EXPERT PANEL EVALUATION OF THE VISIT PROTOTYPE: A WEB-BASED, EMR-INTEGRATED TOOL TO FACILITATE PATIENT VALUES ELICITATION IN PRIMARY CARE CONSULTATIONS
The VISIT website was developed by the research team and a hospital-based information technology department, aimed to facilitate value-based consultations by asking patients to enter information on their concerns and health-related values (e.g. family, career, religion). This information would be displayed on the doctor’s electronic medical records (EMR) screen during the consultation. This study aims to report expert panel feedback on the VISIT (Values in Shared Interactions Tool) website.
Method(s):
A stakeholder expert panel discussion moderated by a trained researcher was conducted to evaluate the website prototype. The session was audio-recorded and field notes were taken. The playback recordings and field notes were used to guide a revision of the website for pilot testing in actual consultations.
Result(s):
Five participants were involved; two patients, one usability expert, one EMR expert/ primary care physician, and one external reviewer/family medicine specialist. The following themes emerged.
First, there was a need to clarify the function of the website as a face-to-face consultation tool as patients wanted an e-consultation platform where concerns raised were answered electronically. A diagramed flowchart of the VISIT tool use was included to clarify the function of VISIT.
Second, patients did not feel that the website was valuable to them as they were already making paper-based lists and they believed the consultation agenda should be determined by patient’s laboratory results. Thus, we emphasized the website’s importance from a patient perspective by highlighting that VISIT could help address patient problems such as lack of time and unmet needs.
Third, patients felt uncomfortable disclosing their personal life priorities and said they would lie if asked about them. The website was revised to include examplars of how patient life priorities could affect their health to help patients see the value of discussing these with their doctor.
Lastly, there were practical concerns raised such as IT security, clearer wording and instructions, having facilities for using the website, and integrating VISIT with the hospital IT system.
Conclusion(s):
The expert panel revealed that patients were unclear about the goals and function of the VISIT website. Changes were made to ensure the website goals, layout and instructions were clearer for users.