The impact of patient-generated contextual data on communication in clinical practice: A qualitative assessment of patient and clinician perspectives

Rachel Cusatis, Jeana M. Holt, Joni Williams, Sandile Nukuna, Onur Asan, Kathryn E. Flynn, Joan Neuner, Jennifer Moore, Gregory Makoul, Bradley H. Crotty

    Research output: Contribution to journalArticlepeer-review

    20 Scopus citations

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)734-740
    Number of pages7
    JournalPatient Education and Counseling
    Volume103
    Issue number4
    DOIs
    StatePublished - Apr 2020

    Keywords

    • Health information technology
    • Patient contextual data
    • Patient-centered communication
    • Patient-provider communication
    • Qualitative research

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