Abstract
Background
The increasing popularity of consumer-grade wearable (CGW) devices for everyday use has prompted discussions within learning healthcare systems (LHSs) about the integration of patient-generated health data (PGHD) into clinical workflow.
Objective
To report findings from interviews with healthcare professionals (HCPs) about the potential role of CGWs and PGHD in clinical workflow, which in turn informed recommendations for health systems to consider when integrating PGHD from CGWs.
Design
Mixed methods.
Participants
Clinical care providers and holistic/wellness providers with various training and expertise from the largest integrated health system in the USA (i.e., Veterans Health Administration).
Approach
A purposive sample of 29 individuals who were knowledgeable informants were invited to complete a survey focused on CGW feasibility and usability of PGHD. Those who completed the survey were invited to participate in a semi-structured interview to elicit their perceptions of the barriers and facilitators for PGHD utilization. Survey data were analyzed descriptively and rapid qualitative analysis techniques were used to identify themes from interview data.
Key Results
Twenty-one HCPs were included in this study. Quantitative and qualitative findings revealed significant interest in PGHD integration in clinical workflow and patient interactions. Clinical care providers focused on the value of PGHD as a complement to traditional clinical data, whereas holistic/wellness providers emphasized using CGWs and PGHD for behavioral change. Their interest levels were tempered by concerns about workload implications and apprehension about having to distill the vast amount of PGHD of varying validity into clinically actionable information.
Conclusions
Integrating CGWs and PGHD can enable an LHS to improve patient outcomes, particularly to promote health access and equity. Yet, concerns were raised regarding staffing and workload issues, data interpretation, expectations, access, privacy, and educational needs. Therefore, harnessing the benefits of CGWs will require investing in health systems’ infrastructure to optimally integrate PGHD into clinical workflow.
Topic
JGIM
Author Descriptions
Veterans Health Administration at the Greater Los Angeles Healthcare System, Los Angeles, CA, USA
Selene S. Mak PhD, MPH
VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), Los Angeles, CA, USA
Selene S. Mak PhD, MPH
Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
Rebecca L. Kinney PhD, MPH
U.S. Department of Veterans Affairs, VA National Center On Homelessness Among Veterans, Washington, DC, USA
Rebecca L. Kinney PhD, MPH
Department of Veteran Affairs, Veterans Health Administration Strategic Initiatives Lab, Washington, DC, USA
Anne L. Bailey PharmD, BCPS
Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
Allison E. Gaffey PhD
Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
Allison E. Gaffey PhD & Mark R. Relyea PhD
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
Mark R. Relyea PhD
Division of Endocrinology, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
Elias K. Spanakis MD
Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
Elias K. Spanakis MD
Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
Garrett I. Ash PhD
Department of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA
Garrett I. Ash PhD
Pain, Research, Informatics, Medical Comorbidities and Education Center, Vetrans Affairs Connecticut Healthcare System, West Haven, CT, USA
Garrett I. Ash PhD
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