Integrating data from an online diabetes prevention program into an electronic health record and clinical workflow, a design phase usability study.
Integrating data from an online diabetes prevention program into an electronic health record and clinical workflow, a design phase usability study.
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DOI：
10.1186/s12911-016-0328-x
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发表时间：
2016-07-11
影响因子：
3.5
通讯作者：
Mann D
中科院分区：
文献类型：
--
作者：
Mishuris RG;Yoder J;Wilson D;Mann D
健康信息越来越多地以数字方式存储和交换。公众定期在自己的电子设备和云中收集和存储与健康相关的数据。预防糖尿病是一项日益重要的预防性健康措施，而饮食和锻炼是其中的关键组成部分。患者正在求助于在线项目来帮助他们减肥。尽管初级保健医生对患者的减肥成功很重要，但初级保健提供者(PCP)和这些在线减肥计划之间没有信息交换。将这些数据直接集成到电子健康记录(EHR)中的机会正在出现，但人们对共享哪些信息或如何最有效地共享知之甚少。这项研究的目的是描述提供者对将外部产生的生活方式改变数据整合到初级保健电子健康记录工作流程中的偏好。我们对初级保健提供者进行了两轮半结构化访谈，进行了定性研究。我们使用了一种迭代设计过程，涉及初级保健提供者、卫生信息技术软件开发商和卫生服务研究人员来开发界面。使用扎根理论的主题分析，从访谈中发现了4个主题：1)建立健康生活方式的障碍，2)生活方式改变计划的特点，3)向初级保健提供者报告结果，以及4)与初级保健的整合。这些主题指导了从在线糖尿病预防计划到初级保健电子健康记录工作流程的数据接口的快速循环敏捷设计过程。将外部健康相关数据集成到EHR中必须嵌入到提供者工作流程中，以便对提供者有用，并使患者受益。要做到这一点，需要在软件设计期间对临床工作流程进行评估。这个新界面的开发使用了快速循环迭代设计、提供商的早期参与和可用性测试方法。这为如何以高效和有效的方式将外部数据集成到提供程序工作流中提供了一个框架。现在有可能认识到在临床环境中提供这些数据对于患者参与度和健康结果的重要性。
Health information is increasingly being digitally stored and exchanged. The public is regularly collecting and storing health-related data on their own electronic devices and in the cloud. Diabetes prevention is an increasingly important preventive health measure, and diet and exercise are key components of this. Patients are turning to online programs to help them lose weight. Despite primary care physicians being important in patients’ weight loss success, there is no exchange of information between the primary care provider (PCP) and these online weight loss programs. There is an emerging opportunity to integrate this data directly into the electronic health record (EHR), but little is known about what information to share or how to share it most effectively. This study aims to characterize the preferences of providers concerning the integration of externally generated lifestyle modification data into a primary care EHR workflow. We performed a qualitative study using two rounds of semi-structured interviews with primary care providers. We used an iterative design process involving primary care providers, health information technology software developers and health services researchers to develop the interface. Using grounded-theory thematic analysis 4 themes emerged from the interviews: 1) barriers to establishing healthy lifestyles, 2) features of a lifestyle modification program, 3) reporting of outcomes to the primary care provider, and 4) integration with primary care. These themes guided the rapid-cycle agile design process of an interface of data from an online diabetes prevention program into the primary care EHR workflow. The integration of external health-related data into the EHR must be embedded into the provider workflow in order to be useful to the provider and beneficial for the patient. Accomplishing this requires evaluation of that clinical workflow during software design. The development of this novel interface used rapid cycle iterative design, early involvement by providers, and usability testing methodology. This provides a framework for how to integrate external data into provider workflow in efficient and effective ways. There is now the potential to realize the importance of having this data available in the clinical setting for patient engagement and health outcomes.