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Med Decis Making. 2018 Sep 18:272989X18796223. doi: 10.1177/0272989X18796223. [Epub ahead of print]

The Promise of Electronic Health Records to Promote Shared Decision Making: A Narrative Review and a Look Ahead.

Kuo AM1,2,3,4, Thavalathil B1,2,3,4, Elwyn G1,2,3,4, Nemeth Z1,2,3,4, Dang S1,2,3,4.

Author information

1
University of Miami, Coral Gables, FL, USA (AMK).
2
Geriatric Research Education and Clinical Center, Miami Veterans Affairs Healthcare System, Miami, FL, USA (BT, SD).
3
The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA (GE).
4
Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA (ZN, SD).

Abstract

BACKGROUND:

Shared decision making (SDM) involves the sharing of best available evidence between patients and providers in the face of difficult decisions. We examine outcomes that occur when electronic health records (EHRs) are purposefully used with the goal of improving SDM and detail which EHR functions can benefit SDM.

METHODS:

A systematic search of PubMed yielded 1369 articles. Studies were included only if they used EHR interventions to support SDM and included results that showed impact on SDM. Articles were excluded if they did not measure the impact of the intervention on SDM or did not discuss how SDM had been supported by the EHR.

RESULTS:

Five studies demonstrated improved clinical outcomes, positive lifestyle behavior changes, more deliberation from patients regarding use of imaging, and less decisional conflict about medication use among patients with use of EHRs aiding SDM.

DISCUSSION:

Few EHRs have integrated SDM, and even fewer evaluations of these exist. EHRs have potential in supporting providers during all steps of SDM. The promise of EHRs to support SDM has yet to be fully exploited.

KEYWORDS:

chronic diseases; electronic health records; shared decision making

PMID:
30226100
DOI:
10.1177/0272989X18796223

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