title: HealthATM: personal health cyberinfrastructure for underserved populations.
abstract: BACKGROUND
  There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs.
  
  
  OBJECTIVE
  This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications.
  
  
  METHODS
  A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals.
  
  
  RESULTS
  Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health.
  
  
  CONCLUSIONS
  Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care.
authors.affiliation: Kay Center for E-Health Research, Claremont Graduate University, 130 East Ninth Street, Claremont, CA 91711, USA. nathan.botts@cgu.edu
authors.forename: Nathan E
authors.initials: NE
authors.lastname: Botts
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Horan
authors.forename: Brian P
authors.initials: BP
authors.lastname: Thoms
mesh_terms: D054626:Consumer Health Information / Q000458:organization & administration*; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D015141:Los Angeles; D008297:Male; D008490:Medical Informatics / Q000458:organization & administration; D008507:Medically Underserved Area; D008875:Middle Aged; D010358:Patient Participation; D012648:Self Care; D014584:User-Computer Interface