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RRP 09-225 – HSR&D Study

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RRP 09-225
My HealtheVet Cross-Cutting Quality Enhancement Research Initiative Workgroup
Frances M. Weaver PhD MA BA
Edward Hines Jr. VA Hospital, Hines, IL
Hines, IL
Funding Period: October 2009 - September 2010

BACKGROUND/RATIONALE:
Launched in 2003, My HealtheVet (MHV) is an integrated web-portal and personal health record (PHR) system that aims to empower Veterans to participate more fully in their health care. There is tremendous interest across the Veterans Health Administration (VHA) to maximize use of MHV, capitalize on its potential to facilitate healthcare delivery, and promote superior health outcomes in the Veteran population, but the evidence base necessary to support such initiatives is limited. To address these issues, we formed a collaborative and sustainable MHV cross-cutting QUERI workgroup, the purpose of which is to understand, promote, and support the pursuit of PHR research, particularly as it relates to implementation research efforts

OBJECTIVE(S):
The overarching goal of the proposed MHV workgroup was to explore the relationships between implementation science and PHR-related research, by identifying areas of interest, MHV features that could support research, and methods to disseminate research projects and findings.

METHODS:
The workgroup members participated in bimonthly conference calls to discuss important issues, and disseminated meeting notes via a Share Point site. Members of the committee presented their research related to using MHV during these calls. The workgroup also developed and fielded an IRB-exempted online survey, as part of a Quality Enhancement Research Initiative (QUERI) Cyber Seminar. E-mail messages with a survey hyperlink were sent to 465 seminar registrants. Questions focused on MHV perceptions and awareness, current research activities, use of particular MHV features and functionalities, experience and interest in ehealth technologies, and demographics. Data analyses were descriptive.

FINDINGS/RESULTS:
191 individuals (41% response rate) completed the survey; 81.6% were based at a VA facility, 50.8% were engaged in research and 24.6% were affiliated with a QUERI or HSRD resource center. Before the cyberseminar, 43.5% were moderately/very familiar with MHV, 84.8% had visited MHV, and 71.7% had discussed MHV with colleagues. Participants were interested in using the following MHV-related data: patient self-entered information (62.9%), electronic medical record (EMR) extracts (57.7%), web-trend reports (53.6%), administrative data (47.4%), and the American Customer Satisfaction Survey (37.1%). Respondents agreed/strongly agreed that MHV can be used to deliver healthcare interventions (61.2%), promote healthy behavior (60.7%), and understand patient self-management (63.7%).

In sum, a select group of VA researchers, clinical and operations staff are interested in using MHV and other patient-facing technologies to study, intervene, and measure patient outcomes.

IMPACT:
As part of VA's ongoing transformation initiatives, eHealth strategies will play an important role in reshaping existing disease management and care delivery models for Veterans. These results suggest that VA's research community should be engaged as a resource to understand how and why particular strategies are effective in improving healthcare processes and outcomes. Development of the new eHealth QUERI will help to address these issues. Efforts of the Cross-Cutting Workgroup have been folded into the ongoing work of the newly established eHealth QUERI.

PUBLICATIONS:

Journal Articles

  1. Grady B, Myers KM, Nelson EL, Belz N, Bennett L, Carnahan L, Decker VB, Holden D, Perry G, Rosenthal L, Rowe N, Spaulding R, Turvey CL, White R, Voyles D, American Telemedicine Association Telemental Health Standards and Guidelines Working Group. Evidence-based practice for telemental health. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 2011 Mar 1; 17(2):131-48.
  2. Nazi KM, Hogan TP, Wagner TH, McInnes DK, Smith BM, Haggstrom D, Chumbler NR, Gifford AL, Charters KG, Saleem JJ, Weingardt KR, Fischetti LF, Weaver FM. Embracing a health services research perspective on personal health records: lessons learned from the VA My HealtheVet system. Journal of general internal medicine. 2010 Jan 1; 25 Suppl 1:62-7.
Center Products

  1. Weaver FM, Wakefield B, Hogan TP, Nazi KM, Houston T. Complementary e-health applications that can facilitate access to care: The case for home telehealth technology and personal health records. 2010 Sep 22.
VA Cyberseminars

  1. Weaver FM, Nazi K, Hogan TP, Hogan TP. My HealtheVet: What researchers should know about VA's e-health website and personal health record. [Cyberseminar]. 2010 Aug 24.
Conference Presentations

  1. Turvey CL. The Newer Technologies and Telepsychiatry: Videoteleconferencing, Web-Based Communications and Personal Health Records. Paper presented at: Iowa Psychiatric Society Spring Meeting; 2011 Apr 2; Des Moines, IA.
  2. McInnes DK, Hogan TP, Houston TK, Turvey CL, Nazi KM. Opportunities for the New eHealth QUERI: Developing Approaches to Increase Veteran Adoption and use of my HealtheVet. Presented at: VA HSR&D National Meeting; 2011 Feb 16; National Harbor, MD.


DRA: Health Systems
DRE: Treatment - Observational, Prevention
Keywords: Care Management, Education (patient), Patient-centered Care
MeSH Terms: none

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