Designing and Implementing an Electronic Health Record-Embedded Card Study in Primary Care: Methods and
Arwen Bunce1, Mary Middendorf2, Megan Hoopes2
1OCHIN Inc, Portland, Oregon buncea@ochin.org.
Insights
This study developed an electronic health record (EHR)-embedded card study to streamline patient surveys. The new method simplifies logistics, enhances data quality, and achieves high response rates for clinical research.
Area of Science:
- Health Informatics
- Clinical Research Methods
- Patient Survey Design
Background:
- Traditional card studies rely on physical surveys, posing logistical challenges in distribution, tracking, and data entry.
- Paper-based surveys lack integration with patient clinical and demographic data, limiting analytical depth.
- Electronic Health Record (EHR) systems offer potential for digital survey integration.
Purpose of the Study:
- To develop and evaluate an EHR-embedded card study to overcome limitations of paper-based surveys.
- To reduce logistical complexities for researchers and improve participant experience.
- To enable direct linking of survey data with clinical and demographic information within the EHR.
Main Methods:
- Designed and programmed a card study directly within the EHR system.
- Developed data extraction methods for linking survey responses to EHR data.
- Iteratively refined the programming and implementation based on encountered issues.
Main Results:
- Achieved a 79% response rate, indicating successful participant engagement.
- Generated research-quality data integrated with EHR information.
- Simplified survey implementation for research teams and clinic staff post-development.
Conclusions:
- EHR-embedded card studies offer a viable, efficient alternative to traditional paper-based methods.
- Despite initial development challenges, the approach facilitates richer analyses and streamlines research processes.
- This methodology provides a scalable model for future EHR-integrated patient surveys.
Abstract:
Card studies-short surveys about the circumstances within which patients receive care-are traditionally completed on physical cards. We report on the development of an electronic health record (EHR)-embedded card study intended to decrease logistical challenges inherent to paper-based approaches, including distributing, tracking, and transferring the physical cards, as well as data entry and respondent prompts, while simultaneously decreasing the complexity for participants and facilitating rich analyses by linking to clinical and demographic data found in the EHR. Developing the EHR-based programming and data extraction was time consuming, required specialized expertise, and necessitated iteration to rectify issues encountered during implementation. Nonetheless, future EHR-embedded card studies will be able to replicate many of the same processes as informed by these results. Once built, the EHR-embedded card study simplified survey implementation for both the research team and clinic staff, resulting in research-quality data, the ability to link survey responses to relevant EHR data, and a 79% response rate. This detailed accounting of the development and implementation process, including issues encountered and addressed, might guide others in conducting EHR-embedded card studies.
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