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Feasibility study of an EHR-integrated mobile shared decision making application.

Frank C Day¹, Mohammad Pourhomayoun², Deidre Keeves³

¹Department of Emergency Medicine, David Geffen School of Medicine at UCLA, 924 Westwood Blvd Ste 300, Los Angeles, CA, 90024, USA.

International Journal of Medical Informatics

|February 21, 2019

Summary

This summary is machine-generated.

Integrating a patient decision aid app into electronic health records (EHR) is feasible for usability testing. This approach can enhance patient engagement and shared decision-making, despite challenges with EHR vendor APIs.

Keywords:

Clinical informatics Decision making Electronic health records mobile applications

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Area of Science:

Health Informatics
Digital Health
Medical Decision Making

Background:

Mobile applications (apps) integrating with electronic health records (EHR) offer potential value, particularly for bidirectional data exchange.
Patient decision aids can support informed choices regarding screenings like prostate-specific antigen (PSA) testing for prostate cancer.

Purpose of the Study:

To assess the feasibility and usability of integrating a patient decision aid app into standard EHR workflows.
To evaluate the impact of the integrated app on patient engagement and decision-making regarding PSA testing.

Main Methods:

Enabled real-time, secure bidirectional data exchange between a mobile app and EHR for 14 data elements.
Conducted a pilot test with 9 primary care patients (aged 60-65) using the integrated app.
Measured usability via Net Promoter Score (NPS) and assessed updates to risk factor information and decision preferences.

Main Results:

Seven of nine patients (78%) would recommend the app (NPS = 55.6%).
One patient updated their prostate cancer risk factor information in the EHR.
44% of patients changed their PSA testing decision preference after using the app.

Conclusions:

Implementing decision aids directly into EHR workflows is feasible for limited usability testing.
Broad implementation may enhance patient engagement and shared decision-making.
Challenges remain regarding proprietary EHR vendor application programming interfaces (APIs).