A focus of the Agency for Healthcare Research and Quality (AHRQ) is promoting patient-centered care and consumer participation in healthcare decision-making. Although evidence indicates that better-informed, more engaged patients enjoy better health outcomes, information needs are often unaddressed. This is especially true in hospital settings, where there are over 36 million patient admissions each year in the United States. While consumer health advocacy groups are admonishing people to be active participants in their healthcare, the lack of information available to hospital patients and their families can make them feel anxious and disenfranchised. At NewYork-Presbyterian Hospital/Columbia University Medical Center, we have developed an inpatient personal health record (PHR) portal that provides medication lists, care team information, and educational content to patients and their caregivers. The application was pilot tested with five cardiothoracic surgery patients using Apple iPads, and the response of both patients and their clinician care providers was very enthusiastic. In the proposed study, we have enhanced the existing inpatient PHR portal to allow patients to electronically document questions and concerns related to their care. These questions and concerns are visible to members of the patients'care team within our commercial inpatient electronic health record (EHR). A randomized controlled trial is proposed to rigorously evaluate the impact of the inpatient PHR portal with patients from medical and surgical cardiac units at Columbia University Medical Center. We will demonstrate the generalizability of the research by deploying the inpatient PHR portal at El Camino Hospital, a community hospital in Mountain View, California. Finally, we will analyze patient-entered questions and comments to characterize information needs of hospital patients and assess the salience of patient-entered information to issues of care quality and safety. The proposed research will demonstrate the potential for consumer health information technology to empower patients and caregivers as active participants in the inpatient care delivery process. It will advance scientific knowledge in the field of patient-clinician communication, demonstrate new technical capabilities for sharing information among patients and their care teams, and improve patient activation, engagement and satisfaction.

Public Health Relevance

The Agency for Healthcare Research and Quality (AHRQ) and the Institute of Medicine are advocating for patient-centered care and better communication between patients and their healthcare providers. In response, we created an inpatient personal health record (PHR) portal that shows medication lists, care team information, and educational content to patients and their caregivers. In this project, hospital patients will use the PHR porta via a tablet computer to electronically document questions and concerns they have during their hospital stay, and we will rigorously evaluate the impact the system has on patients and their care providers.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
5R01HS021816-02
Application #
8699199
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Grace, Erin
Project Start
2013-08-01
Project End
2017-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Columbia University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Prey, Jennifer E; Woollen, Janet; Wilcox, Lauren et al. (2014) Patient engagement in the inpatient setting: a systematic review. J Am Med Inform Assoc 21:742-50