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Selena Davis

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  • OS11 - Diversity in Implementation (ID 17)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/06/2017, 10:30 AM - 12:00 PM, Room 205D
    • OS11.01 - Design and Implications of System for Shared Decision-Making via PHR (ID 35)

      Selena Davis, University of Victoria; victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: Engaging patients in the self-management decision-making provides opportunities for positive health outcomes. The process of shared decision-making (SDM) is touted as the pinnacle of patient-centred care, yet it has been difficult to implement in practice. Access to tools resulting from the integration of all health data and clinical evidence, and an ease of communications with care providers are needed to engage patients in self-management decision-making. Personal health record (PHR) technology is a promising approach for overcoming such barriers. To-date, few studies, and no systematic reviews, have addressed the design and implementation of SDM with the use of PHR technology. Yet, for an intervention to be effective in engaging patients and supporting SDM, the system must be designed around that purpose [1]. This paper summarizes the design of a system for SDM via PHR, discusses the implications of the system, and suggests future work.

      Methodology/Approach: A scoping review of the SDM via PHR literature was completed to map the literature in terms of system design and outcomes. A conceptual framework developed from recommendations of relationships between characteristics and elements of the SDM process and key enabling PHR functions by patient activity was used as the foundation for a functional model. Interpretive analysis and synthesis of the literature was carried out and a design of a system for SDM via PHR, including commended PHR architectural type and enabling functionality of PHR for SDM was identified.

      Finding/Results: The scoping review identified a scarcity of rigorous research on SDM via PHR but with an increasing appearance in published literature. Electronic health record systems offer an enabling structure to SDM [2][3]. The interconnected PHR architecture was identified as ideal, transformative, and collaborative, and likely the future of healthcare. Along with other identified, important system functions, a functional model for an integrated shared decision-making–personal health record (iSDM-PHR) system was revealed. Its ecosystem is defined by its core components and complemented by autonomous integrated applications whereby data is kept separate from the applications, enabling greater innovation in the applications [4], and built on standards for privacy and security and data exchange. To exchange data, applications use a common messaging system; an ideal structure for timely, asynchronous communication in a decoupled setting [5]. Patients access the system anywhere, anytime using any device with internet access.

      Conclusion/Implication/Recommendations: The interconnected PHRÂ’s potential to be a transformative and pervasive as a technology lies in its ability to provide quality, completeness, and accessibility of information and knowledge, synchronous and asynchronous patient-provider communications, decision making tools, and auto-population of reusable content. These capabilities shift the control of health information and care management to a shared model [6]. Undoubtedly, the real value of a PHR lies in enabling action such as SDM [7]. SDM is a collaborative process, whose barriers to integration into practice may be overcome with the use of intelligent, ubiquitous PHR technology. The iSDM-PHR architectural and functional model may be used as a foundation for further system design and implementation research and novel evaluation approaches of such innovations are essential next steps.

      140 Character Summary: This presentation describes the design and implications of a system for shared decision-making via personal health record technology.

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