Mobile and web-based education: delivering emergency department discharge and aftercare instructions

Prior research has identified deficiencies in the standard process of providing instructions for care at discharge from the emergency department (ED). Patients typically receive a brief verbal instruction, along with preformatted written discharge documents. Studies have found that understanding and retention of such information by families are very poor, leading to nonadherence in follow-up care, unnecessary return visit to the ED, and poor health outcomes. The combination of systems factors (information content, delivery methods, and timing) and patient factors (health literacy, language proficiency, and cultural factors) contributes to the challenge of providing successful discharge communication. Internet and mobile devices provide a novel opportunity to better engage families in this process.Mobile health can address both system- and patient-level challenges. By incorporating images, animation, and full Web-based video content, more comprehensible content that is better suited for patients with lower health literacy and today's visual learners can be created. Information can also be delivered both synchronously and asynchronously, enabling the health care providers to deliver health education to the patients electronically to their home, where health care occurs. Furthermore, the providers can track information access by patients, customize content to the individual patients, and reach other caregivers who may not be present during the ED visit. Further research is needed to develop the systems and best practices for incorporating mobile health in the ED setting.