Interactive Preventive Health Record to Enhance Delivery of ...

Interactive Preventive Health Record to Enhance Delivery of Recommended Care: A Randomized Trial Alex H. Krist, MD, MPH1,2 Steven H. Woolf, MD, MPH1 Stephen F. Rothemich, MD, MS1 Robert E. Johnson, PhD3 J. Eric Peele, BA4 Tina D. Cunningham, PhD5 Daniel R. Longo, ScD1 Ghalib A. Bello, BS3 Gary R. Matzke, PharmD6 1

Department of Family Medicine, Virginia Commonwealth University, Richmond, Virginia

2

Fairfax Family Practice Residency, Fairfax, Virginia

3

Departments of Biostatistics and Family Medicine, Virginia Commonwealth University, Richmond, Virginia 4

RTI International, Research Triangle Park, North Carolina 5

Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, Virginia 6

Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia

ABSTRACT PURPOSE Americans receive only one-half of recommended preventive services.

Information technologies have been advocated to engage patients. We tested the effectiveness of an interactive preventive health record (IPHR) that links patients to their clinician’s record, explains information in lay language, displays tailored recommendations and educational resources, and generates reminders. METHODS This randomized controlled trial involved 8 primary care practices.

Four thousand five hundred patients were randomly selected to receive a mailed invitation to use the IPHR or usual care. Outcomes were measured using patient surveys and electronic medical record data and included IPHR use and service delivery. Comparisons were made between invited and usual-care patients and between users and nonusers among those invited to use the IPHR. RESULTS At 4 and 16 months, 229 (10.2%) and 378 (16.8%) of invited patients used the IPHR. The proportion of patients up-to-date with all services increased between baseline and 16 months by 3.8% among intervention patients (from 11.4% to 15.2%, P