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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1101 — Personal Health Information Management and the Role of VA’s Personal Health Record Portal among Veterans with Spinal Cord Injury/Disorder

Hogan TP, Center for Management of Complex Chronic Care and SCI-QUERI, Hines, IL; Loyola University, Chicago; Hill JN, Center for Management of Complex Chronic Care and SCI-QUERI, Hines, IL; Bauer E, Center for Management of Complex Chronic Care, Hines, IL; Nazi KM, Veterans and Consumers Health Informatics Office, Washington, DC; Smith BM, Center for Management of Complex Chronic Care and SCI-QUERI, Hines, IL; Loyola University, Chicago; Thomas FP, VA Spinal Cord Injury Service, St. Louis, MO; Richardson MS, VA Spinal Cord Injury Service, Hines, IL; Weaver FM, Center for Management of Complex Chronic Care and SCI-QUERI, Hines, IL; Loyola University, Chicago;

Objectives:
Veterans with a spinal cord injury/disorder (SCI/D) often require extensive health care over their lifetime. Effective self-management hinges on their ability to handle diverse and evolving health information from a variety of sources. Our objectives were to: (1) characterize personal health information management (PHIM) practices of Veterans with SCI/D; and (2) understand the role of patient-facing technologies (PFTs), specifically VA’s My HealtheVet (MHV) personal health record portal, in their PHIM efforts.

Methods:
As part of a larger, QUERI-funded project, we conducted semi-structured, audio-recorded telephone interviews with a purposeful sample of Veterans (n = 30) with SCI/D seen at two SCI Centers. Veterans had to be at least 18 years of age and MHV users. Participants were identified in the course of the larger study, and with the help of clinical contacts. Interviews were transcribed verbatim; data analysis is proceeding through constant comparative techniques.

Results:
Participants were predominantly male (90%), white (87%), had at least some college (93%), and the mean age was 58.3 years. The majority reported that they had “easy access” to a computer (93%) and the Internet (87%), and had completed registration and in-person authentication with MHV (90%). Use of interpersonal, print, and electronic media sources for health information was prominent, as were various PHIM practices, including storage of health information in home-based collections and committing other details to memory. Most had a basic understanding of MHV’s current functionality; however, others lacked awareness of recently released features. There was strong interest in sharing MHV account access, viewing laboratory results, exchanging messages with providers, and more specific to SCI, accessing lists of medical equipment. Despite strong interest in MHV, few described its use as an integral part of their PHIM practices.

Implications:
Veterans with SCI/D manage personal health information in different ways. MHV has great potential to support their PHIM practices; however, improved promotional efforts are necessary to communicate evolving system capabilities, and opportunities to address SCI-specific self-management needs should be pursued.

Impacts:
These findings will inform a subsequent QUERI study to implement self-management support for Veterans with SCI; they also highlight the meaningful uses of PFTs among Veterans faced with complex healthcare needs.


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