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CDA 10-210 – HSR Study

CDA 10-210
Optimizing Veterans Use of eHealth Technologies
Stephanie L Shimada, PhD
VA Bedford HealthCare System, Bedford, MA
Bedford, MA
Funding Period: February 2012 - January 2017
VA has made a considerable investment in My HealtheVet (MHV), its personal health record and patient portal, and is relying on the promise it holds to improve patient access to health information and patient engagement with their care. MHV is a cornerstone of the Patient Aligned Care Team (PACT) initiative that is part of VA's primary care transformation. Despite the fact that MHV has been available for over a decade, and that new features continue to be added, the majority of Veterans have not gone through the in-person authentication process to access the key features of MHV. It is of the utmost importance that we understand who is and is not currently being reached by MHV, and how better to reach those Veterans who are not currently using MHV, so that VA can plan appropriate outreach and ensure health disparities are not widened by disparities in access.

1. Conduct an extensive database study to:
a. Assess the relationship between patient sociodemographic characteristics, clinical characteristics, enabling resources, and adoption and use of MHV;
b. Assess the relationship between a patient's comorbidity burden and in-person authentication for MHV, and the mediating effect of healthcare utilization;
c. Assess whether in-person authentication for MHV, and use of specific features of MHV, are associated with improved health outcomes among diabetic patients in VA.
2. Assess Veterans' user experience with MHV via usability testing.
3. Explore patient and provider experiences with MHV secure messaging via a mixed-methods approach.

1. Conducted an analysis of CDW data on MHV adoption and use of specific features of MHV.
2. Conducted usability testing of MHV and semi-structured interviews with patients to gain an understanding of the barriers to use of MHV, both in terms of patient preferences surrounding eHealth, and in terms of the human-computer interface.
3. Conducted semi-structured qualitative interviews with providers and patients using secure messaging. Surveyed providers using secure messaging. Analyzed message content, the intended and unintended consequences of secure messaging, and the impact on workload, workflow and patient-provider communication.

None to date

This CDA has helped improve the VA's understanding of how to leverage its personal health record/patient portal and other patient-facing technologies to improve Veterans' and their caregivers' engagement in their healthcare and improve health outcomes. Findings have been presented at national conferences and shared with the Office of Connected Care and Veteran/Consumer Health Informatics Office.

External Links for this Project

NIH Reporter

Grant Number: IK2HX000759-01

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None at this time.

DRA: Health Systems
DRE: Technology Development and Assessment
Keywords: none
MeSH Terms: none

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