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Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports
OBJECTIVE: With the unprecedented rise of patient access to clinical documentation through electronic health records, there is a need for health systems to understand best practices for redesigning clinical documentation to support patient needs. This study used an experience-based co-design approac...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747547/ https://www.ncbi.nlm.nih.gov/pubmed/33334872 http://dx.doi.org/10.1136/bmjhci-2020-100197 |
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author | Austin, Elizabeth J Lee, Jenney R Ko, Cynthia W Kilgore, Mark R Parker, Elizabeth U Bergstedt, Brandelyn Mitchell, Anita I Javid, Sara H Gore, John L |
author_facet | Austin, Elizabeth J Lee, Jenney R Ko, Cynthia W Kilgore, Mark R Parker, Elizabeth U Bergstedt, Brandelyn Mitchell, Anita I Javid, Sara H Gore, John L |
author_sort | Austin, Elizabeth J |
collection | PubMed |
description | OBJECTIVE: With the unprecedented rise of patient access to clinical documentation through electronic health records, there is a need for health systems to understand best practices for redesigning clinical documentation to support patient needs. This study used an experience-based co-design approach to inform the redesign of cancer pathology reports to improve their patient-centeredness and impact on patient engagement. MATERIALS AND METHODS: Multiple methods for data collection and stakeholder engagement were used, including Delphi prioritisation with breast and colorectal cancer experts (n=78) and focus groups with patients with cancer (n=23) in the Seattle area. Iterative rounds of consensus generation and reflection were used to elicit themes and design recommendations for the development of patient-centred pathology reports on cancer care. RESULTS: Although each cancer type had nuanced elements to consider, common design requirements emerged around two key themes: (1) clinical documentation language should be framed in a way that informs and engages patients, and (2) clinical documentation format should be leveraged to enhance readability and information flow. Study activities illuminated detailed recommendations to improve the patient-centeredness of pathology reports based on patients’ and clinicians’ lived experience. DISCUSSION: The design requirements that emerged from this study provide a framework that can guide the rapid development of patient-centred pathology reports for all cancer types. Even further, health systems can replicate these methods to guide experience-based co-design of clinical documentation for contexts beyond cancer care. CONCLUSION: This work offers practice-based learnings that can more effectively guide health systems in their clinical documentation redesign efforts. |
format | Online Article Text |
id | pubmed-7747547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-77475472020-12-28 Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports Austin, Elizabeth J Lee, Jenney R Ko, Cynthia W Kilgore, Mark R Parker, Elizabeth U Bergstedt, Brandelyn Mitchell, Anita I Javid, Sara H Gore, John L BMJ Health Care Inform Original Research OBJECTIVE: With the unprecedented rise of patient access to clinical documentation through electronic health records, there is a need for health systems to understand best practices for redesigning clinical documentation to support patient needs. This study used an experience-based co-design approach to inform the redesign of cancer pathology reports to improve their patient-centeredness and impact on patient engagement. MATERIALS AND METHODS: Multiple methods for data collection and stakeholder engagement were used, including Delphi prioritisation with breast and colorectal cancer experts (n=78) and focus groups with patients with cancer (n=23) in the Seattle area. Iterative rounds of consensus generation and reflection were used to elicit themes and design recommendations for the development of patient-centred pathology reports on cancer care. RESULTS: Although each cancer type had nuanced elements to consider, common design requirements emerged around two key themes: (1) clinical documentation language should be framed in a way that informs and engages patients, and (2) clinical documentation format should be leveraged to enhance readability and information flow. Study activities illuminated detailed recommendations to improve the patient-centeredness of pathology reports based on patients’ and clinicians’ lived experience. DISCUSSION: The design requirements that emerged from this study provide a framework that can guide the rapid development of patient-centred pathology reports for all cancer types. Even further, health systems can replicate these methods to guide experience-based co-design of clinical documentation for contexts beyond cancer care. CONCLUSION: This work offers practice-based learnings that can more effectively guide health systems in their clinical documentation redesign efforts. BMJ Publishing Group 2020-12-17 /pmc/articles/PMC7747547/ /pubmed/33334872 http://dx.doi.org/10.1136/bmjhci-2020-100197 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Austin, Elizabeth J Lee, Jenney R Ko, Cynthia W Kilgore, Mark R Parker, Elizabeth U Bergstedt, Brandelyn Mitchell, Anita I Javid, Sara H Gore, John L Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
title | Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
title_full | Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
title_fullStr | Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
title_full_unstemmed | Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
title_short | Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
title_sort | improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747547/ https://www.ncbi.nlm.nih.gov/pubmed/33334872 http://dx.doi.org/10.1136/bmjhci-2020-100197 |
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