If a Tree Falls?: Using the Electronic Medical Record to Understand How Patients Self-Advocate for Their Health and Quality of Life
Year: 2025
Type: article
Abstract: Meaningful use initiatives for electronic health records (EHRs) have led to efforts to facilitate patient engagement. 1 Yet EHRs are infrequently designed to support recognition and support of patients' needs and priorities.2,3 For patients with serious illness, clinicians need to understand patients' priorities and values since advanced care planning needs to be discussed at unpredictable times across interprofessional teams.Understanding the current ability of the EHR to clarify patients' values and engagement is a critical step in identifying potential areas to facilitate patient-centered cancer care.This brief analysis aimed to determine the extent to which patients' EHR documentation captured their self-advocacy, defined as patients' decision-making and communication regarding priorities and values.4 We used extreme-case sampling from participants enrolled in a randomized trial, identifying participants who reported the highest and lowest levels of self-advocacy, hypothesizing that higher self-advocacy would lead to higher EHR documentation of self-advocacy.We further classified participants based on their self-reported symptom severity, hypothesizing that documentation would vary based on patients' symptom burden.The primary reviewer extracted all medical records and captured any documentation of patient involvement, discussion of patient priorities or values, symptom discussion, or indication of patient self-advocacy.Self-advocacy was assessed as the appearance of patients initiating clinical discussions, asking questions, engaging in shared decision-making, and leveraging their social support network.Two reviewers verified findings and classified findings as either expected or unexpected.Results revealed a mix of expected and unexpected documentation of patient self-advocacy (Table 1).Overall, four participants had only expected documentation, two had only unexpected documentation, and four participants had both expected and unexpected
Source: Journal of Palliative Medicine
Authors: Sneha Padamati, Teresa Hagan Thomas
Institution: University of Pittsburgh
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Funder: National Cancer Institute
OpenAlex ID: W4407318592