Designing a patient-centered personal health record to promote preventive care.
Designing a patient-centered personal health record to promote preventive care.
复制标题
DOI：
10.1186/1472-6947-11-73
复制
发表时间：
2011-11-24
影响因子：
3.5
通讯作者：
Kuzel AJ
中科院分区：
文献类型：
--
作者：
Krist AH;Peele E;Woolf SH;Rothemich SF;Loomis JF;Longo DR;Kuzel AJ
循证预防服务可带来深远的健康益处，但美国人只得到一半的指示护理。各种政府和专业协会政策举措正在促进采用信息技术来让患者参与护理，例如个人健康记录，但当前的系统可能无法充分利用该技术的潜力。利用先前描述的模型，使信息技术更加以患者为中心，我们开发了交互式预防性健康记录 (IPHR)，旨在让患者更深入地参与预防性护理和健康促进。我们招募了 14 个初级保健机构来向所有成年患者推广 IPHR，并在设计 IPHR 时寻求实践和患者的意见，以确保其可用性、显着性和普遍性。输入内容包括患者可用性测试、实践工作流程观察、学习协作和患者反馈。 IPHR 的使用情况是通过执业预约和 IPHR 数据库来衡量的。此过程中产生的 IPHR 根据美国预防服务工作组和其他组织的指导方针生成量身定制的患者建议。它从诊所的电子病历中提取临床数据，并获取患者的健康风险评估信息。临床内容以通俗语言翻译和解释。建议审查服务的益处和不确定性以及患者和临床医生可能采取的行动。建议中包含自我管理工具、风险计算器、决策辅助工具和社区资源——根据患者的临床情况进行选择。六个月内，诊所鼓励 14.4% 的患者使用 IPHR（14 家诊所的比例从 1.5% 到 28.3%）。实践成功地将IPHR纳入工作流程，用它来为患者就诊做好准备，增强健康行为咨询，解释测试结果，自动向患者发出逾期服务提醒，提示临床医生所需的服务，并制定个性化的预防计划。 IPHR 表明，以患者为中心的个人健康记录与电子病历相结合，可以为患者提供高水平的个性化指导，并被繁忙的初级保健实践成功采用。需要进一步的研究和完善，以使信息系统更加以患者为中心，并展示其对护理的影响。 ClinicalTrials.gov 标识符：NCT00589173
Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential. Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR) designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases. The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices). Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results, automatically issue patient reminders for overdue services, prompt clinicians about needed services, and formulate personalized prevention plans. The IPHR demonstrates that a patient-centered personal health record that interfaces with the electronic medical record can give patients a high level of individualized guidance and be successfully adopted by busy primary care practices. Further study and refinement are necessary to make information systems even more patient-centered and to demonstrate their impact on care. Clinicaltrials.gov identifier: NCT00589173
登录
查看更多内容
影响因子：
2.4
作者：
Glasgow, Russell E.;Klesges, Lisa M.;Vogt, Thomas M.
通讯作者：
Vogt, Thomas M.
影响因子：
9.7
作者：
Silvestre, Anna-Lisa;Sue, Valerie M.;Allen, Jill Y.
通讯作者：
Allen, Jill Y.
影响因子：
120.7
作者：
Sirovich, BE;Schwartz, LM;Woloshin, S
通讯作者：
Woloshin, S
影响因子：
37.8
作者：
Grundy, SM;Cleeman, JI;Stone, NJ
通讯作者：
Stone, NJ
影响因子：
9.7
作者：
Kahn, James S.;Aulakh, Veenu;Bosworth, Adam
通讯作者：
Bosworth, Adam