scholarly journals The Development of a Point of Care Clinical Guidelines Mobile Application Following a User-Centred Design Approach

2020 ◽  
pp. 294-313
Author(s):  
James Mitchell ◽  
Ed de Quincey ◽  
Charles Pantin ◽  
Naveed Mustfa
Keyword(s):  
Clinical Guidelines ◽  
Mobile Application ◽  
Point Of Care ◽  
Design Approach ◽  
User Centred Design

scholarly journals Cost-Effectiveness Analysis of the Use of Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing in Primary Care

Antibiotics ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 106 ◽  
Author(s):  
Emily Holmes ◽  
Sharman Harris ◽  
Alison Hughes ◽  
Noel Craine ◽  
Dyfrig Hughes
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Respiratory Tract ◽  
Clinical Guidelines ◽  
Antibiotic Prescription ◽  
Point Of Care ◽  
Cost Effective ◽  
Routine Practice ◽  
C Reactive Protein ◽  
Reactive Protein

More appropriate and measured use of antibiotics may be achieved using point-of-care (POC) C-reactive protein (CRP) testing, but there is limited evidence of cost-effectiveness in routine practice. A decision analytic model was developed to estimate the cost-effectiveness of testing, compared with standard care, in adults presenting in primary care with symptoms of acute respiratory tract infection (ARTI). Analyses considered (1) pragmatic use of testing, reflective of routine clinical practice, and (2) testing according to clinical guidelines. Threshold and scenario analysis were performed to identify cost-effective scenarios. In patients with symptoms of ARTI and based on routine practice, the incremental cost-effectiveness ratios of CRP testing were £19,705 per quality-adjusted-life-year (QALY) gained and £16.07 per antibiotic prescription avoided. Following clinical guideline, CRP testing in patients with lower respiratory tract infections (LRTIs) cost £4390 per QALY gained and £9.31 per antibiotic prescription avoided. At a threshold of £20,000 per QALY, the probabilities of POC CRP testing being cost-effective were 0.49 (ARTI) and 0.84 (LRTI). POC CRP testing as implemented in routine practice is appreciably less cost-effective than when adhering to clinical guidelines. The implications for antibiotic resistance and Clostridium difficile infection warrant further investigation.

scholarly journals P227 Remote monitoring of patients with RA: a user-centred design approach

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Melanie J Martin ◽  
Nora Ng ◽  
Laura Blackler ◽  
Toby Garrood
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Remote Monitoring ◽  
Design Approach ◽  
Free Text ◽  
Remote Consultation ◽  
Low Disease Activity ◽  
Disease Flare ◽  
User Centred Design ◽  
Monitoring Service

Abstract Background Patients with rheumatoid arthritis are generally seen at arbitrary intervals in secondary care. Patients with active disease may not always be seen at the most appropriate time and those with low disease activity may be seen more frequently than necessary. The NHS Long Term Plan expects outpatient appointments to be reduced by up to a third, with digital transformation a key enabler. The remote capture of patient-reported outcome measures (PROMs) has the potential to facilitate more flexible and responsive outpatient services. Methods This project aimed to design a digital remote monitoring platform to test the hypothesis that PROMs can be used to proactively monitor and trigger consultations when patients need them most. The Rheumatoid Arthritis Impact of Disease (RAID) questionnaire, a validated multidimensional PROM, was used. Waiting room testing with patients informed the design of an acceptable mobile device format of the RAID. Recruitment criteria and acceptable cut-offs for defining flare were agreed by the rheumatology multidisciplinary team. Patients in low disease activity or remission (DAS <3.2) were invited to the service via SMS. All patients were informed regarding the governance of handling patient data and an opt-out option was offered. Patients were sent an automated monthly SMS with a PROM link and weekly reminder SMS if required. They also had the option to send in SMS messages at other times or add free text comments. Patients submitting a RAID score of ≥ 4 received a SMS with a link to the rheumatology advice service advising a remote consultation. The SMS-based service went live in January 2019 and all incoming communication was monitored on a daily basis. Results 104 RA patients are currently using the remote monitoring service with 10.3% (13/117) opting-out. 847 monthly PROMs have been sent via SMS. The PROM completion rate has been 68.9% (range 59.0-85.1%). 120 RAID (21.8%) scored 2-≤4 indicating low disease activity and 136 RAID (24.7%) ≤ 2 indicating disease remission. 480 SMS have been sent manually to patients who have engaged in two-way communication or returned a RAID score ≥4. 44 telephone advice appointments were triggered through the remote monitoring service by patients in disease flare. 80% (35/44) of remote consultation were considered to have to have averted a face to face consultation with the remaining 20% providing advice alone. Interviews have been conducted with PROM ‘non-completers’ to learn and inform further service design. Conclusion This project has demonstrated how a user-centred design approach to utilising technology can support access to rheumatology care when patients need it most, such as disease flare. The identification of patients self-reporting low disease activity using multidimensional PROMs may enable more efficient utilisation of clinical capacity through patient-initiated appointment deferment and lead to improved patient-centred care. Disclosures M.J. Martin: Honoraria; Novartis, Abbvie. Grants/research support; National Ankylosing Spondylitis Society. N. Ng None. L. Blackler None. T. Garrood None.

Clinical pathways on a mobile device

2019 ◽  
Vol 25 (4) ◽  
pp. 131-137
Author(s):  
John Barrett ◽  
Barbara Turner ◽  
Susan Silva ◽  
Michael Zychowicz
Keyword(s):  
Mobile Application ◽  
Clinical Pathways ◽  
Point Of Care ◽  
Design Principles ◽  
Future Application ◽  
Application Framework ◽  
Application Development ◽  
Project Completion ◽  
Important Barrier ◽  
The Uk

Clinical pathways have been successfully implemented in the primary care setting in New Zealand, Australia and the UK. Despite wide adoption and decreased costs, these pathways have yet to translate evidence into clinical practice while also saving providers time—an important barrier for the translation of evidence at the point of care. The goal of this project was to determine if future development of a point-of-care mobile application should be undertaken with design principles using the theoretical framework of Hick’s law. Three new-to-practice providers participated in three plan-do-study-act cycles using these pathways installed on mobile devices to determine if they were a feasible, efficient and useful method to implement evidence. The project was a success with all three participants wishing to continue using the pathways after project completion. Participants felt the digital clinical pathways were the next evolution of the popular UpToDate software platform and helped them apply the latest evidence better than other available tools. While these results are promising, there were also limitations. Participants felt the lack of chart integration coupled with time constraints made full integration challenging and suggested launching the platform using a variety of delivery systems. The project’s findings suggest that future application development using the developed design principles would be worth further consideration. If this mobile application ultimately proved successful, the application framework could be implemented on a larger scale, thus improving patient outcomes and saving providers time.

436 Feasibility and Acceptability of a Mobile Application for Point-of-Care Data Collection in Assessing Trainee Skills During Colonoscopy Training: a Pilot Study

2014 ◽  
Vol 79 (5) ◽  
pp. AB139-AB140
Author(s):  
Ryan D. Madanick ◽  
Daniel L. Brown ◽  
Kenneth Royal ◽  
Jeff Palmer ◽  
Kim L. Isaacs
Keyword(s):  
Pilot Study ◽  
Data Collection ◽  
Mobile Application ◽  
Point Of Care

scholarly journals The development of an mHealth tool for children with long-term illness to enable person-centred communication: a user centred-design approach (Preprint)

10.2196/30364 ◽  
2021 ◽  
Author(s):  
Angelica Wiljén ◽  
John Chaplin ◽  
Vanessa Crine ◽  
William Jobe ◽  
Ensa Johnson ◽  
...  
Keyword(s):  
Design Approach ◽  
User Centred Design

scholarly journals The development of a clinical interface for a novel newborn resuscitation device; a Human Factors approach to understand cognitive user requirements. (Preprint)

2018 ◽  
Author(s):  
Laura Pickup ◽  
Alexandra Lang ◽  
Lara Shipley ◽  
Caroline Henry ◽  
James Carpenter ◽  
...  
Keyword(s):  
Heart Rate ◽  
Human Factors ◽  
Medical Device ◽  
Interface Design ◽  
New Technology ◽  
Unmet Need ◽  
Neonatal Resuscitation ◽  
Design Approach ◽  
New Device ◽  
User Centred Design

BACKGROUND A novel medical device has been developed to address an unmet need in standardising and facilitating heart rate recording during neonatal resuscitation. In a time critical emergency resuscitation, where failure can mean death of an infant, it is vital that clinicians are provided with information in a timely, precise and clear manner to capacitate appropriate decision making. This new technology provides a hands free, wireless heart rate monitoring solution that easily fits the clinical pathway and procedure for neonatal resuscutation. To understand the requirements of the interface design for this new device, a human factors approach was implemented. This combined a traditional user-centred design approach with an Applied Cognititive Task Analysis (ACTA) to understand the tasks involved, the cognitive requirements and the potential for error during a neonatal resusciation scenario. OBJECTIVE 1. To understand the cognitive requirements of clinicians for a novel medical device to facilitate neonatal resuscitation; 2. To apply a human factors approach and a traditional user-centred design approach to provide a device interface specification. METHODS Fourteen clinical staff were involved in producing the final design requirements. Two paediatric doctors supported the development of a visual representation of the activities associated with neonatal resucitation. This was used to develop a scenario based workshop. Two workshops were carried out in parallel and involved three paediatric doctors, three neonatal nurses, two advance neonatal practitioners and four midwives. Both groups came together at the end to reflect on the findings which emerged during the separate sessions. RESULTS The outputs of this study have provided a comprehensive description of information requirements during neonatal resuscitation, and enabled product developers to understand the core and preferred requirements of the user interface design for the device. The study raised three key areas for the designers to consider, which had not previously been highlighted. These related to interface layout and information priority, size and portability of the device and auditory feedback. CONCLUSIONS This study demonstrates the value of the ACTA approach to inform the development of resuscitation devices, and more generally for medical device development.

Sign in / Sign up

Export Citation Format

Share Document