A Patient Outcomes-Driven Feedback Platform for Emergency Medicine Clinicians: Human-Centered Design and Usability Evaluation of Linking Outcomes Of Patients (LOOP)

Beyond the requirement: A novel patient follow-up report

Background

Residents are required to participate in practice-based learning and improvement. Most commonly, a resident-initiated patient follow-up log is used to meet the requirement. We sought to provide residents with follow-up information in an efficient, value-added manner via a patient follow-up report (PFUR).

Methods

The PFUR is an automated monthly report sent to individual residents via email. It was generated from the electronic medical record and included five categories of cases: patients who were discharged and returned for admission within 72 h, diagnosis-based criteria, patients who expired during the hospital stay, patients who were admitted to or upgraded to the intensive care unit (ICU) within 24 h of admission, and patients independently flagged by the care team for follow-up. The PFURs were analyzed for 6 months after implementation for number and categorization of cases included as well as via survey of the residents.

Results

In 6 months, 1078 patients, generating 1155 follow-ups, were included on the PFUR. ICU upgrades were the most represented category (41%), followed by diagnosis-based criteria (30%). Patients who were discharged and admitted within 72 h were least commonly represented on the PFUR (2%). Seventy-eight percent of residents felt that patient follow-ups were valuable to their education and 82% felt that the PFUR impacted the clinical care they provided. The PFUR was preferred by 90% of resident respondents and had an average value rating of 4.38 out of 5.

Conclusions

Overall numbers of patient follow-ups significantly increased after implementation of the PFUR. Certain categories were more represented overall and within each class, which has implications for future educational initiatives. After a pilot period, the novel PFUR appears to be more efficient, accessible, and highly valued than the log used previously. Programs looking to maximize the educational benefits of patient follow-ups may consider a similar initiative.

The Acceptance and Use of Digital Technologies for Self-Reporting Medication Safety Events After Care Transitions to Home in Patients With Cancer: Survey Study

BACKGROUND

Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in adopting digital technologies and engaging in self-reporting medication safety events during transitions of care have not been fully understood.

OBJECTIVE

We aim to assess oncology patients' perceptions of medication and communication safety during care transitions and their willingness to use digital technologies for self-reporting medication safety events and to identify factors associated with their technology acceptance.

METHODS

A cross-sectional survey study was conducted with adult patients with breast, prostate, lung, or colorectal cancer (N=204) who had experienced care transitions from hospitals or clinics to home in the past 1 year. Surveys were conducted via phone, the internet, or email between December 2021 and August 2022. Participants' perceptions of medication and communication safety and perceived usefulness, ease of use, attitude toward use, and intention to use a technology system to report their medication safety events from home were assessed as outcomes. Potential personal, clinical, and psychosocial factors were analyzed for their associations with participants' technology acceptance through bivariate correlation analyses and multiple logistic regressions.

RESULTS

Participants reported strong perceptions of medication and communication safety, positively correlated with medication self-management ability and patient activation. Although most participants perceived a medication safety self-reporting system as useful (158/204, 77.5%) and easy to use (157/204, 77%), had a positive attitude toward use (162/204, 79.4%), and were willing to use such a system (129/204, 63.2%), their technology acceptance was associated with their activation levels (odds ratio [OR] 1.83, 95% CI 1.12-2.98), their perceptions of communication safety (OR 1.64, 95% CI 1.08-2.47), and whether they could receive feedback after self-reporting (OR 3.27, 95% CI 1.37-7.78).

CONCLUSIONS

In general, oncology patients were willing to use digital technologies to report their medication events after care transitions back home because of their high concerns regarding medication safety. As informed and activated patients are more likely to have the knowledge and capability to initiate and engage in self-reporting, developing a patient-centered reporting system to empower patients and their families and facilitate safety health communications will help oncology patients in addressing their medication safety concerns, meeting their care needs, and holding promise to improve the quality of cancer care.