Evaluating the Effectiveness of a Health Information Technology Self-Management Program for Chronic Disease (Maine)

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Summary:

According to a statewide community health needs assessment, care and treatment of chronic conditions represent some of the highest health care costs in Eastern Maine. A patient portal has the potential to improve care for patients with chronic conditions and reduce health care costs, especially for individuals in medically underserved areas. This project implemented a patient portal and evaluated its impact on health care utilization and patient-reported health outcomes among patients with chronic conditions at five primary care practices.

The specific aims of this project were as follows:

  • Develop the interfaces between the electronic medical records and the patient portal with the disease-specific plan-of-care forms and patient-referred information. 
  • Evaluate the implementation and effectiveness of the inclusion of the Web-based patient portal into the plan-of-care process by assessing the perception of the users, including system adoption and satisfaction by patients, care managers, and providers. 
  • Assess the perceptions of non-users of the patient portal to identify barriers to adoption. 
  • Assess health care utilization related to tertiary and urgent care uses. 
  • Evaluate self efficacy, functional status, clinical outcomes, and plan-of-care adherence rate among the high-risk, high-cost chronic disease patients using the Web-based patient portal. 

A study was conducted to compare outcomes before and after implementation of the patient portal. Patients were enrolled in the portal and asked to complete a wellness questionnaire at the start and end of the study. More than 80 percent of wellness questionnaires required provider followup outside of scheduled office visits for mental health, physical function, fall risk, and pain issues. By the end of the study, patient functional status significantly improved and health care utilization decreased. Adoption of the portal was limited by a need for changes in the provider workflow and technology reliability. Overall, the patient portal enhanced care management.

Evaluating the Effectiveness of a Health Information Technology Self-Management Program for Chronic Disease - 2012

Summary Highlights

  • Principal Investigator: 
  • Funding Mechanism: 
    RFA: HS08-269: Exploratory and Developmental Grant to Improve Health Care Quality Through Health Information Technology (IT) (R21)
  • Grant Number: 
    R21 HS 021005
  • Project Period: 
    June 2012 – June 2014
  • AHRQ Funding Amount: 
    $298,849
  • PDF Version: 
    (PDF, 287.3 KB)

Summary: According to a recent statewide community health needs assessment, care and treatment of chronic conditions represent some of the highest health care costs in Eastern Maine. Health information technology has the potential to improve the lives of patients with chronic conditions as well as to reduce health care costs, especially for those in medically underserved areas. This project aims to improve care coordination between health care providers, patients, and care managers by implementing and evaluating an interactive patient-centered Web-based portal that is embedded in the electronic medical record (EMR) in five primary care practices. The target population is patients who have diabetes mellitus, chronic obstructive pulmonary disease, and/or congestive heart failure within an advanced patient-centered medical home environment.

Specific Aims:

  • Develop the interface between the EMR and the patient portal with the disease-specific plan of care forms and patient-referred information. (Ongoing)
  • Implement and evaluate the effectiveness of the comprehensive patient portal. (Ongoing)

2012 Activities: The project is in the start-up phase. Dr. Sorondo and the research team are developing a smart wellness questionnaire that will be embedded into the patient portal and stored in the EMR for provider use. The goal of the survey is to assess patient outcomes, functional status, self-efficacy, quality of life, wellness, and patient health risk assessment. The research team is mapping the survey questions to the data elements in the EMR to determine if any new fields need to be added to accommodate the survey. As last self-reported in the AHRQ Research Reporting System, project progress and activities are on track, and project spending is somewhat underspent to save funds for more cost-intensive activities.

Preliminary Impact and Findings: There are no findings to date.

Target Population: Adults, Chronic Care*, Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF), Diabetes

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to support patient-centered care, the coordination of care across transitions in care settings, and the use of electronic exchange of health information to improve quality of care.

Business Goal: Implementation and Use

* This target population is one of AHRQ’s priority populations.

Evaluating the Effectiveness of a Health Information Technology Self-Management Program for Chronic Disease - Final Report

Citation:
Sorondo, B. Evaluating the Effectiveness of a Health Information Technology Self-Management Program for Chronic Disease - Final Report. (Prepared by Eastern Maine Medical Center under Grant No. R21 HS021005). Rockville, MD: Agency for Healthcare Research and Quality, 2015. (PDF, 508.38 KB)

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. 
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