Patient-centric alerts close 'prevention gaps'

Sending patients alerts about getting needed care via their personal health record (PHR) is an effective way to boost treatment of those with chronic conditions, according to a new study in Telemedicine and e-Health.

The researchers, from the University of Pittsburgh and elsewhere, noted that many patients with chronic conditions are not receiving optimal care; they receive less than 60 percent of the services recommended. However, sending alerts to the providers has only a modest effect on increasing treatment rates, in part because of alert overload. 

To that end, the authors hypothesized that it may be better to send alerts to the patients instead. They enrolled 584 patients with high cardiovascular risk from 73 primary care practices into an active PHR that provided patient-centered decision support by sending cycles of alerts regarding "prevention gaps," such as the need for a mammogram or liver function testing.

Eighty-six percent of the patients received at least one reminder; of those, 61 percent accessed the PHR or received the care that triggered the message after just one message, and 73 percent did so after the second message. The rates were higher than alerts via telephone, mail or a passive PHR.

Patient engagement is a primary tenet of the Meaningful Use program and considered an important aspect of improving the quality of care overall. Other studies have found that increased patient involvement reduces errors and is positive for patients.

Perhaps not surprisingly, gaps that were more easily closed, such as through documentation or blood testing, required fewer notifications than those that required scheduling an appointment.

"Optimizing care for patients with chronic medical conditions is challenging. Most chronic medical conditions require periodic to daily monitoring that is best accomplished by a patient–provider team," the researchers said. "Active notifications through a PHR can be used to provide patient-centered decision support, without incurring alert fatigue. These tools may help achieve better care and health for patients."

To learn more:
- read the study (.pdf)