Title
Augmenting patient safety through participation by design – An assessment of dual monitors for patients in the outpatient clinic
Abstract
Background: Patients and physicians engaging together in the electronic health record (EHR) during clinical visits may provide opportunities to both improve patient understanding and reduce medical errors.Objective: To assess the potential impact of a patient EHR display intervention on patient quality and safety. We hypothesized that if patients had a dedicated display with an explicit invitation to follow clinicians in the EHR that this would identify several opportunities to engage patients in their care quality and safety.Material and methods: Physician-patient outpatient encounters (24 patients and 8 physicians) were videotaped. Encounters took place in a hospital-based general internal medicine outpatient clinic where physicians and patients had their respective EHR monitors. Following the visits, each patient and physician was interviewed for 30 min to understand their perception of the mirrored-screen setting.Results: The following 7 themes were identified (a) curiosity, (b) opportunity to ask questions, (c) error identification, (d) control over medications, (e) awareness, (f) shared understanding & decision-making, (g) data privacy. These themes collectively comprised a conceptual model for how patient engagement in electronic health record use, through a dedicated second screen or an explicitly shared screen, relates to safety and quality opportunities. Therefore, the double EHR screen provides an explicit invitation for patients to join the process to influence safety.Conclusion: Desired outcomes include real-time error identification and better-shared understanding and decision-making, leading to better downstream follow-through with care plans.
Year
DOI
Venue
2021
10.1016/j.ijmedinf.2020.104345
International Journal of Medical Informatics
Keywords
DocType
Volume
Electronic health record,Patient safety,Patient engagement,Healthcare quality,OpenNotes,Medical informatics
Journal
146
ISSN
Citations 
PageRank 
1386-5056
0
0.34
References 
Authors
0
4
Name
Order
Citations
PageRank
Onur Asan1337.25
Avishek Choudhury252.92
Melek M Somai300.34
Bradley H. Crotty415.21