JMIR Publications

ABSTRACT

Background:

Home health aides (HHAs) provide necessary hands-on care to older adults and those with chronic conditions in their homes. Despite their integral role, HHAs experience numerous challenges on the job, including their ability to communicate with other healthcare professionals about patient care while caring for patients and accessing educational resources. While technological interventions have the potential to address these challenges, little is known about the technological landscape and existing tech-based interventions designed for and used by this workforce.

Objective:

We conducted a scoping review of the scientific literature to identify existing studies which have described, designed, deployed, and/or tested technology-based tools and apps intended for use by HHAs to care for patients in the home. To complement our literature review, we conducted a landscape analysis of existing mobile apps intended for HHAs providing in home care.

Methods:

We searched the following databases from inception to October 2020: Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and CINAHL (EBSCO). Three researchers screened the yield using pre-specified inclusion and exclusion criteria. Four researchers then independently reviewed these articles and a fifth arbitrated when needed. Among studies that met the inclusion criteria, data were extracted and summarized narratively. An analysis of mHealth apps designed for HHAs was performed using a predefined set of terms to search the Google Play Store and Apple App Store. Two researchers independently screened the resulting apps and those that met the inclusion criteria were categorized according to their intended purpose and functionality.

Results:

Of the 8,643 studies retrieved, 182 underwent full-text review, and 9 met our inclusion criteria. Half (n=4) were descriptive in nature, proposing technology-based systems (e.g., web-portal, dashboard) and/or prototypes without a technical or user-based evaluation of the technology. In most papers (n=7), HHAs were just one of several users and not the sole/primary intended user of the technology. Our review of mobile apps yielded 166 Android and iOS apps, of which 48 met the inclusion criteria. These apps provided HHAs with one or more of the following functions: electronic visit verification (29), clocking in and out (23), documentation (22), task checklist (19), communication between HHA and agency (14), patient information (6), resources (5), and communication between HHA and clients (4). Overall, of the 48 apps, 25 performed monitoring functions, 4 supporting functions, and 19 did both.

Conclusions:

A limited number of studies and mobile apps are designed to support HHAs on the job. Further research and rigorous evaluation of technology-based tools are needed to assess their impact on the work HHAs provide in patient’s homes.