a1 Assistant Professor, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
a2 Assistant Professor of Medicine, Department of International Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
a3 Clinic Nurse Manager, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
a4 Associate Professor, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Aim To determine whether an educational strategy using a handheld, multimedia computer (iPod™) is practical and sustainable for routine office-based patient educational tasks.
Background With the limited amount of time allotted to the office encounter and the growing number of patient educational tasks, new strategies are needed to improve the efficiency of patient education. Education of patients anticoagulated with warfarin is considered critical to preventing complications. Despite the dangers associated with the use of warfarin, educational practices are variable and often haphazard
Methods During a four-month period, we examined the implementation of a three-part series of iPod™-based patient educational modules delivered to anticoagulated patients at the time of routine INR (International Normalized Ratio) blood tests for outpatients on the anticoagulation registry at an urban community health center.
Findings A total of 141 computer module presentations were delivered to 91 patients during the four-month period. In all, 44 patients on the registry had no INR checkups, and thus no opportunity to view the modules, and 32 patients had at least three INR checkups but no modules were documented. Of the 130 patients with at least one INR performed during the study period, 22 (16.9%) patients completed all three modules, 91 (70.0%) patients received at least one module, and nine (7.6%) patients refused to view at least one module. Neither of the two handheld computers was lost or stolen, and no physician time was used in this routine educational activity. Patients reported that the audio and visual quality was very good, (9.0/10); the educational experience of the patient was helpful (7.4/10) compared with the patient's previous warfarin education (6.3/10), and the computer strategy extended the INR visit duration by 1–5 min at most.
Conclusions The computer-assisted patient educational strategy was well received by patients, and uptake of the intervention by the clinic was successful and durable. The iPod™strategy standardized the educational message, improved clinic efficiency, and helped this busy clinic meet its educational goals for patient education.
(Received November 04 2010)
(Accepted July 03 2011)
(Online publication August 22 2011)