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

Project Final Report (PDF, 508.38 KB) Disclaimer

Project Details -
Completed

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.