The impact of patient-generated contextual data on communication in clinical practice: A qualitative assessment of patient and clinician perspectives

Patient Educ Couns. 2020 Apr;103(4):734-740. doi: 10.1016/j.pec.2019.10.020. Epub 2019 Oct 30.

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.

Keywords: Health information technology; Patient contextual data; Patient-centered communication; Patient-provider communication; Qualitative research.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Communication*
  • Focus Groups
  • Humans
  • Patient-Centered Care*
  • Qualitative Research
  • Trust