TY - JOUR
T1 - The impact of patient-generated contextual data on communication in clinical practice
T2 - A qualitative assessment of patient and clinician perspectives
AU - Cusatis, Rachel
AU - Holt, Jeana M.
AU - Williams, Joni
AU - Nukuna, Sandile
AU - Asan, Onur
AU - Flynn, Kathryn E.
AU - Neuner, Joan
AU - Moore, Jennifer
AU - Makoul, Gregory
AU - Crotty, Bradley H.
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2020/4
Y1 - 2020/4
N2 - Background: Effective communication is integral to patient-centered care, yet external pressures can impede the ability to discuss important topics. One strategy to facilitate communication is pre-visit collection and sharing of patient contextual data (PCD), including life circumstances such as their beliefs, needs, and concerns. Objective: To understand how patients and care team members perceive the electronic collection of PCD and its impact on communication in the context of a large academic health system that implemented PatientWisdom, a new technology that elicits PCD from patients and integrates within the electronic health record (EHR). Methods: We conducted focus groups with patients (n = 26) and semi-structured interviews with primary care team members (n = 20). Qualitative analysis of focus group/interviews included an iterative and reflexive inductive technique to uncover emergent themes. Results: Four themes were reflected among both patient and care team: (1) the technology enhances the patient's voice; (2) the technology creates a safe space for patients to share sensitive topics; (3) PCD facilitates rapport not only between patient and provider but the entire care team; (4) PCD aligns patient and clinician goals. Two unique themes emerged among patients: (1) PCD provides opportunity for reflection; (2) PCD humanizes patients in the clinical context. One theme was evident in provider comments: collecting PCD may potentially undermine trust if not reviewed by clinical teams. Conclusion: PCD collected directly from patients and available within the EHR was seen by patients and care team members as beneficial to communication. PCD collection supports a paradigm shift towards coproduction of health information and a shared responsibility for information gathering but requires investment from patients and care team to ensure the data are effectively utilized. Practice value: PCD may be useful for team-based care, enabling physicians and non-physician staff to more quickly and responsively connect with patients.
AB - Background: Effective communication is integral to patient-centered care, yet external pressures can impede the ability to discuss important topics. One strategy to facilitate communication is pre-visit collection and sharing of patient contextual data (PCD), including life circumstances such as their beliefs, needs, and concerns. Objective: To understand how patients and care team members perceive the electronic collection of PCD and its impact on communication in the context of a large academic health system that implemented PatientWisdom, a new technology that elicits PCD from patients and integrates within the electronic health record (EHR). Methods: We conducted focus groups with patients (n = 26) and semi-structured interviews with primary care team members (n = 20). Qualitative analysis of focus group/interviews included an iterative and reflexive inductive technique to uncover emergent themes. Results: Four themes were reflected among both patient and care team: (1) the technology enhances the patient's voice; (2) the technology creates a safe space for patients to share sensitive topics; (3) PCD facilitates rapport not only between patient and provider but the entire care team; (4) PCD aligns patient and clinician goals. Two unique themes emerged among patients: (1) PCD provides opportunity for reflection; (2) PCD humanizes patients in the clinical context. One theme was evident in provider comments: collecting PCD may potentially undermine trust if not reviewed by clinical teams. Conclusion: PCD collected directly from patients and available within the EHR was seen by patients and care team members as beneficial to communication. PCD collection supports a paradigm shift towards coproduction of health information and a shared responsibility for information gathering but requires investment from patients and care team to ensure the data are effectively utilized. Practice value: PCD may be useful for team-based care, enabling physicians and non-physician staff to more quickly and responsively connect with patients.
KW - Health information technology
KW - Patient contextual data
KW - Patient-centered communication
KW - Patient-provider communication
KW - Qualitative research
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U2 - 10.1016/j.pec.2019.10.020
DO - 10.1016/j.pec.2019.10.020
M3 - Article
C2 - 31744702
AN - SCOPUS:85075460878
SN - 0738-3991
VL - 103
SP - 734
EP - 740
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 4
ER -