Bringing Informed Consent To The 21st Century - The Impact Of An Online Resource And Consent Process On Fertility Patient Perceptions.

To determine if the use of a multimedia electronic (e)-learning resource and e-consent process influences patients’ perception of their treatment team and eases the administrative burden. Prospective randomized controlled trial. Patients undergoing their first intrauterine insemination (IUI) or in-vitro fertilization (IVF) cycle were randomized to receive standard fertility counseling and sign paper consents with their physician and nurse team (conventional group) or to receive standard counseling plus access to an interactive multimedia e-learning and e-consent platform (EngagedMD group). Surveys were administered prior to treatment (T1) and at cycle completion (T2) to assess their treatment experience, perception of their treatment team, and the informed consent (IC) process. A therapeutic index (TI) score was generated based on the sum of patients’ responses to six questions including how much they agreed or disagreed with statements regarding their physician/nursing team. Additionally, patients were surveyed about their perception of IC in general and their experience with the consent process. The six physicians and four nurses involved in patient care were surveyed regarding their experience during the study. Statistics were performed using the student’s t-test and Chi-squared test where appropriate. Demographics for the 77 patients (42=IVF and 35=IUI) including age, duration of infertility and education level were similar between the conventional and EngagedMD groups. Calculated TI scores revealed no difference at T1 (p = 0.81) or T2 (p = 0.68) between the conventional and EngagedMD groups. Regarding IC, there was no difference between patients’ summed responses in the conventional and EngagedMD groups. Of those that used the online platform, most patients agreed that it was helpful (92.5%), user-friendly (81.4%), and would recommend it to a friend (85.2%). Of those that signed consents online, 25 of 27 (92.5%) patients preferred this over standard paper consents. When rating overall fertility treatment satisfaction on a 1-100 scale, there was no difference between those that used EngagedMD and those that did not (85.2 +/- 21/1 vs. 83.8 +/- 18.5; p = 0.82). While none of the physicians surveyed felt that the addition of e-consents aided in patient understanding, all physicians and nurses felt that having e-consents was a valuable addition to the practice and made the process easier. The addition of an online learning and consent platform did not significantly impact patients’ perception of their treatment team, nor their overall perception of the informed consent process. However, patients and providers using the online consent process agreed that it was a valuable addition to streamline the consent process.