PHRs improve patients' adherence to preventive services guidelines

Integrated PHRs and EHRs are helping patients manage their health and providers manage their patient populations at several Virginia primary care practices, according to a case study published Dec. 5 on Agency for Healthcare Research and Quality's (AHRQ) Innovation Exchange website.

While American receive only about one-half of recommended preventive services and up to 80 percent of patients believe a personal health record (PHR) would provide health benefits, less than 3 percent have access to a PHR, according to Alex H. Krist, MD, MPH, an associate professor of family medicine at Virginia Commonwealth University in Richmond.

Healthcare’s failure to widely promote this tool represents a missed opportunity. A randomized controlled trial involving 2,250 patients in eight primary care practices found that PHR users were more likely to receive all recommended preventive services than patients without PHRs. Sixteen months after implementation at the practices, all affiliated with the Virginia Ambulatory Care Outcomes Research Network, compliance with preventive screening guidelines increased by 11.5 percent among PHR users compared to 2.2 percent among nonusers.

The PHR was implemented in response to providers’ desire for a tool with that offered automated decision support, improved their ability to manage patient populations and improved their ability to deliver information to patients, and it received positive feedback from clinicians post-implementation. The interactive, EHR-integrated PHR reminded users to complete a health risk assessment annually, which an internal algorithm used to determine preventive service recommendations based on United States Preventive Services Task Force guidelines. A log-in page displayed a summary with all overdue screenings and related health information.

Based on his involvement in the project, Krist recommended that organizations considering PHR adoption assess readiness, create interoperability between EHR and PHR, form an implementation team, and remember that the endeavor requires human and financial resources. Maintaining the tool requires performance tracking, reminding patients to use the PHR and incorporating the PHR into other initiatives, Krist concluded.

To read more about the project, visit the AHRQ Innovation Exchange.