Incorporating patient-generated contextual data into care: Clinician perspectives using the Consolidated Framework...

Area of Science:

• Health Informatics
• Clinical Practice
• Patient-Centered Care

Background:

• Patient contextual data (PCD), encompassing patient values, environment, and behaviors, is crucial for optimal healthcare but is frequently absent from electronic health records (EHRs).
• Existing EHR structures and clinical workflows present significant obstacles to the systematic documentation of PCD.
• This study investigated clinicians' perceptions of facilitators and barriers to adopting a consumer informatics technology designed to integrate PCD into the EHR.

Observation:

• Semi-structured interviews were conducted with twenty primary care clinicians at an academic health system implementing a PCD initiative.
• The study employed both inductive analysis and the Consolidated Framework for Implementation Research (CFIR) for a comprehensive evaluation.
• PCD components included patient-reported pressures, joys, care preferences, perceived health status, health goals, and visit agendas.

Findings:

• Key facilitators identified by clinicians included the technology's reinforcement of patient engagement, its potential to enhance team-based care, and clear communication regarding its use for personalized care.
• Significant barriers involved the difficulty of integrating PCD into time-constrained patient visits and the additional step required to access the tool within the EHR.
• CFIR analysis revealed intervention source, relative advantage, organizational needs, and relative priority as facilitators, emphasizing the need for sustained leadership to drive cultural change.

Implications:

• Clinicians generally supported the adoption of the consumer informatics technology, recognizing its value in providing a novel data source to improve patient-centered care.
• Clinician involvement in the development process was a positive factor in adoption.
• User-centered optimization of the application proved effective in enhancing its functionality and facilitating uptake.