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The impact of patient-generated contextual data on communication in clinical practice: A qualitative assessment of patient and clinician perspectives. Patient Educ Couns 2020 04;103(4):734-740

Date

11/21/2019

Pubmed ID

31744702

DOI

10.1016/j.pec.2019.10.020

Scopus ID

2-s2.0-85075460878   13 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.

Author List

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

Authors

Bradley H. Crotty MD Associate Professor in the Medicine department at Medical College of Wisconsin
Rachel N. Cusatis PhD Assistant Professor in the Medicine department at Medical College of Wisconsin
Kathryn Eve Flynn PhD Professor in the Medicine department at Medical College of Wisconsin
Joan Neuner MD, MPH 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

Communication
Focus Groups
Humans
Patient-Centered Care
Qualitative Research
Trust