Use of a tablet computer application to engage patients in updating their medication list

Kripalani, Sunil; Hart, Kimberly W.; Schaninger, Caitlin; Bracken, Stuart; Lindsell, Christopher J.; Boyington, Dane

doi:10.1093/ajhp/zxy047

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Kiosks aided in the provision of acute care in the ED by performing patient triage, reliably collecting patient data, and significantly improving the time to identify new arrivals [ 72 , 73 ]. Other uses in the acute care pathway in the ED included patient registration [ 74 ] and medication adherence [ 75 ].…”

Section: Resultsmentioning

confidence: 99%

The Role of Health Kiosks: Scoping Review

Maramba¹,

Jones²,

Austin³

et al. 2022

JMIR Med Inform

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Background Health kiosks are publicly accessible computing devices that provide access to services, including health information provision, clinical measurement collection, patient self–check-in, telemonitoring, and teleconsultation. Although the increase in internet access and ownership of smart personal devices could make kiosks redundant, recent reports have predicted that the market will continue to grow. Objective We seek to clarify the current and future roles of health kiosks by investigating the settings, roles, and clinical domains in which kiosks are used; whether usability evaluations of health kiosks are being reported, and if so, what methods are being used; and what the barriers and facilitators are for the deployment of kiosks. Methods We conducted a scoping review using a bibliographic search of Google Scholar, PubMed, and Web of Science databases for studies and other publications between January 2009 and June 2020. Eligible papers described the implementation as primary studies, systematic reviews, or news and feature articles. Additional reports were obtained by manual searching and querying the key informants. For each article, we abstracted settings, purposes, health domains, whether the kiosk was opportunistic or integrated with a clinical pathway, and whether the kiosk included usability testing. We then summarized the data in frequency tables. Results A total of 141 articles were included, of which 134 (95%) were primary studies, and 7 (5%) were reviews. Approximately 47% (63/134) of the primary studies described kiosks in secondary care settings. Other settings included community (32/134, 23.9%), primary care (24/134, 17.9%), and pharmacies (8/134, 6%). The most common roles of the health kiosks were providing health information (47/134, 35.1%), taking clinical measurements (28/134, 20.9%), screening (17/134, 12.7%), telehealth (11/134, 8.2%), and patient registration (8/134, 6.0%). The 5 most frequent health domains were multiple conditions (33/134, 24.6%), HIV (10/134, 7.5%), hypertension (10/134, 7.5%), pediatric injuries (7/134, 5.2%), health and well-being (6/134, 4.5%), and drug monitoring (6/134, 4.5%). Kiosks were integrated into the clinical pathway in 70.1% (94/134) of studies, opportunistic kiosks accounted for 23.9% (32/134) of studies, and in 6% (8/134) of studies, kiosks were used in both. Usability evaluations of kiosks were reported in 20.1% (27/134) of papers. Barriers (e.g., use of expensive proprietary software) and enablers (e.g., handling of on-demand consultations) of deploying health kiosks were identified. Conclusions Health kiosks still play a vital role in the health care system, including collecting clinical measurements and providing access to web-based health services and information to those with little or no digital literacy skills and others without personal internet access. We identified research gaps, such as training needs for teleconsultations and scant reporting on usability evaluation methods.

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Section: Resultsmentioning

confidence: 99%

The Role of Health Kiosks: Scoping Review

Maramba¹,

Jones²,

Austin³

et al. 2022

JMIR Med Inform

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“…Lesselroth et al [ 12 , 33 ] have developed a medication reconciliation kiosk where patients can review and edit their medication lists. Similar to MT, this information is imported into the EHR and reviewed by clinicians [ 31 ]. In their evaluation, they found similar rates of discrepancies (29%-39% vs 34%-40%), and the overall number of patients with discrepancies were similar (91%-99% vs 92%-93%) [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Web-Based Medication Reconciliation Application Within a Primary Care Setting: Cluster-Randomized Controlled Trial

Gionfriddo¹,

Hu²,

Maddineni³

et al. 2022

JMIR Form Res

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Background Despite routine review of medication lists during patient encounters, patients’ medication lists are often incomplete and not reflective of actual medication use. Contributing to this situation is the challenge of reconciling medication information from existing health records, along with external locations (eg, pharmacies, other provider/hospital records, and care facilities) and patient-reported use. Advances in the interoperability and digital collection of information provides a foundation for integration of these once disparate information sources. Objective We aim to evaluate the effectiveness of and satisfaction with an electronic health record (EHR)-integrated web-based medication reconciliation application, MedTrue (MT). Methods We conducted a cluster-randomized controlled trial of MT in 6 primary care clinics within an integrated health care delivery system. Our primary outcome was medication list accuracy, as determined by a pharmacist-collected best-possible medication history (BPMH). Patient and staff perspectives were evaluated through surveys and semistructured interviews. Results Overall, 224 patients were recruited and underwent a BPMH with the pharmacist (n=118 [52.7%] usual care [UC], n=106 [47.3%] MT). For our primary outcome of medication list accuracy, 8 (7.5%) patients in the MT arm and 9 (7.6%) in the UC arm had 0 discrepancies (odds ratio=1.01, 95% CI 0.38-2.72, P=.98). The most common discrepancy identified was patients reporting no longer taking a medication (UC mean 2.48 vs MT mean 2.58, P=.21). Patients found MT easy to use and on average would highly recommend MT (average net promoter score=8/10). Staff found MT beneficial but difficult to implement. Conclusions The use of a web-based application integrated into the EHR which combines EHR, patient-reported data, and pharmacy-dispensed data did not improve medication list accuracy among a population of primary care patients compared to UC but was well received by patients. Future studies should address the limitations of the current application and assess whether improved implementation strategies would impact the effectiveness of the application.

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“…To date, similar data have been used for adherence measurement in a small number of studies. 3,4,17,18 Clinical application of these datasets continue to expand with increased uptake of EHR-pharmacy linkages and as EHR vendors build platforms for their…”

Section: Limitationsmentioning

confidence: 99%