JMIR Publications

ABSTRACT

Background:

Commonly used digital health technologies, such as electronic health record systems (EHRs) and patient portals, as well as custom built digital decision aids, have the potential to enhance person-centered shared decision-making (SDM) in cancer care. However, there is little evidence in the literature on how these technologies are used for SDM or how best they can be designed and integrated into workflows and practice. This may be due to the nature of SDM, which is fundamentally human interactions and conversations that produce desired human outcomes. Technology must, therefore, be non-intrusive while supporting the human decision-making process.

Objective:

This study examined how digital technologies can help cancer care professionals improve shared decision-making (SDM) in oncology consultations.

Methods:

Healthcare professionals who treat cancer patients in Sydney, Australia, were invited to participate in online co-design focus group meetings. During these sessions, they shared their experiences using digital technologies for shared decision-making (SDM) and provided suggestions to improve their use of digital technologies. The session recordings were transcribed and then analyzed using qualitative thematic analysis.

Results:

The findings indicated that various digital technologies, such as electronic health record systems (EHRs), mobile devices, and patient portals, are used by cancer care professionals to help improve patients’ understanding of their disease and available care options. Digital technologies can both improve and undermine SDM. Current systems are generally not designed to support SDM. Key issues such as data integration and interoperability between systems negatively impact the ability of digital technologies to support SDM. Emerging technologies such as Generative Artificial Intelligence (AI) were discussed as potential facilitators of SDM by automating the gathering and sharing of information with patients and between health professionals.

Conclusions:

This research indicates that digital technologies have the potential to impact SDM in oncology consultations. However, this potential has not yet been fully realized, and significant modifications are required to optimize their usefulness in person-centered SDM.