Finding the Person in Electronic Health Records. A Mixed-Methods Analysis of Person-Centered Content and Language

Figures & data

Figure 1. Study design.

Table 1. Degree of person-centered content in electronic health records

		Not at all N (%)	Somewhat N (%)	Quite a lot N (%)	Well-documented N (%)	To a great extent N (%)	Mean rating
Domain	Subdomain
Knowledge of the patient as a person	a) Person	3 (4)	34 (50)	24 (35)	5 (7)	3 (4)	1.6
	b) Preferences	29 (42)	25 (36)	13 (19)	2 (3)	0	0.8
	c) Resources	0	0	13 (19)	45 (65)	11 (16)	2.9
	d) Physical	0	1 (1)	9 (13)	43 (62)	16 (23)	3.1
	e) Psychosocial	7 (10)	29 (42)	27 (39)	4 (6)	2 (3)	1.5
Provision of holistic care	a) Patient’s resources	56 (81)	10 (15)	3 (4)	0	0	0.2
	b) Patient’s preferences/wishes	51 (74)	14 (20)	2 (3)	1 (1)	1 (1)	0.4
Partnership in care planning and provision	a) Information provided	4 (6)	4 (6)	14 (20)	33 (48)	14 (20)	2.7
	b) Participation in discussion	48 (70)	16 (23)	2 (3)	2 (3)	1 (1)	0.4
	c) Participation in decision-making	51 (74)	13 (19)	3 (4)	2 (3)	0	0.4

Notes: n = 69

Table 2. The final qualitative coding framework: language, rhetoric, number of codes and patient records

Category	Code Counts in discharge letters (N)	Sub-Code Discharge letters (N)	Examples
Rhetoric	Expository structured (46)		‘You will be called for a return visit to ward xx in 3 months to check your pituitary hormones. You will receive a call for a magnet camera examination which will take place in 6 months.’ (ID 36)
	Expository unstructured (56)		‘-Blood pressure control at GP surgery -visit ophthalmologist Monday next week -decision on radiation treatment at the oncologist’s -return visit in 2 months.’ (ID 32)
Biomedical language	De-personalization (43)		‘Reason for admission: Postoperative care after reoperation’ (ID 100)
		Abbreviations, medical terms (40)	‘Transphenoidal total extirpation of microadenoma in pituitary gland.’ (ID 79) ‘…discrete visual field loss upwards temporal.’ (ID70)
	Agentless passives (50)		‘[…] X-ray on 18/11 and one saw a growth of the pituitary gland.’ (ID102)
	Technology as agent (7)		‘The postoperative MRI scan shows…’ (ID 32)
Person-centered language	Personalization (54)		‘You did not feel well at the beginning of your ward stay. You had a headache and nausea.’(ID 100)
		Plain language (30)	‘you have been on […] Minirin tablets because of Diabetes Insipidus, that is a lack of a pituitary hormone called ADH, which causes you to urinate a lot.’ (ID40)
	Active agents (39)		‘You should go to your health center on Monday and Friday next week and have blood samples taken, which they will fax to us. The doctor here will check them and call you if you need to change your Minirin dose.’(ID 82)
		Patient perspective (5)	‘If you urinate a lot at night, we can discuss an increase [Minirin] to 1 tablet again’ (ID87)