April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Understanding Patient Comfort and Willingness in EHR Social Needs Documentation – A Pilot Survey
Background: The integration of Social Determinants of Health (SDOH) into Electronic Health Records (EHRs) is critical yet insufficiently explored. Research suggests that EHRs tailored for SDOH can significantly impact treatment and health outcomes.
Objective: This study aims to explore patients' perceptions and willingness to express and document social needs in EHRs. Based on the findings of previous studies, we examine demographic factors, perceived barriers, facilitators, and health-related influences on patients' engagement with EHRs.
Methods: A survey was constructed to identify the factors that influence patients' comfort and willingness to disclose their social needs. We recruited 302 participants through Amazon Mechanical Turk during Spring 2023. The survey focused on several predictors: (1) demographic details and social needs of the participants, (2) perceived barriers in expressing social needs, which encompassed issues related to healthcare providers, consultation environments, and legitimacy, (3) facilitators to expressing social needs, gauged through the lens of the theory of planned behavior, which included attitudes towards expressing social needs, societal norms, and perceived control over behavior, and (4) health-related factors, particularly health literacy and the nature of the doctor-patient relationship. The primary variables we sought to measure were the participants’ level of comfort in sharing their social needs and their willingness to have these needs documented in their health records
Results: The Ordinary Least Square regression analysis revealed several key insights into factors affecting patients' comfort with sharing social needs and their willingness to document these needs in EHRs. Income emerged as a significant predictor, indicating that patients with higher income levels feel more comfortable and are more willing to engage in health processes involving their social needs, possibly due to greater financial stability and confidence in healthcare interactions. Patients recognizing their social needs showed a higher tendency to have these needs documented in EHRs. Attitudes towards expressing social needs, as per the Theory of Planned Behavior, significantly influenced both comfort in sharing and willingness to document these needs, highlighting the role of individual beliefs. However, perceived behavioral control and subjective norms did not significantly predict these outcomes. The doctor-patient relationship was found to have a complex impact, enhancing comfort in sharing social needs but correlating with a lower willingness for documentation in EHRs, suggesting a reliance on interpersonal communication over formal documentation. Additionally, health literacy had a strong positive correlation with the willingness to document social needs, implying a preference for a holistic approach to healthcare management.
Discussions: This study enhances understanding of patient engagement with EHRs regarding expressing and documenting social needs and highlights the critical role of income and socioeconomic factors in digital health access. The findings further underscores the need for improved healthcare practices, emphasizing structural competency, cultural humility, and patient-centered communication for effective EHR usage and promoting health equity in digital health technologies. In conclusion, this research contributes to the evolving conversation on health equity, offering valuable insights for designing more inclusive and effective EHR systems that can accommodate and respond to the diverse needs of all patient populations.
Objective: This study aims to explore patients' perceptions and willingness to express and document social needs in EHRs. Based on the findings of previous studies, we examine demographic factors, perceived barriers, facilitators, and health-related influences on patients' engagement with EHRs.
Methods: A survey was constructed to identify the factors that influence patients' comfort and willingness to disclose their social needs. We recruited 302 participants through Amazon Mechanical Turk during Spring 2023. The survey focused on several predictors: (1) demographic details and social needs of the participants, (2) perceived barriers in expressing social needs, which encompassed issues related to healthcare providers, consultation environments, and legitimacy, (3) facilitators to expressing social needs, gauged through the lens of the theory of planned behavior, which included attitudes towards expressing social needs, societal norms, and perceived control over behavior, and (4) health-related factors, particularly health literacy and the nature of the doctor-patient relationship. The primary variables we sought to measure were the participants’ level of comfort in sharing their social needs and their willingness to have these needs documented in their health records
Results: The Ordinary Least Square regression analysis revealed several key insights into factors affecting patients' comfort with sharing social needs and their willingness to document these needs in EHRs. Income emerged as a significant predictor, indicating that patients with higher income levels feel more comfortable and are more willing to engage in health processes involving their social needs, possibly due to greater financial stability and confidence in healthcare interactions. Patients recognizing their social needs showed a higher tendency to have these needs documented in EHRs. Attitudes towards expressing social needs, as per the Theory of Planned Behavior, significantly influenced both comfort in sharing and willingness to document these needs, highlighting the role of individual beliefs. However, perceived behavioral control and subjective norms did not significantly predict these outcomes. The doctor-patient relationship was found to have a complex impact, enhancing comfort in sharing social needs but correlating with a lower willingness for documentation in EHRs, suggesting a reliance on interpersonal communication over formal documentation. Additionally, health literacy had a strong positive correlation with the willingness to document social needs, implying a preference for a holistic approach to healthcare management.
Discussions: This study enhances understanding of patient engagement with EHRs regarding expressing and documenting social needs and highlights the critical role of income and socioeconomic factors in digital health access. The findings further underscores the need for improved healthcare practices, emphasizing structural competency, cultural humility, and patient-centered communication for effective EHR usage and promoting health equity in digital health technologies. In conclusion, this research contributes to the evolving conversation on health equity, offering valuable insights for designing more inclusive and effective EHR systems that can accommodate and respond to the diverse needs of all patient populations.