PT  - JOURNAL ARTICLE
AU  - Alex H. Krist
AU  - Steven H. Woolf
AU  - Stephen F. Rothemich
AU  - Robert E. Johnson
AU  - J. Eric Peele
AU  - Tina D. Cunningham
AU  - Daniel R. Longo
AU  - Ghalib A. Bello
AU  - Gary R. Matzke
TI  - Interactive Preventive Health Record to Enhance Delivery of Recommended Care: A Randomized Trial
AID  - 10.1370/afm.1383
DP  - 2012 Jul 01
TA  - The Annals of Family Medicine
PG  - 312--319
VI  - 10
IP  - 4
4099  - http://www.annfammed.org/content/10/4/312.short
4100  - http://www.annfammed.org/content/10/4/312.full
SO  - Ann Fam Med2012 Jul 01; 10
AB  - PURPOSE Americans receive only one-half of recommended preventive services. Information technologies have been advocated to engage patients. We tested the effectiveness of an interactive preventive health record (IPHR) that links patients to their clinician’s record, explains information in lay language, displays tailored recommendations and educational resources, and generates reminders. METHODS This randomized controlled trial involved 8 primary care practices. Four thousand five hundred patients were randomly selected to receive a mailed invitation to use the IPHR or usual care. Outcomes were measured using patient surveys and electronic medical record data and included IPHR use and service delivery. Comparisons were made between invited and usual-care patients and between users and nonusers among those invited to use the IPHR. RESULTS At 4 and 16 months, 229 (10.2%) and 378 (16.8%) of invited patients used the IPHR. The proportion of patients up-to-date with all services increased between baseline and 16 months by 3.8% among intervention patients (from 11.4% to 15.2%, P <.001) and by 1.5% among control patients (from 11.1% to 12.6%, P = .07), a difference of 2.3% (P = .05). Greater increases were observed among patients who used the IPHR. At 16 months, 25.1% of users were up-to-date with all services, double the rate among nonusers. At 4 months, delivery of colorectal, breast, and cervical cancer screening increased by 19%, 15%, and 13%, respectively, among users. CONCLUSIONS Information systems that feature patient-centered functionality, such as the IPHR, have potential to increase preventive service delivery. Engaging more patients to use systems could have important public health benefits.