Patient Needs and Requirements for a Decision Aid Navigator System (DEAN) Patient Portal: A Qualitative Study
Year: 2026
Type: preprint
Abstract: ABSTRACT Background Patient Decision aids (PtDAs) are important tools that support shared decision- making (SDM) between clinicians and patients, enabling patients to be more informed and engaged in decisions regarding their care. The use of PtDAs can increase patient knowledge, reduce decisional regret, and engage the clinician and patient in meaningful dialogue. Shared decision-making relies on decision aids, but how patients receive the PtDA can vary. This qualitative study elucidated patient familiarity with PtDAs and the barriers, needs, and requirements of patients to access and confidently use DAs, including when received via a clinician-facing EHR-integrated Decision Aid Navigator System (DEANS). Methods We conducted six focus groups (FG) with participants who were recruited from two academic medical centers. Focus groups included an introduction to what a PtDA is and an exploration of how patients or family members, i.e., people who had not made a medical decision for themselves using a PtDA, but who have helped a family member, had previously used PtDAs in their healthcare. The FGs focused on PtDA-users, affordances and barriers to using PtDAs, and PtDA-user needs and requirements of a proposed DEAN patient portal. We applied Rapid Qualitative Analysis (RQA) to summarize the data, using a consensus making approach to identify emerging themes. Results We identified three overarching themes: 1) Patients had varied familiarity with PtDAs and often confused them with general health tools, but found value in SDM, 2) Patients perceived technology accessibility, PtDA credibility, and time as barriers potentially impeding PtDA use, and 3) Patients valued flexible, user-friendly, and accessible PtDAs that support patient-led decisions, particularly when introduced by clinicians and delivered via a patient portal. Conclusion This study provides patient-derived insights into factors that influence PtDA uptake, highlighting common misconceptions about PtDAs and identifying key patient priorities such as accessibility, flexibility, clear content, and clinician-guided usage. Patient also expected clinicians to be familiar with PtDAs, especially when the PtDA covers a complex decision. These findings can inform the development of more patient-centered SDM infrastructure and strategies to support PtDA use in clinical practice, including clinician-supported delivery, accessibility, and integration into routine care to strengthen shared decision-making.
Source: medRxiv
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7221663444
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