Appl Clin Inform 2016; 07(03): 765-776
DOI: 10.4338/ACI-2016-01-RA-0014
Research Article
Schattauer GmbH

Patient Education for Consumer-Mediated HIE

A Pilot Randomized Controlled Trial of the Department of Veterans Affairs Blue Button
Carolyn L. Turvey
1  Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, IA, United States
2  The University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States
,
Dawn M. Klein
1  Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, IA, United States
2  The University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States
,
Matthew Witry
3  The University of Iowa College of Pharmacy, Iowa City, IA
,
J. Stacey Klutts
4  Iowa City VA Healthcare System Pathology and Laboratory Medicine, Iowa City, IA
5  The University of Iowa Carver College of Medicine Department of Pathology, Iowa City, IA
,
Elaine L. Hill
6  University of Rochester School of Medicine Department of Public Health Sciences, Rochester NY
7  Canandaigua VA Medical Center, Geriatrics and Extended Care Data Analysis Center, Canandaigua, NY
,
Bruce Alexander
1  Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City, IA, United States
,
Kim M. Nazi
8  Veterans and Consumers Health Informatics Office, Office of Informatics & Analytics, Veterans Health Administration, Washington DC, United States
› Author Affiliations
Funding This work was supported by the Department of Veterans Affairs, Health Services Research & Development (PPO-13–178). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs
Further Information

Publication History

received: 16 February 2016

accepted: 04 July 2016

Publication Date:
19 December 2017 (online)

Summary

Objectives

Consumer-mediated health information exchange (HIE) is one of the three types of HIE designated by the Office of the National Coordinator. HIE is intended to improve the quality of care while reducing cost, yet empirical support for this claim is mixed. Future research should identify the contexts whereby HIE is most effective.

Methods

This study was conducted as a pilot two-arm randomized controlled trial. In the intervention arm, 27 veterans were taught how to generate a Continuity of Care Document (CCD) within the Blue Button feature of their VA patient portal and were then asked to share it with their community non-VA provider. In the attention control condition, 25 Veterans were taught how to look up health information on the Internet. The impact of this training on the next non-VA medical visit was examined.

Results

Nineteen (90%) veterans in the intervention arm shared their CCD with their non-VA provider as compared with 2 (17%) in the attention control arm (p<0.001). Both veterans and non-VA providers indicated high satisfaction with the CCD. Comparison of medical records between the VA and non-VA providers did not indicate improved medication reconciliation (p=0.72). If veterans shared their CCD prior to their non-VA providers ordering laboratory tests, the number of duplicate laboratories was significantly reduced (p=0.02).

Conclusions

In this pilot randomized controlled trial, training 52 veterans to share their CCD was feasible and accepted by both patients and providers. Sharing this document appeared to reduce duplicate laboratory draws, but did not have an impact on documented medication list concordance.

Citation: Turvey CL, Klein DM, Witry M, Klutts JS, Hill EL, Alexander B, Nazi KM. Patient education for consumer-mediated HIE: A pilot randomized controlled trial of the Department of Veterans Affairs Blue Button.