Designing a patient-centered personal health record to promote preventive care

Autor: Alex H. Krist, Daniel R. Longo, Steven H. Woolf, J Loomis, Stephen F. Rothemich, Eric Peele, Anton J. Kuzel
Rok vydání: 2011
Předmět:
Adult
Male
Patient Identification Systems
020205 medical informatics
Office Visits
Information Dissemination
Guidelines as Topic
Health Informatics
Health Promotion
02 engineering and technology
lcsh:Computer applications to medicine. Medical informatics
Risk Assessment
Health informatics
03 medical and health sciences
0302 clinical medicine
Nursing
Patient-Centered Care
Preventive Health Services
Health care
0202 electrical engineering
electronic engineering
information engineering
Information system
Decision aids
Electronic Health Records
Humans
Medicine
030212 general & internal medicine
Medical History Taking
Aged
Evidence-Based Medicine
Self-management
Primary Health Care
business.industry
Health Policy
Virginia
Evidence-based medicine
Middle Aged
Personal Health Services
3. Good health
Computer Science Applications
Health promotion
Technical Advance
Time and Motion Studies
lcsh:R858-859.7
Female
Medical Record Linkage
Diffusion of Innovation
business
Zdroj: BMC Medical Informatics and Decision Making
BMC Medical Informatics and Decision Making, Vol 11, Iss 1, p 73 (2011)
ISSN: 1472-6947
DOI: 10.1186/1472-6947-11-73
Popis: Background Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential. Methods Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR) designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases. Results The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices). Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results, automatically issue patient reminders for overdue services, prompt clinicians about needed services, and formulate personalized prevention plans. Conclusions The IPHR demonstrates that a patient-centered personal health record that interfaces with the electronic medical record can give patients a high level of individualized guidance and be successfully adopted by busy primary care practices. Further study and refinement are necessary to make information systems even more patient-centered and to demonstrate their impact on care. Trial Registration Clinicaltrials.gov identifier: NCT00589173
Databáze: OpenAIRE
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