Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow - Full Text View

Purpose

The specific aim of this proposed project is to implement a standard process for integrating MedlinePlus health information prescriptions into the clinic workflow.

Hypothesis 1: Individuals in the intervention group who receive tailored email health information with provider selected MedlinePlus links and added commentary for patient specific conditions will be more likely to seek information / use MedlinePlus compared with individuals in the control group.

Hypothesis 2: Individuals in the intervention group who receive tailored email health information with provider selected MedlinePlus links and added commentary for patient specific conditions will be more satisfied with the information received compared with individuals in the control group.

Condition	Intervention
Allergic Rhinitis (Disorder) Asthma Back Pain Benign Prostatic Hypertrophy Bursitis Depression Anxiety Diabetes Mellitus Esophageal Reflux HIV Infections Hyperlipidemia Hypertension Insomnia Irritable Bowel Syndrome Obesity Osteoporosis (Senile) Shoulder Pain Sinusitis Symptomatic Menopause Urinary Incontinence Urinary Tract Infection Vaginitis	Other: Health Information Prescription - MedlinePlus link

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label
Official Title:	Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow

Resource links provided by NLM:

Genetics Home Reference related topics: complement factor I deficiency

MedlinePlus related topics: Anxiety Asthma Back Pain Bursitis Depression Diabetes Esophagus Disorders GERD HIV/AIDS High Blood Pressure Obesity Osteoporosis Sinusitis Urinary Incontinence Urinary Tract Infections

U.S. FDA Resources

Further study details as provided by University of Missouri-Columbia:

Primary Outcome Measures:

health information experiences of the patient [ Time Frame: approximately one week following clinic appointment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

clinician feedback on the health information prescription process [ Time Frame: midpoint and conclusion of the study ] [ Designated as safety issue: No ]

Estimated Enrollment:	400
Study Start Date:	February 2008
Study Completion Date:	March 2009
Primary Completion Date:	March 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
No Intervention: 1. Control While patient is waiting in exam room for physician, a research assistant will enter the exam room and speak with the patient. The research assistant will record the patient's name, willingness to share email, and willingness to participate in the study at the time of the patient encounter. She will later collect their address, gender, age, date of visit, clinic name, and billing diagnoses from IDX data after leaving the exam room. Physician evaluates the patient and documents the diagnoses for the clinic visit on the billing sheet as per their usual practice. At the end of the clinic session/day, the research assistant will review the billing sheets and record all the listed diagnoses for the control patients. The research assistant mails the control patients a f/u survey within one week of clinic visit. The surveys will be coded to correspond to diagnosis from billing data.
Experimental: 2. Health Information Prescription PSR hands the patient the Health Information Prescription (HIP) order form, and patient writes their name at the top of the form. HIP order form will ask if patient uses email, and if they would be willing to share their email address. Physician evaluates the patient, tells the patient they are ordering a Health Information Prescription, and checks a diagnosis on the HIP form. Patient returns to PSR to check-out. If patient has an HIP order, PSR refers patient to the research assistant. The research assistant will record patient name, email address, willingness to participate in the study, and diagnosis at that time, and have patient sign consent and HIPAA authorization. She will later obtain age, date of visit, clinic name, address and diagnoses from billing data from IDX. The research assistant sends the HIP email within 24 hours of the visit, and mails the survey within 5 business days of clinic visit.	Other: Health Information Prescription - MedlinePlus link The patient education materials will consist of approximately 21 topics representing some of the most common conditions seen at the Fairview Internal Medicine Clinic. Twenty-one e-mails, one per topic, will be created by Fairview physicians to be distributed to selected clinic patients. There will be a standard e-mail for each condition with a specific link to MedlinePlus. To create the targeted health information topic email, the physician will review the information available at MedlinePlus. The physician will then select several links of appropriate information and, using the template, will write a short annotation on each link.

Arms

Assigned Interventions

No Intervention: 1. Control

While patient is waiting in exam room for physician, a research assistant will enter the exam room and speak with the patient.
The research assistant will record the patient's name, willingness to share email, and willingness to participate in the study at the time of the patient encounter. She will later collect their address, gender, age, date of visit, clinic name, and billing diagnoses from IDX data after leaving the exam room.
Physician evaluates the patient and documents the diagnoses for the clinic visit on the billing sheet as per their usual practice. At the end of the clinic session/day, the research assistant will review the billing sheets and record all the listed diagnoses for the control patients.
The research assistant mails the control patients a f/u survey within one week of clinic visit. The surveys will be coded to correspond to diagnosis from billing data.

Experimental: 2. Health Information Prescription

PSR hands the patient the Health Information Prescription (HIP) order form, and patient writes their name at the top of the form. HIP order form will ask if patient uses email, and if they would be willing to share their email address.
Physician evaluates the patient, tells the patient they are ordering a Health Information Prescription, and checks a diagnosis on the HIP form.
Patient returns to PSR to check-out. If patient has an HIP order, PSR refers patient to the research assistant.
The research assistant will record patient name, email address, willingness to participate in the study, and diagnosis at that time, and have patient sign consent and HIPAA authorization. She will later obtain age, date of visit, clinic name, address and diagnoses from billing data from IDX.
The research assistant sends the HIP email within 24 hours of the visit, and mails the survey within 5 business days of clinic visit.

Other: Health Information Prescription - MedlinePlus link

The patient education materials will consist of approximately 21 topics representing some of the most common conditions seen at the Fairview Internal Medicine Clinic. Twenty-one e-mails, one per topic, will be created by Fairview physicians to be distributed to selected clinic patients. There will be a standard e-mail for each condition with a specific link to MedlinePlus. To create the targeted health information topic email, the physician will review the information available at MedlinePlus. The physician will then select several links of appropriate information and, using the template, will write a short annotation on each link.

Detailed Description:

Providing patient education in an outpatient practice can be challenging in part due to the variety of patient medical conditions and the quantity of materials needed. Increasingly, electronic resources such as those found on the internet have the potential to provide easily accessible needed information. However, clinicians do not have the time to assemble a list of websites for their patients and even if they did, the quality of information varies greatly and would require close screening. MedlinePlus is a free National Library of Medicine sponsored website that features health information on hundreds of conditions with all information carefully screened for quality standards by expert librarians. We will conduct a pilot study to seamlessly integrate provider-customized MedlinePlus health education prescriptions for specific conditions into the normal clinic workflow to motivate patients to access and expand their use of MedlinePlus to benefit their health. As HIV prevention/education is very important, we will include the HIV clinic as well as a general internal medicine clinic.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

To be included in the study population, patients must also be seen by their physician for one of the 21 target health conditions (Allergic Rhinitis, Asthma, Back Pain, Benign Prostatic Hypertrophy, Bursitis, Depression/Anxiety, Diabetes Mellitus, Esophageal Reflux, HIV, Hyperlipidemia, Hypertension, Insomnia, Irritable Bowel Syndrome, Obesity, Osteoporosis (senile), Shoulder Pain, Sinusitis, Symptomatic Menopause, Urinary Incontinence, Urinary Tract Infection, Vaginitis) and be willing to provide an email address.
Patients will be included only once.
All patients in the intervention and the control group will receive the survey.
All physicians and staff at the Fairview Clinic and HIV Clinic will be invited to complete the physician or staff survey.

Exclusion Criteria:

No email address

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00634608

Locations

United States, Missouri
University of Missouri, Department of Internal Medicine
Columbia, Missouri, United States, 65211

Sponsors and Collaborators

University of Missouri-Columbia

National Library of Medicine (NLM)

Investigators

Principal Investigator:

Robert Hodge, MD

University of Missouri-Columbia

More Information

Publications:

Coberly E, Boren SA, Davis JW, McConnell AL, Chitima-Matsiga R, Ge B, Logan RA, Steinmann WC, Hodge RH. Linking clinic patients to Internet-based, condition-specific information prescriptions. J Med Libr Assoc. 2010 Apr;98(2):160-4. No abstract available.

Responsible Party:	Robert Hodge, University of Missouri
ClinicalTrials.gov Identifier:	NCT00634608 History of Changes
Other Study ID Numbers:	HHSN276200700263P
Study First Received:	February 22, 2008
Last Updated:	March 1, 2011
Health Authority:	United States: Institutional Review Board

Additional relevant MeSH terms:

HIV Infections
Acquired Immunodeficiency Syndrome
Anxiety Disorders
Asthma
Back Pain
Prostatic Hyperplasia
Bursitis
Depression
Depressive Disorder
Diabetes Mellitus
Esophageal Diseases
Gastroesophageal Reflux
Hyperlipidemias
Hypertension
Hypertrophy

Irritable Bowel Syndrome
Obesity
Osteoporosis
Rhinitis
Shoulder Pain
Sinusitis
Urinary Incontinence
Urinary Tract Infections
Vaginitis
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases

ClinicalTrials.gov processed this record on March 03, 2013