Integrating a Personalized Patient Portal for Prevention into Primary Care

1. Integrating a Personalized Patient Portal for Prevention into Primary Care Alex Krist MD MPH, Stephen Rothemich MD MS, Paulette Kashiri MPH, Steven Mitchell MS, Robert Johnson PhD, Eric Peele (RTI International), John Loomis MyPreventiveCare Design Preliminary Findings Context: In a previously funded randomized controlled trial, patients who used MyPreventiveCare, a personalized electronic portal for prevention, were up-to-date on 5.4% more services than control patients (p=0.02). MyPreventiveCare links patients to their physician’s electronic medical record, provides personally tailored prevention recommendations, directs patients to individualized educational resources and decision aids to promote self management, and generates reminders. Objective: To systematically study the steps and procedures for practices to follow or avoid to successfully integrate MyPreventiveCare into daily clinical activities in a range of primary care settings. Design:Mixed methods observational study. Setting:Six independent primary care practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN). The practices have a wide variation in location, patient populations, internet use, EMR experience, personal health record (PHR) experience, information technology infrastructure, and organizational culture. Patients: All patients age 18 to 75 years presenting for care. Intervention: Based on organizational change theory and through a series of learning collaboratives and benchmarked performance feedback, guide practices to create a shared vision of how to implement MyPreventiveCare. Main outcome:Steps that practices take to field MyPreventiveCare, measured by field notes and audio-recordings of learning collaboratives, will be linked to a monthly repeated measures analysis of the use of MyPreventiveCare and delivery of preventive services. Personalized Patient Message Patient Summary Page • Preliminary Conclusions and Future Directions • There is substantial variation between sites including: • How well data are entered into the EMR • Delivery of preventive and chronic care as recorded in the EMR. • MyPreventiveCare was successfully integrated into the Professional EMR and sites #1-3 went live 10/18/2010 • At 2 practices, 10%of patients had used MyPreventiveCare in the first two weeks it was available. • MyPreventiveCare will be integrated into Epic and MyChart by December 2010 for sites #4-6. • Through a series of 4 learning collaboratives at each site between now and May 2011, we will continue to observe factors that influence use of MyPreventiveCare. Funded by the Agency for Healthcare Research and Quality (RFTO #17, 290-07-100113) Virginia Ambulatory Care Outcomes Research Network (VACORN) Coordinated by the Department of Family Medicine at Virginia Commonwealth University