title: Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.
abstract: Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current personal health record and patient portal implementation process. Further studies are needed using larger samples in other settings to ascertain if these results are generalizable to other populations.
authors.affiliation: Author Affiliations: University of Maryland School of Nursing (Drs Nahm and Zhu and Mss Sagherian and Kongs); University of Maryland Medical Center (Mss Diblasi and Gonzales); University of Maryland School of Medicine (Dr Silver), Baltimore.
authors.forename: Eun-Shim
authors.initials: ES
authors.lastname: Nahm
authors.forename: Catherine
authors.initials: C
authors.lastname: Diblasi
authors.forename: Eva
authors.initials: E
authors.lastname: Gonzales
authors.forename: Kristi
authors.initials: K
authors.lastname: Silver
authors.forename: Shijun
authors.initials: S
authors.lastname: Zhu
authors.forename: Knar
authors.initials: K
authors.lastname: Sagherian
authors.forename: Katherine
authors.initials: K
authors.lastname: Kongs
mesh_terms: D000368:Aged; D003142:Communication; D003920:Diabetes Mellitus / Q000628:therapy; D019468:Disease Management; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D055991:Health Records, Personal; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008297:Male; D062527:Meaningful Use; D008490:Medical Informatics; D008875:Middle Aged; D010349:Patient Compliance; D000072638:Patient Portals / Q000592:standards*; D018802:Patient-Centered Care / Q000592:standards*; D010817:Physician-Patient Relations; D020377:Self Efficacy; D014481:United States