title: How patients want to engage with their personal health record: a qualitative study.
abstract: OBJECTIVE
  To assess factors related to use and non-use of a sophisticated interactive preventive health record (IPHR) designed to promote uptake of 18 recommended clinical preventive services; little is known about how patients want to use or be engaged by such advanced information tools.
  
  
  METHODS
  Descriptive and interpretive qualitative analysis of transcripts and field notes from focus groups of the IPHR users and of patients who were invited but did not use the IPHR (non-users). Grounded theory techniques were then applied via an editing approach for key emergent themes.
  
  
  METHODS
  Primary care patients in eight practices of the Virginia Ambulatory Care Outcomes Research Network (ACORN).
  
  
  METHODS
  Three focus groups involved a total of 14 IPHR users and two groups of non-users totalled 14 participants.
  
  
  RESULTS
  For themes identified (relevance, trust and functionality) participants indicated that endorsement and use of the IPHR by their personal clinician was vital. In particular, participants' comments linked the IPHR use to: (1) integrating the IPHR into current care, (2) promoting effective patient-clinician encounters and communication and (3) their confidence in the accuracy, security and privacy of the information.
  
  
  CONCLUSIONS
  In addition to patients' stated desires for advanced functionality and information accuracy and privacy, successful adoption of the IPHRs by primary care patients depends on such technology's relevance, and on its promotion via integration with primary care practices' processes and the patient-clinician relationship. Accordingly, models of technological success and adoption, when applied to primary care, may need to include the patient-clinician relationship and practice workflow. These findings are important for healthcare providers, the information technology industry and policymakers who share an interest in encouraging patients to use personal health records.
  
  
  BACKGROUND
  Clinicaltrials.gov identifier: NCT00589173.
authors.affiliation: Shenandoah Valley Family Practice Residency, Front Royal, Virginia, USA.
authors.forename: John William
authors.initials: JW
authors.lastname: Kerns
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Krist
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Longo
authors.forename: Anton J
authors.initials: AJ
authors.lastname: Kuzel
authors.forename: Steven H
authors.initials: SH
authors.lastname: Woolf
keywords: Preventive Medicine; Primary Care; Qualitative Research
references.citation: BMC Med Inform Decis Mak. 2011 Nov 24;11:73
references.pmid: 22115059
references.citation: Med Care. 2007 Mar;45(3):245-51
references.pmid: 17304082
references.citation: N Engl J Med. 2010 Aug 5;363(6):501-4
references.pmid: 20647183
references.citation: J Med Internet Res. 2009 Apr 29;11(2):e14
references.pmid: 19403467
references.citation: Ann Fam Med. 2012 Jul-Aug;10(4):312-9
references.pmid: 22778119
references.citation: N Engl J Med. 2009 Mar 26;360(13):1276-8
references.pmid: 19321866
references.citation: Health Soc Work. 2010 Aug;35(3):163-6
references.pmid: 20853643
references.citation: JAMA. 2011 Jan 19;305(3):300-1
references.pmid: 21245186
references.citation: Ann Intern Med. 1985 Apr;102(4):520-8
references.pmid: 3977198
references.citation: Soc Sci Med. 2011 May;72(9):1570-3
references.pmid: 21497971
references.citation: JAMA. 2012 Feb 8;307(6):569-70
references.pmid: 22318276
references.citation: Am J Med Qual. 2012 Nov-Dec;27(6):494-502
references.pmid: 22517909
references.citation: Int J Med Inform. 2006 Jan;75(1):8-28
references.pmid: 16125453
references.citation: J Med Internet Res. 2013 Apr 04;15(4):e70
references.pmid: 23557596
references.citation: Med Care. 1989 Mar;27(3 Suppl):S110-27
references.pmid: 2646486
references.citation: J R Soc Med. 2009 Dec;102(12):539-44
references.pmid: 19966130
references.citation: Circulation. 2004 Jul 13;110(2):227-39
references.pmid: 15249516
references.citation: J Med Internet Res. 2010 Dec 18;12(4):e73
references.pmid: 21169163
references.citation: Arch Intern Med. 2011 Mar 28;171(6):568-74
references.pmid: 21444847
references.citation: Adv Data. 2007 Mar 12;(383):1-15
references.pmid: 17370700
references.citation: Comput Inform Nurs. 2012 Jun;30(6):330-45
references.pmid: 22411411
references.citation: Med Anthropol Q. 1996 Dec;10(4):551-74
references.pmid: 8979239
references.citation: JAMA. 2003 May 21;289(19):2560-72
references.pmid: 12748199
references.citation: Image J Nurs Sch. 1997;29(2):169-74
references.pmid: 9212515
references.citation: Int J Med Inform. 2006 Jan;75(1):29-41
references.pmid: 16129659
references.citation: J Am Board Fam Med. 2013 Mar-Apr;26(2):168-76
references.pmid: 23471930
references.citation: Health Aff (Millwood). 2010 Apr;29(4):607-13
references.pmid: 20368589
references.citation: J Am Med Inform Assoc. 2011 Jul-Aug;18(4):515-22
references.pmid: 21672914
references.citation: BMJ. 2001 Feb 24;322(7284):444-5
references.pmid: 11222407
references.citation: Health Aff (Millwood). 2009 Mar-Apr;28(2):334-44
references.pmid: 19275988