Challenges when engaging diabetic patients and their clinicians in using e-health technologies to improve clinical outcomes

Abstract

Diabetes mellitus (DM) is a chronic disease affecting more than 285 people worldwide and the fourth leading cause of death. Increasing evidence suggests that many DM patients have poor adherence with prescribed medication therapies, impacting clinical outcomes. Patients' barriers to medication adherence and the extent to which barriers contribute to poor outcomes, however, are not routinely assessed. We designed a dashboard for an electronic health record system to integrate DM disease and medication data, including patient-reported barriers to adherence. The dashboard was pilot tested at multiple ambulatory clinics to examine whether integrated electronic tools can support patient-centered decision-making processes involving complex medication regimens for DM and other chronic diseases. During pilot testing, we encountered several challenges when engaging patients and clinicians in using the dashboard as well as a portal used to gather self-reported psychosocial information directly from patients. In this paper we explore those challenges and suggest methods for better supporting the adoption and use of e-health technologies to improve care delivery processes as well as health outcomes for populations like diabetic patients. © 2014 Springer International Publishing.