scholarly journals Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study

2019 ◽  
Vol 17 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Timothy B Plante ◽  
Kelly T Gleason ◽  
Hailey N Miller ◽  
Jeanne Charleston ◽  
Kristen McArthur ◽  
...  
Keyword(s):  
Vitamin D ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Response Rate ◽  
Controlled Trial ◽  
Patient Portal ◽  
Message Content ◽  
Patient Portals ◽  
Trial Participants

Background/aim: Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. Methods: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health–sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. Results: Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005). Conclusion: Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.

scholarly journals Use of electronic recruitment methods in a clinical trial of adults with gout

2020 ◽  
pp. 174077452095696
Author(s):  
Hailey N Miller ◽  
Jeanne Charleston ◽  
Beiwen Wu ◽  
Kelly Gleason ◽  
Karen White ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cost Effectiveness ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Response Rate ◽  
Cost Effective ◽  
Demographic Characteristics ◽  
Completion Rate ◽  
Patient Portal ◽  
Recruitment Methods

Background/aims: Electronic-based recruitment methods are increasingly utilized in clinical trials to recruit and enroll research participants. The cost-effectiveness of electronic-based methods and impact on sample generalizability is unknown. We compared recruitment yields, cost-effectiveness, and demographic characteristics across several electronic and traditional recruitment methods. Methods: We analyzed data from the diet gout trial recruitment campaign. The diet gout trial was a randomized, controlled, cross-over trial that examined the effects of a dietary approaches to stop hypertension (DASH)–like diet on uric acid levels in adults with gout. We used four electronic medical record and four non-electronic medical record–based recruitment methods to identify and recruit potentially eligible participants. We calculated the response rate, screening visit completion rate, and randomization rate for each method. We also determined cost per response, the screening, and randomization for each method. Finally, we compared the demographic characteristics among individuals who completed the screening visit by recruitment method. Results: Of the 294 adults who responded to the recruitment campaign, 51% were identified from electronic medical record–based methods. Patient portal messaging, an electronic medical record–based method, resulted in the highest response rate (4%), screening visit completion rate (37%), and randomization rate (21%) among these eight methods. Electronic medical record–based methods ($60) were more cost-effective per response than non-electronic medical record–based methods ($107). Electronic-based methods, including patient portal messaging and Facebook, had the highest proportion of White individuals screened (52% and 60%). Direct mail to non-active patient portal increased enrollment of traditionally under-represented groups, including both women and African Americans. Conclusion: An electronic medical record–based recruitment strategy that utilized the electronic medical record for participant identification and postal mailing for participant outreach was cost-effective and increased participation of under-represented groups. This hybrid strategy represents a promising approach to improve the timely execution and broad generalizability of future clinical trials.

scholarly journals Electronic medical record‐verified hepatitis C virus screening in a large health system

2019 ◽  
Vol 8 (10) ◽  
pp. 4555-4564 ◽  
Author(s):  
Monica L. Kasting ◽  
Anna R. Giuliano ◽  
Richard R. Reich ◽  
Linh M. Duong ◽  
Julie Rathwell ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Virus Screening

Electronic Medical Record Implementation Challenges for the National Health System in Greece

2018 ◽  
Vol 7 (1) ◽  
pp. 16-30 ◽  
Author(s):  
Dimitrios G. Katehakis
Keyword(s):  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
National Health ◽  
National Health System ◽  
Public Hospitals ◽  
Medical Decision ◽  
Significant Information ◽  
Implementation Challenges ◽  
Clinically Significant

The purpose of this work is to expose challenges related to the implementation of quality electronic medical record (EMR) systems in public hospitals in Greece, a country where the national health system (NHS) has already acquired electronic medical records (EMRs). The level of EMR implementation, together with organizational maturity at a hospital level, are explored. What is discovered is that there are different adoption levels, not recorded in a systematic manner. The majority of physicians are either reluctant to implement EMRs or do not know options available to them. Implications include not continuous flow of events, cut off of critical information, lower quality of health services, patients not empowered to carry with them clinically significant information, unnecessary repetition of medical procedures and higher costs. It is concluded that focus should be paid on enabling the use of quality, interoperable and secure EMRs to better support medical decision, in an effort to improve the health of the population and to better control costs.

scholarly journals Delivering a Pilot Smoking Cessation Program through the Patient Portal of an Electronic Medical Record (EMR) at a Patient-Centered Medical Home (PCMH)

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Amanda M Singrey ◽  
Kristin A Casper ◽  
Nicole V Brown ◽  
Bella H Mehta
Keyword(s):  
Smoking Cessation ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Medical Home ◽  
Lessons Learned ◽  
Smoking Cessation Program ◽  
Original Research ◽  
Patient Centered Medical Home ◽  
Patient Portal ◽  
Patient Centered

Pharmacists are providing clinical services in nontraditional practice settings including the patient-centered medical home (PCMH). PCMHs strive to improve patient outcomes in a number of ways, including through innovative use of health information technology (HIT) and by encouraging patients to take an active role in their health care. This paper describes a pharmacist-directed smoking cessation program at a PCMH that utilizes HIT to engage patients in the smoking cessation process and lessons learned from implementation of the program to guide other pharmacists considering implementing a similar program. Secure messaging through the patient portal of the electronic medical record (EMR) can be an effective way to deliver a smoking cessation program for appropriately selected patients and aligns with PCMH standards as the program uses HIT to engage patients in self-management.   Type: Original Research

scholarly journals P232 Assessing effectiveness and patient perceptions of a novel electronic medical record for the management of inflammatory bowel disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S281-S281
Author(s):  
P Kaazan ◽  
T Li ◽  
W Seow ◽  
J Bednarz ◽  
J Pipicella ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Chronic Disease ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Medical Records ◽  
Data Capture ◽  
Patient Portal ◽  
Specific Data ◽  
Qualitative Feedback ◽  
Inflammatory Bowel

Abstract Background There is an increasing prevalence of chronic disease worldwide, resulting in multiple management challenges. Inflammatory bowel disease (IBD) is an exemplar chronic disease requiring optimal longitudinal coordinated care. We propose that Crohn’s Colitis Care (CCCare), a novel IBD-specific electronic medical record intended to improve IBD care is effective and acceptable to patients. We aimed to assess both the effectiveness of CCCare for data capture and patients’ acceptability of CCCare. Methods Methods: The study was conducted at two tertiary Australian hospitals with dedicated IBD services: Royal Adelaide Hospital and Liverpool Hospital. The effectiveness of CCCare was examined by comparing IBD-specific data completeness between pre-existing medical records and CCCare. Acceptability was assessed with quantitative and qualitative feedback through the CCCare patient portal and with standardized paper-based questionnaires administered to a convenience sample of IBD clinic patients in two unmatched pre-CCCare and post-CCCare exposure cohorts. Descriptive statistics and multivariable regression models were applied to specifically examine overall ratings of CCCare acceptability using a 10-point numeric scale; factors associated with acceptability before exposure to the system and whether exposure or security concerns influenced its acceptability. Results In all 73 cases reviewed, there was data gain when using structured CCCare fields compared to IBD documentation in usual medical records. Acceptability assessment through the patient portal feedback of 287 patients showed that the majority were very likely to recommend it to others (score, 8.56 ± 2.2 on a scale of 0–10). Common themes of concern among the 22 respondents with qualitative feedback were related to the novelty and limited experience of CCCare. Study questionnaires indicated that the overall acceptability in the combined cohort (n=310) was very high (8.4 ± 2.1; scale of zero to ten) with more than three-quarters of patients rating acceptability as at least 8 out of 10. Self-reported information technology (IT) literacy was positively associated with acceptability. Exposure had a small positive affect on acceptability while the level security concerns had little impact on acceptability. Conclusion The IBD-specific electronic medical record CCCare is effective in facilitating enhanced completeness of IBD-specific data capture in comparison to pre-existing medical records. It is highly acceptable to patients, especially those with reasonable IT literacy. Patient concerns about privacy and security of EMRs did not significantly influence acceptability.

scholarly journals Linkage of whole genome sequencing with administrative health, and electronic medical record data for the study of autism spectrum disorder: Feasibility, Opportunities and Challenges

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Jennifer Brooks ◽  
Evdokia Anagnostou ◽  
Farah Rahman ◽  
Karen Tu ◽  
Lavnaya Uruthiramoorthy ◽  
...  
Keyword(s):  
Health System ◽  
Whole Genome Sequencing ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Administrative Data ◽  
Genome Sequencing ◽  
Health Data ◽  
Spectrum Disorder ◽  
Whole Genome ◽  
Administrative Health Data

IntroductionAutism Spectrum Disorder (ASD) is a neurodevelopmental disorder (NDD) that presents with a high degree of heterogeneity (e.g., co-occurrence of other NDDs and other co-morbid conditions), contributing to differential health system needs. Genetics are known to play an important role in ASD and may be associated with different disease trajectories. Objectives and ApproachIn this proof of principle project, our objective is to link >2,200 children with a confirmed diagnosis of a NDD from the Province of Ontario Neurodevelopmental (POND) Study to administrative health data and electronic medical record (EMR) data in order to identify subgroups of ASD with unique health system trajectories. POND includes detailed phenotype and whole genome sequencing (WGS) data. Identified subgroups will be characterized based on clinical phenotype and genetics. To meet this goal, consideration of WGS-specific privacy and data issues is needed to implement processes which are above and beyond traditional requirements for analyzing individual-level administrative health data. ResultsLinkage of WGS data with administrative health data is an emerging area of research. As such it has presented a number of initial challenges for our study of ASD. Privacy concerns surrounding the use of WGS data and rare-variant analysis are of particular importance. Practical issues required the need for analysts with expertise in administrative data, EMR data and genetic analyses, and specialized software and sufficient processing power to analyze WGS data. Transdisciplinary discussions of the scope and significance of research questions addressed through this linkage were crucial. The identification of genetic determinants of phenotypes and trajectories in ASD could support targeted early interventions; EMR linkage may inform algorithms to identify ASD in broader populations. These approaches could improve both patient outcome and family experience. Conclusion/ImplicationsAs the cost of genetic sequencing decreases, WGS data will become part of the routine clinical management of patients. Linkage of WGS, EMR and administrative data has tremendous potential that has largely not been realized; including population-level ASD research to improve our ability to predict long-term outcomes associated with ASD.

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