Addressing Hospital Patient Information Needs Using a Personal Health Record Portal (New York)

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 encouraging people to be active participants in their health care, the lack of information available to hospital patients and their families, and resulting unanswered questions about their care can often leave them feeling isolated and afraid.  

New York-Presbyterian Hospital/Columbia University Medical Center has 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 electronic tablets, and the response of both patients and their clinician care providers was enthusiastic. In the proposed study, the existing inpatient PHR portal will be enhanced to allow patients to electronically document questions and concerns related to their care while in the hospital. These questions and concerns are visible to members of the patients’ care team within a commercial inpatient electronic health record. 

A randomized controlled trial will be conducted to rigorously evaluate the impact of the inpatient PHR portal with patients from medical and surgical cardiac units at Columbia University Medical Center. The project team will attempt to demonstrate the generalizability of the research by deploying the inpatient PHR portal at El Camino Hospital, a community hospital in Mountain View, California. The team will analyze patient-entered questions and comments to characterize information needs of hospital patients. 

The specific aims of the proposal are to:  

• Evaluate the impact of an inpatient PHR portal intervention using a randomized controlled trial.
• Demonstrate the generalizability of the inpatient PHR application by deploying it at El Camino Hospital in Mountain View, California.
• Characterize information needs of hospital patients and assess clinicians’ attitudes toward patient engagement in the hospital setting.  

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.