Care partners and consumer health information technology: A framework to guide systems-level initiatives in support of digital health equity.

Autor: Wolff JL; Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA., Wec A; Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA., Peereboom D; Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA., Gleason KT; Johns Hopkins University School of Nursing Baltimore Maryland USA., Amjad H; Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Baltimore Maryland USA., Burgdorf JG; Center for Home Care Policy & Research Visiting Nurse Service of New York New York New York USA., Cassidy J; School of Social Work University of Texas at Arlington Arlington Texas USA., DesRoches CM; Department of Medicine Harvard Medical School Boston Massachusetts USA., Fabius CD; Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA., Green AR; Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Baltimore Maryland USA., Lin CT; University of Colorado Aurora Colorado USA., Nothelle SK; Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Baltimore Maryland USA., Powell DS; Department of Hearing & Speech Sciences University of Maryland College Park Maryland USA., Riffin CA; Division of Geriatrics and Palliative Medicine Weill Cornell Medical Center New York New York USA., Smith J; Johns Hopkins School of Nursing Baltimore Maryland USA., Lum HD; Division of Geriatric Medicine University of Colorado School of Medicine Aurora Colorado USA.
Jazyk: angličtina
Zdroj: Learning health systems [Learn Health Syst] 2024 Feb 27; Vol. 8 (Suppl 1), pp. e10408. Date of Electronic Publication: 2024 Feb 27 (Print Publication: 2024).
DOI: 10.1002/lrh2.10408
Abstrakt: Introduction: Consumer-oriented health information technologies (CHIT) such as the patient portal have a growing role in care delivery redesign initiatives such as the Learning Health System. Care partners commonly navigate CHIT demands alongside persons with complex health and social needs, but their role is not well specified.
Methods: We assemble evidence and concepts from the literature describing interpersonal communication, relational coordination theory, and systems-thinking to develop an integrative framework describing the care partner's role in applied CHIT innovations. Our framework describes pathways through which systematic engagement of the care partner affects longitudinal work processes and multi-level outcomes relevant to Learning Health Systems.
Results: Our framework is grounded in relational coordination, an emerging theory for understanding the dynamics of coordinating work that emphasizes role-based relationships and communication, and the Systems Engineering Initiative for Patient Safety (SEIPS) model. Cross-cutting work systems geared toward explicit and purposeful support of the care partner role through CHIT may advance work processes by promoting frequent, timely, accurate, problem-solving communication, reinforced by shared goals, shared knowledge, and mutual respect between patients, care partners, and care team. We further contend that systematic engagement of the care partner in longitudinal work processes exerts beneficial effects on care delivery experiences and efficiencies at both individual and organizational levels. We discuss the utility of our framework through the lens of an illustrative case study involving patient portal-mediated pre-visit agenda setting.
Conclusions: Our framework can be used to guide applied embedded CHIT interventions that support the care partner role and bring value to Learning Health Systems through advancing digital health equity, improving user experiences, and driving efficiencies through improved coordination within complex work systems.
Competing Interests: CT Lin reports serving as an unpaid advisory board member to Doximity Telehealth and Epic Physician Advisory Council. The remaining authors have nothing to disclose.
(© 2024 The Authors. Learning Health Systems published by Wiley Periodicals LLC on behalf of University of Michigan.)
Databáze: MEDLINE
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