Date of Award
Fall 9-1-2015
Document Type
Dissertation
Degree Name
Doctor of Science in Information Systems
Department
Business and Information Systems
First Advisor
Surendra Sarnikar
Second Advisor
Wayne Pauli
Third Advisor
Stacey Berry
Abstract
One of the emerging trends of healthcare delivery is that of patient-centered medicine which promotes patient empowerment through sharing of medical decision making. Information technology is one of key enablers of patient-centered care and patient engagement in clinical decision making. One of the technological tools used to stimulate patient health care involvement is patient decision aids. Hidden potential of patient decision aids has already been revealed. However, their real-world application remains lackluster. The lack of real-world use is two-fold. First problem is shortage of recognition that individual patients utilize different decision making strategies and that medical decision making highly emotional. Second problem is lack of practical utility needed to motivate physicians implement patient decision aids in their everyday clinical workflows. Existing patient decision aids make generalized assumptions about their users and fail to satisfy the variability of individual information needs and decision making preferences known to literature. Clinical decision making is also an inherently emotional process. Existing patient decision aids rarely rely on official decision making theories, which consider the role of human emotions during the challenging process of medical treatment selection. Clinical integration of patient decision aids in everyday practice hinges on physician acceptance, which makes it critical to provide utility to practicing physicians. Patient decision aids can be used to streamline clinical encounters by improving patient-centeredness and facilitating the development of trusting patient-physician relationships while simultaneously decreasing the level of administrative burden. This work investigates the influence of such patient attributes as individual preferences for shared decision making and personal information needs on the preferred format of decision making strategies and resulting quality of clinical decision making. Physician perceptions towards needed clinical utility are also studied. Framework for future patient decision aids is designed as a blueprint for creating individualized, theory-based, and clinically integrated treatment selection instruments. The designed framework is instantiated in the context of an end-stage renal disease treatment selection. The instrument is evaluated via a role playing experiment, and physicians are interviewed to measure clinical utility.
Recommended Citation
Motorny, Sergey, "Design of a Patient-Centered and Clincially Integrated Patient Decision Aid" (2015). Masters Theses & Doctoral Dissertations. 296.
https://scholar.dsu.edu/theses/296