Project File: eHOME
This project is part of the PhD programme of drs. Nienke Dijkstra. The University of Applied Sciences Utrecht and the University Utrecht (the Netherlands) collaborated in this project. The project is under supervision of prof. dr. Marieke Schuurmans, prof. dr. Lisette Schoonhoven, dr. Carolien Sino, and dr. Rob Heerdink.
The aim of this projects was twofold.
The first aim was to develop an electronic HOME system (eHOME), a mobile versions of the home care employees (HOME)-instrument with a consultation system between the home care, pharmacies and general practises was developed. The HOME instrument has been validated in previous research by our research group (https://doi.org/10.1016/j.jamda.2013.09.014). The instrument is an observation list with 28 signs and symptoms of potential DRPs categorized in 3 categories (process, pill, and patient). We followed the development phase of the Medical Research Council (MRC) framework in which we applied an iterative human-centered design (HCD) approach. The approach involved a Delphi round for the context of use and user requirements analysis of the digital HOME-instrument and the monitoring and consulting system followed by 2 series of pilots for testing the usability and redesign. Users refer to care professionals of the home care, general practice and pharmacy. In clinical practice, the eHOME-instrument was found to be an easy-to-use system (10.2196/humanfactors.8319)
The second aim was to determine the potential clinical consequences of process problems that were reported by home care professionals in the eHOME system. Three experts assessed 309 medication process problems (in 120 out of 451 patients) on a three-point scale (potentially no/moderate/severe discomfort or clinical deterioration). The problems were categorized in (1) medication discrepancies (new prescription not listed on the MARL; medication stopped by the prescriber but still listed on the MARL; discrepant time of intake/frequency/dose; therapeutic duplication listed on the MARL; discrepant information on route of administration), (2) undelivered MARL, (3) undelivered medication, and (4) excessive medication delivery. 180 (58.2%) out of 309 medication process problems were assessed as having the potential for moderate or severe discomfort or clinical deterioration in patients. http://doi.org/10.23937/2469-5858/1510085
Special thanks to:
- Home care workers, general practitioners, and pharmacists who participated in the human-centered design study
- Judith van Leeuwen-Jans, Ineke Hammann-Borgdorff, Aouktje Kaspers, Eric Hiddink, and Ineke Zekveld who assisted during the Delphi round and usability evolution pilots of the human-centered design study.
Nienke Dijkstra, University of
Applied Sciences, Utrecht
Prof. dr. Marieke Schuurmans,
University Medical Centre Utrecht
Prof. dr. Lisette Schoonhoven,
dr. Carolien Sino, University of
Applied Sciences, Utrecht
dr. Rob Heerding,