Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare

Research output: Contribution to journalArticle

Abstract

In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

Original languageEnglish (US)
Pages (from-to)10-19
Number of pages10
JournalHome healthcare now
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

medication
nurse
Delivery of Health Care
Physicians
physician
Communication
Community Health Nurses
Home Care Services
Nurses
experience
home care
communication
Electronic Health Records
Medication Reconciliation
Patient Transfer
electronics
House Calls
Informatics
Workflow
workflow

ASJC Scopus subject areas

  • Health(social science)
  • Community and Home Care
  • Advanced and Specialized Nursing

Cite this

@article{b04a627ab54f43548007bf5ca587b779,
title = "Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare",
abstract = "In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.",
author = "Orla Sheehan and Kharrazi, {Hadi H K} and Carl, {Kimberly J.} and Leff, {Bruce A} and Jennifer Wolff and Roth, {David L} and Jennifer Gabbard and Cynthia Boyd",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/NHH.0000000000000632",
language = "English (US)",
volume = "36",
pages = "10--19",
journal = "Home healthcare now",
issn = "2374-4529",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare

AU - Sheehan, Orla

AU - Kharrazi, Hadi H K

AU - Carl, Kimberly J.

AU - Leff, Bruce A

AU - Wolff, Jennifer

AU - Roth, David L

AU - Gabbard, Jennifer

AU - Boyd, Cynthia

PY - 2018/1/1

Y1 - 2018/1/1

N2 - In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

AB - In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

UR - http://www.scopus.com/inward/record.url?scp=85039934493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039934493&partnerID=8YFLogxK

U2 - 10.1097/NHH.0000000000000632

DO - 10.1097/NHH.0000000000000632

M3 - Article

VL - 36

SP - 10

EP - 19

JO - Home healthcare now

JF - Home healthcare now

SN - 2374-4529

IS - 1

ER -