Patient-provider communication while using a clinical decision support tool: explaining satisfaction with shared decision making for mammography screening
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Published:2022-12-07
Issue:1
Volume:22
Page:
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ISSN:1472-6947
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Container-title:BMC Medical Informatics and Decision Making
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language:en
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Short-container-title:BMC Med Inform Decis Mak
Author:
Liu Yan,Kornfield Rachel,Yang Ellie Fan,Burnside Elizabeth,Keevil Jon,Shah Dhavan V.
Abstract
Abstract
Background
Clinical decision aids may support shared decision-making for screening mammography. To inform shared decision-making between patients and their providers, this study examines how patterns of using an EHR-integrated decision aid and accompanying verbal patient-provider communication predict decision-making satisfaction.
Methods
For 51 patient visits during which a mammography decision aid was used, linguistic characteristics of patient-provider verbal communication were extracted from transcribed audio recordings and system logs automatically captured uses of the decision aid. Surveys assessed patients’ post-visit decisional satisfaction and its subcomponents. Linear mixed effects models assessed how patients’ satisfaction with decision making was related to patterns of verbal communication and navigation of the decision aid.
Results
The results indicate that providers’ use of quantitative language during the encounter was positively associated with patients’ overall satisfaction, feeling informed, and values clarity. Patients’ question-asking was negatively associated with overall satisfaction, values clarity, and certainty perception. Where system use data indicated the dyad had cycled through the decision-making process more than once (“looping” back through pages of the decision aid), patients reported improved satisfaction with shared decision making and all subcomponents. Overall satisfaction, perceived support, certainty, and perceived effectiveness of decision-making were lowest when a high number of navigating clicks occurred absent “looping.”
Conclusions
Linguistic features of patient-provider communication and system use data of a decision aid predict patients’ satisfaction with shared decision making. Our findings have implications for the design of decision aid tools and clinician training to support more effective shared decision-making for screening mammography.
Funder
Ministry of Education of the People's Republic of China
Shanghai Pujiang Program
Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research
National Center for Advancing Translational Sciences
National Institutes of Health, National Cancer Institute,
University of Wisconsin Carbone Cancer Center
Publisher
Springer Science and Business Media LLC
Subject
Health Informatics,Health Policy,Computer Science Applications
Cited by
1 articles.
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