Dr. Walter Stewart is the Principal Investigator on the project entitled Does Access to an EHR Patient Portal Influence Chronic Disease Outcomes? A Randomized Trial Assessing Clinical and Behavioral Change Outcomes in Patients with CHF, Diabetes, or Secondary CVD at Geisinger Health System in Danville, PA.

What is unique and/or innovative about your study?
Helping patients to get involved in their own care is a common goal. We are conducting a randomized controlled trial to determine if tailored interventions delivered via a patient portal activates patients. As part of this novel strategy, we are also leveraging the physician-patient relationship by having the physician “prescribe” the use of the on-line tool to the patient. We are measuring baseline and follow-up “patient activation” and will be able to track just how much the intervention affects self-efficacy, clinical outcomes and the cost of care.

How is your project progressing so far?
We have successfully navigated the study through the Institutional Review Board (IRB), established a partnership with HealthMedia, Inc. (a provider of web-based, customized behavior health interventions for patients and fellow Health e-Technologies Initiative grantee), gained the support of primary care physicians to send a letter to more than 1800 patients and collected baseline data from participants. The intervention was initiated on May 1 and will have a one-year intervention and follow-up period.

What prompted you to explore this research?
The prospects for increasing productivity while simultaneously improving quality and access are not mutually exclusive options, but rather elements of a sustainable solution. Access to a patient portal opens new ways for patients and care providers to interact. At Geisinger, we have a high-end patient portal being used by more than 20,000 patients across the system. During the planned growth of this portal, we were looking for demonstration projects that would allow us to expand use of our portal beyond basic functions and deliver care in innovative ways. The Health e-Technologies Initiative gave us that opportunity.

How would a typical end-user utilize the final product/results of your research?
We hope to show that eHealth can play a vital role in the overall care for patients with chronic diseases, and make quantifiable improvements comparable to commonly used medications and procedures. An end-user can log-on to the Internet and complete a program “prescribed” by his or her physician, extending the prescribing model to non-traditional areas.

What are the greatest challenges in eHealth and more specifically, your project?
The greatest challenge is creating eHealth solutions that are easy to use, relevant and useful to the patient and clinically sensible and meaningful to the care provider that can be delivered in a seamless manner as an extension of the patient-provider relationship. The solutions need to be sustainable and scalable.

In what ways would you like to see eHealth evolve?
eHealth has already started to take over mundane yet essential tasks, allowing providers to regain some time to focus on complex issues of care. eHealth can translate and implement a physician’s recommendations to each patient’s unique needs, delivering care at the intensity and frequency no individual doctor could be expected to monitor.

How do you stay informed of advances and innovations in eHealth?
Read journals, attend relevant meetings and talk to colleagues. We also meet regularly with staff from IT, disease management and clinical effectiveness to refine eHealth strategies and make them relevant to all stakeholders.

Walter – thank you for the update!

Dr. Dirk Schroeder will be featured in the June edition of Meet the Grantees.