Patient-Centered Informatics System to Enhance Health Care in Rural Communities
Project Final Report (PDF, 408.37 KB) Disclaimer
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.
Disclaimer
Disclaimer details
Project Details -
Completed
-
Grant NumberR18 HS017308
-
AHRQ Funded Amount$1,160,659
-
Principal Investigator(s)
-
Organization
-
LocationSalt Lake CityUtah
-
Project Dates09/30/2007 - 09/29/2011
-
Care Setting
-
Type of Care
-
Health Care Theme
This demonstration project was conducted to evaluate whether the Unified Health Resource (UHR) led to more patient-centered care in rural communities in the Intermountain West. The UHR combines a personal health record, an electronic medical record (EMR), and a communication system to promote shared-decisionmaking, patient activation, and health management. It provides patients with enhanced control of their own health data, increased options for solving personal health issues, and improved access and continuity of clinical care. This health information technology supports a new model of interaction between clinicians and patients, aiming to increase the patient-centeredness of care.
The aims of the project were to:
- Recruit two rural primary care clinics that use UHR and two primary care clinics that us an alternative, non-UHR EMR system to participate in a 3-year research demonstration project.
- Apply formative evaluation methods to assess and improve usability, usefulness, and adoption of the UHR personal health system by patients.
- Enroll patients from the four participating rural clinics into a prospective cohort study to assess the impact of the UHR personal health system on patient-centered care.
- Examine patterns of use of the UHR personal health system.
- Increase awareness, confidence, and skills to use PHRs and Internet health resources among rural community residents, leveraging local libraries and health departments.
Primary care clinics in five rural communities were recruited to participate in the study. Three clinics used the UHR and two used an alternative EMR. Efforts to promote use of the UHR were systematically implemented. Evaluation methods included usability testing, measurement of adoption, and analysis of patterns of use.
User feedback led to significant improvements in the design of the UHR. Distribution of physician letters to patients was an effective method of recruiting UHR users. Almost half of the individuals who used the UHR once used it again, sometimes frequently. An analysis of UHR sessions indicated that medication refill, reconciliation functions, drug safety, and adverse event components were the most frequently accessed and most favorably reviewed. Communication functions and medication management tasks were associated with more intensive use of the UHR.
Citation: Butler JM, Carter M, Hayden C, et al. Understanding adoption of a personal health record in rural health care clinics: revealing barriers and facilitators of adoption including attributions about potential patient portal users and self-reported characteristics of early adopting users. AMIA Annu Symp Proc 2013 Nov 16;2013:152-61. PMID: 24551328.
Principal Investigator: Samore, Matthew
Document Type: Journal Publication
Research Method: Mixed Methods, Structured/Semi-Structured Interview, Survey
Technology: Patient Portal, Personal Health Record
Population: Clinical Staff/Clinician, Patient
Citation: Hung M, Carter M, Hayden C, et al. Psychometric assessment of the patient activation measure short form (PAM-13) in rural settings. Qual Life Res 2013 Apr;22(3):521-9.
Principal Investigator: Samore, Matthew
Document Type: Journal Publication
Research Method: Cross-Sectional (Prevalence) Study
Technology: Clinical Decision Support System, Computerized Provider Order Entry System, Patient Portal, Secure Messaging
Population: Rural Populations
Citation: Samore M. Patient-Centered Informatics System to Enhance Health Care in Rural Communities - Final Report. (Prepared by the University of Utah under Grant No. R18 HS017308). Rockville, MD: Agency for Healthcare Research and Quality, 2011.
Link:
r18hs017308-samore-final-report-2011.pdf
(408.37 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: Samore, Matthew
Document Type: Report
Technology: Clinical Decision Support System, Computerized Provider Order Entry System, Patient Portal, Secure Messaging
Population: Adults, Individuals with Chronic Care Needs, Rural Populations
Disclaimer
Disclaimer details
Citation: Samarth A, Grant E. Using Health Information Technology to Perform Medication Reconciliation: Findings from the AHRQ Health IT Portfolio. (Prepared by the AHRQ National Resource Center for Health Information Technology under Contract No. 290-04-0016.) AHRQ Publication No. 10-0051-EF. Rockville, MD: Agency for Healthcare Research and Quality. February 2010.
Disclaimer
Disclaimer details