viernes, 14 de noviembre de 2014

Engaging primary care patients to use a patient-centered personal h... - PubMed - NCBI

Primary care practices can encourage patients to use interactive preventive health records (IPHRs) by directly engaging patients, according to research supported by the Agency for Healthcare Research and Quality. Investigators conducted a mixed methods assessment of a proactive implementation strategy for an IPHR portal offered by eight primary care practices. Strategies included learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. The study found that a customized implementation strategy designed by practices resulted in 25.6% of patients using the personal health portal. The study, “Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record,” was published in the September/October issue of the Annals of Family Medicine.

Select to access the abstract: http://www.ncbi.nlm.nih.gov/pubmed/25354405.

2014 Sep-Oct;12(5):418-26. doi: 10.1370/afm.1691.

Engaging primary care patients to use a patient-centered personal health record.

Krist AH1, Woolf SH2, Bello GA3, Sabo RT4, Longo DR5, Kashiri P5, Etz RS5, Loomis J6, Rothemich SF5, Peele JE7, Cohn J8.

Author information

Abstract

PURPOSE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.