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Khosravi M, Izadi R, Shojaei P, Delavari S. Strategies to promote patient-centeredness within the healthcare industry: A grey-based multicriteria decision making methods. J Eval Clin Pract 2024. [PMID: 38970257 DOI: 10.1111/jep.14070] [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: 10/30/2023] [Revised: 05/09/2024] [Accepted: 06/14/2024] [Indexed: 07/08/2024]
Abstract
RATIONALE The international policy agenda has recently advocated for the development of patient-centeredness in healthcare service delivery. Consequently, various stakeholders in the healthcare systems have expressed a vital need for identifying strategies and tools that can enhance patient-centeredness. AIMS AND OBJECTIVES The objective of this paper was to prioritise and benchmark the strategies that can improve patient-centeredness in healthcare service delivery. METHOD We employed a multi-stage research scenario that consisted of two phases: a phase including of a scoping review to identify the current strategies to improve patient-centeredness (PC); And, a phase including of a multicriteria best-worst method to assign weights to PC principles, and a questionnaire administered to a sample of experts for benchmarking the strategies derived from the literature using the Grey Multi-Attributive Border Approximation Area Comparison (MABAC-G) method. RESULTS The most important principle of patient-centeredness was deemed to be access to care, while telehealth tools and Electronic Health Information Systems were respectively suggested as the most efficacious platforms for promoting patient-centeredness. CONCLUSION We recommend that administrators and policy makers in the healthcare industry prioritise the implementation and research of strategies such as telehealth tools and electronic health information systems to enhance access and patient-centeredness in the healthcare systems.
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Affiliation(s)
- Mohsen Khosravi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reyhane Izadi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Payam Shojaei
- Department of Management, Shiraz University, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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2
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Ciudad-Gutiérrez P, Del Valle-Moreno P, Lora-Escobar SJ, Guisado-Gil AB, Alfaro-Lara ER. Electronic Medication Reconciliation Tools Aimed at Healthcare Professionals to Support Medication Reconciliation: a Systematic Review. J Med Syst 2023; 48:2. [PMID: 38055124 DOI: 10.1007/s10916-023-02008-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023]
Abstract
The development of health information technology available and accessible to professionals is increasing in the last few years. However, a low number of electronic health tools included some kind of information about medication reconciliation. To identify all the electronic medication reconciliation tools aimed at healthcare professionals and summarize their main features, availability, and clinical impact on patient safety. A systematic review of studies that included a description of an electronic medication reconciliation tool (web-based or mobile app) aimed at healthcare professionals was conducted. The review protocol was registered with PROSPERO: registration number CRD42022366662, and followed PRISMA guidelines. The literature search was performed using four healthcare databases: PubMed, EMBASE, Cochrane Library, and Scopus with no language or publication date restrictions. We identified a total of 1227 articles, of which only 12 met the inclusion criteria.Through these articles,12 electronic tools were detected. Viewing and comparing different medication lists and grouping medications into multiple categories were some of the more recurring features of the tools. With respect to the clinical impact on patient safety, a reduction in adverse drug events or medication discrepancies was detected in up to four tools, but no significant differences in emergency room visits or hospital readmissions were found. 12 e-MedRec tools aimed at health professionals have been developed to date but none was designed as a mobile app. The main features that healthcare professionals requested to be included in e-MedRec tools were interoperability, "user-friendly" information, and integration with the ordering process.
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Affiliation(s)
- Pablo Ciudad-Gutiérrez
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
| | - Paula Del Valle-Moreno
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
| | - Santiago José Lora-Escobar
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
| | - Ana Belén Guisado-Gil
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain.
| | - Eva Rocío Alfaro-Lara
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
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Garabedian PM, Rui A, Volk LA, Neville BA, Lipsitz SR, Healey MJ, Bates DW. A Multiyear Survey Evaluating Clinician Electronic Health Record Satisfaction. Appl Clin Inform 2023; 14:632-643. [PMID: 37586414 PMCID: PMC10431971 DOI: 10.1055/s-0043-1770900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/12/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVES We assessed how clinician satisfaction with a vendor electronic health record (EHR) changed over time in the 4 years following the transition from a homegrown EHR system to identify areas for improvement. METHODS We conducted a multiyear survey of clinicians across a large health care system after transitioning to a vendor EHR. Eligible clinicians from the first institution to transition received a survey invitation by email in fall 2016 and then eligible clinicians systemwide received surveys in spring 2018 and spring 2019. The survey included items assessing ease/difficulty of completing tasks and items assessing perceptions of the EHR's value, usability, and impact. One item assessing overall satisfaction and one open-ended question were included. Frequencies and means were calculated, and comparison of means was performed between 2018 and 2019 on all clinicians. A multivariable generalized linear model was performed to predict the outcome of overall satisfaction. RESULTS Response rates for the surveys ranged from 14 to 19%. The mean response from 3 years of surveys for one institution, Brigham and Women's Hospital, increased for overall satisfaction between 2016 (2.85), 2018 (3.01), and 2019 (3.21, p < 0.001). We found no significant differences in mean response for overall satisfaction between all responders of the 2018 survey (3.14) and those of the 2019 survey (3.19). Systemwide, tasks rated the most difficult included "Monitoring patient medication adherence," "Identifying when a referral has not been completed," and "Making a list of patients based on clinical information (e.g., problem, medication)." Clinicians disagreed the most with "The EHR helps me focus on patient care rather than the computer" and "The EHR allows me to complete tasks efficiently." CONCLUSION Survey results indicate room for improvement in clinician satisfaction with the EHR. Usability of EHRs should continue to be an area of focus to ease clinician burden and improve clinician experience.
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Affiliation(s)
- Pamela M. Garabedian
- Clinical Quality and IS Analysis, Mass General Brigham, Inc., Somerville, Massachusetts, United States
| | - Angela Rui
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Lynn A. Volk
- Clinical Quality and IS Analysis, Mass General Brigham, Inc., Somerville, Massachusetts, United States
| | - Bridget A. Neville
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Stuart R. Lipsitz
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Harvard Medical School, Harvard University, Ariadne Labs, Boston, Massachusetts, United States
| | - Michael J. Healey
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
| | - David W. Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
- Harvard School of Public Health, Harvard University, Boston, Massachusetts
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4
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Ring LM, Cinotti J, Hom LA, Mullenholz M, Mangum J, Ahmed-Winston S, Cheng JJ, Randolph E, Harahsheh AS. A Quality Improvement Initiative to Improve Pediatric Discharge Medication Safety and Efficiency. Pediatr Qual Saf 2023; 8:e671. [PMID: 37434598 PMCID: PMC10332828 DOI: 10.1097/pq9.0000000000000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/13/2023] [Indexed: 07/13/2023] Open
Abstract
Medication errors are a leading safety concern, especially for families with limited English proficiency and health literacy, and patients discharged on multiple medications with complex schedules. Integration of a multilanguage electronic discharge medication platform may help decrease medication errors. This quality improvement (QI) project's primary aim (process measure) was to increase utilization in the electronic health record (EHR) of the integrated MedActionPlanPro (MAP) for cardiovascular surgery and blood and marrow transplant patients at hospital discharge and for the first clinic follow-up visit to 80% by July 2021. Methods This QI project occurred between August 2020 and July 2021 on 2 subspecialty pediatric acute care inpatient units and respective outpatient clinics. An interdisciplinary team developed and implemented interventions, including integration of MAP within EHR; the team tracked and analyzed outcomes for discharge medication matching, and efficacy and safety MAP integration occurred with a go-live date of February 1, 2021. Statistical process control charts tracked progress. Results Following the implementation of the QI interventions, there was an increase from 0% to 73% in the utilization of the integrated MAP in the EHR across the acute care cardiology unit-cardiovascular surgery/blood and marrow transplant units. The average user hours per patient (outcome measure) decreased 70% from the centerline of 0.89 hours during the baseline period to 0.27 hours. In addition, the medication matching between Cerner inpatient and MAP inpatient increased significantly from baseline to postintervention by 25.6% (P < 0.001). Conclusion MAP integration into the EHR was associated with improved inpatient discharge medication reconciliation safety and provider efficiency.
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Affiliation(s)
- Lisa M. Ring
- Children’s National Heart Institute, Children’s National Hospital, Washington, D.C
- Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, D.C
- Department of Advanced Practice Providers, Children’s National Hospital, Washington, D.C
| | - Jamie Cinotti
- Global Services, Children’s National Hospital, Washington, D.C
| | - Lisa A. Hom
- Children’s National Heart Institute, Children’s National Hospital, Washington, D.C
- Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, D.C
| | - Mary Mullenholz
- Children’s National Heart Institute, Children’s National Hospital, Washington, D.C
| | - Jordan Mangum
- Children’s National Heart Institute, Children’s National Hospital, Washington, D.C
| | | | - Jenhao Jacob Cheng
- Children’s National Heart Institute, Children’s National Hospital, Washington, D.C
| | - Ellie Randolph
- Global Services, Children’s National Hospital, Washington, D.C
| | - Ashraf S. Harahsheh
- Children’s National Heart Institute, Children’s National Hospital, Washington, D.C
- Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, D.C
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5
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Awad S, Amon K, Baillie A, Loveday T, Baysari MT. Human factors and safety analysis methods used in the design and redesign of electronic medication management systems: A systematic review. Int J Med Inform 2023; 172:105017. [PMID: 36809716 DOI: 10.1016/j.ijmedinf.2023.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/15/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Poorly designed electronic medication management systems (EMMS) or computerized physician order entry (CPOE) systems in hospital settings can result in usability issues and in turn, patient safety risks. As a safety science, human factors and safety analysis methods have potential to support the safe and usable design of EMMS. OBJECTIVE To identify and describe human factors and safety analysis methods that have been used in the design or redesign of EMMS used in hospital settings. MATERIALS AND METHODS A systematic review, following PRISMA guidelines, was conducted by searching online databases and relevant journals from January 2011 to May 2022. Studies were included if they described the practical application of human factors and safety analysis methods to support the design or redesign of a clinician-facing EMMS, or its components. Methods used were extracted and mapped to human centered design (HCD) activities: understanding context of use; specifying user requirements; producing design solutions; and evaluating the design. RESULTS Twenty-one papers met the inclusion criteria. Overall, 21 human factors and safety analysis methods were used in the design or redesign of EMMS with prototyping, usability testing, participant surveys/questionnaires and interviews the most frequent. Human factors and safety analysis methods were most frequently used to evaluate the design of a system (n = 67; 56.3%). Nineteen of 21 (90%) methods used aimed to identify usability issues and/or support iterative design; only one paper utilized a safety-oriented method and one, a mental workload assessment method. DISCUSSION AND CONCLUSION While the review identified 21 methods, EMMS design primarily utilized a subset of available methods, and rarely a method focused on safety. Given the high-risk nature of medication management in complex hospital environments, and the potential for harm due to poorly designed EMMS, there is significant potential to apply more safety-oriented human factors and safety analysis methods to support EMMS design.
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Affiliation(s)
- Selvana Awad
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; eHealth NSW, Australia.
| | - Krestina Amon
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Andrew Baillie
- Sydney School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Australia; Sydney Local Health District, Australia
| | | | - Melissa T Baysari
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Australia
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6
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Mannino RG, Arconada Alvarez SJ, Greenleaf M, Parsell M, Mwalija C, Lam WA. Navigating the complexities of mobile medical app development from idea to launch, a guide for clinicians and biomedical researchers. BMC Med 2023; 21:109. [PMID: 36959646 PMCID: PMC10035117 DOI: 10.1186/s12916-023-02833-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
With today's pace of rapid technological advancement, many patient issues in modern medicine are increasingly solvable by mobile app solutions, which also have the potential to transform how clinical research is conducted. However, many critical challenges in the app development process impede bringing these translational technologies to patients, caused in large part by the lack of knowledge among clinicians and biomedical researchers of "what it takes" to design, develop, and maintain a successful medical app. Indeed, problems requiring mobile app solutions are often nuanced, requiring more than just clinical expertise, and issues such as the cost and effort required to develop and maintain a well-designed, sustainable, and scalable mobile app are frequently underestimated. To bridge this skill set gap, we established an academic unit of designers, software engineers, and scientists that leverage human-centered design methodologies and multi-disciplinary collaboration to develop clinically viable smartphone apps. In this report, we discuss major misconceptions clinicians and biomedical researchers often hold regarding medical app development, the steps we took to establish this unit to address these issues and the best practices and lessons learned from successfully ideating, developing, and launching medical apps. Overall, this report will serve as a blueprint for clinicians and biomedical researchers looking to better benefit their patients or colleagues via medical mobile apps.
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Affiliation(s)
- Robert G Mannino
- Georgia Clinical Translational Science Alliance, Atlanta, USA.
- Emory University School of Medicine, Atlanta, USA.
| | - Santiago J Arconada Alvarez
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, USA
| | - Morgan Greenleaf
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- Emory University School of Medicine, Atlanta, USA
| | - Maren Parsell
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- Emory University School of Medicine, Atlanta, USA
| | | | - Wilbur A Lam
- Georgia Clinical Translational Science Alliance, Atlanta, USA.
- Emory University School of Medicine, Atlanta, USA.
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, USA.
- Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, USA.
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7
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Tabaeeian RA, Hajrahimi B, Khoshfetrat A. A systematic review of telemedicine systems use barriers: primary health care providers' perspective. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2022. [DOI: 10.1108/jstpm-07-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose
The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.
Design/methodology/approach
This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.
Findings
Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.
Originality/value
This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.
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8
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van Velsen L, Ludden G, Grünloh C. The Limitations of User-and Human-Centered Design in an eHealth Context and How to Move Beyond Them. J Med Internet Res 2022; 24:e37341. [PMID: 36197718 PMCID: PMC9582917 DOI: 10.2196/37341] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/27/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022] Open
Abstract
Human-centered design (HCD) is widely regarded as the best design approach for creating eHealth innovations that align with end users’ needs, wishes, and context and has the potential to impact health care. However, critical reflections on applying HCD within the context of eHealth are lacking. Applying a critical eye to the use of HCD approaches within eHealth, we present and discuss 9 limitations that the current practices of HCD in eHealth innovation often carry. The limitations identified range from limited reach and bias to narrow contextual and temporal focus. Design teams should carefully consider if, how, and when they should involve end users and other stakeholders in the design process and how they can combine their insights with existing knowledge and design skills. Finally, we discuss how a more critical perspective on using HCD in eHealth innovation can move the field forward and offer 3 directions of inspiration to improve our design practices: value-sensitive design, citizen science, and more-than-human design. Although value-sensitive design approaches offer a solution to some of the biased or limited views of traditional HCD approaches, combining a citizen science approach with design inspiration and imagining new futures could widen our view on eHealth innovation. Finally, a more-than-human design approach will allow eHealth solutions to care for both people and the environment. These directions can be seen as starting points that invite and support the field of eHealth innovation to do better and to try and develop more inclusive, fair, and valuable eHealth innovations that will have an impact on health and care.
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Affiliation(s)
- Lex van Velsen
- eHealth Department, Roessingh Research and Development, Enschede, Netherlands.,Department of Communication Science, University of Twente, Enschede, Netherlands
| | - Geke Ludden
- Department of Design, Production and Management, University of Twente, Enschede, Netherlands
| | - Christiane Grünloh
- eHealth Department, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Systems and Signals group, University of Twente, Enschede, Netherlands
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9
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Gionfriddo M, Hu Y, Maddineni B, Kern M, Duboski V, Kaledas WR, Elder N, Border J, Frusciante K, Kobylinski M, Wright E. Evaluation of a web-based medication reconciliation application within a primary care setting: Results from a cluster randomized controlled trial. JMIR Form Res 2022; 6:e33488. [PMID: 35023836 PMCID: PMC8941436 DOI: 10.2196/33488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/25/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background Despite routine review of medication lists during patient encounters, patients’ medication lists are often incomplete and not reflective of actual medication use. Contributing to this situation is the challenge of reconciling medication information from existing health records, along with external locations (eg, pharmacies, other provider/hospital records, and care facilities) and patient-reported use. Advances in the interoperability and digital collection of information provides a foundation for integration of these once disparate information sources. Objective We aim to evaluate the effectiveness of and satisfaction with an electronic health record (EHR)-integrated web-based medication reconciliation application, MedTrue (MT). Methods We conducted a cluster-randomized controlled trial of MT in 6 primary care clinics within an integrated health care delivery system. Our primary outcome was medication list accuracy, as determined by a pharmacist-collected best-possible medication history (BPMH). Patient and staff perspectives were evaluated through surveys and semistructured interviews. Results Overall, 224 patients were recruited and underwent a BPMH with the pharmacist (n=118 [52.7%] usual care [UC], n=106 [47.3%] MT). For our primary outcome of medication list accuracy, 8 (7.5%) patients in the MT arm and 9 (7.6%) in the UC arm had 0 discrepancies (odds ratio=1.01, 95% CI 0.38-2.72, P=.98). The most common discrepancy identified was patients reporting no longer taking a medication (UC mean 2.48 vs MT mean 2.58, P=.21). Patients found MT easy to use and on average would highly recommend MT (average net promoter score=8/10). Staff found MT beneficial but difficult to implement. Conclusions The use of a web-based application integrated into the EHR which combines EHR, patient-reported data, and pharmacy-dispensed data did not improve medication list accuracy among a population of primary care patients compared to UC but was well received by patients. Future studies should address the limitations of the current application and assess whether improved implementation strategies would impact the effectiveness of the application.
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Affiliation(s)
- Michael Gionfriddo
- Division of Pharmaceutical, Administrative and Social Sciences, School of Pharmacy, Duquesne University, Pittsburgh, US.,Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, US
| | - Yirui Hu
- Department of Population Health Sciences, Geisinger, Danville, US
| | - Bhumika Maddineni
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, US
| | - Melissa Kern
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, US
| | - Vanessa Duboski
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, US
| | | | - Nevan Elder
- The Steele Institute for Health Innovation, Geisinger, Danville, US
| | - Jeffrey Border
- The Steele Institute for Health Innovation, Geisinger, Danville, US
| | - Katie Frusciante
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, US
| | | | - Eric Wright
- Center for Pharmacy Innovation and Outcomes, Geisinger, 100 N Academy Ave, Danville, US
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10
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Waldron C, Cahill J, Cromie S, Delaney T, Kennelly SP, Pevnick JM, Grimes T. Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review. BMC Med Inform Decis Mak 2021; 21:307. [PMID: 34732176 PMCID: PMC8565006 DOI: 10.1186/s12911-021-01659-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/15/2021] [Indexed: 11/28/2022] Open
Abstract
Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-021-01659-8.
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Affiliation(s)
- Catherine Waldron
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Joan Cahill
- Centre for Innovative Human Systems & School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Sam Cromie
- Centre for Innovative Human Systems & School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Tim Delaney
- Pharmacy Department, Tallaght University Hospital, Dublin, Ireland
| | - Sean P Kennelly
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | | | - Tamasine Grimes
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
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11
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Gordon B, Barrett J, Fennessy C, Cake C, Milward A, Irwin C, Jones M, Sebire N. Development of a data utility framework to support effective health data curation. BMJ Health Care Inform 2021; 28:bmjhci-2020-100303. [PMID: 33980500 PMCID: PMC8117992 DOI: 10.1136/bmjhci-2020-100303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives The value of healthcare data is being increasingly recognised, including the need to improve health dataset utility. There is no established mechanism for evaluating healthcare dataset utility making it difficult to evaluate the effectiveness of activities improving the data. To describe the method for generating and involving the user community in developing a proposed framework for evaluation and communication of healthcare dataset utility for given research areas. Methods An initial version of a matrix to review datasets across a range of dimensions was developed based on previous published findings regarding healthcare data. This was used to initiate a design process through interviews and surveys with data users representing a broad range of user types and use cases, to help develop a focused framework for characterising datasets. Results Following 21 interviews, 31 survey responses and testing on 43 datasets, five major categories and 13 subcategories were identified as useful for a dataset, including Data Model, Completeness and Linkage. Each sub-category was graded to facilitate rapid and reproducible evaluation of dataset utility for specific use-cases. Testing of applicability to >40 existing datasets demonstrated potential usefulness for subsequent evaluation in real-world practice. Discussion The research has developed an evidenced-based initial approach for a framework to understand the utility of a healthcare dataset. It is likely to require further refinement following wider application and additional categories may be required. Conclusion The process has resulted in a user-centred designed framework for objectively evaluating the likely utility of specific healthcare datasets, and therefore, should be of value both for potential users of health data, and for data custodians to identify the areas to provide the optimal value for data curation investment.
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Affiliation(s)
- Ben Gordon
- Central Team, Health Data Research UK, London, UK
| | - Jake Barrett
- Central Team, Health Data Research UK, London, UK
| | | | | | | | | | - Monica Jones
- Central Team, Health Data Research UK, London, UK.,Health Data Research UK hub for cancer hosted by UCLPartners, DATA-CAN, Leeds, UK
| | - Neil Sebire
- Central Team, Health Data Research UK, London, UK
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12
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Dunn Lopez K, Chin CL, Leitão Azevedo RF, Kaushik V, Roy B, Schuh W, Banks K, Sousa V, Morrow D. Electronic health record usability and workload changes over time for provider and nursing staff following transition to new EHR. APPLIED ERGONOMICS 2021; 93:103359. [PMID: 33556884 DOI: 10.1016/j.apergo.2021.103359] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 12/29/2020] [Accepted: 01/07/2021] [Indexed: 05/17/2023]
Abstract
The ubiquity of EHRs in healthcare means that small EHR inefficiencies can have a major impact on clinician workload. We conducted a sequential explanatory mixed methods study to: 1) identify EHR-associated workload and usability effects for clinicians following an EHR change over time, 2) determine workload and usability differences for providers (MD and Advance Practice Nurses) versus nurses (RNs and MAs), 3) determine if usability predicts workload, 4) identify potential sources of EHR design flaws. Workload (NASA-Task Load Index) and usability (System Usability Scale) measures were administered pre, 6-8 month and 30-32 months post-implementation. We found significant increase in perceived workload post-implementation that persisted for 2.5 years (p < .001). The workload increase was associated with usability ratings, which in turn may relate to EHR interface design violations identified by a heuristic evaluation. Our findings suggest further innovation and attention to interface design flaws are needed to improve EHR usability and reduce clinician workload.
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Affiliation(s)
| | - Chieh-Li Chin
- University of Illinois at Urbana-Champaign, School of Information Sciences, United States
| | - Renato Ferreira Leitão Azevedo
- University of Illinois at Urbana-Champaign, College of Education, United States; University of Illinois at Urbana-Champaign, Beckman Institute, United States
| | - Varsha Kaushik
- University of Illinois at Urbana-Champaign, Beckman Institute, United States
| | - Bidisha Roy
- University of Illinois at Urbana-Champaign, Beckman Institute, United States
| | | | | | - Vanessa Sousa
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira (Unilab), Redenção, Brazil
| | - Daniel Morrow
- University of Illinois at Urbana-Champaign, College of Education, United States; University of Illinois at Urbana-Champaign, Beckman Institute, United States
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13
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Vogel JP, Comrie‐Thomson L, Pingray V, Gadama L, Galadanci H, Goudar S, Laisser R, Lavender T, Lissauer D, Misra S, Pujar Y, Qureshi ZP, Amole T, Berrueta M, Dankishiya F, Gwako G, Homer CSE, Jobanputra J, Meja S, Nigri C, Mohaptra V, Osoti A, Roberti J, Solomon D, Suleiman M, Robbers G, Sutherland S, Vernekar S, Althabe F, Bonet M, Oladapo OT. Usability, acceptability, and feasibility of the World Health Organization Labour Care Guide: A mixed-methods, multicountry evaluation. Birth 2021; 48:66-75. [PMID: 33225484 PMCID: PMC8246537 DOI: 10.1111/birt.12511] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/07/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The World Health Organization's (WHO) Labour Care Guide (LCG) is a "next-generation" partograph based on WHO's latest intrapartum care recommendations. It aims to optimize clinical care provided to women and their experience of care. We evaluated the LCG's usability, feasibility, and acceptability among maternity care practitioners in clinical settings. METHODS Mixed-methods evaluation with doctors, midwives, and nurses in 12 health facilities across Argentina, India, Kenya, Malawi, Nigeria, and Tanzania. Purposively sampled and trained practitioners applied the LCG in low-risk women during labor and rated experiences, satisfaction, and usability. Practitioners were invited to focus group discussions (FGDs) to share experiences and perceptions of the LCG, which were subjected to framework analysis. RESULTS One hundred and thirty-six practitioners applied the LCG in managing labor and birth of 1,226 low-risk women. The majority of women had a spontaneous vaginal birth (91.6%); two cases of intrapartum stillbirths (1.63 per 1000 births) occurred. Practitioner satisfaction with the LCG was high, and median usability score was 67.5%. Practitioners described the LCG as supporting precise and meticulous monitoring during labor, encouraging critical thinking in labor management, and improving the provision of woman-centered care. CONCLUSIONS The LCG is feasible and acceptable to use across different clinical settings and can promote woman-centered care, though some design improvements would benefit usability. Implementing the LCG needs to be accompanied by training and supportive supervision, and strategies to promote an enabling environment (including updated policies on supportive care interventions, and ensuring essential equipment is available).
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Affiliation(s)
- Joshua P. Vogel
- Maternal, Child and Adolescent Health ProgramBurnet InstituteMelbourneVictoriaAustralia
| | - Liz Comrie‐Thomson
- Maternal, Child and Adolescent Health ProgramBurnet InstituteMelbourneVictoriaAustralia,Department of Epidemiology and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia,Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
| | - Veronica Pingray
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
| | - Luis Gadama
- College of MedicineDepartment of Obstetrics and GynaecologyUniversity of MalawiZombaMalawi
| | - Hadiza Galadanci
- Africa Center of Excellence for Population Health and PolicyBayero UniversityKano StateNigeria
| | - Shivaprasad Goudar
- KLE Academy of Higher Education and ResearchJ N Medical CollegeBelagaviKarnatakaIndia
| | - Rose Laisser
- Archbishop Antony Mayala School of NursingCatholic University of Health and Allied Health SciencesMwanzaTanzania
| | - Tina Lavender
- Division of Nursing, Midwifery and Social WorkSchool of Health SciencesFaculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - David Lissauer
- Malawi‐Liverpool‐Wellcome Trust Research InstituteQueen Elizabeth Central HospitalCollege of MedicineBlantyreMalawi,Institute of Lifecourse and Medical SciencesUniversity of LiverpoolLiverpoolUK
| | - Sujata Misra
- Fakir Mohan Medical College & HospitalBalasoreOdishaIndia
| | - Yeshita Pujar
- KLE Academy of Higher Education and ResearchJ N Medical CollegeBelagaviKarnatakaIndia
| | - Zahida P. Qureshi
- Department of Obstetrics and GynaecologySchool of MedicineUniversity of NairobiNairobiKenya
| | - Taiwo Amole
- Africa Center of Excellence for Population Health and PolicyBayero UniversityKano StateNigeria
| | - Mabel Berrueta
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
| | - Faisal Dankishiya
- Africa Center of Excellence for Population Health and PolicyBayero UniversityKano StateNigeria
| | - George Gwako
- Department of Obstetrics and GynaecologySchool of MedicineUniversity of NairobiNairobiKenya
| | - Caroline S. E. Homer
- Maternal, Child and Adolescent Health ProgramBurnet InstituteMelbourneVictoriaAustralia
| | - Jonathan Jobanputra
- Malawi‐Liverpool‐Wellcome Trust Research InstituteQueen Elizabeth Central HospitalCollege of MedicineBlantyreMalawi
| | - Sam Meja
- Queen Elizabeth Central HospitalBlantyreMalawi
| | - Carolina Nigri
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
| | | | - Alfred Osoti
- Department of Obstetrics and GynaecologySchool of MedicineUniversity of NairobiNairobiKenya
| | - Javier Roberti
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
| | | | | | - Gianna Robbers
- Maternal, Child and Adolescent Health ProgramBurnet InstituteMelbourneVictoriaAustralia
| | - Shireen Sutherland
- Malawi‐Liverpool‐Wellcome Trust Research InstituteQueen Elizabeth Central HospitalCollege of MedicineBlantyreMalawi
| | - Sunil Vernekar
- KLE Academy of Higher Education and ResearchJ N Medical CollegeBelagaviKarnatakaIndia
| | - Fernando Althabe
- Development and Research Training in Human Reproduction (HRP)Department of Sexual and Reproductive Health and ResearchUNDP/UNFPAUNICEF/WHO/World Bank Special Programme of ResearchWorld Health OrganizationGenevaSwitzerland
| | - Mercedes Bonet
- Development and Research Training in Human Reproduction (HRP)Department of Sexual and Reproductive Health and ResearchUNDP/UNFPAUNICEF/WHO/World Bank Special Programme of ResearchWorld Health OrganizationGenevaSwitzerland
| | - Olufemi T. Oladapo
- Development and Research Training in Human Reproduction (HRP)Department of Sexual and Reproductive Health and ResearchUNDP/UNFPAUNICEF/WHO/World Bank Special Programme of ResearchWorld Health OrganizationGenevaSwitzerland
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14
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Costa M, Correard F, Montaleytang M, Baumstarck K, Loubière S, Amichi K, Villani P, Honore S, Daumas A, Verger P. Acceptability of a Novel Telemedication Review for Older Adults in Nursing Homes in France: A Qualitative Study. Clin Interv Aging 2021; 16:19-34. [PMID: 33442242 PMCID: PMC7800438 DOI: 10.2147/cia.s283496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/17/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose In France, polypharmacy among older people living in nursing homes (NH) is a major public health concern. In this context, the randomized controlled trial TEM-EHPAD was recently launched in various NH in southern France to evaluate the impact of implementing a novel telemedication review (TMR) on hospital admission rates of NH residents at high risk of iatrogenic disease. A qualitative study was integrated into the main trial study to assess general practitioners' (GP) and other NH healthcare professionals' (HP) acceptability of the proposed TMR before its implementation. Material and Methods A qualitative study using face-to-face semi-structured interviews was conducted with 16 HP before the beginning of the intervention. A manual thematic analysis was performed on the transcribed interviews. Results Four main themes emerged from the thematic analysis: HP perceptions of the TMR, difficulties related to medication management for NH residents, HP perceptions of the roles of different professionals, and facilitators of good practices. Most participants were favorable to the TMR, but some GP expressed fears about loss of control over their prescription writing. Conclusion This study fulfilled its objective to assess pre-intervention acceptability by GP and other HP. Results provided important information about how to adapt the TMR intervention to make it more acceptable to HP who will be involved in TEM-EHPAD. One of the main recommendations is the importance of providing participating GP with the opportunity to take part in the process of reviewing prescriptions.
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Affiliation(s)
- Marie Costa
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Florian Correard
- AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France.,Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France
| | - Maeva Montaleytang
- AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France.,Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France
| | - Karine Baumstarck
- EA3279, Self-Perceived Health Assessment Research Unit, Aix-Marseille University, Marseille 13385, France
| | - Sandrine Loubière
- EA3279, Self-Perceived Health Assessment Research Unit, Aix-Marseille University, Marseille 13385, France
| | - Kahena Amichi
- Direction de la Recherche Clinique et de l'Innovation (DRCI), AP-HM, Marseille 13354, France
| | - Patrick Villani
- Service de Médecine Interne Gériatrie et Thérapeutique, CHU Sainte Marguerite, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille 13274, France
| | - Stephane Honore
- AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France.,Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France.,Service de Pharmacie Clinique, Faculté de Pharmacie Timone, Aix-Marseille Université, Marseille F-13000, France
| | - Aurélie Daumas
- Service de Médecine Interne Gériatrie et Thérapeutique, CHU Sainte Marguerite, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille 13274, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
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15
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Vest TA, Gazda NP, Schenkat DH, Eckel SF. Practice-enhancing publications about the medication-use process in 2019. Am J Health Syst Pharm 2021; 78:141-153. [PMID: 33119100 DOI: 10.1093/ajhp/zxaa355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This article identifies, prioritizes, and summarizes published literature on the medication-use process (MUP) from calendar year 2019 that can impact health-system pharmacy daily practice. The MUP is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The MUP is defined in this article as having the following components: prescribing/transcribing, dispensing, administration, and monitoring. Articles that evaluated one of the steps were gauged for their usefulness in promoting daily practice change. SUMMARY A PubMed search was conducted in January 2020 for calendar year 2019 using targeted Medical Subject Headings keywords; in addition, searches of the table of contents of selected pharmacy journals were conducted. A total of 4,317 articles were identified. A thorough review identified 66 potentially practice-enhancing articles: 17 for prescribing/transcribing, 17 for dispensing, 7 for administration, and 25 for monitoring. Ranking of the articles for importance by peers led to the selection of key articles from each category. The highest-ranked articles are briefly summarized, with a mention of why each article is important within health-system pharmacy. The other articles are listed for further review and evaluation. CONCLUSION It is important to routinely review the published literature and to incorporate significant findings into daily practice; this article assists in identifying and summarizing the most impactful recently published literature in this area. Health-system pharmacists have an active role in improving the MUP in their institution, and awareness of the significant published studies can assist in changing practice at the institutional level.
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Affiliation(s)
- Tyler A Vest
- Duke University Hospital, Durham, NC.,University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC
| | | | | | - Stephen F Eckel
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC.,University of North Carolina Medical Center, Chapel Hill, NC
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16
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Kujala S, Ammenwerth E, Kolanen H, Ervast M. Applying and Extending the FITT Framework to Identify the Challenges and Opportunities of Successful eHealth Services for Patient Self-Management: Qualitative Interview Study. J Med Internet Res 2020; 22:e17696. [PMID: 32784175 PMCID: PMC7450365 DOI: 10.2196/17696] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/24/2020] [Accepted: 06/03/2020] [Indexed: 01/16/2023] Open
Abstract
Background The number of public eHealth services that support patient self-management is rapidly increasing. However, the implementation of these eHealth services for self-management has encountered challenges. Objective The purpose of this paper was to analyze the challenges and opportunities of implementing eHealth services for self-management by focusing on the fit between the technical solution and clinical use. Methods We performed in-depth interviews with 10 clinical project coordinators and managers who were responsible for developing and implementing various eHealth services for self-management interventions in five university hospitals in Finland. The results were analyzed using content analysis and open coding. The Fit between Individuals, Task, and Technology (FITT) framework was used to interpret the findings. Results The implementation of self-management services involved many challenges related to technical problems, health professional acceptance, patient motivation, and health organization and management. The implementers identified practices to manage the identified challenges, including improving the design of the technology, supporting health professionals in the adoption of the eHealth services, changing the work processes and tasks, involving patients, and collectively planning the implementation inside an organization. The findings could be mostly attributed to the dimensions of the FITT framework. Conclusions The FITT framework helped to analyze the challenges related to the implementation, and most of them were related to poor fit. The importance of patients as stakeholders in eHealth services for patient self-management needs to be highlighted. Thus, we propose that patients should be added as a different type of individual dimension to the FITT framework. In addition, the framework could be extended to include organization and management in a new context dimension.
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Affiliation(s)
- Sari Kujala
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Elske Ammenwerth
- UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Heta Kolanen
- HUS IT Management, HUS Helsinki University Hospital, Helsinki, Finland
| | - Minna Ervast
- Development Unit, Hospital District of South-West Finland, Turku, Finland
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17
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Gaynor M, Schneider D, Seltzer M, Crannage E, Barron ML, Waterman J, Oberle A. A user-centered, learning asthma smartphone application for patients and providers. Learn Health Syst 2020; 4:e10217. [PMID: 32685685 PMCID: PMC7362673 DOI: 10.1002/lrh2.10217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 12/06/2019] [Accepted: 01/02/2020] [Indexed: 11/23/2022] Open
Abstract
PROBLEM Smartphone applications are an increasingly useful part of patients' self-management of chronic health conditions. Asthma is a common chronic health condition for which good self-management by patients is very helpful in maintaining stability. User-centered design and intelligent systems that learn are steps forward in building applications that are more effective in providing quality care that is scalable and tailored to each patient. METHODS A literature and application store search to review historic and current asthma smart phone applications. User-centered design is a methodology that involves all stakeholders of a proposed system from the beginning of the design phase to the end of installation. One aspect of this user-centered approach involved conducting focus groups with patients and health care providers to determine what features they desire for use in applications and create a model to build smart infrastructure for a learning health care system. A simple prototype for an asthma smartphone application is designed and built with basic functionality. OUTCOMES Only one publication in the literature review of asthma smartphone applications describes both user-centered design and intelligent learning systems. The authors have presented a set of user-desired attributes for a smart health care application and a possible data flow diagram of information for a learning system. A prototype simple user-centered designed asthma smartphone application that better assists patients in their care illustrates the value of the proposed architecture. DISCUSSION Our user-centered approach helped design and implement a learning prototype smart phone application to help patients better manage their asthma and provide information to clinical care providers. While popular in other industries, user-centered design has had slow adoption in the health care area. However, the popularity of this approach is increasing and will hopefully result in mobile application that better meets the needs of both patients and their care providers.
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Affiliation(s)
- Mark Gaynor
- Saint Louis University (SLU)College for Public Health and Social Justice (CPHSJ)St. LouisMissouri
| | | | - Margo Seltzer
- University of British ColumbiaVancouverBristish ColumbiaCanada
| | | | | | | | - Andrew Oberle
- Saint Louis University (SLU)College for Public Health and Social Justice (CPHSJ)St. LouisMissouri
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18
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Navarro-Alamán J, Lacuesta R, Garcia-Magariño I, Gallardo J. A methodology for the design and development of gamified mobile apps for monitoring cancer survivors. J Biomed Inform 2020; 106:103439. [PMID: 32380179 DOI: 10.1016/j.jbi.2020.103439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 01/25/2023]
Abstract
An increasing number of cancer patients is treated and recover each year, and consequently there are survivors that require specialized and coordinated follow-up. The physical, social, working, psychological and emotional aspects of these survivors have to be characterized, investigated and treated by multidisciplinary and interdisciplinary teams. Nowadays, oncology community is focused on tracking records of interest in Patient-Reported Outcome (PROs) for patients of different cancer types. In the last years, several articles have proven that PROs are an effective method to improve the management of patient symptoms and, subsequently, clinical care. In this scenario, patient engagement is one of the most relevant aspects for PROs success. In this sense, one of the most promising strategies for increasing engagement is gamification, that is, the introduction of game elements in systems that are not games. Therefore, in this work we introduce a methodology for developing gamification apps for cancer survivors that aims at increasing engagement when collecting PROs data.
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Affiliation(s)
- Javier Navarro-Alamán
- Department of Computer Science and Engineering of Systems, University of Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón. University of Zaragoza, Zaragoza, Spain.
| | - Raquel Lacuesta
- Department of Computer Science and Engineering of Systems, University of Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón. University of Zaragoza, Zaragoza, Spain.
| | - Iván Garcia-Magariño
- Department of Software Engineering and Artificial Intelligence, Complutense University of Madrid, c/ Prof. José García Santesmases 9, 28040 Madrid, Spain; Instituto de Tecnología del Conocimiento, UCM, c/ Prof. José García Santesmases 9, 28040 Madrid, Spain.
| | - Jesús Gallardo
- Department of Computer Science and Engineering of Systems, University of Zaragoza, Spain.
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19
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Jiamsanguanwong A, Tientrakul P, Sookseng F, Ophaswongse C, Kittithreerapronchai O. System improvement of medicine delivery service: Case study of traditional Chinese medicine. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1723945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Pattarapa Tientrakul
- Department of Industrial Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Fuanglada Sookseng
- Department of Industrial Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Chayapol Ophaswongse
- Department of Industrial Engineering, Chulalongkorn University, Bangkok, Thailand
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