Abstract
Objectives: To compare use of 7 shared electronic medical record (SMR) features by adult HIV patients. Study Design: Observational cohort study of adult HIV-positive patients in the first 36 months following implementation of the SMR at Group Health and Kaiser Permanente Northern California. Methods: Automated data from the 36 months following SMR implementation were assessed in 2 integrated delivery systems. Cox proportional hazards analysis identified factors associated with any SMR use. Results: Most (3888/7398) patients used the SMR at least once. Users were most likely to view medical test results (49%), use secure messaging (43%), or request appointments (31%) or medication refills (30%). Initial use was associated with new prescription for antiretroviral therapy (rate ratio [RR] 1.65, P <.001), recent change to a CD4+ count of fewer than 200 cells per microliter (RR = 1.34, P <.02), new HIV RNA of 75 or more copies per milliliter (RR = 1.63, P <.001), or recent increase in non-HIV comorbidity score (RR = 1.49, P = .0001). Users were less likely to be women (RR = 0.49, P = .0001), injection drug users (RR = 0.59, P = .0001), or from lower-socioeconomic status neighborhoods (RR = 0.68, P = .0001), and were less likely to be black (RR = 0.38, P = .0001), Hispanic (RR = 0.52, P = .0001) or Asian/Pacific Islander (RR = 0.59, P = .001). Conclusions: SMR use was higher among HIVpatients who had indicators of recent increases in healthcare needs and lower among several vulnerable populations.
| Original language | English (US) |
|---|---|
| Journal | American Journal of Managed Care |
| Volume | 19 |
| Issue number | 4 |
| State | Published - Apr 2013 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Health Policy
Cite this
Use of web-based shared medical records among patients with HIV. / Ralston, James D.; Silverberg, Michael J.; Grothaus, Louis; Leyden, Wendy A.; Ross, Tyler; Stewart, Christine; Carzasty, Steven; Horberg, Michael; Catz, Sheryl L.
In: American Journal of Managed Care, Vol. 19, No. 4, 04.2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of web-based shared medical records among patients with HIV
AU - Ralston, James D.
AU - Silverberg, Michael J.
AU - Grothaus, Louis
AU - Leyden, Wendy A.
AU - Ross, Tyler
AU - Stewart, Christine
AU - Carzasty, Steven
AU - Horberg, Michael
AU - Catz, Sheryl L
PY - 2013/4
Y1 - 2013/4
N2 - Objectives: To compare use of 7 shared electronic medical record (SMR) features by adult HIV patients. Study Design: Observational cohort study of adult HIV-positive patients in the first 36 months following implementation of the SMR at Group Health and Kaiser Permanente Northern California. Methods: Automated data from the 36 months following SMR implementation were assessed in 2 integrated delivery systems. Cox proportional hazards analysis identified factors associated with any SMR use. Results: Most (3888/7398) patients used the SMR at least once. Users were most likely to view medical test results (49%), use secure messaging (43%), or request appointments (31%) or medication refills (30%). Initial use was associated with new prescription for antiretroviral therapy (rate ratio [RR] 1.65, P <.001), recent change to a CD4+ count of fewer than 200 cells per microliter (RR = 1.34, P <.02), new HIV RNA of 75 or more copies per milliliter (RR = 1.63, P <.001), or recent increase in non-HIV comorbidity score (RR = 1.49, P = .0001). Users were less likely to be women (RR = 0.49, P = .0001), injection drug users (RR = 0.59, P = .0001), or from lower-socioeconomic status neighborhoods (RR = 0.68, P = .0001), and were less likely to be black (RR = 0.38, P = .0001), Hispanic (RR = 0.52, P = .0001) or Asian/Pacific Islander (RR = 0.59, P = .001). Conclusions: SMR use was higher among HIVpatients who had indicators of recent increases in healthcare needs and lower among several vulnerable populations.
AB - Objectives: To compare use of 7 shared electronic medical record (SMR) features by adult HIV patients. Study Design: Observational cohort study of adult HIV-positive patients in the first 36 months following implementation of the SMR at Group Health and Kaiser Permanente Northern California. Methods: Automated data from the 36 months following SMR implementation were assessed in 2 integrated delivery systems. Cox proportional hazards analysis identified factors associated with any SMR use. Results: Most (3888/7398) patients used the SMR at least once. Users were most likely to view medical test results (49%), use secure messaging (43%), or request appointments (31%) or medication refills (30%). Initial use was associated with new prescription for antiretroviral therapy (rate ratio [RR] 1.65, P <.001), recent change to a CD4+ count of fewer than 200 cells per microliter (RR = 1.34, P <.02), new HIV RNA of 75 or more copies per milliliter (RR = 1.63, P <.001), or recent increase in non-HIV comorbidity score (RR = 1.49, P = .0001). Users were less likely to be women (RR = 0.49, P = .0001), injection drug users (RR = 0.59, P = .0001), or from lower-socioeconomic status neighborhoods (RR = 0.68, P = .0001), and were less likely to be black (RR = 0.38, P = .0001), Hispanic (RR = 0.52, P = .0001) or Asian/Pacific Islander (RR = 0.59, P = .001). Conclusions: SMR use was higher among HIVpatients who had indicators of recent increases in healthcare needs and lower among several vulnerable populations.
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UR - http://www.scopus.com/inward/citedby.url?scp=84877726891&partnerID=8YFLogxK
M3 - Article
C2 - 23725449
AN - SCOPUS:84877726891
VL - 19
JO - American Journal of Managed Care
JF - American Journal of Managed Care
SN - 1088-0224
IS - 4
ER -