patient portal

Screen Shot 2014-09-24 at 7.32.39 PMOften, at scientific conferences, the most important learning happens in the question and answer period.

I spoke at the American Diabetes Association conference earlier this year, presenting results of an observational study we did on medication adherence and diabetes.

We found that if people starting using the online patient portal (sometimes called the personal health record), to order their medication refills, they were more likely to take their medication regularly. Dr. Katherine Newton of Group Health Research Institute spoke before me, describing a randomized study showing that a clinical pharmacist-led blood pressure management program did not lower blood pressure any more than usual care by an outpatient provider.

The first audience comment came from a program officer from the National Heart, Lung, Blood Institute, part of the National Institutes of Health. Program officers are incredibly important because they help set the research priorities for the major funding mechanism for medical research. I will never forget her comment, because it was so strongly worded.

Continue reading “What’s So Wrong With Randomized Trials?”

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Hey there Accountable Care Organization executive.

You’re probably willing to continue to commit millions of dollars toward an electronic health record (EHR) coupled to an online patient portal.  That’s because you’ve been told by your leadership team that electronic consumer empowerment, patient-provider communication and the substitution of efficient two-way messaging for costly face-to-face visits will increase quality, reduce expenses, generate shared savings and guarantee that your life-sized portrait will be prominently displayed in your flagship hospital’s lobby.

Well, after you’ve read a just-published JAMA research study by Ted Palen, Colleen Ross, David Powers and Stanley Xu, you may want to tell your administrative assistant to cancel that appointment with the portrait artist.

The article’s title is Association of Online Patient Access to Clinicians and Medical Records With Use of Clinical Services.

How the study was done:

Kaiser Permanente Colorado added “MyHealthManager” (MHM) to their EHR in May 2006. MHM allows patients to view tests, records, problem lists as well as care plans, schedule appointments, request refills and message their doctors. By June of 2009, over 375,000 Kaiser patients had signed up for MHM. Of those, about 45% had used the system at least once.  Of this number, Kaiser researchers pulled the records of 44,321 persons who had been continuously enrolled in the Kaiser system for at least two years.

Continue reading “Study Says, Something Other Than What We Were Expecting. EHR Portals Increase Hospitalization Rates”

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