Provider approaches to palliative dyspnea assessment: implications for informatics-based clinical tools.
OBJECTIVE
To understand provider practices around dyspnea assessment to inform the development of an electronic medical record (EMR)-based dyspnea assessment module in an inpatient palliative care consultation template.


METHODS
Qualitative analysis of palliative care provider interviews.


RESULTS
Three themes emerged: (1) integration of patient self-report of breathlessness with a clinical observation of dyspnea; (2) identification of patients for dyspnea assessment based on perceived patient need; and (3) variability in preferences for and use of existing severity scales for dyspnea.


CONCLUSIONS
The assessment approaches described by providers underscore the challenge of developing an informatics tool that supports the natural clinical experience and facilitates standardized care. The complexity of the dyspnea assessment process and variation in provider practices necessitate a level of flexibility and choice to be built into a computer-based tool.
Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, CA 90064, USA. sangeeta.c.ahluwalia@gmail.com
Sangeeta C
SC
Ahluwalia
Rosana L
RL
Leos
Joy R
JR
Goebel
Steven M
SM
Asch
Karl A
KA
Lorenz
D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004417:Dyspnea / Q000175:diagnosis*; D057286:Electronic Health Records; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D010820:Physicians; D012720:Severity of Illness Index