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J Am Med Inform Assoc. 2016 Jan;23(1):74-9. doi: 10.1093/jamia/ocv085. Epub 2015 Jul 9.

Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report.

Author information

1
Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA charle@phhp.ufl.edu.
2
Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA.
3
Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.
4
Department of Anesthesiology, Stanford University, Palo Alto, CA, USA.
5
Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA.
6
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.

Abstract

In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden.

KEYWORDS:

clinical informatics; electronic health record; patient outcome assessment; patient-reported outcomes; primary care; work flow

PMID:
26159464
PMCID:
PMC5009936
DOI:
10.1093/jamia/ocv085
[Indexed for MEDLINE]
Free PMC Article

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