224448 Consumer Health Informatics: Is There Any Evidence of Effectiveness?

Monday, November 8, 2010

M. Christopher Gibbons, MD, MPH , Urban Health Institute, Johns Hopkins University, Baltimore, MD
Renee Wilson, MA , Evidence Based Practice Center, Johns Hopkins University, Baltimore, MD
Lipika Samal, MD , School of Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
Harold Lehmann, MD, PhD , Division of Health Sciences Informatics, Johns Hopkins University, Baltimore, MD
Christoph Lehmann, MD , School of Medicine, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
Kay Dickersin, PhD , US Cochrane Center, Johns Hopkins University, Baltimore, MD
Joseph Finkelstein, MD, PhD , School of Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
Hannan Aboumatar, MD , Department of Medicine, Johns Hopkins University, Baltimore, MD
Eric Bass, MD, MPH , Department of Medicine, Johns Hopkins University, Baltimore, MD
Background. Public interest in Consumer Health Informatics (CHI) is growing. The impact/effectiveness of these tools and applications is unknown and has not previously been systematically evaluated. The objective of this study was to review the evidence of the impact of consumer health informatics applications on health outcomes. Methods. We searched MEDLINEŽ, EMBASEŽ, The Cochrane Library, Scopus, and CINAHL databases, references in eligible articles, the table of contents of selected journals; and query of experts. The Grey literature was also evaluated. A CHI conceptual model along with inclusion and exclusion criteria were developed to guide the evaluation. Paired reviewers reviewed eligible citations to identify randomized controlled trials (RCTs) of the impact of CHI applications, and all studies that addressed barriers to use of CHI applications. All studies were independently assessed for quality. All data was abstracted, graded and reviewed by 2 different reviewers. Results. 146 eligible articles were identified including 121 RCTs from over 20,000 papers. Included studies were very heterogenous and of variable quality. Significant positive impact of CHI applications was found on select healthcare process outcomes, intermediate health outcomes, doctor patient relationship related outcomes and select clinical outcomes. No evidence of consumer harm attributable to a CHI application was found. Evidence was insufficient to determine the economic impact of CHI applications. Conclusions: Despite study heterogeneity, quality variability and some data paucity, the best available literature suggests that select CHI applications may effectively engage consumers, enhance traditional clinical interventions, and improve both intermediate and clinical health outcomes. Several significant research gaps remain.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Communication and informatics

Learning Objectives:
1. Define consumer health informatics (CHI) 2. Describe a conceptual framework for evaluating CHI interventions 3. Discuss the results of a systematic evidence review of the impact of CHI 4. Discuss evidence gaps and future CHI research needs

Keywords: Information Technology, Disease Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principle Investigator for an Agency for Healthcare Research and Quality funded Systematic Review of the literature on the evidence of impact of Consumer Health Informatics applications. In this capacity I led a group of research scientists at the Johns Hopkins Evidence Based Practice Center in the conduct and completion of this research project.
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.

Back to: 3317.3: The Use of Consumer Health Informatics in Health Education Promotion and Disease Management