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. 2024 Jul 24;7(3):ooae056.
doi: 10.1093/jamiaopen/ooae056. eCollection 2024 Oct.

Development of an electronic health record-integrated patient-reported outcome-based shared decision-making dashboard in oncology

Nisha A Mohindra  1   2 , Sofia F Garcia  2   3 , Sheetal Kircher  1   2 , Cynthia Barnard  4   5 , Laura M Perry  2   3 , Madison Lyleroehr  3 , Ava Coughlin  3 , Victoria Morken  3 , Ryan Chmiel  4 , Lisa R Hirschhorn  3   6 , David Cella  2   3
Affiliations

Development of an electronic health record-integrated patient-reported outcome-based shared decision-making dashboard in oncology

Nisha A Mohindra et al. JAMIA Open. .

Abstract

Objectives: Patient-reported outcomes (PROs) describe a patient's unique experiences with disease or treatment, yet effective use of this information during clinical encounters remains challenging. This project sought to build a PRO based dashboard within the electronic health record (EHR), prioritizing interpretability and utility of PROs for clinical decision-making.

Materials and methods: Codesign principles were used to define the goal, features, and visualization of the data elements on the dashboard. Codesign sessions occurred between February 2019 and May 2020 and involved a diverse group of stakeholders. Pilot evaluation of dashboard usability was performed with patients and clinicians not involved in the codesign process through qualitative interviews and the Systems Usability Scale.

Results: The dashboard was placed into a single tab in the EHR and included select PROM scores, clinical data elements, and goals of care questions. Real-time data analytics and enhanced visualization of data was necessary for the dashboard to provide meaningful feedback to clinicians and patients for decision-making during clinic visits. During soft launch, the dashboard demonstrated "good" usability in patients and clinicians at 3 and 6 months (mean total SUS score >70).

Discussion: The current dashboard had good usability and made PRO scores more clinically understandable to patients and clinicians. This paper highlights the development, necessary data elements, and workflow considerations to implement this dashboard at an academic cancer center.

Conclusion: As the use of PROs in clinical care is increasing, patient- and clinician-centered tools are needed to ensure that this information is used in meaningful ways.

Keywords: cancer; patient-reported outcomes; shared decision-making.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Dashboard integrated in the EHR (© 2022 Epic Systems Corporation, published with permission from EPIC, reproduced/adapted from Mohindra et al, with permission from Wolters Kluwer Health).
Figure 2.
Figure 2.
Dashboard Evolution through Iterative Co-design.
See this image and copyright information in PMC

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