Engaging Disadvantaged Patients in Sharing Patient-Generated Health Data and Patient-Reported Outcomes Through Health Information Technology (Colorado)

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Engaging Disadvantaged Patients in Sharing Patient-Generated Health Data and Patient-Reported Outcomes through Health Information Technology - Final Report

Citation:
Moore S. Engaging Disadvantaged Patients in Sharing Patient-Generated Health Data and Patient-Reported Outcomes through Health Information Technology - Final Report. (Prepared by Denver Health and Hospital Authority under Grant No. R21 HS025505). Rockville, MD: Agency for Healthcare Research and Quality, 2020. (PDF, 605.18 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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Commercial off-the-shelf technology, including mobile phones and fitness trackers, can successfully engage disadvantaged patients to collect patient-generated health data and patient-reported outcomes that can be integrated into electronic health records to improve chronic disease care planning during clinical visits.

Summary:

Patient engagement is critically important in achieving good chronic disease management. Obtaining patient-generated health data (PGHD) and patient-reported outcomes (PROs) from engaged patients can help improve chronic disease management in primary care. This is especially important for disadvantaged patients who are disproportionately affected by chronic disease. While health information technology (IT) solutions have been shown to improve chronic disease self-management, adoption and use of costly, specialized technologies among disadvantaged patients is lower than among higher-income populations. In contrast, commercial off-the-shelf (COTS) technologies, such as mobile phones and fitness trackers, are more accessible to and widely adopted by disadvantaged patients.

This study tested the hypothesis that low-income, disadvantaged patients both can and will provide high-quality PGHD and PROs through these COTS health IT solutions and that these data can be integrated into clinical systems and used to improve healthcare quality and delivery.

The specific aims of the research were as follows:

  • Assess the needs and preferences of disadvantaged patients and the primary care providers who care for them regarding the use of health IT to collect PGHD and PROs. 
  • Demonstrate the feasibility of PGHD and PROs collection through COTS health IT solutions in a randomized controlled trial of a patient-centered intervention for weight management. 
  • Create an ontology mapping tool and a set of interoperability resources that can be used to support integration of PGHD and PROs into electronic health records (EHRs) and other clinical information systems. 

Researchers employed a sequential integrated mixed methods approach with three phases: 1) a qualitative formative phase; 2) a randomized controlled trial to assess PGHD and PROs data collection feasibility through COTS health IT solutions; and 3) development of a data model, terminology map, and set of Fast Healthcare Interoperability Resources to facilitate future data integration into clinical information systems. Having PGHD and PROs readily available to providers through integration into clinical workflows and EHRs makes these data actionable for use in care planning during clinical visits, thus improving the quality of care. The results of this study suggest that appropriate mobile technology can be used to increase engagement among disadvantaged patients, with the potential to improve chronic disease management.