Harnessing Information Technology to Inform Patients Facing Routine Decisions: Cancer Screening as a Test Case

Authors

Alex Krist, Virginia Commonwealth UniversityFollow
Steven H. Woolf, Virginia Commonwealth University
Camille Hochheimer, Virginia Commonwealth University
Roy T. Sabo, Virginia Commonwealth University
Paulette Kashiri, Virginia Commonwealth University
Resa M. Jones, Virginia Commonwealth University
Jennifer Elston Lafata, University of North Carolina at Chapel Hill
Rebecca S. Etz, Virginia Commonwealth University
Shin-Ping Tu, University of Washington

Document Type

Article

Original Publication Date

2017

Volume

15

DOI of Original Publication

10.1370/afm.2063

Comments

Originally published at https://doi.org/10.1370/afm.2063

Date of Submission

July 2017

Abstract

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.

Rights

© 2017 Annals of Family Medicine, Inc.

Is Part Of

VCU Family Medicine and Population Health Publications