Designing a ‘Patient Values Tab’ for the Electronic Health Record (EHR): An Investigation of the Needs and Perspectives of Key Stakeholders at a Dedicated Cancer Center (FR461B)

Abstract

•Describe the shared user needs of a broad range of stakeholders across our institution, which will be used to inform the development of a new “Patient Values Tab” in our HER.•Recognize the differing opinions of a broad range of stakeholders across our institution, which will be used to inform the development of a new “Patient Values Tab” in our EHR. Patient-centered care respects a patient's personal values, including what means most in life and defines living well for that patient. The EHR provides access to myriad medical details, but rarely reveals a patient's personal values, which provide a touchstone for shared decision-making throughout illness. Our dedicated cancer center is creating a new EHR “Patient Values Tab,” which will serve as a centralized home for documentation related to patient values, goals and preferences. We aimed to elicit user needs and perspectives of key stakeholders at our center regarding the new tab. These insights will be used to inform the tab's design and implementation. Using a written question guide, two trained interviewers conducted semi-structured, face-to-face individual interviews with a broad range of institutional stakeholders (N = 105), including medical and surgical oncologists, nursing professionals, other clinicians across multiple disciplines, trainees, health system leaders, administrative and clinical staff, patients, families, informaticians, and design experts. Interviews were audio-recorded, transcribed, and are being qualitatively analyzed by an interdisciplinary and interprofessional team using grounded theory and ATLAS.ti software. All informants emphasized the relevance and importance of a patient's personal values to guide care delivery, current lack of access to information about values and other elements of “personhood” in the EHR, and the need to incorporate key design principles (e.g., streamlined, succinct, easy to navigate) in building the tab. Their opinions differed more in other areas, including the optimal role for patients in contributing to the tab content and processes for updating this information. We identified shared user needs, as well as differing opinions, among stakeholders. All stakeholders appreciated the opportunity to share their perspectives and expressed strong enthusiasm for the tab.