Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study

BackgroundElectronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. ObjectiveTo evaluate the impact of an educational c...

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Main Authors: Alkureishi, Maria A, Johnson, Tyrone, Nichols, Jacqueline, Dhodapkar, Meera, Czerwiec, M K, Wroblewski, Kristen, Arora, Vineet M, Lee, Wei Wei
Format: Article
Language:English
Published: JMIR Publications 2021-04-01
Series:JMIR Human Factors
Online Access:https://humanfactors.jmir.org/2021/2/e25054
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spelling doaj-ad88a481fb9c4225a1fb31d41aba9d9e2021-04-28T13:01:59ZengJMIR PublicationsJMIR Human Factors2292-94952021-04-0182e2505410.2196/25054Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational StudyAlkureishi, Maria AJohnson, TyroneNichols, JacquelineDhodapkar, MeeraCzerwiec, M KWroblewski, KristenArora, Vineet MLee, Wei Wei BackgroundElectronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. ObjectiveTo evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. MethodsWe conducted a prospective observational study with adult patients and parents of pediatric patients at the University of Chicago General Internal Medicine (GIM) and Pediatric Primary Care (PPC) clinics. We developed an educational comic highlighting EHR self-advocacy behaviors and distributed it to study participants during check-in for their primary care visits between May 2017 and May 2018. Participants completed a survey immediately after their visit, which included a question on whether they would be interested in a follow-up telephone interview. Of those who expressed interest, 50 participants each from the adult and pediatric parent cohorts were selected at random for follow-up telephone interviews 8 months (range 3-12 months) post visit. ResultsOverall, 71.0% (115/162) of adult patients and 71.6% (224/313) of pediatric parents agreed the comic encouraged EHR involvement. African American and Hispanic participants were more likely to ask to see the screen and become involved in EHR use due to the comic (adult P=.01, P=.01; parent P=.02, P=.006, respectively). Lower educational attainment was associated with an increase in parents asking to see the screen and to be involved (ρ=−0.18, P=.003; ρ=−0.19, P<.001, respectively) and in adults calling for physician attention (ρ=−0.17, P=.04), which was confirmed in multivariate analyses. Female GIM patients were more likely than males to ask to be involved (median 4 vs 3, P=.003). During follow-up phone interviews, 90% (45/50) of adult patients and all pediatric parents (50/50) remembered the comic. Almost half of all participants (GIM 23/50, 46%; PPC 21/50, 42%) recalled at least one best-practice behavior. At subsequent visits, adult patients reported increases in asking to see the screen (median 3 vs 4, P=.006), and pediatric parents reported increases in asking to see the screen and calling for physician attention (median 3 vs 4, Ps<.001 for both). Pediatric parents also felt that the comic had encouraged them to speak up and get more involved with physician computer use since the index visit (median 4 vs 4, P=.02) and that it made them feel more empowered to get involved with computer use at future visits (median 3 vs 4, P<.001). ConclusionsOur study found that an educational comic may improve patient advocacy for enhanced patient-physician-EHR engagement, with higher impacts on African American and Hispanic patients and patients with low educational attainment.https://humanfactors.jmir.org/2021/2/e25054
collection DOAJ
language English
format Article
sources DOAJ
author Alkureishi, Maria A
Johnson, Tyrone
Nichols, Jacqueline
Dhodapkar, Meera
Czerwiec, M K
Wroblewski, Kristen
Arora, Vineet M
Lee, Wei Wei
spellingShingle Alkureishi, Maria A
Johnson, Tyrone
Nichols, Jacqueline
Dhodapkar, Meera
Czerwiec, M K
Wroblewski, Kristen
Arora, Vineet M
Lee, Wei Wei
Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study
JMIR Human Factors
author_facet Alkureishi, Maria A
Johnson, Tyrone
Nichols, Jacqueline
Dhodapkar, Meera
Czerwiec, M K
Wroblewski, Kristen
Arora, Vineet M
Lee, Wei Wei
author_sort Alkureishi, Maria A
title Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study
title_short Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study
title_full Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study
title_fullStr Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study
title_full_unstemmed Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study
title_sort impact of an educational comic to enhance patient-physician–electronic health record engagement: prospective observational study
publisher JMIR Publications
series JMIR Human Factors
issn 2292-9495
publishDate 2021-04-01
description BackgroundElectronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. ObjectiveTo evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. MethodsWe conducted a prospective observational study with adult patients and parents of pediatric patients at the University of Chicago General Internal Medicine (GIM) and Pediatric Primary Care (PPC) clinics. We developed an educational comic highlighting EHR self-advocacy behaviors and distributed it to study participants during check-in for their primary care visits between May 2017 and May 2018. Participants completed a survey immediately after their visit, which included a question on whether they would be interested in a follow-up telephone interview. Of those who expressed interest, 50 participants each from the adult and pediatric parent cohorts were selected at random for follow-up telephone interviews 8 months (range 3-12 months) post visit. ResultsOverall, 71.0% (115/162) of adult patients and 71.6% (224/313) of pediatric parents agreed the comic encouraged EHR involvement. African American and Hispanic participants were more likely to ask to see the screen and become involved in EHR use due to the comic (adult P=.01, P=.01; parent P=.02, P=.006, respectively). Lower educational attainment was associated with an increase in parents asking to see the screen and to be involved (ρ=−0.18, P=.003; ρ=−0.19, P<.001, respectively) and in adults calling for physician attention (ρ=−0.17, P=.04), which was confirmed in multivariate analyses. Female GIM patients were more likely than males to ask to be involved (median 4 vs 3, P=.003). During follow-up phone interviews, 90% (45/50) of adult patients and all pediatric parents (50/50) remembered the comic. Almost half of all participants (GIM 23/50, 46%; PPC 21/50, 42%) recalled at least one best-practice behavior. At subsequent visits, adult patients reported increases in asking to see the screen (median 3 vs 4, P=.006), and pediatric parents reported increases in asking to see the screen and calling for physician attention (median 3 vs 4, Ps<.001 for both). Pediatric parents also felt that the comic had encouraged them to speak up and get more involved with physician computer use since the index visit (median 4 vs 4, P=.02) and that it made them feel more empowered to get involved with computer use at future visits (median 3 vs 4, P<.001). ConclusionsOur study found that an educational comic may improve patient advocacy for enhanced patient-physician-EHR engagement, with higher impacts on African American and Hispanic patients and patients with low educational attainment.
url https://humanfactors.jmir.org/2021/2/e25054
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