Chronic Disease, Electronic Health Records, Patient Outcome Assessment
Conditions
Keywords
patient outcome assessment, electronic health records
Brief summary
Patient use of health IT tools to interact with healthcare providers and delivery systems, including exchanging secure messages with their medical providers and using other web-based tools, has great potential to increase patient access to care, change the way healthcare is delivered, and affect patient clinical outcomes. This study will examine the impact of implementation and use of consumer health IT tools on patient-reported access to care, utilization of medical care services, and clinical outcomes.
Interventions
None listed
Sponsors
Patient-Centered Outcomes Research Institute
Kaiser Permanente
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with chronic conditions * Patient had at least 10-month membership in 2005
Exclusion criteria
* Patients less than age 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Ambulatory Care Sensitive Conditions (ACSC) Hospitalizations. Portal Users vs Those Who Are Not Portal Users | Data from 2006-2007 | Number of ambulatory care sensitive conditions (ACSC) hospitalizations per 1000 patients per month among those who accessed the portal and those who did not access the portal. |
| Patient Self-report Survey Data | March 2015-April 2016 | Patient-reported reasons for using the patient portal |
Participant flow
Recruitment details
Adult patients with at least 10-month membership in 2005
Pre-assignment details
Note: the participants in the Medical Record only arm of the study and the participants in the Survey arm of the study are two different groups of participants. The Medical Record arm of the study includes data from January 2006 to December 2007. The Survey was completed between March 2015 and April 2016.
Participants by arm
| Arm | Count |
|---|---|
| Adult Patients With Chronic Conditions: Medical Record Data Medical record data of adult patients with diabetes and/or complex chronic conditions in a large integrated delivery system. | 165 |
| Adult Patients With Chronic Conditions Survey Data Survey data competed by adult patients with diabetes and/or complex chronic conditions in a large integrated delivery system. Participants were given the option to complete the survey by mail, by phone with a research assistant, or online | 1,824 |
| Total | 1,989 |
Baseline characteristics
| Characteristic | Adult Patients With Chronic Conditions: Medical Record Data | Adult Patients With Chronic Conditions Survey Data | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 73,472 Participants | 883 Participants | 74355 Participants |
| Age, Categorical Between 18 and 65 years | 92,005 Participants | 941 Participants | 92946 Participants |
| Region of Enrollment United States | 165,477 Participants | 1824 Participants | 167301 Participants |
| Sex: Female, Male Female | 79,594 Participants | 948 Participants | 80542 Participants |
| Sex: Female, Male Male | 85,883 Participants | 876 Participants | 86759 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Number of Ambulatory Care Sensitive Conditions (ACSC) Hospitalizations. Portal Users vs Those Who Are Not Portal Users
Number of ambulatory care sensitive conditions (ACSC) hospitalizations per 1000 patients per month among those who accessed the portal and those who did not access the portal.
Time frame: Data from 2006-2007
Population: Only those participants who had an event (ACSC Hospitalization) were included in this analysis.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ACSC Hospitalizations for Those Accessing the Portal | Number of Ambulatory Care Sensitive Conditions (ACSC) Hospitalizations. Portal Users vs Those Who Are Not Portal Users | 6.2 hospitalizations/1000 participants/month |
| ACSC Hospitalizations - Non Portal Users. | Number of Ambulatory Care Sensitive Conditions (ACSC) Hospitalizations. Portal Users vs Those Who Are Not Portal Users | 7.0 hospitalizations/1000 participants/month |
Primary
Patient Self-report Survey Data
Patient-reported reasons for using the patient portal
Time frame: March 2015-April 2016
Population: Only those participants completing a survey and indicating that they used the portal were included in this analysis.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| ACSC Hospitalizations for Those Accessing the Portal | Patient Self-report Survey Data | Use portal because it is convenient | 1252 participants |
| ACSC Hospitalizations for Those Accessing the Portal | Patient Self-report Survey Data | Use portal to access data/information | 1284 participants |
| ACSC Hospitalizations for Those Accessing the Portal | Patient Self-report Survey Data | Say the portal integrates with other health care | 1285 participants |