220922 Beyond the technical interface: Creating successful multi-sector partnerships for personal health records

Tuesday, November 9, 2010 : 10:50 AM - 11:10 AM

Jill Rissi, PhD , Hatfield School of Government, Division of Public Administration, Portland State University, Portland, OR
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
Sean Kolmer, MPH , Office of Health Policy and Research, State of Oregon, Salem, OR
The ability of government agencies to forge successful partnerships with community-based organizations and private vendors is critical to creating awareness, facilitating enrollment and assuring utilization of personal health records (PHR), particularly among vulnerable and underserved populations. In addition to technical problems arising from questions of interoperability, privacy, security and access, such partnerships must overcome obstacles to sustainability through alignment of incentives and reconciliation of diverse and, often, divergent goals. This paper presents the findings of an evaluation study which utilized mixed methods to assess the organizational performance and management of a multi-stakeholder partnership for the design, delivery, outreach and enrollment of Medicaid beneficiaries in an online personal health record (PHR). The collaborative partnership included state government agencies, a non-profit organization and a private corporation. Qualitative methods included content analysis of outreach materials, guided interviews with key informants, and participant-observation of Critical Event meetings. Qualitative analysis was augmented by statistical analysis of enrollment volume, PHR utilization and enrollee survey data. Data were inductively analyzed to identify key themes and synthesized to produce a final interpretive analysis. Key themes identified in the design, development and implementation of the Medicaid PHR project included the alignment of short and long-term financial incentives, recognition of computer and health literacy limitations among the target population, and the challenges posed by competing initiatives such as provider-based electronic health records. Collaboration with other government agencies, public and private corporations and community-based service providers has resulted in the identification and/or development of HIT tools specifically tailored to the Medicaid population, but with a broader, service-oriented design that is applicable to multiple parties in multiple settings. This study provides key insights into the challenges posed by the partnership itself, and ways in which the structure of contractual and other obligations may facilitate or constrain successful public-private HIT ventures.

Learning Areas:
Administer health education strategies, interventions and programs
Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
1) Define the challenges presented by multi-sector partnerships for implementation of online personal health records. 2) Analyze the structural factors that facilitate and/or constrain implementation and utilization of online personal health records for Medicaid enrollees. 3) Identify underlying differences in organizational culture and behavior that affect public-private partnerships for health information technologies.

Keywords: Collaboration, Health Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the a co-investigator on this evaluation project, overseeing the collection, analysis and interpretation of qualitative data.
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.