Careful design of personal health records can improve the delivery of preventive care
Health Information Technology
Studies show that Americans receive just half of the preventive care services they need. New information technologies may help improve these outcomes, suggests a new study. It focused on designing a patient-centered personal health record (PHR) to promote preventive care. When the PHR was integrated with the patient's electronic medical record, it gave patients individualized guidance on preventive care services and was successfully adopted by busy primary care practices.
Researchers designed an interactive PHR that addressed 18 different clinical preventive services. They included the receipt of immunizations, colonoscopy, pap smears, cholesterol tests, mammograms, and more. The PHR asked patients to take a brief health risk assessment to gather additional information that might be missing from the medical record. Users received a customized profile with reminders to obtain various preventive services specific to them and explanations of the benefits. The researchers recruited 14 primary care practices to promote the PHR to all adult patients and sought practice and patient input in designing the PHR to ensure its usability and generalizability.
Within 6 months, between 1.5 percent and 28.3 percent of patients across the 14 practices used the PHR. After establishing their PHR account, nearly half of patients (49 percent) returned at least once within 3 months. The average time spent on the site was 7 minutes 21 seconds. Patients reported its ease of use and enjoyed seeing their health information in one place. In addition, each practice was able to incorporate the PHR into patient visits. Providers used it to provide behavioral counseling, explain test results, and develop preventive care plans for their patients. The PHR also helped providers know about overdue care and fulfill annual wellness visit requirements for Medicare. The study was supported in part by the Agency for Healthcare Research and Quality (HS17046 and HS18811).
See "Designing a patient-centered personal health record to promote preventive care," by Alex H. Krist, MD, PhD, Eric Peele, Steven, H. Woolf, MD, MPH, and others, in BMC Medical Informatics & Decision Making 11, pp. 73-84, 2011.