Lavallee Danielle C, Lee Jenney R, Austin Elizabeth, Bloch Richard, Lawrence Sarah O, McCall Debbe, Munson Sean A, Nery-Hurwit Mara B, Amtmann Dagmar
Department of Surgery, University of Washington, Seattle, WA, USA.
Digital Healthcare I/O, Seattle, WA, USA.
Mhealth. 2020 Jan 5;6:8. doi: 10.21037/mhealth.2019.09.17. eCollection 2020.
Wearable devices, mobile health apps, and geolocation technologies place the ability to track, monitor and report data in the individuals' hands - or on their bodies. These innovations create an opportunity for "connected health," where individuals collect data outside of the healthcare encounter and report it to care providers. Collection of such patient-generated health data (PGHD) has the potential to impact the delivery of healthcare through remote monitoring, and by allowing patients and healthcare teams to provide targeted and efficient care that aligns with the health status of individual patients.
To understand the value and barriers associated with clinical integration of PGHD we engaged a range of stakeholders, examining their perspectives and experiences of PGHD use. We conducted open-ended interviews with healthcare consumers (patients and care partners), healthcare providers, and healthcare administrators. Open recruitment and purposive sampling were utilized to identify participants that represented the breadth of PGHD use in research and clinical care. Interview guides focused on the value and barriers of PGHD use. Interviews were recorded, transcribed, and analyzed for emergent themes.
Themes emerged around the value of PGHD to support care decisions and improve patient-provider communication and engagement, and the promise of applying PGHD to formal care pathways and measurement-based care. Significant barriers included data validity and actionability, and the burden of integrating PGHD into existing care processes. Interviews highlighted areas for future research to better understand how PGHD can advance care transformation.
These findings provide rich context for understanding the experiences and needs of the individuals who interface with PGHD. Translating advances in technology and data tracking into successful clinical implementation requires understanding how stakeholders conceptualize and make use of PGHD, the potential value that PGHD can add to care, and the challenges that may limit PGHD's promise. Our results illustrate the value and challenges associated with health-system implementation of PGHD. Efforts to increase the scale and spread of PGHD will benefit from an approach that addresses the value and challenges PGHD brings to clinical care.
可穿戴设备、移动健康应用程序和地理定位技术使个人能够自行跟踪、监测和报告数据——这些数据或是在他们手中，或是在他们身上。这些创新为“互联健康”创造了机会，即个人在医疗保健接触之外收集数据并报告给护理提供者。收集此类患者生成的健康数据（PGHD）有可能通过远程监测影响医疗保健的提供，并使患者和医疗团队能够根据个体患者的健康状况提供有针对性的高效护理。
为了解与PGHD临床整合相关的价值和障碍，我们与一系列利益相关者进行了接触，考察了他们对PGHD使用的看法和经验。我们对医疗保健消费者（患者和护理伙伴）、医疗保健提供者和医疗保健管理人员进行了开放式访谈。采用公开招募和目的抽样的方法，确定在研究和临床护理中代表PGHD广泛使用情况的参与者。访谈指南聚焦于PGHD使用的价值和障碍。访谈进行了录音、转录，并对出现的主题进行了分析。
出现的主题围绕PGHD在支持护理决策、改善患者与提供者沟通及互动方面的价值，以及将PGHD应用于正式护理途径和基于测量的护理的前景。重大障碍包括数据有效性和可操作性，以及将PGHD整合到现有护理流程中的负担。访谈突出了未来研究的领域，以便更好地了解PGHD如何推动护理转型。
这些发现为理解与PGHD交互的个人的经验和需求提供了丰富的背景。将技术和数据跟踪方面的进展转化为成功的临床应用，需要了解利益相关者如何概念化和使用PGHD、PGHD可为护理增添的潜在价值，以及可能限制PGHD前景的挑战。我们的结果说明了PGHD在卫生系统实施中的价值和挑战。扩大PGHD规模和传播的努力将受益于一种解决PGHD给临床护理带来的价值和挑战的方法。
