在共享决策中关闭基于价值的循环:通过患者报告的结果和经验指标,为共享决策过程提供信息的数字框架
Marta Del Olmo Rodríguez1,2,3, Rafael Martos Martinez4,5, Adriana Pascual Martínez6,7
1Hospital Management, Quirónsalud 4H Network, Madrid, Spain.
Frontiers in public health
|September 13, 2024
概括
基于价值的医疗保健使用患者报告的结果和经验指标 (PROM) 来改善共享决策 (SDM). 将PROM数据集成到患者决策辅助工具中的数字框架显示出有希望的结果,以提高患者参与治疗选择的可能性.
科学领域:
- 提供医疗保健的模式.
- 医疗信息学 医疗信息学
- 患者的参与度 患者的参与度
背景情况:
- 基于价值的医疗保健模式越来越多地利用患者报告的结果和经验指标 (PROM / PREM).
- PROM/PREM有潜力将患者报告的数据纳入临床决策.
- 本研究重点关注PROM/PREM在共享决策 (SDM) 中的整合.
研究的目的:
- 探索患者报告结果 (PRO) 和基于价值的医疗保健中的共享决策 (SDM) 的作用.
- 通过聚合的PROM/PREM数据,呈现一个数字框架来增强SDM.
- 报告这个数字框架的早期实施结果.
主要方法:
- 开发了一个数字框架,将聚合的PROM/PREM数据纳入患者决策辅助器 (PDA).
- 为淋巴瘤患者实施了PDA,允许他们审查结果,优先考虑偏好,并选择行动.
- 患者报告的数据被整合到电子健康记录 (EHR) 中,并被反到PDA中.
主要成果:
- 在14个月的时间里,25名毛囊淋巴瘤患者中有13名参与了数字决策辅助程序.
- 参与和非参与患者之间没有发现显著的人口差异.
- 参与患者的共享决策问卷-9 (SDM Q-9) 平均得分为45.5分中的36.15.
结论:
- 共享决策 (SDM) 的实施面临时间限制和对变革的抵抗等障碍.
- 政策制定者和医疗保健经理的支持对于系统级采用患者报告数据和SDM至关重要.
- 早期的发现表明,以PRO丰富的SDM数字框架可以有利于决策过程.
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