Abstract
PURPOSE Technology could transform routine decision making by anticipating patients’ information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use such a decision module and its impact on care, using 3 cancer screening decisions as test cases. METHODS Twelve practices with 55,453 patients using a patient portal participated in this prospective observational cohort study. Participation was open to patients who might face a cancer screening decision: women aged 40 to 49 who had not had a mammogram in 2 years, men aged 55 to 69 who had not had a prostate-specific antigen test in 2 years, and adults aged 50 to 74 overdue for colorectal cancer screening. Data sources included module responses, electronic health record data, and a postencounter survey. RESULTS In 1 year, one-fifth of the portal users (11,458 patients) faced a potential cancer screening decision. Among these patients, 20.6% started and 7.9% completed the decision module. Fully 47.2% of module completers shared responses with their clinician. After their next office visit, 57.8% of those surveyed thought their clinician had seen their responses, and many reported the module made their appointment more productive (40.7%), helped engage them in the decision (47.7%), broadened their knowledge (48.1%), and improved communication (37.5%). CONCLUSIONS Many patients face decisions that can be anticipated and proactively facilitated through technology. Although use of technology has the potential to make visits more efficient and effective, cultural, workflow, and technical changes are needed before it could be widely disseminated.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 217-224 |
| Number of pages | 8 |
| Journal | Annals of Family Medicine |
| Volume | 15 |
| Issue number | 3 |
| DOIs | |
| State | Published - May 1 2017 |
| Externally published | Yes |
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Keywords
- Computer-assisted
- Decision making
- Health information technology
- Patient education
- Practice-based research
- Primary care
- Screening
ASJC Scopus subject areas
- Family Practice
Cite this
Harnessing information technology to inform patients facing routine decisions : Cancer screening as a test case. / Krist, Alex H.; Woolf, Steven H.; Hochheimer, Camille; Sabo, Roy T.; Kashiri, Paulette; Jones, Resa M.; Lafata, Jennifer Elston; Etz, Rebecca S.; Tu, Shin-Ping.
In: Annals of Family Medicine, Vol. 15, No. 3, 01.05.2017, p. 217-224.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Harnessing information technology to inform patients facing routine decisions
T2 - Cancer screening as a test case
AU - Krist, Alex H.
AU - Woolf, Steven H.
AU - Hochheimer, Camille
AU - Sabo, Roy T.
AU - Kashiri, Paulette
AU - Jones, Resa M.
AU - Lafata, Jennifer Elston
AU - Etz, Rebecca S.
AU - Tu, Shin-Ping
PY - 2017/5/1
Y1 - 2017/5/1
N2 - PURPOSE Technology could transform routine decision making by anticipating patients’ information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use such a decision module and its impact on care, using 3 cancer screening decisions as test cases. METHODS Twelve practices with 55,453 patients using a patient portal participated in this prospective observational cohort study. Participation was open to patients who might face a cancer screening decision: women aged 40 to 49 who had not had a mammogram in 2 years, men aged 55 to 69 who had not had a prostate-specific antigen test in 2 years, and adults aged 50 to 74 overdue for colorectal cancer screening. Data sources included module responses, electronic health record data, and a postencounter survey. RESULTS In 1 year, one-fifth of the portal users (11,458 patients) faced a potential cancer screening decision. Among these patients, 20.6% started and 7.9% completed the decision module. Fully 47.2% of module completers shared responses with their clinician. After their next office visit, 57.8% of those surveyed thought their clinician had seen their responses, and many reported the module made their appointment more productive (40.7%), helped engage them in the decision (47.7%), broadened their knowledge (48.1%), and improved communication (37.5%). CONCLUSIONS Many patients face decisions that can be anticipated and proactively facilitated through technology. Although use of technology has the potential to make visits more efficient and effective, cultural, workflow, and technical changes are needed before it could be widely disseminated.
AB - PURPOSE Technology could transform routine decision making by anticipating patients’ information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use such a decision module and its impact on care, using 3 cancer screening decisions as test cases. METHODS Twelve practices with 55,453 patients using a patient portal participated in this prospective observational cohort study. Participation was open to patients who might face a cancer screening decision: women aged 40 to 49 who had not had a mammogram in 2 years, men aged 55 to 69 who had not had a prostate-specific antigen test in 2 years, and adults aged 50 to 74 overdue for colorectal cancer screening. Data sources included module responses, electronic health record data, and a postencounter survey. RESULTS In 1 year, one-fifth of the portal users (11,458 patients) faced a potential cancer screening decision. Among these patients, 20.6% started and 7.9% completed the decision module. Fully 47.2% of module completers shared responses with their clinician. After their next office visit, 57.8% of those surveyed thought their clinician had seen their responses, and many reported the module made their appointment more productive (40.7%), helped engage them in the decision (47.7%), broadened their knowledge (48.1%), and improved communication (37.5%). CONCLUSIONS Many patients face decisions that can be anticipated and proactively facilitated through technology. Although use of technology has the potential to make visits more efficient and effective, cultural, workflow, and technical changes are needed before it could be widely disseminated.
KW - Computer-assisted
KW - Decision making
KW - Health information technology
KW - Patient education
KW - Practice-based research
KW - Primary care
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85019113285&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019113285&partnerID=8YFLogxK
U2 - 10.1370/afm.2063
DO - 10.1370/afm.2063
M3 - Article
C2 - 28483886
AN - SCOPUS:85019113285
VL - 15
SP - 217
EP - 224
JO - Annals of Family Medicine
JF - Annals of Family Medicine
SN - 1544-1709
IS - 3
ER -