5:00 - 5:20 pmSaturday, September 6
LK 120
A proposed e-health model based on the experiences of chronically ill adults using electronic personal health records
LK 120
A proposed e-health model based on the experiences of chronically ill adults using electronic personal health records
Assistant Professor of Nursing, Idaho State University
Background Chronic illnesses are costly to older adults and society. One tool that has been promoted to facilitate self-management support of chronic illness by policy makers, health advocates, providers,... Read more

Description

Background

Chronic illnesses are costly to older adults and society. One tool that has been promoted to facilitate self-management support of chronic illness by policy makers, health advocates, providers, and consumers is the electronic personal health record or patient portal (PHR). Federal incentives are in place to mandate that providers and health care organizations to offer PHR’s to patients and caregivers. However, little is known how consumers actually use these systems for self-management support and productive patient-provider interactions.

Objectives

The aim of this study is to investigate why and how experienced adult healthcare consumers with chronic illness use PHR’s for self-management support and productive patient-provider interactions as defined by the Chronic Care Model (CCM). Findings of this study informed the authors in the development of an adapted version of the CCM highlighting the influence of eHealth support for the model.

Methods

This qualitative descriptive study following a grounded theory approach used a homogeneous group of chronically ill adults who were identified by their providers as skilled and experienced PHR users. Eighteen purposively selected research participants ages 50-65 were interviewed in two Northern California communities.

Results

The 18 participants included English-speaking adults with a mean age of 60 and included 7 females and 11 males who have an average of 3.0 chronic illnesses.  The majority of the participants were working adults who had a minimum education level of a bachelor’s degree.  All participants were identified by providers as those having a tethered PHR/patient portal through their primary healthcare provider and reported a mean of 19.8 PHR use episodes per year. The participants had a mean of 2.9 years of experience with the system and reported that averages of 2.5 of their providers were using PHR’s and 2.5 of their providers were not. There were four major thematic categories that describe the perceptions of the chronically ill using PHR’s identified through an analysis of the transcripts: (a) patient-based factors (b) system-based factors (c) interaction factors and (d) training opportunities. The participants were very positive about using PHR’s for self-management support, preparation for appointments and communication with the health care team. Participants did raise concerns about provider messaging confusion, inadequate system design, PHR navigation concerns and the desire for greater access to the comprehensive electronic health record.

Implications

Based on the study findings the authors identified factors to propose an adapted version of the CCM that includes eHealth facilitators for self-management support and patient-provider interaction.  Knowledge gained from the experienced PHR users suggest that improvements to the PHR and providing PHR use education to patients and the provider team will increase the utility of the system among the experienced users and encourage new users to embrace adoption and use.

Perry Gee has been a registered nurse for 30 years obtaining bachelor of science nursing from Montana State University and his Master of Science in physiologic nursing and clinical informatics from the University of Utah and his PhD in Nursing Science and Health-care Leadership with an emphasis in consumer health informatics from the Betty Irene Moore School of Nursing at the University of California, Davis. Perry has a medical surgical, critical care, flight and home care nursing clinical background as well as 15 years’ experience as a clinical informatics specialist and educator. Perry currently teaches in the Health Informatics Certificate program at UC Davis and is a full-time nursing faculty member in the undergraduate and graduate nursing programs at Idaho State University. His current research interests are in the area of consumer health informatics, e-Patients, eHealth, geriatrics and chronic illness self-management.

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Not readable? Change text. captcha txt

Start typing and press Enter to search