Cloud-based multi-media systems for patient education and adherence: a pilot study to explore patient compliance with colonoscopy procedure preparation.

Technology based patient education and adherence approaches are increasingly utilized to instruct and remind patients to prepare correctly for medical procedures. This study examines the interaction between two primary factors: patterns of patient adherence to challenging medical preparation procedures; and the demonstrated, measurable potential for cloud-based multi-media information technology (IT) interventions to improve patient adherence. An IT artifact was developed through prior design science research to serve information, reminders, and online video instruction modules to patients. The application was tested with 297 patients who were assessed clinically by physicians. Results indicate modest potential (43.4% relative improvement) for the IT-based approach for improving patient adherence to endoscopy preparations. Purposively designed cloud-based applications hold promise for aiding patients with complex medical procedure preparation. Health care provider involvement in the design and evaluation of a patient application may be an effective strategy to produce medical evidence and encourage the adoption of adherence apps.

Patient-provider communications in outpatient clinic settings: a clinic-based evaluation of mobile device and multimedia mediated communications for patient education.

BACKGROUND: Many studies have provided evidence of the importance of quality provider-patient communications and have suggested improvements to patient understanding by using video-based instruction. OBJECTIVE: The objective of this study was to understand how mobile information technology assisted video and three-dimensional (3D) image instruction, provided by a health care worker, influences two categories of outcome: (1) patient understanding of information about their condition and detailed medical discharge instructions; and (2) patient perceptions and attitudes toward their health care providers, which included physicians, nurses, and staff. We hypothesize that video and 3D image instruction, provided on a mobile, tablet hardware platform, will improve patient understanding about the diagnostic testing, diagnoses, procedures, medications, and health topics provided to them. We also propose that use of the tablet/video combination will result in improved attitudinal evaluation by patients of their providers and the treatment plan. METHODS: This study evaluated a hospital clinic-based trial (patient N=284) of video and 3D image instruction, provided on a mobile, tablet hardware platform, and its potential to improve patient understanding about the diagnostic testing, diagnoses, procedures, medications, and health topics provided to them. RESULTS: Results showed strong evidence that the system was perceived as helpful for improving patient understanding, and that it improved communication between physicians and patients (P<.001). The advanced age of some patients had no effect on their perceptions of the tablet-based mediation. Physician comments provided useful insights on effective use of such systems in the future. Implications for further development and future research are discussed. CONCLUSIONS: This study added to the body of evidence that computer-assisted video instructional systems for patients can improve patient understanding of medical instructions from their health care providers and assist with patient compliance. In addition, such systems can be appealing to both patient and provider.

A multidimensional view of personal health systems for underserved populations.

The advent of electronic personal health records (PHR) provides a major opportunity to encourage positive health management practices, such as chronic disease management. Yet, to date there has been little attention toward the use of PHRs where advanced health information services are perhaps most needed, namely, in underserved communities. Drawing upon research conducted with safety net providers and patients, the authors propose a multi-level analytical framework for guiding actions aimed at fostering PHR adoption and utilization. The authors first outline distinctive user and technical requirements that need to be considered. Next, they assess organizational requirements necessary to implement PHRs within health systems bound by limited resources. Finally, the authors analyze the overriding health care policy context that can facilitate or thwart such efforts. The conclusion notes that heightened national attention toward health information technology and reform provides a significant opportunity for initiatives whose goal is to increase widepread access to PHRs.