TY - JOUR
T1 - Augmenting patient safety through participation by design – An assessment of dual monitors for patients in the outpatient clinic
AU - Asan, Onur
AU - Choudhury, Avishek
AU - Somai, Melek M.
AU - Crotty, Bradley H.
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Patients and physicians engaging together in the electronic health record (EHR) during clinical visits may provide opportunities to both improve patient understanding and reduce medical errors. Objective: To assess the potential impact of a patient EHR display intervention on patient quality and safety. We hypothesized that if patients had a dedicated display with an explicit invitation to follow clinicians in the EHR that this would identify several opportunities to engage patients in their care quality and safety. Material and methods: Physician-patient outpatient encounters (24 patients and 8 physicians) were videotaped. Encounters took place in a hospital-based general internal medicine outpatient clinic where physicians and patients had their respective EHR monitors. Following the visits, each patient and physician was interviewed for 30 min to understand their perception of the mirrored-screen setting. Results: The following 7 themes were identified (a) curiosity, (b) opportunity to ask questions, (c) error identification, (d) control over medications, (e) awareness, (f) shared understanding & decision-making, (g) data privacy. These themes collectively comprised a conceptual model for how patient engagement in electronic health record use, through a dedicated second screen or an explicitly shared screen, relates to safety and quality opportunities. Therefore, the double EHR screen provides an explicit invitation for patients to join the process to influence safety. Conclusion: Desired outcomes include real-time error identification and better-shared understanding and decision-making, leading to better downstream follow-through with care plans.
AB - Background: Patients and physicians engaging together in the electronic health record (EHR) during clinical visits may provide opportunities to both improve patient understanding and reduce medical errors. Objective: To assess the potential impact of a patient EHR display intervention on patient quality and safety. We hypothesized that if patients had a dedicated display with an explicit invitation to follow clinicians in the EHR that this would identify several opportunities to engage patients in their care quality and safety. Material and methods: Physician-patient outpatient encounters (24 patients and 8 physicians) were videotaped. Encounters took place in a hospital-based general internal medicine outpatient clinic where physicians and patients had their respective EHR monitors. Following the visits, each patient and physician was interviewed for 30 min to understand their perception of the mirrored-screen setting. Results: The following 7 themes were identified (a) curiosity, (b) opportunity to ask questions, (c) error identification, (d) control over medications, (e) awareness, (f) shared understanding & decision-making, (g) data privacy. These themes collectively comprised a conceptual model for how patient engagement in electronic health record use, through a dedicated second screen or an explicitly shared screen, relates to safety and quality opportunities. Therefore, the double EHR screen provides an explicit invitation for patients to join the process to influence safety. Conclusion: Desired outcomes include real-time error identification and better-shared understanding and decision-making, leading to better downstream follow-through with care plans.
KW - Electronic health record
KW - Healthcare quality
KW - Medical informatics
KW - OpenNotes
KW - Patient engagement
KW - Patient safety
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U2 - 10.1016/j.ijmedinf.2020.104345
DO - 10.1016/j.ijmedinf.2020.104345
M3 - Article
C2 - 33260089
AN - SCOPUS:85097574118
SN - 1386-5056
VL - 146
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
M1 - 104345
ER -