Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: a quasi-experimental study

Abstract Objectives To determine the impact of tethered personal health record (PHR) use on patient engagement and intermediate health outcomes among patients with coronary artery disease (CAD). Methods Adult CAD patients ( N = 200) were enrolled in this prospective, quasi-experimental observational study. Each patient received a PHR account and training on its use. PHRs were populated with information from patient electronic medical records, hosted by a Health Information Exchange. Intermediate health outcomes including blood pressure, body mass index, and hemoglobin A1c (HbA1c) were evaluated through electronic medical record review or laboratory tests. Trends in patient activation measure® (PAM) were determined through three surveys conducted at baseline, 6 and 12 months. Frequency of PHR use data was collected and used to classify participants into groups for analysis: Low , Active , and Super users. Results There was no statistically significant improvement in patient engagement as measured by PAM scores during the study period. HbA1c levels improved significantly in the Active and Super user groups at 6 months; however, no other health outcome measures improved significantly. Higher PAM scores were associated with lower body mass index and lower HbA1c, but there was no association between changes in PAM scores and changes in health outcomes. Use of the PHR health diary increased significantly following PHR education offered at the 6-month study visit and an elective group refresher course. Conclusions The study findings show that PHR use had minimal impact on intermediate health outcomes and no significant impact on patient engagement among CAD patients.

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Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study (Preprint)

10.2196/preprints.10692 ◽

2018 ◽

Author(s):

Will L Tarver ◽

Bruce W Robb ◽

David A Haggstrom

Keyword(s):

Colorectal Cancer ◽

Health Care ◽

Cancer Survivors ◽

Personal Health Record ◽

Care Plan ◽

Survivorship Care Plan ◽

Personal Health ◽

Health Record ◽

Survivorship Care ◽

The Impact

BACKGROUND As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors. OBJECTIVE The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors. METHODS Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method. RESULTS CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information. CONCLUSIONS For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management.

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Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study

JMIR Cancer ◽

10.2196/10692 ◽

2019 ◽

Vol 5 (2) ◽

pp. e10692

Author(s):

Will L Tarver ◽

Bruce W Robb ◽

David A Haggstrom

Keyword(s):

Colorectal Cancer ◽

Health Care ◽

Cancer Survivors ◽

Personal Health Record ◽

Care Plan ◽

Survivorship Care Plan ◽

Personal Health ◽

Health Record ◽

Survivorship Care ◽

The Impact

Background As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors. Objective The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors. Methods Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method. Results CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information. Conclusions For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management.

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Geometric Data Perturbation-Based Personal Health Record Transactions in Cloud Computing

The Scientific World JOURNAL ◽

10.1155/2015/927867 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

S. Balasubramaniam ◽

V. Kavitha

Keyword(s):

Cloud Computing ◽

Key Management ◽

Information Exchange ◽

Service Providers ◽

Health Information Exchange ◽

Personal Health Record ◽

Personal Health ◽

Health Record ◽

Data Perturbation ◽

Geometric Data

Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud.

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Best Paper Selection

Yearbook of Medical Informatics ◽

10.1055/s-0038-1641120 ◽

2017 ◽

Vol 26 (01) ◽

pp. e3-e4

Keyword(s):

Health Information ◽

Information Exchange ◽

Health Information Exchange ◽

Point Of Care ◽

Personal Health Record ◽

Pediatric Emergency ◽

Personal Health ◽

Genomic Information ◽

Electronic Personal Health Record ◽

Quasi Experimental

Bahous MC, Shadmi E. Health information exchange and information gaps in referrals to a pediatric emergency department. Int J Med Inform 2016;87:68-74 https://linkinghub.elsevier.com/retrieve/pii/S1386-5056(15)30078-2 Esmaeilzadeh P, Sambasivan M. Health Information Exchange (HIE): A literature review, assimilation pattern and a proposed classification for a new policy approach. J Biomed Inform 2016;64:74-86 http://www.sciencedirect.com/science/article/pii/S1532046416301241?via%3Dihub Massoudi BL, Marcial LH, Tant E, Adler-Milstein J, West SL. Using health information exchanges to calculate clinical quality measures: A study of barriers and facilitators. Healthc (Amst) 2016;4(2):104-8 https://linkinghub.elsevier.com/retrieve/pii/S2213-0764(15)30057-9 Toscos T, Daley C, Heral L, Doshi R, Chen YC, Eckert GJ, Plant RL, Mirro MJ. Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: a quasi-experimental study. J Am Med Inform Assoc 2016;23(1):119-28 https://academic.oup.com/jamia/article-lookup/doi/10.1093/jamia/ocv164 Warner JL, Rioth MJ, Mandl KD, Mandel JC, Kreda DA, Kohane IS, Carbone D, Oreto R, Wang L, Zhu S, Yao H, Alterovitz G. SMART precision cancer medicine: a FHIR-based app to provide genomic information at the point of care. J Am Med Inform Assoc 2016;23(4):701-10 https://academic.oup.com/jamia/article-lookup/doi/10.1093/jamia/ocw015

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Best Paper Selection

Yearbook of Medical Informatics ◽

10.1055/s-0037-1606483 ◽

2017 ◽

Vol 26 (01) ◽

pp. 82-83

Keyword(s):

Health Information ◽

Information Exchange ◽

Health Information Exchange ◽

Point Of Care ◽

Personal Health Record ◽

Pediatric Emergency ◽

Personal Health ◽

Genomic Information ◽

Electronic Personal Health Record ◽

Quasi Experimental

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Efficacy of intra-articular autologous platelet rich plasma injection in primary knee osteoarthritis; a quasi-experimental study

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1131 ◽

2020 ◽

pp. 1-10

Author(s):

Uzma Akhlaque ◽

Saeed Bin Ayaz ◽

Noreen Akhtar

Keyword(s):

Body Mass Index ◽

Experimental Study ◽

Knee Osteoarthritis ◽

Body Mass ◽

Rating Scale ◽

Numerical Rating Scale ◽

Platelet Rich Plasma ◽

Pain Reduction ◽

Quasi Experimental ◽

The Impact

Abstract Objectives: To observe the efficacy of platelet rich plasma on pain improvement in knee osteoarthritis patients, and to explore the impact of various facotrs on pain reduction with such a treatment. Method: The quasi-experimental study was conducted at the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan, from October 2017 to April 2018, and comprised patients with primary knee osteoarthritis. The sample was sub-grouped into “normal”, “overweight” and “obese” on the basis of body mass index. Two age-based sub-groups were also formed at ?60 years and >60 years. Three injections of calcium gluconate activated 2.5ml platelet rich plasma were given in the knees at an interval of two weeks each. The pain score was calculated using the numerical rating scale at the 6th week. Data was analysed using SPSS 20. Results: Of the 50 patients, 26(52%) were females and 24(48%) were males. The overall mean age was 59.6±9.6 years (range: 42-75 years), with 22(44%) aged ? 60 years. There were 21(42%) patients who were overweight, 7(14%) had normal weight and 22(44%) were obese. There was significant pain reduction post-treatment compared to the baseline (p<0.001). The reduction in pain was not significantly related to gender, age, knee osteoarthritis grade, or body mass index (p>0.05). Conclusions: Platelet rich plasma significantly improved pain in knee osteoarthritis patients regradless of all age, gender, grade and body mass index. Key Words: Intra-articular injections, Primary knee osteoarthritis, Platelet rich plasma, Efficacy. Continuous...

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