title: Harmonized patient-reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors.
abstract: BACKGROUND
  Electronic health records (EHR) have the potential to improve patient care through efficient access to complete patient health information. This potential may not be reached because many of the most important determinants of health outcome are rarely included. Successful health promotion and disease prevention requires patient-reported data reflecting health behaviors and psychosocial issues. Furthermore, there is a need to harmonize this information across different EHR systems.
  
  
  METHODS
  To fill this gap a three-phased process was used to conceptualize, identify and recommend patient-reported data elements on health behaviors and psychosocial factors for the EHR. Expert panels (n=13) identified candidate measures (phase 1) that were reviewed and rated by a wide range of health professionals (n=93) using the grid-enabled measures wiki social media platform (phase 2). Recommendations were finalized through a town hall meeting with key stakeholders including patients, providers, researchers, policy makers, and representatives from healthcare settings (phase 3).
  
  
  RESULTS
  Nine key elements from three areas emerged as the initial critical patient-reported elements to incorporate systematically into EHR--health behaviors (eg, exercise), psychosocial issues (eg, distress), and patient-centered factors (eg, demographics). Recommendations were also made regarding the frequency of collection ranging from a single assessment (eg, demographic characteristics), to annual assessment (eg, health behaviors), or more frequent (eg, patient goals).
  
  
  CONCLUSIONS
  There was strong stakeholder support for this initiative reflecting the perceived value of incorporating patient-reported elements into EHR. The next steps will include testing the feasibility of incorporating these elements into the EHR across diverse primary care settings.
authors.affiliation: Department of Human, Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, Virginia 24016, USA. estabrkp@vt.edu
authors.forename: Paul A
authors.initials: PA
authors.lastname: Estabrooks
authors.forename: Maureen
authors.initials: M
authors.lastname: Boyle
authors.forename: Karen M
authors.initials: KM
authors.lastname: Emmons
authors.forename: Russell E
authors.initials: RE
authors.lastname: Glasgow
authors.forename: Bradford W
authors.initials: BW
authors.lastname: Hesse
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kaplan
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Krist
authors.forename: Richard P
authors.initials: RP
authors.lastname: Moser
authors.forename: Martina V
authors.initials: MV
authors.lastname: Taylor
mesh_terms: D003256:Community Participation; D032921:Consensus; D057286:Electronic Health Records; D015438:Health Behavior; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D062527:Meaningful Use; D008603:Mental Health; D018802:Patient-Centered Care; D014481:United States