Ross Stephen E, Johnson Kevin B, Siek Katie A, Gordon Jeffry S, Khan Danish U, Haverhals Leah M
Division of General Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
J Med Internet Res. 2011 Jul 12;13(3):e45. doi: 10.2196/jmir.1815.
Adverse drug events are a major safety issue in ambulatory care. Improving medication self-management could reduce these adverse events. Researchers have developed medication applications for tethered personal health records (PHRs), but little has been reported about medication applications for interoperable PHRs.
Our objective was to develop two complementary personal health applications on a common PHR platform: one to assist children with complex health needs (MyMediHealth), and one to assist older adults in care transitions (Colorado Care Tablet).
The applications were developed using a user-centered design approach. The two applications shared a common PHR platform based on a service-oriented architecture. MyMediHealth employed Web and mobile phone user interfaces. Colorado Care Tablet employed a Web interface customized for a tablet PC.
We created complementary medication management applications tailored to the needs of distinctly different user groups using common components. Challenges were addressed in multiple areas, including how to encode medication identities, how to incorporate knowledge bases for medication images and consumer health information, how to include supplementary dosing information, how to simplify user interfaces for older adults, and how to support mobile devices for children.
These prototypes demonstrate the utility of abstracting PHR data and services (the PHR platform) from applications that can be tailored to meet the needs of diverse patients. Based on the challenges we faced, we provide recommendations on the structure of publicly available knowledge resources and the use of mobile messaging systems for PHR applications.
药物不良事件是门诊医疗中的一个重大安全问题。改善药物自我管理可以减少这些不良事件。研究人员已经为绑定式个人健康记录（PHR）开发了药物应用程序，但关于可互操作的PHR的药物应用程序的报道却很少。
我们的目标是在一个通用的PHR平台上开发两个互补的个人健康应用程序：一个用于帮助有复杂健康需求的儿童（MyMediHealth），另一个用于帮助老年人进行护理过渡（科罗拉多护理平板电脑）。
这些应用程序采用以用户为中心的设计方法开发。这两个应用程序基于面向服务的架构共享一个通用的PHR平台。MyMediHealth采用网络和手机用户界面。科罗拉多护理平板电脑采用为平板电脑定制的网络界面。
我们使用通用组件创建了针对截然不同用户群体需求的互补药物管理应用程序。在多个领域解决了挑战，包括如何编码药物标识、如何纳入药物图像和消费者健康信息的知识库、如何包含补充剂量信息、如何简化老年人的用户界面以及如何支持儿童使用移动设备。
这些原型展示了从可定制以满足不同患者需求的应用程序中抽象出PHR数据和服务（PHR平台）的效用。基于我们面临的挑战，我们就公开可用知识资源的结构以及PHR应用中移动消息系统的使用提供了建议。
