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Exploring the Use of Personal Health Records in Diabetes Management A Pilot Study

Exploring the Use of Personal Health Records in Diabetes Management A Pilot Study. Linda Wells Freiberger, FNP-C, MSN. Acknowledgments.

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Exploring the Use of Personal Health Records in Diabetes Management A Pilot Study

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  1. Exploring the Use of Personal Health RecordsinDiabetes ManagementA Pilot Study Linda Wells Freiberger, FNP-C, MSN

  2. Acknowledgments The project described was supported by 1 U56 AE000012-01 from the Department of Health and Human Services. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Health and Human Services.

  3. Contextual BackgroundJUBILEE COMMUNITY HEALTH • A nonprofit(501c3) health clinic established in 1999 in Paoli, Indiana • Mission: To provide low fee-for-service primary care to uninsured populations • Partially supported through IU Health-Paoli and local community grants • Self-pay population for health care

  4. Study Goal and Objectives • Goal • To explore the use of a PHR by rural, uninsured patients with diabetes • Objectives • Texting and PHR use to improve glucose outcomes • Shared care between clinician and patient using PHR • Methodology • Use of a convenience sample (N=28) • Pre/Post Variables Examined • A1c • Glucose levels

  5. Results • Early findings – • most were attempting use within 1 month • After 6 months 35.7% were actively engaging in PHR use and recording glucose readings • Final findings • 28.6% of patients who completed study had improved A1c levels, and reported they were feeling better. • Another 21.4% had normal A1c levels beginning the study but failed to obtain post-study A1c • 21.4% of patients who no longer participated had no improvement or worse A1c levels

  6. Patient Portal

  7. PHR Member Summary

  8. Data Sharing

  9. PHR Glucose Log

  10. The Super Engaged Patient 12.2 8.2 66.8

  11. Immediate Feedback Normal Glucose Message High Glucose Message

  12. Outcomes • Enhanced patient – clinician engagement • Potential to improve clinical outcomes of patients with diabetes • Uninsured populations can use Health Information Technology (HIT) tools to improve self-care management of chronic disease • Potential to reduce health care costs

  13. Benefits Patient Engagement • 1 Admission, 1 ED visit in the 6 months preceding the study among all 28 study participants • Records reviewed for IU Health Paoli and IU Health Bloomington only

  14. Benefits of Engagement • H. H. • “Oh, I will just go to the library and enter my sugar readings.” • Home PC failed during the study • Unable to afford A1c levels • Continued testing and entering glucose levels in PHR • Improved glucose: 370 110-120 mg/dl

  15. Burden of Poor Engagement and Inadequate Self-care Management • S. B. Suffered Acute MI in September 2012 • Cost of hospitalization, treatment including stent placement, new and expensive medications • Cost of pain and suffering • E. C. Suffered amputation of a toe • Became Medicaid eligible • History many years undiagnosed and untreated for his diabetes

  16. THANK YOU!! Lwells-freib@iuhealth.org Lindawells-feib@healthlinc.org

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