An Electronic Personal Health Record for Mental Health Consumers

描述（由申请人提供）：护理质量差可能是严重精神障碍患者发病率过高的重要风险因素。电子个人健康记录（PHR）有望通过将健康记录的所有权和所在地从分散在多个提供者到纵向和以患者为中心的转变来帮助重塑医疗保健。考虑到严重精神障碍患者面临的复杂的健康需求和零散的护理，这些人可以从PHR中获得特别的好处。 为填补这方面的空白，我们建议修改现行的医疗保健制度，以配合严重精神病患者的需要。PHR将建立在共享护理计划的基础上，该计划是在医疗消费者的广泛投入下开发的，并在美国和国外的一些社区中积极使用。该研究小组包括共享护理计划的开发人员，质量改进和信息学专家，心理健康消费者领袖以及健康服务和干预研究人员。 在研究的第一阶段，定性方法将用于纳入心理健康消费者，提供者和初级保健提供者的输入，以适应精神障碍和一种或多种共病医疗条件的人的共享护理计划。内容将根据这些信息进行修改，并对程序进行电子增强。在研究的第二阶段，将进行一项为期12个月的随机试验，以评估MH-PHR对患有严重精神疾病和一种或多种共病医学状况的人的护理的影响。分析将测试干预措施对患者激活、慢性病的提供者和系统级管理以及医疗和精神卫生保健质量的影响。在研究的最后阶段，PHR将通过国家和州精神卫生消费者和提供者组织传播。 为心理健康消费者开发个人健康记录有可能帮助提高护理质量，其方式与这些人的价值观和优先事项高度一致。MH-PHR的成本相对较低且易于传播，再加上与国家和地区精神卫生宣传和提供者团体的合作，将有助于确保该项目产生重大的公共卫生影响

DESCRIPTION (provided by the applicant): Poor quality of care may be an important risk factor for excess rates of morbidity in persons with serious mental disorders. Electronic Personal Health Records (PHRs) hold promise in helping reshape healthcare by shifting the ownership and locus of health records from being scattered across multiple providers to being longitudinal and patient-centered. Given the complex health needs and the fragmentation of care faced by individuals with serious mental disorders, these individuals could derive particular benefit from a PHR. However, there are currently no established web-based PHRs available for this population. In order to fill this gap, we propose to adapt an existing medical PHR to fit the needs of persons with serious mental disorders. The PHR will build on the Shared Care Plan, a PHR that was developed with extensive input from medical consumers and is in active use in a number of communities in the United States and abroad. The study team includes the developers of the Shared Care Plan, quality improvement and informatics experts, mental health consumer leaders, and health services and intervention researchers. During the first phase of the study, qualitative methods will be used to incorporate input from mental health consumers, providers, and primary care providers to adapt the Shared Care Plan for persons with mental disorders and one or more comorbid medical condition. Content will be modified and electronic enhancements made to the program based on this information. During the second phase of the study, a 12-month, randomized trial will be conducted to assess the impact of the MH-PHR on care for persons with serious mental illness and one or more comorbid medical condition. Analyses will test the impact of the intervention on patient activation, provider and system-level management of chronic illness, and quality of medical and mental health care. During the final phase of the study, the PHR will be disseminated via national and state mental health consumer and provider organizations. Developing a personal health record for mental health consumers has the potential to help improve quality of care in a manner that is highly consistent with these individuals' values and priorities. The relative low cost and ease of dissemination of the MH-PHR, coupled with partnerships with national and regional mental health advocacy and provider groups, will help ensure that this project has a major public health impact