Toward a patient-centered ambulatory after-visit summary: Identifying primary care patients’ information needs

Clarke, Martina A.; Moore, Joi L.; Steege, Linsey M.; Koopman, Richelle J.; Belden, Jeffery L.; Canfield, Shannon M.; Kim, Min S.

doi:10.1080/17538157.2017.1297305

Cited by 11 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our approach to thematic analysis included a deductive, realist approach to the data using a theoretical frame to identify key themes across the dataset in response to predefined research questions. Both RJK and SMC are experienced with qualitative research, with RJK a family physician researcher and SMC a long-time project director with a public health, diversity, and patient needs perspective [48][49][50][51][52][53]. First, researchers RJK and SMC became familiar with the data by reviewing and checking accuracy of verbatim transcripts.…”

Section: Discussionmentioning

confidence: 99%

Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs

Koopman

Canfield

Belden

et al. 2020

BMC Med Inform Decis Mak

Self Cite

View full text Add to dashboard Cite

Background: Nearly half of US adults with diagnosed hypertension have uncontrolled blood pressure. Clinical inertia may contribute, including patient-physician uncertainty about how variability in blood pressures impacts overall control. Better information display may support clinician-patient hypertension decision making through reduced cognitive load and improved situational awareness. Methods: A multidisciplinary team employed iterative user-centered design to create a blood pressure visualization EHR prototype that included patient-generated blood pressure data. An attitude and behavior survey and 10 focus groups with patients (N = 16) and physicians (N = 24) guided iterative design and confirmation phases. Thematic analysis of qualitative data yielded insights into patient and physician needs for hypertension management. Results: Most patients indicated measuring home blood pressure, only half share data with physicians. When receiving home blood pressure data, 88% of physicians indicated entering gestalt averages as text into clinical notes. Qualitative findings suggest that including a data visualization that included home blood pressures brought this valued data into physician workflow and decision-making processes. Data visualization helps both patients and physicians to have a fuller understanding of the blood pressure 'story' and ultimately promotes the activated engaged patient and prepared proactive physician central to the Chronic Care Model. Both patients and physicians expressed concerns about workflow for entering and using home blood pressure data for clinical care. Conclusions: Our user-centered design process with physicians and patients produced a well-received blood pressure visualization prototype that includes home blood pressures and addresses patient-physician information needs. Next steps include evaluating a recent EHR visualization implementation, designing annotation functions aligned with users' needs, and addressing additional stakeholders' needs (nurses, care managers, caregivers). This significant innovation has potential to improve quality of care for hypertension through better patient-physician understanding of control and goals. It also has the potential to enable remote monitoring of patient blood pressure, a newly reimbursed activity, and is a strong addition to telehealth efforts.

show abstract

Section: Discussionmentioning

confidence: 99%

Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs

Koopman

Canfield

Belden

et al. 2020

BMC Med Inform Decis Mak

Self Cite

View full text Add to dashboard Cite

show abstract

“…Patients who accessed their clinical information online through their EHR strongly believed that they would be able to access their clinical information quickly and efficiently, track visits and tests, and reinforce their understanding of physicians' instructions. 8,9,11,12,[14][15][16]19,25 Similarly, a randomized study by Pavlik et al 15 found that satisfaction with the clinical visit summary was significantly associated with online access through the electronic medical record.…”

Section: Discussionmentioning

confidence: 99%

Helpfulness of Clinical Visit Summary Content From Multi-Specialty Care: A Mixed-Methods Assessment

Ramar

Roellinger

Merrick

et al. 2020

Health Services Research and Managerial Epidemiology

View full text Add to dashboard Cite

Objective: We surveyed patients who visited multiple outpatient specialty practices to understand what summary content was most helpful with the goal of optimizing meaningful outpatient clinical visit summary content. Materials and Methods: We constructed a survey instrument to measure delivery, use, and contents of clinical visit summaries. We surveyed patients who visited with at least 2 different outpatient medical specialties to understand preferences. Results: Most patients in our sample valued the summary information they received, and retained it as healthcare documentation (84%) and/or quick reference in supporting self-care (70%). Patients most commonly reported that information on results of completed tests (91%) and treatment plan instructions (89%) were very helpful. Additionally, patients expressed the importance of online access to clinical visit summary information. Discussion: Most patients used the clinical visit summary as healthcare documentation, and valued online availability of their summary information. Patients most often reported that information on results of recently completed tests and specific instructions on treatment plan were very helpful. Patients who sought further information after their visit most often looked to a provider and/or online. Conclusions: Patients valued clinical visit summary accessibility and as a reference tool to summarize care and provide next steps. Optimal clinical visit summaries might collate and integrate assessments and recommendations from multiple specialties into coherent care plans for patients.

show abstract

“…Research has found that patient needs vary based on health contexts of chronic illness vs acute medical situations, and longitudinal primary care vs specialty care. 26,27 Current solutions provided by EHR vendors may not meet the needs of patients, caregivers, or providers. 26 Health care providers have the opportunity to push the development of health care visit summaries tailored to patient learning styles, incorporating technological solutions such as audio and video to supplement printed materials.…”

Section: Discussionmentioning

confidence: 99%

Creation of a Patient-Centered Journey Map to Improve the Patient Experience: A Mixed Methods Approach

Philpot

Khokhar

DeZutter

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

View full text Add to dashboard Cite

show abstract

Toward a patient-centered ambulatory after-visit summary: Identifying primary care patients’ information needs

Abstract: The results of this study can be used to inform the development of an after-visit summary that assists patients to fully understand their treatment plan, which may improve treatment adherence.

Cited by 11 publications

References 34 publications

Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs

Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs

Helpfulness of Clinical Visit Summary Content From Multi-Specialty Care: A Mixed-Methods Assessment

Creation of a Patient-Centered Journey Map to Improve the Patient Experience: A Mixed Methods Approach

Contact Info

Product

Resources

About