Alissa L Russ1, Michelle A Jahn2, Himalaya Patel3, Brian W Porter3, Khoa A Nguyen4, Alan J Zillich5, Amy Linsky6, Steven R Simon7. 1. Center for Health Information and Communication, Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States; Department of Pharmacy Practice, College of Pharmacy, West Lafayette, IN, United States; Regenstrief Institute, Inc., Indianapolis, IN, United States. Electronic address: aruss@purdue.edu. 2. Center for Health Information and Communication, Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States; School of Industrial Engineering, Purdue University, West Lafayette, IN, United States. 3. Center for Health Information and Communication, Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States. 4. Center for Health Information and Communication, Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States; Department of Pharmacy Practice, College of Pharmacy, West Lafayette, IN, United States. 5. Department of Pharmacy Practice, College of Pharmacy, West Lafayette, IN, United States. 6. Section of General Internal Medicine at the VA Boston Healthcare System and Boston Medical Center, Boston, MA, United States; Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, United States. 7. Section of General Internal Medicine at the VA Boston Healthcare System and Boston Medical Center, Boston, MA, United States; Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, United States; Geriatrics and Extended Care Service, VA Boston Healthcare System, Brockton, MA, United States.
Abstract
OBJECTIVE: An electronic medication reconciliation tool was previously developed by another research team to aid provider-patient communication for medication reconciliation. To evaluate the usability of this tool, we integrated artificial safety probes into standard usability methods. The objective of this article is to describe this method of using safety probes, which enabled us to evaluate how well the tool supports users' detection of medication discrepancies. MATERIALS AND METHODS: We completed a mixed-method usability evaluation in a simulated setting with 30 participants: 20 healthcare professionals (HCPs) and 10 patients. We used factual scenarios but embedded three artificial safety probes: (1) a missing medication (i.e., omission); (2) an extraneous medication (i.e., commission); and (3) an inaccurate dose (i.e., dose discrepancy). We measured users' detection of each probe to estimate the probability that a HCP or patient would detect these discrepancies. Additionally, we recorded participants' detection of naturally occurring discrepancies. RESULTS: Each safety probe was detected by ≤50% of HCPs. Patients' detection rates were generally higher. Estimates indicate that a HCP and patient, together, would detect 44.8% of these medication discrepancies. Additionally, HCPs and patients detected 25 and 45 naturally-occurring discrepancies, respectively. DISCUSSION: Overall, detection of medication discrepancies was low. Findings indicate that more advanced interface designs are warranted. Future research is needed on how technologies can be designed to better aid HCPs' and patients' detection of medication discrepancies. CONCLUSION: This is one of the first studies to evaluate the usability of a collaborative medication reconciliation tool and assess HCPs' and patients' detection of medication discrepancies. Results demonstrate that embedded safety probes can enhance standard usability methods by measuring additional, clinically-focused usability outcomes. The novel safety probes we used may serve as an initial, standard set for future medication reconciliation research. More prevalent use of safety probes could strengthen usability research for a variety of health information technologies. Published by Elsevier Inc.
OBJECTIVE: An electronic medication reconciliation tool was previously developed by another research team to aid provider-patient communication for medication reconciliation. To evaluate the usability of this tool, we integrated artificial safety probes into standard usability methods. The objective of this article is to describe this method of using safety probes, which enabled us to evaluate how well the tool supports users' detection of medication discrepancies. MATERIALS AND METHODS: We completed a mixed-method usability evaluation in a simulated setting with 30 participants: 20 healthcare professionals (HCPs) and 10 patients. We used factual scenarios but embedded three artificial safety probes: (1) a missing medication (i.e., omission); (2) an extraneous medication (i.e., commission); and (3) an inaccurate dose (i.e., dose discrepancy). We measured users' detection of each probe to estimate the probability that a HCP or patient would detect these discrepancies. Additionally, we recorded participants' detection of naturally occurring discrepancies. RESULTS: Each safety probe was detected by ≤50% of HCPs. Patients' detection rates were generally higher. Estimates indicate that a HCP and patient, together, would detect 44.8% of these medication discrepancies. Additionally, HCPs and patients detected 25 and 45 naturally-occurring discrepancies, respectively. DISCUSSION: Overall, detection of medication discrepancies was low. Findings indicate that more advanced interface designs are warranted. Future research is needed on how technologies can be designed to better aid HCPs' and patients' detection of medication discrepancies. CONCLUSION: This is one of the first studies to evaluate the usability of a collaborative medication reconciliation tool and assess HCPs' and patients' detection of medication discrepancies. Results demonstrate that embedded safety probes can enhance standard usability methods by measuring additional, clinically-focused usability outcomes. The novel safety probes we used may serve as an initial, standard set for future medication reconciliation research. More prevalent use of safety probes could strengthen usability research for a variety of health information technologies. Published by Elsevier Inc.
Entities:
Keywords:
Medical informatics; Medication errors; Medication reconciliation; Patient portals; Usability
Authors: Evan W Orenstein; Irit R Rasooly; Mark V Mai; Adam C Dziorny; Wanczyk Phillips; Levon Utidjian; Anthony Luberti; Jill Posner; Rebecca Tenney-Soeiro; Chris P Bonafide Journal: J Am Med Inform Assoc Date: 2018-11-01 Impact factor: 4.497
Authors: Michelle A Jahn; Brian W Porter; Himalaya Patel; Alan J Zillich; Steven R Simon; Alissa L Russ Journal: Appl Clin Inform Date: 2018-06-27 Impact factor: 2.342
Authors: Denise J van der Nat; Victor J B Huiskes; Margot Taks; Bart P H Pouls; Bart J F van den Bemt; Hein A W van Onzenoort Journal: BMC Health Serv Res Date: 2022-06-13 Impact factor: 2.908
Authors: Julianne E Brady; Amy M Linsky; Steven R Simon; Kate Yeksigian; Amy Rubin; Alan J Zillich; Alissa L Russ-Jara Journal: JMIR Hum Factors Date: 2022-08-03
Authors: Blake Lesselroth; Victoria Lee Church; Kathleen Adams; Amanda Mixon; Amy Richmond-Aylor; Naomi Glasscock; Jack Wiedrick Journal: BMJ Open Qual Date: 2022-10
Authors: Khoa A Nguyen; Himalaya Patel; David A Haggstrom; Alan J Zillich; Thomas F Imperiale; Alissa L Russ Journal: BMC Med Inform Decis Mak Date: 2019-10-17 Impact factor: 2.796