The use of health IT to enhance patient engagement in diagnostic decision making in the ED is still evolving and requires future research to inform and optimize its development and implementation. A sociotechnical approach, which has been effectively applied to address other safety and quality challenges, should be incorporated to guide design, implementation, and evaluation of such health IT applications. This type of approach will address barriers, additional areas for research, and regulatory changes to ensure applications are evidence based, unbiased, safe, and effective (Table 1).
In addition, Figure 1 suggests several areas where health IT applications can be integrated within the diagnostic process based on a recently proposed framework.48,49
We suggest codesigning these applications with ED team members and patient representatives so that they are user friendly, easily accessible, and affordable. In addition, applications must be rigorously evaluated to ensure they are effective in achieving patient engagement. Similar to other settings, disparities related to the access and use of health IT applications in EDs should be addressed. Diagnostic processes that are specifically ready for intervention include timely communication of test results, communication regarding diagnostic uncertainty, and shared decision making with patients and caregivers about diagnosis and subsequent testing and treatment options.
In conclusion, health IT offers several promising opportunities for engaging patients in the diagnostic process in the ED. Current opportunities include:
- Optimization of the health portal for reviewing test results and personal health information.
- Text messaging to promote behavioral change.
- Efforts to support self-management.
- Enhanced education for patients about their health problems.
- Applications to facilitate shared decision making and patient-provider communication.
Additional research and implementation efforts should focus on addressing key barriers and optimizing use of health IT to improve diagnostic safety and patient engagement.
