The critical components of an electronic care plan tool for primary care: an exploratory qualitative study

Abstract

Background A critical need exists for effective electronic tools that facilitate multidisciplinary care for complex patients in patient-centered medical homes. Objective To identify the essential components of a primary care (PC) based electronic care plan (ECP) tool that facilitates coordination of care for complex patients. Methods Three focus groups and nine semi-structured interviews were conducted at an academic PC practice in order to identify the ideal components of an ECP. Results Critical components of an ECP identified included: 1) patient background information, including patient demographics, care team member designation and key patient contacts, 2) user-and patient-centric task management functionalities, 3) a summary of a patient's care needs linked to the responsible member of the care team and 4) integration with the electronic medical record. We then designed an ECP mockup incorporating these components. Conclusion Our investigation identified key principles that healthcare software developers can integrate into PC and patient-centered ECP tools.

Electronic Health Records’ Support for Primary Care Physicians’ Situation Awareness: A Metanarrative Review

“…Clinical teams' information needs were driven by care transitions. Advanced levels of SA-Level 2 (Comprehension) and Level 3 (Projection)-were identified in 11 studies (Clarke et al, 2014;Friedman et al, 2014;Harle et al, 2019;Koopman et al, 2015;Menon et al, 2016;Pet et al, 2019;Robelia et al, 2017;Rogers et al, 2012;Rotenstein et al, 2016;Savoy et al, 2019;Weir et al,…”

“…Table 2 displays information needs specified across the studies and links them to the three SA Levels. (Ahluwalia et al, 2015;Dillon et al, 2017;Flanagan et al, 2013;Friedman et al, 2014;Harle et al, 2019;Koopman et al, 2015;Menon et al, 2016;Robelia et al, 2017;Rogers et al, 2012;Rotenstein et al, 2016;Savoy et al, 2019;Singh et al, 2013;Smith et al, 2019;Weir et al, 2015) SA…”

“…PCPs attempted to use the EHR to communicate and collaborate, relying on notes and alerts/notifications for information transfer, which would increase SA. However, findings across studies consistently indicated that EHRs were not effective tools for communication or collaborations (Ahluwalia et al, 2015;Flanagan et al, 2013;Koopman et al, 2015;Robelia et al, 2017;Rotenstein et al, 2016;Smith et al, 2019). Similarly, EHRs did not adequately support individual or team decisionmaking (Clarke et al, 2014;Harle et al, 2019;Koopman et al, 2015;Pet et al, 2019;Robelia et al, 2017;Weir et al, 2015).…”

In this issue: Realising benefits and that informatics is all about the patient

“…However, such paper care plans are often out of date as soon as they have been written. There is an overwhelming need for electronic care plans – and the paper by Rotenstein et al,6 from Boston, describes their components. If this approach to the design of a care plan was taken up, it would be great to see the plan developed into a more formal model 18…”

“…We hear about video consulting,4 and an eHealth tool to monitor symptoms in ankylosing spondylitis,5 components of an electronic care plan,6 patient portals,7 and an app to identify cases of airways disease 8…”