Anand V, McKee S, Dugan T M, Downs S M
Pediatric Institute , Cleveland Clinic, Cleveland, OH.
Childrens Health Services Research, School of Medicine, Indiana University , IN.
Appl Clin Inform. 2015 Jan 7;6(1):1-15. doi: 10.4338/ACI-2014-09-RA-0071. eCollection 2015.
We have previously shown that a scan-able paper based interface linked to a computerized clinical decision support system (CDSS) can effectively screen patients in pediatric waiting rooms and support the physician using evidence based care guidelines at the time of clinical encounter. However, the use of scan-able paper based interface has many inherent limitations including lacking real time communication with the CDSS and being prone to human and system errors. An electronic tablet based user interface can not only overcome these limitations, but may also support advanced functionality for clinical and research use. However, use of such devices for pediatric care is not well studied in clinical settings.
In this pilot study, we enhance our pediatric CDSS with an electronic tablet based user interface and evaluate it for usability as well as for changes in patient questionnaire completion rates.
Child Health Improvement through Computers Leveraging Electronic Tablets or CHICLET is an electronic tablet based user interface. It is developed to augment the existing scan-able paper interface to our CDSS. For the purposes of this study, we deployed CHICLET in one outpatient pediatric clinic. Usability factors for CHICLET were evaluated via caregiver and staff surveys.
When compared to the scan-able paper based interface, we observed an 18% increase or 30% relative increase in question completion rates using CHICLET. This difference was statistically significant. Caregivers and staff survey results were positive for using CHICLET in clinical environment.
Electronic tablets are a viable interface for capturing patient self-report in pediatric waiting rooms. We further hypothesize that the use of electronic tablet based interfaces will drive advances in computerized clinical decision support and create opportunities for patient engagement.
我们之前已经表明,与计算机化临床决策支持系统(CDSS)相连的可扫描纸质界面能够有效地在儿科候诊室筛查患者,并在临床会诊时帮助医生遵循循证护理指南。然而,可扫描纸质界面存在许多固有局限性,包括无法与CDSS进行实时通信,并且容易出现人为和系统错误。基于电子平板电脑的用户界面不仅可以克服这些局限性,还可能支持临床和研究使用的高级功能。然而,在临床环境中,此类设备在儿科护理中的应用尚未得到充分研究。
在这项试点研究中,我们通过基于电子平板电脑的用户界面增强了儿科CDSS,并对其可用性以及患者问卷完成率的变化进行评估。
通过计算机利用电子平板电脑改善儿童健康(CHICLET)是一种基于电子平板电脑的用户界面。它是为增强我们CDSS现有的可扫描纸质界面而开发的。在本研究中,我们在一家儿科门诊诊所部署了CHICLET。通过对护理人员和工作人员的调查来评估CHICLET的可用性因素。
与可扫描纸质界面相比,我们发现使用CHICLET时问题完成率提高了18%,即相对提高了30%。这一差异具有统计学意义。护理人员和工作人员对在临床环境中使用CHICLET的调查结果呈积极态度。
电子平板电脑是在儿科候诊室获取患者自我报告的可行界面。我们进一步推测,基于电子平板电脑的界面的使用将推动计算机化临床决策支持的进步,并为患者参与创造机会。