Addressing Hospital Patient Information Needs Using a PHR Portal

医疗保健研究和质量机构（AHRQ）的重点是促进以患者为中心的护理和消费者参与医疗保健决策。尽管有证据表明，知情程度更高、参与度更高的患者享有更好的健康结果，但信息需求往往得不到满足。在医院环境中尤其如此，美国每年有超过3600万患者入院。虽然消费者健康倡导组织告诫人们积极参与医疗保健，但医院患者及其家人缺乏信息可能会使他们感到焦虑和被剥夺权利。在纽约长老会医院/哥伦比亚大学医学中心，我们开发了一个住院病人个人健康记录（PHR）门户网站，为患者及其护理人员提供药物列表、护理团队信息和教育内容。该应用程序进行了试点测试与五个心胸 手术病人使用苹果iPad，病人和他们的临床护理提供者的反应非常热烈。在拟议的研究中，我们加强了现有的住院PHR门户网站，使患者能够以电子方式记录与其护理相关的问题和担忧。这些问题和担忧对我们商业住院电子健康记录（EHR）中的患者护理团队成员来说是显而易见的。一项随机对照试验旨在严格评估住院PHR门户网站对哥伦比亚大学医学中心内科和外科心脏病房患者的影响。我们将通过在加州山景的社区医院El Camino医院部署住院PHR门户来证明研究的普遍性。最后，我们将分析病人输入的问题和意见，以表征医院病人的信息需求，并评估病人输入的信息的护理质量和安全问题的显着性。拟议的研究将展示消费者健康信息技术的潜力，使患者和护理人员能够积极参与住院护理提供过程。它将推进患者-临床医生沟通领域的科学知识，展示患者及其护理团队之间共享信息的新技术能力，并提高患者的激活，参与和满意度。

DESCRIPTION (provided by applicant): A focus of the Agency for Healthcare Research and Quality (AHRQ) is promoting patient-centered care and consumer participation in healthcare decision-making. Although evidence indicates that better-informed, more engaged patients enjoy better health outcomes, information needs are often unaddressed. This is especially true in hospital settings, where there are over 36 million patient admissions each year in the United States. While consumer health advocacy groups are admonishing people to be active participants in their healthcare, the lack of information available to hospital patients and their families can make them feel anxious and disenfranchised. At NewYork-Presbyterian Hospital/Columbia University Medical Center, we have developed an inpatient personal health record (PHR) portal that provides medication lists, care team information, and educational content to patients and their caregivers. The application was pilot tested with five cardiothoracic surgery patients using Apple iPads, and the response of both patients and their clinician care providers was very enthusiastic. In the proposed study, we have enhanced the existing inpatient PHR portal to allow patients to electronically document questions and concerns related to their care. These questions and concerns are visible to members of the patients' care team within our commercial inpatient electronic health record (EHR). A randomized controlled trial is proposed to rigorously evaluate the impact of the inpatient PHR portal with patients from medical and surgical cardiac units at Columbia University Medical Center. We will demonstrate the generalizability of the research by deploying the inpatient PHR portal at El Camino Hospital, a community hospital in Mountain View, California. Finally, we will analyze patient-entered questions and comments to characterize information needs of hospital patients and assess the salience of patient-entered information to issues of care quality and safety. The proposed research will demonstrate the potential for consumer health information technology to empower patients and caregivers as active participants in the inpatient care delivery process. It will advance scientific knowledge in the field of patient-clinician communication, demonstrate new technical capabilities for sharing information among patients and their care teams, and improve patient activation, engagement and satisfaction.