RT Journal Article
SR Electronic
T1 Harnessing Information Technology to Inform Patients Facing Routine Decisions: Cancer Screening as a Test Case
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 217
OP 224
DO 10.1370/afm.2063
VO 15
IS 3
A1 Alex H. Krist
A1 Steven H. Woolf
A1 Camille Hochheimer
A1 Roy T. Sabo
A1 Paulette Kashiri
A1 Resa M. Jones
A1 Jennifer Elston Lafata
A1 Rebecca S. Etz
A1 Shin-Ping Tu
YR 2017
UL http://www.annfammed.org/content/15/3/217.abstract
AB PURPOSE Technology could transform routine decision making by anticipating patients’ information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use such a decision module and its impact on care, using 3 cancer screening decisions as test cases.METHODS Twelve practices with 55,453 patients using a patient portal participated in this prospective observational cohort study. Participation was open to patients who might face a cancer screening decision: women aged 40 to 49 who had not had a mammogram in 2 years, men aged 55 to 69 who had not had a prostate-specific antigen test in 2 years, and adults aged 50 to 74 overdue for colorectal cancer screening. Data sources included module responses, electronic health record data, and a postencounter survey.RESULTS In 1 year, one-fifth of the portal users (11,458 patients) faced a potential cancer screening decision. Among these patients, 20.6% started and 7.9% completed the decision module. Fully 47.2% of module completers shared responses with their clinician. After their next office visit, 57.8% of those surveyed thought their clinician had seen their responses, and many reported the module made their appointment more productive (40.7%), helped engage them in the decision (47.7%), broadened their knowledge (48.1%), and improved communication (37.5%).CONCLUSIONS Many patients face decisions that can be anticipated and proactively facilitated through technology. Although use of technology has the potential to make visits more efficient and effective, cultural, workflow, and technical changes are needed before it could be widely disseminated.