Alexander G Fiks1, Stephanie L Mayne2, Dean J Karavite3, Andrew Suh2, Ryan O'Hara3, A Russell Localio4, Michelle Ross4, Robert W Grundmeier5. 1. The Pediatric Research Consortium, Center for Biomedical Informatics, PolicyLab, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Departments of Pediatrics, and fiks@email.chop.edu. 2. PolicyLab, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and. 3. Center for Biomedical Informatics. 4. Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 5. The Pediatric Research Consortium, Center for Biomedical Informatics, Departments of Pediatrics, and.
Abstract
BACKGROUND:Electronic health record (EHR)-linked patient portals are a promising approach to facilitate shared decision-making between families of children with chronic conditions and pediatricians. This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma. METHODS: We conducted a 6-month randomized controlled trial of MyAsthma at 3 primary care practices. Families were randomized to MyAsthma, which tracks families' asthma treatment concerns and goals, children's asthma symptoms, medication side effects and adherence, and provides decision support, or to standard care. Outcomes included the feasibility and acceptability of MyAsthma for families, child health care utilization and asthma control, and the number of days of missed school (child) and work (parent). Descriptive statistics and longitudinal regression models assessed differences in outcomes between study arms. RESULTS:We enrolled 60 families, 30 in each study arm (mean age 8.3 years); 57% of parents in the intervention group used MyAsthma during at least 5 of the 6 study months. Parents of children with moderate to severe persistent asthma used the portal more than others; 92% were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment. Parents in the intervention group reported that children had a lower frequency of asthma flares and intervention parents missed fewer days of work due to asthma. CONCLUSIONS: Use of an EHR-linked asthma portal was feasible and acceptable to families and improved clinically meaningful outcomes.
RCT Entities:
BACKGROUND: Electronic health record (EHR)-linked patient portals are a promising approach to facilitate shared decision-making between families of children with chronic conditions and pediatricians. This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma. METHODS: We conducted a 6-month randomized controlled trial of MyAsthma at 3 primary care practices. Families were randomized to MyAsthma, which tracks families' asthma treatment concerns and goals, children's asthma symptoms, medication side effects and adherence, and provides decision support, or to standard care. Outcomes included the feasibility and acceptability of MyAsthma for families, child health care utilization and asthma control, and the number of days of missed school (child) and work (parent). Descriptive statistics and longitudinal regression models assessed differences in outcomes between study arms. RESULTS: We enrolled 60 families, 30 in each study arm (mean age 8.3 years); 57% of parents in the intervention group used MyAsthma during at least 5 of the 6 study months. Parents of children with moderate to severe persistent asthma used the portal more than others; 92% were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment. Parents in the intervention group reported that children had a lower frequency of asthma flares and intervention parents missed fewer days of work due to asthma. CONCLUSIONS: Use of an EHR-linked asthma portal was feasible and acceptable to families and improved clinically meaningful outcomes.
Authors: Alexandra E Shields; Peter Shin; Michael G Leu; Douglas E Levy; Renée Marie Betancourt; Dan Hawkins; Michelle Proser Journal: Health Aff (Millwood) Date: 2007 Sep-Oct Impact factor: 6.301
Authors: Alexander G Fiks; A Russell Localio; Evaline A Alessandrini; David A Asch; James P Guevara Journal: Pediatrics Date: 2010-07-12 Impact factor: 7.124
Authors: Alexander G Fiks; Stephanie Mayne; A Russell Localio; Evaline A Alessandrini; James P Guevara Journal: Pediatrics Date: 2011-12-19 Impact factor: 7.124
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