Project Details - Ended
- Grant Number:R21 HS025000
- Funding Mechanism:
- AHRQ Funded Amount:$300,000
- Principal Investigator:
- Project Dates:9/30/2016 to 9/29/2019
- Care Setting:
- Medical Condition:
- Type of Care:
- Health Care Theme:
Coordination of care across the health system is an essential component of high-quality primary care. However, primary care providers (PCPs) often do not know when their patients are in the hospital or emergency department (ED), preventing them from providing important followup care. These circumstances may disproportionately harm vulnerable populations, who are likely to frequently visit the ED and have comorbid medical and social needs that put them at risk for poor outcomes.
To address this issue, a research team from Northwestern University developed a smartphone application (app) that notifies PCPs when one of their patients arrives in the hospital or ED. The app asks patients to confirm “Are you a patient in the ED/hospital now?” when real-time location data in their smartphone indicate that they are at a hospital. If the patient confirms, the app securely notifies their PCP through the electronic health record, thereby providing an opportunity for rapid followup and care coordination activities.
The specific aims of this research were as follows:
- Develop a care coordination system in which a novel smartphone app facilitates information transfer and care coordination following inpatient admissions and ED visits.
- Conduct a feasibility study examining the system’s preliminary impacts and implementation in a care management program for high-risk patients.
The app was developed through a team-based process that included feedback collected through focus groups with patients and provider interviews. Fifteen patients were observed using the app during beta testing. Findings were used to improve the app, including development of a Spanish-language version. The app was further tested with 62 patients at Erie Family Health Centers, a Chicago-area federally qualified health center serving a predominantly low-income and minority population.
Study participants liked the simplicity of the app, felt it would improve their care, and did not report many barriers to using it. PCPs learned their patients received emergency care at many area hospitals that otherwise were not communicating information about the hospital visit to them. When the app notified primary care practices that a patient was in the hospital, a care manager followed up within 2 days 92 percent of the time. This study showed that smartphones may be effective for facilitating information transfer and care coordination in vulnerable populations.