Colorado Care Tablet

The Design of an Interoperable Personal Health Application to Help Older Adults with Multimorbidity Manage Their Medications

A Personal Health Application (PHA) running on a tablet PC and using simple navigation, touch screens, artifacts, and workflows based on everyday life can help older Americans and lay caregivers with limited computing experience manage medications, particularly during care transitions, according to a recent study reported in the Journal of Biomedical Informatics.

Care for older adults with multiple chronic conditions is often fragmented, as patients are moved to different care settings. The Colorado Care Tablet (CCT), a functional electronic prototype, is based on a paper Personal Health Record already in use and specifically developed to support transitional care. The CCT helps users: create and maintain a personal medication list when they receive care from different sources; get medication information; prepare for a doctor’s visit; and determine when to seek help.

Key Findings:

  • Although established design guidelines for older adults informed developers, CCT refinement relied on user needs assessments and iterative user studies.
  • During 14 in situ interviews, developers documented with notes and photographs, how older adults manage medications in the reality of their everyday lives. They discovered patients arrange medications around their homes based on their daily routines; get information from many sources; and use a variety of organizational tools, including pillboxes, envelopes and plastic bags. The developers built these familiar images and workflows into the programming so that use was intuitive.
  • Six iterative user studies involving 22 older adults and nine caregivers, determined that users want medication pictures with their lists and want the simplest interface possible. Hence, CCT relies on image-rich, linear navigation with fewer utilities and more prompts.
  • Although a bar scanner was welcomed by users and was handy to add new medications, the technology was inconsistent.

More electronic prescribing information must be available before CCT can become a reality.