Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA.
ALACRITY Center, University of Washington, Seattle, WA.
Perm J. 2021 May;25. doi: 10.7812/TPP/20.213.
The use of data from wearable sensors, smartphones, and apps holds promise as a clinical decision-making tool in health and mental health in primary care medicine. The aim of this study was to determine provider perspectives about the utility of these data for building digitally based decision-making tools.
This mixed quantitative and qualitative cross-sectional survey of a convenience sample of primary-care clinicians at Kaiser Permanente Northwest was conducted between April and July 2019 online via Institute for Translational Health Sciences' Research Electronic Data Capture. Study outcomes were 1) attitudes toward digital data, 2) willingness to use digital data to support clinical decision making, and 3) concerns and recommendations about implementing a digital tool for clinical decision making.
This sample of 131 clinicians was largely white (n = 98) female (n = 91) physicians (n = 86). Although respondents (75.7%, n = 87) had a positive attitude toward using digital tools in their practice, 88 respondents (67.3%) voiced concerns about the possible lack of clinical utility, suspected difficulty in integration with clinical workflows, and worried about the potential burden placed on patients. Participants indicated that the accuracy of the data in detecting the need for treatment adjustments would need to be high and the tool should be clinically tested.
Primary care providers find value in collecting real-world patient data to assist in clinical decision making, provided such information does not interfere with provider workflow or impose undue burden on patients. In addition, digital tools will need to demonstrate high accuracy, be able to integrate into current clinical workflows, and maintain the privacy and security of patients' data.
在初级保健医学中，使用可穿戴传感器、智能手机和应用程序的数据有望成为临床决策的工具。本研究旨在确定提供者对这些数据用于构建基于数字的决策工具的实用性的看法。
这是对 Kaiser Permanente Northwest 的初级保健临床医生的便利样本进行的混合定量和定性横断面调查，于 2019 年 4 月至 7 月通过转化健康科学研究所的研究电子数据捕获在线进行。研究结果为：1）对数字数据的态度；2）使用数字数据支持临床决策的意愿；3）对实施临床决策数字工具的关注和建议。
本研究的 131 名临床医生样本主要为白人（n = 98），女性（n = 91），医生（n = 86）。尽管受访者（75.7%，n = 87）对在实践中使用数字工具持积极态度，但 88 名受访者（67.3%）对可能缺乏临床实用性、怀疑难以与临床工作流程集成以及担心对患者造成潜在负担表示担忧。参与者表示，数据在检测治疗调整需求方面的准确性需要很高，并且该工具应经过临床测试。
初级保健提供者发现收集真实世界患者数据以协助临床决策具有价值，但前提是这些信息不会干扰提供者的工作流程或给患者带来不必要的负担。此外，数字工具需要具有高度的准确性，能够融入当前的临床工作流程，并维护患者数据的隐私和安全。
