Factors impacting electronic patient-generated data use in safety-net systems: a qualitative study
Authors: Elaine C Khoong, MD, MS , Jeanette Wong, BS , Faviola Garcia, BA , Kristan Olazo, MPH , Mahal Miles, BS , Billy Zeng, MD , Courtney R Lyles, PhD , Urmimala Sarkar, MD, MPH
This study explored perceived barriers and facilitators to using electronic patient-generated data (PGD) in safety-net health systems, through 43 semi-structured interviews with patients and clinicians and observations of 15 clinical encounters. Using frameworks such as the Consolidated Framework for Implementation Research and the Behavior Change Wheel, the analysis revealed themes related to capability (knowledge of PGD), motivation (preferences for data sharing, attitudes toward digital tools, privacy concerns, and relationships with clinicians), and opportunity (social support and available resources). Non-English-speaking patients expressed worry about burdening others, while clinicians cited resource constraints and implementation processes as additional challenges. The findings highlight that, despite the promise of electronic PGD to improve chronic disease care, successful adoption in under-resourced safety-net systems requires addressing capability, motivation, and opportunity factors across patient, clinician, system, and policy levels.