Reduced emergency room and hospital utilization in persons with multiple chronic conditions and disability receiving home-based primary care.

Background: Persons with multiple chronic conditions and disability face access barriers to office-based primary care and have very high rates of emergency department (ED) use and hospital admissions. Home-based primary care (HBPC) has been proposed as a way to improve disease management and prevent health crises.

Hypothesis: Enrollment of patients with disability and multiple chronic conditions in a HBPC program is associated with a subsequent decrease in ED visits and hospital admissions.

Testing of a tethered personal health record framework for early end-of-life discussions.

Objectives: The process of planning for end-of life decisions, also known as advance care planning (ACP), is associated with numerous positive outcomes, including improved patient satisfaction with care and improved patient quality of life in terminal illness. In this study, we sought to test a novel personal health record (PHR)-delivered ACP framework through a small-scale randomized trial of usual care practices versus PHR-delivered ACP.

Study Design: Randomized controlled pilot intervention.

Development of a tethered personal health record framework for early end-of-life discussions.

Objectives: End-of-life planning, known as advance care planning (ACP), is associated with numerous positive outcomes, such as improved patient satisfaction with care and improved patient quality of life in terminal illness. However, patient-provider ACP conversations are rarely performed or documented due to a number of barriers, including time required, perceived lack of skill, and a limited number of resources. Use of tethered personal health records (PHRs) may help streamline ACP conversations and documentations for outpatient workflows.

Diffusion and Use of Tethered Personal Health Records in Primary Care.

Background: Personal health records (PHRs) enable patients to access their healthcare information in a secure environment, increasing patient engagement in medical care. PHRs can be tethered to a patient's electronic health record (EHR). Tethered PHRs, also known as patient portals, allow patients to access relevant medical information from their provider.