Opportunities for addressing gaps in primary care shared decision-making with technology: a mixed-methods needs...

Area of Science:

• Primary Care Research
• Health Informatics
• Patient Engagement

Background:

• Shared decision-making (SDM) is crucial for patient-centered care in primary care settings.
• Current SDM practices require analysis to identify areas for enhancement.
• Information technology (IT) interventions present a potential avenue for improving SDM.

Purpose of the Study:

• To analyze current shared decision-making (SDM) practices in primary care.
• To assess the need for information technology (IT) interventions to support SDM.
• To identify specific opportunities for IT to enhance physician-patient communication.

Main Methods:

• A mixed-methods study involving ethnographic observation of clinical encounters.
• Patient and physician interviews were conducted to gather qualitative data.
• The OPTION scale was used to quantitatively measure SDM, supplemented by qualitative thematic analysis.

Main Results:

• Low average OPTION scores indicated suboptimal SDM in observed primary care practices.
• Patient interviews highlighted themes of trust, external influences, flexibility, frustrations, values, and preferences.
• Physician interviews revealed concerns about technology, current decision-making methods, and patient understanding.

Conclusions:

• Significant opportunities exist for IT to enhance SDM by addressing specific gaps, such as patient information preferences and involvement levels.
• Both patients and physicians are receptive to IT solutions that improve communication regarding care options.
• Future primary care IT platforms should focus on standardizing SDM workflows and overcoming adoption barriers.