Personal health record reach in the Veterans Health Administration: a cross-sectional analysis.

Shimada SL, Brandt CA, Feng H, McInnes DK, Rao SR, Rothendler JA, Haggstrom DA, Abel EA, Cioffari LS, Houston TK. Personal health record reach in the Veterans Health Administration: a cross-sectional analysis. Journal of medical Internet research. 2014 Dec 12; 16(12):e272.

Related HSR&D Project(s)

• CDA 10-210 – Optimizing Veterans Use of eHealth Technologies
• CDA 07-016 – Patterns of Follow-up Care Among Colorectal Cancer Survivors
• RRP 11-404 – Identifying Opportunities for Targeted Interventions via My HealthVet

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

BACKGROUND: My HealtheVet (MHV) is the personal health record and patient portal developed by the United States Veterans Health Administration (VA). While millions of American veterans have registered for MHV, little is known about how a patient''s health status may affect adoption and use of the personal health record. OBJECTIVE: Our aim was to characterize the reach of the VA personal health record by clinical condition. METHODS: This was a cross-sectional analysis of all veterans nationwide with at least one inpatient admission or two outpatient visits between April 2010 and March 2012. We compared adoption (registration, authentication, opt-in to use secure messaging) and use (prescription refill and secure messaging) of MHV in April 2012 across 18 specific clinical conditions prevalent in and of high priority to the VA. We calculated predicted probabilities of adoption by condition using multivariable logistic regression models adjusting for sociodemographics, comorbidities, and clustering of patients within facilities. RESULTS: Among 6,012,875 veterans, 6.20% were women, 61.45% were Caucasian, and 26.31% resided in rural areas. The mean age was 63.3 years. Nationwide, 18.64% had registered for MHV, 11.06% refilled prescriptions via MHV, and 1.91% used secure messaging with their clinical providers. Results from the multivariable regression suggest that patients with HIV, hyperlipidemia, and spinal cord injury had the highest predicted probabilities of adoption, whereas those with schizophrenia/schizoaffective disorder, alcohol or drug abuse, and stroke had the lowest. Variation was observed across diagnoses in actual (unadjusted) adoption and use, with registration rates ranging from 29.19% of patients with traumatic brain injury to 14.18% of those with schizophrenia/schizoaffective disorder. Some of the variation in actual reach can be explained by facility-level differences in MHV adoption and by differences in patients'' sociodemographic characteristics (eg, age, race, income) by diagnosis. CONCLUSIONS: In this phase of early adoption, opportunities are being missed for those with specific medical conditions that require intensive treatment and self-management, which could be greatly supported by functions of a tethered personal health record.