Usability of a Web-based Software Tool for History Taking in the Emergency Department

Renggli, Johanna Frey; Eken, Ceylan; Siegrist, Victoria; Ortega, Ricardo Nieves; Nickel, Christian H.; Rosin, Christiane; Hertwig, Ralph; Bingisser, Roland

doi:10.52964/amja.0816

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…According to the literature, the use and acceptance of digital tools [11], and telehealth specifically, depend on age [12], gender [13,14] and level of education [14]. In order to optimise the use of emergency telehealth in the future, reliable data are needed on both the current use and the users of telehealth, the outcomes of its use and the willingness of patients to use telehealth in emergency situations.…”

Section: Introductionmentioning

confidence: 99%

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

et al. 2021

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AIMS OF THE STUDY: An increasing number of patients are using telehealth before contacting the healthcare system. If we are to optimise future telehealth strategies and adequately respond to patient needs, we need to know more about the frequency and characteristics of telehealth use. Our objectives were (i) to investigate whether patients use telehealth before consulting the emergency department (ED), (ii) to compare patients with and without use of telehealth, and (iii) to investigate adherence, confidence and satisfaction. MATERIALS AND METHODS:A survey was conducted among ED walk-in patients at a tertiary university hospital in Switzerland. Eligible patients were questioned about their use of telehealth before current presentation, during 30 shifts from 23 October to 15 December 2019. RESULTS: A total of 183 (43.9%) of 417 surveyed patients used telehealth, with the telephone being the most commonly used modality, especially among elderly patients. Patients using telehealth were more likely to be male (53.5%, p = 0.001) and were similar in age to non-users. Telehealth users tended to be better educated. Telehealth was predominantly used for semi-urgent non-traumatic diseases that did not lead to hospitalisation. All age groups expressed satisfaction with telehealth, trusted the recommendations and adhered to them. The main reason for "non-use" of telehealth was lack of knowledge. CONCLUSIONS: Lack of knowledge about telehealth opportunities and barriers in specific patient groups should be addressed to include all patients, and thus to exploit telehealth's many advantages.

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Section: Introductionmentioning

confidence: 99%

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

et al. 2021

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Express check-in: developing a personal health record for patients admitted to hospital with medical emergencies: a mixed-method feasibility study

Tomos

Jones

Barach

2021

International Journal for Quality in Health Care

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Background Patient participation is increasingly recognized as a key component in the redesign of health care processes and is advocated as a means to improve patient safety. We explored the usage of participatory engagement in patient-created and co-designed medical records for emergency admission to hospital. Methods Design: Prospective iterative development and feasibility testing of personal health records. Setting: An Acute Medical Unit in a University affiliated hospital. Participants: Patients admitted to hospital for medical emergencies. Interventions: We used a design-led development of personal health record prototypes and feasibility testing of records completed by patients during the process of emergency admission. ‘Express-check-in’ records contained items of social history, screening questions for sepsis and acute kidney injury, in addition to the patients’ ideas, concerns and expectations. Main outcomes measures: The outcome metrics focused on feasibility and a selection of quality-domains: Effectiveness of recording relevant history, time-efficiency of documentation process, patient centredness of resulting records, staff and patient feedback. The incidence of sepsis and acute kidney injury were used as surrogate measures for assessing the safety impact. Results The medical record prototypes were developed in an iterative fashion and tested with 100 patients in which 39 patients were 70 or older, and 25 patients were classified as clinically frail. 96% of the data items were completed by patients with no or minimal help from healthcare professionals. The completeness of these patient records was superior to that of the corresponding medical records in that they contained deeply held beliefs and fears, whereas concerns and expectations recorded by patients were only mirrored in a small proportion of the formal clinical records. The sepsis self-screening tool identified 68% of patients requiring treatment with antibiotics. The intervention was feasible independent of the level of formal education and effective in frail and elderly patients with support from family and staff. The prototyped records were well received and felt to be practical by patients and staff. The staff indicated that reading the patients’ documentation led to significant changes in their clinical management. Conclusions Medical record accessibility to patients during hospital care contributes to the co-management of personal health care and might add critical information over and above the records compiled by healthcare professionals.

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Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review

Tellier

Barach

2021

BMJ Open

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ObjectivesReview available evidence for impact of electronic health records (EHRs) on predefined patient safety outcomes in interventional studies to identify gaps in current knowledge and design interventions for future research.DesignScoping review to map existing evidence and identify gaps for future research.Data sourcesPubMed, the Cochrane Library, EMBASE, Trial registers.Study selectionEligibility criteria: We conducted a scoping review of bibliographic databases and the grey literature of randomised and non-randomised trials describing interventions targeting a list of fourteen predefined areas of safety. The search was limited to manuscripts published between January 2008 and December 2018 of studies in adult inpatient settings and complemented by a targeted search for studies using a sample of EHR vendors. Studies were categorised according to methodology, intervention characteristics and safety outcome.Results from identified studies were grouped around common themes of safety measures.ResultsThe search yielded 583 articles of which 24 articles were included. The identified studies were largely from US academic medical centres, heterogeneous in study conduct, definitions, treatment protocols and study outcome reporting. Of the 24 included studies effective safety themes included medication reconciliation, decision support for prescribing medications, communication between teams, infection prevention and measures of EHR-specific harm. Heterogeneity of the interventions and study characteristics precluded a systematic meta-analysis. Most studies reported process measures and not patient-level safety outcomes: We found no or limited evidence in 13 of 14 predefined safety areas, with good evidence limited to medication safety.ConclusionsPublished evidence for EHR impact on safety outcomes from interventional studies is limited and does not permit firm conclusions regarding the full safety impact of EHRs or support recommendations about ideal design features. The review highlights the need for greater transparency in quality assurance of existing EHRs and further research into suitable metrics and study designs.

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Usability of a Web-based Software Tool for History Taking in the Emergency Department

Cited by 4 publications

References 27 publications

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

Express check-in: developing a personal health record for patients admitted to hospital with medical emergencies: a mixed-method feasibility study

Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review

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