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Randomized Controlled Trial
. 2023 Jan 27;7(2):e0030.
doi: 10.1097/HC9.0000000000000030. eCollection 2023 Feb 1.

Subjective and objective burden on providers from a multicenter app-based study of patients with cirrhosis and caregivers

Jawaid Shaw  1 , Chathur Acharya  2 , Somaya Albhaisi  1 , Andrew Fagan  3 , Sara McGeorge  2 , Melanie B White  2 , Jatinder Lachar  1 , Jessica Olson  4 , Amy Olofson  4 , Lori Bergstrom  4 , Patrick S Kamath  4 , Jasmohan S Bajaj  2   3
Affiliations
Randomized Controlled Trial

Subjective and objective burden on providers from a multicenter app-based study of patients with cirrhosis and caregivers

Jawaid Shaw et al. Hepatol Commun. .

Abstract

Background: App-based technologies could enhance patient and caregiver communication and provide alerts that potentially reducing readmissions. However, the burden of App alerts needs to be optimized to reduce provider burnout.

Aim: The purpose of this study was to determine subjective and objective burden of using the Patient Buddy App, a health information technology (HIT) on providers in a randomized multicenter trial, who completed a semi-quantitative Likert scale survey regarding training procedures, data and privacy concerns, follow-up details, and technical support. This randomized multicenter trial recruits cirrhosis inpatients and their caregivers, and randomizes them into standard-of-care, HIT (communication only via App) and HIT+visits (App+phone calls/visits) for 30 days after discharge. The alerts are monitored by providers through a central iPad. The reason(s) and number of alerts were recorded as the objective burden. A total of 1442 messages were sent as alerts from the 103 dyads (patient + caregiver) (n=206) randomized to HIT arms. The most common messages related to Hepatic Encephalopathy (HE) (high or low bowel movement=50% or orientation tests=37%). Twelve providers completed the surveys reflecting the following themes-92% and 100%, felt adequately trained and confident about educating the patients and caregivers before roll out of App and had no concerns related to data and privacy; 70%, felt that appropriate time was spent on pursuing reason for data not being logged; 60% each, had issues with availability of adequate technical support and connectivity.

Conclusion: The Patient Buddy App randomized multicenter trial till date shows an overall favorable rating regarding training procedures/education, privacy concerns, and ease of message follow-up, from providers. However, it is important to gauge and address subjective and objective burdens of monitoring human resources in current and future HIT studies to avoid burnout and to ensure successful study completion.

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Figures

FIGURE 1
FIGURE 1
Schematic of the patient and caregiver data monitoring, trigger for alerts and sample resolution by the providers.
FIGURE 2
FIGURE 2
Summary of the representative themes from the provider survey graphically.
See this image and copyright information in PMC

Comment in

References

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