Wilcox Lauren, Woollen Janet, Prey Jennifer, Restaino Susan, Bakken Suzanne, Feiner Steven, Sackeim Alexander, Vawdrey David K
School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, USA Department of Computer Science, Columbia University, New York, NY, USA
Department of Biomedical Informatics, Columbia University, New York, NY, USA.
J Am Med Inform Assoc. 2016 Jan;23(1):144-58. doi: 10.1093/jamia/ocv160. Epub 2016 Jan 7.
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.
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.
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.
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.
先前关于支持患者用药知识和自我管理的计算应用程序的研究，为有效的应用程序设计提供了有价值的见解，但未涉及住院环境。本研究首次探讨支持住院患者用药管理和跟踪的面向患者工具的设计和实用性。
我们通过迭代的、以用户为中心的方法设计了myNYP住院患者应用程序，这是一个定制的个人健康记录应用程序。myNYP住院患者应用程序中的用药跟踪工具包括家庭和医院用药数据的交互式视图以及对这些数据进行评论的功能。在一项两阶段的试点研究中，患者在哥伦比亚大学医学中心心胸外科术后护理期间使用了这些工具。在第一阶段，我们为20名患者提供该应用程序24至48小时，并在此期间结束后进行了一次结束访谈。在第二阶段，我们对12名患者和5名临床药剂师进行了半结构化访谈，他们根据在第一阶段收到的反馈对工具的改进进行了评估。
患者报告称用药跟踪工具很有用。在第一阶段，20名参与者中有14名积极使用这些工具，以查看用药清单并记录关于他们药物的评论和问题。患者的访谈回复和审核日志显示，他们经常使用医院用药功能，并发现对问题和评论进行电子报告很有用。我们还发现了此类工具后续设计的重要考虑因素。在第二阶段，参与研究的患者和药剂师确认了改进后工具的可用性和实用性。
住院患者用药跟踪工具在设计上满足患者需求时，可在促进患者在住院期间参与自身护理以及患者与提供者沟通方面发挥重要作用。
