Patient Education for Consumer-Mediated HIE. A Pilot Randomized Controlled Trial of the Department of Veterans Affairs Blue Button.

Autor:	Turvey CL; Carolyn L. Turvey, Ph.D., Iowa City VA Health Care System (152), 601 Highway West, Iowa City, IA 52246, Phone: 319-338-0581, extension 7714;, Fax: 319-887-4932;, Email: carolyn.turvey@va.gov., Klein DM, Witry M, Klutts JS, Hill EL, Alexander B, Nazi KM
Jazyk:	angličtina
Zdroj:	Applied clinical informatics [Appl Clin Inform] 2016 Aug 03; Vol. 7 (3), pp. 765-76. Date of Electronic Publication: 2016 Aug 03.
DOI:	10.4338/ACI-2016-01-RA-0014
Abstrakt:	Objectives: Consumer-mediated health information exchange (HIE) is one of the three types of HIE designated by the Office of the National Coordinator. HIE is intended to improve the quality of care while reducing cost, yet empirical support for this claim is mixed. Future research should identify the contexts whereby HIE is most effective. Methods: This study was conducted as a pilot two-arm randomized controlled trial. In the intervention arm, 27 veterans were taught how to generate a Continuity of Care Document (CCD) within the Blue Button feature of their VA patient portal and were then asked to share it with their community non-VA provider. In the attention control condition, 25 Veterans were taught how to look up health information on the Internet. The impact of this training on the next non-VA medical visit was examined. Results: Nineteen (90%) veterans in the intervention arm shared their CCD with their non-VA provider as compared with 2 (17%) in the attention control arm (p<0.001). Both veterans and non-VA providers indicated high satisfaction with the CCD. Comparison of medical records between the VA and non-VA providers did not indicate improved medication reconciliation (p=0.72). If veterans shared their CCD prior to their non-VA providers ordering laboratory tests, the number of duplicate laboratories was significantly reduced (p=0.02). Conclusions: In this pilot randomized controlled trial, training 52 veterans to share their CCD was feasible and accepted by both patients and providers. Sharing this document appeared to reduce duplicate laboratory draws, but did not have an impact on documented medication list concordance. Competing Interests: There are no conflicts of interest for any of the authors of this study. This work was supported by the Department of Veterans Affairs, Health Services Research & Development (PPO-13–178). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs
Databáze:	MEDLINE
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