Harle Christopher A, Golembiewski Elizabeth H, Rahmanian Kiarash P, Krieger Janice L, Hagmajer Dorothy, Mainous Arch G, Moseley Ray E
Department of Health Policy and Management, Indiana University, Indianapolis, IN, USA.
Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA.
J Am Med Inform Assoc. 2018 Mar 1;25(3):360-368. doi: 10.1093/jamia/ocx145.
The purpose of this study was to assess patient perceptions of using an interactive electronic consent (e-consent) application when deciding whether or not to grant broad consent for research use of their identifiable electronic health record (EHR) information.
For this qualitative study, we conducted a series of 42 think-aloud interviews with 32 adults. Interview transcripts were coded and analyzed using a modified grounded theory approach.
We identified themes related to patient preferences, reservations, and mixed attitudes toward consenting electronically; low- and high-information-seeking behavior; and an emphasis on reassuring information, such as data protections and prohibitions against sharing data with pharmaceutical companies. Participants expressed interest in the types of information contained in their EHRs, safeguards protecting EHR data, and specifics on studies that might use their EHR data.
This study supports the potential value of interactive e-consent applications that allow patients to customize their consent experience. This study also highlights that some people have concerns about e-consent platforms and desire more detailed information about administrative processes and safeguards that protect EHR data used in research.
This study contributes new insights on how e-consent applications could be designed to ensure that patients' information needs are met when seeking consent for research use of health record information. Also, this study offers a potential electronic approach to meeting the new Common Rule requirement that consent documents contain a "concise and focused" presentation of key information followed by more details.
本研究旨在评估患者在决定是否给予对其可识别电子健康记录(EHR)信息进行研究使用的广泛同意时,对使用交互式电子同意(电子同意)应用程序的看法。
对于这项定性研究,我们对32名成年人进行了一系列42次出声思考访谈。访谈记录采用改进的扎根理论方法进行编码和分析。
我们确定了与患者偏好、保留意见以及对电子同意的混合态度相关的主题;低信息寻求行为和高信息寻求行为;以及对诸如数据保护和禁止与制药公司共享数据等安心信息的强调。参与者对其EHR中包含的信息类型、保护EHR数据的保障措施以及可能使用其EHR数据的研究细节表示感兴趣。
本研究支持交互式电子同意应用程序的潜在价值,该应用程序允许患者定制其同意体验。本研究还强调,一些人对电子同意平台存在担忧,并希望获得有关保护研究中使用的EHR数据的行政程序和保障措施的更详细信息。
本研究为如何设计电子同意应用程序以确保在寻求对健康记录信息进行研究使用的同意时满足患者的信息需求提供了新的见解。此外,本研究提供了一种潜在的电子方法,以满足新的《共同规则》要求,即同意文件包含关键信息的“简洁且重点突出”的呈现,随后是更多细节。