EP05.01 - Shared Decision-Making Using Personal Health Record Technology: A Scoping Review at the Crossroads
e-Health ePoster Library. Davis S. Jun 7, 2016; 131576; EP05.01
Selena Davis
Selena Davis
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Purpose/Objectives: Engaging diabetic youth in the self-management of daily tasks and decision-making provides opportunities for positive health outcomes. However, emerging adulthood is a volatile time and the transition from pediatric to adult care is a high risk period associated with poor glycemic control and decreased clinic attendance. 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 personalized education and decision-support tools resulting from the integration of all health data and an ease of communications with care providers are needed to engage youth in self-care and decision-making. Personal health record (PHR) technology supports patient–centred care by making all relevant information and tools available to support self-management and it is a promising approach for overcoming barriers to implementing SDM in practice. Still, today PHRs are underutilized and present a major opportunity for improvement in patient-centred care and patient engagement. The state of SDM is not a question of whether we should do it, rather how can we make SDM routine for patients and their providers within today's electronic health record environment. This scoping review aims to map the literature on SDM via PHR in terms of system design and impact and provides an opportunity to identify key concepts, gaps in the research and types and sources of evidence. Methodology/Approach: We performed a scoping study using Arksey and O'Malley's methodological framework. Searches to identify articles were performed between June–Dec 2015 and adapted for the following databases: Medline, Google Scholar, CINAHL, Engineering Village and the Web of Science. Searches of both peer-reviewed and grey literature were adapted for each source and included combinations of the following search terms or their synonyms: personal health records, shared decision-making, patient–provider communication, decision aid and decision support. The goal was to conduct a sensitive rather than specific search of the literature. Final inclusion criteria dictated that the article address the efficacy or effectiveness of PHRs with SDM components in relation to engaging patients in self-care and decision making and/ or ways patients may be supported in SDM via PHR, including original research, models, focused discussions or methodological approaches. Finding/Results: Included studies in this scoping review reported research evidence or referenced relevant descriptive supporting papers and were categorized as reporting on: (i) evidence of PHR technology for SDM and (ii) design issues for system development. Charting the enabling functionality exploited the PHR functional requirements identified by several groups of authors which were mapped and adapted to SDM process. Collation and summarization of the data is currently underway. Conclusion/Implication/Recommendations: While there is abundant literature on patient-centric care and patient-facing health information technologies separately, there is very little evidence on the efficacy or effectiveness of SDM via PHR in practice. This research has permitted us to characterize and catalogue the current body of literature pertaining to SDM via PHR which provides confirmation of PHR architecture and functionalities that align with the elements of the SDM process for engaging diabetic youth in the management of daily tasks and decision-making. 140 Character Summary: A scoping review of the literature to investigate the extent of published evidence on shared decision-making via PHR technology in terms of system design and impact.
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