Difference between revisions of "Patient entered data"
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Many patients, health professionals, and other stakeholders are interested in the feasibility, scientific acceptability, usability, and usefulness of data entered directly by patients for review in the primary care summary. While the perception is that the practice has advanced considerably in the last decade, the evidence about use and best practices of use are not yet well specified. This review attempts to capture the state of the evidence and current practice in order to facilitate appropriate, beneficial use of patient entered data. | Many patients, health professionals, and other stakeholders are interested in the feasibility, scientific acceptability, usability, and usefulness of data entered directly by patients for review in the primary care summary. While the perception is that the practice has advanced considerably in the last decade, the evidence about use and best practices of use are not yet well specified. This review attempts to capture the state of the evidence and current practice in order to facilitate appropriate, beneficial use of patient entered data. | ||
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| + | Questions Related to Patient-Entered Data | ||
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| + | A number of questions have emerged related the issue of patient-entered data collection that would automatically populate the electronic health record. Major issues, each discussed below, include: | ||
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| + | 1. Trusting the data: Is the data valid and reliable? | ||
| + | 2. Populations: What about patients with lower education, literacy or numeracy skills? | ||
| + | 3. Privacy: This is major concern for PHRs; won’t this reduce participation? | ||
| + | 4. Data Overload: Is it feasible to expect clinicians review all the data patients enter? | ||
| + | 5. Responsibility: Who is liable for all data entered? | ||
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| + | Review of Research Relevant to Questions | ||
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| + | Research using computerized survey applications have measured feasibility, data capture, and patient satisfaction for risk factor screening, symptom findings, behavioral measures, and quality of life scores. Most results support using a computerized mode of data entry compared to paper or in-person surveys. Many cite increased speed of data collection and higher rates of user satisfaction. Computerized methods lead to higher rates of completion and reduce missing data, particularly for sensitive problems such as substance abuse and other behaviors. | ||
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| + | There is a plausible concern about poorer data completion by individuals with lower levels of education, literacy or numeracy. Research shows computerized survey methods are a reasonable choice for most populations, but attention must be given to usability and technical assistance for those without prior computer experience. | ||
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| + | Regarding privacy issues, research has demonstrated taht individuals taking computerized surveys feel they are more private than other modes of questioning. This may be a particularly valuable finding, given the concern about PHRs and privacy. Even with the implicit understanding that their answers will be reviewed, patients appear less inhibited about responding to a computer. | ||
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| + | Patients have positive opinions about secure messaging and PHR applications, however, clinicians offer less positive assessments. Clinician concerns center on increased workload and inability to screen for relevant data and information. | ||
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Review of previous summaries | Review of previous summaries | ||
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David A. Dorr | David A. Dorr | ||
| + | Susan S. Woods | ||
Revision as of 03:16, 10 December 2007
Patient entered data in primary care
This is a review for the primary care informatics working group of AMIA.
Premise / justification
Scope of the work
Patient entered data for review in primary care setting - Information not knowledge? (e.g., there is a summary on electronic patient education – dispensing knowledge and evaluating) - Telemonitoring? (EPC review exists, even with update) - Other subdomains need to be specified ...
Reason for summary
Many patients, health professionals, and other stakeholders are interested in the feasibility, scientific acceptability, usability, and usefulness of data entered directly by patients for review in the primary care summary. While the perception is that the practice has advanced considerably in the last decade, the evidence about use and best practices of use are not yet well specified. This review attempts to capture the state of the evidence and current practice in order to facilitate appropriate, beneficial use of patient entered data.
Questions Related to Patient-Entered Data
A number of questions have emerged related the issue of patient-entered data collection that would automatically populate the electronic health record. Major issues, each discussed below, include:
1. Trusting the data: Is the data valid and reliable? 2. Populations: What about patients with lower education, literacy or numeracy skills? 3. Privacy: This is major concern for PHRs; won’t this reduce participation? 4. Data Overload: Is it feasible to expect clinicians review all the data patients enter? 5. Responsibility: Who is liable for all data entered?
Review of Research Relevant to Questions
Research using computerized survey applications have measured feasibility, data capture, and patient satisfaction for risk factor screening, symptom findings, behavioral measures, and quality of life scores. Most results support using a computerized mode of data entry compared to paper or in-person surveys. Many cite increased speed of data collection and higher rates of user satisfaction. Computerized methods lead to higher rates of completion and reduce missing data, particularly for sensitive problems such as substance abuse and other behaviors.
There is a plausible concern about poorer data completion by individuals with lower levels of education, literacy or numeracy. Research shows computerized survey methods are a reasonable choice for most populations, but attention must be given to usability and technical assistance for those without prior computer experience.
Regarding privacy issues, research has demonstrated taht individuals taking computerized surveys feel they are more private than other modes of questioning. This may be a particularly valuable finding, given the concern about PHRs and privacy. Even with the implicit understanding that their answers will be reviewed, patients appear less inhibited about responding to a computer.
Patients have positive opinions about secure messaging and PHR applications, however, clinicians offer less positive assessments. Clinician concerns center on increased workload and inability to screen for relevant data and information.
Review of previous summaries
- literature review of primary sources - needs to be completed immediately prior to advancement.
Methods
Structure and domains - By function? E.g., HL7 EHR-S function involved? - By domain of information entered? E.g., - By activity? E.g., formal questionnaires, pre-visit assessment, specific quality / safety components, disease status, etc.
Literature review
Terms for lit review
Sources
- local brainstorming and contacts need to be one source
Verification - Recommend ABC abstract review - Then larger abstraction template with inclusion and exclusion criteria included
Formal inclusion and exclusion criteria
Current practice review - best practices (expert) - examples of archetype systems - ?appendix with all discovered systems?
Results
Discussion
Contributors to date
David A. Dorr Susan S. Woods
