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Accepted for/Published in: JMIR mHealth and uHealth

Date Submitted: May 28, 2018
Open Peer Review Period: May 31, 2018 - Jul 11, 2018
Date Accepted: Jul 17, 2018
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Simulated Clinical Encounters Using Patient-Operated mHealth: Experimental Study to Investigate Patient-Provider Communication

Tunnell H, Faiola A, Bolchini D, Bartlett Ellis R

Simulated Clinical Encounters Using Patient-Operated mHealth: Experimental Study to Investigate Patient-Provider Communication

JMIR Mhealth Uhealth 2018;6(11):e11131

DOI: 10.2196/11131

PMID: 30389652

PMCID: 6238098

Simulated Clinical Encounters Using Patient-Operated mHealth: Experimental Study to Investigate Patient-Provider Communication

  • Harry Tunnell; 
  • Anthony Faiola; 
  • Davide Bolchini; 
  • Rebecca Bartlett Ellis

ABSTRACT

Background:

This study investigates patient-centered mobile health (mHealth) technology in terms of the secondary user experience (UX). Specifically, it examines how personal mobile technology, under patient control, can be used to improve patient-provider communication about the patient’s health care during their first visit to a provider. Common ground, a theory about language use, is used as the theoretical basis to examine interactions. A novel concept of this study is that it is one of the first empirical studies to explore the relative meaningfulness of a secondary UX for specific health care tasks.

Objective:

The objective of this study was to investigate the extent that patient-operated mHealth technology can be designed to improve the communication between the patient and provider during an initial face-to-face encounter.

Methods:

The experimental study was conducted in 2 large Midwestern cities from February 2016 to May 2016. A custom-designed smartphone app prototype was used as the study treatment. The experimental design was posttest-only control group and included video-recorded simulated face-to-face clinical encounters in which an actor role-played a patient. Experienced clinicians consisting of doctors (n=4) and nurses (n=8) were the study participants. A thematic analysis of qualitative data was performed. Quantitative data collected from time on task measurements were analyzed using descriptive statistics.

Results:

Three themes that represent how grounding manifested during the encounter, what it meant for communication during the encounter, and how it influenced the provider’s perception of the patient emerged from the qualitative analysis. The descriptive statistics were important for inferring evidence of efficiency and effectiveness of communication for providers. Overall, encounter and task times averaged slightly faster in almost every instance for the treatment group than that in the control group. Common ground clearly was better in the treatment group, indicating that the idea of designing for the secondary UX to improve provider outcomes has merit.

Conclusions:

Combining the notions of common ground, human-computer interaction design, and smartphone technology resulted in a prototype that improved the efficiency and effectiveness of face-to-face collaboration for secondary users. The experimental study is one of the first studies to demonstrate that an investment in the secondary UX for high payoff tasks has value but that not all secondary UXs are meaningful for design. This observation is useful for prioritizing how resources should be applied when considering the secondary UX.


 Citation

Please cite as:

Tunnell H, Faiola A, Bolchini D, Bartlett Ellis R

Simulated Clinical Encounters Using Patient-Operated mHealth: Experimental Study to Investigate Patient-Provider Communication

JMIR Mhealth Uhealth 2018;6(11):e11131

DOI: 10.2196/11131

PMID: 30389652

PMCID: 6238098

Per the author's request the PDF is not available.

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