Personal Health Records in Maternity care “a process evaluation”

Abstract

Background: Personal Health Records [PHR, a private, secure, online environment for patients] have been reported to empower patients, to achieve better collaboration between health care professionals and to improve outcome. This process evaluation study explores the feasibility of the introduction of PHR in Dutch maternity care and possibilities for sustainable implementation. Methods: A process evaluation study was carried out alongside the entire period of the effect study. Quantitative and qualitative methods were used and described reach, dose delivered en dose received of the intervention. Results: 88% of the target population was reached, while 4% started a PHR [dose delivered] and 83% [out of 4%] used the PHR as intended [dose received]. It took more time for the professionals to integrate this new intervention into their care process than expected before. Pregnant women did not start a PHR when they favoured an alternative way to communicate with the health care professional or when they felt the PHR lacked additional value. Active involvement of the professional in the patients PHR is explicitly mentioned as desirable by pregnant women. Conclusions: The introduction of a PHR in maternity care is feasible, requiring the following steps: a dialogue between patients and professionals about expectations and wishes, sufficient time for the implementation, using early adopters as part of the implementation and integration of the PHR in standard care.

Usability and Perception of a Wearable-Integrated Digital Maternity Record App in Germany: User Study

“…Our results from the semistructured interviews are overall in line with previous work. Groenen et al [ 38 ] found that users do not start a DMR if they feel it has no perceived value and that physicians play a key role in the adoption of technology. In this previous work, participants similarly stated that pregnancy complications increase the value of technology.…”

Effects of a Personal Health Record in Maternity Care: A Stepped-Wedge Trial

“…However, handling and acceptance of the aforementioned changes by professionals requires them to embrace a change in norms. Our process analyses [ 14 ] describe a difference in client and professional expectations of MyPregn@ncy. Therefore, we recommend that discussing the expectations and wishes of pregnant women and professionals should be part of the implementation process.…”

“…We acknowledge several shortcomings in the present study, including the small number of pregnant women actively using MyPregn@ncy and the absence of the active involvement of pregnant women in designing the implementation elements. As stated in our previously published paper concerning the process evaluation of the study, such user involvement in the design of a PHR contributes to its successful implementation and integration in standard care [ 14 ].…”

“…We designed a study to assess the introduction of MyPregn@ncy in one Dutch maternity care region. A process evaluation of the introduction of MyPregn@ncy was published previously [ 14 ].…”

Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

“…This study demonstrated an adoption rate of 4%, which was explained by the low perceived usefulness of the PHR by healthy women with uncomplicated pregnancies. The authors suggested that the PHR might be more useful if it would be embedded in standard care [ 20 , 21 ]. Searching for new ways to facilitate patient involvement and foster patient-centered care, MijnZorgnet has recently been made interoperable with the infrastructure of the Dutch National Connection Point, which is used for the exchange of summary records between GPs and out-of-hour GP services and of medication lists between GPs and pharmacies.…”