Randomized Controlled Trial of Health Maintenance Reminders Provided Directly to Patients Through an Electronic PHR
Open Access
- 9 September 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 27 (1), 85-92
- https://doi.org/10.1007/s11606-011-1859-6
Abstract
Provider and patient reminders can be effective in increasing rates of preventive screenings and vaccinations. However, the effect of patient-directed electronic reminders is understudied. To determine whether providing reminders directly to patients via an electronic Personal Health Record (PHR) improved adherence to care recommendations. We conducted a cluster randomized trial without blinding from 2005 to 2007 at 11 primary care practices in the Partners HealthCare system. A total of 21,533 patients with access to a PHR were invited to the study, and 3,979 (18.5%) consented to enroll. Patients in the intervention arm received health maintenance (HM) reminders via a secure PHR “eJournal,” which allowed them to review and update HM and family history information. Patients in the active control arm received access to an eJournal that allowed them to input and review information related to medications, allergies and diabetes management. The primary outcome measure was adherence to guideline-based care recommendations. Intention-to-treat analysis showed that patients in the intervention arm were significantly more likely to receive mammography (48.6% vs 29.5%, p = 0.006) and influenza vaccinations (22.0% vs 14.0%, p = 0.018). No significant improvement was observed in rates of other screenings. Although Pap smear completion rates were higher in the intervention arm (41.0% vs 10.4%, p < 0.001), this finding was no longer significant after excluding women’s health clinics. Additional on-treatment analysis showed significant increases in mammography (p = 0.019) and influenza vaccination (p = 0.015) for intervention arm patients who opened an eJournal compared to control arm patients, but no differences for any measure among patients who did not open an eJournal. Providing patients with HM reminders via a PHR may be effective in improving some elements of preventive care.Keywords
This publication has 28 references indexed in Scilit:
- Digital divide: Use of electronic personal health record by different population groups2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2010
- Survey analysis of patient experience using a practice-linked PHR for type 2 diabetes mellitus.2009
- Challenges to Using an Electronic Personal Health Record by a Low-Income Elderly PopulationJournal of Medical Internet Research, 2009
- Disparities in Use of a Personal Health Record in a Managed Care OrganizationJournal of the American Medical Informatics Association, 2009
- The effects of on-screen, point of care computer reminders on processes and outcomes of careCochrane Database of Systematic Reviews, 2009
- Practice-Linked Online Personal Health Records for Type 2 Diabetes MellitusJAMA Internal Medicine, 2008
- Design and implementation of a web-based patient portal linked to an electronic health record designed to improve medication safety: the Patient Gateway medications moduleJournal of Innovation in Health Informatics, 2008
- Some unintended consequences of clinical decision support systems.2007
- Medscape's response to the Institute of Medicine Report: Crossing the quality chasm: a new health system for the 21st century.2001
- Effect of Patient Reminder/Recall Interventions on Immunization RatesJama-Journal Of The American Medical Association, 2000