Implementing a Patient-Reported Outcome Dashboard in Oncology Telemedicine Encounters: Clinician and Patient Adoption and Acceptability.
| Autor: | Mohindra, Nisha A., Coughlin, Ava, Kircher, Sheetal, O'Daniel, Alesia, Barnard, Cynthia, Cameron, Kenzie A., Hirschhorn, Lisa R., Cella, David |
|---|---|
| Předmět: |
DASHBOARDS (Management information systems)
HEALTH services accessibility PATIENT education PEARSON correlation (Statistics) HUMAN services programs INTERPROFESSIONAL relations T-test (Statistics) RESEARCH funding CANCER patient medical care PILOT projects INTERVIEWING MEDICARE PSYCHOLOGICAL adaptation TREATMENT effectiveness DESCRIPTIVE statistics CHI-squared test TELEMEDICINE PHYSICIAN-patient relations RESEARCH methodology ELECTRONIC health records HEALTH outcome assessment CONFIDENCE intervals COMPARATIVE studies DATA analysis software SOCIODEMOGRAPHIC factors PATIENT participation EVALUATION |
| Zdroj: | JCO Oncology Practice; Mar2024, Vol. 20 Issue 3, p409-418, 10p |
| Abstrakt: | PURPOSE: Telemedicine provides numerous benefits to patients, yet effective communication and symptom assessment remain a concern. The recent uptake of telemedicine provided an opportunity to use a newly developed dashboard with patient-reported outcome (PRO) information to enhance communication and shared decision making (SDM) during telemedicine appointments. The objective of this study was to identify barriers to using the dashboard during telemedicine, develop implementation strategies to address barriers, and pilot test use of this dashboard during telemedicine appointments in two practice settings to evaluate acceptability, adoption, fidelity, and effectiveness. METHODS: Patients and clinicians were interviewed to identify determinants to dashboard use in telemedicine. Implementation strategies were designed and refined through iterative feedback from stakeholders. A pilot study of dashboard use was conducted from March to September 2022. Acceptability, adoption, and fidelity were evaluated using mixed methods. SDM was evaluated using the collaboRATE measure. RESULTS: One hundred two patient encounters were evaluated. Most patients (62; 60%) had completed some PRO data at the time of their telemedicine encounter. Most (82; 80%) encounters had clinician confirmation that PRO data had been reviewed; however, collaborative review of the dashboard was documented in only 27%. Degree of SDM was high (mean collaboRATE score 3.40; SD, 0.11 [95% CI, 3.17 to 3.63] out of a maximum score of 4). Implementation strategies focused on patient engagement, education, and remote PRO completion. Clinician-facing strategies included education, practice facilitation, and small tests of change. CONCLUSION: This study demonstrated that implementation of a PRO-based dashboard into telemedicine appointments was feasible and had acceptable adoption and acceptability by patients and clinicians when several strategies were used to engage end users. Strategies targeting both patients and clinicians are needed to support routine and effective PRO integration in telemedicine. As telemedicine is increasing in oncology, we need to understand ways to bring patient-reported outcomes into that setting. This study found that engaging end users and presenting PROs in an interpretable and meaningful way through use of dashboard can help align clinicians with patient preferences and health status when they are not in clinic together. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
| Externí odkaz: |
|