Your Doctor's Office or the Internet? Two Paths to Personal Health Records

Tang, Paul C.; Lee, Thomas H.

doi:10.1056/nejmp0810264

Cited by 74 publications

(44 citation statements)

References 3 publications

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“…29,30 Although work is underway to develop criteria for reimbursement of e-visits, to date there has not been widespread reimbursement for these services. 31 Given the issues noted above, the policy implications from this study may depend heavily on where the program is implemented. In an integrated care system like KPCO, where a large majority of the enrollees have access to the Internet, HPWCC may allow greater flexibility for patients and clinicians and for a more efficient allocation of resources for highrisk pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

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A New Model of Well-Child Care: Implications for Resource Costs and Dissemination

Ritzwoller

Sukhanova²,

Beck³

et al. 2011

TPJ

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Section: Discussionmentioning

confidence: 99%

“…13 31,2006. These data were used to estimate the age distribution of pediatric members by the following age categories: age <1 year, age 1 to 2 years, and age 3 to 5 years.…”

Section: Methodsmentioning

confidence: 99%

A New Model of Well-Child Care: Implications for Resource Costs and Dissemination

Ritzwoller

Sukhanova²,

Beck³

et al. 2011

TPJ

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“…For the purposes of this article, personal health records are broadly defi ned as health information systems used by patients, whereas electronic health records (EHRs) are systems primarily used by clinicians. The existing generation of personal health records can give patients direct access to the EHR of their clinician, 9,10 which is empowering, speeds access to results, and enables patients to discover inaccuracies in their medical record. The next generation of personal health records could offer higher functionality 11 -assessing patients' needs by applying the latest evidence-based guidelines and incorporating personal medical data to derive individualized recommendations.…”

Section: Introductionmentioning

confidence: 99%

Interactive Preventive Health Record to Enhance Delivery of Recommended Care: A Randomized Trial

Krist¹,

Woolf²,

Rothemich³

et al. 2012

The Annals of Family Medicine

101

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PURPOSE Americans receive only one-half of recommended preventive services. Information technologies have been advocated to engage patients. We tested the effectiveness of an interactive preventive health record (IPHR) that links patients to their clinician's record, explains information in lay language, displays tailored recommendations and educational resources, and generates reminders. METHODSThis randomized controlled trial involved 8 primary care practices. Four thousand fi ve hundred patients were randomly selected to receive a mailed invitation to use the IPHR or usual care. Outcomes were measured using patient surveys and electronic medical record data and included IPHR use and service delivery. Comparisons were made between invited and usual-care patients and between users and nonusers among those invited to use the IPHR.RESULTS At 4 and 16 months, 229 (10.2%) and 378 (16.8%) of invited patients used the IPHR. The proportion of patients up-to-date with all services increased between baseline and 16 months by 3.8% among intervention patients (from 11.4% to 15.2%, P <.001) and by 1.5% among control patients (from 11.1% to 12.6%, P = .07), a difference of 2.3% (P = .05). Greater increases were observed among patients who used the IPHR. At 16 months, 25.1% of users were up-todate with all services, double the rate among nonusers. At 4 months, delivery of colorectal, breast, and cervical cancer screening increased by 19%, 15%, and 13%, respectively, among users.CONCLUSIONS Information systems that feature patient-centered functionality, such as the IPHR, have potential to increase preventive service delivery. Engaging more patients to use systems could have important public health benefi ts. Ann Fam Med 2012;10:312-319. doi:10.1370/afm.1383. INTRODUCTIONA mericans receive only one-half of recommended preventive services.1 Among the various causes is poor access to reliable information. Patients need evidence-based information about what is recommended-tailored to their individual risk factors (eg, age, sex, co mbordities, prior testing, family history, health behaviors)-and presented in an understandable format.2 They need reminders when services are due, guidance to deal with inconsistent recommendations, and access to decision aids for choices that require shared decision making. [3][4][5] To act on their choices, patients need written plans and logistical details. 6,7 Clinicians often lack time and resources to provide this information. 8 One proposed solution is to harness the power of information technology, especially personal health records. For the purposes of this article, personal health records are broadly defi ned as health information systems used by patients, whereas electronic health records (EHRs) are systems primarily used by clinicians. 313 INT ER AC T IVE PR E V ENT IV E HE A LT H R ECOR Dgive patients direct access to the EHR of their clinician, 9,10 which is empowering, speeds access to results, and enables patients to discover inaccuracies in their medical record. The next gene...

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“…In the US, for instance, integrated personal health records, whereby patients view and actively upload their own measurements such as home blood pressure readings is no longer a futuristic scenario. 6 It seems that individuals who are younger, female, and better educated prefer more active participation 7 in healthcare matters, which is also corroborated in other areas of health care. 8 Physicians will require strong interpersonal and communication skills when advising such active patients and may feel challenged in their authority.…”

Section: Doctor-patient Relationshipmentioning

confidence: 80%

“…5,6 What is clear, however, is that there has been a To allow for timely translation of information into clinical practice, evidencebased medicine (EBM) requires mechanisms to retrieve all relevant available data. 1 In addition to databases such as PubMed and other traditional online resources, the tools and technologies built around so-called usergenerated content, collectively termed Web 2.0, provide for the efficient spreading and distribution of health information.…”

Section: Doctor-patient Relationshipmentioning

confidence: 99%