Research aims to better inform patients and physicians

iSchool Professor Wanda Pratt has seen the danger of medical errors first-hand.

In 2013, her husband became ill and went to the emergency room with an abnormal heart rate and rhythm. He was given a drug and sent home, where his blood pressure bottomed out and his heart rate slowed to 20 beats per minute. He spent the next week in intensive care for what was eventually diagnosed as Lyme disease. The drug he had been given was contraindicated for his situation and had made his condition much worse.

Pratt’s husband recovered completely, but their story is all too common. A 2013 study in the Journal of Patient Safety found that medical errors contributed to as many as 400,000 deaths per year in America, making it the third-leading cause of death behind heart disease and cancer.

Now Pratt (third from right) and her research team, made up of iSchool students, physicians, and other colleagues, are working on research they hope will improve patient safety by reducing the number of medical errors – through better use and sharing of information.

Their research focuses on whether patients and their families can help prevent errors by taking a more active role in medical care. To do so, they need to be better informed.

“Our idea is to set up information systems that help enable patients to be much more informed about what should be happening, what could be happening, what they’re doing and why,” Pratt said.

Pratt and her team have recently completed the first year of a five-year study funded by a grant from the Agency for Healthcare Research & Quality. They’ve focused initially on surveying patients and their family caregivers at Seattle’s Virginia Mason Hospital and Seattle Children’s Hospital, asking them how they think communication could be improved.

Sonali Mishra (second from right), a second-year Ph.D. student at the iSchool, said patients and their families have been very receptive to their efforts.

“A number of patients and caregivers we’ve interviewed, when they hear about the project, they say, ‘Wow, this is so valuable.’” Mishra said. “They tell us, ‘You don’t even know how much this would mean to have a way to be more active.’”

Among the ideas that have surfaced so far is a “One Doc Away” app, modeled on One Bus Away, that would give family caregivers a better idea of when a doctor is likely to stop by the patient’s room. Without knowing when a doctor might stop by, family members don’t know when they can safely step away from the patient's room.

“The way that they get that information is primarily through conversations with physicians who come by the room, so if they miss that, now they may not see the doctor until 24 hours later,” Mishra said. “The patient’s situation might have changed dramatically in that time.”

Mishra said one theme that emerged quickly was a desire among patients and their families to give more information to doctors.

“We weren’t expecting that to come out so strongly,” Mishra said. “It was striking how many of the participants in our study were really appreciative of our efforts and really want to be involved, and they want a good way of doing that.”

The need for better communication goes both ways. Patients and their families also can have information to share that helps doctors decide on a course for care. Pratt said the value of these interactions to doctors has been one of the most surprising things to surface so far.

“It’s important for doctors to listen to their stories and to know more about that patient,” Pratt said. “Some things happen because the clinical care team doesn’t know things that the personal family care team knows.”

Ari Pollack (second from left) serves as part of the research team and as a liaison with Seattle Children’s Hospital, where he works as a physician. A 2014 graduate of the iSchool’s Master of Science in Information Management (MSIM) program, Pollack said he’s looking forward to testing solutions based on the initial research.

“What’s exciting for me is being able to take the ideas and listen to the needs of people and then turn them into something that will actually benefit them,” Pollack said.

In addition to Pratt, Mishra, and Pollack, the research team includes physician Barry Aaronson of Virginia Mason; Biomedical & Health Informatics (BHI) Ph.D. students Logan Kendall, Shefali Haldar and Maher Khelifi; BHI post-doctoral researcher Andrew Miller; MSIM student Alex Filipkowski; and Informatics students Kelsey Aiello and Cory Brown.

Over the next four years, the researchers will create new methods and technologies to share information. They plan to try them out in hospital rooms to see what helps and what further steps could be taken to prevent medical errors.

It’s a process of finding people’s needs and designing around them, Pratt said.

“It’s all about the information,” she said.