Dawn Gauthier's Blog

Patient spreads awareness of the Shared Care Plan

Mon, 01 Dec 2003 21:25:17 GMT

I've always suspected that usage of the Shared Care Plan will spread among healthcare professionals mainly by patients asking them to use it. Here's a story from a nurse showing how this kind of spread can happen:

My name is Ida Richards, and I am one of the pre-op nurses at Pacific Rim Surgery Center. I was interviewing a patient by phone on Friday afternoon in preparation for surgery tomorrow. He asked me to access his Shared Care Plan for the information. I had to tell him that it was a new concept for me, but I was willing to look into it and learn about how to do this.

I called Jone Hoag and asked her, and she asked me to contact you on the protocol for this process. I am assuming I would have to get a password set up, and clearance, and then the patient would have to give me their password. I did not obtain his password – I wanted to see how to proceed first. He is very willing for me to do this, so let me know if it is something that can be set up.

Thank you. I think this has great potential for the patients, when we get this set up.

This is an excellent example of an empowered patient realizing that he didn't necessarily have to fill out yet another admission form asking for all the same information as the last one he filled out: "All that information can be found accurate and up-to-date online in my Shared Care Plan!"

When I called Ida to orient her, she was very impressed at how easy it was for her to login (using her existing NT login) and use the application. In a follow up email, she added:

I did access the Shared Care Plan and found it to be wonderful! The gentleman ended up not having the surgery at our Center, but it was nice to learn the process and to save him the effort of retelling all of his history. I will look forward to having more patients have this option available to them as they gain knowledge and comfort in this new techno age! Thank you, Ida

As a result of this story, we started seeing more clearly the opportunities that might be possible with the Shared Care Plan. For example, our community has already agreed to standardize the "Patient Health History Questionnaire" that all patients have to fill out every time they need to have a procedure done. Wouldn't it be nice if this long and involved questionnaire could be automatically extracted from the Shared Care Plan when needed instead of asking patients to fill it out time and time again?

How many of the multiple forms used in our healthcare community could be supplemented with information from the Shared Care Plan? Imagine if patients only had to fill out forms that asked for information not already available in the Shared Care Plan: how much time, aggravation and guesswork would be saved if patients didn't have to write out their medication lists and diagnoses every time they had an encounter with system? Aiming toward having fewer and standardized forms throughout our healthcare community and having fewer data sources from which to fill them out is crucial for everyone's sanity, both patient and healthcare professionals, in this age of being overloaded by inaccurate, out-of-date, and isolated silos of information.

Thank you to the patient who was willing to ask a healthcare professional to try something new, and to Ida for being so willing to try it!

PatientPowered.org wins award!

Mon, 17 Nov 2003 18:42:25 GMT

PatientPowered.org was recently recognized by receiving a silver eHealthcare Leadership Award in the category "Best Care/Disease Management Site". This award was presented by eHealthcare Strategy and Trends at their annual "Leveraging Technology and the Internet" conference that I attended earlier this month in Phoenix. At the awards ceremony I was impressed to learn that PatientPowered was selected to receive an award from almost 1200 entries reviewed by 104 judges!

PatientPowered excelled in the following features for this category: medical management tools and news and information available online to help consumers manage a chronic condition, two-way communication between patient and health practitioners, and opportunities to monitor clinical care. These points are exactly what the PatientPowered website, coupled with the Shared Care Plan, was designed to do and it's great to be recognized for this.

A big shout-out to Annie Gort (missing from photo), who did incredible work with patients putting together the bulk of the site. Left to right: Jonathan King (Web application developer), Dawn Gauthier (Web development analyst), and Jayson Olson (Web application developer).

Shared Care Plan Design Principles

Thu, 06 Nov 2003 00:58:50 GMT

Design principles specifically for senior citizen users:

· Use large font sizes

· Assume 800x600 screen resolution

· Use a sans-serif font

· Avoid using similar hues or colors in the blue-green range

· Keep bulk of website text black on a white background (high contract regardless)

· Present visual information using predictable and simply structured formats

· Keep the navigation, functionality, and design consistent across the application

I also pulled from my collection of guidelines and heuristics for usable web design:

· Jakob Nielson's: http://www.useit.com/papers/heuristic/heuristic_list.html

· Bruce Tognazzini's: http://www.asktog.com/basics/firstPrinciples.html

Other design principles:

· No use of frames within the SCP

· Light-weight graphics and optimized data calls for acceptable download times for patients using dialup modems

· We just recently managed to make the SCP work on all newer versions of Internet Explorer and Netscape for both PC and Mac operating systems.

· We didn't shoot for a specific reading level, but we did try to keep it at a low level and tried to make all language "patient friendly" instead of "medicalese" ("no Latin" is a system requirement) unless the design team felt that a specific term should be learned by patients (such as "contraindications"). There is contextual help throughout the app that defines terms and phrases users encounter in the interface.

· I used Edward Tufte's principle of information visualization: try to shoot for high information resolution; don't make people dig into multiple layers/pages to see lots of information.

· One design requirement that came from clinicians: present snapshots of current information for this patient, not historical info.

· Design first and foremost a useful self-management tool for patients, NOT an EMR/clinician record

Check out the electronic Shared Care Plan!

Sat, 01 Feb 2003 01:00:20 GMT

If you would like to take a look at the new web-based Shared Care Plan, please use the information below to access a test plan.

https://www.patientpowered.org/PatientSite/LogIn.asp

Click the "Guest" button to login.

After logging in, click the "view" button to look at John Doe's Shared Care Plan.

Interesting news bits

Wed, 11 Dec 2002 01:43:03 GMT

Two interesting articles:

Study of Malpractice Claims Shows Many Medication Mistakes Preventable
Likelihood of Adverse Drug Events can be lessened with better technology, procedures
http://www.brighamandwomens.org/publicaffairs/news/malpractice_and_medication_mistakes.asp

Beth Israel Deaconess copes with a massive computer crash
Hospital praised for being open about the problem and sharing lessons learned, both about technology itself and about policy
http://www.boston.com/dailyglobe2/330/science/Got_paper_P.shtml

Week in Review: 5 December 2002

Thu, 05 Dec 2002 21:39:12 GMT

Deliverable/Project: Shared Care Plan

Update Summary:
> Bulk of coding for the SCP interface done
> Security work nearly finished
> Data entry person has entered 16 SCPs
> Both CCSs registered and oriented
> Print version of SCP available
> Doctor demographic data imported from LW into person database

Tasks Scheduled Next 2 Weeks:
> Streamline registration process
> Add instructions
> Add Confidentiality Statement pop-up
> Register docs at clinics
> Have CCSs double check data entry work
> Create test/development system (copy database and website)
> Move live site to Internet
> Auditing functionality
> Usability testing
> Implement new tabs for interface
> FDB Medication data source?
> Thorough testing and troubleshooting of the application

Coming up:
> 12/18/02: doctors and CCSs give feedback on SCP at implementation meeting
> Week of January 6th: register a few patients to use SCP via Internet

Week in Review: November 14th

Fri, 22 Nov 2002 18:40:04 GMT

Deliverable/Project: Shared Care Plan
Update Summary:

> Bulk of coding for the SCP interface done; should have enough in place for a data entry person to start adding existing SCP data late next week.
> Hammered out remaining issues with medications
> Registration screens nearly finished
> Progress on integrating SCP with rest of web site (conceptually)
> eSCP shown to both patients and clinicians with good feedback

Tasks Scheduled Next 2 Weeks:
> Finish building interfaces
> Some amount of testing before data entry begins
> LW data dump
> Medication entry screen
> Polish some functionality for usability (e.g. Next Steps)
> Polish look with graphic designer
> Thorough testing and troubleshooting of the application