Using Life Stories to Support Patient-Centered Care: A Narrative Review of Implementation and Impact

My Life, My Story (MLMS) is a narrative medicine initiative that was initially developed to collect patients' life stories with the goal of supporting patient-centered healthcare delivery in the Veterans Affairs health system and has since spread to various healthcare settings across the country. Despite widespread intervention, there has been little research published on MLMS. We conducted a narrative review to better understand the nature of MLMS implementation, its impact on providers and patients, and gaps in knowledge. We found that, while there is great variation in the implementation of MLMS, all projects share a similar framework that includes a patient-driven interview process about their life story, the interviewer's writing of the story from the patient's perspective, story revision based on patient feedback, and its final dissemination in the electronic health record and to the patient. Notably, while MLMS initiatives involve veteran and non-veteran individuals, the typical MLMS participant is older and white. Additionally, research on patient outcomes is sparse with a few studies showing that the experience is enjoyable for patients, can support the disclosure of information to providers that patients deem relevant to their healthcare, and may increase patient satisfaction with care. We found that providers had mostly positive experiences with MLMS and felt it could support care provision to a patient's individual context. Healthcare trainees also benefited, with studies demonstrating the development of empathy skills. Overall, research is limited given that existing work has not adequately explored the patient perspective and potential drawbacks of MLMS, especially in patients who have marginalized identities. We suggest future research should take a more nuanced, longitudinal, and qualitative approach to the impact of the initiative on patients, beyond the evaluation of generic, Likert-style positive measures, to better understand if and how MLMS can truly be a patient-centered initiative.