Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach
BackgroundPatient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) of...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2022-03-01
|
| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2022/3/e33584 |
| _version_ | 1797735257156354048 |
|---|---|
| author | Selena Davis Marcy Antonio Mindy Smith Paul Burgener Danielle C Lavallee Morgan Price Sarah C Fletcher Francis Lau |
| author_facet | Selena Davis Marcy Antonio Mindy Smith Paul Burgener Danielle C Lavallee Morgan Price Sarah C Fletcher Francis Lau |
| author_sort | Selena Davis |
| collection | DOAJ |
| description |
BackgroundPatient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process.
ObjectiveThis study aims to test the feasibility of using patient-generated data in team-based care; describe the use of these data for team-based mental health care; and summarize patient and provider care experiences with PCM.
MethodsWe conducted a multi-method exploratory study in a rural team-based primary care clinic using IKT to co-design, implement, and evaluate the use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were adjusted iteratively to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating to the use of PCM and patient portals in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation.
ResultsDuring co-design, a care workflow was developed to incorporate electronically collected patient-generated data from the patient portal into the electronic medical record, and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work, and the lack of portal and electronic medical record integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding the ongoing barriers to PCM use and quality improvement.
ConclusionsAlthough the culture toward using PCM is changing, the use of PCM during care has not been successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are required before PCM can be integrated into routine care. |
| first_indexed | 2024-03-12T12:55:32Z |
| format | Article |
| id | doaj.art-4fb80d9459aa49f9a019890277066169 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-03-12T12:55:32Z |
| publishDate | 2022-03-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj.art-4fb80d9459aa49f9a0198902770661692023-08-28T21:06:23ZengJMIR PublicationsJMIR Formative Research2561-326X2022-03-0163e3358410.2196/33584Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation ApproachSelena Davishttps://orcid.org/0000-0003-4542-3341Marcy Antoniohttps://orcid.org/0000-0001-9332-8512Mindy Smithhttps://orcid.org/0000-0002-5965-8881Paul Burgenerhttps://orcid.org/0000-0002-7749-3216Danielle C Lavalleehttps://orcid.org/0000-0002-5555-9675Morgan Pricehttps://orcid.org/0000-0001-6409-1579Sarah C Fletcherhttps://orcid.org/0000-0002-6560-3772Francis Lauhttps://orcid.org/0000-0001-7010-3281 BackgroundPatient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. ObjectiveThis study aims to test the feasibility of using patient-generated data in team-based care; describe the use of these data for team-based mental health care; and summarize patient and provider care experiences with PCM. MethodsWe conducted a multi-method exploratory study in a rural team-based primary care clinic using IKT to co-design, implement, and evaluate the use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were adjusted iteratively to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating to the use of PCM and patient portals in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. ResultsDuring co-design, a care workflow was developed to incorporate electronically collected patient-generated data from the patient portal into the electronic medical record, and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work, and the lack of portal and electronic medical record integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding the ongoing barriers to PCM use and quality improvement. ConclusionsAlthough the culture toward using PCM is changing, the use of PCM during care has not been successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are required before PCM can be integrated into routine care.https://formative.jmir.org/2022/3/e33584 |
| spellingShingle | Selena Davis Marcy Antonio Mindy Smith Paul Burgener Danielle C Lavallee Morgan Price Sarah C Fletcher Francis Lau Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach JMIR Formative Research |
| title | Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach |
| title_full | Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach |
| title_fullStr | Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach |
| title_full_unstemmed | Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach |
| title_short | Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach |
| title_sort | paving the way for electronic patient centered measurement in team based primary care integrated knowledge translation approach |
| url | https://formative.jmir.org/2022/3/e33584 |
| work_keys_str_mv | AT selenadavis pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT marcyantonio pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT mindysmith pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT paulburgener pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT danielleclavallee pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT morganprice pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT sarahcfletcher pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach AT francislau pavingthewayforelectronicpatientcenteredmeasurementinteambasedprimarycareintegratedknowledgetranslationapproach |