JMIR Publications

ABSTRACT

Background:

Electronic Paper (E-Paper) screens use electrophoretic ink to provide paper-like low power displays with advanced networking capabilities that may potentially serve as an alternative to traditional whiteboards and television display screens in hospital settings. E-paper may be leveraged in the emergency department (ED) to facilitate communication. Providing ED patient status updates on E-paper screens may address patient satisfaction and overall experience.

Objective:

We aimed to pilot a patient-facing digital whiteboard using E-Paper to display relevant hospital, care plan, and care team information in real-time. We deployed this system in an urban, tertiary care, academic ED and enrolled N=110 patients to understand their experience. Participants completed a modified HCAHPS satisfaction questionnaire about their ED stay. We compared responses to a matched control group of patients triaged to ED rooms without digital whiteboards.

Methods:

We installed digital whiteboards in 4 ED rooms. We designed the digital whiteboard based on iterative feedback from various departmental stakeholders. After establishing IT infrastructure to support the project, we enrolled patients on a convenience basis into a control and an intervention (digital whiteboard) group. Enrollees were given a baseline survey to evaluate their comfort with technology, and an exit survey to evaluate their opinions of the digital whiteboard, as well as their overall ED satisfaction. Statistical analysis was performed to compare baseline characteristics as well as satisfaction.

Results:

We screened 471 patients for inclusion. We enrolled 110 patients, and 100 completed the study protocol. Of these, 68% (n=68) were female and 32% (n=32) were male. The racial composition was 61% White (n=61), 22% Black (n=22), 6% (n=6) Asian, and 11% (n=11) unknown. Ninety-six percent (n=48) of patients exposed to the E-Paper whiteboard stated that they preferred a room with a digital whiteboard, and 70% found the intervention “quite a bit” or “extremely” helpful in understanding their ED stay. We saw significant increases in satisfaction when patients were asked about communication regarding delays (p=0.0198), and what to do after discharge (p=0.0082).

Conclusions:

Digital whiteboards are a feasible and acceptable method of displaying patient-facing data in the ED. Patients are accepting of this technology. The display of ED care information on E-Paper is associated with significant changes in perceptions of ED communication and post-discharge planning. E-Paper screens coupled with relevant real-time clinical data packaged together as a digital whiteboard may positively impact patient satisfaction during ED visits. Clinical Trial: This study was reviewed and approved by the Mass General Brigham Institutional Review Board and registered on clinicaltrials.gov (NCT04497922).