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数字时代的处方平板电脑:一项探索患者和医生对使用平板电脑进行基于诊所的个性化医疗保健信息交流态度的横断面研究。

Prescription Tablets in the Digital Age: A Cross-Sectional Study Exploring Patient and Physician Attitudes Toward the Use of Tablets for Clinic-Based Personalized Health Care Information Exchange.

作者信息

Patel Vishal, Hale Timothy M, Palakodeti Sandeep, Kvedar Joseph C, Jethwani Kamal

机构信息

Kaiser Permanente, San Francisco, CA, United States.

出版信息

JMIR Res Protoc. 2015 Oct 19;4(4):e116. doi: 10.2196/resprot.3806.

Abstract

BACKGROUND

To reduce the cost of health care while increasing efficiency and quality, health systems are seeking innovative means to engage and empower patients. Improved use of information technology and electronic health record (EHR) infrastructure is essential, and required for "meaningful use" as mandated by the federal government. Providing personalized health information using tablets at the point of care could enhance the clinical experience and enable efficient collection of patient reported outcome measures to guide clinical decision making.

OBJECTIVE

The aim of this study is to explore patient and provider attitudes and interest in a proposed clinic-based tablet system for personal health information exchange. To provide a context to understand patients' use of tablets during their clinic visit, we also examine patients' current activities and time spent in the waiting room, and their use of health information resources.

METHODS

Surveys were administered to 84 patients in the waiting room of a community health center affiliated with Massachusetts General Hospital (MGH) in Boston, MA. This survey included a vignette and illustration describing a proposed tablet-based system in which the patient, upon sign in at the clinic, receives a tablet loaded with personalized information tailored to their specific medical conditions and preferences. Patients were queried about their interest in such a system in comparison to traditional forms of patient education as well as their current health information seeking behaviors and activities and time spent in the waiting room. Interviews with five MGH-affiliated health care providers were conducted to assess their opinions regarding the proposed tablet system.

RESULTS

The majority (>60%) of patients were "very" or "extremely" interested in the proposed tablet system and thought it would improve their knowledge about their medical condition (60%), assist them in making healthy choices (57%), and help them to feel more comfortable talking with their provider (55%). Patients thought the system would be more motivating, informative, and engaging than traditional printed health education materials. The tablet system was not considered more effective than face-to-face interaction with providers, though 44% thought it would improve their relationship with their physician. Overall, 91% of respondents were willing to learn how to use a tablet and 75% reported being "very" or "extremely" confident they could use one. Four of the five providers believed that the proposed tablet system would improve clinical workflow and patient education. Patients and providers were concerned about privacy and security of data collected using the tablets.

CONCLUSIONS

Both patients and providers were highly amenable to integrating tablets into the clinical experience, and tablets may be useful in improving patients' health knowledge, the collection of patient reported outcome measures, and improved patient-provider communication. Further research into operationalizing such systems and their validation is necessary before integration into standard clinical practice.

摘要

背景

为了在提高效率和质量的同时降低医疗成本,卫生系统正在寻求创新方法来让患者参与并赋予其权力。更好地利用信息技术和电子健康记录(EHR)基础设施至关重要,也是联邦政府规定的“有意义使用”所必需的。在护理点使用平板电脑提供个性化健康信息可以提升临床体验,并能高效收集患者报告的结局指标以指导临床决策。

目的

本研究的目的是探讨患者和医护人员对一种提议的基于诊所的平板电脑系统用于个人健康信息交换的态度和兴趣。为了提供背景以了解患者在诊所就诊期间对平板电脑的使用情况,我们还考察了患者当前在候诊室的活动、花费的时间以及他们对健康信息资源的使用情况。

方法

对马萨诸塞州波士顿市麻省总医院(MGH)附属社区健康中心候诊室的84名患者进行了调查。该调查包括一个短文和一幅插图,描述了一个提议的基于平板电脑的系统,在该系统中,患者在诊所签到时会收到一台加载了根据其特定医疗状况和偏好量身定制的个性化信息的平板电脑。与传统形式的患者教育相比,询问患者对这样一个系统的兴趣,以及他们当前的健康信息寻求行为、活动和在候诊室花费的时间。对五名与MGH有关联的医护人员进行了访谈,以评估他们对提议的平板电脑系统的看法。

结果

大多数(>60%)患者对提议的平板电脑系统“非常”或“极其”感兴趣,并认为它会提高他们对自身病情的了解(60%),帮助他们做出健康选择(57%),并帮助他们在与医护人员交谈时感觉更自在(55%)。患者认为该系统比传统的印刷健康教育材料更具激励性、信息性和吸引力。虽然44%的患者认为平板电脑系统会改善他们与医生的关系,但该系统并不被认为比与医护人员面对面互动更有效。总体而言,91%的受访者愿意学习如何使用平板电脑,75%的受访者表示“非常”或“极其”有信心能够使用。五名医护人员中有四名认为提议的平板电脑系统会改善临床工作流程和患者教育。患者和医护人员担心使用平板电脑收集的数据的隐私和安全问题。

结论

患者和医护人员都非常愿意将平板电脑融入临床体验,平板电脑可能有助于提高患者的健康知识、收集患者报告的结局指标以及改善医患沟通。在将此类系统整合到标准临床实践之前,有必要对其实施和验证进行进一步研究。

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