HealthIT Success Portal Enhances Patient-Centered Preventive Care

I'm Jim Mold, and I was the principal investigator on the My Wellness Portal Project. Our team has been developing the "My Wellness Portal" personal health record system, or PHR, since 2008 as part of a strategic plan to build and test a novel, comprehensive care delivery system through primary care practices. We originally set about to develop an immunization registry, to help clinicians know what immunizations were due on patients at a particular visit. But then we realized that it would make sense to add other preventive services to the same registry.

That actually created the opportunity to embed evidence-based guidelines into the software, so that we no longer think in terms of individual diseases, but rather in terms of outcomes. Basically, what we're trying to do is change the way we take care of folks. We want to move in the direction of person-centered care and away from disease-oriented care. And the clinicians said that if the patients came and asked for preventive services, that they would be more likely to deliver them.

And that's why we set about to develop My Wellness Portal. I think the My Wellness portal is different from other patient portals and personal health care records primarily because it follows the patient goal-directed model, which is a different way of looking at health and health care. The My Wellness Portal was studied in a cluster randomized controlled trial, in eight clinician practices in our practice-based research network called the Oklahoma Physicians Resource/ Research Network, OKPRN. We investigated the records of 422 adults and 166 records of children less than six years old.

The wellness portal was available to patients on any internet-enabled device. We also provided tablet computers for practices, especially for those patients who didn't have internet access. The reason we called it My Wellness Portal is because, it's actually about what preventive services would benefit you as an individual given all of your risk factors. So, if you ride a bicycle it recommends a bicycle helmet, but if you don't, it doesn't.

And if you smoke, it recommends smoking cessation, but if you don't it doesn't, and so forth. So it's truly personalized. It certainly made it more person-centered, and that's what we found in the study, that people felt that their care was more patient-centered. Clinicians like that the My Wellness Portal did not put a significant burden on their practice.

They also said that converging on evidence-based recommendations could be the most important outcome of the wellness portal implementation. One of our clinicians was Kristy Baker. She's a nurse practitioner in Clinton, Oklahoma. I have been involved in the My Wellness Portal research for several years.

And now that it is being launched for use we are implementing it here for our patients to log in and use it. Integrating the My Wellness Portal into our practice has changed the way that we approach our patients. We can tell patients ahead of time to log in to their portal. And they're more ready to talk to me about what they want to accomplish in their health, and I can also look at their portal from my side and get an idea of where they're headed, some trends that they have logged in, and information that they are sharing with me.

And of course, some of the other things like that my mother's history of breast cancer, I already knew about that but it kind of triggered that too so... Sure, now did you enter some of your family history into the My Wellness Portal? Yes. Good, and you can use that, it's portable, so you can access that anytime, anywhere that you need to. The next step is integration, where we need to go beyond the confines, the walls of the practice, and include information that resides outside of the practice.

And finally we need a system where we can implement the health record and the wellness portal in a practice setting. I think the future of health care is prioritization. If you ask most doctors to look at a patient's medical record and prioritize the various interventions that would be suggested by that medical record, they would have a very difficult time doing that. And so, that's what we've built into My Wellness Portal, and it really requires sophisticated math.

And that's where information technology is the perfect answer..