title: Impact of a web-based personally controlled health management system on influenza vaccination and health services utilization rates: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the impact of a web-based personally controlled health management system (PCHMS) on the uptake of seasonal influenza vaccine and primary care service utilization among university students and staff.
  
  
  METHODS
  A PCHMS called Healthy.me was developed and evaluated in a 2010 CONSORT-compliant two-group (6-month waitlist vs PCHMS) parallel randomized controlled trial (RCT) (allocation ratio 1:1). The PCHMS integrated an untethered personal health record with consumer care pathways, social forums, and messaging links with a health service provider.
  
  
  RESULTS
  742 university students and staff met inclusion criteria and were randomized to a 6-month waitlist (n=372) or the PCHMS (n=370). Amongst the 470 participants eligible for primary analysis, PCHMS users were 6.7% (95% CI: 1.46 to 12.30) more likely than the waitlist to receive an influenza vaccine (waitlist: 4.9% (12/246, 95% CI 2.8 to 8.3) vs PCHMS: 11.6% (26/224, 95% CI 8.0 to 16.5); χ(2)=7.1, p=0.008). PCHMS participants were also 11.6% (95% CI 3.6 to 19.5) more likely to visit the health service provider (waitlist: 17.9% (44/246, 95% CI 13.6 to 23.2) vs PCHMS: 29.5% (66/224, 95% CI: 23.9 to 35.7); χ(2)=8.8, p=0.003). A dose-response effect was detected, where greater use of the PCHMS was associated with higher rates of vaccination (p=0.001) and health service provider visits (p=0.003).
  
  
  CONCLUSIONS
  PCHMS can significantly increase consumer participation in preventive health activities, such as influenza vaccination.
  
  
  CONCLUSIONS
  Integrating a PCHMS into routine health service delivery systems appears to be an effective mechanism for enhancing consumer engagement in preventive health measures.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12610000386033. http://www.anzctr.org.au/trial_view.aspx?id=335463.
authors.affiliation: Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia. a.lau@unsw.edu.au
authors.forename: Annie Y S
authors.initials: AY
authors.lastname: Lau
authors.forename: Vitali
authors.initials: V
authors.lastname: Sintchenko
authors.forename: Jacinta
authors.initials: J
authors.lastname: Crimmins
authors.forename: Farah
authors.initials: F
authors.lastname: Magrabi
authors.forename: Blanca
authors.initials: B
authors.lastname: Gallego
authors.forename: Enrico
authors.initials: E
authors.lastname: Coiera
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D001315:Australia; D057286:Electronic Health Records; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D020407:Internet; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care; D010346:Patient Care Management / Q000379:methods*; D011314:Preventive Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D016037:Single-Blind Method; D013333:Student Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data