TY - JOUR
T1 - Using REDCap and Apple ResearchKit to integrate patient questionnaires and clinical decision support into the electronic health record to improve sexually transmitted infection testing in the emergency department
AU - Ahmad, Fahd A.
AU - Payne, Philip R.O.
AU - Lackey, Ian
AU - Komeshak, Rachel
AU - Kenney, Kenneth
AU - Magnusen, Brianna
AU - Metts, Christopher
AU - Bailey, Thomas
N1 - Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: [email protected].
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objective: Audio-enhanced computer-assisted self-interviews (ACASIs) are useful adjuncts for clinical care but are rarely integrated into the electronic health record (EHR). We created a flexible framework for integrating an ACASIs with clinical decision support (CDS) into the EHR. We used this program to identify adolescents at risk for sexually transmitted infections (STIs) in the emergency department (ED). We provide an overview of the software platform and qualitative user acceptance. Materials and Methods: We created an ACASI with a CDS algorithm to identify adolescents in need of STI testing. We offered it to 15- to 21-year-old patients in our ED, regardless of ED complaint. We collected user feedback via the ACASI. These were programmed into REDCap (Research Electronic Data Capture), and an iOS application utilizing Apple ResearchKit generated a tablet compatible representation of the ACASI for patients. A custom software program created an HL7 (Health Level Seven) message containing a summary of responses, CDS recommendations, and STI test orders, which were transmitted to the EHR. Results: In the first year, 1788 of 6227 (28.7%) eligible adolescents completed the survey. Technical issues led to decreased use for several months. Patients rated the system favorably, with 1583 of 1787 (88.9%) indicating that they were "somewhat"or "very comfortable"answering questions electronically and 1291 of 1787 (72.2%) preferring this format over face-to-face interviews or paper questionnaires. Conclusions: We present a novel use for REDCap to combine patient-answered questionnaires and CDS to improve care for adolescents at risk for STIs. Our program was well received and the platform can be used across disparate patients, topics, and information technology infrastructures.
AB - Objective: Audio-enhanced computer-assisted self-interviews (ACASIs) are useful adjuncts for clinical care but are rarely integrated into the electronic health record (EHR). We created a flexible framework for integrating an ACASIs with clinical decision support (CDS) into the EHR. We used this program to identify adolescents at risk for sexually transmitted infections (STIs) in the emergency department (ED). We provide an overview of the software platform and qualitative user acceptance. Materials and Methods: We created an ACASI with a CDS algorithm to identify adolescents in need of STI testing. We offered it to 15- to 21-year-old patients in our ED, regardless of ED complaint. We collected user feedback via the ACASI. These were programmed into REDCap (Research Electronic Data Capture), and an iOS application utilizing Apple ResearchKit generated a tablet compatible representation of the ACASI for patients. A custom software program created an HL7 (Health Level Seven) message containing a summary of responses, CDS recommendations, and STI test orders, which were transmitted to the EHR. Results: In the first year, 1788 of 6227 (28.7%) eligible adolescents completed the survey. Technical issues led to decreased use for several months. Patients rated the system favorably, with 1583 of 1787 (88.9%) indicating that they were "somewhat"or "very comfortable"answering questions electronically and 1291 of 1787 (72.2%) preferring this format over face-to-face interviews or paper questionnaires. Conclusions: We present a novel use for REDCap to combine patient-answered questionnaires and CDS to improve care for adolescents at risk for STIs. Our program was well received and the platform can be used across disparate patients, topics, and information technology infrastructures.
KW - REDCap
KW - clinical decision support
KW - electronic health record
KW - emergency care
KW - sexually transmitted diseases
UR - http://www.scopus.com/inward/record.url?scp=85078392349&partnerID=8YFLogxK
U2 - 10.1093/jamia/ocz182
DO - 10.1093/jamia/ocz182
M3 - Article
C2 - 31722414
AN - SCOPUS:85078392349
SN - 1067-5027
VL - 27
SP - 265
EP - 273
JO - Journal of the American Medical Informatics Association
JF - Journal of the American Medical Informatics Association
IS - 2
ER -