Using Tablet Computers to Increase Patient Engagement With Electronic Personal Health Records: Protocol For a Prospective, Randomized Interventional Study

S Ryan Greysen, Yimdriuska Magan Mendoza, Jaime Rosenthal, Ronald Jacolbia, Alvin Rajkomar, Herman Lee, Andrew Auerbach, S Ryan Greysen, Yimdriuska Magan Mendoza, Jaime Rosenthal, Ronald Jacolbia, Alvin Rajkomar, Herman Lee, Andrew Auerbach

Abstract

Background: Inadequate patient engagement in care is a major barrier to successful transitions from the inpatient setting and can lead to preventable adverse events after discharge, particularly for older adults. While older adults may be less familiar with mobile devices and applications, they may benefit from focused bedside training to engage them in using their Personal Health Record (PHR). Mobile technologies such as tablet computers can be used in the hospital to help bridge this gap in experience by teaching older, hospitalized patients to actively manage their medication list through their PHR during hospitalization and continue to use their PHR for other post-discharge tasks such as scheduling follow-up appointments, viewing test results, and communicating with providers. Bridging this gap is especially important for older, hospitalized adults as they are at higher risk than younger populations for low engagement in transitions of care and poor outcomes such as readmission. Greater understanding of the advantages and limitations of mobile devices for older adults may be important for improving transitions of care.

Objective: To better understand the effective use of mobile technologies to improve transitions in care for hospitalized, older adults and leverage these technologies to improve inpatient and postdischarge care for older adults.

Methods: We will compare an intervention group with tablet-based training to engage effectively with their PHR to a control group also receiving tablets and basic access to their PHR but no additional training on how to engage with their PHR.

Results: Patient enrollment is ongoing.

Conclusions: Through this grant, we will further develop our preliminary dataset and practical experience with these mobile technologies to catalyze patient engagement during hospitalization.

Clinicaltrial: ClinicalTrials.gov NCT02109601; https://ichgcp.net/clinical-trials-registry/NCT02109601 (Archived by WebCite at http://www.webcitation.org/6jpXjkwM8).

Keywords: mobile health; older adults; patient engagement.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Inpatient iPad tablet daily workflow.

References

    1. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003 Feb 4;138(3):161–167.
    1. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. Adverse drug events occurring following hospital discharge. J Gen Intern Med. 2005 Apr;20(4):317–323. doi: 10.1111/j.1525-1497.2005.30390.x.
    1. Coleman EA, Smith JD, Raha D, Min S. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med. 2005 Sep 12;165(16):1842–1847. doi: 10.1001/archinte.165.16.1842.
    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418–1428. doi: 10.1056/NEJMsa0803563.
    1. Centers for Medicare & Medicaid Services (CMS)‚ HHS Medicare program; hospital inpatient value-based purchasing program. Final rule. Fed Regist. 2011 May 6;76(88):26490–26547.
    1. Kocher RP, Adashi EY. Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. JAMA. 2011 Oct 26;306(16):1794–1795. doi: 10.1001/jama.2011.1561.
    1. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, Forsythe SR, O'Donnell JK, Paasche-Orlow MK, Manasseh C, Martin S, Culpepper L. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009 Feb 3;150(3):178–187.
    1. Coleman EA, Parry C, Chalmers S, Min S. The care transitions intervention: results of a randomized controlled trial. Arch Intern Med. 2006 Sep 25;166(17):1822–1828. doi: 10.1001/archinte.166.17.1822.
    1. Schnipper JL, Liang CL, Hamann C, Karson AS, Palchuk MB, McCarthy PC, Sherlock M, Turchin A, Bates DW. Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge. J Am Med Inform Assoc. 2011 May 1;18(3):309–313. doi: 10.1136/amiajnl-2010-000040.
    1. Schnipper JL, Hamann C, Ndumele CD, Liang CL, Carty MG, Karson AS, Bhan I, Coley CM, Poon E, Turchin A, Labonville SA, Diedrichsen EK, Lipsitz S, Broverman CA, McCarthy P, Gandhi TK. Effect of an electronic medication reconciliation application and process redesign on potential adverse drug events: a cluster-randomized trial. Arch Intern Med. 2009 Apr 27;169(8):771–780. doi: 10.1001/archinternmed.2009.51.
    1. Turchin A, Hamann C, Schnipper JL, Graydon-Baker E, Millar SG, McCarthy PC, Coley CM, Gandhi TK, Broverman CA. Evaluation of an inpatient computerized medication reconciliation system. J Am Med Inform Assoc. 2008;15(4):449–452. doi: 10.1197/jamia.M2561.
    1. Murphy KC, Wong FL, Martin LA, Edmiston D. Ongoing evaluation of ease-of-use and usefulness of wireless tablet computers within an ambulatory care unit. Stud Health Technol Inform. 2009;143:459–464.
    1. Patel BK, Chapman CG, Luo N, Woodruff JN, Arora VM. Impact of mobile tablet computers on internal medicine resident efficiency. Arch Intern Med. 2012 Mar 12;172(5):436–438. doi: 10.1001/archinternmed.2012.45.
    1. Kho A, Henderson LE, Dressler DD, Kripalani S. Use of handheld computers in medical education. A systematic review. J Gen Intern Med. 2006 May;21(5):531–537. doi: 10.1111/j.1525-1497.2006.00444.x.
    1. Cockerham M. Use of a tablet personal computer to enhance patient care on multidisciplinary rounds. Am J Health Syst Pharm. 2009 Nov 1;66(21):1909–1911. doi: 10.2146/ajhp080593.
    1. Prgomet M, Georgiou A, Westbrook JI. The impact of mobile handheld technology on hospital physicians' work practices and patient care: a systematic review. J Am Med Inform Assoc. 2009;16(6):792–801. doi: 10.1197/jamia.M3215.
    1. McCreadie SR, McGregory ME. Experiences incorporating Tablet PCcs into clinical pharmacists' workflow. J Healthc Inf Manag. 2005;19(4):32–37.
    1. Vawdrey DK, Wilcox LG, Collins SA, Bakken S, Feiner S, Boyer A, Restaino SW. A tablet computer application for patients to participate in their hospital care. AMIA Annu Symp Proc. 2011;2011:1428–1435.
    1. Ludwin S, Greysen SR. Use of smartphones and mobile devices in hospitalized patients: Untapped opportunities for inpatient engagement. J Hosp Med. 2015 Jul;10(7):459–461. doi: 10.1002/jhm.2365.
    1. Older adults and technology use. Washington, DC: Pew Internet and American Life Project; 2014. Apr 03, [2016-07-28]. .

Source: PubMed

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