Abstract
Objective: To determine factors that influence the adoption and use of patient-reported outcomes (PROs) in the electronic health record (EHR) among users. Materials and Methods: Q methodology, supported by focus groups, semistructured interviews, and a review of the literature was used for data collection about opinions on PROs in the EHR. An iterative thematic analysis resulted in 49 statements that study participants sorted, from most unimportant to most important, under the following condition of instruction: "What issues are most important or most unimportant to you when you think about the adoption and use of patient-reported outcomes within the electronic health record in routine clinical care?"Using purposive sampling, 50 participants were recruited to rank and sort the 49 statements online, using HTMLQ software. Principal component analysis and Varimax rotation were used for data analysis using the PQMethod software. Results: Participants were mostly physicians (24%) or physician/researchers (20%). Eight factors were identified. Factors included the ability of PROs in the EHR to enable: efficient and reliable use; care process improvement and accountability; effective and better symptom assessment; patient involvement for care quality; actionable and practical clinical decisions; graphical review and interpretation of results; use for holistic care planning to reflect patients' needs; and seamless use for all users. Discussion: The success of PROs in the EHR in clinical settings is not dependent on a "one size fits all"strategy, demonstrated by the diversity of viewpoints identified in this study. A sociotechnical approach for implementing PROs in the EHR may help improve its success and sustainability. Conclusions: PROs in the EHR are most important to users when the technology is used to improve patient outcomes. Future research must focus on the impact of embedding this EHR functionality on care processes.
Original language | English (US) |
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Pages (from-to) | 443-452 |
Number of pages | 10 |
Journal | Journal of the American Medical Informatics Association |
Volume | 29 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2022 |
Funding
We would like to extend special thanks to all those who made this work possible including the focus group and interview discussion participants; EASIPRO principal investigators and members; PRO-EPIC PROMIS members; the following AMIA Working Groups: Evaluation, Student, Clinical Information System working group, Primary Care Informatics, Consumer & Pervasive Health Informatics; individuals from Northwestern Memorial Hospital/Northwestern University; the University of Utah; and the University of Illinois Chicago.
Keywords
- Q methodology
- patient-centered
- patient-reported outcomes
- socio-technical
ASJC Scopus subject areas
- Health Informatics