Improving Uptake and Use of Personal Health Records

描述（由申请人提供）：拟议的项目将演示和评估一种干预措施，以改善门诊环境中个人健康记录（PHR）的吸收和使用。采用率普遍较低，即使在慢性病患者，如糖尿病，虽然慢性病患者可能会受益最大的使用PHR。关键的差距存在于文献中的通过和使用PHR周围的因素，影响患者采用或拒绝PHR在通过时。虽然研究正在出现的病人使用PHRs，我们需要更好地了解PHRs在提供以病人为中心的护理及其对护理质量和协调的影响。另一个差距是缺乏对组织一级的程序和影响医生促进人权的采用和执行的因素的了解。 拟议项目的具体目标如下：（1）引入一项干预措施，部署多种战略，以改善在流动环境中对PHR的吸收和使用;（2）评估与PHR实施相关的个人和组织层面促进者和障碍相关的干预措施;（3）评估干预措施对采用率和使用率的影响;（4）分析PHR在提供以病人为中心的护理中的作用及其对护理质量和协调的影响。 公共卫生相关性：个人健康记录（PHR）是使患者更容易管理其健康并通过互联网与医生和医生办公室沟通的工具。患者可以通过跟踪他们的情况来管理他们的病情，PHR还允许他们检查他们的实验室结果，订购处方续药，并在线提问。这可能会节省患者的时间、精力和成本，并提高他们的护理质量。尽管如此，迄今为止，PHR在患者中的采用率一直很低，特别是在可能受益最多的慢性病患者中。该项目旨在通过引入针对患者和医生办公室工作人员的多种策略的干预措施来提高这些采用率。除了干预外，该项目还将评估患者采用或不采用PHR的原因、患者如何使用PHR以及PHR使用对护理质量的影响。

DESCRIPTION (Provided by the Applicant): The proposed project will demonstrate and evaluate an intervention to improve the uptake and use of personal health records (PHRs) in an ambulatory setting. Adoption rates have generally been low, even among patients with chronic conditions such as diabetes although patients with chronic diseases may stand to benefit the most from using a PHR. Critical gaps exist in the literature on the adoption and use of PHRs around the factors that influence patients to adopt or reject a PHR at the time of adoption. Although studies are now emerging on the use of PHRs by patients, we need to better understand the role of PHRs in providing patient-centered care and its impacts for quality and coordination of care. Yet another gap is the lack of knowledge about organizational-level processes and factors influencing PHR adoption and implementation. The specific aims of the proposed project are as follows: (1) Introduce an intervention deploying multiple strategies to improve the uptake and use of PHR in an ambulatory setting; (2) Evaluate the intervention with respect to individual- and organizational-level facilitators and barriers associated with PHR implementation; (3) Assess the impact of the intervention on adoption and use rates; and (4) Analyze the role of the PHR in providing patient-centered care and its impacts on quality and coordination of care. PUBLIC HEALTH RELEVANCE: Personal health records (PHRs) are tools that make it easier for patients to manage their health and to communicate with their doctors and doctor's offices via the Internet. Patients can manage their conditions, by tracking how they are doing, and PHRs also allow them to check their lab results, order prescription refills, and ask questions online. This could result in potential savings in time, effort, and cost for the patient as well as improve their quality of care. Despite this, to date PHR adoption rates among patients have been low, especially among patients with chronic conditions who might benefit most. This project seeks to improve these adoption rates by introducing an intervention with multiple strategies aimed at both patients and the staff at doctor's offices. In addition to the intervention, the project will evaluate why patients adopt or do not adopt a PHR, how patients use a PHR, and the impact of PHR use on quality of care.