Interactive Tools for Inpatient Medication Tracking: a Multi-phase Study with Cardiothoracic Surgery Patients

Overview

Journal J Am Med Inform Assoc

Publisher Oxford University Press

Specialty Medical Informatics

Date 2016 Jan 9

PMID 26744489

Citations 30

Authors

Lauren Wilcox

Janet Woollen

Jennifer Prey

Susan Restaino

Suzanne Bakken

Steven Feiner

Alexander Sackeim

David K Vawdrey

Affiliations

Soon will be listed here.

Abstract

Objective: Prior studies of computing applications that support patients' medication knowledge and self-management offer valuable insights into effective application design, but do not address inpatient settings. This study is the first to explore the design and usefulness of patient-facing tools supporting inpatient medication management and tracking.

Materials And Methods: We designed myNYP Inpatient, a custom personal health record application, through an iterative, user-centered approach. Medication-tracking tools in myNYP Inpatient include interactive views of home and hospital medication data and features for commenting on these data. In a two-phase pilot study, patients used the tools during cardiothoracic postoperative care at Columbia University Medical Center. In Phase One, we provided 20 patients with the application for 24-48 h and conducted a closing interview after this period. In Phase Two, we conducted semi-structured interviews with 12 patients and 5 clinical pharmacists who evaluated refinements to the tools based on the feedback received during Phase One.

Results: Patients reported that the medication-tracking tools were useful. During Phase One, 14 of the 20 participants used the tools actively, to review medication lists and log comments and questions about their medications. Patients' interview responses and audit logs revealed that they made frequent use of the hospital medications feature and found electronic reporting of questions and comments useful. We also uncovered important considerations for subsequent design of such tools. In Phase Two, the patients and pharmacists participating in the study confirmed the usability and usefulness of the refined tools.

Conclusions: Inpatient medication-tracking tools, when designed to meet patients' needs, can play an important role in fostering patient participation in their own care and patient-provider communication during a hospital stay.

Citing Articles

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating.

Reynolds T, Cobb J, Steitz B, Ancker J, Rosenbloom S Appl Clin Inform. 2023; 14(4):654-669.

PMID: 37611795 PMC: 10446914. DOI: 10.1055/s-0043-1770901.

Patient engagement in perioperative settings: A mixed method systematic review.

Cooper Z, Cleary S, Stelmach W, Zheng Z J Clin Nurs. 2023; 32(17-18):5865-5885.

PMID: 37073113 PMC: 10946744. DOI: 10.1111/jocn.16709.

Attitude and Needs Toward MTM Applications of Chronic Disease in China: A Questionnaire Survey.

Huang S, Huang J, Deng X, Ouyang L, He G, Sun J Front Public Health. 2022; 10:812709.

PMID: 35968452 PMC: 9372339. DOI: 10.3389/fpubh.2022.812709.

Articulation of postsurgical patient discharges: coordinating care transitions from hospital to home.

Abraham J, Kandasamy M, Huggins A J Am Med Inform Assoc. 2022; 29(9):1546-1558.

PMID: 35713640 PMC: 9382373. DOI: 10.1093/jamia/ocac099.

Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review.

Harahap N, Handayani P, Hidayanto A J Med Internet Res. 2021; 23(7):e26236.

PMID: 34287210 PMC: 8339989. DOI: 10.2196/26236.

References

Miller N, Lacroix E, Backus J . MEDLINEplus: building and maintaining the National Library of Medicine's consumer health Web service. Bull Med Libr Assoc. 2000; 88(1):11-7. PMC: 35193. View

BECKER M, Maiman L . Sociobehavioral determinants of compliance with health and medical care recommendations. Med Care. 1975; 13(1):10-24. DOI: 10.1097/00005650-197501000-00002. View

Bodenheimer T, Wagner E, Grumbach K . Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002; 288(15):1909-14. DOI: 10.1001/jama.288.15.1909. View

Cimino J, Patel V, Kushniruk A . The patient clinical information system (PatCIS): technical solutions for and experience with giving patients access to their electronic medical records. Int J Med Inform. 2002; 68(1-3):113-27. DOI: 10.1016/s1386-5056(02)00070-9. View

Hibbard J . Engaging health care consumers to improve the quality of care. Med Care. 2003; 41(1 Suppl):I61-70. DOI: 10.1097/00005650-200301001-00007. View

Kushniruk A, Patel V . Cognitive and usability engineering methods for the evaluation of clinical information systems. J Biomed Inform. 2004; 37(1):56-76. DOI: 10.1016/j.jbi.2004.01.003. View

Hibbard J, Stockard J, Mahoney E, Tusler M . Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004; 39(4 Pt 1):1005-26. PMC: 1361049. DOI: 10.1111/j.1475-6773.2004.00269.x. View

Trachtenberg F, Dugan E, Hall M . How patients' trust relates to their involvement in medical care. J Fam Pract. 2005; 54(4):344-52. View

Moen A, Brennan P . Health@Home: the work of health information management in the household (HIMH): implications for consumer health informatics (CHI) innovations. J Am Med Inform Assoc. 2005; 12(6):648-56. PMC: 1294036. DOI: 10.1197/jamia.M1758. View

10.

Farmer T, Robinson K, Elliott S, Eyles J . Developing and implementing a triangulation protocol for qualitative health research. Qual Health Res. 2006; 16(3):377-94. DOI: 10.1177/1049732305285708. View

11.

Fuertes J, Mislowack A, Bennett J, Paul L, Gilbert T, Fontan G . The physician-patient working alliance. Patient Educ Couns. 2006; 66(1):29-36. DOI: 10.1016/j.pec.2006.09.013. View

12.

Clever S, Jin L, Levinson W, Meltzer D . Does doctor-patient communication affect patient satisfaction with hospital care? Results of an analysis with a novel instrumental variable. Health Serv Res. 2008; 43(5 Pt 1):1505-19. PMC: 2653895. DOI: 10.1111/j.1475-6773.2008.00849.x. View

13.

Businger A, Buckel L, Gandhi T, Grant R, Poon E, Schnipper J . Patient review of selected electronic health record data improves visit experience. AMIA Annu Symp Proc. 2008; :887. View

14.

Kaelber D, Jha A, Johnston D, Middleton B, Bates D . A research agenda for personal health records (PHRs). J Am Med Inform Assoc. 2008; 15(6):729-36. PMC: 2585530. DOI: 10.1197/jamia.M2547. View

15.

Jaspers M . A comparison of usability methods for testing interactive health technologies: methodological aspects and empirical evidence. Int J Med Inform. 2008; 78(5):340-53. DOI: 10.1016/j.ijmedinf.2008.10.002. View

16.

Cumbler E, Wald H, Kutner J . Lack of patient knowledge regarding hospital medications. J Hosp Med. 2009; 5(2):83-6. DOI: 10.1002/jhm.566. View

17.

OLeary K, Kulkarni N, Landler M, Jeon J, Hahn K, Englert K . Hospitalized patients' understanding of their plan of care. Mayo Clin Proc. 2010; 85(1):47-52. PMC: 2800283. DOI: 10.4065/mcp.2009.0232. View

18.

Reti S, Feldman H, Ross S, Safran C . Improving personal health records for patient-centered care. J Am Med Inform Assoc. 2010; 17(2):192-5. PMC: 3000780. DOI: 10.1136/jamia.2009.000927. View

19.

Brennan P, Casper G, Burke L, Johnson K, Brown R, Valdez R . Technology-enhanced practice for patients with chronic cardiac disease: home implementation and evaluation. Heart Lung. 2010; 39(6 Suppl):S34-46. PMC: 3033014. DOI: 10.1016/j.hrtlng.2010.09.003. View

20.

Siek K, Khan D, Ross S, Haverhals L, Meyers J, Cali S . Designing a personal health application for older adults to manage medications: a comprehensive case study. J Med Syst. 2011; 35(5):1099-121. DOI: 10.1007/s10916-011-9719-9. View