A study published recently in the Annals of Family Medicine found that patients who use an online interactive personal health record (IPHR) are almost twice as likely to receive recommended preventive health services, including laboratory screenings, as those who don't. This study included 4,500 patients from 8 primary care practices.
Researchers evenly divided study participants into a control group and an intervention group. The intervention group received up to three invitations to use an IPHR. The control group received no invitation and had no access to the system.
Patients in the intervention group who chose to use the IPHR created an online account that connected the system with their electronic health record. They also completed a questionnaire that addressed factors such as race or ethnic group, family history, and activities and lifestyle choices that affect health.
The IPHR system considered 18 preventive services recommended by U.S. Preventive Services Task Force guidelines, such as cancer screenings and vaccines. Based on these and answers from the patients' questionnaires as well as 167 medical facts gathered from the patients' health records, the IPHR system recommended prevention services tailored to each individual who signed up. The system also provided detailed personal messages describing the preventive service and its importance, pointing to relevant details in a patient's health record.
The researchers mailed surveys to all study participants at 4 months and again at 16 months after the start of the study. They used the answers from completed surveys to determine which patients had received which preventive services.
At 16 months, the surveys showed that slightly more patients in the intervention group were up to date with all recommended services compared to the control group (15.2% versus 12.6%). However, 25% of the patients who were placed in the intervention group and chose to use the IPHR system were up to date with all recommended services. Those who didn't use the IPHR system were not much different than the control group in the services they received. Screenings for colorectal, breast, and cervical cancer rose significantly across the board for all patients who used the IPHR system.
"Interactive personal health records allow patients to make informed decisions about their health care, and could have important public health benefits," says Alex H. Krist MD, a study author and associate professor of family medicine at the Virginia Commonwealth University School of Medicine. "Many of the preventive services that exhibited the largest increases were those identified by the National Commission on Prevention Priorities as saving the most quality-adjusted life years."
The results of the study might suggest that patients who opt to use an IPHR may also be the ones who are more likely to be proactive about their care, thus more likely to take the time to get the services, than patients who aren't interested in such a system. Nevertheless, IPHRs might prove to be a valuable tool for improving healthcare for patients who wish to take a more active role.
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Elsewhere on the web
MyPreventiveCare (information on the IPHR used in the study)
NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.
Krist A, et al. Interactive Preventive Health Record to Enhance Delivery of Recommended Care: A Randomized Trial. Ann Fam Med July/August 2012 vol. 10 no. 4 312-319. Available online at http://www.annfammed.org/content/10/4/312.full through http://www.annfammed.org. Accessed October 2013.
Virginia Commonwealth University. Interactive personal health records increase clinical preventive services. ScienceDaily 10 July 2012. Available online at http://www.sciencedaily.com/releases/2012/07/120710120333.htm through http://www.sciencedaily.com. Accessed October 2013.