IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v30y2010i4pe1-e13.html
   My bibliography  Save this article

A Method for Understanding Some Consequences of Bringing Patient-Generated Data into Health Care Delivery

Author

Listed:
  • Duane A. Steward

    (Nemours Health Informatics, Nemours Children's Clinic, Orlando, Florida, dsteward@nemours.org)

  • Richard A. Hofler

    (Economics Department, College of Business Administration, University of Central Florida, Orlando, Florida)

  • Carey Thaldorf

    (Doctoral Program, College of Health and Public Affairs, University of Central Florida, Orlando, Florida)

  • David E. Milov

    (Received 9 July 2008 from Nemours Health Informatics, Nemours Children's Clinic, Orlando, Florida)

Abstract

Objective. The consequences of personal health record (PHR) phenomena on the health care system are poorly understood. This research measures one aspect of the phenomena—the time-cost impact of patient-generated data (PGD) using discrete event model (DEM) simulation. Background/Significance. Little has been written about the temporal and cognitive burden associated with new workflows that include PGD. This pilot study reports the results for time-cost and resource utilization of a ‘‘typical’’ ambulatory clinic under varying conditions of PGD burden. Methods. PGD effects are modeled with DEM simulation reflecting the sequential relationships, temporal coupling, and impact assumptions within a virtual clinic. Three simulation scenarios of ever-increasing PGD impact are compared to a baseline case of no PGD use. Results. Introduction of PGD resulted in expected increases in cost and resource utilization along with a few key exceptions and unanticipated consequences. Direct and indirect impacts were observed with notable nonlinear, nonadditive, disproportionate, heterogeneous aspects and interactions among consequent labor cost, visit length, workday length, and resource utilization. The middle-impact simulations showed a 29% increase in daily labor costs and 28% shrinkage of the margin between revenues and labor costs. Lengths of both workday and patient visit were extended and less predictable with PGD use. Utilization rates of most staff positions rose. Nurse utilization rates showed greatest increases. Physicians’ utilization rates paradoxically stayed relatively unchanged. Conclusion. This analysis contributes to an understanding of the effects of PGD on time and cognitive burdens of physicians, staff, and physical resources. It illustrates the usefulness of DEM simulation for the purpose. Avoidable consequences are exposed quantifiably for both the patient and the clinic. More realistic ways to respond to PGD impact are needed.

Suggested Citation

  • Duane A. Steward & Richard A. Hofler & Carey Thaldorf & David E. Milov, 2010. "A Method for Understanding Some Consequences of Bringing Patient-Generated Data into Health Care Delivery," Medical Decision Making, , vol. 30(4), pages 1-13, July.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:4:p:e1-e13
    DOI: 10.1177/0272989X10371829
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X10371829
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X10371829?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:30:y:2010:i:4:p:e1-e13. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.