Westphal Monika, Yom-Tov Galit Bracha, Parush Avi, Carmeli Nitzan, Shaulov Alina, Shapira Chen, Rafaeli Anat
Technion - Israel Institute of Technology, Haifa, Israel.
JMIR Form Res. 2020 Feb 25;4(2):e16410. doi: 10.2196/16410.
Medical care is highly complex in that it addresses patient-centered health goals that require the coordination of multiple care providers. Emergency department (ED) patients currently lack a sense of predictability about ED procedures. This increases frustration and aggression. Herein, we describe a system for providing real-time information to ED patients regarding the procedures in their ED medical journey.
This study aimed to develop a system that provides patients with dynamically updated information about the specific procedures and expected waiting times in their personal ED journey, and to report initial evaluations of this system.
To develop the myED system, we extracted information from hospital databases and translated it using process mining and user interface design into a language that is accessible and comprehensible to patients. We evaluated the system using a mixed methods approach that combined observations, interviews, and online records.
Interviews with patients, accompanying family members, and health care providers (HCPs) confirmed patients' needs for information about their personal ED journey. The system developed enables patients to access this information on their personal mobile phones through a responsive website. In the third month after deployment, 492 of 1614 (30.48%) patients used myED. Patients' understanding of their ED journey improved significantly (F=2.519; P=.01), and patients showed positive reactions to the system. We identified future challenges, including achieving quick engagement without delaying medical care. Salient reasons for poor system adoption were patients' medical state and technological illiteracy. HCPs confirmed the potential of myED and identified means that could improve patient experience and staff cooperation.
Our iterative work with ED patients, HCPs, and a multidisciplinary team of developers yielded a system that provides personal information to patients about their ED journey in a secure, effective, and user-friendly way. MyED communicates this information through mobile technology. This improves health care by addressing patients' psychological needs for information and understanding, which are often overlooked. We continue to test and refine the system and expect to find positive effects of myED on patients' ED experience and hospital operations.
医疗保健极为复杂，因为它要实现以患者为中心的健康目标，这需要多个护理提供者之间的协调。急诊科（ED）患者目前对急诊程序缺乏可预测感。这增加了他们的挫败感和攻击性。在此，我们描述一种向急诊科患者提供其急诊医疗过程中相关程序实时信息的系统。
本研究旨在开发一个系统，为患者提供其个人急诊过程中特定程序及预期等待时间的动态更新信息，并报告该系统的初步评估情况。
为开发“我的急诊”（myED）系统，我们从医院数据库中提取信息，并通过流程挖掘和用户界面设计将其转化为患者易懂的语言。我们采用混合方法对该系统进行评估，该方法结合了观察、访谈和在线记录。
对患者、陪同家属和医疗保健提供者（HCPs）的访谈证实了患者对其个人急诊过程信息的需求。所开发的系统使患者能够通过响应式网站在其个人手机上获取此信息。在部署后的第三个月，1614名患者中有492名（30.48%）使用了myED。患者对其急诊过程的理解有显著改善（F = 2.519；P = 0.01），并且患者对该系统表现出积极反应。我们确定了未来的挑战，包括在不延迟医疗护理的情况下实现快速参与。系统采用率低的主要原因是患者的医疗状况和技术文盲。HCPs确认了myED的潜力，并确定了可以改善患者体验和医护人员合作的方法。
我们与急诊科患者、HCPs以及多学科开发团队的迭代工作产生了一个系统，该系统以安全、有效且用户友好的方式为患者提供其急诊过程的个人信息。MyED通过移动技术传达此信息。这通过满足患者对信息和理解的心理需求改善了医疗保健，而这些需求往往被忽视。我们继续测试和完善该系统，并期望发现myED对患者急诊体验和医院运营产生积极影响。
