Technologic innovation helping patients become active partners in their healthcare

Technology continues to offer innovative ways of helping your patients improve their health.

An article in Annals of Family Medicine describes an experiment in which an online tool improved patients’ use of primary care preventive services-in some cases significantly. The tool, which the authors call an interactive preventive health record (IPHR), is an evidence-based patient portal that interfaces with the electronic health record (EHR) system of a patient’s doctors, explains information in lay language, provides hyperlinks to recommendations and educational resources tailored to the patient’s individual health needs, and generates reminders of needed services.

The research team sent invitations to use the IPHR to 2,250 randomly selected patients at eight primary care practices in northern Virginia, of whom 378 used the tool. After 16 months of use, 25% of the IPHR users were up to date with all services, about double the rate of nonusers-either those who were not invited to use the IPHR or those who were invited and chose not to use it.

“I think our take-home message from this study is that when people use a personal health record [PHR], it can have a pretty big impact on their care delivery,” Alex H. Krist, MD, MPH, the study’s lead author and associate professor of family medicine at Virginia Commonwealth University, tells Medical Economics. “But one of the major challenges is figuring out how to better engage patients to use this type of resource.”

Krist says that in follow-up research, in which invitations to use the IPHR were sent to all the patients in a practice, and doctors and staff encouraged patients to use it, usage rates exceeded 60%.

Widespread use of PHRs also required changes in the way doctors and practices operate, Krist says, such as entering information in their EHRs in a way that patients could easily comprehend. Practices also had to learn how to integrate PHRs into their workflow by using it in ways such as informing patients of lab results and counseling them on behavior changes.

A guide for helping physicians make the best use of PHRs, “An Interactive Preventive Health Record (IPHR) to Promote Patient-Centered Preventive Care,” is available on the Web site of the Agency for Healthcare Research and Quality.

Meanwhile, another study shows that patients are using the Web as a tool for becoming more active in their own care. Researchers at the University of California–Davis (UC Davis) and the University of Southern California surveyed about 500 people who belonged to online support groups to see how they made use of support groups, other resources on the Web, and traditional media and social relations before going to see a doctor.

The researchers found that about 70% of the patients planned to ask their doctors questions regarding information they found on the Web, including about 40% who planned to print out information to take to their appointments and 50% who said they planned to make at least one request of their doctors based on information they found on the Web.

“The [Web] has become a mainstream source of information about health and other issues,” says Xinyi Hu, a coauthor of the study and a master’s degree student in the Department of Communications at UC Davis. “Many people go online to get information when they anticipate a challenge in their life. It makes sense that they would do the same when dealing with a health issue.”

The authors found no evidence that patients who use the Web for health-related information do so because they trust their doctors less than patients who don’t go online for such information.

“As a practicing physician, these results provide some degree of reassurance,” says Richard Kravitz , MD, professor of internal medicine at UC Davis Health System and a study coauthor. “The results mean that patients are not turning to the [Web] out of mistrust; more likely, [Web] users are curious information seekers who are just trying to learn as much as they can before their visit.”

Factors that do predict the likelihood of a patient going online before a medical visit include a health situation that is especially distressful, a perception that the patient has some level of personal control over their illness, or the patient’s belief that the medical condition is likely to persist.

The study, “The prepared patient: Information seeking of online support group members before their medical appointments,” was published in the Journal of Health Communication.

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