Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record
Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record
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DOI：
10.1370/afm.1691
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发表时间：
2014-09-01
影响因子：
4.4
通讯作者：
Cohn, Jeffrey
中科院分区：
文献类型：
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作者：
Krist, Alex H.;Woolf, Steven H.;Cohn, Jeffrey
卫生保健领导者鼓励临床医生提供门户网站，使患者能够访问个人健康记录，但实施一直是一个挑战。虽然大型综合卫生系统通过昂贵的广告宣传推广使用，其他的实施方法是需要小到中型的做法，大多数患者接受他们的care.METHODS我们进行了一个积极主动的实施策略的混合方法评估的患者门户网站（互动式预防性健康记录[IPHR]）提供的8个初级保健的做法。实践实施了一系列的学习协作与实践冠军和重新设计的工作流程，将门户网站的使用纳入护理。实践实施策略，门户网站的使用，影响使用的因素进行了评估prospectively.RESULTS一个积极主动的和定制的实施策略设计的做法导致25.6%的患者使用IPHR，每月增加1.0%的速度超过31个月。整整23.5%的IPHR用户在他们访问办公室的1天内注册。老年患者和合并症患者更有可能使用IPHR，但黑人和西班牙裔患者的可能性较小。在调整合并症后，老年作为一个因素减少了。实践中的执行情况差异很大（从22.1%到27.9%，P
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