Patient Reminders and Notifications

描述（由申请人提供）：患者提醒和通知在帮助人们达到健康目标方面是有效的。他们提醒人们安排医疗访问和筛查，提醒人们如何采取复杂的医疗方案，并在患者，提供者和卫生保健系统之间提供联系。大多数关于提醒的研究都集中在单一的卫生保健需求或条件上，并使用单一的途径，如邮政邮件或电话。我们缺乏关于包含患者多种慢性和预防性卫生保健需求的提醒和通知系统的知识。我们对如何将提醒和通知整合到与患者沟通的新形式（包括短信、移动电话应用程序和与电子健康记录链接的患者网站）知之甚少。当与功能齐全的电子健康记录相结合时，新的通信技术提供了一个机会，可以更频繁地与患者联系，并提供比以前更全面的提醒和通知。尽管有这样的承诺，但如果设计不当，提醒和通知可能会让患者感到压力或烦恼，并破坏其效果。在本项目中，我们将首先通过了解患者工作流程模型、用户需求和上下文因素，确定患者对通知和提醒的需求和偏好。接下来，我们将通过构建和测试患者控制的健康提醒和通知系统原型，明确核心设计元素，并建立与以患者为中心的医疗之家集成的可行性。为了解决用户需求和偏好的多样性，我们将重点关注两种具有不同慢性和预防性保健问题的常见人群，他们将受益于有效的提醒和通知系统：患有哮喘（儿童中最常见的慢性疾病）的12岁以下儿童的母亲；还有患有多种其他慢性疾病的糖尿病患者。我们将在团体健康合作社（Group Health）的成员中进行研究，这是一个大型的综合医疗保健系统，有超过65%的登记人口使用患者网站和移动应用程序，通过电子健康记录进行护理。Group Health实施了以患者为中心的医疗家庭模式，并通过电子健康记录与患者和家庭进行互动，使其成为开展这项工作的理想环境。医疗之家和电子病历正在稳步渗透到全国的医疗保健系统中。这项工作将为提醒和通知系统提供关键的设计元素，可以广泛地为护理重新设计提供信息。这项工作的结果将为卫生保健组织、卫生信息技术开发人员和卫生保健研究人员提供信息。

DESCRIPTION (provided by applicant): Patient reminders and notifications are effective at helping people reach health goals. They alert people to schedule medical visits and screenings, remind people how to take complex medical regimens, and provide a liaison between patients, providers, and the health care system. Most studies of reminders have focused on a single health care need or condition and have used a single route, such as postal mail or the telephone. We lack knowledge about reminder and notification systems that incorporate the breadth of patients' multiple chronic and preventive health care needs. We know little about how to incorporate reminders and notifications into newer forms of communication with patients including text messaging, mobile phone applications, and patient websites linked to electronic health records. When combined with fully functional electronic health records, new communication technologies are an opportunity to contact patients more often with a more comprehensive set of reminders and notifications than previously possible. Despite their promise, reminders and notifications, if poorly designed, can overwhelm or annoy patients and undermine their effectiveness. In this project, we will first establish the needs and preferences o patients for notifications and reminders through an understanding of patient workflow models, user requirements, and contextual factors. Next, we will clarify core design elements through building and testing a prototype of a patient-controlled health reminder and notification system and establish feasibility of integration with the patient-centered medical home. To address the diversity of user needs and preferences, we will focus on two common populations with different chronic and preventive care issues who would benefit from effective reminder and notification systems: mothers with children under age 12 who have asthma, the most common chronic condition among children; and individuals with diabetes who have multiple other chronic conditions. We will perform our study among members of Group Health Cooperative (Group Health), a large, integrated health care system with a patient website and mobile application used by more than 65 percent of the enrolled population to engage in care through an electronic health record. Group Health's implementation of a patient-centered medical home model and experience interacting with patients and families through the electronic health record make it an ideal environment for this work. The medical home and electronic medical records are steadily permeating health care systems across the country. This work will provide the key design elements for reminder and notification systems that could broadly inform care redesign. The results of this work will be informative to health care organizations, health information technology developers, and health care researchers.