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Cho J, Yoo S, Lee EE, Lee HY. Impact of a Nationwide Medication History Sharing Program on the Care Process and End-User Experience in a Tertiary Teaching Hospital: Cohort Study and Cross-Sectional Study. JMIR Med Inform 2024; 12:e53079. [PMID: 38533775 PMCID: PMC11004625 DOI: 10.2196/53079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 03/28/2024] Open
Abstract
Background Timely and comprehensive collection of a patient's medication history in the emergency department (ED) is crucial for optimizing health care delivery. The implementation of a medication history sharing program, titled "Patient's In-home Medications at a Glance," in a tertiary teaching hospital aimed to efficiently collect and display nationwide medication histories for patients' initial hospital visits. Objective As an evaluation was necessary to provide a balanced picture of the program, we aimed to evaluate both care process outcomes and humanistic outcomes encompassing end-user experience of physicians and pharmacists. Methods We conducted a cohort study and a cross-sectional study to evaluate both outcomes. To evaluate the care process, we measured the time from the first ED assessment to urgent percutaneous coronary intervention (PCI) initiation from electronic health records. To assess end-user experience, we developed a 22-item questionnaire using a 5-point Likert scale, including 5 domains: information quality, system quality, service quality, user satisfaction, and intention to reuse. This questionnaire was validated and distributed to physicians and pharmacists. The Mann-Whiteny U test was used to analyze the PCI initiation time, and structural equation modeling was used to assess factors affecting end-user experience. Results The time from the first ED assessment to urgent PCI initiation at the ED was significantly decreased using the patient medication history program (mean rank 42.14 min vs 28.72 min; Mann-Whitney U=346; P=.03). A total of 112 physicians and pharmacists participated in the survey. Among the 5 domains, "intention to reuse" received the highest score (mean 4.77, SD 0.37), followed by "user satisfaction" (mean 4.56, SD 0.49), while "service quality" received the lowest score (mean 3.87, SD 0.79). "User satisfaction" was significantly associated with "information quality" and "intention to reuse." Conclusions Timely and complete retrieval using a medication history-sharing program led to an improved care process by expediting critical decision-making in the ED, thereby contributing to value-based health care delivery in a real-world setting. The experiences of end users, including physicians and pharmacists, indicated satisfaction with the program regarding information quality and their intention to reuse.
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Affiliation(s)
- Jungwon Cho
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Eunkyung Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Ho-Young Lee
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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2
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Mahmudah NA, Shin HG, Ock M, Jo AJ, Min A, Pyo J, Im D, Kim S. Barcode and radio frequency identification utilization varied across Korean hospitals. Int J Qual Health Care 2023; 35:mzad063. [PMID: 37616491 DOI: 10.1093/intqhc/mzad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 07/05/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023] Open
Abstract
Barcodes and radio frequency identification (RFID) are increasingly used in health care to improve patient safety. However, studies on their utilization in clinical settings are limited. This study aimed to comprehensively examine the utilization status of barcodes and RFID in Korean hospitals, recognize the effects and obstacles associated with utilization, and explore the measures to expand the applications of barcodes and RFID. A self-reported online survey was conducted in tertiary hospitals, general hospitals, hospitals, and nursing hospitals in the Republic of Korea. The survey questionnaire comprised questions on barcodes and RFID utilization status, the effect of barcodes and RFID utilization, measures to expand the utilization of barcodes and RFID, and information on respondents' demographics and hospitals. A representative from each of 23 tertiary hospitals, 101 general hospitals, 232 hospitals, and 214 nursing hospitals completed the survey (total response rate 17%). The data were analysed using the chi-square test or Fisher's exact test to determine the differences in responses based on the type and characteristics of hospitals. The tertiary hospitals had the highest utilizations of both RFID and barcodes (n = 10, 43.5%), whereas the nursing hospitals had the lowest (n = 96, 55.1%). Barcodes and RFID were most commonly used in the visits and security management domains. However, the use of barcodes and RFID in medication dispensing and administration safety was low, despite its value in improving patient safety. The hospitals recognized the positive effect of utilization of barcodes and RFID, reporting the highest frequency for the prevention of patient safety incidents (n = 79, 85.9%). Nevertheless, the cost of barcodes and RFID facility investments (n = 128, 90.3%) appeared to be the greatest obstacle to the introduction of barcodes and RFID. Hence, barcodes and RFID facility investment support (n = 133, 95.5%) were given the highest priority among the measures to expand barcode and RFID utilization in health care. The utilization of barcodes and RFID varied across the type and domain of hospitals in the Republic of Korea. Hospitals recognized the positive effects of barcode and RFID utilization. Nonetheless, all hospitals were concerned about the cost of investment and maintenance of barcode and RFID facilities as the main obstacles to utilization. Therefore, a support plan must be developed for the cost of barcodes and RFID facility investments to expand barcode and RFID utilization in health care.
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Affiliation(s)
- Noor Afif Mahmudah
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Daehagbyeongwon-ro 25, Dong-gu, Ulsan 44033, Republic of Korea
| | - Ho Gyun Shin
- National Evidence-based Healthcare Collaborating Agency, 3~5F Health and Welfare Social Administration, 400 Neungdong-ro, Gwangjingu, Seoul 04933, Republic of Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Daehagbyeongwon-ro 25, Dong-gu, Ulsan 44033, Republic of Korea
- Department of Preventive Medicine, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Ae Jeong Jo
- National Evidence-based Healthcare Collaborating Agency, 3~5F Health and Welfare Social Administration, 400 Neungdong-ro, Gwangjingu, Seoul 04933, Republic of Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Daehagbyeongwon-ro 25, Dong-gu, Ulsan 44033, Republic of Korea
| | - Dasom Im
- Department of Preventive Medicine, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Sukyeong Kim
- National Evidence-based Healthcare Collaborating Agency, 3~5F Health and Welfare Social Administration, 400 Neungdong-ro, Gwangjingu, Seoul 04933, Republic of Korea
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3
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Marlow N, Eckert M, Sharplin G, Gwilt I, Carson-Chahhoud K. Graphical User Interface Development for a Hospital-Based Predictive Risk Tool: Protocol for a Co-Design Study. JMIR Res Protoc 2023; 12:e47717. [PMID: 37651166 PMCID: PMC10502603 DOI: 10.2196/47717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND This co-design research method details the iterative process developed to identify health professional recommendations for the graphical user interface (GUI) of an artificial intelligence (AI)-enabled risk prediction tool. Driving the decision to include a co-design process is the belief that choices regarding the aesthetic and functionality of an intervention are best made by its intended users and that engaging these users in its design will promote the tool's adoption and use. OBJECTIVE The aim of this research is to identify health professional design and uptake recommendations for the GUI of an AI-enabled predictive risk tool. METHODS We will hold 3 research phases, each consisting of 2 workshops with health professionals, between mid-2023 and mid-2024. A total of 6 health professionals will be sought per workshop, resulting in a total enrollment of 36 health professionals at the conclusion of the research. A total of 7 workshop activities have been scheduled across the 3 workshops; these include context of use, notifiers, format, AI survey-Likert, prototype, AI survey-written, and testing. The first 6 of these activities will be repeated in each workshop to enable the iterative development and refinement of GUI. The last activity (testing) will be performed in the final workshop to examine health professionals' thoughts on the final GUI iteration. Qualitative and quantitative results data will be produced from tasks in each research activity. Qualitative data will be examined through inductive thematic analysis or deductive thematic analysis in accordance with the Nonadoption, Abandonment, and Challenges to the Scale-up, Spread, and Sustainability (NASSS) framework; visual data will be examined in accordance with "framework of interactivity;" and quantitative data will be examined using descriptive statistics. RESULTS Project registration with the Australia and New Zealand Clinical Trial Registry has been requested (#384098). Finalized design recommendations are expected in early to mid-2024, with a results manuscript to be submitted in mid-2024. This research method has human research ethics approval from the South Australian Department of Health and Wellbeing (#2022/HRE00131) as well as from the Human Research Ethics Committee of the University of South Australia (application ID#204143). CONCLUSIONS Understanding whether an intervention is needed in a particular situation is just the start; designing an intervention so that it is used within that situation is paramount. This co-design process engages end users to create a GUI that includes the aesthetic and functional details they need in a manner that aligns with their existing work practices. Indeed, interventions that fail to do this may be disliked, and at worst, they may be dangerous. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47717.
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Affiliation(s)
| | | | | | - Ian Gwilt
- University of South Australia, Adelaide, Australia
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4
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Gasteiger N, Vercell A, Khan N, Dowding D, Davies AC, Davies A. Digital interventions for genomics and genetics education, empowerment, and service engagement: A systematic review. J Community Genet 2023:10.1007/s12687-023-00648-w. [PMID: 37198378 DOI: 10.1007/s12687-023-00648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Patient-facing digital technologies may reduce barriers to and alleviate the burden on genetics services. However, no work has synthesised the evidence for patient-facing digital interventions for genomics/genetics education and empowerment, or to facilitate service engagement more broadly. It is also unclear which groups have been engaged by digital interventions. AIM This systematic review explores which existing patient-facing digital technologies have been used for genomics/genetics education and empowerment, or to facilitate service engagement, and for whom and for which purposes the interventions have been developed. METHODS The review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eight databases were searched for literature. Information was extracted into an Excel sheet and analysed in a narrative manner. Quality assessments were conducted using the Mixed Methods Appraisal Tool. RESULTS Twenty-four studies were included, of which 21 were moderate or high quality. The majority (88%) were conducted in the United States of America or within a clinical setting (79%). More than half (63%) of the interventions were web-based tools, and almost all focussed on educating users (92%). There were promising results regarding educating patients and their families and facilitating engagement with genetics services. Few of the studies focussed on empowering patients or were community-based. CONCLUSION Digital interventions may be used to deliver information about genetics concepts and conditions, and positively impact service engagement. However, there is insufficient evidence related to empowering patients and engaging underserved communities or consanguineous couples. Future work should focus on co-developing content with end users and incorporating interactive features.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Amy Vercell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Naz Khan
- Genomic Medicine, St. Mary's Hospital, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Angela C Davies
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Alan Davies
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester, UK.
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5
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Alenoghena CO, Onumanyi AJ, Ohize HO, Adejo AO, Oligbi M, Ali SI, Okoh SA. eHealth: A Survey of Architectures, Developments in mHealth, Security Concerns and Solutions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13071. [PMID: 36293656 PMCID: PMC9603507 DOI: 10.3390/ijerph192013071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The ramifications of the COVID-19 pandemic have contributed in part to a recent upsurge in the study and development of eHealth systems. Although it is almost impossible to cover all aspects of eHealth in a single discussion, three critical areas have gained traction. These include the need for acceptable eHealth architectures, the development of mobile health (mHealth) technologies, and the need to address eHealth system security concerns. Existing survey articles lack a synthesis of the most recent advancements in the development of architectures, mHealth solutions, and innovative security measures, which are essential components of effective eHealth systems. Consequently, the present article aims at providing an encompassing survey of these three aspects towards the development of successful and efficient eHealth systems. Firstly, we discuss the most recent innovations in eHealth architectures, such as blockchain-, Internet of Things (IoT)-, and cloud-based architectures, focusing on their respective benefits and drawbacks while also providing an overview of how they might be implemented and used. Concerning mHealth and security, we focus on key developments in both areas while discussing other critical topics of importance for eHealth systems. We close with a discussion of the important research challenges and potential future directions as they pertain to architecture, mHealth, and security concerns. This survey gives a comprehensive overview, including the merits and limitations of several possible technologies for the development of eHealth systems. This endeavor offers researchers and developers a quick snapshot of the information necessary during the design and decision-making phases of the eHealth system development lifecycle. Furthermore, we conclude that building a unified architecture for eHealth systems would require combining several existing designs. It also points out that there are still a number of problems to be solved, so more research and investment are needed to develop and deploy functional eHealth systems.
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Affiliation(s)
| | - Adeiza James Onumanyi
- Next Generation Enterprises and Institutions, Council for Scientific and Industrial Research (CSIR), Pretoria 0001, South Africa
| | - Henry Ohiani Ohize
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Achonu Oluwole Adejo
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Maxwell Oligbi
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Shaibu Ibrahim Ali
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Supreme Ayewoh Okoh
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
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6
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Rai A, Keil M, Choi H, Mindel V. Understanding how physician perceptions of job demand and process benefits evolve during CPOE implementation. Health Syst (Basingstoke) 2022; 12:98-122. [PMID: 36926371 PMCID: PMC10013386 DOI: 10.1080/20476965.2022.2113343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 08/03/2022] [Indexed: 10/14/2022] Open
Abstract
We examine how physicians' perceptions of two computerized provider order entry (CPOE) capabilities, standardisation of care protocols and documentation quality, are associated with their perceptions of turnaround time, medical error, and job demand at three phases of CPOE implementation: pre-go-live, initial use, and continued use. Through a longitudinal study at a large urban hospital, we find standardisation of care protocols is positively associated with turnaround time reduction in all phases but positively associated with job demand increase only in the initial use phase. Standardisation also has a positive association with medical error reduction in the initial use phase, but later this effect becomes fully mediated through turnaround time reduction in the continued use phase. Documentation quality has a positive association with medical error reduction in the initial use phase and this association strengthens in the continued use phase. Our findings provide insights to effectively manage physicians' response to CPOE implementation.
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Affiliation(s)
- Arun Rai
- Georgia State University, Atlanta, Georgia, United States
| | - Mark Keil
- Georgia State University, Atlanta, Georgia, United States
| | - Hyoungyong Choi
- Hankuk University of Foreign Studies, Dongdaemun-gu, Seoul, Korea
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7
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Van Dort BA, Carland JE, Penm J, Ritchie A, Baysari MT. Digital interventions for antimicrobial prescribing and monitoring: a qualitative meta-synthesis of factors influencing user acceptance. J Am Med Inform Assoc 2022; 29:1786-1796. [PMID: 35897157 PMCID: PMC9471701 DOI: 10.1093/jamia/ocac125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/16/2022] [Accepted: 07/16/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To understand and synthesize factors influencing user acceptance of digital interventions used for antimicrobial prescribing and monitoring in hospitals. MATERIALS AND METHODS A meta-synthesis was conducted to identify qualitative studies that explored user acceptance of digital interventions for antimicrobial prescribing and/or monitoring in hospitals. Databases were searched and qualitative data were extracted and systematically classified using the unified theory of acceptance and use of technology (UTAUT) model. RESULTS Fifteen qualitative studies met the inclusion criteria. Eleven papers used interviews and four used focus groups. Most digital interventions evaluated in studies were decision support for prescribing (n = 13). Majority of perceptions were classified in the UTAUT performance expectancy domain in perceived usefulness and relative advantage constructs. Key facilitators in this domain included systems being trusted and credible sources of information, improving performance of tasks and increasing efficiency. Reported barriers were that interventions were not considered useful for all settings or patient conditions. Facilitating conditions was the second largest domain, which highlights the importance of users having infrastructure to support system use. Digital interventions were viewed positively if they were compatible with values, needs, and experiences of users. CONCLUSIONS User perceptions that drive users to accept and utilize digital interventions for antimicrobial prescribing and monitoring were predominantly related to performance expectations and facilitating conditions. To ensure digital interventions for antimicrobial prescribing are accepted and used, we recommend organizations ensure systems are evaluated and benefits are conveyed to users, that utility meets expectations, and that appropriate infrastructure is in place to support use.
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Affiliation(s)
- Bethany A Van Dort
- Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane E Carland
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jonathan Penm
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Pharmacy, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Angus Ritchie
- Health Informatics Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Melissa T Baysari
- Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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8
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Gasteiger N, van der Veer SN, Wilson P, Dowding D. How, for Whom, and in Which Contexts or Conditions Augmented and Virtual Reality Training Works in Upskilling Health Care Workers: Realist Synthesis. JMIR Serious Games 2022; 10:e31644. [PMID: 35156931 PMCID: PMC8893595 DOI: 10.2196/31644] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/16/2021] [Accepted: 10/12/2021] [Indexed: 01/20/2023] Open
Abstract
Background Using traditional simulators (eg, cadavers, animals, or actors) to upskill health workers is becoming less common because of ethical issues, commitment to patient safety, and cost and resource restrictions. Virtual reality (VR) and augmented reality (AR) may help to overcome these barriers. However, their effectiveness is often contested and poorly understood and warrants further investigation. Objective The aim of this review is to develop, test, and refine an evidence-informed program theory on how, for whom, and to what extent training using AR or VR works for upskilling health care workers and to understand what facilitates or constrains their implementation and maintenance. Methods We conducted a realist synthesis using the following 3-step process: theory elicitation, theory testing, and theory refinement. We first searched 7 databases and 11 practitioner journals for literature on AR or VR used to train health care staff. In total, 80 papers were identified, and information regarding context-mechanism-outcome (CMO) was extracted. We conducted a narrative synthesis to form an initial program theory comprising of CMO configurations. To refine and test this theory, we identified empirical studies through a second search of the same databases used in the first search. We used the Mixed Methods Appraisal Tool to assess the quality of the studies and to determine our confidence in each CMO configuration. Results Of the 41 CMO configurations identified, we had moderate to high confidence in 9 (22%) based on 46 empirical studies reporting on VR, AR, or mixed simulation training programs. These stated that realistic (high-fidelity) simulations trigger perceptions of realism, easier visualization of patient anatomy, and an interactive experience, which result in increased learner satisfaction and more effective learning. Immersive VR or AR engages learners in deep immersion and improves learning and skill performance. When transferable skills and knowledge are taught using VR or AR, skills are enhanced and practiced in a safe environment, leading to knowledge and skill transfer to clinical practice. Finally, for novices, VR or AR enables repeated practice, resulting in technical proficiency, skill acquisition, and improved performance. The most common barriers to implementation were up-front costs, negative attitudes and experiences (ie, cybersickness), developmental and logistical considerations, and the complexity of creating a curriculum. Facilitating factors included decreasing costs through commercialization, increasing the cost-effectiveness of training, a cultural shift toward acceptance, access to training, and leadership and collaboration. Conclusions Technical and nontechnical skills training programs using AR or VR for health care staff may trigger perceptions of realism and deep immersion and enable easier visualization, interactivity, enhanced skills, and repeated practice in a safe environment. This may improve skills and increase learning, knowledge, and learner satisfaction. The future testing of these mechanisms using hypothesis-driven approaches is required. Research is also required to explore implementation considerations.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, United Kingdom.,Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom.,Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Sabine N van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Paul Wilson
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, United Kingdom
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9
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Mlakar I, Smrke U, Flis V, Bergauer A, Kobilica N, Kampič T, Horvat S, Vidovič D, Musil B, Plohl N. A randomized controlled trial for evaluating the impact of integrating a computerized clinical decision support system and a socially assistive humanoid robot into grand rounds during pre/post-operative care. Digit Health 2022; 8:20552076221129068. [PMID: 36185391 PMCID: PMC9515524 DOI: 10.1177/20552076221129068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022] Open
Abstract
Although clinical decision support systems (CDSSs) are increasingly emphasized as
one of the possible levers for improving care, they are still not widely used
due to different barriers, such as doubts about systems’ performance, their
complexity and poor design, practitioners’ lack of time to use them, poor
computer skills, reluctance to use them in front of patients, and deficient
integration into existing workflows. While several studies on CDSS exist, there
is a need for additional high-quality studies using large samples and examining
the differences between outcomes following a decision based on CDSS support and
those following decisions without this kind of information. Even less is known
about the effectiveness of a CDSS that is delivered during a grand round routine
and with the help of socially assistive humanoid robots (SAHRs). In this study,
200 patients will be randomized into a Control Group (i.e. standard care) and an
Intervention Group (i.e. standard care and novel CDSS delivered via a SAHR).
Health care quality and Quality of Life measures will be compared between the
two groups. Additionally, approximately 22 clinicians, who are also active
researchers at the University Clinical Center Maribor, will evaluate the
acceptability and clinical usability of the system. The results of the proposed
study will provide high-quality evidence on the effectiveness of CDSS systems
and SAHR in the grand round routine.
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Affiliation(s)
- Izidor Mlakar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Vojko Flis
- University Clinical Centre Maribor, Maribor, Slovenia
| | | | - Nina Kobilica
- University Clinical Centre Maribor, Maribor, Slovenia
| | - Tadej Kampič
- University Clinical Centre Maribor, Maribor, Slovenia
| | - Samo Horvat
- University Clinical Centre Maribor, Maribor, Slovenia
| | | | - Bojan Musil
- Faculty of Arts, Department of Psychology, University of Maribor, Maribor, Slovenia
| | - Nejc Plohl
- Faculty of Arts, Department of Psychology, University of Maribor, Maribor, Slovenia
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