Dr. Lisa I. Iezzoni is the Principal Investigator on the project entitled Improving Chronic Disease Care with PatientSite at Beth Israel Deaconess Medical Center.

Can you give us a quick overview of this study?
Our project uses PatientSite, a patient Internet portal, to educate patients about communicating more effectively with their primary care physicians – about preparing beforehand for doctor office visits and addressing their critical health concerns during these encounters. Our intervention involves what we call an “e-coach” – a clinical practice nurse who corresponds electronically with patients prior to regularly scheduled visits, giving them standard tips about how to approach the visit and accomplish their goals for that appointment. Through online screening of potential project participants, we are targeting individuals who may have depression, chronic pain, or mobility difficulties – common conditions that often go undetected or under-treated. The ultimate goal of our project is to improve patient-physician communication and, by doing so, to improve patients’ clinical outcomes and visit experiences and to enhance the efficiency of care.

What prompted your organization to explore this research?
PatientSite is a secure Internet portal serving Boston’s Beth Israel Deaconess Medical Center and its affiliates. We are very proud of PatientSite, which already allows patients to confidentially e-mail their clinicians, make appointments, arrange referrals, refill prescriptions, check various test results (such as laboratory, radiology, and pathology results), view their medication and problem lists, and obtain general health information. However, we wanted to explore whether PatientSite could do even more to educate and inform patients and improve their quality of care. On-line communication, whether through e-mails or completion of questionnaires delivered and processed electronically, offers virtually instantaneous transmission of critical information directly to specific individuals who could use it most effectively – be they patients, physicians, or researchers. Therefore, providing an e-coach intervention through PatientSite seemed an excellent opportunity to efficiently enhance patient care.

How would a typical end-user utilize the final product/results of your research?
We are specifying the e-coach intervention, such as the initial messages e-mailed to patients with tips about preparing for their office visits, in great detail. We plan to make these details available when the project is over. Therefore, if others wish to replicate our programs, they can easily access our tools.

What are the greatest challenges that you have faced so far?
The greatest challenges thus far are those that inevitably arise in new research projects – taking what seems like a good idea on paper and making it happen in practice. Our intervention has numerous “moving parts,” including introductory messages, informed consent forms, screening questionnaires, follow-up surveys, and the e-coach transactions, which we must specify and integrate into PatientSite. We are working with a great team of highly skilled and knowledgeable programmers, but we are also confronting the realities of computer capabilities and what can work within PatientSite. We are confident of ironing out the various bumps we have encountered, but it can be slow and painstaking work.

Lisa, thank you so much for your time!

Check back in May to read an update from Dr. Walter Stewart of Geisinger Health System.