A mixed-methods feasibility study to evaluate and assess the clinical utility of multidisciplinary patient-centered information in breast cancer care.

Abstract

e13594 Background: Patient-centered care (PCC) is an important paradigm shift in healthcare and is considered an essential component in improving the quality of care. Breast cancer care incorporates PCC that considers patients’ preferences, values and circumstances. The purpose of this study was to evaluate and assess the clinical utility of the integrated multidisciplinary patient-centered information (PCI) documented by various healthcare professionals (HPs) for promoting PCC in the treatment and care of breast cancer patients. Methods: This study applied a convergent mixed-methods interventional design in which Control and Intervention were compared by integrating both quantitative and qualitative results obtained from questionnaires and verbatim transcripts. In three breast cancer cases (up to 10 years data), a multidisciplinary team meeting (MDTM) using a conventional electronic health record (EHR) viewer was designated Control, and a MDTM using a conventional EHR viewer plus the integrated unstructured multidisciplinary PCI was designated Intervention. The questionnaires used a 5-point Likert scale consisting of questions related to efficiency and patient-centeredness. Statistical analysis was performed using Wilcoxon rank test and summary statistics. Verbatim transcripts were analyzed using a thematic analysis hybrid approach. Results: Three surgical oncologists and three nurses (ward, outpatient chemotherapy, and palliative care) participated in the MDTMs for both Control and Intervention. The quantitative data suggested that there were statistically significant differences between Control and Intervention (p<0.05), with Intervention superior to Control from the viewpoints of efficiency and patient-centeredness. The qualitative data suggested that the MDTM for Intervention involved more PCI and promoted shared understanding from early in the meeting. The number of agreed contents per minute was higher for Intervention than for Control. Synthesis of both the quantitative and qualitative results suggested that use of the integrated multidisciplinary PCI in MDTMs may facilitate the utilization of PCI and lead to more efficient and patient-centered discussions and decision-making to lead to PCC (Table). Conclusions: Integrating the unstructured PCI obtained from various medical records written by different HPs already documented in the hospital information system could be helpful for supporting PCC in MDTMs and routine clinical practice without placing an additional burden on busy HPs while also promoting the digital transformation of healthcare. Comparison of control and intervention. Case1 Case2 Case3 p-value for efficacy <0.01 <0.01 0.19 p-value for patient-centeredness <0.01 <0.01 <0.01 Change in the required time per agreement (Control to Intervention [minutes]) 0.72 to 0.71 0.59 to 0.57 2.18 to 0.74