Design and implementation of a web-based patient portal linked to an ambulatory care electronic health record: patient gateway for diabetes collaborative care.

Full Abstract

BACKGROUND:
Despite the availability of expert guidelines and widespread diabetes quality improvement efforts, care of patients with diabetes remains suboptimal. Two key barriers to care that may be amenable to informatics-based interventions include (1) lack of patient engagement with therapeutic care plans and (2) lack of medication adjustment by physicians ("clinical inertia") during clinical encounters.

METHODS:
The authors describe the conceptual framework, design, implementation, and analysis plan for a diabetes patient web-portal linked directly to the electronic health record (EHR) of a large academic medical center via secure Internet access designed to overcome barriers to effective diabetes care.

RESULTS:
Partners HealthCare System (Boston, MA), a multi-hospital health care network comprising several thousand physicians caring for over 1 million individual patients, has developed a comprehensive patient web-portal called Patient Gateway that allows patients to interact directly with their EHR via secure Internet access. Using this portal, a specific diabetes interface was designed to maximize patient engagement by importing the patient's current clinical data in an educational format, providing patient-tailored decision support, and enabling the patient to author a "Diabetes Care Plan." The physician view of the patient's Diabetes Care Plan was designed to be concise and to fit into typical EHR clinical workflow.

CONCLUSIONS:
We successfully designed and implemented a Diabetes Patient portal that allows direct interaction with our system's EHR. We are assessing the impact of this advanced informatics tool for collaborative diabetes care in a clinic-randomized controlled trial among 14 primary care practices within our integrated health care system.

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Author information

Author/s: Grant, Richard W (RW); Wald, Jonathan S (JS); Poon, Eric G (EG); Schnipper, Jeffrey L (JL); Gandhi, Tejal K (TK); Volk, Lynn A (LA); Middleton, Blackford (B);

Affiliation: Division of General Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. Rgrant(-atsign-)partners.org

Grants: K23 DK067452 (Agency:NIDDK NIH HHS) ; R01 HS013660-02 (Agency:AHRQ HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.

Journal: Diabetes technology & therapeutics (Diabetes Technol Ther), published in United States. (Language: eng)

Reference: 2006-Oct; vol 8 (issue 5) : pp 576-86

Dates: Created 2006/10/13; Completed 2006/12/13; Revised 2007/12/03;

PMID: 17037972, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Ambulatory Care - organization & administration
Decision Support Systems, Clinical
Diabetes Mellitus - therapy
Humans

Internet
Medical Records Systems, Computerized
Patient Participation - methods
Program Evaluation

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