Needs and Perspectives of Cancer Center Stakeholders for Access to Patient Values in the Electronic Health Record.

QUESTION ASKED: What is the most important information that diverse institutional stakeholders at a comprehensive cancer center need to know about patients to provide patient-centered care, and what is the best way to display this information in a new single-location feature in the electronic health record (EHR)?

SUMMARY ANSWER: Thematic content analysis of semistructured interviews with a large and diverse group of institutional stakeholders at our comprehensive cancer center revealed themes informing design and development of the Patient Values Tab EHR feature, generated enthusiasm and buy-in for this digital innovation, created a sense of awareness among future users, and paved the way for implementation.

WHAT WE DID: Qualitative data were collected through in-person, guide-based, audio-recorded, individual interviews with a total of 110 stakeholders representing a wide range of disciplines and professions, as well as others involved in administration of the hospital or clinics within our cancer center.

WHAT WE FOUND: Respondents felt that to facilitate the delivery of patient-centered care, information in the following categories should be displayed: the patient's personhood, support system and resources, social history, communication preferences, future planning, end of life, and illness and treatment understanding. Other important themes that arose in the interviews included implementation considerations, improved communication and relationship building, and privacy implications.

BIAS, CONFOUNDING FACTORS, DRAWBACKS, REAL-LIFE IMPLICATIONS: Since this study was conducted at a single dedicated cancer center, generalizability of findings across other healthcare settings merits further investigation. It is possible that non-English-speaking clinicians and patients, who were not interviewed, might have different needs or perspectives. We designed our Patient Values Tab for our institution's EHR (Allscripts); however, this display feature can be configured in other EHR software. By interviewing a large and varying sample of stakeholders and rigorously analyzing their responses, we obtained robust results to inform the development and implementation of this innovative EHR feature centralizing key information needed to enhance patient-centered cancer care. The introduction of the new Patient Values Tab at this well-known cancer center signals the importance of patient personhood and values throughout the institution and advances the use of the EHR as a driver of the delivery of patient-centered care throughout the illness.