The engagement of patients and their families in patients’ health care is a prominent goal of the EHR Incentive Program (also called Meaningful Use). This policy priority aims to improve patients’understanding of their health and related conditions so they take a more active role in their health care. It also encourages the involvement of patients’families, as many patients depend on their support. The use of certified EHR technologies can assist with making health information available to patients and their families. Meaningful use of EHRs will also help involve patients and their families in healthcare decision making and promote patients’ management of their own health.
Why is it important to engage patients and families in their healthcare? Most importantly, it is vital to improving patients’ health outcomes. Patients who are well informed of their medical condition are more likely to comply with their provider’s recommended regimen. They are also better able to communicate important health information to their providers, which can assist providers with their diagnosis and care plans. Informed and educated patients and their families can take an active role in healthcare decision making; for example, when faced with multiple treatment options (e.g., choice of breast or prostate cancer treatments), educational materials and tools can help them share in treatment decisions. They are also more likely to effectively manage their own care, as healthy behaviors and chronic care are ongoing, everyday activities. Patients’participation in chronic care self-management programs can have a substantial impact on their health (e.g., self-management programs for diabetics that help patients effectively manage their diabetes).
Disease management has been used as a process for people with chronic diseases. As compared to the traditional chronic disease management, research on an online disease management (ODM) has been conducted by the Palo Alto Medical Foundation (PAMF). The project evaluated the care of diabetes through the multidisciplinary team approach combined with technology tools known as the Personal Health Care Project (PHCP). PHCP was developed as a patient-centered care model. The main objective of this project was to engage the patients directly in their own care through the use of ODM, to compare PHCP with the traditional chronic disease management, and to disseminate the results of the randomized controlled trial to other ambulatory settings for use in diabetes and other chronic diseases.
The ODM allowed frequent communications between members of the multidisciplinary team, continuous access to health records, uploading glucometer data, trends, reating a patient-specific Diabetes Summary Status Report, making available nutrition and exercise logs, offering a record for insulin tracking, providing secure messaging capability with the health care team via the PHR, and sharing of various patient-education materials including videos. The primary outcome measurement of the study was hemoglobin A1c (HbA1c).
The results of the study showed that at 6- and 12-months, patients enrolled in the ODM reduced their HbA1c by a statistically significant amount. When the results were compared between the traditional management method and the PCHP using ODM, the difference was statistically significant at 6 months but not at 12 months. It was concluded that the PHCP appeared to be a successful way to engage patients in the care of their diabetes and improve their outcomes.
The ODM allowed frequent communications between members of the multidisciplinary team, continuous access to health records, uploading glucometer data, trends, reating a patient-specific Diabetes Summary Status Report, making available nutrition and exercise logs, offering a record for insulin tracking, providing secure messaging capability with the health care team via the PHR, and sharing of various patient-education materials including videos. The primary outcome measurement of the study was hemoglobin A1c (HbA1c).
The results of the study showed that at 6- and 12-months, patients enrolled in the ODM reduced their HbA1c by a statistically significant amount. When the results were compared between the traditional management method and the PCHP using ODM, the difference was statistically significant at 6 months but not at 12 months. It was concluded that the PHCP appeared to be a successful way to engage patients in the care of their diabetes and improve their outcomes.