Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study

Abstract

Objective To describe the experiences of patients with type 2 diabetes in a web based disease management programme based on an interactive electronic medical record. Design Qualitative analysis of semistructured interviews with patients enrolled in a diabetes care module that included access to their electronic medical record, secure email, ability to upload blood glucose readings, an education site with endorsed content, and an interactive online diary for entering exercise, diet, and medication. Setting Patients' homes in Washington state, United States. Participants Nine participants aged 45-65 completed interviews before and after they used the programme. Results Six themes emerged: feeling that non-acute concerns are uniquely valued; enhanced sense of security about health and health care; frustration with unmet expectations; feeling more able to manage; valuing feedback; and difficulty fitting the programme into activities of daily life. Three themes-valuing non-acute concerns, feeling secure, and unmet expectations-have particular relevance to the design and use of web based tools for care of patients with diabetes and chronic medical conditions. Conclusion Participants' experiences support further study of open access to the electronic medical record and online communication between patients and their care providers. The development of web based disease management programmes should take into account the specific needs and expectations of patients, and patients and providers should have candid discussions about what web based care can and cannot provide.

Prevalence and characteristics of home Internet access in patients with cardiovascular disease from diverse geographical locations

“…While government-led telehealth initiatives tend to focus on video conferencing, a number of small studies and pilot projects delivering health services via the Internet have been reported in patients with breast cancer (21,22), asthma (23), chronic obstructive pulmonary disease (24,25), diabetes (26)(27)(28)(29)(30)(31)(32), lung transplantation (33), overweight (34)(35)(36)(37)(38)(39)(40), smokers (41), chronic heart failure (25,(42)(43)(44) and CVD (45)(46)(47)(48). These studies demonstrated that patients were willing to enter self-measured data online and communicate with health care providers via e-mail and/or chat/video conferencing.…”

Interval Examination: Moving Toward Open Notes

“…With the growth of health information technology, small experiments with open records began. [14][15][16] Researchers targeted chronic disease management and found improvements in care plan adherence with the assistance of online medical records. These positive findings encouraged us to mount a larger study.…”

The Challenge of Compliance and Persistence: Focus on Ulcerative Colitis

“…3 Health care systems can also provide reporting and tracking systems that will better enable providers to monitor patient adherence. 16 Interactive computer-based disease management programs can provide online support to the patient, 51,52 encouraging them to continue taking medications, while at the same time collecting patient information on a large scale to track patient outcomes based on side effects, adherence, cost, and effectiveness. Additionally, and whenever possible, coverage plans, generic formulations, and refill requirements should be leveraged to remove financial barriers to adherence.…”