Addressing Hospital Patient Information Needs Using Information Technology

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2014 by Columbia University
Sponsor:
Collaborators:
Information provided by (Responsible Party):
David Vawdrey, Columbia University
ClinicalTrials.gov Identifier:
NCT01970852
First received: October 18, 2013
Last updated: March 7, 2014
Last verified: March 2014
  Purpose

The aim of this study is to evaluate the impact of an inpatient personal health record (PHR) portal intervention within the hospital environment. The intervention hopes to improve patient engagement with their care and to measure patient activation and satisfaction. Additional clinical measure (e.g. number of adverse events that occur during the stay, changes to medication orders, etc.) will also be studied. Characterization of hospital patient and clinician attitudes towards patient engagement will also be formalized.


Condition Intervention
Inpatient
Other: Standard tablet computer
Other: Enhanced tablet computer

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Addressing Hospital Patient Information Needs Using a Personal Health Record Portal

Resource links provided by NLM:


Further study details as provided by Columbia University:

Primary Outcome Measures:
  • Change in Patient Activation Measure [ Time Frame: Admission to Unit and 3-5 days after ] [ Designated as safety issue: No ]
    The PAM assesses the knowledge, skills and confidence essential to managing one's own health and healthcare. It segments consumers into one of four progressively higher activation levels. The PAM score has been used to predict healthcare outcomes including medication adherence, ER utilization and hospitalization.


Secondary Outcome Measures:
  • Patient Satisfaction [ Time Frame: 3-5 days after admission to study ] [ Designated as safety issue: No ]
    We will measure patient patient satisfaction using a survey instrument along with data obtained from EHR and PHR system logs. The Patient Survey instrument measures information needs, satisfaction, patient engagement, and system usefulness. It is derived from the 26-item Telemedicine Satisfaction and Usefulness Questionnaire (Bakken, 2006)


Estimated Enrollment: 426
Study Start Date: March 2014
Estimated Study Completion Date: October 2017
Estimated Primary Completion Date: May 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Standard tablet computer
Patient will receive tablet computer within 18 hours of admission and will continue to have access to it for the rest of his/her stay. Tablet has typical applications including access to the internet and entertainment.
Other: Standard tablet computer
No special enhancements or links to personal health information.
No Intervention: Usual Care
Patients will receive usual care and will answer surveys during the usual time-frame specified.
Experimental: Enhanced tablet computer
Patients will receive a tablet computer within 18 hours of admission. Tablet will give access to a personalized inpatient personal health record portal. Will also provide access to standard tablet applications (e.g. video calling, streaming movies, etc.)
Other: Enhanced tablet computer
Tablet computer with personalized access to data from the patient's electronic health record.

Detailed Description:

This study will utilize an enhanced inpatient PHR portal to allow patients to view their care team, documented allergies and medications (home and hospital) as well as electronically document questions and concerns related to their care. These questions and concerns are visible to members of the patients' care teams within our commercial inpatient electronic health record (EHR). We will study the impact of the technology using a randomized trial of 426 cardiology and cardiothoracic surgery patients at Columbia University Medical Center in Upper Manhattan. We hypothesize that the use of the inpatient PHR portal will identify and address patients' information needs, improve patient activation, engagement and satisfaction, and encourage PHR use after hospital discharge. We also hypothesize that information entered by patients into the PHR portal will be useful to clinicians. There is no compensation for participating in this study.

The specific aims of the proposal are to:

Aim 1: Evaluate the impact of an inpatient PHR portal intervention using a randomized controlled trial. The primary outcomes will be patient activation, engagement and satisfaction. We will also determine whether access to the inpatient PHR portal is correlated with greater use of the PHR after hospital discharge.

Aim 2: Characterize information needs of hospital patients and assess clinicians' attitudes toward patient engagement in the hospital setting. We will analyze the questions and comments that patients record within the PHR portal application and assess the salience of patient-entered information to issues of care quality and safety. This aim will expand our previous work in taxonomy development and hazard and near-miss recognition. A survey will be administered to collect clinicians' perceptions of the barriers to and facilitators of system use. EHR documentation will be reviewed to assess whether patient-entered information was acknowledged by clinicians, and whether changes were made to the patient's plan of care as a result.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Speaks English or Spanish
  • Admitted to unit where study is ongoing

Exclusion Criteria:

  • Does not pass Mini-mental status exam
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01970852

Locations
United States, New York
Columbia University Medical Center Recruiting
New York, New York, United States, 10032
Contact: David K Vawdrey, PhD    212-305-9801    david.vawdrey@dbmi.columbia.edu   
Principal Investigator: David K Vawdrey, PhD         
Sponsors and Collaborators
Columbia University
Investigators
Principal Investigator: David Vawdrey, PhD Columbia University
  More Information

Publications:
Responsible Party: David Vawdrey, Assistant Professor of Clinical Biomedical Informatics, Columbia University
ClinicalTrials.gov Identifier: NCT01970852     History of Changes
Other Study ID Numbers: AAAF0264, R01HS021816, T15LM00707
Study First Received: October 18, 2013
Last Updated: March 7, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by Columbia University:
Inpatient
PHR Portal
Information Technology

ClinicalTrials.gov processed this record on September 30, 2014