PURPOSE: To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services. METHODS: A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4%) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported. RESULTS: No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7% of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use. CONCLUSIONS: Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use. CLINICAL TRIAL REGISTRATION NUMBER: http://ClinicalTrials.gov Identifier: NCT01317537.
RCT Entities:
PURPOSE: To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services. METHODS: A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4%) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported. RESULTS: No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7% of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use. CONCLUSIONS: Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use. CLINICAL TRIAL REGISTRATION NUMBER: http://ClinicalTrials.gov Identifier: NCT01317537.
Authors: Cyrus K Yamin; Srinivas Emani; Deborah H Williams; Stuart R Lipsitz; Andrew S Karson; Jonathan S Wald; David W Bates Journal: Arch Intern Med Date: 2011-03-28
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Mark A Earnest; Stephen E Ross; Loretta Wittevrongel; Laurie A Moore; Chen-Tan Lin Journal: J Am Med Inform Assoc Date: 2004-06-07 Impact factor: 4.497
Authors: Andrea Hassol; James M Walker; David Kidder; Kim Rokita; David Young; Steven Pierdon; Deborah Deitz; Sarah Kuck; Eduardo Ortiz Journal: J Am Med Inform Assoc Date: 2004-08-06 Impact factor: 4.497
Authors: Stephen E Ross; Laurie A Moore; Mark A Earnest; Loretta Wittevrongel; Chen-Tan Lin Journal: J Med Internet Res Date: 2004-05-14 Impact factor: 5.428
Authors: Traber Davis Giardina; Shailaja Menon; Danielle E Parrish; Dean F Sittig; Hardeep Singh Journal: J Am Med Inform Assoc Date: 2013-10-23 Impact factor: 4.497
Authors: Kyungsook Gartrell; Carla L Storr; Alison M Trinkoff; Marisa L Wilson; Ayse P Gurses Journal: Nurs Outlook Date: 2014-11-28 Impact factor: 3.250
Authors: Elizabeth A Chrischilles; Juan Pablo Hourcade; William Doucette; David Eichmann; Brian Gryzlak; Ryan Lorentzen; Kara Wright; Elena Letuchy; Michael Mueller; Karen Farris; Barcey Levy Journal: J Am Med Inform Assoc Date: 2013-12-10 Impact factor: 4.497
Authors: Rebecca G Mishuris; Max Stewart; Gemmae M Fix; Thomas Marcello; D Keith McInnes; Timothy P Hogan; Judith B Boardman; Steven R Simon Journal: Health Expect Date: 2014-05-12 Impact factor: 3.377