RT Journal Article
SR Electronic
T1 Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 418
OP 426
DO 10.1370/afm.1691
VO 12
IS 5
A1 Alex H. Krist
A1 Steven H. Woolf
A1 Ghalib A. Bello
A1 Roy T. Sabo
A1 Daniel R. Longo
A1 Paulette Kashiri
A1 Rebecca S. Etz
A1 John Loomis
A1 Stephen F. Rothemich
A1 J. Eric Peele
A1 Jeffrey Cohn
YR 2014
UL http://www.annfammed.org/content/12/5/418.abstract
AB PURPOSE Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. METHODS We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. RESULTS A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. CONCLUSIONS By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems.