220818 Personal Health Records and the Oregon Medicaid experience: An evaluation study

Monday, November 8, 2010

Oliver Droppers, MS MPH , Mark O. Hatfield School of Government, Portland State University, Portland, OR
Sherril B. Gelmon, DrPH , Professor of Public Health, Mark O. Hatfield School of Government, Portland State University, Portland, OR
Jill J. Rissi, PhD , St. Luke's Health Initiatives, Phoenix, AZ
Aasta Thielke , Mark O. Hatfield School of Goverment, Portland State University, Portland, OR
Background: The State of Oregon is implementing a personal health record system (PHR) for its Medicaid population, supported by a federal Medicaid Transformation Grant. This unique consumer-centric PHR approach could potentially enhance Medicaid clients' ability to monitor and manage their own health, helping individuals become more active participants in their own wellness and self-care.

Objective/Purpose: An evaluation team from Portland State University was contracted to assess the utility of the PHR based on the experiences of Medicaid clients. An evaluation conceptual framework of key concepts and indicators will guide the research, helping to illustrate barriers to and facilitators of PHR adoption.

Methods: The study is quasi-experimental, employing mixed methods through a community-engagement research strategy including use of online surveys, interviews, focus groups, and documentation review. Data will be collected during three stages of PHR adoption: design, implementation and optimization.

Population Studied: Potential participants include all publicly insured individuals within the Oregon Medicaid system who create a PHR during the study period. Adults are enrolling in the first phase; followed by children and their associated caregivers, case managers and/or foster parents. All individuals creating a PHR account are eligible to receive the baseline survey.

Results: Factors likely to influence accessibility and use of PHRs among the study population are limited computer and health literacy, challenges with informed decision-making using their own medical information, and usability of health information accessed through PHR Internet based Web sites.

Discussion/Conclusions: PHR systems, particularly those that are consumer-oriented and controlled, are in their infancy, but must be designed to be accessible to underserved and vulnerable populations and address existing disparities around eHealth. Enhanced understanding of this new technology is an important first step. Findings from this research may inform how Medicaid clients interact with PHRs, given fundamental issues related to Internet access and health literacy.

Learning Areas:
Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Identify the underlying mechanisms that facilitate or hinder widespread use of Personal Health Records (PHR) among Oregonís Medicaid population. Develop and acquire skills used in conducting a qualitative evaluation around implementation and use of PHRs, particularly evaluating the initial use of an advanced health information technology among vulnerable and underserved population groups. Articulate and identify an evolving set of best practices for future PHR development and implementation in Oregon and elsewhere. Be able to assess the potential benefits and challenges with ongoing use of PHRs among Medicaid population groups.

Keywords: Information Technology, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I serve as the evaluation project manager for the research study being presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.