Impact of a Wellness Portal on the Delivery of Patient-Centered Prospective Care (Oklahoma)

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Summary:

As the number of recommended preventive services continues to increase, clinicians struggle to maintain a balance between immediate patient concerns and the time required to address prevention. Optimal delivery of primary, secondary, and tertiary preventive services will increasingly require sophisticated information processing and significantly greater patient involvement. Despite the importance of patient-centered delivery approaches, little information is available on the impact of integrated health information technologies on the delivery of patient centered, preventive care in primary care settings.

The primary purpose of this completed study was to evaluate the impact of a Web-based patient Wellness Portal on the delivery of individualized patient-centered preventive care from the perspectives of both patients and primary care clinicians. Specific objectives of this study were to:

  • Develop, field test, and refine an Internet-based patient Wellness Portal linked to Preventative Services Reminder System to facilitate patient-centered, preventive care in primary care practices.
  • Determine the impact of the Wellness Portal on the process of patient-centered preventive care by examining the behavior and experiences of both patients and providers and the degree to which recommended services are individualized.
  • Develop model Wellness Portal practices and disseminate the Wellness Portal technology and knowledge derived from the first two objectives above.

The team found that a comprehensive patient portal integrated into the regular process of care delivery can increase the patient-centeredness of care, enhance the delivery of both age and personal risk factor -dependent preventive services, improve patient activation, promote the utilization of web-based personal health records, and increase the knowledge of clinicians about their patients' medical history in primary care settings.

Impact of a Wellness Portal on the Delivery of Patient-Centered Prospective Care - 2010

Summary Highlights

  • Principal Investigator: 
  • Funding Mechanism: 
    RFA: HS07-007: Ambulatory Safety and Quality Program: Enabling Patient-Centered Care (PCC) Through Health Information Technology
  • Grant Number: 
    R18 HS 017188
  • Project Period: 
    October 2007 – December 2011, Including No-Cost Extension
  • AHRQ Funding Amount: 
    $902,411
  • PDF Version: 
    (PDF, 366.78 KB)


Target Population: Adults, Pediatric*

Summary: As the number of recommended preventive services continues to increase, clinicians struggle to maintain a balance between immediate patient concerns and the time required to address prevention. If effective and timely clinical decision support is not integrated into a comprehensive care delivery approach (e.g., the Chronic Care Model), and patient-centered tailoring of recommendations is not incorporated, primary care clinicians' performance in this area will not improve from the current suboptimal levels—40 to 60 percent rates of delivery of well-accepted preventive services. Optimal delivery of primary, secondary, and tertiary preventive services will increasingly require sophisticated information processing and much greater patient involvement.

This project develops and tests an Internet-based patient-centered Wellness Portal to allow patient access to the Preventive Services Reminder System (PSRS), a pre-existing, internally-developed clinical tool for improving the delivery of patient-centered preventive services. Practices within the Oklahoma Physicians Resource/Research Network (OKPRN) use the PSRS. The PSRS contains a patient registry, preventive service reminders according to evidence-based guidelines, an electronic chart-auditing and patient recall tool for clinical decision support, patient education materials, and a 3-year prospective wellness plan. The project team members have enhanced functionality of the PSRS by allowing patient access via the Wellness Portal, which patients can access through their home computer or provider office kiosks. The Wellness Portal allows patients to securely input personal information on their health behaviors and wellness status in order to personalize their wellness plan through the risk assessment algorithm. In addition, the Portal would allow patients to securely contact their provider and schedule visits, transfer their wellness record to other providers using the Continuity of Care Record interface, and review educational materials.

The Wellness Portal project enrolled guardians of children (6 years old and younger) and adult patients (50 years or older) at four clinician practices within a primary care practice-based research network in Oklahoma. The research team conducted a 12-month randomized controlled trial with four intervention and four control OKPRN practices to elucidate whether the Wellness Portal improves the delivery of appropriate preventive services at the right time; increases patient experience with patient-centered care; enhances patient activation; and improves delivery of preventive services controlled for the level of utilization, patient demographics, and health status.

Specific Aims:
  • Develop, field test, and refine an Internet-based patient Wellness Portal linked to PSRS to facilitate patient-centered, preventive care in primary care practices. (Achieved)
  • Determine the impact of the Wellness Portal on the process of patient-centered preventive care by examining the behavior and experiences of both patients and providers, and the degree to which recommended services are individualized. (Achieved)
  • Develop model Wellness Portal practices, and disseminate the Wellness Portal technology and knowledge derived from findings from the first two aims. (Achieved)

2010 Activities: The participating practices were visited to provide assistance, as required, to make the Wellness Portal available to patients at the practice site and through home computers.

The team continued development of presentation materials and work on articles for publication in peer-reviewed journals. Dissemination activities have resulted in the development of several brochures to encourage patients and practices to make the Wellness Portal a part of routine patient care. In addition to these dissemination activities, the project contracted with a public relations firm to provide additional brochures for patients and clinicians, posters for clinicians' offices, and a Web page design to facilitate electronic distribution.

During 2010, the project’s primary focus has been on continuing the intervention and collecting data. Post intervention data was collected at each of the eight sites through chart audits. Data has been cleaned and most analyses completed. Each of the providers in the intervention practices was interviewed to understand his or her perspective regarding the project impact. These interviews were digitally recorded and transcribed, and will be analyzed using coding procedures supported by NVivo software.

Grantee’s Most Recent Self-Reported Quarterly Status (as of December 2010): Project progress was on track, with all aims were completed. The team completed data collection and analysis and when the grant ended, the team was in the final stages of writing up final results, including submission of manuscripts to peer reviewed journals.

Preliminary Impact and Findings: Preliminary data with a sub-set of the final data showed significant improvement in preventive services in the intervention practices compared with control practices. An article describing the preliminary data analysis has been produced and is now in press. Additional findings will be presented in forthcoming manuscripts.

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

*AHRQ Priority Population.

Impact of a Wellness Portal on the Delivery of Patient-Centered Preventive Care - Final Report

Citation:
Mold JW. Impact of a Wellness Portal on the Delivery of Patient-Centered Preventive Care - Final Report. (Prepared by the University of Oklahoma Health Sciences Center Department of Family & Preventive Medicine under Grant No. R18 HS017188). Rockville, MD: Agency for Healthcare Research and Quality, 2010. (PDF, 778.52 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.
Principal Investigator: 
Document Type: 
Population: 

Wellness Portal Satisfaction Questionnaire: Clinicians

This is a questionnaire designed to be completed by clinical staff in an ambulatory setting. The tool includes questions to assess user's satisfaction of personal health records.

Year of Survey: 
Created prior to 2010
Survey Link: 
Wellness Portal Satisfaction Questionnaire: Clinicians (PDF, 57.32 KB)
Document Type: 
Research Method: 
Population: 
Care Setting: 
Copyright Status: 
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.

Wellness Portal User Satisfaction Survey: Patients

This is a questionnaire designed to be completed by patients in ambulatory and home settings. The tool includes questions to assess user's satisfaction of personal health records.

Year of Survey: 
Created prior to 2010
Survey Link: 
Wellness Portal User Satisfaction Survey: Patients (PDF, 54.57 KB)
Document Type: 
Research Method: 
Population: 
Copyright Status: 
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
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