Designing Patient-facing Health Information Technologies for the Outpatient Settings: A Literature Review

Yang, Yushi; Asan, Onur

doi:10.14236/jhi.v23i1.185

Cited by 14 publications

(8 citation statements)

References 48 publications

(111 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 Current designs might be problematic even in the more sheltered environment of an outpatient clinic and might require separate evaluation. 12 Like others, we observed how electronic systems can aid to enhance communication between patients and healthcare professionals but might move focus from the patient to the screen and reduce eye contact. 13 Recording of urgent information was slowed down by the electronic system.…”

Section: Discussionsupporting

confidence: 68%

Scenario-based design for a hospital setting: An exploratory study of opportunities and barriers for personal health records usage

Pearson

Wischhusen

Hibbs³

et al. 2020

Future Healthcare Journal

View full text Add to dashboard Cite

Personal health records (PHRs) offer patients the opportunity to be more actively involved in their own care. There is limited research into the application during hospital admissions for elective or emergency presentations. We used techniques from scenario-based design to test the opportunities and boundaries of a commercially available PHR in a simulated environment. Scenarios included a patient in his 80s admitted for hip surgery with his son, and a younger patient admitted with pneumonia. A catastrophic deterioration was demonstrated with a mannequin in a highfidelity simulation. Workflows were summarised in swim-lane diagrams. The PHR allowed patients to file information prior to the interaction with the clinical team. This led to shorter time requirements for acquisition of data. The elderly patient required assistance from a relative but this aided verification of history prior to the encounter with the clinical team. Ward rounds could be prepared by the patient with specific 'what matters' questions. Documentation in the PHR environment during a simulated life-threatening emergency did not result in information that was unintelligible or useful for the 'patient'. Usage of a commercially available PHR during hospital admission is feasible and might aid workflow. Documentation of emergencies might require different documentation formats.

show abstract

Section: Discussionsupporting

confidence: 68%

Scenario-based design for a hospital setting: An exploratory study of opportunities and barriers for personal health records usage

Pearson

Wischhusen

Hibbs³

et al. 2020

Future Healthcare Journal

View full text Add to dashboard Cite

show abstract

“…While this educational intervention targeted patients, it is also important to teach patient-centered EHR behaviors to physicians to promote patient-physician-EHR engagement [ 20 - 26 , 58 , 59 ], and these efforts should be pursued in tandem. Additionally, EHRs should evolve to account for user experience, patient health literacy levels, and language needs to help reduce the digital divide and health disparities [ 19 , 60 - 68 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study

et al. 2021

View full text Add to dashboard Cite

Background Electronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. Objective To evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. Methods We conducted a prospective observational study with adult patients and parents of pediatric patients at the University of Chicago General Internal Medicine (GIM) and Pediatric Primary Care (PPC) clinics. We developed an educational comic highlighting EHR self-advocacy behaviors and distributed it to study participants during check-in for their primary care visits between May 2017 and May 2018. Participants completed a survey immediately after their visit, which included a question on whether they would be interested in a follow-up telephone interview. Of those who expressed interest, 50 participants each from the adult and pediatric parent cohorts were selected at random for follow-up telephone interviews 8 months (range 3-12 months) post visit. Results Overall, 71.0% (115/162) of adult patients and 71.6% (224/313) of pediatric parents agreed the comic encouraged EHR involvement. African American and Hispanic participants were more likely to ask to see the screen and become involved in EHR use due to the comic (adult P=.01, P=.01; parent P=.02, P=.006, respectively). Lower educational attainment was associated with an increase in parents asking to see the screen and to be involved (ρ=−0.18, P=.003; ρ=−0.19, P<.001, respectively) and in adults calling for physician attention (ρ=−0.17, P=.04), which was confirmed in multivariate analyses. Female GIM patients were more likely than males to ask to be involved (median 4 vs 3, P=.003). During follow-up phone interviews, 90% (45/50) of adult patients and all pediatric parents (50/50) remembered the comic. Almost half of all participants (GIM 23/50, 46%; PPC 21/50, 42%) recalled at least one best-practice behavior. At subsequent visits, adult patients reported increases in asking to see the screen (median 3 vs 4, P=.006), and pediatric parents reported increases in asking to see the screen and calling for physician attention (median 3 vs 4, Ps<.001 for both). Pediatric parents also felt that the comic had encouraged them to speak up and get more involved with physician computer use since the index visit (median 4 vs 4, P=.02) and that it made them feel more empowered to get involved with computer use at future visits (median 3 vs 4, P<.001). Conclusions Our study found that an educational comic may improve patient advocacy for enhanced patient-physician-EHR engagement, with higher impacts on African American and Hispanic patients and patients with low educational attainment.

show abstract

“…While this educational intervention targeted patients, it is also important to teach patient-centered EHR behaviors to physicians to promote patient-physician-EHR engagement [20][21][22][23][24][25][26]58,59], and these efforts should be pursued in tandem. Additionally, EHRs should evolve to account for user experience, patient health literacy levels, and language needs to help reduce the digital divide and health disparities [19,[60][61][62][63][64][65][66][67][68].…”

Section: Discussionmentioning

confidence: 99%

“…Studies on the impact of EHR use have found that certain physician behaviors (eg, poor eye contact, long silences) may lead to decreased patient satisfaction with the patient-physician relationship and communication [4][5][6][7][8][9][10][11]. While studies show there are certain patient-centered care behaviors that can positively impact patient satisfaction and health outcomes, with Table 1 serving as a model for incorporating many evidence-based behaviors, physicians are faced with the challenge of staying focused on their patients while efficiently navigating the EHR during clinical encounters [4,6,[12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study (Preprint)

Alkureishi¹,

Johnson²,

Nichols³

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND Electronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. OBJECTIVE To evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. METHODS We conducted a prospective observational study with adult patients and parents of pediatric patients at the University of Chicago General Internal Medicine (GIM) and Pediatric Primary Care (PPC) clinics. We developed an educational comic highlighting EHR self-advocacy behaviors and distributed it to study participants during check-in for their primary care visits between May 2017 and May 2018. Participants completed a survey immediately after their visit, which included a question on whether they would be interested in a follow-up telephone interview. Of those who expressed interest, 50 participants each from the adult and pediatric parent cohorts were selected at random for follow-up telephone interviews 8 months (range 3-12 months) post visit. RESULTS Overall, 71.0% (115/162) of adult patients and 71.6% (224/313) of pediatric parents agreed the comic encouraged EHR involvement. African American and Hispanic participants were more likely to ask to see the screen and become involved in EHR use due to the comic (adult P=.01, P=.01; parent P=.02, P=.006, respectively). Lower educational attainment was associated with an increase in parents asking to see the screen and to be involved (ρ=−0.18, P=.003; ρ=−0.19, P<.001, respectively) and in adults calling for physician attention (ρ=−0.17, P=.04), which was confirmed in multivariate analyses. Female GIM patients were more likely than males to ask to be involved (median 4 vs 3, P=.003). During follow-up phone interviews, 90% (45/50) of adult patients and all pediatric parents (50/50) remembered the comic. Almost half of all participants (GIM 23/50, 46%; PPC 21/50, 42%) recalled at least one best-practice behavior. At subsequent visits, adult patients reported increases in asking to see the screen (median 3 vs 4, P=.006), and pediatric parents reported increases in asking to see the screen and calling for physician attention (median 3 vs 4, Ps<.001 for both). Pediatric parents also felt that the comic had encouraged them to speak up and get more involved with physician computer use since the index visit (median 4 vs 4, P=.02) and that it made them feel more empowered to get involved with computer use at future visits (median 3 vs 4, P<.001). CONCLUSIONS Our study found that an educational comic may improve patient advocacy for enhanced patient-physician-EHR engagement, with higher impacts on African American and Hispanic patients and patients with low educational attainment.

show abstract

Designing Patient-facing Health Information Technologies for the Outpatient Settings: A Literature Review

Abstract: The designs of patient-facing HITs in outpatient settings are promising in facilitating the doctor-patient communication and patient engagement. However, their effectiveness and usefulness need to be further evaluated and improved from a systems perspective.

Cited by 14 publications

References 48 publications

Scenario-based design for a hospital setting: An exploratory study of opportunities and barriers for personal health records usage

Scenario-based design for a hospital setting: An exploratory study of opportunities and barriers for personal health records usage

Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study

Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study (Preprint)

Contact Info

Product

Resources

About