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What Keeps Providers from Using Patient-Generated Health Data?

Research shows that disruption to clinical workflow and time constraints may be barriers to providers using patient-generated health data.

Patient-generated health data may have several reported patient engagement and empowerment benefits, but lingering issues may prohibit providers from actually using patients’ data.

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In a study published in the Journal of the American Medical Informatics Association, a research team led by Christopher A. Harle sought to understand some of the physician barriers to integrating patient-generated health data into their EHRs and clinical workflows.

The healthcare industry is currently amidst a shift in care delivery, focusing on patient-centered strategies and accountable care. In order to integrate such concepts into care, industry professionals tout the usefulness of patient-generated health data, which not only gives providers a window into patient wellness when away from the doctor’s office, but gives patients a stake in their own care, fostering patient engagement.

Through programs like meaningful use, industry leaders ask providers to foster engagement by requiring EHRs to demonstrate the capability to integrate patient-generated health data integration into the systems. However, in order to make this a feasible requirement, researchers and technology developers must understand provider needs.

“Given the importance of social and behavioral factors in health, researchers must understand barriers and facilitators related to integrating [patient reported outcomes] in EHRs,” the researchers explained.

In order to identify these potential barriers, the research team investigated six family practices affiliated with a Florida healthcare system. They worked with the system’s health IT department as well as physicians, physician’s assistants, and nurse practitioners, to develop an EHR system that effectively collected PGHD without burdening provider workload.

From this project, the research team was able to glean the main barriers to PGHD integration and determine what system characteristics providers value.

Overall, the research team identified two main barriers to PGHD integration: first, they needed to quickly assess the clinical benefit of the data collected, and second, they needed the data collection to not burden their workflows or practice time constraints.

Primarily, providers reported concern that indiscriminately collecting patient-generated health data would distract them from treating an acute condition deemed more vital than what the patient reported.

“Providers described concern that systematically collecting [PGHD] information, in particular psychological data on depression and anxiety, could open ‘Pandora’s Box’ during visits,” the researchers reported. “For example, some said discussing these issues could harm care quality by diverting their attention away from acute problems that they judged to be more relevant at a given visit or more aligned with their clinical expertise.”

These concerns led the researchers to identify a right place at the right time mentality to developing PGHD integration systems. Providers and other hospital staff reported wanting a system that could analyze patient conditions and deliver PGHD results to providers based on current patient needs.

This right place at the right time mentality was also cited as a means to alleviate workflow concerns. Since providers reported that they did not want patient-generated health data integration to detract from their workflows or time constraints, they stated that they wanted a system that could deliver the PGHD at the right time.

Providers also expressed interest in automated approaches to integrating patient-generated health data into EHRs. Respondents cited the use of templates or other shortcuts that could help ease the burden of entering patient-generated health data into electronic systems.

Through these two issues, the researchers determined three facilitators that may help providers integrate patient-generated health data into their EHR systems and workflows, including process automation, usable system interfaces, and the need to administer and communicate PGHD for the right patient at a relevant time.

Although the researchers noted that this study was performed on a fairly small sample size, and that the project may be expanded to determine more scalable results, it still indicates that health IT developers must consult with providers to understand the barriers in PGHD use.

Once they identify those barriers, the researchers concluded, developers may create patient-generated health data systems that providers are more likely to use, and therefore help them deliver more patient-centered care in the long run.

“Designers should focus on easy-to-use interfaces, automated PRO collection, and communicating PROs only when directly relevant to a given patient visit,” the researchers concluded. “Finally, policymakers and clinical leaders may need to better demonstrate clear clinical usefulness or provide other incentives for practices to routinely incorporate PROs in EHRs.”