Design and testing of Medivate, a mobile app to achieve medication list portability via Fast Healthcare Interoperability Resources

To describe the architecture, design, and testing of an innovative mobile application (Medivate) that facilities accurate sharing of medication lists with linked education. The deployment and testing of this app occurred in both the community and hospital settings in Pittsburgh, PA. Medivate is an iOS smartphone application and cloud architecture for patients and providers to keep medication and vaccine lists accurate by providing a method and tool to easily exchange these data. Medications are added directly to the app from the electronic health record (EHR) or by the patient manually. Quick response (QR) code technology is used to trigger the secure transfer and sharing of medications on demand via HL-7 Fast Healthcare Interoperability Resources–based data transfer. An iterative user-centered design process involving patients and student pharmacists practicing in community settings was used to develop and refine functionality. Adults with an iPhone were approached for participation in the design and evaluation of Medivate. Its functionality and integration into clinical workflow at hospital discharge or vaccine administration in the community were determined. In the community setting, interviews of pharmacists were conducted. In the hospital, metrics of study participation and experience with app deployment were determined. The app was deployed in the community for patients that received vaccinations. Interviews provided insight into barriers and logistics for successful engagement. The app was integrated into hospital workflow and demonstrated interoperability with the inpatient EHR. Thirteen patients were provided the app before discharge. Engagement with the app was evident through medication list shares, education access, and changes to medication lists. Patients noted strong agreement with usefulness of the app to learn more about the purposes and adverse effects of medications prescribed. A mobile app to achieve medication and vaccine list portability was successfully designed and integrated into the inpatient and community settings.