Abstract

The collection of patient reported outcomes (PROs) allows us to incorporate the patient’s voice into their care in a quantifiable, validated manner. Large-scale collection of PROs is facilitated by the electronic health record and its portal, though, historically, patients have eschewed the portal and completed patient-reported outcome measures in the clinic via tablet. Furthermore, access and use of the portal is associated with known racial inequities. Our institution oversees the largest clinical PRO program in the world, and has a long history of racially equitable PRO completion rates via tablet. However, when the COVID-19 pandemic forced us to remove tablets from clinics and rely exclusively on portal use for PRO completion, profound racial disparities resulted immediately. Our experience quantifiably demonstrates the magnitude of inequity that the portal, in its current configuration, generates and serves as a cautionary tale to other health care systems and electronic health records.

中文翻译：

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数字差异：从 COVID-19 大流行期间患者报告结果计划中吸取的经验教训

摘要

患者报告结果 (PRO) 的收集使我们能够以可量化、经过验证的方式将患者的声音纳入他们的护理中。电子健康记录及其门户促进了 PRO 的大规模收集，但从历史上看，患者避开门户并通过平板电脑在诊所完成患者报告的结果测量。此外，门户的访问和使用与已知的种族不平等有关。我们的机构负责监督世界上最大的临床 PRO 计划，并且在通过平板电脑实现种族平等的 PRO 完成率方面有着悠久的历史。然而，当 COVID-19 大流行迫使我们从诊所移除平板电脑并完全依赖门户网站来完成 PRO 时，立即产生了深刻的种族差异。