- Healthcare interoperability means more than connecting information technology systems and tools with one another. From a holistic standpoint, the concept extends into the patient-facing sphere, offering individuals an interactive means of taking charge of their own health.
In support of the latter approach, researchers at large-scale healthcare provider/health plan Kaiser Permanente Southern California (KPSC) report that the recent addition of the “Online Personal Action Plan” (oPAP) to its member portal is making a positive difference in patient-enabled care.
The web-based oPAP system consolidates information about prevention, health promotion and care gaps — and provides tools for patients to schedule appointments, close gaps and improve health.
The research team published it findings in the American Journal of Preventive Medicine. The study compared care gap closure rates between oPAP users and members not registered on the online portal between December 2014 and March 2015. They examined a total of 838,638 cases. Care gap closure was defined as resolving deficits in preventive or chronic care by obtaining care; ideally, such gaps are closed within 30 to 90 days of when they become due.
The study revealed that users of oPAP are more likely than non-registered members to close care gaps, especially cancer screening tests; therefore, the portal appears to be effective at improving patient engagement in preventive healthcare.
“Adjusting for demographics, body-mass index [BMI], smoking status, health and insurance status, and number of open care gaps, oPAP access was associated with a somewhat greater likelihood of care gap closure within 90 days for select care gap types, particularly hemoglobin A1c testing and breast, cervical and colorectal cancer screening among eligible members,” the study report states.
KPSC uses oPAP to flag open care gaps. For example, it provides the date of a patient’s last colorectal screening and the date of the next recommended test. It also offers information about specific health conditions, such as links to smoking-cessation programs for smokers or weight management materials for members with elevated BMI.
oPAP users were about 9 percent more likely than non-registered users to close mammogram screening gaps. For Pap smears, the divergence was a positive 6 percent. oPAP users were also about 9 percent more likely to receive colorectal screening. oPAP users scheduled for HbA1c testing were about 12 percent more likely to complete their testing than non-registered members scheduled for testing. The most limited impact was observed in closing gaps for vaccination; oPAP users were no more likely to receive their flu vaccination than non-registered members.
The co-authors acknowledge that traditional panel management programs, which use support staff the help close gaps, are generally useful; however, they are resource-intensive and “often do not empower the patient to take charge of their own health and disease management.” In contrast, online tools “patient-facing web- or mobile-based tools can provide automated tracking of health status and gaps in care in real time, [send alerts to patients regarding] care needs, enable interactive communication between members and healthcare teams, and provide educational interventions to better engage members in their own care,” according to the report.
The researchers conclude, “Although these findings represent only a small segment of the overall KPSC membership, and the effect sizes are modest, the results of the present study indicate that the oPAP has considerable potential to be a model for cost- and resource-effective patient engagement in health maintenance and disease prevention. Importantly, once created, the oPAP allows for patient self-management, creating a minimal-cost intervention to maintain its operation.”