Appl Clin Inform 2021; 12(02): 362-371
DOI: 10.1055/s-0041-1729165
Case Report

MyEDCare: Evaluation of a Smartphone-Based Emergency Department Discharge Process

Peter A. D. Steel
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
David Bodnar
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Maryellen Bonito
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Jane Torres-Lavoro
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Dona Bou Eid
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Andrew Jacobowitz
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Amos Shemesh
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Robert Tanouye
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Patrick Rumble
2  NewYork-Presbyterian Hospital, New York, New York, United States
,
Daniel DiCello
2  NewYork-Presbyterian Hospital, New York, New York, United States
,
Rahul Sharma
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Brenna Farmer
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Sandra Pomerantz
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
,
Yiye Zhang
1  Department of Emergency Medicine, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, United States
3  Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
› Author Affiliations
Funding This study was funded by MCIC Vermont (2019 Patient Safety Award.

Abstract

Background Poor comprehension and low compliance with post-ED (emergency department) care plans increase the risk of unscheduled ED return visits and adverse outcomes. Despite the growth of personal health records to support transitions of care, technological innovation's focus on the ED discharge process has been limited. Recent literature suggests that digital communication incorporated into post-ED care can improve patient satisfaction and care quality.

Objectives We evaluated the feasibility of utilizing MyEDCare, a text message and smartphone-based electronic ED discharge process at two urban EDs.

Methods MyEDCare sends text messages to patients' smartphones at the time of discharge, containing a hyperlink to a Health Insurance Portability and Accountability Act (HIPAA)-compliant website, to deliver patient-specific ED discharge instructions. Content includes information on therapeutics, new medications, outpatient care scheduling, return precautions, as well as results of laboratory and radiological diagnostic testing performed in the ED. Three text messages are sent to patients: at the time of ED discharge with the nurse assistance for initial access of content, as well as 2 and 29 days after ED discharge. MyEDCare was piloted in a 9-month pilot period in 2019 at two urban EDs in an academic medical center. We evaluated ED return visits, ED staff satisfaction, and patient satisfaction using ED Consumer Assessment of Healthcare Providers and Systems (ED-CAHPS) patient satisfaction scores.

Results MyEDCare enrolled 27,713 patients discharged from the two EDs, accounting for 43% of treat-and-release ED patients. Of the treat-and-release patients, 27% completed MyEDCare discharge process, accessing the online content at the time of ED discharge. Patients discharged via MyEDCare had fewer 72-hour, 9-day, and 30-day unscheduled return ED visits and reported higher satisfaction related to nursing care.

Conclusion EDs and urgent care facilities may consider developing a HIPAA-compliant, text message, and smartphone-based discharge process, including the transmission of test results, to improve patient-centered outcomes.

Protection of Human and Animal Subjects

This case report summarizes a quality-improvement evaluation.




Publication History

Received: 28 December 2020

Accepted: 15 March 2021

Publication Date:
28 April 2021 (online)

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