scholarly journals Computer Skills Drive Personal Health Record Adoption: A Multi-dimensional Evaluation of Users versus Non-Users (Preprint)

2020 ◽  
Author(s):  
Martina A Clarke ◽  
Ann L Fruhling ◽  
Alvin E Tarrell ◽  
Tamara L Bernard ◽  
John R Windle
Keyword(s):  
Self Efficacy ◽  
Information Technologies ◽  
Personal Health Record ◽  
Patient Activation ◽  
Personal Health ◽  
Health Record ◽  
Health Information Technologies ◽  
Complex Information ◽  
Significant Difference ◽  
Computer Self Efficacy

BACKGROUND In the era of precision medicine, it is critical for health communication efforts to improve the comprehension level of the complex information being presented in the personal health record (PHR). OBJECTIVE To assess and understand the characteristics associated with patients’ choice to use or not use their PHR. METHODS A diverse group of patients with chronic cardiovascular disease was selected to participate in this study. They were screened by race, ethnicity, sex, age and zip code, specifically. Seventy-nine patients participated: 48 PHR users and 31 non-users. They completed seven surveys related to their choice to use or not use the PHR: demographics, patient activation, medication adherence, health literacy, computer self-efficacy, numeracy and graph literacy. RESULTS There is no significant difference between users and non-users in sociodemographic measures: age (P=0.17), sex (P=0.35), education (P=0.068), ethnicity (P=0.43), race (P=0.42), and employment (P=0.75). There is a significant difference between PHR users and PHR non-users in computer self-efficacy (P=0.0053), subjective graph literacy (P=0.0073), subjective numeracy scale (P=0.0074). CONCLUSIONS In this study, we demonstrate that sociodemographic characteristics were not an important factor in patients’ use of their PHR. Our results did demonstrate that there is a difference between PHR users and non-users related to their computer self-efficacy (CSE), graph literacy, and numeracy. This work suggests that incorporating CSE and graph literacy into the design of PHRs is critical. The design of patient facing tools must take into account patients’ preferences and abilities when developing effective user-friendly health information technologies (HIT). CLINICALTRIAL NA

Impact of a Personal Health Record Intervention upon Surveillance Among Colorectal Cancer Survivors: Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Eric Vachon ◽  
Bruce W. Robb ◽  
David A. Haggstrom
Keyword(s):  
Colorectal Cancer ◽  
Feasibility Study ◽  
Self Efficacy ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record ◽  
Post Intervention ◽  
Patient Centered ◽  
Patient Beliefs

BACKGROUND There are currently an estimated 1.5 million individuals living in the United States (US) with colorectal cancer (CRC), and although the five-year survival rate has increased, survivors are at risk for recurrence, particularly within the first 2-3 post-treatment. National guidelines recommend continued surveillance post-resection, in order to identify recurrence early on. Adherence among survivors ranges from 49%-94%. Novel interventions are needed to increase CRC survivors’ knowledge and confidence in managing their cancer and thus increase adherence to follow-up surveillance. OBJECTIVE The objective of this study was to develop and test the feasibility and efficacy of a web-based personal health record (PHR) to increase surveillance adherence among CRC survivors, with patient beliefs about surveillance as secondary outcomes. METHODS A pre- and post-intervention feasibility trial was conducted testing the efficacy of the Colorectal Cancer Survivor (CRCS)-PHR, which had been previously developed using an iterative, user-centered design approach. The CRCS-PHR includes surveillance guidelines, treatment tracking, potential treatment toxicities, as well as a journaling tab and communities to interact with other CRC survivors. A total of 28 stage I-III CRC survivors (9 colon, 18 rectal, 1 unknown) were recruited from an academic medical center in the Midwest US. At enrollment, patient demographics and cancer characteristics were gathered via medical record audit. Following enrollment, patients completed surveys at baseline and 6 months post-intervention asking about adherence to colonoscopy, computed tomography (CT) scan, and carcinoembryonic antigen (CEA) and beliefs about surveillance (barriers, benefits, self-efficacy, and knowledge). Paired t-test analyses were used to compare pre- and post-intervention ratings for each of the four patient beliefs categories and surveillance adherence. RESULTS The average age of the sample was 58 years old, with 57% males and the majority being married and employed full time. We observed a significant increase in adherence to colonoscopy (pre: 52% vs. post: 86%, p<.01) and CEA (67% vs. 95%, p=.01), as well as a slight increase in CT scans (67% vs. 84%, p=.1). The only significant impact on secondary outcome (patient beliefs) was benefits of CEA test (p=.04), as most of the beliefs were high at baseline. CONCLUSIONS This feasibility study lays the groundwork for continued development of the CRCS-PHR to increase CRC surveillance. Patient-centered technologies, such as the CRCS-PHR, represent an important potential approach to improving the receipt of guideline-concordant care and follow-up surveillance, not just for CRC survivors. Researchers should continue to develop patient-centered health technologies with clinician implementation in mind to increase patient self-efficacy and surveillance adherence.

Developing a personal health record self-efficacy tool

2013 ◽  
Vol 26 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Kathleen M. Nokes ◽  
Jay Verkuilen ◽  
Dorothy E. Hickey ◽  
Judith C. James-Borga ◽  
Jing Shan
Keyword(s):  
Self Efficacy ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record

scholarly journals A pilot study to evaluate the magnitude of association of patient activation in HIV-infected veterans who use electronic personal health records

2014 ◽  
Author(s):  
Pierre-Cedric Crouch ◽  
Carol PhD, RN, FAAN Dawson Rose ◽  
Mallory I. Johnson ◽  
Susan Janson
Keyword(s):  
Health Care ◽  
Viral Load ◽  
Personal Health Record ◽  
Patient Activation ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Electronic Personal Health Record ◽  
Electronic Personal Health Records

Background: The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. Objective: To determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. Participants: HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. Methods: In-person surveys were completed either online or on paper and data abstraction was completed from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. Measures: The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. Results: In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. Conclusions: The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.

Factors affecting the acceptance of integrated electronic personal health records in Saudi Arabia: The impact of e-health literacy

2020 ◽  
pp. 183335832096489
Author(s):  
Yaser A Alsahafi ◽  
Valerie Gay ◽  
Adel A Khwaji
Keyword(s):  
Saudi Arabia ◽  
Health Literacy ◽  
Structural Equation ◽  
Information Technologies ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Information Technologies ◽  
Widespread Agreement ◽  
National Implementation ◽  
The Impact

Background: National implementation of electronic personal health record (ePHR) systems is of vital importance to governments worldwide because this type of technology promises to promote and enhance healthcare. Although there is widespread agreement as to the advantages of ePHRs, the level of awareness and acceptance of this technology among healthcare consumers has been low. Objective: The aim of this study was to identify the factors that can influence the acceptance and use of an integrated ePHR system in Saudi Arabia. Method: The unified theory of acceptance and use of technology model was extended in this study to include e-health literacy (e-HL) and tested using structural equation modelling. Data were collected via a questionnaire survey, resulting in 794 valid responses. Results: The proposed model explained 56% of the variance in behavioural intention (BI) to use the integrated ePHR system. Findings also highlighted the significance of performance expectancy, effort expectancy, social influence (SI) and e-HL as determinants of Saudi healthcare consumers’ intentions to accept and use the integrated ePHR system. Additionally, assessment of the research model moderators revealed that only gender had a moderating influence on the relationship between SI and BI. Finally, findings showed a low level of awareness among Saudi citizens about the national implementation of an integrated ePHR system, suggesting the need to promote a greater and more widespread awareness of the system and to demonstrate its usefulness. Conclusion: Findings from this study can assist governments, policymakers and developers of health information technologies and systems by identifying important factors that may influence the diffusion and use of integrated ePHRs.

scholarly journals A pilot study to evaluate the magnitude of association of patient activation in HIV-infected veterans who use electronic personal health records

2014 ◽  
Author(s):  
Pierre-Cedric Crouch ◽  
Carol PhD, RN, FAAN Dawson Rose ◽  
Mallory I. Johnson ◽  
Susan Janson
Keyword(s):  
Health Care ◽  
Viral Load ◽  
Personal Health Record ◽  
Patient Activation ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Electronic Personal Health Record ◽  
Electronic Personal Health Records

Background: The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. Objective: To determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. Participants: HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. Methods: In-person surveys were completed either online or on paper and data abstraction was completed from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. Measures: The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. Results: In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. Conclusions: The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.

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