Design, Development and Initial Adoption of myED: A Patient-Centered Information System for Emergency Care Journeys (Preprint)

Abstract

Medical care is highly complex, addressing patient-centered health goals that require coordination of multiple care providers. We focus on Emergency Department (ED) patients, who currently lack a sense of predictability about their medical journey, which increases the occurrences of frustration and aggression. ED patients need a better understanding about their ED procedures. We suggest and describe a system for providing real-time information to ED patients regarding the procedures in their ED medical journey.

The purpose of this study was to develop a system that provides patients with dynamically updated information about the specific procedures and expected wait times their personal ED journey comprises, and to report initial evaluations of this system.

To develop the system myED, we extracted information from hospital databases and translated it using process mining and user interface (UI) design into a language that is accessible and comprehensible to patients. We evaluate the system using a mixed-methods approach, combining observations, interviews and online records.

Interviews with patients, escorts and Health Care Providers (HCPs) confirm patients’ need for information about their personal ED journey. Our iterative work with ED patients, HCPs, and a multidisciplinary team of developers enabled provision of such information in a secure, effective and user-friendly way. In the third month after deployment, 492 of 1,614 patients (30.48%), used myED. Patients’ understanding of their ED journey improved significantly (F(1,348)=13.109, P=.000), and patients showed positive reactions to the system. We identified future challenges, including reaching quick engagement without delaying medical care. Salient reasons for poor system adoption were patients’ medical state and technological illiteracy. HCPs confirmed the potential of myED and identified means that could improve patient experience and staff cooperation.

myED communicates personal information to patients about their ED journey through mobile technology. Such communication improves healthcare by addressing patient psychological needs for information and understanding, which are often overlooked. We continue to test and refine the system, and expect to find positive effects of myED on patients’ ED experience and on hospital operations.