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Incorporating patient-generated contextual data into care: Clinician perspectives using the Consolidated Framework for Implementation Science. Healthc (Amst) 2020 Mar;8(1):100369

Date

08/26/2019

Pubmed ID

31445878

DOI

10.1016/j.hjdsi.2019.100369

Scopus ID

2-s2.0-85070927852   12 Citations

Abstract

Patient contextual data (PCD), defined as patient's values, environment, or behavior influencing health, are essential to the proper care of patients, yet often are missing in the electronic health record (EHR). The current EHR structures and practice demands produce barriers to document PCD systemically. We sought to understand clinicians' perceived facilitators and barriers to use PCD using a consumer informatics technology integrated into the EHR. The PCD components include patient perceived pressures; joys; preferred approach to care; perceived health; health-goals; and visit agenda. We conducted semi-structured interviews of twenty primary care clinicians from an academic health system implementing a PCD initiative. The analysis included an inductive approach and a deductive a priori framework, the Consolidated Framework for Implementation Research (CFIR). Clinicians identified the following facilitators of adoption: reinforcement of patient engagement; a focus on enhancing team-based care; and communication around how the tool can be incorporated for individualized care. Clinicians identified barriers as: challenges incorporating PCD into the time-compressed visit and reviewing the tool involved another click in the EHR. The deductive results spanned four domains and seven constructs of CFIR, principally finding intervention source, relative advantage, organizational needs, and relative priority as facilitators with a need for ongoing leadership for the culture change. Overall, clinicians supported the adoption of a consumer informatics technology, as they reflected on the perceived value of a new data source to enhance patient-centered care and involvement in the development process. User-focused optimization efforts aided in the improved functionality and adoption of the application.

Author List

Holt JM, Cusatis R, Asan O, Williams J, Nukuna S, Flynn KE, Moore J, Crotty BH

Authors

Bradley H. Crotty MD Associate Professor in the Medicine department at Medical College of Wisconsin
Kathryn Eve Flynn PhD Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Data Collection
Delivery of Health Care
Disease Management
Health Personnel
Humans
Qualitative Research
Self Report