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Patient-centered care and the electronic health record: exploring functionality and gaps
Jorie M Butler1,2,3, Bryan Gibson4, Lacey Lewis2
1Geriatric Research and Clinical Center (GRECC), George E. Wahlen Veteran Affairs Medical Center, Salt Lake City, Utah, USA.
JAMIA Open
|November 20, 2020
Summary
Electronic health records (EHRs) have gaps in supporting patient-centered care (PCC). Redesigning EHRs offers opportunities to better integrate patient preferences and data for improved holistic care.
Area of Science:
- Health Informatics
- Clinical Systems Research
- Patient-Centered Care
Background:
- Electronic health records (EHRs) are widely adopted in healthcare systems to enhance clinical care delivery.
- Patient-centered care (PCC), focusing on the whole person and patient self-management, is a key goal for many healthcare organizations.
- The integration of EHR functionalities with PCC principles is crucial for modern healthcare.
Purpose of the Study:
- To evaluate how current EHR systems facilitate patient-centered care (PCC).
- To identify specific functionalities within EHRs that support or hinder the practice of PCC.
- To explore the perspectives of both technical and clinical users on EHR support for PCC.
Main Methods:
- Survey and interview methodology was employed, targeting technical representatives and expert clinical users of six leading EHR systems.
- Assessment focused on the availability of EHR functions related to PCC, including patient goals, preferences, care plans, and contextual/patient-generated data.
- Data collection specifically queried the presence of PCC-related features and their perceived clinical utility.
Main Results:
- Technical representatives confirmed the implementation of functions for patient communication preferences, medication indications, and end-of-life preferences across the surveyed EHRs.
- Clinical users reported moderate usefulness of existing PCC functions, indicating significant room for enhancement.
- Interviews highlighted a lack of shared understanding of PCC among clinicians and that essential PCC data is often unstructured within EHRs.
Conclusions:
- Current EHR systems exhibit deficiencies in functionalities that fully support patient-centered care (PCC).
- Significant opportunities exist for EHR redesign to better incorporate and facilitate PCC.
- Future development should focus on integrating patient data and preferences more effectively to enhance holistic patient care.
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