An innovative use of Quick Response codes to provide patients information in Urology

Objective:

The use of Quick Response (QR) codes has the potential to overcome some of the healthcare challenges we currently face, especially those presented by the COVID-19 pandemic. The aim of this research was to evaluate the use of QR codes poster in delivering patient information effectively in a Urology Outpatient department.

Methods:

A national online survey of Urologists was distributed, and leaflet costs were estimated. QR codes for the British Association of Urological Surgeons (BAUS) patient information leaflets were incorporated into a poster for the Urology Outpatient department. Feedback on the poster was sought from patients.

Results:

Overall, 108 Urologists responded to the initial survey; 44% were consultants. However, 54% provided > 50% of patients with an information leaflet during face-to-face clinics prior to the Covid-19 pandemic, decreasing to 33% during COVID-19. Using departmental outgoings, a cost of £3120 was calculated for printed leaflets per year normally. Rise in telephone clinics during the pandemic meant 47% of patients were provided an Internet link or asked to use Google in the clinical letter, up from 17% prior to the pandemic. In response to the QR codes poster, in a patient population, mostly male (82%) and older people(60% between 60 and 80 years of age), 40% were familiar with QR codes, 73% could access Internet and 53% used it to find information, 46% found the poster easy to use or follow and 61% found it informative.

Conclusion:

QR codes offer benefits, including capability for touch-free access, cost-effectiveness, potential to increase engagement and understanding, enable user-initiated learning and improve adherence. Patient perception varies with age group and smartphone access and usage.

Level of Evidence:

4

Effective Use of Mobile Electronic Medical Records by Medical Interns in Real Clinical Settings: Mixed Methods Study

Background

In South Korea, most graduated medical students undertake a 1-year internship before beginning residency and specialization. Interns usually work in a tertiary hospital and rotate between different, randomly assigned departments to be exposed to different medical specialties. Their jobs are mostly simple and repetitive but are still essential for the patient care process. However, owing to the lack of experience and overwhelming workload, interns at tertiary hospitals in South Korea are usually inefficient, often delaying the entire clinical process. Health care providers have widely adopted mobile electronic medical records (mEMRs) as they have been shown to improve workflow efficiency.

Objective

This study investigates the association between the frequency of mEMR usage and the clinical task completion interval time among interns in a tertiary hospital.

Methods

This mixed methods study was conducted at the Samsung Medical Center, Seoul, South Korea. Interns who worked at the Samsung Medical Center from March 2018 to February 2019 were included. The hospital electronic medical record (EMR) system known as DARWIN (Data Analysis and Research Window for Integrated kNowledge) was launched with PC and mobile. Both versions are actively used in hospitals by personnel in various positions. We collected the log data from the mEMR server and the intern clinical task time-series data from the EMR server. Interns can manage the process of identifying patients, assigning the clinical task, finishing the requested clinical intern tasks, etc, through the use of the mEMR system. We compared the clinical task completion interval among 4 groups of interns divided by the mEMR frequency quantile. Then, System Usability Score (SUS) questionnaires and semistructured interviews were conducted.

Results

The regular mEMR users were defined as those who logged in more than once a day on average and used the mEMR until the level after login. Among a total of 87 interns, 84 used the mEMR to verify the requested clinical tasks. The most frequently used item was “Intern task list.” Analysis of the 4 intern groups revealed an inverse relationship between the median time of the task completion interval and the frequency of mEMR use. Correlation analysis showed that the intern task completion time interval had a significant inverse relationship with the individual frequency of mEMR usage (coefficient=-0.27; 95% CI -0.46 to -0.04; P=.02). In the additional survey, the mean SUS value was 81.67, which supported the results of the data analysis.

Conclusions

Our findings suggest that frequent mEMR use is associated with improved work efficiency in hospital interns with good usability of the mEMR. Such finding supports the idea that the use of mEMR improves the effectiveness and workflow efficiency of interns working in hospitals and, more generally, in the context of health care.

A quasi-experimental study examining QR code-based video education program on anxiety, adherence, and satisfaction in coronary angiography patients

Background: QR (quick response) codes are a promising tool for health education, however effects of QR code application in providing peri-procedure education to patients with coronary angiography is unclear.Aim/Objective: This study investigated the effect of a QR code-based video education program on anxiety, adherence, and satisfaction in Chinese coronary angiography patients.Material and Methods: This prospective controlled clinical trial included 335 patients undergoing coronary angiography, including 166 patients in the experimental group and 169 patients in the control group. On the day before coronary angiography, patients in the experimental group had access to and could watch an educational video on their smartphones by scanning a QR code for multiple times, while patients in the control group watched the same video on a tablet once only. The primary outcome was anxiety assessed using the Chinese State Anxiety Inventory (C-SAI). Adherence to instructions and patient satisfaction with the information delivery method were also evaluated.Results: The C-SAI scores improved in the experimental group compared to the control group (F = 9.8, P < 0.001) over time. There is a significant difference in the changes of anxiety scores from baseline to pre-procedure (P < 0.001) and post-procedure (P < 0.01) between the two groups. Individuals in the experimental group showed better adherence to instructions on removing dentures and jewelry, and taking medicines before the procedure (P < 0.05), and limb activity, water consumption, and diet after the procedure (P < 0.001).Conclusion: Patient education programs on smartphone that can be accessed multiple times by scanning a QR code can be an effective and convenient approach to reducing anxiety and enhancing adherence to instructions among Chinese coronary angiography patients. Hospitals and clinicians should consider more investments in developing such patient education programs and also help improve ehealth literacy.

Sauver JL, Olson JE, Rohrer Vitek CR. An assessment of patient perspectives on pharmacogenomics educational materials

Aim: Pharmacogenomics (PGx) holds potential to improve patient treatment; yet, effective patient educational materials are limited. Materials & methods: Using a 'think aloud' technique, we sought to understand comprehension and perceptions of a multimedia PGx results packet including a cover letter with QR code to an educational video, brochure and prototype report in the context of PGx case vignettes. Results: The cover letter and video components were viewed less favorably due to excess detail, complex jargon and technology challenges. Recommendations were to enhance comprehension and utility and to customize materials to each patient's medications or disease conditions. Conclusion: Educational materials were revised to improve comprehension and usability, and diminish concerns to better prepare patients to understand the importance of discussing test results with their provider.

Uses of quick response codes in healthcare education: a scoping review

BACKGROUND

To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context.

METHODS

Medline, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HMIC (Healthcare Management Information Consortium) and HBE (Health Business Elite) were searched using specified search terms that included 'quick response code' and 'education'. Title and abstract review of 217 publications was performed. Papers which discussed the application of QR codes relevant to healthcare education were included. A total of 24 articles were reviewed and thematic analysis conducted to generate themes.

RESULTS

Use of QR codes in healthcare education were broadly aligned to four common themes. These included: to increase participant engagement, for simulation training, for just-in-time (JIT) learning and to facilitate with administrative tasks in training. Perceptions towards the use of QR codes was generally positive. Challenges identified, included: problems with technical infrastructure, unavailability of smartphones and resistance to use in certain environments.

CONCLUSIONS

The use of QR codes for healthcare education is increasing, and whilst they offer some advantages there are also some important considerations including: provision of the necessary technological infrastructure, patient and staff safety and governance and adherence to guidelines on safe and appropriate use of this technology in sensitive settings.

Mobile applications in oncology: A systematic review of health science databases

INTRODUCTION

In recent years there has been an exponential growth in the number of mobile applications (apps) relating to the early diagnosis of cancer and prevention of side effects during cancer treatment. For health care professionals and users, it can thus be difficult to determine the most appropriate app for given needs and assess the level of scientific evidence supporting their use. Therefore, this review aims to examine the research studies that deal with this issue and determine the characteristics of the apps involved.

METHODOLOGY

This study involved a systematic review of the scientific literature on randomized clinical trials that use apps to improve cancer management among patients, using the Pubmed (Medline), Latin America and the Caribbean in Health Sciences (LILACS), and Cochrane databases. The search was limited to articles written in English and Spanish published in the last 10 years. A search of the App Store for iOS devices and Google Play for Android devices was performed to find the apps identified in the included research articles.

RESULTS

In total, 54 articles were found to analyze the development of an application in the field of oncology. These articles were most frequently related to the use of apps for the early detection of cancer (n = 28), particularly melanoma (n = 9). In total, 21 studies reflected the application used. The apps featured in nine articles were located using the App Store and Google Play (n = 9), of which five were created to manage cancer-related issues. The rest of the apps were designed for use in the general population (n = 4).

CONCLUSIONS

There is an increasing number of research articles that study the use of apps in the field of oncology; however, these mobile applications tend to disappear from app stores after the studies are completed.

Using Quick Response Codes to Increase Students' Participation in Case-Based Learning Courses

The purpose of this study was to use Quick Response codes to increase engagement in a case-based learning course. A quasi-experiment was conducted, and 103 students enrolled in a pharmacology course participated. The students were divided into high-, medium-, and low-scoring groups, based on their previous semester grades in the pharmacology course. A Chinese-version questionnaire of the Nursing Students' Attitude Toward Quick Response Codes in Case-Based Learning Scale was used. The major findings were as follows: (1) Most participants held positive attitudes toward the use of Quick Response codes in case-based learning courses. It was suggested that participants perceived the use of Quick Response codes to be easy and useful in learning activities. They also demonstrated positive attitudes toward the Quick Response codes and expressed their intention to use this application in the future. (2) After applying Quick Response codes in classroom teaching, students performed better in asking questions and discussions than they did before. The performance of the medium-level students improved significantly.