362 Acceptability of a Novel Smartphone Application as a Patient Engagement Tool in the Emergency Department

Abstract

The experience of care is a primary tenant of healthcare value. Growing evidence indicates that patients who are more engaged have better experiences and health outcomes. Engaging patients in the emergency department (ED) setting is challenging, often leading to dissatisfaction. We developed navigatER®, a mobile application (app) designed by frontline providers to help engage, inform, and educate patients as care is being delivered. The goals of this quality improvement project were to evaluate patient and provider perceptions of the utility, ease of use, efficacy, acceptability, and impact on care delivery of the navigatER app. For this small pilot project, we enrolled a convenience sample of adult patients (≥ 18) treated in our Level 1, tertiary care ED over a 6 week period. Included were willing English-speakers with smartphones and a chest or abdominal complaint. Following consent, participants were instructed on how to download the app. Dual factor authentication was used to confirm identity and link the app to the participant’s medical record. Participants received care notifications and corresponding educational material in real-time and were queried on satisfaction throughout care delivery. Upon disposition, a 6 question QI survey utilizing a Likert-type response scale ranging from 1-5 (1 = Strongly Disagree through 5 = Strongly Agree), was delivered via the app evaluating participant impressions of navigatER. Endorsing the two strongest categories (agree or strongly agree) was considered an affirmative response. ED providers were queried in a post-shift assessment following encounters with patients who used navigatER. Providers were not intentionally informed as to which patients were using the app. 146 participants were enrolled with 110 (75%) responding to a care related survey question and 29 (20%) completing the disposition survey. Survey respondents were 58% female with a mean age 45 years (range 20-77). Of the disposition survey respondents 76% agreed or strongly agreed that navigatER was useful in communicating diagnostic tests, 69% affirmed that the app kept them updated, 66% endorsed it as being helpful, 76% supported the app’s ease of use, 76% endorsed the educational material as being helpful, and 72% reported liking the app overall. All 16 of the providers queried had a neutral or favorable impression of the app’s usefulness as a communication tool and none felt that it was disruptive or increased workload. In this small pilot the majority of participants found this early stage version of the navigatER app to be useful, effective, easy to use, and acceptable when used during care delivery in the ED setting. No providers indicated that the app was disruptive to the care environment. The app holds promise as a useful tool for engaging ED patients. Participant feedback will be used to improve the app’s utility and usability prior to wider adoption. Future studies will evaluate the impact of navigatER on publicly reported patient experience metrics such as the Net Promoter Score to validate the role of this digital tool.