MyPreventiveCare: implementation and dissemination of an interactive preventive health record in three practice-based research networks serving disadvantaged patients--a randomized cluster trial

Alex H. Krist, Rebecca A. Aycock, Rebecca S. Etz, Jennifer Devoe, Roy T. Sabo, Robert Williams, Karen L. Stein, Gary Iwamoto, Jon Puro, Jon Deshazo, Paulette L ail Kashiri, Jill Arkind, Crystal Romney, Miria Kano, Christine Nelson, Daniel R. Longo, Susan Wolver, Steven H. Woolf

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: Evidence-based preventive services for early detection of cancer and other health conditions offer profound health benefits, yet Americans receive only half of indicated services. Policy initiatives promote the adoption of information technologies to engage patients in care. We developed a theory-driven interactive preventive health record (IPHR) to engage patients in health promotion. The model defines five levels of functionality: (1) collecting patient information, (2) integrating with electronic health records (EHRs), (3) translating information into lay language, (4) providing individualized, guideline-based clinical recommendations, and (5) facilitating patient action. It is hypothesized that personal health records (PHRs) with these higher levels of functionality will inform and activate patients in ways that simpler PHRs cannot. However, realizing this vision requires both technological advances and effective implementation based upon clinician and practice engagement.

METHODS/DESIGN: We are starting a two-phase, mixed-method trial to evaluate whether the IPHR is scalable across a large number of practices and how its uptake differs for minority and disadvantaged patients. In phase 1, 40 practices from three practice-based research networks will be randomized to add IPHR functionality to their PHR versus continue to use their existing PHR. Throughout the study, we will engage intervention practices to locally tailor IPHR content and learn how to integrate new functions into their practice workflow. In phase 2, the IPHR to all nonintervention practices to observe whether the IPHR can be implemented more broadly (Scalability). Phase 1 will feature an implementation assessment in intervention practices, based on the RE-AIM model, to measure Reach (creation of IPHR accounts by patients), Adoption (practice decision to use the IPHR), Implementation (consistency, fidelity, barriers, and facilitators of use), and Maintenance (sustained use). The incremental effect of the IPHR on receipt of cancer screening tests and shared decision-making compared to traditional PHRs will assess Effectiveness. In phase 2, we will assess similar outcomes as phase 1 except for effectiveness.

DISCUSSION: This study will yield information about the effectiveness of new health information technologies designed to actively engage patients in their care as well as information about how to effectively implement and disseminate PHRs by engaging clinicians.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT02138448.

Original languageEnglish (US)
Pages (from-to)181
Number of pages1
JournalImplementation Science
Volume9
DOIs
StatePublished - 2014
Externally publishedYes

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Vulnerable Populations
Personal Health Records
Health
Research
Early Detection of Cancer
Medical Informatics
Workflow
Electronic Health Records
Insurance Benefits
Health Promotion
Decision Making
Patient Care
Language
Maintenance
Guidelines
Technology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

MyPreventiveCare : implementation and dissemination of an interactive preventive health record in three practice-based research networks serving disadvantaged patients--a randomized cluster trial. / Krist, Alex H.; Aycock, Rebecca A.; Etz, Rebecca S.; Devoe, Jennifer; Sabo, Roy T.; Williams, Robert; Stein, Karen L.; Iwamoto, Gary; Puro, Jon; Deshazo, Jon; Kashiri, Paulette L ail; Arkind, Jill; Romney, Crystal; Kano, Miria; Nelson, Christine; Longo, Daniel R.; Wolver, Susan; Woolf, Steven H.

In: Implementation Science, Vol. 9, 2014, p. 181.

Research output: Contribution to journalArticle

Krist, AH, Aycock, RA, Etz, RS, Devoe, J, Sabo, RT, Williams, R, Stein, KL, Iwamoto, G, Puro, J, Deshazo, J, Kashiri, PLA, Arkind, J, Romney, C, Kano, M, Nelson, C, Longo, DR, Wolver, S & Woolf, SH 2014, 'MyPreventiveCare: implementation and dissemination of an interactive preventive health record in three practice-based research networks serving disadvantaged patients--a randomized cluster trial', Implementation Science, vol. 9, pp. 181. https://doi.org/10.1186/s13012-014-0181-1
Krist, Alex H. ; Aycock, Rebecca A. ; Etz, Rebecca S. ; Devoe, Jennifer ; Sabo, Roy T. ; Williams, Robert ; Stein, Karen L. ; Iwamoto, Gary ; Puro, Jon ; Deshazo, Jon ; Kashiri, Paulette L ail ; Arkind, Jill ; Romney, Crystal ; Kano, Miria ; Nelson, Christine ; Longo, Daniel R. ; Wolver, Susan ; Woolf, Steven H. / MyPreventiveCare : implementation and dissemination of an interactive preventive health record in three practice-based research networks serving disadvantaged patients--a randomized cluster trial. In: Implementation Science. 2014 ; Vol. 9. pp. 181.
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