• Clinician Perceptions of a Mobile Electronic Health Record Application

      Davis, Stacian A.; Piscotty, Ronald (2020-05)
      Problem and Purpose: Due to healthcare technology advancements, increasing patient acuity, and patient safety efforts, the Informatics Department at a research hospital has undertaken an initiative to provide remote access of the organization's Electronic Health Record (EHR) system to clinicians via a mobile application. The purpose of this quality improvement project was to test the prototype EHR mobile application to ascertain clinicians’ perceptions of the system, evaluate potential usability, and gauge overall satisfaction prior to implementation. Methods: Clinicians (N=10) who had been working at the hospital for at least 6 months were randomly recruited. Usability testing was completed using the EHR mobile application testing environment. Clinicians completed a pre-test survey regarding their perceptions of the utility of having mobile EHR access prior to reviewing the application. The clinicians were then instructed to navigate the system on their own for a few minutes and were provided with a script with instructions for order entry and results review. Once done with the application, the clinicians completed the post-test survey, a usability questionnaire, and answered several open-ended questions. The responses were captured using Microsoft Forms and Microsoft Excel. Results: The pre-test data indicated that 60% of clinicians strongly agree that having access to the mobile application would be clinically useful. This increased to 80% after the clinicians viewed and used the application. The pre-test data also revealed that 70% of the clinicians agreed that the mobile application would improve patient care. After using the application, this increased to 100%. Prior to using the application, 80% of clinicians agreed that that the application would increase clinicians’ productivity. After viewing the application, there was an increase to 100%. Additionally, a paired sample t-test indicated that there was a significant difference (p<0.005) in the mean score between the pre and post-test, suggesting that there was a significant change in the clinicians’ perception of the mobile application after using it. The usability survey revealed that at least 70% of clinicians strongly agreed and 30% agreed that they would use the mobile application frequently, with 100% confidence in its utilization. About 90% thought it was easy to use. Based on the overall responses from the clinicians, the application is viewed as intuitive and user friendly. Conclusions: The goal of this quality improvement project was to determine the usability and usefulness of an EHR mobile application. Findings from surveyed clinicians indicated that the mobile EHR application is user friendly and that it will allow increased access to patient data therefore provide a high-level of patient care.
    • Improving Medication Adherence Among Diabetes Patients Utilizing Mobile App and Pamphlet

      Pacheco, Aileen D.; Jones-Parker, Hazel (2020-05)
      Problem and Purpose: The American Diabetes Association set the antidiabetic oral medication adherence rate to 80%. Medication nonadherence is strongly associated with poor glycemic control resulting in more healthcare services utilization. A family practice clinic noted that the majority of patients with diabetes are nonadherent to their medication. The purpose of this quality improvement (QI) project was to improve the medication adherence of patients with type 2 diabetes mellitus (T2DM) through the implementation of mobile health application reminder (MHAR) and diabetes adherence education pamphlet (DAEP). Methods: This project was implemented over thirteen weeks at a suburban primary care practice using the Mobilize, Assess, Plan, Implement, Track process framework. During an office visit, participants (N = 6) completed the likelihood of nonadherence (LON) online survey before the intervention and receive the DAEP. The participants used MHAR for four weeks and self-reported medication adherence rates. They also completed a post-LON survey via phone call by the project leader. Results: All the of participants (N=6) achieved low to medium LON post scores. There were no differences (z=0.577, p > 0.05) between pre- and post-intervention LON scores using the sign test as an alternative statistic. Only 67% (average) of patients seen received the DAEP at the last week of implementation. After four weeks of usage of the MHAR of each participant, 67% (n=4) reported adherent with an 80% or higher adherence rate, and 33% (n=2) nonadherent. The Pearson correlation coefficient for dichotomized compliance data predicted by post-intervention LON scores was found to be -0.31. This result indicated a weak negative correlation between adherence rate and post-LON. Conclusion: With the availability of MHAR, this tool must be leveraged to help patients adhere to their medication as prescribed. This project has demonstrated that when combined DAEP and MHAR have the potential to improve medication adherence among patients with T2DM. Providers can optimize the efficacy of these interventions to enhance verbal education during clinic visits.