@article {Austine100197, author = {Elizabeth J Austin and Jenney R Lee and Cynthia W Ko and Mark R Kilgore and Elizabeth U Parker and Brandelyn Bergstedt and Anita I Mitchell and Sara H Javid and John L Gore}, title = {Improving the impact of clinical documentation through patient-driven co-design: experiences with cancer pathology reports}, volume = {27}, number = {3}, elocation-id = {e100197}, year = {2020}, doi = {10.1136/bmjhci-2020-100197}, publisher = {BMJ Specialist Journals}, abstract = {Objective With the unprecedented rise of patient access to clinical documentation through electronic health records, there is a need for health systems to understand best practices for redesigning clinical documentation to support patient needs. This study used an experience-based co-design approach to inform the redesign of cancer pathology reports to improve their patient-centeredness and impact on patient engagement.Materials and methods Multiple methods for data collection and stakeholder engagement were used, including Delphi prioritisation with breast and colorectal cancer experts (n=78) and focus groups with patients with cancer (n=23) in the Seattle area. Iterative rounds of consensus generation and reflection were used to elicit themes and design recommendations for the development of patient-centred pathology reports on cancer care.Results Although each cancer type had nuanced elements to consider, common design requirements emerged around two key themes: (1) clinical documentation language should be framed in a way that informs and engages patients, and (2) clinical documentation format should be leveraged to enhance readability and information flow. Study activities illuminated detailed recommendations to improve the patient-centeredness of pathology reports based on patients{\textquoteright} and clinicians{\textquoteright} lived experience.Discussion The design requirements that emerged from this study provide a framework that can guide the rapid development of patient-centred pathology reports for all cancer types. Even further, health systems can replicate these methods to guide experience-based co-design of clinical documentation for contexts beyond cancer care.Conclusion This work offers practice-based learnings that can more effectively guide health systems in their clinical documentation redesign efforts.}, URL = {https://informatics.bmj.com/content/27/3/e100197}, eprint = {https://informatics.bmj.com/content/27/3/e100197.full.pdf}, journal = {BMJ Health \& Care Informatics} }