Kiessling Karalyn A, Iott Bradley E, Pater Jessica A, Toscos Tammy R, Wagner Shauna R, Gottlieb Laura M, Veinot Tiffany C
School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
School of Information, University of Michigan, Ann Arbor, Michigan, USA.
JAMIA Open. 2022 Feb 24;5(1):ooac007. doi: 10.1093/jamiaopen/ooac007. eCollection 2022 Apr.
To explore diverse provider perspectives on: strategies for addressing patient medication cost barriers; patient medication cost information gaps; current medication cost-related informatics tools; and design features for future tool development.
We conducted 38 semistructured interviews with providers (physicians, nurses, pharmacists, social workers, and administrators) in a Midwestern health system in the United States. We used 3 rounds of qualitative coding to identify themes.
Providers lacked access to information about: patients' ability to pay for medications; true costs of full medication regimens; and cost impacts of patient insurance changes. Some providers said that while existing cost-related tools were helpful, they contained unclear insurance information and several questioned the information's quality. Cost-related information was not available to everyone who needed it and was not always available when needed. Fragmentation of information across sources made cost-alleviation information difficult to access. Providers desired future tools to compare medication costs more directly; provide quick references on costs to facilitate clinical conversations; streamline medication resource referrals; and provide centrally accessible visual summaries of patient affordability challenges.
These findings can inform the next generation of informatics tools for minimizing patients' out-of-pocket costs. Future tools should support the work of a wider range of providers and situations and use cases than current tools do. Such tools would have the potential to improve prescribing decisions and better link patients to resources.
Results identified opportunities to fill multidisciplinary providers' information gaps and ways in which new tools could better support medication affordability for patients.
探讨医疗服务提供者对以下方面的不同观点:应对患者药物费用障碍的策略;患者药物费用信息缺口;当前与药物费用相关的信息学工具;以及未来工具开发的设计特点。
我们对美国中西部一个医疗系统中的医疗服务提供者(医生、护士、药剂师、社会工作者和管理人员)进行了38次半结构化访谈。我们使用三轮定性编码来确定主题。
医疗服务提供者缺乏以下方面的信息:患者支付药物费用的能力;完整药物治疗方案的真实成本;以及患者保险变更对费用的影响。一些医疗服务提供者表示,虽然现有的与费用相关的工具很有帮助,但其中包含的保险信息不明确,一些人对这些信息的质量提出了质疑。与费用相关的信息并非所有需要的人都能获取,而且在需要时也并非总是可用。信息来源分散使得减轻费用的信息难以获取。医疗服务提供者希望未来的工具能更直接地比较药物费用;提供费用的快速参考以促进临床交流;简化药物资源转诊;并提供可集中访问的患者支付能力挑战的可视化总结。
这些发现可为下一代信息学工具提供参考,以尽量减少患者的自付费用。未来的工具应比当前工具支持更广泛的医疗服务提供者以及更多的情况和用例。这样的工具有可能改善处方决策,并更好地将患者与资源联系起来。
研究结果确定了填补多学科医疗服务提供者信息缺口的机会,以及新工具可以更好地支持患者药物支付能力的方式。