Investigating the possibilities of using patient-generated health data in emergency care: an explorative study

AbstractIt is well known that emergency departments (EDs) are exposed to human errors and unintended events due to large patient flow, high work pressure and overload of information. Strategies for providing efficient and effective health care are therefore imperative, and health information technologies are suggested to be one of the solutions. This study sought to investigate if the use of patient-generated health data gathered through a digital patient questionnaire and visualised as a patient-generated journal (PGJ v.1.0) has the potential to improve the care delivered in EDs.MethodsUsing a mixed-method approach, the PGJ (v.1.0) was investigatedfrom key stakeholders’ perspectives. First, we examined the PGJ from a patient perspective via participant observation (n = 18) and interviews (n = 18), supported by statistical data from the PGJ (n = 56). Second, we used questionnaires to explore the physicians’ perspectives (n = 9). Lastly, two interviews were conducted with healthcare leaders from the ED. The data were compared and analysed using descriptive statistics and hermeneutic analysis.Results From the findings, it appears that patients in need of urgent care accept the use of patient-generated data, and patients highly favoured being active in their patient pathway. However, the system needed some adjustments to fit the patients’abilities in urgent situations.The physicians expressed mixed attitudes towards the PGJ: the majority agreed that the system needed some adjustments in order for the full benefits to be gained, but thought that it had potential to improve their work processes when fully developed.Conclusions This study concludes that the use of patient-generated data is well accepted by patients in an urgent setting, and that the PGJ has the potential to improve quality of care in patient pathways by adding value to patient flows as well as clinical workflows. The concept of utilising patient-generated health data in emergency care should therefore be further developed and investigated

Emergency department personnel's individual preferences should not be neglected when an IT-technology is to be introduced

There is an increasing demand and importance for quick clinical assessment of patients by experienced front-line physician, and for efficient patientflow in emergency department without delay. That requires application of new technologies, including IT-solutions. From the other side, healthpersonnel, as a human factor applying technology, should accept it and not be neglected. Purpose: preliminary qualitative assessment of physicians' individual preferences related to introduction of conceptual tablet-device based documentation technology in emergency department. We used ”Presurvey” solution developed for the emergency department in order to speed-up documentation process by front-line physicians, which is mobile device based web-app system allowing data input via button selection and visualising standardised autotext (front-line doctor's clinical assessment note) based on the ABCDE clinical algorithm. Author had participated in the concept development.  ”Presurvey” was used at Emergency department, Regional Hospital Horsens, during 100-days period, from October 2017, working days, between 7.30-18.00. Mini-iPad was used as mobile device. “Presurvey” was introduced to doctors individually. 9 experienced emergency doctors were invited, they were completely free to apply the concept or not on a case to case basis.  There was gathered feedback and undertaken audit. ”Presurvey” was applied by 8 (89%) doctors in 528 patient-cases (12,5%) out of 4.215 admitted patients of medical and surgical profiles. 1 (11%) physician wouldn't use ”Presurvey”, 3 (33%) doctors have tried, but preferred the conventional documentation way. 5 (55%) users, including author, had positive attitude. 4 (44%) of them (without author) were active users, based on criteria of repeated use of ”Presurvey”. Audit revealed personal preferences, mostly addressed to autotext. The concept was evaluated as making sense by 7 (78%) doctors, however there was different level of unsatisfaction related to the text formulations. 4 (50%) participating doctors accepted autotext concept with minor adjustments, while the other 50% would prefer flexibility of ”alive” language as communication tool for documentation. Small-population observational study demonstrates that for implementation of a new IT-based technology related to the medical documentation in emergency department it is important to consider as choice flexibility for specialists as their individual variables and preferences, which should be carefully studied when introduced bigger scale solutions