An Interactive Preventive Health Record (IPHR) to Promote Patient-Centered Care

The Interactive Preventive Health Record (IPHR) is a personal health record that was created and tested to make preventive information actionable for patients. The IPHR gives patients direct access to information in their clinician's electronic medical record (EMR), displays tailored recommendations, provides links to online educational resources, delivers individualized self-management resources, and generates patient and clinician reminders. This project sought to test whether a particular IPHR, MyPreventiveCare, which provided this kind of highly personalized online resource, would increase the delivery of recommended preventive services. The project used a randomized controlled trial involving 5,500 patients invited to use the IPHR or receive usual care in eight primary care practices. Outcomes were assessed using data from the practices' EMR and patient surveys.

The main objectives of this study were to:

1. Evaluate whether an invitation from a patient's primary care clinician to use MyPreventiveCare results in use of the system.
2. Evaluate whether an invitation from a patient's primary care clinician to use MyPreventiveCare results in increased delivery of age- and gender-appropriate clinical preventive services.
3. Evaluate whether an invitation from a patient's primary care clinician to use MyPreventiveCare results in increased shared decisionmaking for preventive services.
4. Evaluate whether an invitation from a patient's primary care clinician to use MyPreventiveCare results in improved clinician-patient communication about preventive needs.

This study demonstrated that MyPreventiveCare can be integrated into a variety of EMRs and into the clinical workflow of small, medium, and large practices in rural, suburban, and urban areas. Early findings show that patients who use MyPreventiveCare are on average 5 percent more up-to-date on their screenings than patients who do not use the IPHR. Screenings for colonoscopies increased by as much as 12 percent, and for mammograms by as much as 16 percent. Patients also benefited from MyPreventiveCare-generated appointments and health tips.

The project continues to look for new ways to add value to MyPreventiveCare for physicians and patients. As part of a Centers for Medicare and Medicaid Services (CMS) initiative, physicians can receive incentive payment for reporting certain data. In July 2010, MyPreventiveCare was officially recognized by CMS as a qualified Physician Quality Reporting Initiative reporting registry. As a result, it is easier for practices that use MyPreventiveCare to report CMS quality measures.