Addressing Hospital Patient Information Needs Using Information Technology
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.
|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|
- 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.
- 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)
|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)|
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.
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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01970852
|United States, New York|
|Columbia University Medical Center||Recruiting|
|New York, New York, United States, 10032|
|Contact: David K Vawdrey, PhD 212-305-9801 firstname.lastname@example.org|
|Principal Investigator: David K Vawdrey, PhD|
|Principal Investigator:||David Vawdrey, PhD||Columbia University|