ĭepiction of the ways information interacts with patients and clinicians.
Informatics can also help patients share information with their family and friends, and with other patients (e.g., social networking sites), as well as helping multiple members of their care team update and share critical information about them (e.g., electronic medical records). Similarly, clinicians can use informatics to integrate the information they learn from patients with their medical knowledge and data resources to improve patient care. One way that information technology can promote patient-centered care is by providing a mechanism for a patient to provide his or her clinician(s) with critical information about him or herself, including the patient’s functioning and well-being (e.g., health-related quality of life). This information is of varying quality, with only a portion representing high-quality information. Specifically, patients and clinicians exist in a universe of information. Figure 1 depicts a variety of ways that informatics can be used to promote, or detract from, quality oncology care. While informatics can facilitate the availability of important information, information technology can also increase bureaucracy, contribute to dehumanization, and interfere with doctor-patient relationships. 5 Informatics can promote patient-centered care, though it can potentially serve as a barrier to patient-centered care, as well. Information is critical to patient-centered care, and the field of health informatics has evolved in recent years to focus on how information is acquired, stored, and used in health care, with a particular emphasis on technology. Jim Naugton of the American Board of Internal Medicine has proposed an action agenda for patient-centered care as reported by Wachter: “1) Patients’ preferences should be respected 2) We should attend to patients’ emotional needs, context, comfort and meaning 3) Patients should be engaged and empowered 4) There should be shared decision-making that promotes patient autonomy 5) Family and friends should be involved in care decisions where appropriate and 6) Care should be coordinated within and across systems.” 4 Patient-centered care ensures that transitions between providers, departments, and health care settings are respectful, coordinated, and efficient.” 2 In an extreme vision of patient-centered care, Berwick defines it as “The experience (to the extent the informed, individual patient desires it) of transparency, individualization, recognition, respect, dignity, and choice in all matters, without exception, related to one’s person, circumstances, and relationships in health care.” 3 puts responsibility for important aspects of self-care and monitoring in patients’ hands - along with the tools and support they need to carry out that responsibility. Patient-centered care is specifically defined as “care that is respectful of and responsive to individual patient preferences, needs, and values.” 1 The Institute for Healthcare Improvement has expanded this brief definition to explain that “Care that is truly patient-centered … makes the patient and their loved ones an integral part of the care team who collaborate with health care professionals in making clinical decisions…. 1 This landmark study created a new framework for defining health care quality and improving systems of care and defined six aims, or core values, for the delivery of health care: safe, effective, efficient, patient-centered, timely, and equitable. The concept of patient-centered care has received increased attention since the publication of the 2001 Institute of Medicine (IOM) report Crossing the Quality Chasm. Perhaps the greatest challenge for both patients and providers is identifying information that is high-quality and which enhances (and does not impede) their interactions. Caution in using new information resources is warranted to avoid reliance on biased or inappropriate data, and clinicians may need to direct patients to appropriate information resources. Patients and clinicians may use communication tools and information resources to interact with one another in new ways. Clinicians may use information systems (e.g., electronic medical records) to coordinate care and share information with other clinicians.
This information may enable patients to exert greater control over their own care.
Informatics can provide a mechanism for patients to provide their clinician(s) with critical information, and to share information with family, friends, and other patients.
Health informatics, particularly advances in technology, has the potential to facilitate, or detract from, patient-centered cancer care. Patient-centered care is an important aspect of high-quality care.