Quick Response Technology on Patient Smartphone as Hospital Appointment Reminder - Literature review Example

QR Technology on Patient Smartphone as Hospital Appointment Reminder Name: Institution: Literature Review QR technology History and Adoption QR (quick response) technology, popularly known as QR code, represents a 2-dimension barcode that facilitates fast decoding of data (Bellavista, Chang, Chao, Lin, & Sloot, 2010, p.151). It was developed by a Japanese corporation, Denso Wave (subsidiary of Toyota) in 1994 to assist in tracking of components and parts in its automobile plants (Aktas, 2010). A few years later, firms in other industries started using QR codes as marketing tools for their products. As Weir (2010) observes, companies across the globe are increasingly using QR codes as the standard approach to communicate with potential customers through print media. By 2011, Radwanick (2012) reports that 20 percent of users of smartphones in USA “scanned a QR code with their phone,” leading Canada (16.1 percent), Germany (15.6%), France (12.6%), UK (12.3%), Spain (11.9%), and Italy (10.1%). The users scan in the QR code using cameras inbuilt in their smartphones, after which a decoding program (Reed Solomon codes) converts the captured QR code into actionable data, prompting the Smartphone users to open a website, view a video, listen to music, or to dial a number to enable individuals to connect with the companies (Walsh, 2010). In 2011, majority of users who scanned the codes were directed to product information (75 percent), product offer or coupon (33 percent) and event information (25%) (Radwanick, 2011). Use of QR codes on smartphones is expected to expand by more than 10 percent by the end of this year as the phones become more available to a large part of the global population (Radwanick, 2011). Benefits The process of scanning, decoding, and executing data stored in the QR codes occurs instantaneously, hence the name quick response technology (Baker et al., 2012). Besides offering high processing speed, QR technology offers various benefits to users. First, it presents a secure and safe channel of communication between businesses and consumers, as the stored information has to be decoded to understand meaning of the codes (Kincade, Vass, & Cassill, 2001). Secondly, it enables use of a wide range of data types, including alphanumeric characters, symbols, binary codes, kana, Kanji, control codes, and Hiragana. Unlike conventional barcodes, QR codes require small space for printing as they can the data can be stored in two by two matrix (Kanev, Barneva, Brimkov, & Kaneva, 2009). Others benefits include high error rectification abilities (up to 30% of distorted characters) and high Omni-directional scanning because of use of position detection patterns in codes (Denso Wave Incorporated, 2010). Uses in Healthcare Sector Today, healthcare sector is increasing using QR technology to improve service delivery to patients. For instance, Dolan (2011a) notes that Nebraska Medical Center uses QR codes to link its patients to films of healthcare professionals introducing themselves, allowing the clients to understand the professionals better. The center also relies on the codes to link women to videos showing them quality and nature of its motherhood services. Another hospital, Athens (Ga.) Regional Health Services prints QR codes in their print advertisements that direct female clients to an electronic appointment center, which reminds them to book mammography tests. Vocus PRW Holdings, LLC (2012) reports that other healthcare organizations rely on the technology to enhance retrieval of medical history of patients during emergencies. For instance, Maryville Company relies on ERMedStat (a system integrating Smartphone and QR technologies) to enable first responders to retrieve medical history in time of emergencies (Harrington, 2012). The organization issues its clients with QR coded key chain tags and wallet cards, which when scanned by the responders, show client’s details such as emergency contacts, clinical complications, allergies, type of blood, and other information. Matsui (2012) argues that QR codes are also being used as labels on prescription medications, enabling patients to access details such as dosage and physical address of prescribing organization as well as manufacturing, issue, and expiry dates of the medicines. Other uses of QR codes in the sector include links to testimonies of their clients (as used in Poudre Valley Health System, Colorado) and health promotion programs (as applied in Safe Care Campaign (Tode, 2012). Smartphone Background In the past three years, Smartphones’ global market has expanded greatly, outpacing that of personal digital assistants (PDA) (Radwanick, 2012). Yang, Zheng, and Ni (2007) define a Smartphone as a powerful, multifunctional mobile phone that integrates a wide range of PDA features and capabilities, including an address book, internet applications and services, personal scheduler, multimedia applications, and calendar, among others. Over the past several years, market share of smartphones has been growing at a faster pace than that of personal computers (Penderworth, 2012). Between 2010 and 2011, Goasduff and Pettey (2012) report that the number of users using the phones grew by about 58 percent, bringing the number to 472 million users worldwide. In 2011, use of Smartphone in Europe reached approximately 44 percent, with Germany (34 percent) trailing France (38 percent), Italy (42 percent), UK (48.1 percent), and Spain (48.4 percent) (Abraham & Block, 2012). Ironically, Germany recorded the highest increase in number of users at 64 percent between 2010 and 2011. Smartphone users in USA in 2011 stood at approximately 42 percent, which compares to number of users in Italy (Radwanick, 2012). A survey by Gartner (2011) predicts that the number of people with Smartphone will increase to about 631 million by end of 2012 and to more than one billion by 2015, which will represent about 47 percent of the global market of mobile devices. Smartphone in Healthcare Sector According to Radwanick (2012), although Smartphone has been in use in other industries, its adoption in the healthcare sector has gained popularity recently. Ironically, it is being adopted in the sector at a faster rate than in the other sectors, with close to 30 million users relying on the phones to access health information today (Radwanick, 2012). By 2009, more than 60 percent of physicians used Smartphone to provide health care and close to 42 percent of users accessed health information from their phones (Gullo, 2011). The number of health care applications inbuilt within the phones has also grown in tandem with usage (Verkasalo, Lopez-Nicolas, Molina-Castillo, & Bouwman, 2010). For example, by 2010, the number clinical care applications in Apple AppStore were over 6,000, 73 percent of which were meant for patients and the remaining, for physicians (Sarasohn-Kahn, 2010). The phones are finding wide applications in telemedicine and delivery of healthcare in remote areas. For example, eCAALYX (Smartphone-enabled healthcare system) is being used to provide off-site clinical diagnosis to people in rural communities as well as to raise awareness about and to treat HIV/AIDS in hard-to-reach rural regions (Boulos, Wheeler, Taveres, & Jones, 2011; Marshall, Medvedev, & Antonov, 2008). Other healthcare institutions use Smartphone to facilitate efficient communication with their personnel as well as exchange of information and communication among the professionals during their work (Amcom Software, 2011). Patients also use the phones to monitor and report to healthcare organizations about progress of their treatment (Gilddon, 2011). Healthcare organizations rely on Smartphone to improve payment procedures, where professionals working remotely send diagnosis of patients and accompanying billing details to the institutions (MedicalSmartphones.com, 2012). The phones also represent an effective tool for receiving and producing multimedia feedback signals in wireless bio-feedback healthcare systems (Zhang, Wu, W. Wang, & B. Wang, 2010). Other applications include taking medicine administration, inventory management, and capturing dictation (IIyas & Ahson, 2006). Smartphone provides various benefits to patients and healthcare providers. First, it enhances communication between providers and their clients, making it possible for better doctor-patient relationship (Chen, Park, & Putzer, 2010). Secondly, it offers more applications and services than a standard mobile phone, making it possible for providers to use it as a tool to enter patient records in electronic databases, provide diagnosis to patients without the need to meet face-to-face, and to access medical information through internet applications (Putzer & Park, 2010; Choi et al., 2011). In addition, patients are able to access health care services without the hassle of attending the facilities physically and to interact with physicians at work, or at home (Al-Ubaydli, 2006; Bateman, 2011). Patient Appointment Reminder Effects of Not Showing Despite advances in healthcare services, the problem of patients missing scheduled appointments remains a major health issue facing many health care institutions across the globe (Johnson, Mold, & Pontious, 2007; Chakraborty, Muthuraman, & Lawley, 2010). In terms of clinical appointments, no-show refer to when patients schedule appointment and then fail to honor them and fail to contact the hospitals to inform them that they will not show up (Baum & Henkel, 2010). However, it does include cancellations, when the clients with appointments contact the hospitals, informing them they will not keep the appointment. Although the problem persists significantly in mental healthcare institutions (about 80%), it remains a major problem in other institutions, ranging between 5 percent and 60 percent (Zeng, Zhao, & Lawley, n.d.). The problem affects negatively patients who miss the appointments as well as the affected healthcare institutions. According to Mitchell and Selmes (2007), patients who fail to keep appointments are at “high risk of further deterioration, drop-out, relapse, and hospital readmission” (424). For the healthcare sector, the no-shows implies reduction in health care quality because of overbooking, increased costs of health care delivery, reduced productivity of professionals, erosion of continuity of care, and erosion of physician-patient relationship, among others (Witter, Steele, McEwen, & Mehler, 2002; LaGanga & Lawrence, 2007; Woodcock, 2003). For example, BBC (2012) observes that hospitals in UK lost approximately £100 per client because of no-shows from 2007 to 2008, which cost the National Health Service (NHS) over £600 million. Rojas (2012) argues that the no-shows cost NHS about £800 million per year, which translates to about £120 for every patient out of the 6.9 million who did not show for appointments in 2011. Reasons for Not Showing Various studies indicate that patients fail to keep their scheduled appointments because of various reasons (Mohamed & Al-Doghaither, 2002). Forgetfulness remains the major reason for missed appointments across the various healthcare institutions (Moore, Wilson-Witherspoon, & Probst, 2001). A study by Killaspy, Banerjee, King, and Lloyd (2000) observe that patient’s forgetfulness (27%) remains most prevalent single reason for many patients missing out their appointments. Another study by Murdock, Rodgers, Lindsay, and Tham (2002) in a gastroenterology clinic in Belfast found that 30% of the 73 participants in the study reported that they did not show for appointment because they forgot. A study by Herrick, Gilhooly, and Geddes (1994) to examine reasons for no-shows at periodontal healthcare institutions found out 51.4% of participants cited forgetfulness as the main reason they did not show for clinical appointments. Strategies to Resolve Forgetfulness Healthcare institutions have been implementing various strategies to resolve forgetfulness, which remains the leading reason for patients failing to keep their appointments (Lowes, 2005). For instance, a family practice residency clinic in Rochester, New York uses telephone calls to remind patients with appointments about their visiting dates (Hashim, Franks, & Fiscella, 2001). Initially, the clinic was experiencing a no-show rate of 26%, which reduced to 19% after one year of implementation. Majority of hospitals around rely on sending SMS to clients with appointments to remind them of their visiting days and time (Milne, Horne, & Torsney, 2006). The strategy remains the most commonly used in UK National Health Service, which has seen the country reduce greatly non-attendance although at high costs (Milne, Horne, & Torsney, 2006). In Australia, Royal Brisbane and Women’s Hospital (RBWH) uses computer system to send SMSs (Telstra Desktop Messaging System) to patients with appointments in the following day (Queensland Government, 2011). Since its implementation in 2009, the hospital has been able to reduce non-attendance from about 24 percent to about 10 percent. Almog, Devries, Borrelli, and Kopycka-Kedzierawski (2003) argues that email appointment reminders present another strategy for hospitals to reduce number of clients not showing for appointments as well as enhance physician-patient relationship. For example, Horvath et al. (2011) observe a reduction in no-shows in seven Duke Medicine clinics to 2.0% through use of email reminders. Hospitals can also use QR coded postcards to enable patients to remember appointments or include an appointment in calendars inbuilt in the phones (Henry Schein, n.d.). eCentral uses QR codes to enable patients to remember their appointments in the dental health industry (Graves, 2012). Patients are usually issued with appointment reminder postcards with QR codes printed on them, which opens a window prompting the patients to either confirm or add the appointment date on calendar (Graves, 2012). Akinmusuru (2012) observes that healthcare institutions can rely on QR codes as appointment reminders in three different ways. They can send patients appointment cards with QR codes, which when scanned using Smartphone direct the patients to an internet-based appointment center to schedule, confirm, cancel, or reschedule their appointments (American National Red Cross, 2011). Secondly, they can use the codes to direct patients to information about appointments on corporate websites (Dolan, 2011b). In addition, the codes can also be used to load email clients on patients’ Smartphones, prompting them to send email to the institutions to request, schedule, or confirm appointments (Cathy, 2011). However, Graves (2012) notes that use of QR codes as appointment reminders is not common in hospitals because of high costs of QR code-enabled phones. References Abraham, L., & Block, B. (2012, Jan.). Connected Europe: How smartphones and tablets are shifting media consumption. http://www.comscore.com/Press_Events/Presentations_Whitepapers/2012/Connected_Europe Akinmusuru, T. (2012). 6 ways to grow your medical practice with QR codes. Retrieved from http://www.healthcarecommunication.com/Main/Articles/6_ways_to_grow_your_medical_practice_with_QR_codes_7848.aspx Aktas, A. (2010). Analysis of current mobile marketing applications, selected best practices, and future development. Munich: GRIN Verlag. Almog, D., Devries, J., Borrelli, J., & Kopycka-Kedzierawski, D. (2003). The reduction of broken appointment rates through an automated appointment confirmation system. Journal of Dental Education, 67 (9), 1016-1022. Al-Ubaydli, M. (2006). The doctor’s PDA and Smartphone handbook. Glasgow: Idiopathic Publishing. Amcom Software. (2011). Industry survey results: Smartphone trends. Retrieved from http://calwa.org/wp-content/uploads/2012/01/WP-US-Smartphones-Survey1.pdf American National Red Cross. (2011, June 28). Scan the QR code, make an appointment! Mid-Atlantic blood service region. Retrieved from http://www.redcrossblood.org/news/midatlantic/scan-qr-code-make-appointment Baker, K.R., Attridge, E., Bennett, J., Hiserman, T., Horne, A.S., Moody, D., …, Vaughn, P. (2012). 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