Patient and researcher stakeholder preferences for use of electronic health record data: a qualitative study to guide the design and development of a platform to honor patient preferences

Author:

Morse Brad1,Kim Katherine K2ORCID,Xu Zixuan2,Matsumoto Cynthia G3,Schilling Lisa M1,Ohno-Machado Lucila45,Mak Selene S6,Keller Michelle S78ORCID

Affiliation:

1. Division of General Internal Medicine, Department of Medicine, University of Colorado—Anschutz Medical Campus , Denver, Colorado, USA

2. School of Medicine, Department of Public Health Sciences, University of California-Davis , Davis, California, USA

3. Office of Population Health and Accountable Care, University of California Davis Health , Sacramento, California, USA

4. Department of Biomedical Informatics, University of California-San Diego , La Jolla, California, USA

5. Section of Biomedical Informatics & Data Science, Yale School of Medicine , New Haven, Connecticut, USA

6. Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System , Los Angeles, California, USA

7. Division of General Internal Medicine-Health Services Research, Department of Medicine, Cedars-Sinai Medical Center , Los Angeles, California, USA

8. Division of Informatics, Department of Biomedical Research, Cedars-Sinai Medical Center , Los Angeles, California, USA

Abstract

Abstract Objective This qualitative study aimed to understand patient and researcher perspectives regarding consent and data-sharing preferences for research and a patient-centered system to manage consent and data-sharing preferences. Materials and Methods We conducted focus groups with patient and researcher participants recruited from three academic health centers via snowball sampling. Discussions focused on perspectives on the use of electronic health record (EHR) data for research. Themes were identified through consensus coding, starting from an exploratory framework. Results We held two focus groups with patients (n = 12 patients) and two with researchers (n = 8 researchers). We identified two patient themes (1–2), one theme common to patients and researchers (3), and two researcher themes (4–5). Themes included (1) motivations for sharing EHR data, (2) perspectives on the importance of data-sharing transparency, (3) individual control of personal EHR data sharing, (4) how EHR data benefits research, and (5) challenges researchers face using EHR data. Discussion Patients expressed a tension between the benefits of their data being used in studies to benefit themselves/others and avoiding risk by limiting data access. Patients resolved this tension by acknowledging they would often share their data but wanted greater transparency on its use. Researchers expressed concern about incorporating bias into datasets if patients opted out. Conclusions A research consent and data-sharing platform must consider two competing goals: empowering patients to have more control over their data and maintaining the integrity of secondary data sources. Health systems and researchers should increase trust-building efforts with patients to engender trust in data access and use.

Funder

NIH

National Human Genome Research Institute

National Institute on Aging

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

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