walker
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Lindsey N Sova
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Shonda Vink
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | | | - Ann Scheck McAlearney
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
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Werner NE, Ponnala S, Doutcheva N, Holden RJ. Human factors/ergonomics work system analysis of patient work: state of the science and future directions. Int J Qual Health Care 2021; 33:60-71. [PMID: 33432984 DOI: 10.1093/intqhc/mzaa099] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To demonstrate the use and value of the Human Factors/Ergonomics-based Systems Engineering Initiative for Patient Safety (SEIPS) family of work system models for studying and improving patient work. DATA SOURCES We conducted a review of the published empirical literature applying the SEIPS family of work system models for patient work. STUDY SELECTION Included studies had to apply one of the SEIPS family of work system models to study patient work; be published in a peer-reviewed journal in English and include analysis of data. We identified 16 articles that met our inclusion criteria. DATA EXTRACTION For each study, we extracted settings and situations in which models were applied; research design; study methods; model(s) used; type and number of study participants; study objective(s); whether the study included an intervention; specific aspects of the model used; knowledge generated about patient work and benefits of using the models. RESULTS OF DATA SYNTHESIS Our analysis revealed that a majority of studies were conducted in the United States, used qualitative or mixed methods and employed a variety of data collection techniques to study adult patient populations with chronic illness and their informal caregivers and healthcare providers performing patient work in the home and clinical setting. The studies resulted in a variety of useful products, demonstrating several benefits of using the models. CONCLUSION Our review has demonstrated the value of using the SEIPS family of work systems models to study and improve patient and family contributions to health-related work.
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Affiliation(s)
| | - Siddarth Ponnala
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison
| | - Nadia Doutcheva
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison
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Holden RJ, Carayon P. SEIPS 101 and seven simple SEIPS tools. BMJ Qual Saf 2021; 30:901-910. [PMID: 34039748 PMCID: PMC8543199 DOI: 10.1136/bmjqs-2020-012538] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/11/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | - Pascale Carayon
- Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
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McAlearney AS, Hefner JL, MacEwan SR, Gaughan A, DePuccio M, Walker DM, Hogan CT, Fareed N, Sieck CJ, Huerta TR. Care Team Perspectives About an Inpatient Portal: Benefits and Challenges of Patients' Portal Use During Hospitalization. Med Care Res Rev 2020; 78:537-547. [PMID: 32552351 DOI: 10.1177/1077558720925296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While current research about inpatient portals has focused largely on the patient perspective, it is also critical to consider the care team point of view, as support from these individuals is essential to successful portal implementation and use. We held brief in-person interviews with 433 care team members across a six-hospital health system to explore opinions about patients' use of an inpatient portal as perceived by care team members. Using the Inpatient Portal Evaluation Framework, we characterized benefits and challenges of portal use that care team members reported affected patients, themselves, and the collaborative work of these care teams with their patients. Interviewees noted inpatient portals can improve patient care and experience and also indicated room for improvement in portal use for hospitalized patients. Further understanding of the care team perspective is critical to inform approaches to inpatient portal implementation that best benefit both patients and providers.
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Patient and physician perspectives on training to improve communication through secure messaging: Clarifying the rules of engagement. Health Care Manage Rev 2020; 47:3-11. [PMID: 32379081 DOI: 10.1097/hmr.0000000000000279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to incorporate the perspectives of both patients and providers into the development of training to improve the exchange of secure messages through a patient portal as well as to identify management strategies that support patient engagement. METHODOLOGY Three patient focus groups (17 patients) and interviews with 21 ambulatory physicians across 17 outpatient clinics at a large Midwestern academic medical center using Epic MyChart were performed. Rigorous thematic analysis was guided by the Systems Engineering Initiative for Patient Safety 2.0 framework adapted to patient portal implementation. RESULTS Patients and physicians identified strategies at the patient, portal, physician, and health system levels that could help each group navigate the portal to communicate via secure messages more efficiently. Patient-focused training strategies included multimodal materials addressing how to navigate portal features and direction on when, what, and how to message. Changes to the format of the messaging feature and pop-ups with communication tips were also frequently mentioned. Physician and clinic-level strategies focused on how the clinic and health system management could enhance physician training on the patient-facing portal features and on how to manage patient care within the portal. Physicians also requested that the health system administration standardize physician and care team work processes related to secure messages within the portal and communicate clear management expectations of physician portal management. CONCLUSION As communication via secure messaging has become more common, our study identified patient, physician, portal and health system-level management and training strategies to enhance patient portal use. PRACTICE IMPLICATIONS Health system administrators and outpatient clinic management could implement these strategies to clarify the rules of engagement in the collaborative work of incorporating a patient portal into the primary care workflow and facilitating provider and patient use.
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Fareed N, Walker D, Sieck CJ, Taylor R, Scarborough S, Huerta TR, McAlearney AS. Inpatient portal clusters: identifying user groups based on portal features. J Am Med Inform Assoc 2019; 26:28-36. [PMID: 30476122 DOI: 10.1093/jamia/ocy147] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/18/2018] [Indexed: 01/17/2023] Open
Abstract
Objective Conduct a cluster analysis of inpatient portal (IPP) users from an academic medical center to improve understanding of who uses these portals and how. Methods We used 18 months of data from audit log files, which recorded IPP user actions, of 2815 patient admissions. A hierarchical clustering algorithm was executed to group patient admissions on the basis of proportion of use for each of 10 IPP features. Post-hoc analyses were conducted to further understand IPP use. Results Five cluster solutions were developed for the study sample. Our taxonomy included users with high levels of accessing features that were linked to reviewing schedules, results, tutorials, and ordering food. Patients tended to stay within their clusters over multiple admissions, and the clusters had differences based on patient and clinical characteristics. Discussion Distinct groups of users exist among IPP users, suggesting that training on IPP use to enhance patient engagement could be tailored to patients. More exploration is also needed to understand why certain features were not used across all clusters. Conclusions It is important to understand the specifics about how patients use IPPs to help them better engage with their healthcare. Our taxonomy enabled characterization of 5 groups of IPP users who demonstrated distinct preferences. These results may inform targeted improvements to IPP tools, could provide insights to improve patient training around portal use, and may help care team members effectively engage patients in the use of IPPs. We also discuss the implications of our findings for future research.
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Affiliation(s)
- Naleef Fareed
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Daniel Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Cynthia J Sieck
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Robert Taylor
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Seth Scarborough
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Timothy R Huerta
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Ann Scheck McAlearney
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
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Walker DM, Gaughan A, Fareed N, Moffatt-Bruce S, McAlearney AS. Facilitating Organizational Change to Accommodate an Inpatient Portal. Appl Clin Inform 2019; 10:898-908. [PMID: 31777056 DOI: 10.1055/s-0039-1700867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Patient portals are becoming more commonly used in the hospital inpatient setting. While the potential benefits of inpatient portals are acknowledged, there is a need for research that examines the challenges of portal implementation and the development of best practice approaches for successful implementation. OBJECTIVE We conducted this study to improve our understanding of the impact of the implementation of an inpatient portal on care team members in the context of a large academic medical center. Our study focused on the perspectives of nursing care team members about the inpatient portal. METHODS We interviewed care team members (n = 437) in four phases throughout the 2 years following implementation of an inpatient portal to learn about their ongoing perspectives regarding the inpatient portal and its impact on the organization. RESULTS The perspectives of care team members demonstrated a change in acceptance of the inpatient portal over time in terms of buy-in, positive workflow changes, and acknowledged benefits of the portal for both care team members and patients. There were also changes over time in perspectives of the care team in regards to (1) challenges with new technology, (2) impact of the portal on workflow, and (3) buy-in. Six strategies were identified as important for implementation success: (1) convene a stakeholder group, (2) offer continual portal training, (3) encourage shared responsibility, (4) identify champions, (5) provide provisioning feedback, and (6) support patient use. CONCLUSION Inpatient portals are recognized as an important tool for both patients and care team members, but the implementation of such a technology can create challenges. Given the perspectives care team members had about the impact of the inpatient portal, our findings suggest implementation requires attention to organizational changes that are needed to accommodate the tool and the development of strategies that can address challenges associated with the portal.
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Affiliation(s)
- Daniel M Walker
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Alice Gaughan
- Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Naleef Fareed
- Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Susan Moffatt-Bruce
- Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Ann Scheck McAlearney
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
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Leung K, Lu-McLean D, Kuziemsky C, Booth RG, Collins Rossetti S, Borycki E, Strudwick G. Using Patient and Family Engagement Strategies to Improve Outcomes of Health Information Technology Initiatives: Scoping Review. J Med Internet Res 2019; 21:e14683. [PMID: 31596241 PMCID: PMC6806121 DOI: 10.2196/14683] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/14/2019] [Accepted: 07/30/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Many health care organizations around the world have implemented health information technologies (ITs) to enhance health service efficiency, effectiveness, and safety. Studies have demonstrated that promising outcomes of health IT initiatives can be obtained when patients and family members participate and engage in the adoption, use, and evaluation of these technologies. Despite knowing this, there is a lack of health care organizations using patient and family engagement strategies to enhance the use and adoption of health ITs, specifically. OBJECTIVE This study aimed to answer the following three research questions (RQs): (1) what current frameworks or theories have been used to guide patient and family engagement in health IT adoption, use, implementation, selection, and evaluation?, (2) what studies have been done on patient and family engagement strategies in health IT adoption, use, implementation, selection, and evaluation?, and (3) what patient and family engagement frameworks, studies, or resources identified in the literature can be applied to health IT adoption, use, implementation, selection, and evaluation? METHODS This scoping review used a five-step framework developed by Arksey and O'Malley and adapted by Levac et al. These steps include the following: (1) identifying the RQ, (2) identifying relevant studies, (3) selecting studies, (4) charting relevant data, and (5) summarizing and reporting the result. Retrieved academic and grey literature records were evaluated using a literature review software based on inclusion and exclusion criteria by two independent reviewers. If consensus was not achieved, two reviewers would resolve conflicts by discussion. Research findings and strategies were extracted from the studies and summarized in data tables. RESULTS A total of 35 academic articles and 23 gray literature documents met the inclusion criteria. In total, 20 of the 35 included studies have been published since 2017. Frameworks found include the patient engagement framework developed by Healthcare Information and Management Systems Society and the patient and family engagement framework proposed by Carman et al. Effective strategies include providing patients with clear expectations and responsibilities and providing reimbursement for time and travel. The gray literature sources outlined key considerations for planning and supporting engagement initiatives such as providing patients with professional development opportunities, and embedding patients in existing governance structures. CONCLUSIONS Several studies have reported their findings regarding successful strategies to engage patients and family members in health IT initiatives and the positive impact that can emerge when patients and family members are engaged in such initiatives in an effective manner. Currently, no framework has consolidated all of the key strategies and considerations that were found in this review to guide health care organizations when engaging patients and family members in a health IT-specific project or initiative. Further research to evaluate and validate the existing strategies would be of value.
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Affiliation(s)
- Kevin Leung
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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11
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Inpatients Sign On: An Opportunity to Engage Hospitalized Patients and Caregivers Using Inpatient Portals. Med Care 2019; 57:98-100. [PMID: 30520834 DOI: 10.1097/mlr.0000000000001043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inpatient portals are online patient portals linked to electronic health records that provide hospitalized patients and caregivers secure access to real-time clinical information and tools to enhance their communication with providers and hospital experience. OBJECTIVE The main objective of this commentary was to provide a perspective that inpatient portals are innovative tools poised to engage patients and caregivers during hospitalization and, thus, enhance patient-centered care. RESULTS Inpatient portals are desired by patients and caregivers and may contribute to improved recognition of their inpatient care team, knowledge of their treatment plan and overall inpatient experience. A sociotechnical systems approach is recommended to mitigate potential unintended consequences of inpatient portal use and support effective portal design, implementation and evaluation. CONCLUSIONS This article highlights the potential of using inpatient portals to engage hospitalized patients and caregivers and proposes next steps to evaluate this emerging technology.
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Sieck CJ, Walker DM, Hefner JL, Volney J, Huerta TR, McAlearney AS. Understanding Secure Messaging in the Inpatient Environment: A New Avenue for Communication and Patient Engagement. Appl Clin Inform 2018; 9:860-868. [PMID: 30517969 PMCID: PMC6281442 DOI: 10.1055/s-0038-1675814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/05/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patient portals, and the secure messaging feature in particular, have been studied in the outpatient setting, but research in the inpatient setting is relatively less mature. OBJECTIVE To understand the topics discussed in secure messaging in the inpatient environment, we analyzed and categorized messages sent within an inpatient portal. MATERIALS AND METHODS This observational study examined the content of all secure messages sent from December 2013 to June 2017 within an inpatient portal at a large Midwestern academic medical center (AMC). We analyzed a total of 2,598 messages, categorizing them by sender (patient, family, or care team member), type, and topic, and conducted a descriptive analysis of categories and an examination of code co-occurrence. RESULTS Patients were the most frequent message senders (63%); family members sent the fewest messages (10%). We identified five types of messages: Alert/Request; Thanks; Response; Question; and Other (typo/test message). Patient messages included Alerts/Requests (38%), Questions (31%), Statements of Thanks (24%), Response (1.2%), and Other (5%). We also identified 14 nonmutually exclusive message topics: Medication; Procedure/Treatment Plan; Schedule; Pain; Results; Diet; Discharge; Non-Medication Questions; Provider Requests; Symptoms; Custodial; Technical Issues; Potential Error; and Contact Information. Patient message topics most commonly discussed Symptoms (18%), Procedure/Treatment Plan (14%), or Pain (12%). CONCLUSION Our analysis of secure message content suggests certain message types and topics such as Alerts/Requests and Questions about symptoms and treatment plans are particularly important to patients. These findings demonstrate that both patients and family members utilize the secure messaging function to engage in the care process by posing questions, making requests, and alerting staff to problems. As this technology is implemented in additional facilities, future work should examine how use of secure messaging may be influenced by factors including patients' demographics, reasons for hospitalization, and length of stay.
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Affiliation(s)
- Cynthia J. Sieck
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Daniel M. Walker
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Jennifer L. Hefner
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Jaclyn Volney
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Timothy R. Huerta
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Ann Scheck McAlearney
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
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