Cho Jungwon, Yoo Sooyoung, Lee Eunkyung Euni, Lee Ho-Young
College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
JMIR Med Inform. 2024 Mar 20;12:e53079. doi: 10.2196/53079.
Timely and comprehensive collection of a patient's medication history in the emergency department (ED) is crucial for optimizing health care delivery. The implementation of a medication history sharing program, titled "Patient's In-home Medications at a Glance," in a tertiary teaching hospital aimed to efficiently collect and display nationwide medication histories for patients' initial hospital visits.
As an evaluation was necessary to provide a balanced picture of the program, we aimed to evaluate both care process outcomes and humanistic outcomes encompassing end-user experience of physicians and pharmacists.
We conducted a cohort study and a cross-sectional study to evaluate both outcomes. To evaluate the care process, we measured the time from the first ED assessment to urgent percutaneous coronary intervention (PCI) initiation from electronic health records. To assess end-user experience, we developed a 22-item questionnaire using a 5-point Likert scale, including 5 domains: information quality, system quality, service quality, user satisfaction, and intention to reuse. This questionnaire was validated and distributed to physicians and pharmacists. The Mann-Whiteny U test was used to analyze the PCI initiation time, and structural equation modeling was used to assess factors affecting end-user experience.
The time from the first ED assessment to urgent PCI initiation at the ED was significantly decreased using the patient medication history program (mean rank 42.14 min vs 28.72 min; Mann-Whitney U=346; P=.03). A total of 112 physicians and pharmacists participated in the survey. Among the 5 domains, "intention to reuse" received the highest score (mean 4.77, SD 0.37), followed by "user satisfaction" (mean 4.56, SD 0.49), while "service quality" received the lowest score (mean 3.87, SD 0.79). "User satisfaction" was significantly associated with "information quality" and "intention to reuse."
Timely and complete retrieval using a medication history-sharing program led to an improved care process by expediting critical decision-making in the ED, thereby contributing to value-based health care delivery in a real-world setting. The experiences of end users, including physicians and pharmacists, indicated satisfaction with the program regarding information quality and their intention to reuse.
在急诊科及时全面地收集患者用药史对于优化医疗服务至关重要。在一家三级教学医院实施了一项名为“患者居家用药一览”的用药史共享项目，旨在高效收集并展示患者初次就诊时的全国用药史。
由于需要进行评估以全面了解该项目，我们旨在评估护理过程结果和人文结果，包括医生和药剂师的最终用户体验。
我们进行了一项队列研究和一项横断面研究以评估这两种结果。为评估护理过程，我们从电子健康记录中测量了从首次急诊科评估到紧急经皮冠状动脉介入治疗（PCI）开始的时间。为评估最终用户体验，我们使用5点李克特量表编制了一份包含22个条目的问卷，包括5个领域：信息质量、系统质量、服务质量、用户满意度和再使用意愿。该问卷经过验证并分发给医生和药剂师。使用曼-惠特尼U检验分析PCI开始时间，并使用结构方程模型评估影响最终用户体验的因素。
使用患者用药史项目后，从首次急诊科评估到急诊科紧急PCI开始的时间显著缩短（平均秩次42.14分钟对28.72分钟；曼-惠特尼U = 346；P = 0.03）。共有112名医生和药剂师参与了调查。在5个领域中，“再使用意愿”得分最高（平均4.77，标准差0.37），其次是“用户满意度”（平均4.56，标准差0.49），而“服务质量”得分最低（平均3.87，标准差0.79）。“用户满意度”与“信息质量”和“再使用意愿”显著相关。
使用用药史共享项目及时完整地检索信息，通过加快急诊科的关键决策改善了护理过程，从而有助于在现实环境中提供基于价值的医疗服务。包括医生和药剂师在内的最终用户的体验表明，他们对该项目的信息质量和再使用意愿感到满意。
