Implementation of a patient-centered mobile shared decision making platform and healthcare workers' evaluation: a case in a medical center.

Shared decision making is a patient-centered clinical decision-making process that allows healthcare workers to share the existing empirical medical outcomes with patients before making critical decisions. This study aims to explore a project in a medical center of developing a mobile SDM in Taiwan. Chi Mei Medical Center developed the mobile SDM platform and conducted a survey of evaluation from healthcare workers. A three-tier platform that based on cloud infrastructure with seven functionalities was developed. The survey revealed that healthcare workers with sufficient SDM knowledge have an antecedent effect on the three perceptive factors of acceptance of mobile SDM. Resistance to change and perceived ease of use show significant effect on behavioral intention. We provided a comprehensive architecture of mobile SDM and observed the implementation in a medical center. The majority of healthcare workers expressed their acceptancem; however, resistance to change still present. It is, therefore, necessary to be eliminated by continuously promoting activities that highlight the advantages of the Mobile SDM platform. In clinical practice, we validated that the mobile SDM provides patients and their families with an easy way to express their concerns to healthcare workers improving significantly their relationship with each other.

Developing and Evaluating A One-Stop Patient-Centered Interprofessional Collaboration Platform in Taiwan.

(1) Background: Effective healthcare collaboration not only improves the outcomes of patients, but also provides benefits to healthcare providers. A patient-centered communication platform, a so-called "one-stop platform", is necessary to promote interprofessional collaboration (IPC) for optimal patient care. (2) Methods: Chi Mei Medical Center developed a patient-centered computerized platform to fulfill interprofessional collaboration needs. The platform features a spiral-shaped integrated care area and a communication area that allows the medical team to access patients' information including the medical care they received within seven days, and veritably shows whether the team members have read communication messages. After pilot adoption, an online survey was conducted. (3) Results: A one-stop IPC platform was implemented and promoted for patient care. The online survey revealed that medical team members have high positive appraisal of the platform. It also pointed out that resistance to change among the medical team still has a significant impact on behavioral intention. (4) Conclusions: The interprofessional collaboration platform was recognized by the medical teams of Chi Mei Medical Center as an effective and convenient tool for assisting clinical decision making. However, actions to reduce user resistance to change and encourage collaboration among team members still need to be continued. Shared decision making within physicians and patients will be valuable to develop in the platform in the future.