Engaging primary care patients to use a patient-centered personal health record
| Autor: | Roy T. Sabo, Paulette Lail Kashiri, Jeffrey Cohn, Alex H. Krist, Ghalib Bello, Rebecca S. Etz, Steven H. Woolf, Daniel R. Longo, Stephen F. Rothemich, J Loomis, J. Eric Peele |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Quality management Adolescent Office Visits Health Promotion Cohort Studies Young Adult Advertising campaign Nursing Patient-Centered Care Health care Medicine Electronic Health Records Humans Prospective Studies Aged Original Research Analysis of Variance Primary Health Care business.industry Patient portal Middle Aged Quality Improvement United States Workflow Health promotion Health Records Personal Informatics Linear Models Feasibility Studies Female Diffusion of Innovation Family Practice business Cohort study |
| Zdroj: | Annals of family medicine. 12(5) |
| ISSN: | 1544-1717 |
| Popis: | Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care.We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively.A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake.By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. |
| Databáze: | OpenAIRE |
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