J Am Med Inform Assoc - Organizational strategies for promoting patient and provider uptake of personal health records.

Tópicos

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Resumo

JECTIVE: To investigate organizational strategies to promote personal health records (PHRs) adoption with a focus on patients with chronic disease.METHODS: Using semi-structured interviews and a web-based survey, we sampled US health delivery organizations which had implemented PHRs for at least 12 months, were recognized as PHR innovators, and had scored highly in national patient satisfaction surveys. Respondents had lead positions for clinical information systems or high-risk population management. Using grounded theory approach, thematic categories were derived from interviews and coupled with data from the survey.RESULTS: Interviews were conducted with 30 informants from 16 identified organizations. Organizational strategies were directed towards raising patient awareness via multimedia communications, and provider acceptance and uptake. Strategies for providers were grouped into six main themes: organizational vision, governance and policies, work process redesign, staff training, information technology (IT) support, and monitoring and incentives. Successful organizations actively communicated their vision, engaged leaders at all levels, had clear governance, planning, and protocols, set targets, and celebrated achievement. The most effective strategy for patient uptake was through health professional encouragement. No specific outreach efforts targeted patients with chronic disease. Registration and PHR activity was routinely measured but without reference to a denominator population or high risk subpopulations.DISCUSSION AND CONCLUSION: Successful PHR implementation represents a social change and operational project catalyzed by a technical solution. The key to clinician acceptance is making their work easier. However, organizations will likely not achieve the value they want from PHRs unless they target specific populations and monitor their uptake.

Resumo Limpo

jectiv investig organiz strategi promot person health record phrs adopt focus patient chronic diseasemethod use semistructur interview webbas survey sampl us health deliveri organ implement phrs least month recogn phr innov score high nation patient satisfact survey respond lead posit clinic inform system highrisk popul manag use ground theori approach themat categori deriv interview coupl data surveyresult interview conduct inform identifi organ organiz strategi direct toward rais patient awar via multimedia communic provid accept uptak strategi provid group six main theme organiz vision govern polici work process redesign staff train inform technolog support monitor incent success organ activ communic vision engag leader level clear govern plan protocol set target celebr achiev effect strategi patient uptak health profession encourag specif outreach effort target patient chronic diseas registr phr activ routin measur without refer denomin popul high risk subpopulationsdiscuss conclus success phr implement repres social chang oper project catalyz technic solut key clinician accept make work easier howev organ will like achiev valu want phrs unless target specif popul monitor uptak

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