The National Academies of Sciences, Engineering, and Medicine (NASEM) report Improving Diagnosis in Health Care calls for healthcare professionals to engage patients in diagnostic decision making.1 Patient engagement refers to the concept of patients being actively involved in their healthcare, including but not limited to engaging with medical providers and the health system in diagnosis, treatment, and overall disease management decisions.2,3 An increasing body of research shows that patients engaged in their care have improved health outcomes and care experiences.4,5
The emergency department (ED) presents unique challenges to engage patients in the diagnostic process. Patients evaluated in the ED typically have no prior relationship with the care team. Engagement is further challenged in the unpredictable, chaotic environment where clinicians operate in time-constrained situations and care for multiple patients simultaneously. Finally, patients presenting to the ED may be critically ill, emotionally distressed, intoxicated, or otherwise unable to fully participate in their own care.
Health information technology (IT) is increasingly used to promote patient engagement by enhancing patient-provider communication, ensuring shared decision making, and enabling positive behavioral changes.6-9 Health IT tools such as electronic patient portals, mobile text messaging, health applications (henceforth referred to as “apps”), and recent advancements in virtual environments offer new opportunities for patient engagement in the ED. This issue brief reviews the current state of health IT-based methods for engaging patients in the diagnostic process in the ED and outlines opportunities for further development.
