JMIR Publications

ABSTRACT

Background:

Patient-centered care is respectful of and responsive to individual patient preferences, needs, and values. To provide patient-centered care, clinicians need to know and incorporate the patient’s context into their communication and care with patients. Patient-contextual data (PCD) encompass social determinants of health and patients' needs, values, goals, and preferences relevant to their care. PCD can be challenging to collect as a routine component of the time-compressed primary care visit.

Objective:

The study aims are to (1) determine if patient-provider communication and patient activation are different for patient-users and patient-non-users of an electronic health record (EHR)-integrated PCD tool; and (2) assess if the impact of using PCD on patient-provider communication and patient activation differs for Black and White patients.

Methods:

We describe a randomized trial of a prospective cohort of non-Hispanic White and Black patients who receive primary care services at a midwestern academic healthcare system in the United States. We will evaluate if providing PCD through a consumer informatics tool enhances patient-provider communication, as measured by the Communication Assessment Tool, and we will evaluate patient activation, as measured by the Patient Activation Measure for PCD Tool users and non-users. Further, because of racial disparities in care and communication, we seek to determine if the adoption and use of the tool might narrow differences between patient groups.

Results:

As of October 2019, we enrolled 301 participants in the trial. Trial results expected to be published Fall, 2020.

Conclusions:

Recently, there has been increased attention to the role of health information technology tools to enable patients to collaborate with providers through the sharing of PCD. The adoption of such tools may overcome the barriers of current EHRs by directly engaging patients to submit their contextual data. Effectively, these tools would support the EHR in providing a more holistic understanding of the patient. Research further supports that individuals who have a robust digital engagement using consumer informatics tools have higher participation in treatment follow-up and self-care across populations. Therefore, it is critical to investigate interventions that elicit and share patients’ social risks and care preferences with the healthcare team as a mechanism to improve individualized care and lessen the gap in health outcomes. Clinical Trial: ClinicalTrials.gov, NCT03766841. Registered on 6 December 2018