Needs and Perspectives of Cancer Center Stakeholders for Access to Patient Values in the Electronic Health Record

Anjali V. Desai, Rajiv Agarwal, Andrew S. Epstein, Gilad J. Kuperman, Chelsea L. Michael, Haley Mittelstaedt, Mary Ann Connor, Camila Bernal, Kathleen A. Lynch, Jamie S. Ostroff, Brittany Katz, Kelsey L. Corrigan, Dana Kramer, Mary Elizabeth Davis, Judith E. Nelson

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

PURPOSE High-quality cancer care must incorporate patients’ personal values in decision making throughout illness. Unfortunately, patient values are neither consistently elicited nor easily accessible in the electronic health record (EHR). Memorial Sloan Kettering Cancer Center is deploying a major EHR innovation, called the Patient Values Tab, which provides ready access to patients’ values and personhood. To inform the Tab’s design, we interviewed a large, diverse group of institutional stakeholders to understand their user needs for this Tab. METHODS Qualitative data were collected through semistructured, audio-recorded, in-person, individual interviews. An interdisciplinary team of four coders conducted a process of thematic content analysis. Thematic saturation was achieved, and member checking was performed. RESULTS A total of 110 stakeholders were approached and interviewed. Participants comprised a wide range of disciplines or professions and others involved in hospital and/or clinic administration. Analysis revealed the following themes related to important Tab content: personhood, support system or resources, social history, communication preferences, future planning, end of life, and illness and treatment understanding. Participants also discussed implementation considerations, the Tab’s potential to improve communication, and privacy implications. CONCLUSION This study focused on a major EHR innovation to centralize information about values and personhood of patients with cancer. We elicited views of over 100 institutional stakeholders through in-depth interviews that were rigorously analyzed, yielding themes related to content and format that helped guide the Tab’s design. The interviews generated a sense of ownership and enthusiasm for the Tab among future users. The Tab’s introduction advances the use of the EHR as a driver of the delivery of patient-centered care.

Original languageEnglish
Pages (from-to)E1524-E1536
JournalJCO Oncology Practice
Volume17
Issue number10
DOIs
StatePublished - 1 Oct 2021
Externally publishedYes

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