Måling af forbedringen Measurement of improvement The first sub-study was blind for doctors while they were unaware about the study. There was registered patient time to complete the application, the PGJ content was analyzed and compared against conventional patient-admittance chart. Complaints were analyzed quantitatively and qualitatively. The second sub-study was conducted in accordance to the real life consequence – patients completed application, and consequently got doctors the PGJ content prior to patient examination. Focus was put on qualitative assessment, as narratives. Måling af forbedringen

Måling af forbedringen Measurement of improvement The first sub-study was blind for doctors while they were unaware about the study. There was registered patient time to complete the application, the PGJ content was analyzed and compared against conventional patient-admittance chart. Complaints were analyzed quantitatively and qualitatively. The second sub-study was conducted in accordance to the real life consequence – patients completed application, and consequently got doctors the PGJ content prior to patient examination. Focus was put on qualitative assessment, as narratives. Måling af forbedringen

Måling af forbedringen Measurement of improvement The first sub-study was blind for doctors while they were unaware about the study. There was registered patient time to complete the application, the PGJ content was analyzed and compared against conventional patient-admittance chart. Complaints were analyzed quantitatively and qualitatively. The second sub-study was conducted in accordance to the real life consequence – patients completed application, and consequently got doctors the PGJ content prior to patient examination. Focus was put on qualitative assessment, as narratives. Måling af forbedringen

Forandringseffekter Effects of changes 33,4 min M K The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. Tid, min 33,4 min Alder, år M K

Registreret symptomer, % Forandringseffekter Effects of changes The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. Registreret symptomer, % N 22 12 15 57 9 21 14 28 24 100% 54% 33% 67% 25% 19% 36% 18% 21% 50% 12 4 10 14 6 5 Alder, år M K

Forandringseffekter Effects of changes The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. Forandringseffekter

6.9 21.4 Forandringseffekter 32.2% 100% Effects of changes The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. 32.2% 100% 6.9 21.4 I alle tilfælde er der flere symptomer, som patienter nævner i Patient-genereret Journal, men ikke til lægen (eller ikke registreret?) Der er ikke fundet noget symptom i lægelige journaler, som ikke har været registreret i PGJ

Forandringseffekter Effects of changes The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. Forandringseffekter

Forbedringer og Resultater: Forandringseffekter Effects of changes The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. Forbedringer og Resultater: Patientsikkerhed Patienten bliver altid spurgt grundigt og ensartet om sine symptomer, uafhængigt af lægens erfaring eller tidspunkt Undersøgelse (N=10) viser at i alle tilfælde (100%) dokumenteres færre symptomer i EPJ (32,2%) end patienten selv registrerer Patientens føler sig hørt og inddraget i behandlingsforløb Mundtlig eller skriftlig feedback fra patienterne: Ingen af patienterne (0%) har været negativ om metoden (N=87) Patienternes generel vurdering: Det giver mening Alle patienter (N=10)

Forbedringer og Resultater: Forandringseffekter Effects of changes The first sub-study revealed that patients (age 23-78) can complete the PGJ. It required 20-63 min (mean 33,4), depending on age and technology-readiness. All patients (100%) responded to all questions, accepted PGJ as matching to symptoms. Average symptoms number in the PGJ was approximately 3-fold higher compared to those documented in conventional admittance charts (21.4 against 6.9). No symptom mentioned in chart was missing in the PGJ. Interviews demonstrated no difficulties in completing the PGJ. Every patient enrolled in study confirms that PGJ makes sense and is positive to run “through their body” and get better prepared for patient-doctor contact. The second sub-study confirmed patients’ readiness and acceptance of the PGJ (99%), unless there was severe pain, confusion or low functionality. PGJ is being accepted by doctors as an assisting tool. It reveals patient’s problems and highlights main, and examination can be more efficient. Forbedringer og Resultater: Patientsikkerhed Patientens symptomer bliver dokumenteret af patienten selv (”habil” patient), direkte Alle patienter (N=100) svarer at det giver mening Patientens ventetid fyldes og bliver brugt meningsfuld Alle patienter udfylder PGJ i eget tempo. Tiden for at få uafbrudt udfyldelse af PGJ ligger mellem 15-65 min (N=20) Lægernes generel vurdering: Det giver mening Ønskes integrering med EPJ

Hvad vi har lært Lessons learned The study allowed continuously to get patients comments and feedback, gather critical remarks from doctors and focus on better PGJ functionality. Hvad vi har lært

Jeg har ingen hovedpine Jeg har hovedpine Hvad vi har lært Lessons learned The study allowed continuously to get patients comments and feedback, gather critical remarks from doctors and focus on better PGJ functionality. Jeg har ingen hovedpine Jeg har hovedpine Jeg har ingen smerter Jeg har smerter Enig Uenig Ja Nej

Messages for others Messages for others The method provides unified quality of comprehensive symptoms screening, chief-complaints selection, facilitates documentation process involving patients and presenting their health problems in professionally appropriate way. The PGJ appears to be an efficient tool which assist to get documented around a half of admittance journal content. There is need to integrate the PGJ with existing electronic health record systems. To realize integration into real life there is need for further research. As international experience suggests, “it is important to move towards achievement that science, healthcare policy, health economy, technology and clinical practice work synergistically together”. Patientens største klager: vejrtrækningsproblemer, over 1 år hjertebanken, over 1 år træthed, over 1 år Test Testesen 48-årig mand modtages via Testlæge pga åndenød. Ingen 2000 Depression 2013 Lleddegigt 2013 aug. Auto immun hepatitis Paroxetin 40 mg x 1 / døgn (som Depression, over 1 år) Nihil Bor ikke alene. Har pårørende. Arbejder (Fysisk). Andre aktuelle symptomer: nakkestivhed lysskyhed benødem Patient Genereret Journal (PGJ) Systematisk adspurgt og nævne følgende symptomer: svedeture svimmelhed kvalme

Messages for others Messages for others The method provides unified quality of comprehensive symptoms screening, chief-complaints selection, facilitates documentation process involving patients and presenting their health problems in professionally appropriate way. The PGJ appears to be an efficient tool which assist to get documented around a half of admittance journal content. There is need to integrate the PGJ with existing electronic health record systems. To realize integration into real life there is need for further research. As international experience suggests, “it is important to move towards achievement that science, healthcare policy, health economy, technology and clinical practice work synergistically together”. Messages for others

Messages for others Messages for others The method provides unified quality of comprehensive symptoms screening, chief-complaints selection, facilitates documentation process involving patients and presenting their health problems in professionally appropriate way. The PGJ appears to be an efficient tool which assist to get documented around a half of admittance journal content. There is need to integrate the PGJ with existing electronic health record systems. To realize integration into real life there is need for further research. As international experience suggests, “it is important to move towards achievement that science, healthcare policy, health economy, technology and clinical practice work synergistically together”. Messages for others

Patientinvolvering Involvement of patients This is the first attempt in the Danish Hospital System to involve patients into treatment by providing mobile tool for their Subjective Journal, which conforms to the clinical standard. From patients’ perspective, the PGJ helps to focus more critically on own symptoms, get better prepared for patient-doctor contact, allows to use waiting time more efficiently. Patientinvolvering

Conflict of interest: Author has contributed to the functionality of the software and has equity in the solution. Ethics Approval: Not required for the study purpose.

Ethics Approval: Not required for the study purpose. Conflict of interest: Author has contributed to the functionality of the software and has equity in the solution. Ethics Approval: Not required for the study purpose.

TAK!