Promoting electronic health risk assessments takes work

Significant additional outreach and engagement strategies are necessary to get patients to complete an electronic health risk assessment (eHRA), according to a study published at the American Journal of Managed Care.

The assessment was designed for patients of Group Health Cooperative in Seattle to identify risk factors and tailor feedback to help them adopt healthier behaviors and to promote screening, immunization and other preventive measures.

Such assessments have been used in the workplace, but there's less evidence of their effectiveness when used by providers, according to the study. This assessment was designed to be completed in 15 to 20 minutes through the secure Web portal and to employ an extensive branched algorithm exploring factors such as medical history, medication use, prior use of preventive services and other factors. It would then generate risk estimations--for cardiovascular disease, for instance--and recommendations, along with Web links to specific resources, such as tobacco cessation programs.

Group Health offered clinics financial incentives to promote the eHRA, though there were no incentives for individual clinicians or patients. Most clinics used phone calls or emails to encourage patients to complete the assessment. However, only 8.8 percent of eligible patients did, though that number rose to 22.4 percent among registered users of its web portal.

Those who completed the assessment were more likely to be female, between ages 41 and 65, to have had a recent well-care visit and to not have multiple conditions. There were no differences found between the completers and Group Health members overall health status, body mass index, physical activity. Completers, however, were less likely to smoke, have depression or hypertension.

In December, the Agency for Healthcare Research and Quality released a guide for primary care physicians and other clinicians to help them implement health assessments, such as those performed at annual wellness visits.

Bryce Willians, director of health and wellness at Blue Shield of California, told FierceMobileHealthcare that online and mobile platforms that borrow tactics from social media and gaming are key to boosting patient participation in wellness programs.

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