Using REDCap and Apple ResearchKit to integrate patient questionnaires and clinical decision support into the electronic health record to improve sexually transmitted infection testing in the emergency department

Abstract

Objective Audio-enhanced computer-assisted self-interviews (ACASIs) are useful adjuncts for clinical care but are rarely integrated into the electronic health record (EHR). We created a flexible framework for integrating an ACASIs with clinical decision support (CDS) into the EHR. We used this program to identify adolescents at risk for sexually transmitted infections (STIs) in the emergency department (ED). We provide an overview of the software platform and qualitative user acceptance. Materials and Methods We created an ACASI with a CDS algorithm to identify adolescents in need of STI testing. We offered it to 15- to 21-year-old patients in our ED, regardless of ED complaint. We collected user feedback via the ACASI. These were programmed into REDCap (Research Electronic Data Capture), and an iOS application utilizing Apple ResearchKit generated a tablet compatible representation of the ACASI for patients. A custom software program created an HL7 (Health Level Seven) message containing a summary of responses, CDS recommendations, and STI test orders, which were transmitted to the EHR. Results In the first year, 1788 of 6227 (28.7%) eligible adolescents completed the survey. Technical issues led to decreased use for several months. Patients rated the system favorably, with 1583 of 1787 (88.9%) indicating that they were “somewhat” or “very comfortable” answering questions electronically and 1291 of 1787 (72.2%) preferring this format over face-to-face interviews or paper questionnaires. Conclusions We present a novel use for REDCap to combine patient-answered questionnaires and CDS to improve care for adolescents at risk for STIs. Our program was well received and the platform can be used across disparate patients, topics, and information technology infrastructures.

Towards an effective framework for integrating patient-reported outcomes in electronic health records

“…Historically, databases are used for PROMs customization. 45 , 46 The database-driven solution lacks interoperability because it tends to bind the customization with a specific EHR platform. JSON fits better in terms of interoperability due to its readability and portability.…”

Using Electronic Data Capture for Cardiovascular Electrophysiology Invasive Procedures: An Important Step Towards Interoperable Clinical Registries

“…This implemented web-based EDC systems, capture structured data from point of care, that leading to improving the efficiency of clinical documentation and prospectively populating clinical registries. These applications are practical for routine clinical use, and estimated a reduction in total documentation time per patient, during a standard course of procedure in cardiac EP department [34][35][36].…”

A Smartphone-Based Technique to Detect Dynamic User Preferences for Tailoring Behavioral Interventions: Observational Utility Study of Ecological Daily Needs Assessment

“…We developed the needs assessment using Status/Post, a digital platform (developed by CLM) that integrates the Apple ResearchKit (Apple Inc) framework with the REDcap (REDCap Consortium) web app through an application programming interface [ 34 ]. The app framework included a daily prompt for health intention setting and scaling, 6 prompts for needs assessment during the day designated by users as times they would be most likely to eat (3 prompts) or exercise (3 prompts), and reflection on goal progress at the end of the day (screen shots in Multimedia Appendix 1 ).…”