scholarly journals A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

2017 ◽  
Author(s):  
Sophie Marien ◽  
Delphine Legrand ◽  
Ravi Ramdoyal ◽  
Val�ry Ramon ◽  
Jimmy Nsenga ◽  
...  
Keyword(s):  
Medication Reconciliation ◽  
Qualitative Data ◽  
Perceived Usefulness ◽  
Three Dimensions ◽  
Medication List ◽  
Medication Discrepancies ◽  
Time Points ◽  
System Usability Scale ◽  
User Centered ◽  
At Home

BACKGROUND Medication discrepancies consist of unexplained differences between medication lists at different transition points of care; they are a threat to patient safety. These discrepancies can be solved through medication reconciliation (MedRec), a complex and time-consuming process. Several approaches to optimizing MedRec have been encouraged, including the development of information technology (IT) tools and patient engagement. The SEAMPAT project aims to develop a MedRec IT platform based on two applications (one for the patient, the “patient app”, the other for healthcare professionals), which were developed using a three-iteration user-centered design. The patient app presents the patient with a medication list compiled from different medication resources. OBJECTIVE To evaluate the usability and usefulness of the third iteration of the patient app, from the perspective of different categories of users, with the aims of making recommendations for wider use and informing further research. METHODS We performed a four-month user-centered observational study. After a kick-off session, patients, identified through purposive sampling, were invited to use the patient app at home, to update their medication lists whenever required. Quantitative and qualitative data were collected at different time points to evaluate three dimensions of usability (efficiency, satisfaction, and effectiveness), as well as usefulness. Participants completed two questionnaires on satisfaction and usefulness (including the system usability scale, SUS) at the kick-off and the end of the study. Effectiveness was assessed by measuring the completeness and correctness (i.e. medication discrepancies) of the final medication list generated by the patient application. Qualitative data were collected from observations at different time points and from semi-structured interviews at the end of the study. RESULTS Forty-eight patients agreed to participate and 42 completed the study, of whom 32 connected at least once to the application at home. Sixty-nine percent of patients considered the patient app to be acceptable (SUS Score ≥ 70) and perceived usefulness was high. The medication list was complete for a quarter of the patients and there was a median of two discrepancies per patient. The main causes were technology-related. The qualitative data enabled the identification of several barriers and, thus, of approaches to optimizing usability and usefulness. These relate to both functional (e.g. access, on-screen display, additional functionalities) and non-functional aspects (e.g. patient awareness, concordance between patient and physician) of the application. For future adoption of the tool, it will be important to address these issues. CONCLUSIONS Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in “real-world” conditions. We believe our study also underlines the need to take patients’ points of view into consideration. To achieve adoption and sustained use by patients, the patient app should meet patients’ needs while also efficiently improving the quality of MedRec.

scholarly journals A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study

2018 ◽  
Vol 25 (11) ◽  
pp. 1488-1500
Author(s):  
Sophie Marien ◽  
Delphine Legrand ◽  
Ravi Ramdoyal ◽  
Jimmy Nsenga ◽  
Gustavo Ospina ◽  
...  
Keyword(s):  
Web Application ◽  
Medication Reconciliation ◽  
Qualitative Data ◽  
Improve Patient Safety ◽  
Three Dimensions ◽  
Medication List ◽  
Medication History ◽  
Medication Discrepancies ◽  
System Usability Scale ◽  
User Centered

Abstract Objective Medication reconciliation (MedRec) can improve patient safety by resolving medication discrepancies. Because information technology (IT) and patient engagement are promising approaches to optimizing MedRec, the SEAMPAT project aims to develop a MedRec IT platform based on two applications: the “patient app” and the “MedRec app.” This study evaluates three dimensions of the usability (efficiency, satisfaction, and effectiveness) and usefulness of the patient app. Methods We performed a four-month user-centered observational study. Quantitative and qualitative data were collected. Participants completed the system usability scale (SUS) questionnaire and a second questionnaire on usefulness. Effectiveness was assessed by measuring the completeness of the medication list generated by the patient application and its correctness (ie medication discrepancies between the patient list and the best possible medication history). Qualitative data were collected from semi-structured interviews, observations and comments, and questions raised by patients. Results Forty-two patients completed the study. Sixty-nine percent of patients considered the patient app to be acceptable (SUS Score ≥ 70) and usefulness was high. The medication list was complete for a quarter of the patients (7/28) and there was a discrepancy for 21.7% of medications (21/97). The qualitative data enabled the identification of several barriers (related to functional and non-functional aspects) to the optimization of usability and usefulness. Conclusions Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in “real-world” conditions. To achieve adoption and sustained use by patients, the app should meet patients’ needs while also efficiently improving the quality of MedRec.

scholarly journals Engaging hospital patients in the medication reconciliation process using tablet computers

2018 ◽  
Vol 25 (11) ◽  
pp. 1460-1469 ◽  
Author(s):  
Jennifer E Prey ◽  
Fernanda Polubriaginof ◽  
Lisa V Grossman ◽  
Ruth Masterson Creber ◽  
Demetra Tsapepas ◽  
...  
Keyword(s):  
Medication Review ◽  
Medication Safety ◽  
Medication Reconciliation ◽  
Adverse Drug Events ◽  
Medication List ◽  
Medication Discrepancies ◽  
Home Medication ◽  
Verbal Participation ◽  
Hospital Patients ◽  
Home Medication Review

Abstract Objective Unintentional medication discrepancies contribute to preventable adverse drug events in patients. Patient engagement in medication safety beyond verbal participation in medication reconciliation is limited. We conducted a pilot study to determine whether patients’ use of an electronic home medication review tool could improve medication safety during hospitalization. Materials and Methods Patients were randomized to use a toolbefore orafter hospital admission medication reconciliation to review and modify their home medication list. We assessed the quantity, potential severity, and potential harm of patients’ and clinicians’ medication changes. We also surveyed clinicians to assess the tool’s usefulness. Results Of 76 patients approached, 65 (86%) participated. Forty-eight (74%) made changes to their home medication list [before: 29 (81%),after: 19 (66%),p = .170].Before group participants identified 57 changes that clinicians subsequently missed on admission medication reconciliation. Thirty-nine (74%) had a significant or greater potential severity, and 19 (36%) had a greater than 50-50 chance of harm.After group patients identified 68 additional changes to their reconciled medication lists. Fifty-one (75%) had a significant or greater potential severity, and 33 (49%) had a greater than 50-50 chance of harm. Clinicians reported believing that the tool would save time, and patients would supply useful information. Discussion The results demonstrate a high willingness of patients to engage in medication reconciliation, and show that patients were able to identify important medication discrepancies and often changes that clinicians missed. Conclusion Engaging patients in admission medication reconciliation using an electronic home medication review tool may improve medication safety during hospitalization.

Evaluation of Adverse Drug Events and Medication Discrepancies in Transitions of Care Between Hospital Discharge and Primary Care Follow-Up

2014 ◽  
Vol 29 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Becky L. Armor ◽  
Avery J. Wight ◽  
Sandra M. Carter
Keyword(s):  
Primary Care ◽  
Hospital Discharge ◽  
Medication Reconciliation ◽  
Adverse Drug Events ◽  
Medication Management ◽  
Transitions Of Care ◽  
Therapeutic Monitoring ◽  
Medication List ◽  
Medication Discrepancies

Approximately two-thirds of adverse events posthospital discharge are due to medication-related problems. Medication reconciliation is a strategy to reduce medication errors and improve patient safety. Objective: To evaluate adverse drug events (ADEs), potential ADEs (pADEs), and medication discrepancies occurring between hospital discharge and primary care follow-up in an academic family medicine clinic. Adult patients recently discharged from the hospital were seen by a pharmacist for medication reconciliation between September 1, 2011, and November 30, 2012. The pharmacist identified medication discrepancies and pADEs or ADEs from a best possible medication history obtained from the electronic medical record (EMR) and hospital medication list. In 43 study participants, an average of 2.9 ADEs or pADEs was identified ( N = 124). The most common ADEs/pADEs identified were nonadherence/underuse (18%), untreated medical problems (15%), and lack of therapeutic monitoring (13%). An average of 3.9 medication discrepancies per participant was identified (N = 171), with 81% of participants experiencing at least 1 discrepancy. The absence of a complete and accurate medication list at hospital discharge is a barrier to comprehensive medication management. Strategies to improve medication management during care transitions are needed in primary care.

scholarly journals Usability, usefulness, and acceptance of mRehab: A novel, portable rehabilitation system using smartphone and 3D print technology (Preprint)

2020 ◽  
Author(s):  
Sutanuka Bhattacharjya ◽  
Lora Anne Cavuoto ◽  
Brandon Reilly ◽  
Wenyao Xu ◽  
Heamchand Subryan ◽  
...  
Keyword(s):  
Technology Acceptance ◽  
Technology Use ◽  
Structured Interview ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Home Exercise ◽  
3D Print ◽  
System Usability Scale ◽  
Rehabilitation System ◽  
At Home

BACKGROUND Smart technology use in rehabilitation is growing and can be used remotely to assist clients in self-monitoring their performance. With written home exercise programs being the commonly prescribed form of rehabilitation after discharge, mHealth technology coupled with task-oriented programs can enhance self-management of upper extremity training. In the current study, a functional rehabilitation system, namely mRehab, was designed which included a smartphone app and 3D printed household items such as mug, bowl, key, and doorknob embedded with a smartphone The app's user interface allowed the participant to select rehabilitation activities and receive feedback on the number of activity repetitions completed, time to complete each activity and quality of movement. OBJECTIVE To assess the usability, perceived usefulness, and acceptance of the mRehab system by individuals with stroke and identify the challenges experienced by them when using the system remotely in a home-based setting. METHODS A mixed-methods approach was used with 11 individuals with chronic stroke. Following training, individuals with stroke used the mRehab system for six weeks at home. Each participant completed surveys and engaged in a semi-structured interview. Participants’ qualitative reports regarding the usability of mRehab were integrated with their survey reports and quantitative performance data. RESULTS Ten of the eleven participants rated the mRehab system between 67.5 to 97.5 percentile on the System Usability Scale, indicating their satisfaction with the usability of the system. Participants also provided high ratings of perceived usefulness (median=6), and perceived ease of use (median=5.75), on a 7-point scale based on the Technology Acceptance Model. Common themes reported by participants showed a positive response to mRehab with some suggestions for improvements. Participants reported an interest in activities they perceived to be of ‘just right challenge’. Some participants indicated a need for customizing the feedback to be more interpretable. Overall, most participants indicated that they would like to continue using the mRehab system at home. CONCLUSIONS Assessing usability in the lived environment over a prolonged duration of time is essential to identify match between the system and users’ needs and preferences. While mRehab was well accepted, further customization is desired for a better fit with the end users. CLINICALTRIAL NCT04363944

Usability and perceived usefulness of patient-centered medication reconciliation using a personalized health record (Preprint)

2021 ◽  
Author(s):  
Denise Jacoline van der Nat ◽  
Victor J B Huiskes ◽  
Margot Taks ◽  
Bart Pouls ◽  
Bart J F van den Bemt ◽  
...  
Keyword(s):  
Medication Reconciliation ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Perceived Usefulness ◽  
Health Record ◽  
Patient Centered ◽  
Related Factors ◽  
Cross Sectional ◽  
System Usability Scale ◽  
Personalized Health

BACKGROUND The acceptance and usage of a personalized health record (PHR) depends on usability and perceived usefulness of the PHR. OBJECTIVE Therefore, the aim of this study was to assess usability and perceived usefulness of an online PHR for medication reconciliation and to describe associations between usability and perceived usefulness and patient-, setting-, and medication-related factors. METHODS A multicenter cross-sectional study was conducted with patients with either an outpatient visit (rheumatology ward) or planned admission in the hospital (cardiology, neurology, internal medicine or pulmonary wards). All patients received an invitation to update their medication list in an online PHR two weeks prior to their appointment/admission. One month after the hospital visit, PHR-users were asked to rate usability (using the System Usability Scale (SUS)) and perceived usefulness on a 5-point Likert scale. The SUS-scores were classified according to the adjective rating scale and furthermore dichotomized in the categories: low (SUS between 0-51) or good (SUS 51-100) usability. Association between patient-, setting-, and medication-related factors and the usability and perceived usefulness were analysed. RESULTS 255 (34%) of the 743 invited PHR-users completed the questionnaire. The majority of inpatients (78%) and outpatients (83%) indicated that usability of the PHR was good. At the outpatient clinic, experience with digital devices (adjusted odds ratio 1.36; 95%CI:1.01–1.83) was significantly associated with a good usability. Regarding perceived usefulness, the majority of the in- and outpatients (76% and 78%, respectively) reported that the PHR yielded at least one benefit (out of seven) with regard to their visit to the physician. CONCLUSIONS Usability and perceived usefulness of a PHR for medication reconciliation were rated by patients as good. Further research should explore the barriers and facilitators of patients with a low rated usability and perceived usefulness.

scholarly journals Comparison of the validity, perceived usefulness and usability of I-MeDeSA and TEMAS, two tools to evaluate alert system usability: a study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050448
Author(s):  
Romaric Marcilly ◽  
Wu Yi Zheng ◽  
Regis Beuscart ◽  
Melissa T Baysari
Keyword(s):  
Human Factors ◽  
Convergent Validity ◽  
Perceived Usefulness ◽  
Decision Makers ◽  
Free Text ◽  
Alert System ◽  
System Usability Scale ◽  
System Usability ◽  
Ethical Approval ◽  
Alerting Systems

IntroductionResearch has shown that improvements to the usability of medication alert systems are needed. For designers and decisions-makers to assess usability of their alert systems, two paper-based tools are currently available: the instrument for evaluating human-factors principles in medication-related decision support alerts (I-MeDeSA) and the tool for evaluating medication alerting systems (TEMAS). This study aims to compare the validity, usability and usefulness of both tools to identify their strengths and limitations and assist designers and decision-makers in making an informed decision about which tool is most suitable for assessing their current or prospective system.Methods and analysisFirst, TEMAS and I-MeDeSA will be translated into French. This translation will be validated by three experts in human factors. Then, in 12 French hospitals with a medication alert system in place, staff with expertise in the system will evaluate their alert system using the two tools successively. After the use of each tool, participants will be asked to fill in the System Usability Scale (SUS) and complete a survey on the understandability and perceived usefulness of each tool. Following the completion of both assessments, participants will be asked to nominate their preferred tool and relay their opinions on the tools. The design philosophy of TEMAS and I-MeDeSA differs on the calculation of a score, impacting the way the comparison between the tools can be performed. Convergent validity will be evaluated by matching the items of the two tools with respect to the usability dimensions they assess. SUS scores and answers to the survey will be statistically compared for I-MeDeSA and TEMAS to identify differences. Free-text responses in surveys will be analysed using an inductive approach.Ethics and disseminationEthical approval is not required in France for a study of this nature. The results will be published in a peer-reviewed journal.

The Benefits of Quantifying Qualitative Brand Data

2016 ◽  
Vol 58 (3) ◽  
pp. 421-450
Author(s):  
Kaleel Rahman ◽  
Charles S. Areni
Keyword(s):  
Brand Equity ◽  
Knowledge Creation ◽  
Qualitative Data ◽  
Reliability And Validity ◽  
Free Association ◽  
Serial Order ◽  
Three Dimensions ◽  
Innovative Approach ◽  
Association Strength ◽  
Brand Associations

Researchers suggest quantification of qualitative data as an innovative approach to knowledge creation. Brand associations, a form of qualitative data, are common in measuring customer-based brand equity. The branding literature suggests that not all brand associations are equal. The strength, uniqueness and valence of brand associations need to be considered when assessing brand associations (Keller 1993). Although Keller's work is cited by many, no study has devised a method to quantify and integrate these three dimensions into a single index. This study provides an approach to address all three dimensions simultaneously. The approach first determines uniqueness of brand associations by coding associations into several mutually exclusive meaning categories. Then the serial order of free-association elicitation is used to assess association strength. The serial order, combined with a measure of valence, creates a quantification of open-ended brand associations called a ‘weighted valence index’ (WVI). In conclusion, the paper discusses the reliability and validity of the proposed measure.

scholarly journals Evaluation of an Electronic Module for Reconciling Medications in Home Health Plans of Care

2016 ◽  
Vol 07 (02) ◽  
pp. 412-424 ◽  
Author(s):  
Bryan Gibson ◽  
Yarden Livnat ◽  
Iona Thraen ◽  
Abraham Brody ◽  
Randall Rupper ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Medication Reconciliation ◽  
Confidence Score ◽  
Electronic System ◽  
Home Health ◽  
Home Healthcare ◽  
Medication Discrepancies ◽  
Increased Risk ◽  
Perceived Usability ◽  
Improved Accuracy

SummaryTransitions in patient care pose an increased risk to patient safety. One way to reduce this risk is to ensure accurate medication reconciliation during the transition. Here we present an evaluation of an electronic medication reconciliation module we developed to reduce the transition risk in patients referred for home healthcare.Nineteen physicians with experience in managing home health referrals were recruited to participate in this within-subjects experiment. Participants completed medication reconciliation for three clinical cases in each of two conditions. The first condition (paper-based) simulated current practice – reconciling medication discrepancies between a paper plan of care (CMS 485) and a simulated Electronic Health Record (EHR). For the second condition (electronic) participants used our medication reconciliation module, which we integrated into the simulated EHR.To evaluate the effectiveness of our medication reconciliation module, we employed repeated measures ANOVA to test the hypotheses that the module will: 1) Improve accuracy by reducing the number of unaddressed medication discrepancies, 2) Improve efficiency by reducing the reconciliation time, 3) have good perceived usability.The improved accuracy hypothesis is supported. Participants left more discrepancies unaddressed in the paper-based condition than the electronic condition, F (1,1) = 22.3, p < 0.0001 (Paper Mean = 1.55, SD = 1.20; Electronic Mean = 0.45, SD = 0.65). However, contrary to our efficiency hypothesis, participants took the same amount of time to complete cases in the two conditions, F (1, 1) =0.007, p = 0.93 (Paper Mean = 258.7 seconds, SD = 124.4; Electronic Mean = 260.4 seconds, SD = 158.9). The usability hypothesis is supported by a composite mean ability and confidence score of 6.41 on a 7-point scale, 17 of 19 participants preferring the electronic system and an SUS rating of 86.5.We present the evaluation of an electronic medication reconciliation module that increases detection and resolution of medication discrepancies compared to a paper-based process. Further work to integrate medication reconciliation within an electronic medical record is warranted.

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