Taking Charge

Electronic Health Records Aim to Put Patients in the Driver’s Seat

Does an electronic handle on one’s health reduce the risk of a leading chronic disease?

MCG is participating in a study funded by the federal Agency for Healthcare Research and Quality to help answer the question. The study will enable hundreds of patients with hypertension to electronically post their blood pressure, weight and diet in their medical record and e-mail their physicians when needed.

“From a chronic-illness standpoint, the literature is pretty clear: The more involved and engaged I am in managing my own illness, the better my outcome,” says Patricia Sodomka, director of the Medical College of Georgia Center for Patient- and Family-Centered Care, senior vice president for Patient- and Family-Centered Care for MCG Health, Inc. and principal investigator on the $1.2 million grant. “It just makes common sense.”

MCG researchers will work with hypertensive patients in MCG Health System’s family medicine and internal medicine practices to see if the electronic personal health record enhances patient involvement.

"Our first measure is patient activation,” says Dr. Peggy Wagner, research director for the MCG Department of Family Medicine and study co-investigator, citing the hope that hypertension will improve if a patient is empowered by ready access to health information.
Two small studies will compile patient and physician input on how to optimize IQHealth™, the electronic personal health record developed by Kansas City, Mo.-based Cerner Corp.

A yearlong study of 720 hypertensive patients will follow in which half the participants will use the newly refined electronic personal health record and the remainder will receive standard treatment for the condition that affects about one-quarter of Americans.

“Hypertension, which is so pervasive in our society, is a great model because lifestyle has such an impact and the outcomes are relatively easy to measure,” Dr. Wagner says. “The hypothesis clearly is that the electronic personal health record [will help bring] hypertension under control.”

The MCG Center for Patient- and Family-Centered Care received a $30,000 grant from the Institute for Healthcare Improvement/Robert Wood Johnson Foundation in 2005 to test the Cerner system, used under the brand name, My HealthLink, for MCG multiple sclerosis patients. The 12-month study found that patients like having a secure electronic link to caregivers and that the tool helps battle chronic disease.

“An electronic personal health record is recognition that if we are serious about optimal outcomes in health care, we have to involve the patient,” says Dr. Charlotte Weaver, vice president and executive director for nursing research at Cerner. The company gathered patient input for the system and looks forward to additional input to refine the product, she says.

Refinements likely will include feeding blood pressure measurements directly from the cuff to the electronic personal health record. Similar direct feeds with weight scales and even urine analysis also are under development.

“At the end of the day, if you can deliver a personal health record that people will use, that delivers just tremendous value to our health care system as well as to individuals,” Dr. Weaver says.

The Institute for Family Centered Care, headquartered in Bethesda, Md., also is gathering input on the system. “This project will help demonstrate that when we partner with patients to really redesign the system of care, we will build the system in a way that works best for the people we serve,” says Beverley H. Johnson, the institute’s president and CEO.

“Patient-care documentation systems today are predominantly in the hands of the providers and written from their perspective,” Mrs. Sodomka says. “The shift is toward shared information systems with patients and families. The idea is that if patients start documenting things that are important to them, what they are eating, for example, they will realize what they are eating and finally get control of their diet.”

Study coordinators will help match resources with patients who lack a computer.

Study participants will learn how to use the electronic record, then have follow-up visits at three, six and 12 months. Researchers will measure patient activation, gather pertinent biological data such as blood pressure and waist circumference and use a widely accepted test to assess their relationship with their physician.

-- Toni Baker