: Poor quality of care may be an important risk factor for excess rates of morbidity in persons with serious mental disorders. Electronic Personal Health Records (PHRs) hold promise in helping reshape healthcare by shifting the ownership and locus of health records from being scattered across multiple providers to being longitudinal and patient-centered. Given the complex health needs and the fragmentation of care faced by individuals with serious mental disorders, these individuals could derive particular benefit from a PHR. However, there are currently no established web-based PHRs available for this population. In order to fill this gap, we propose to adapt an existing medical PHR to fit the needs of persons with serious mental disorders. The PHR will build on the Shared Care Plan, a PHR that was developed with extensive input from medical consumers and is in active use in a number of communities in the United States and abroad. The study team includes the developers of the Shared Care Plan, quality improvement and informatics experts, mental health consumer leaders, and health services and intervention researchers. During the first phase of the study, qualitative methods will be used to incorporate input from mental health consumers, providers, and primary care providers to adapt the Shared Care Plan for persons with mental disorders and one or more comorbid medical condition. Content will be modified and electronic enhancements made to the program based on this information. During the second phase of the study, a 12-month, randomized trial will be conducted to assess the impact of the MH-PHR on care for persons with serious mental illness and one or more comorbid medical condition. Analyses will test the impact of the intervention on patient activation, provider and system-level management of chronic illness, and quality of medical and mental health care. During the final phase of the study, the PHR will be disseminated via national and state mental health consumer and provider organizations. Developing a personal health record for mental health consumers has the potential to help improve quality of care in a manner that is highly consistent with these individuals'values and priorities. The relative low cost and ease of dissemination of the MH-PHR, coupled with partnerships with national and regional mental health advocacy and provider groups, will help ensure that this project has a major public health impact

Public Health Relevance

There is an urgent need to develop approaches for improving the quality of medical and mental health care for mental health consumers. The study proposes to address this goal by developing, testing, and disseminating a personal health record for persons with serious mental disorders. The mental health personal health record will be developed in conjunction with consumer and provider leaders, who will help ensure that it will be widely distributed to, and used by, mental health consumers in the United States.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
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Special Emphasis Panel (ZHS1-HSR-A (01))
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Mullican, Charlotte
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Emory University
Public Health & Prev Medicine
Schools of Public Health
United States
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Druss, Benjamin G; Ji, Xu; Glick, Gretl et al. (2014) Randomized trial of an electronic personal health record for patients with serious mental illnesses. Am J Psychiatry 171:360-8