User-centered design should focus on workflow functionality, terminology, and user interface issues for mHealth applications. These themes illustrated issues aligned with four of Nielsen's Usability Heuristics: match between system and the real world, consistency and standards, flexibility and efficiency of use, and aesthetic and minimalist design. We identified workflow and terminology issues that may be specific to the use of an mHealth application focused on safety and used by hospitalized patients and their families.

Objective To evaluate the amount and content of data patients and carepartners reported using a real-time electronic safety tool compared to other reporting mechanisms, and understand their perspectives on safety concerns and reporting in the hospital. Methods Mixed-methods study including 20 month pre- and post-implementation trial evaluating MySafeCare, a web-based application which allows hospitalized patients/carepartners to report safety concerns in real-time. Comparison of MySafeCare submission rates for three hospital units (oncology acute care; vascular intermediate care; medical intensive care) to submissions rates of Patient Family Relations (PFR) Department, a hospital service to address patient/family concerns. Triangulation of quantitative data with thematic analysis of safety concern submissions and patient/carepartner interviews to understand submission content and perspectives on safety reporting. Results Thirty-two MySafeCare submissions were received with an average rate of 1.7 submissions per 1,000 patient-days and a range of 0.3 to 4.8 submissions per 1,000 patient-days across all units, indicating notable variation between units. MySafeCare submission rates were significantly higher than PFR submission rates during the post-intervention period on the vascular unit (4.3 [95% CI 2.8 – 6.5] versus 1.5 [95% CI 0.7 – 3.1], Poisson) (P=0.01). Overall trends indicated a decrease in PFR submissions after MySafeCare implementation. Triangulated data indicated patients preferred to report anonymously and did not want concerns submitted directly to their care team. Conclusions MySafeCare evaluation confirmed the potential value of providing an electronic, anonymous reporting tool in the hospital to capture safety concerns in real-time. Such applications should be tested further as part of patient safety programs.

A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. The dashboard aligns all care team members, including patients and families, in the safety plan. The screensaver content includes icons that pertain to common geriatric syndromes. In two phases, interviews were conducted with nurses, nursing assistants, patients, and informal caregivers in a large, tertiary care center. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined. Many themes were identified, ranging from appreciation of the clinical decision support provided by the screensavers to the value of the safety-centric content. Differences emerged stemming from each group of end users' role on the care team. All feedback will inform requirements for improvements to the personalized safety plan screensaver. [Journal of Gerontological Nursing, 43(4), 15-22.].

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As part of an interdisciplinary acute care patient portal task force with members from 10 academic medical centers and professional organizations, we held a national workshop with 71 attendees representing over 30 health systems, professional organizations, and technology companies. Our consensus approach identified 7 key sociotechnical and evaluation research focus areas related to the consumption and capture of information from patients, care partners (eg, family, friends), and clinicians through portals in the acute and post-acute care settings. The 7 research areas were: (1) standards, (2) privacy and security, (3) user-centered design, (4) implementation, (5) data and content, (6) clinical decision support, and (7) measurement. Patient portals are not yet in routine use in the acute and post-acute setting, and research focused on the identified domains should increase the likelihood that they will deliver benefit, especially as there are differences between needs in acute and post-acute care compared to the ambulatory setting.