Diabetes Mellitus is a costly and devastating chronic illness with African Americans disproportionately affected. Coordination of care and self-management can significantly reduce the economic and psychological burden of this disease. The use of state-of-the-art communications and networking technologies are increasingly being used to improve patient-provider communication, disease management, and self-care behavior. Patient web portals (PWPs) using internet-based strategies provide the integration of the electronic medical record with the patient health record for enhanced patient outcomes. Smartphones are communication devices that can provide instant access to the internet for health information. The integration of the PWP with a Smartphone provides real-time feedback for secure and instant messaging from provider to patient and immediate access to health related information. Louis Stokes Health Sciences Library and Howard University Hospital Diabetes Treatment Center (HUH-DTC) are both located on the campus of Howard University, a Historically Black College and University. The HUH- DTC currently provides a diabetes PWP to its patients. In the initial design of the PWP, health science librarians were not involved. To date, there are several barriers in patients effectively using the PWP such as forgotten passwords, lack of use of the PWP educational component, etc. This study will integrate the expertise of health science librarians, clinicians, and computer scientists for an improved PWP. The study goals are to: (1) improve PWP use by removing barriers through patient and provider focus groups, (2) redesign the current PWP using feedback from the focus groups with the assistance of health science librarians, (3) integrate the Smartphone with the existing PWP for enhanced patient/provider communication and health information and (4) measure patient activation for improved diabetes self-management along with reduction in hemoglobin A1c after the redesigned PWP-Smartphone intervention. The study design is two-fold. First, is to implement a patient-centered redesign of the diabetes PWP and the second, is a non-masked randomized interventional parallel assignment trial. Trial participants will be randomized into one of two behavioral diabetes intervention arms: (1) web-enabled Smartphone educational PWP, or (2) standard diabetes care with access to the PWP, but no Smartphone-enabled PWP intervention. The study will take place at the HUH-DTC. A total of 210 African American men and women 18 years or older will be recruited from HUH-DTC to achieve adequate power to detect differences in patient activation for enhanced diabetes self-care management. Web activity use will be monitored using Google Analytics. The proposed study will receive thorough review and oversight from the Institutional Review Board at Howard University. There will be a secure socket layer for security of all electronic health information that will eliminate security breaches of electronic health data meeting HIPPA regulations of patient portability and privacy.
Patient web portals (PWPs) with Smartphone integration specifically designed for patients with diabetes is the focus of this study. The study will target African American diabetic patients because of the high prevalence of the diabetes in this population. Useful and credible diabetes health information that is culturally appropriate will be vetted by health science librarians to enhance patient/provider use of the PWP for communication and disease management.
