Computer tools and shared decision making: Patient perspectives of “knowledge coupling” in primary care

Abstract

Two parallel developments in health care have begun to converge: (1) the demand for greater patient participation in health care, and (2) the evolution of computer tools designed to inform patients of health care options so they might decide among them. Little is known about how patients see these tools and how these perceptions affect participation in care. This study examines patients' responses to the routine use of “knowledge coupling” computer tools in primary care, and their influence on “shared decision making”. Three hundred fifty seven (357) patients responded to a survey that asked about various aspects of the knowledge coupling system used in a primary care practice. The results indicate that how patients see the knowledge coupling tools used in the practice affects perceptions of their involvement in care and decisions. Perceptions of involvement also positively relate to age, but remain unrelated to gender, education, income, and home computer use. Trends toward using computer tools to assist in health decisions will likely continue. This study suggests that as these tools become integrated into the routine care of patients they will have important implications for patient participation in care and decision making.