Abstract 213: Engaging Cardiology Patients Via Electronic Patient-Reported Outcomes: A Usability Assessment

Abstract

Background: The use of electronic patient-reported outcomes (ePROs) in clinical practice is a powerful method of engaging the patient voice to help design, assess, and improve the healthcare we provide. Understanding how well patients interact with technology underlies our ability to engage patients to share their experiences regarding health, illness, and treatment using computers. To date, little is known regarding patients’ perceptions of ePROs in clinical practice; the literature is even thinner regarding patients’ experiences with ePROs in the cardiology setting. Methods: In 2012, we implemented an ePRO collection system throughout the University of Pittsburgh Medical Center’s (UPMC) Heart and Vascular Institute; sites included both community and academic cardiology practices. Patients use tablet computers to complete various symptom and quality-of-life assessments, which are seamlessly integrated into the electronic medical record. In this study, patients completed a short usability assessment at the conclusion of their ePRO survey. We assessed five types of trouble using the system: visibility, item comprehension, physical limitations, tapping, and other. Patients’ clinical and demographic data were abstracted from the electronic medical record, and matched to their ePRO assessments .We conducted univariate and bivariate statistics to describe the sample, as well as to identify associations between patient characteristics and patient-reported difficulty using the ePRO system. Results: From 01-August-2012 to 15-August-2013, 2,728 cardiology outpatients completed ePRO questionnaires. The average patient was a 63-year-old White male with a Charlson comorbidity score of 1. Eighty-two percent (n=2,247) of patients reported no difficulty using the ePRO system; of the 481 patients reporting any difficulty, 47% (n=221) found the tablet unresponsive to tapping, and 14% (n=66) of patients reported issues with item comprehension. Patients ≥65 years old and patients with rheumatoid disease were more likely to report difficulty (p<0.0001 and p=0.056, respectively) using the ePRO system. Patients who reported difficulty with the tablets were likelier to have reported worse health at the time of interview than a year prior (p=0.002), and were likelier to report both poorer physical and mental health than those patients without difficulty (p<0.001 and p<0.001, respectively). Conclusions: We have implemented a usable system to collect ePROs in cardiology patients across a variety of clinical settings. Although only a minority of patients reported difficulty with the system, future research is needed to facilitate maximal patient engagement with this method of data collection.