Using technology to engage hospitalised patients in their care: a realist review

Abstract

BackgroundPatient participation in health care is associated with improved outcomes for patients and hospitals. New technologies are creating vast potential for patients to participate in care at the bedside. Several studies have explored patient use, satisfaction and perceptions of health information technology (HIT) interventions in hospital. Understanding what works for whom, under what conditions, is important when considering interventions successfully engaging patients in care. This realist review aimed to determine key features of interventions using bedside technology to engage hospital patients in their care and analyse these in terms of context, mechanisms and outcomes.MethodsA realist review was chosen to explain how and why complex HIT interventions work or fail within certain contexts. The review was guided by Pawson’s realist review methodology, involving: clarifying review scope; searching for evidence; data extraction and evidence appraisal; synthesising evidence and drawing conclusions. Author experience and an initial literature scope provided insight and review questions and theories (propositions) around why interventions worked were developed and iteratively refined. A purposive search was conducted to find evidence to support, refute or identify further propositions, which formed an explanatory model. Each study was ‘mined’ for evidence to further develop the propositions and model.ResultsInteractive learning was the overarching theme of studies using technology to engage patients in their care. Several propositions underpinned this, which were labelled: information sharing; self-assessment and feedback; tailored education; user-centred design; and support in use of HIT. As studies were mostly feasibility or usability studies, they reported patient-centred outcomes including patient acceptability, satisfaction and actual use of HIT interventions. For each proposition, outcomes were proposed to come about by mechanisms including improved communication, shared decision-making, empowerment and self-efficacy; which acted as facilitators to patient participation in care. Overall, there was a stronger representation of health than IT disciplines in studies reviewed, with a lack of IT input in terms of theoretical underpinning, methodological design and reporting of outcomes.ConclusionHIT interventions have great potential for engaging hospitalised patients in their care. However, stronger interdisciplinary collaboration between health and IT researchers is needed for effective design and evaluation of HIT interventions.

Technology to engage hospitalised patients in their nutrition care: a qualitative study of usability and patient perceptions of an electronic foodservice system

“…Our recent realist review highlighted several key features of studies using technology to engage hospitalised patients in their care .These included information sharing; self‐assessment and feedback; tailored education; user‐centred design; and support in use of technology. The proposed intervention being tested in the present study used information sharing and self‐assessment and feedback through intake tracking and MST self‐completion.…”

“…Our recent realist review highlighted several key features of studies using technology to engage hospitalised patients in their care (35) . These included information sharing; self-assessment and feedback; tailored education; user-centred design; and support in use of technology.…”

“…Patients in the present study raised the importance of having training and support from HCPs in using the technology, although the amount of support needed varied between patients; consistent with tailored interventions (31,32) and minimally disruptive healthcare (33) . In the realist review, a user-centred approach to designing technology-based interventions for hospitalised patients was described as crucial for promoting usability, satisfaction and willingness to use (35) ; key determinants of technology acceptance (14) . The present study adopts this user-centred design approach because the purpose of the study was to understand users' perspectives of the EFS to inform further development of functions allowing patients to participate in their nutrition care.…”

Métodos Para Desenvolvimento De Aplicativos Móveis Em Saúde: Revisão Integrativa Da Literatura

“…[1][2][3][4][5] These technologies are considered a global resource, which connects various computers, creating a network of information, and which makes it possible to contribute to the development and improvement of the health professions. 1 ICT, in addition to making it possible to publicize and spread knowledge in the area of health, besides bringing it constantly up-to-date, can also support professionals' critical decisionmaking, contributing to the making of reliable diagnoses and qualified therapeutic guidance/ conducts, aimed at patients/service users.…”

Tecnologia computacional para gerenciar o cuidado e indicadores relacionados à lesão por pressão

“…Em relação ao conceito de qualidade, o que melhor se refere à qualidade nos serviços de saúde, relaciona-se com as melhorias obtidas, a diminuição de riscos, a diminuição dos custos e satisfação do paciente (DONABEDIAN, 1988;DONABEDIAN, 1992 BARRA et al, 2016;FILIPOVA, 2013;ROBERTS et al, 2017;MATSUDA et al, 2015).…”