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An Interactive Preventive Health Record (IPHR) to Promote Patient-Centered Preventive Care

NCT ID: NCT00589173

Last Updated: 2012-07-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

5500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-09-30

Study Completion Date

2011-06-30

Brief Summary

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Americans only receive 50% of indicated preventive services. We hypothesize that an interactive preventive health record (IPHR) will increase the delivery of recommended screening tests, immunizations, and counseling. The IPHR will function as a highly sophisticated personal health record for prevention, linking patients directly to their health information in the electronic record of their primary care physician. The functions of the IPHR will extend beyond those of personal health records by providing tailored recommendations, links to educational resources and decision aids, and patient and clinician reminders. Year one will focus on updating and refining an existing IPHR prototype. The second and third year, through a randomized controlled trial, will examine the effectiveness of the IPHR. Outcomes will include (1) whether the IPHR increases the delivery of recommended preventive services, (2) whether participants use the IPHR, and (3) whether the IPHR increases shared decision-making and improves clinician-patient communication. The study will take place in seven primary care practices in the Virginia Ambulatory Care Outcomes Network (ACORN) that utilize a common electronic medical record (EMR). A randomly selected sample of 5,500 of the practices' 228,000 patients, stratified by age and gender, will be assigned in a one-to-one ratio to receive a request from their clinician to use the IPHR (intervention group) or receive "usual" preventive care (control group). A Preventive Services Survey, which uses standardized questions to evaluate the delivery of preventive care, will be mailed to 4,500 patients and the CAHPS Clinician \& Group Survey will be mailed to 1,000 patients. Surveys will be mailed pre-intervention, 6 month post-intervention, and 18 months post-intervention. Delivery of preventive care will be measured by the Preventive Services Survey and EMR data, while shared decision-making and clinician-patient communication will be measured by the CAHPS survey. The change from baseline to 6 and 18 months post-intervention for the control and intervention groups will be compared.

Detailed Description

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Conditions

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Prevention

Keywords

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Preventive Care Health information technology Personal health record

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention

Patients referred to the IPHR

Group Type EXPERIMENTAL

Interactive Preventive Health Record (IPHR)

Intervention Type BEHAVIORAL

Preventive health record designed to a) show patients the status of their preventive care recorded in their electronic record and b) make recommendations on what USPSTF endorsed preventive services that the user needs to receive.

Control

Patients receiving "standard" preventive care

Group Type ACTIVE_COMPARATOR

"Standard" preventive care

Intervention Type BEHAVIORAL

Existing mechanisim for receiving preventive care in primary care (i.e. patients not referred to the IPHR).

Interventions

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Interactive Preventive Health Record (IPHR)

Preventive health record designed to a) show patients the status of their preventive care recorded in their electronic record and b) make recommendations on what USPSTF endorsed preventive services that the user needs to receive.

Intervention Type BEHAVIORAL

"Standard" preventive care

Existing mechanisim for receiving preventive care in primary care (i.e. patients not referred to the IPHR).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All adult patients seen in the study practices within the previous year

Exclusion Criteria

* Age \<18 years
* Age \>75 years
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role collaborator

Virginia Commonwealth University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alex H Krist, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Virginia Commonwealth University

Locations

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Fairfax Family Practice Centers

Fairfax, Virginia, United States

Site Status

Countries

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United States

References

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Krist AH, Peele E, Woolf SH, Rothemich SF, Loomis JF, Longo DR, Kuzel AJ. Designing a patient-centered personal health record to promote preventive care. BMC Med Inform Decis Mak. 2011 Nov 24;11:73. doi: 10.1186/1472-6947-11-73.

Reference Type BACKGROUND
PMID: 22115059 (View on PubMed)

Krist AH, Woolf SH. A vision for patient-centered health information systems. JAMA. 2011 Jan 19;305(3):300-1. doi: 10.1001/jama.2010.2011. No abstract available.

Reference Type BACKGROUND
PMID: 21245186 (View on PubMed)

Krist AH, Woolf SH, Rothemich SF, Johnson RE, Peele JE, Cunningham TD, Longo DR, Bello GA, Matzke GR. Interactive preventive health record to enhance delivery of recommended care: a randomized trial. Ann Fam Med. 2012 Jul-Aug;10(4):312-9. doi: 10.1370/afm.1383.

Reference Type RESULT
PMID: 22778119 (View on PubMed)

Kerns JW, Krist AH, Longo DR, Kuzel AJ, Woolf SH. How patients want to engage with their personal health record: a qualitative study. BMJ Open. 2013 Jul 30;3(7):e002931. doi: 10.1136/bmjopen-2013-002931.

Reference Type DERIVED
PMID: 23901027 (View on PubMed)

Related Links

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http://healthit.ahrq.gov/KRIST-IPHR-Guide-0612.pdf

A How-To Guide for Using Patient-Centered Personal Health Records to Promote Prevention

Other Identifiers

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RFA-07-007

Identifier Type: -

Identifier Source: secondary_id

PD300045

Identifier Type: -

Identifier Source: org_study_id